Kenya's Rift Valley Fever outbreak may be waning (02 Feb 2007)
Source: Reuters
WASHINGTON, Feb 1 (Reuters) - An outbreak of Rift Valley Fever that has killed more than 120 people over the past two months may be slowing down, but neighboring countries are at risk, an international health expert said on Thursday.
"We do seem to be way past the peak," Dr. Robert Breiman, head of the Global Disease Detection Division at the U.S. Centers for Disease Control and Prevention's field office in Nairobi, said in a telephone interview.
"We are not ready to say it's over."
Kenya's government said on Tuesday it would spend $2.4 million on livestock vaccinations and quarantines to save its meat industry.
An estimated 400,000 head of cattle have been vaccinated and the government is targeting 2 million in the affected areas and other districts prone to the epidemic.
There is no vaccine and no treatment for humans. In 1997-1998, a similar outbreak in Kenya killed hundreds of people.
The disease is unpleasant and highly infectious. People can catch it from animals or through mosquito bites. "The major risk is slaughtering animals," Breiman said.
The virus can cause hemorrhaging, which in turn causes anemia.
"Many have blood in their respiratory secretions, they vomit blood, have bloody stool. Sometimes they have bleeding gums and bloody noses," Breiman added.
Heavy rainfall in Kenya at the end of last year caused flooding, which made good breeding grounds for different species of mosquitoes.
"As of January 25, 2007, 404 cases of severe RVF with 118 deaths were reported. Rift Valley Fever cases in livestock have been reported from the same area," the CDC said in its weekly report on death and disease.
Kenyan authorities on Tuesday put the death toll at 150.
The nation's Ministry of Health has launched a campaign to watch for outbreaks of the virus, quarantine and vaccinate affected animals and control the spread of mosquitoes.
They are educating people on ways to look for outbreaks in their herds. When young animals die suddenly or pregnant animals miscarry, it could be a sign and people are urged not to touch dead or dying animals, Breiman said.
Although it has been dry for weeks, mosquitoes could carry the virus to other areas. "It can easily spread to other countries in the region," Breiman said.
By Maggie Fox, Health and Science Editor
Situation in Kenya and Somalia (as of January 30, 2007)
As of 30 January 2007, 411 suspected cases, including 121 deaths (case-fatality rate, 29%) have been reported in North Eastern Province, Coast Province, Eastern Province and Central Province (see map). One hundred and thirty-one cases have been laboratory confirmed.
The North Eastern Province has been the most affected, with Garissa district (175 suspected cases, 58 confirmed cases, including 57 deaths) and Ijara district (125 suspected cases and 22 confirmed cases, including 23 deaths) reporting the most cases and deaths. Sporadic cases have also been reported from districts in Eastern Province (Isiolo - 8 suspected cases, 3 confirmed cases) and from districts in Central Province (Kirinyanga - 4 suspected cases, 4 confirmed cases, including 1 death; Kajiado - 3 suspected cases, 1 confirmed case, including 3 deaths; Maragua - 1 suspected case, 1 confirmed case); Thika - 2 suspected cases, 1 confirmed case). Some of the cases from Central Province were diagnosed in Nairobi.
The outbreak appears to be in decline, although the Ministry of Health continues to coordinate activities to contain the outbreak, including active surveillance. The team from the Global Outbreak Alert and Response Network (see previous report) has returned from the affected areas, having provided a mobile laboratory for initial diagnosis of the disease, training in case management/infection control to provincial health officials and assistance with health education and informing affected communities about the disease. WHO, the Ministry of Health and the Ministry of Livestock and Fisheries Development developed key public health messages which have been disseminated in the local community, and meetings were held with community religious leaders.
Somalia
As of 30 January 2007, WHO has reported 100 suspected cases, including 48 deaths, in Somalia (see map) with 1 case laboratory confirmed by the Kenyan Institute of Medical Research (KEMRI) and the Centers for Disease Control and Prevention/ International Emerging Infectious Program (CDC/EIP) in Kenya.
Médecins sans Frontières is facilitating transport of samples and the WHO country office has held training sessions with Somali medical officers on how to detect and contain the disease. However, the deteriorating security situation continues to hamper control measures in the affected area.
Situation in Kenya (as of January 24, 2007)=Since the disease broke out, at least 220 cases were reported, including 82 deaths
NAIROBI, 24 January (IRIN) - Two cases of Rift Valley Fever, a deadly viral disease that broke out in northeastern Kenya in December 2006, have been reported in the capital, Nairobi, despite assurances by health officials on Wednesday that the disease had been contained.
Kariuki Njenga, a virologist and laboratory director for the United States Centers for Disease Control (CDC) in Kenya and the Kenya Medical Research Institute (KEMRI), described the two as "spot cases", transferred from other parts of the country, and said they did not represent an escalation.
"One was the case of a journalist returning on Sunday from an assignment in the Northeastern Province while the other was that of a man who had travelled to the city from Kirinyaga [where the outbreak has also been reported]," he added.
Since the disease broke out, at least 220 cases, including 82 deaths, have been reported in Northeastern and Coast provinces, according to a 15 January statement by the United Nations World Health Organization (WHO). The agency said KEMRI had confirmed 56 of the cases, including 12 deaths.
The epicentres of the outbreak were the northeastern districts of Garissa and Ijara, where the disease has also killed hundreds of livestock, mostly goats, sheep and cattle. Coast Province, Wajir and Tana River districts have also been affected and local media reports on Wednesday said the disease had spread to Kirinyaga and Maragwa districts, which are close to Nairobi.
A Kenyan government ban on the sale and slaughter of livestock in Northeastern Province, imposed in December, has not been lifted.
"There is no pressure and the Kenyan government is going to cope should the disease spread beyond expectations," he said. "What I can confirm now is that RVF is under control in Kenya."
The RVF virus is spread to humans from livestock via the aedes mosquito, which breeds rapidly during floods. Northeastern Province, inhabited by nomadic pastoralists, was hit by devastating floods between October and December 2006.
The disease can also be transmitted through contact with infected animal material such as blood or other body fluids or organs. Consumption of milk, a staple for many pastoralists, is also a possible risk. Symptoms in humans include bleeding through the nose and mouth, and liver failure.
The Ministry of Health has been working together with KEMRI and the CDC to curb the spread of the disease.
Njenga said ministry officials had managed to keep the RVF virus from spreading to other parts of Kenya and to other countries in the region. He said health officials were working around the clock to inform the public on how best to keep the virus at bay.
"We are working together and have increased surveillance throughout the country, especially in livestock areas," Njenga said.
He added that KEMRI and the CDC were analyzing samples received from various parts of the country.
"No cases have been confirmed in Ethiopia although one spot case was reported in Somalia," he said. "Spot cases are not uncommon in areas where RVF is endemic and the positive case in Somalia is one such example; it does not represent an escalation of new cases.
"Continued public education is the best tool available in the fight against RVF," Njenga said. "We must teach the people how to handle animal products, especially raw meat, carefully; to avoid consuming uncooked meat and use treated mosquito nets."
Northeastern Province was previously hit by an outbreak of RVF in 1997 after heavy flooding caused by the El Niño weather pattern. The disease was first identified in Kenya in 1931. A first sign of it is spontaneous abortions in sheep, goats and cattle.
U N I T E D N A T I O N S
Office for the Coordination of Humanitarian Affairs (OCHA) Integrated Regional Information Network (IRIN) -
[This report does not necessarily reflect the views of the United Nations]
