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Kenya: Cholera Kills 40 in Western Region
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Nairobi
At least 42 people have died in western Kenya following an outbreak of Cholera, health officials said.
"At least 701 cases of the disease have been reported in the western province of Nyanza," SK Sharif, the senior deputy director of the area's medical services, said on 2 April.
The disease, which was initially reported in the districts of Rongo, Siaya and Suba in January, had spread to other districts in the region despite control measures.
The most affected areas included the districts of Bondo, Homa Bay, Kisumu, Migori and Nyando. Cases had also been reported in Kisii and in the Bunyala area of Busia.
"There has been an on and off recurrence of the disease," Sharif said.
He said the outbreak had been caused by gaps in water and sanitation hygiene in the region and frequent outbreaks of the disease in neighbouring Uganda. Other risk factors included the use of untreated water and contaminated food.
"The mass movement of people during the post-election crisis may also have contributed to the outbreak of the disease as people found themselves in areas with inadequate water and sanitation facilities," he said.
Outbreak control measures, including targeted public health education campaigns and the strengthening of water treatment through chlorination, were put in place in the affected areas.
"We are also encouraging awareness on personal hygiene, the safe disposal of human waste and on how to minimise family contact with affected members," Sharif said.
The mass movement of people during the post-election crisis may also have contributed to the outbreak of the disease as people found themselves in areas with inadequate water and sanitation facilities
Measures to strengthen disease surveillance and the updating of health workers on detection and case management are ongoing. "We are trying to contain the disease where it is," he added.
Intervention efforts appeared to be succeeding, with the number of cases being reported reducing compared to mid-February when there had been a rapid spread of the disease.
"We are also partnering with other organisations to control the spread of the disease," Sharif said, adding that there was a need to address the issue of water provision to reduce gaps in water sanitation hygiene through increased coordination with relevant ministries.
"We also need to increase advocacy on public health awareness, water safety promotion and strengthen case management and disease control," he said.
Cholera, which is caused by the Vibrio cholerae bacteria, is characterised by profuse watery diarrhoea, vomiting, muscle cramps and severe dehydration.
Cholera cases were also reported in Northeastern Province in January and February in the districts of Mandera Central, Mandera East and Wajir, where there were at least 12 deaths and 448 cases. The outbreak followed similar outbreaks in Ethiopia and Somalia and was exacerbated by inadequate water and sanitation hygiene.
[ This report does not necessarily reflect the views of the United Nations ]
State health officials in Kenya issued an alert Thursday after an outbreak of cholera killed over 60 people in the last five months. All health personnel have been advised to actively monitor patients with diarrhea, and the government issued a ban on preparing and eating food in public gatherings.

Nyanza Province has been the area hardest hit by the cholera outbreak in Kenya.
Nyanza Province, with 750 infections and 45 deaths, has felt the brunt of the outbreak. Over 1,200 cases have been reported in the provinces of Nyanza, Rift Valley, North Eastern and Western. According to ''Agence France-Presse'', officials have reported 45 people dead in Nyanza Province, 12 in North Eastern Province and seven in Rift Valley Province. Health officials have stated that the actual number of deaths due to the outbreak could be higher due to under reporting. 


SK Sharif, senior deputy director of health services in Nyanza, commented on contributing factors to the outbreak: "The mass movement of people during the post-election crisis may also have contributed to the outbreak of the disease as people found themselves in areas with inadequate water and sanitation facilities".

Health workers are working to contain the outbreak, and are focusing efforts on areas affected by violence related to the December elections. Suba, Migori, Homabay, Rongo, Siaya, Kisumu, Bondo, Nyando, Kisii, Wajir, Mandera, Naivasha, Nakuru and Bunyala are among the worst affected districts.

The possibility of a disease outbreak in Kenya was previously raised by health officials, specifically in camps where hundreds of thousands of displaced people reside. Revenge killings, tribal fighting and upheaval following the December elections in Kenya has displaced many in the country. 

Titus Mung'ou, spokesman for Kenya Red Cross Society, told ''Agence France-Presse'' "We are trying to reduce the prevalence of the mix up that may happen by scrutinising food donations that are brought in the camps, but mostly we are ensuring that all the water is well treated".

In a news conference Thursday in Nairobi, Director of Medical Service Dr. James Nyikal said that if urgent measures were not undertaken to control the outbreak, it could become much worse. "Most deaths occurred at home or on the way to hospital," said Dr. Nyikal. Medicines worth KSh17.3 million (GBP 2.4 million) and other equipment worth KSh700,000 (GBP 5,700) has been sent to the affected areas. The Kenyan government has allocated KSh38 million (GBP 11.75 million) to contain the outbreak.


On Friday the Health Ministry requested aid from the United Nations Children's Fund, and Dr. Nyikal stated: "Health workers are a problem and we have written to Unicef, requesting assistance. Already some staff have been dispatched". Dr. Nyikal voiced concerns over high risk areas: "We are particularly concerned by risk areas such as eating premises and bus stops in major towns such as Busia, Kisumu, Kericho, Nakuru, Naivasha, Nairobi, Voi, Mtito Andei and Mombasa".

World Health Organization Country Director Dr. David Okello emphasized the importance of hygiene, stating: "We need to emphasise the importance of water safety and the public needs to adopt the measures of keeping water safe." Dr. Okello stressed that "Boiling drinking water or treating water with chlorine and practising good toilet manners are necessary to avoid contamination". 

Cholera is a waterborne disease and causes serious diarrhea and vomiting. The disease can be fatal if it is not treated within 24 hours. Spread of the disease can be prevented by avoiding contaminated drinking water, and practicing proper hand washing before touching food.  Southern Sudan also reported an increase in cholera cases recently.