Iraq plans to hold a mass vaccination campaign to halt a cholera outbreak that has infected more than 1,800 people amid fears it could spread among refugees in the region and beyond, the World Health Organization said Thursday.

"We are going to start a vaccination campaign to try to prevent a further spread of the disease," Dominique Legros, head of WHO's cholera unit, told reporters.

He said a half million doses of the oral cholera vaccine  -- enough to treat some 250,000 people -- were being shipped to Iraq and "should arrive today or tomorrow," with the immunisation campaign set to get underway by October 31.

Iraq has confirmed 1,811 cases of the acute diarrhoeal disease since early September across 15 of the country's 18 governorates, including most recently in the northern autonomous Kurdish region.

The arrival of cholera in the northern Kurdish region is particularly concerning due to the large numbers of Syrian refugees there, Legros said, pointing out that conditions in refugee camps are particularly conducive to the spread of the disease.

According to Iraqi authorities, the disease has killed six people so far, including four in the Abu Ghraib region at the very beginning of the outbreak, before health authorities had set up a response plan.

"The case management is well carried out, (and) cases are declining," Legros said, adding that the situation in Iraq seemed to be "under control".

The big concern now, Legros said, was "a spread towards the Middle East, towards Syria and refugee camps."

- Spread to Europe? -

Already a few cases have popped up in Kuwait and Bahrain, but the situations there are under control.

He said other countries in the region had been alerted to the danger, and acknowledged that those infected risked bringing cholera with them to Europe.

Cases of cholera are imported to Europe each year, but since sanitation conditions on the continent tend to be good, there is usually no risk of the disease spreading.

Legros acknowledged though that the large numbers of refugees and migrants moving through Europe and stuck at borders with rudimentary shelter ran a greater risk.

"Whether you put a refugee camp in Europe or in Nigeria or in Syria, the problem remains the same," he said, pointing out that if people "don't have access to safe water and someone contaminates the water and someone else drinks it, they get cholera."

Cholera is an acute diarrhoeal infection caused by eating contaminated food or water, with children facing a particularly high risk of infection. It can kill in a matter of hours due to rapid dehydration.

Legros said the Iraqi vaccination campaign would focus on the refugee camps in the north and camps for displaced Iraqis in the south.

The vaccine used to fight cholera epidemics is scarce and can only be used in rare cases to urgently stop the spread of the disease.

Last year the sole producer of the vaccine, Indian firm Shantha Biotechnics, made just two million doses -- enough to protect one million people.

WHO estimates that around 40 million people in Africa alone live in areas where they are exposed to cholera.
Source: AFP