While cholera is spreading in western Iran there are reports of deadly outbreaks of the disease in Afghanistan and Iraq, raising concerns of a regional pandemic.

According to the Kurdistan University of Medical Sciences on Monday, the number of cholera patients in the province has reached 39, most of which are reported in the city of Marivan located at the border with Iraq. 

The university’s public relations manager, Bahram Kandai, said the outbreak has not caused any fatalities in the province yet. 

Earlier in the week, Kermanshah University of Medical Sciences confirmed that at least eight people have contracted the disease. 

The cholera outbreak in Iraq was officially confirmed by the country’s health ministry in June, with infections were mostly concentrated in Kirkuk and Sulaimaniyah, in the autonomous Kurdistan region. The current number of cases is at least 160.

On July 10, health officials in Afghanistan's Helmand province said that 20 people died in the previous 24 hours of cholera and a further 120 were infected. 

Late in June, The UN humanitarian office (OCHA) said preparations were underway to avoid a cholera outbreak in Afghanistan after the country’s deadliest earthquake in two decades, saying that half a million cases of acute, watery diarrhea had already been reported. "Cholera outbreaks in the aftermath of earthquakes are of particular and serious concern," OCHA said in a statement. 

The acute diarrheal illness is caused by infection of the intestine with Vibrio cholerae bacteria, when people swallow food or water contaminated with the cholera bacteria.