Kenya records 85 cholera deaths, officials urge caution

Wards at the Cholera Treatment centre at Mandera Referral Hospital

Wards at the Cholera Treatment centre at Mandera Referral Hospital. 

Photo credit: File | Nation Media Group

Kenya has recorded 4,821 cholera cases and 85 deaths since the outbreak on October 10 last year, as concern has been raised over counties lacking reagents to test for the illness.

The disease – which was first reported in Limuru, Kiambu County – on October 8, continues to spread and has now been recorded in 15 counties.

According to a February 14 World Health Organisation (WHO) report, Kenya is among the top five countries in Africa with the highest number of infections. The country’s case fatality ratio is 1.8 per cent.
During a briefing on cholera outbreak in Africa, WHO Africa Regional Epidemiologist – Patrick Otim – said the transmissions have been triggered by the harsh climatic conditions resulting in drought or flooding.

“Parts of Kenya, Somalia and Ethiopia are facing drought that has affected sources of clean water, with residents forced to use the scarce and contaminated water,” Dr Otim said.

According to the Ministry of Health, Nairobi County leads with 29 deaths, followed by Tana River with 17.
Garissa has lost 12 people, Wajir (nine), Kiambu (five), Machakos and Kitui (four each), Meru (three) deaths and Homa Bay two deaths.
The disease has spread to Nairobi, Kiambu, Nakuru, Kajiado, Uasin Gishu, Muranga, Machakos, Garissa, Wajir, Meru, Nyeri, Tana River, Kitui, Homa Bay, Mandera and West Pokot counties.
 

The country has recorded 4,845 cases, with Garissa leading with 2,012 cases. Tana River has registered 730 cases, Nairobi (624), Kiambu (380), Wajir (326), Machakos (268) and Mandera 219.
The disease has been controlled in Machakos, Meru, Nyeri, Kitui and Uasin Gishu counties.
The remaining 11 counties are still recording new cases.
Nakuru County has reported a third wave of cholera in Naivasha. Four new cases were reported in Nakuru as of yesterday.

Hospitals in Nairobi are also recording active cases. The hospitals have started taking precautions to ensure the disease is controlled. Several counties have suspended the hawking of food. Schools, on the other hand, are giving oral vaccination to children.

Cholera outbreak

Two temporary tents put up by Medecins Sans Frontieres (Doctors without borders) to be used by people showing signs of being infected with cholera at Homa Bay County Referral Hospital.

Photo credit: George Odiwuor I Nation Media Group

From the Ministry of Health, division of disease surveillance and response, the disease cannot be controlled faster because most healthcare workers in 14 of the 16 affected counties do not have the capacity to identify and manage cholera patients on time.

Financial support

The Ministry of Health also indicated that inadequate resources to facilitate critical response pillars limit response capacity in detecting, investigating, and follow-up on cases (especially lack of laboratory reagents).
“Response to drought in high counties has been slow because of competing activities coupled with inadequate financial support.
Acting Director General for Health Patrick Amoth warned that the ongoing drought has since worsened the outbreak.
He called upon counties to be conversant with the case definition and sensitised on potential cholera outbreaks.
Also read: Three die of cholera in Wajir as 29 cases are reported

Researchers who published their work in the International Journal of Public Health warned that neglecting cholera prevention services, especially in areas with poor sanitation and hygiene, was a ticking time bomb.
Dr Ojwang Lusi, a public health expert says the country needs to start educating Kenyans on the risk that comes with the disease and how fatal it is.

“All we need to do is start educating people on the risk that comes with poor handling of food and they also need to observe hygiene by boiling water before drinking. With the drought that has hit the country, water is scarce and people are consuming dirty water. We may record more cases,” Dr Lusi said.

Drought

The outbreak was first reported in October last year by a group of people who had attended a wedding in Kiambu County. The outbreak has since spread across other counties
Consultant pathologist Dr Ahmed Kalebi, the root cause of cholera outbreaks is poor food handling, water hygiene, and lately drought.
Read: Surveillance in top gear to contain cholera outbreak in Nyanza

“People need to be better sensitised about water and food hygiene. The government, especially county governments, need to do better in terms of water supply since its scarcity is contributing to the whole mess,” he said.
“The ongoing drought has contributed to the cholera outbreaks because water scarcity means people are turning to more polluted and contaminated water sources,” he added.
Dr Kalebi lamented that public health awareness seems to

have been neglected now and the ripple effect is felt in the rising number of cholera cases.
The Ministry of Health has since launched a campaign for the Oral Cholera Vaccination (OCV) aimed to protect 2.2 million individuals in Nairobi, Wajir, Tana River, Garissa, and the Dadaab refugee camps from the current cholera outbreak.

Dr Francis Kuria, Director of Public Health called upon Kenyans to ensure that they take the vaccine and even allow their children to be vaccinated.

“The vaccine alone will not control the disease, but it will play a crucial role in reducing the number of cholera cases, ensuring that you get the vaccine as well as observing other hygiene measures including washing of hands all the time. Avoid handshaking,” Dr Kuria said.
Contaminated water
Ministry of Health officials are moving from house to house and even schools providing the vaccine to those who are eligible.

Cholera is enabled and transmitted through the ingestion of contaminated water.

Vibrio cholera, the bacteria that causes cholera, is transmitted mostly by faecal matter from an infected person. It is severe during rainy seasons when surface runoffs find their way into water bodies.

Cholera is easy to detect since its incubation period is three to five days. Other diseases resulting from contaminated food or water such as typhoid take longer to show symptoms.

It infects a person’s intestines. Symptoms include watery diarrhoea and vomiting.
Patients are advised to take large quantities of an oral rehydration solution containing sugar and salt.

The disease can easily be prevented. One is advised to eat food that is cooked and served hot and to drink beverages from sealed bottles or cans.

Careful hand hygiene should be observed. Food handlers must wash their hands with soap and clean water and after using the bathroom.