Wednesday, July 4, 2018

PRO/AH/EDR> Rift Valley fever - Eastern Africa (10): Kenya, WHO, livestock vaccination

RIFT VALLEY FEVER - EASTERN AFRICA (10): KENYA, WHO, LIVESTOCK
VACCINATION
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In this posting:
[1] WHO report
[2] Isiolo county: livestock preventive vaccination

******
[1] Kenya: WHO report
Date: Fri 29 Jun 2018
Source: WHO, Health Emergency Information and Risk Assessment
[edited]
<https://reliefweb.int/sites/reliefweb.int/files/resources/OEW26-2329062018.pdf>


Event description
-----------------
The Rift Valley fever (RVF) outbreak in Kenya continues to evolve.
Since our last report on 22 Jun 2018 (Weekly Bulletin 25;
<http://apps.who.int/iris/bitstream/handle/10665/272939/OEW25_1622062018.pdf>),
an additional 36 RVF cases (with no new deaths) have been reported. A
retrospective epidemiologic investigation has established that the
date of onset of illness in the index case was 11 May 2018, marking
the beginning of the outbreak. Since then, a cumulative total of 90
cases and 10 deaths (case fatality rate 11 percent) have been reported
as of 27 Jun 2018. Of the 90 cases, 18 have been confirmed by
polymerase chain reaction. The most affected age group is 21-30 years,
with men making up 70 percent of the cases. So far, 3 counties have
been affected: Wajir (78 cases, 6 deaths), Marsabit (11 cases, 3
deaths), and Siaya (1 case, 1 death).

The RVF outbreak in Kenya was detected on 2 Jun 2018, confirmed by the
Kenya Medical Research Institute on 7 Jun 2018 and officially declared
by the Ministry of Health on 8 Jun 2018. A RVF epizootic had been
reported in 4 counties (Kadjiado, Kitui, Marsabit, and Wajir) by the
Ministry of Livestock, with a number of animal blood samples testing
positive for RVF. Risk assessment for RVF in humans and livestock
identified 8 counties (Tana River, Tharaka Nithi, Garissa, Lamu,
Kajiado, Baringo, Mombasa, and Nairobi) as having high risk for RVF
outbreak.

Public Health Actions
---------------------
- A national RVF technical committee has been activated and chaired by
the Director of Veterinary Services, who meet weekly and execute the
guidelines in the RVF contingency plan and coordinate and work with
the counties who have formed their own joint technical working
groups.
- The Ministry of Health has activated the Emergency Operations Centre
and identified the Event Manager and supporting technical team.
- A joint human and animal health multisectoral team from government
and nongovernmental agencies has been meeting weekly to update the
situation report and provide technical guidance to counties.
- Four treatment centres have been set up in Wajir County and are
managing cases.
- A team from the Field Epidemiology and Laboratory Training Program
has been dispatched to Wajir to support the county health teams, and
active surveillance is ongoing in all the affected and high risk
counties.
- Information, education and communication (IEC) materials in English
and Kiswahili have been dispatched to Wajir County, and information is
being broadcast on local FM radio stations and at mosques, as well as
house-to-house by the Kenya Red Cross using Community Health
Volunteers.
- The ban on movement and slaughter of animals from affected and
at-risk counties remains in place.
- Indoor residual spraying was carried out at the epicenter in Eldas
sub-county, and animal spraying with pyrethroids is ongoing in
affected counties.
- A total of 500 000 doses of RVF vaccine has been provided to
high-risk counties, based on risk analysis.
- Protective Personal Equipment (PPE) and sample protection protocols
have been shared with Wajir, and PPE for veterinary officers in Wajir
has been provided through collaboration with the Ministry of Health.

Situation interpretation
------------------------
The RVF outbreak in Kenya has rapidly increased in the last week, with
more cases reported. This outbreak is occurring among seminomadic and
remote communities, who are largely dependent on their livestock for
livelihood and as their main food source. While response interventions
are ongoing, several gaps have been identified, including lack of
information on emergency stocks at county level; inadequate vector
control tools, equipment, pesticides and personal protective
equipment; limited knowledge of RVF by healthcare workers; and
inadequate information, education and communication materials. Vector
surveillance and control for humans and animals in high risk counties
is yet to start, while communication flow between the national,
counties and the responding partners is inadequate.

