The WHO said the first doses of the vaccine are expected to be administered in the next few days in response to the outbreak which has infected 2,055 people since mid-September

The World Health Organization (WHO) is launching a campaign to vaccinate 255,000 people against cholera in Iraq over the next month, in a bid to contain the country’s first major cholera outbreak since 2012, the U.N. agency said.

The WHO said the first doses of the vaccine are expected to be administered in the next few days in response to the outbreak which has infected 2,055 people since mid-September.

The illness, first detected in Baghdad’s western outskirts, has spread throughout the country, mainly affecting Iraqis who have been forced from their homes and Syrian refugees.

The WHO said cholera has killed two people so far, although the Iraqi health ministry said last week it has caused six deaths.

Cholera is spread mainly through contaminated water and food and, if untreated, can lead to death by dehydration and kidney failure within hours.

The cholera vaccine is given in two doses.

“The problem is that 510,000 doses for 255,000 people for a huge country is not a lot, therefore this has to be used very strategically to find the areas where it is most useful,” WHO spokesman Christian Lindmeier told the Thomson Reuters Foundation on Wednesday.

Syrian refugees living in Iraq and internally displaced Iraqis are most at risk from further spread because they often lack access to clean water and sanitation, Lindmeier said.

“Cholera happens when either basic sanitation and hygiene are not available, or in a crisis scenario when health and sanitation systems get disrupted,” he said by telephone from Geneva.

“When people have to get water from unsafe sources like rivers and wells where at the same time they’re washing and using them as a toilet … that’s where you have (outbreaks).”

Iraq is gripped by a sectarian conflict mostly between Shiite and Sunni Muslims that has been exacerbated by the rise of the ultra-hardline Sunni group, Islamic State of Iraq and Syria (ISIS), which seized swathes of northern and western Iraq last year.

According to the International Organization for Migration (IOM) more than 3 million Iraqis are displaced within the country hosting 249,000 Syrian refugees.

Lindmeier said that five cases of cholera had been detected outside of Iraq last week – four in Kuwait and one in Bahrain. He also said a 5-year-old boy in northern Syria was suspected to have died of the illness.

Around 300 people were diagnosed with the cholera 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.

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