Rift Valley Fever (RVF) reaches Nairobi

With 148 deaths so far, RVF is no longer a distant irritation to be ignored, but a threat that needs to be tackled with all the might that the government can muster. I am not sure at what stage this pandemic gets classified as a National Disaster(or whatever other lower or higher ratings there are for catastrophes), but once it hits Nairobi, you can be sure that GoK will come out with the guns blazing. It bothers me that, so long as such an outbreak is confined to marginal Kenya (North Eastern, parts of Eastern, parts of Coast and Rift Valley), the perception is one of events taking place in a foreign land and therefore distant and removed from the real "Kenya"! The media seems only interested in the effects the disease will have on the ubiquitous nyama choma business. I havent heard, seen or read much on prevention or diagnosis. I was therefore pleasantly suprised when I received the e-mail below with information on the disease. Have you ever heard of Disease Outbreak Management Unit (DOMU) ? Neither have I, but it sure is gratifying to know that someone at Afya House is paid to protect my family and I from disease outbreaks. "RIFT VALLEY FEVER (RVF) WHAT IS RIFT VALLEY FEVER? Rift Valley Fever is a disease which primarily affects animals, but occasionally causes disease in humans. It may cause disease in both animals and humans leading to a lot of deaths. WHAT CAUSES RIFT VALLEY FEVER? This is caused by a virus which was first isolated in 1930 in the Rift Valley of Kenya. HAS THERE BEEN AN OUTBREAK OF RVF BEFORE IN KENYA? During the El Nino of 1997/1998, there was a major outbreak in Kenya. A similar outbreak was reported in 1951. WHICH OTHER COUNTRIES HAVE HAD THE PROBLEM? Similar outbreaks have been reported in other countries e.g. Egypt & Senegal – 1993, Somalia – 1997/8, Saudi Arabia and Yemen – 2000. HOW IS IT TRANSMITTED AMONG ANIMALS? · RVF virus is primarily spread amongst animals by the bite of infected mosquitoes. · Many types of animals may be infected with RVF, including cattle, sheep, camels and goats. HOW IS IT TRANSMITTED FROM ANIMALS TO HUMANS? 1. Direct contact with infected animals or infected products e.g. blood, milk, meat etc. 2. Through the bites of mosquitoes which may have fed on infected animals. (Many different species of mosquitoes e.g. Aedes, Culex, even Anopheles are vectors for the RVF virus). IS THERE A POSSIBILITY OF EPIDEMICS OF THE DISEASE? Yes, as is happening now in North Eastern Province, and can happen in other areas following the introduction of the virus where these vectors are present. HOW MANY PEOPLE HAVE BEEN AFFECTED IN THIS CURRENT OUTBREAK SO FAR? By 5th January 2007, the reported cases are 188 with 68 deaths, in the districts of Garissa, Tana River, Wajir, Kilifi and Ijara. DO PEOPLE GET SICK IMMEDIATELY THEY ARE BITTEN BY THE MOSQUITOES? No, it may take 2-6 days before they start showing signs/symptoms of the disease. WHAT ARE THE SIGNS AND SYMPTOMS OF THE DISEASE? This may include: - o sudden onset high body temperature (fever) o headache o muscle pain o backache o vomiting · In severe cases, one may get; o eye disease o meningitis (meningo-encephalitis) inflammation of the brain and surrounding tissue o bleeding tendencies (such as vomiting blood, passing blood in the faeces, bleeding in the skin and bleeding from the gums). HOW DO WE DIAGNOSE THE DISEASE? · Clinical presentation · Blood tests are used for confirmation. HOW DO WE TREAT THE PATIENTS? · The mainstay of treatment is general supportive therapy. HOW DO WE PREVENT AND CONTROL THIS DISEASE? · Avoiding contact with blood, body fluid or tissue of infected animals. · Use of insecticide treated nets and mosquito repellant to reduce contact with mosquitoes. · Indoor spraying with insecticides. · RVF can be prevented by a sustained program of animal vaccination. WHAT HAS THE GOVERNMENT DONE SO FAR TO TACKLE THIS DISEASE? Distribution of over 100,000 insecticide treated nets is ongoing in North Eastern Province. Wide-scale insecticide spraying in affected area to reduce the increasing mosquito population following the recent floods. Supportive drugs and other medical supplies have been distributed to the affected district for management of suspected cases. Health educations on early recognition of the disease as well as its prevention and control measures have been stepped up. Additional health and veterinary officers have been mobilized and are on the ground helping in the control efforts. The vaccines for animal vaccination are available in the country, and an animal vaccination programme will be on as from 8th January 2007. Quarantine for animal movement has been imposed in North Eastern Province. Home slaughtering of animals for the coming Muslim festival has been banned, and they can only slaughter at abattoirs where they can be inspected under strict hygienic conditions. CASE DEFINITIONS FOR SUSPECTED RIFT VALLEY FEVER – DRAFT 2 Suspected Case · Any person presenting with fever of acute onset (>37.50C) with any of the following symptoms:- Headache, muscle and joint pains · In a patient where other causes of acute febrile illness such as malaria have not been identified as a cause since 1st December 2006. Probable Case · Any person presenting with fever of acute onset (>37.50C) with unexplained bleeding tendencies (bloody stool, vomiting blood, coughing blood, bleeding from gums, nose, vagina, skin or eyes) or deterioration of vision or decreased consciousness. Confirmed Case · A suspected or probable case with Laboratory confirmation of Rift Valley Fever by ELISA (anti-RVFV IgM) or PCR. For more information contact: Disease Outbreak Management Unit (DOMU) Ministry of Health Headquarters Telephone : 254 020 2718292 Fax: 254 020 2720533 Information Source: (DOMU, MoH) MESSAGE IN THE INTEREST OF PUBLIC HEALTH"