In addition, a number of the areas affected by RVF are experiencing
outbreaks of other epidemic-prone diseases, along with major
insecurity in some regions. These factors are of great concern as they
could contribute to further spread of the disease in the subregion.
There are already reports of an epizootic in Rwanda and suspected
human cases in Rwanda and Uganda. The national authorities and
partners in Kenya need to continue scaling up response activities,
based on the One Health approach, to prevent a much wider disease
outbreak. The national authorities in the neighbouring countries also
need to enhance preparedness for RVF, including active surveillance in
both animals and humans.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The RVF outbreak continues in humans, with 36 new cases. Fortunately,
there have been no new deaths.

The above report indicates that surveillance is needed to detect human
and animal RVF virus cases and of vector virus mosquitoes as well. The
prolonged rains mentioned in earlier reports have doubtless provided
breeding sites for RVF virus vector mosquitoes. The advice to the
public to only consume inspected animal products is prudent. The loss
of hundreds of camels, sheep, and goats is a significant economic and
cultural loss for their owners, many of whom depend on these animals
for their livelihoods. - Mod.TY]

******
[2] Isiolo county: livestock preventive vaccination
Date: Tue, 3 Jul 2018
Source: NTV News (formerly Nation TV, Kenya) [edited]
<https://www.nation.co.ke/video/news/4146788-4644764-eavi5bz/>


The County government of Isiolo has launched a vaccination exercise
targeting over 150 000 heads of livestock within the next 12 days.
This follows positive confirmation of Rift Valley fever found in
livestock blood samples examined at the government laboratory. Isiolo
Governor Mohamed Kuti urged pastoralists to present their stock to
veterinary officers for vaccination in order to curb the spread of the
zoonotic disease to other unaffected areas.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[As detailed in the WHO report above, human RVF cases have been
diagnosed since 11 May 2018, in 3 of Kenya's counties, namely Wajir,
Marsabit (both in the former province North Eastern), and Siaya (in
the former province of Nyanza, bordering Uganda and Tanzania). RVF was
identified, by positive blood tests, in animals (camels, sheep, goats)
in the counties Wajir, Marsabit, Kadjiado (in the former 'Rift Valley'
province) and in Kitui (in the former Eastern province).

According to recent information, RVF has also been identified in
animals in Mandera county, in the former North Eastern province (see
http://promedmail.org/post/20180702.5885427), and in Isiolo county,
located within the former Eastern province. That means that, so far,
the virus has been shown as active in 7 out of Kenya's 47 counties. In
addition to the 6 above, the following counties have been recognized
as currently at high risk for RVF: Tana River, Tharaka Nithi, Garissa,
Lamu, Baringo, Mombasa, and Nairobi. Obviously, preventive measures,
including mass vaccination of susceptible animal species, are urgently
required in the counties above and others at-risk, not yet infected.

For an interactive administrative map of Kenya, see
<https://www.citypopulation.de/php/kenya-admin.php>. - Mod.AS

HealthMap/ProMED-mail maps:
Kenya: <http://healthmap.org/promed/p/174>
Isiolo county: <http://healthmap.org/promed/p/3879>]

[See Also:
Rift Valley fever - Eastern Africa (09): Kenya, animals
http://promedmail.org/post/20180702.5885427
Rift Valley fever - Eastern Africa (08): Kenya, Uganda, human,
animals, spread http://promedmail.org/post/20180701.5884295
Rift Valley fever - Eastern Africa (07): Kenya, animals, spread
http://promedmail.org/post/20180626.5877838
Rift Valley fever - Eastern Africa (06): Kenya, South Africa
http://promedmail.org/post/20180625.5875458
Rift Valley fever - Eastern Africa (05): regional cooperation
http://promedmail.org/post/20180625.5874116
Rift Valley fever - Eastern Africa (04): Kenya
http://promedmail.org/post/20180622.5869367
Rift Valley fever - Eastern Africa (03): Kenya
http://promedmail.org/post/20180621.5866921
Rift Valley fever - Eastern Africa (02): Kenya
http://promedmail.org/post/20180620.5865028
Rift Valley fever - Kenya (06): (WJ)
http://promedmail.org/post/20180619.5863401
Rift Valley fever - Kenya (05): (WJ) WHO
http://promedmail.org/post/20180619.5862204
Rift Valley fever - Kenya (04): (WJ)
http://promedmail.org/post/20180615.5858590
Rift Valley fever - Kenya (03): (WJ) camel, human, OIE
http://promedmail.org/post/20180609.5847976
Rift Valley fever - Kenya (02): (WJ) susp
http://promedmail.org/post/20180609.5847216]
.................................................jh/ty/msp/jh/mj/jh
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