:On 19 October 2022, the Kenya Ministry of health issued a communication to all County Directors of Health on a multicounty cholera outbreak following the isolation of Vibrio cholerae-01 Ogawa serotype at The National Public Health Microbiology Laboratory.
The ministry of health has issued a cholera alert following confirmation of 61 cases reported across six counties. According to acting Director General for health Dr Patrick Amoth, the outbreak whose origin can be traced to a wedding festival in Kiambu County was spread across Kiambu (31), Nairobi (17),Murang’a (1), Kajiado (2), Nakuru (2) and Uasin Gishu (8) counties.
Of the sixty-one cases reported, thirteen people are currently hospitalized while eight have been discharged with forty treated as outpatients. The acting Director General for health says the National Public Health Microbiology Laboratory has isolated Vibrio cholera-01-Ogawa as the responsible serotype. This even as he warned that the ongoing drought situation in the country may worsen the outbreak.
Following the outbreak, the acting director general of health has directed all County and Sub-County Health Management Teams under the County Directors of Health to immediately notify all health workers of the alert, watch out for patients presenting with watery diarrhoea of acute onset, conduct active search for acute watery diarrhoea in health facilities and within the communities for missed/unreported cases, strengthen surveillance activities up to the village level and ensure 100% case-based reporting, strengthen the involvement of laboratory personnel in disease surveillance for timely confirmation as well as ensure that all health workers are conversant with the case definition and are sensitized on potential Cholera outbreak.
The sub-county health management teams will also be expected to step up weekly IDSR reporting to ensure that over 90% of facilities are reporting, enhance sharing of information between sub-counties, conduct support supervision on a more regular basis, re-activate the outbreak management teams at all levels, improve laboratory capacity for specimen collection and shipment, enhance involvement of other stakeholders such as county and sub-county commissioners, communities, the water agencies and other partners in surveillance and advocacy activities, carry out cholera risk analysis for all areas in the sub-county and take appropriate preventive actions besides strengthening management of cases at sub-county and health facility level.
Other measures include developing an appropriate preparedness and response plan for sub-counties to prevent propagation of any potential outbreak and plan for sustained contact tracing, ensuring isolation of cholera cases if admitted in the wards as well as strengthening community sensitization on safe water practices, use of latrines and prompt treatment for diarrhoea cases.
This even as the Division of Disease Surveillance and Response (DDSR), Field Epidemiology and Laboratory Program (FELTP) and the County Departments of Health of the affected counties commenced response activities including field investigations, enhanced surveillance, laboratory testing, case management, risk communication, community engagement and environmental sanitation to prevent further spread of the disease and manage the outbreak.
Cholera is an acute diarrheal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Cholera is an extremely virulent disease which affects both children and adults and can kill within hours. People with low immunity – such as malnourished children or people living with HIV – are at a greater risk of death if infected.
Cholera transmission is closely linked to inadequate environmental management. Typical at-risk areas include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced people or refugees, where minimum requirements of clean water and sanitation are not met.