A cholera outbreak in Iraq has spread to Kuwait and Bahrain, and risks turning into a region-wide epidemic as millions of pilgrims prepare to visit the country, Unicef’s Iraq director said.

The disease, which can lead to death by dehydration and kidney failure within hours if left untreated, was detected west of Baghdad in September and has since infected at least 2,200 people in Iraq and has killed six.

“The outbreak already has a regional dynamic and the risk of that can only be increased by people from all over the region coming into Iraq,” Unicef country director, Peter Hawkins, said yesterday.

Cholera moves into Bahrain, Kuwait and Syria

Mr Hawkins said cholera had spread to Bahrain, Kuwait and Syria but, in a later statement, Unicef said the cases in Syria were not confirmed: “However, given the scale of the outbreak in Iraq the risk of cholera spreading across Iraq’s borders remains high,” it said.

Millions of Shi’ite Muslims are due to visit Iraq in December for Arbaeen, a religious ritual marking the end of an annual mourning period for the Prophet Mohammad’s grandson Hussein, whose death in 680 AD entrenched the schism between Shi’ites and Sunnis.

Mr Hawkins said Unicef was working with clerics in the Shi’ite shrine cities of Najaf and Kerbala to convey information about how to guard against cholera, which is endemic in Iraq and the wider region. The outbreak can be traced to a number of factors including low water levels in the Euphrates and winter flooding that has contaminated the river and shallow wells with sewage water.

The war against Islamic State militants who control large swathes of territory in northern and western Iraq has also contributed to the outbreak.