Rift
Valley Fever, a rare zoonotic viral disease, has claimed 155
lives in Kenya and caused huge losses of income in Kenya’s
pastoralist communities. The outbreak of the disease has exacerbated
an already precarious food insecurity and livelihoods situation,
following the massive floods in Kenya and neighbouring countries
at the end of 2006. A large number of animals were lost to the
disease.
While Rift Valley Fever is unfortunately familiar to farmers
in Kenya, Tanzania and other countries in the region, not much
is known about the virus causing the disease. It is transmitted
primarily to humans through contact with infected animal matter
such as blood or other fluids, as well as animal organs. Consumption
of raw milk from an infected animal, an important element in
the diet of many nomadic pastoralists in Kenya, is also thought
to lead to infection. RVF is also spread by livestock through
mosquito bites. The infected mosquito eggs are often laid around
river banks and can stay dormant for years until they get submerged.
The eggs then hatch to mosquitoes that spread the virus.
In Kenya, RVF has been well known for over 60 years. As early
as 1913, a disease fitting the description of RVF was blamed
for the loss of sheep in the Rift Valley in Kenya. So far, there
is no cure and doctors are only able to treat the symptoms.
About one per cent of people contracting RVF develop the disease
in a severe form; approximately half of those die. The last
large outbreak was in 1997, following heavy rains blamed on
El Nino, when some 27,500 people were infected and 170 died
in Garissa District.
This time around, the first case of RVF was reported in Gurufa,
Garissa, on 7 December 2006. Almost simultaneously, outbreaks
were reported in a number of other districts, including Ijara,
Wajir, Tana River and Isiolo – all of which had suffered
from the extensive flooding in Kenya’s North Eastern Province.
Nearly 700 suspected cases of RVF were recorded in Kenya, according
to the Ministry of Health, with 155 deaths. The worst affected
districts were Garissa, Ijara and Wajir districts in North Eastern
Province, Tana River and Kilifi districts in Coast Province,
and Kirinyaga and Maragwa districts in Central Province.
The outbreak lead to a government-imposed ban on the slaughter
of livestock in the affected areas, which led to the closure
of key livestock markets, as well as a ban on movement and slaughter
of animals. This accentuated the precarious situation of pastoralists’
welfare particularly in North Eastern Province. The ban on the
slaughter of animals has now been lifted in Garissa, Ijara,
Mandera and Wajir districts of in North Eastern Province. However,
the animal quarantine is in force awaiting review of veterinary
department investigation.
At the peak of the RVF outbreak, the Kenya Red Cross Society
was engaged in social mobilization activities, targeting health
workers and the affected communities. Access to affected areas
in Garissa posed the greatest challenge due to flooding in the
area. With the assistance of Emergency Response Units (ERUs)
from sister societies around the world and other partners, the
Kenya Red Cross assisted in the establishment of Special Wards
in Garissa Provincial Hospital and Ngao Sub-District Hospital
in Garsen.
The ward in Ngao Sub-District Hospital was established with
support from the Japanese and Australian Red Cross and MSF-Spain.
The Kenya Red Cross also worked with the MoH to institute timely
and effective care to suspected and/or confirmed RVF cases.
The Medical ERUs helped to train medical personnel working in
local health facilities on universal precautions, early case
detection and referral.
Significant government vaccination campaigns targeting 1.5 million
livestock (cattle, sheep and goats), as well as other preventive
activity is ongoing in 33 districts where RVF cases have been
reported. Other interventions include supportive case management;
enhanced surveillance; community mobilization/public health
education and veterinary intervention like the ban on slaughtering
of animals currently in force in Marigat and Makutano parts
of Baringo. Vector Control is also ongoing through the spraying
of high risk animals with synthetic pyrethroid (SI).
According to the World Health Organization (WHO), RVF can be
prevented by a sustained programme of animal vaccination. Live,
attenuated and killed vaccines have been developed for veterinary
use. The live vaccine requires only one dose and produces long-lived
immunity, but the presently-available vaccine may cause abortion
if given to pregnant animals. The killed vaccines do not cause
these unwanted effects, but multiple doses must be given to
produce protective immunity. This may prove problematic in endemic
areas.
The available vaccine is only for use with livestock. In humans,
an inactivated vaccine has been developed. This vaccine is not
licensed and is not commercially available, but has been used
experimentally to protect veterinary and laboratory personnel
at high risk of exposure to RVF. Other candidate vaccines are
under investigation.
In neighbouring Tanzania, the National Society has organized
a one-day seminar on RVF in the capital city of Dodoma with
participation of local authorities, Tanzania Red Cross volunteers
and representatives of local townships and villages. Following
the seminar the volunteers went back into villages to educate
local communities on this epidemic.
A total of 90 people in Dodoma were infected and 19 of those
lost their lives. The total number of RVF deaths in Tanzania
now stands at 33. The majority of Dodoma residents are livestock
keepers and the death of large number of livestock simply means
dwindling of peoples economic resources, Mr Yunus Rugaiyamu,
the Regional Administrative Secretary, lamented and added that
“we must cooperate and work together in order to get rid
of this killer disease in our region.”
The number of Tanzanian regions with suspected cases of RVF
has continued to rise – now standing at eight: Arusha,
Manyara, Tanga, Kilimanjaro, Dodoma, Morogoro, Singida and Iringa.
In Dar es Salaam, Regional Commissioner Mr. A Kandoro has announced
a tentative ban on the sale of meat grilled at roadside stalls
(kebabs) and urges the community to watch their eating manners
as precautionary measure, while leading authorities asked to
raise the level of alertness against its entry in the city.
Responding to the outbreaks, the Tanzania Red Cross has distributed
100 mosquito nets, 200 blankets and two tents through the Regional
Medical Officer in Dodoma to be used at established treatment
camps, while another 100 mosquito nets will be distributed by
Dodoma Red Cross branch to RVF affected families. The Society
also provided 4,000 leaflets to give health education to the
local communities.
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The
Rift Valley Fever outbreaks follow the massive floods
that hit East Africa in late 2006 – and further
exacerbate the already precarious situation many families
find themselves in. Photo by Paul Rogers, London Times.(p15686)
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First
it was fleeing the drought, then fleeing the floods –
now the triple whammy is complete with widespread outbreaks
of Rift Valley Fever. (p15685)
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Many
of the same communities that experienced severe drought
in early 2006 and devastating floods later in the year
are now battling the vicious Rift Valley Fever in both
Kenya and Tanzania. (p15683)
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