Health Officials Finally Admit Hepatitis A Outbreak in Khuzestan

Iranwire – After nearly two months of denial, a senior official in Khuzestan has admitted the province has been hit by an outbreak of Hepatitis A.

Mohammad Nejatipour, the governor of Baghmalek county in the northern part of the province, confirmed 17 positive cases among residents of the village of Lalab in Mangesht district, as well as in other areas.

Prior to this announcement, Iranians had reported on social media about the cases of Hepatitis A, and about water pollution in Ahvaz, Hendijan and Baghmalek. Authorities denied these reports, despite confirmation from doctors, medical staff, and health networks in these cities.

Abolfazl Moradi, a 14-year-old teenager in the Siedoun district of Baghmalek county, has been in an Ahvaz hospital since January 18, after being diagnosed with hepatitis A.

“After the rains that caused floods in Baghmalek and Siedoun, the tap water in our area became very dirty, smelly and polluted,” Abolfazl’s mother told IranWire.

“At first, we hoped that after a few days, it would be fine, but the water is still polluted. One week ago, last Friday, Abolfazl woke up with diarrhea and was vomiting and pale. His eyes were yellow. I gave him some herbal medicine; because it was Friday everywhere was closed. He stayed at home but at night, his condition got worse. He had a fever and severe abdominal pain. We had to take him to Baghmalek Hospital along with his father.”

According to Abolfazl’s mother, the emergency physician on duty at Tabatabaei Hospital in Baghmalek carried out a blood test and, after receiving the results, asked about Abolfazl’s diet: “The doctor said, tell me if he has had polluted water, or uncooked shrimp or fish. I said the water was muddy everywhere and we had used that water. The doctor said: your child has Hepatitis and has to be vaccinated and hospitalized. You yourself may be infected.”

According to the doctor, house-to-house diagnosis is underway in the affected areas, and so far it has been confirmed that at least 17 Lalab residents have been infected with Hepatitis A, some of whom have been admitted to Tabatabaei Hospital in Baghmalek.

The governor of Baghmalek also promised residents would be provided with health care and preventive education and that patients were being treated and vaccinated.

But Abolfazl’s family said that, despite the difficulty and the distance, they preferred to take Abolfazl to a hospital in Ahvaz. “They did not give us an ambulance,” his mother said.”They said, your son’s condition is not critical but he could stay in the hospital. We were scared. Baghmalek Hospital has no facilities. There is no medicine even for a cold. There is also the coronavirus outbreak. We got the results of the tests and went to Ahvaz with his father at night to take better care of him. When they admitted our son, we found out that several other people were hospitalized in the same ward with similar and other suspicious symptoms. Most of them were children and the same age as Abolfazl.”

The outbreak in Khuzestan is reported to have begun in December. In mid-December, officials denied these reports — including reports from health centers of cholera cases in the cities of Ahvaz and Hendijan.

When news outlets continued to focus on the emergence of Hepatitis A cases in the area, as well as on the December 2020 floods and rumors that sewage had entered the drinking water system, Governor Mohammad Nejatipour spoke to the Iranian Students’ News Agency (ISNA) to give his response. The governor stated that as soon as he was aware of the first case of Hepatitis A, the city’s rapid health response team went to the center of the outbreak in Lalab, and that he visits the area on a daily basis. He also reported that a health team from Khuzestan province’s medical center had been sent to Lalab to assess the situation and said that the necessary measures were being taken to treat the patients.

Mayor Sent to Prison for Water Scandal

The flood damage in Khuzestan was so disastrous that the mayor of Ahvaz, also the former CEO of the ABFA water company, not only lost his job but was handed down a prison sentence. Ahvaz city councilor Mohammad Reza Izadi told ISNA: “Every few months, I received confidential reports from ABFA saying that the health centers had reported people contracting Hepatitis and that the confluence of water and sewage caused intestinal disease. But these cases were ignored.”

Izadi also claimed the governor had threatened him a year and a half ago when he announced that citizens in 13 different areas of Ahvaz had contracted Hepatitis due to sewage getting into drinking water. The councilor should remain silent about the issue, the governor said.

But that was not an isolated case: In recent months, the Ahvaz governor’s office has repeatedly denied reports of Hepatitis and cholera outbreaks and drinking water being contaminated with sewage. Officials at the governor’s office claimed that the city’s drinking water is monitored daily by health officials, and that everything that had been published about water pollution was a rumor and could be dismissed.

IranWire spoke to Somayeh, a public health expert working in one of the health centers in Ahvaz. “During the recent floods in Ahvaz, in addition to destroying people’s homes and belongings, the health of citizens was severely endangered.” She said it was clear to see that sewage had infiltrated drinking water supplies in Kemplo, Pardis Golestan, and many suburban areas. “More than 50 people came to us every day with symptoms of illness from water pollution. Elderly people and children had fever, diarrhea, and abdominal pain. I personally referred four cases of cholera to Razi Hospital. The head of the West Ahvaz Health Center also confirmed these cases, but again, the authorities continue to deny this news coverage.”

Somayeh pointed to comments made by Mehran Ahmadi Baloutaki, the director of West Ahvaz Health, in December. He warned that cases of infectious and gastrointestinal diseases caused by sewage contamination were on the rise in Ahvaz. He said this was contributing to an already serious health crisis in Khuzestan province, which had been hard hit by the coronavirus pandemic.

A Long History of Contamination and Neglect

An expert from the Ahwaz Water and Sewerage Company, who asked not to be named for security reasons, told IranWire this situation was nothing new: water contamination has long been a serious issue for Khuzestan. “The time-worn urban water and sewage network in Ahvaz and other cities of Khuzestan is an old problem. In Ahvaz, where I have several years of experience working in the ABFA complex, it does not matter which region you live in — from Kianpars, Amaniyeh and Padadshahr, the upper and middle-class neighborhoods of the city, to the suburbs and surrounding towns, without exception, the streets turn into swimming pools after the rains. In Abadan, Khorramshahr and Mahshahr, reports show that not only during the rainy season, but also during the warm seasons of the year, the sewage in residential neighborhoods endangers the safety of residents. The situation is more or less the same in other cities. Perhaps the only place we do not see such a phenomenon is the city of Dezful, due to the soil conditions there, the fact that many streets are built on a slope, and the relative attention city officials pay to the issue.”

The expert told us that flooding had caused sewage overflow and due to the lack of a standard network for surface water disposal and the inadequacy of the existing infrastructure, the situation reoccurs every year.

“This problem has been repeated so many times and every time a request for extra budget is submitted, so my fellow citizens and I are surprised by what the governor and his deputies say.”

In September 2020, the deputy governor of Khuzestan announced the allocation of 50 million euros for 2020-2021 and 50 million euros for the following year from the National Development Fund for Ahvaz Comprehensive Sewage Plan. This budget was allocated explicitly for the purpose of overhauling the city’s water network and has been approved by Supreme Leader Ayatollah Ali Khamenei.

Now, more than two months after floods swept through Khuzestan and other southern provinces of Iran, and more than five months after the announcement that the necessary funds to solve the sewage problem in Khuzestan had been allocated, not only has the problem of polluted water not been solved, but every day more and more citizens are admitted to hospitals reporting of ailments that can be linked to contaminated drinking water.