Virulent hepatitis breaks out in two Iraqi towns


BAGHDAD, Iraq - A virulent form of hepatitis that is especially lethal for pregnant women has broken out in two of Iraq's most troubled districts, Iraqi Health Ministry officials said in interviews here this week, and they warned that a collapse of water and sewage systems during the continuing violence in the country is probably at the root of the outbreak.

The disease, called hepatitis E, is caused by a virus that is often spread by sewage-contaminated drinking water.

The officials said that they had equipment to test only a limited number of people showing symptoms, suggesting that only a fraction of the actual cases has been firmly diagnosed. In Sadr City, a Baghdad slum that has been convulsed for months by gunbattles between a local militia and U.S. troops, the officials said as many as 155 cases had turned up.

The second outbreak is in Mahmudiya, a town 35 miles south of Baghdad that is known as much for its kidnappings and drive-by shootings as for its poverty, where there are an estimated 60 cases. At least nine pregnant women are believed to have been infected, and one has died. Five deaths have been reported overall.

"We are saying that the real number is greatly more than this, because the area is greatly underreported," said Dr. Atta-alla Mekhlif Al-Salmani, leader of the viral hepatitis section at the Health Ministry's Center of Disease Control.

Viral hepatitis comes in many forms, and another ominous set of statistics suggests that the quality of water supplies around the country has deteriorated since the U.S.-led war began last year, Salmani said. In 2003, 70 percent more cases of hepatitis of all types were reported across Iraq than in the year before, he said.

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