Iraq, already struggling to regain lost territory from the Islamic State group, now faces a new enemy: a deadly outbreak of cholera.
Since being detected for the first time last week in the town of Abu Ghraib, about 25 kilometers west of Baghdad, the number of cholera cases has risen rapidly to 121, Iraq's health ministry said September 23.
At least four deaths were recorded in Abu Ghraib, and the disease is spreading quickly to southern provinces along the Euphrates River. Most of the new cases are in Babel province south of Baghdad, while at least 54 of those sickened are in the capital.
Cholera is spread mainly through contaminated water and food and, if untreated, can lead to death by dehydration and kidney failure within hours.
Iraq's water and sewage systems are outdated, and infrastructure development has been hindered by years of war and neglect. Poor public services were a catalyst for street protests last month in Baghdad and cities in the south.
Iraqi Prime Minister Haider al-Abadi has ordered emergency measures be taken, particularly in the Abu Ghraib area. These include conducting daily water-quality tests, setting up water purification stations, and distributing bottled water to families displaced from their homes by fighting with IS.
Iraq's Education Ministry announced that the opening of primary schools would be delayed to October 18 to give public health workers time to "complete precautionary measures in all schools."
Television networks are airing public service announcements about cholera, its symptoms, and how to prevent it. Public health teams have been deployed to some of Iraq's most remote areas.
Panicked Iraqis have been rushing to government-run medical centers since the outbreak was first announced in mid-September to receive free water purification tablets.
Health ministry spokesman Rifaq al-Araji has blamed the cholera outbreak on low water levels in the Euphrates, from where locals extract water for drinking and farming, as well as winter flooding that contaminated the river and shallow wells with sewage water.
He said high summer temperatures may also have activated the bacterium that causes cholera. Temperatures topped 50 degrees Celsius during July and August.
Araji said public awareness has helped keep the current outbreak under control.
"If treatment is received within the first 24 to 48 hours of infection, there is no peril to the patient," he said.
This is not the first time Iraq has battled cholera. Around 300 people were diagnosed with the illness in 2012 in the northern city of Kirkuk and the Kurdistan region. Five years earlier, at least 24 people died and more than 4,000 cases were confirmed.
The latest outbreak piles on a long list of grievances facing Iraqis and adds to the despair that has prompted thousands of Iraqis to join a mass migration of people seeking safer lives in Europe.
Those who stay home are taking to social media to express their anger and frustration.
"Cholera, mass migrations, economic collapse, terrorism, and corruption, etc. Dear God: Is there more?" an Iraqi named Hussein Adam asked on Twitter.
"We are afraid... We've been on high alert since the declaration of the disease," said Fadhil Hassan Kaies as he recently visited a Sadr City clinic to get water purification tablets.
"We have not gotten rid of Daesh, yet along with other miseries, now we have this disease," said the 41-year-old father of four. "Calamities come together."
With reporting by AP and Reuters