Experts warn of cholera outbreak amid heavy rainfall
Five people have died of cholera in Murang'a County. FILE PHOTO
What you need to know:
- Cholera cases can be averted provided people have access to clean drinking water and observe hygiene.
- Many county governments are building toilets, discouraging open defecation and creating hygiene awareness.
The rainy season is here and health experts are warning of possible cholera outbreaks due to dirty water and poor sanitation.
The medics warn that if nothing is done to rectify the situation by educating people on the importance of observing hygiene and boiling drinking water, the country is staring at a full-blown cholera epidemic.
Dr Ojwang Lusi, a public health officer in Kisumu, said the disease is already ravaging parts of the country.
“All we need is to do is start educating people on the risk that comes with poor handling of food and they also need to observe hygiene by boiling water before drinking. With the drought that has hit the country, water is scarce and people are consuming dirty water,” Dr Lusi said.
Early this year, five people died and several others were hospitalised following a cholera outbreak in Kiunyu village, Murang’a County.
ROTICH TREATED
The deaths, according to Murang’a Health executive Joseph Mbai, were a result of drinking contaminated water from River Gathwariga.
In Tana River County, 218 people were suspected to be infected with cholera.
Cholera is an acute diarrhoeal illness. Lack of toilets, poor hygiene and unsafe drinking water have been blamed for outbreaks.
Slum dwellers are particularly vulnerable but, following past experience in the country, the disease is no longer just associated with poverty.
Three top government officials were treated for cholera-related symptoms after taking meals during a trade fair at Kenyatta International Convention Centre, Nairobi, last year.
Treasury Cabinet Secretary Henry Rotich, his Trade counterpart Adan Mohammed and Trade Principal Secretary Chris Kiptoo were among the more than 50 people treated for cholera-related symptoms and discharged.
WESTON HOTEL
A doctors’ conference held at Weston Hotel in Nairobi ended prematurely following a cholera outbreak mid last year.
Some 26 participants were admitted to Nairobi Hospital after taking meals at the hotel while a doctor from the United Kingdom had to be flown home for treatment when he developed complications while at the conference.
In May last year, three people died of cholera after attending a wedding in Karen, Nairobi.
Five others, including a German, were treated in city hospitals.
Mr Alex Wolf, who was at the wedding with his Kenyan girlfriend, was put in an isolation ward at Nairobi Hospital. He later developed kidney complications.
The question that has escaped that debate is why cholera, a disease that, for all intents and purposes, is regarded in medical circles as outdated, has come back to ravage a modern metropolis.
RESISTANCE
Dr John Kiiru, an infectious diseases expert at Kenya Medical and Research Institute, fears that the strain responsible for the cholera has “decorated itself to become resistant”.
The strain, vibrio cholerae inaba, has acquired a resistant characteristic. It is suspected to have hatched in the Indian sub-continent and was first detected in Kenya in 2015 at the Daadab refugee camp.
It has been responsible for mass casualties in Haiti, Rwanda and the Democratic Republic of Congo, riding the wave of the common stereotypes of cholera.
The drugs used in treating cholera have lost their efficacy to kill pathogens in the body.
Prof Samuel Kariuki, a lecturer in tropical microbiology who has studied enteric pathogens long enough to label them as “sly and cunning”, is sure we have a long fight in our hands.
“When you expose it to subtle doses of drugs, and it feels ‘this dose is not strong enough to kill me’, it learns the attacking style of that drug, and it changes itself for the next attack,” Prof Kariuki explained in an earlier interview.
“It may develop ‘pumps’ to flush the drugs out or grow a thicker layer against the drug, and the next time you take medicine, the bacteria will just scoff at the drug.”
ANTIBIOTICS
The other way cholera has become hard to control is through genetic re-assortment, where all the bacteria sit together and “marry” one another to form a newer, stronger pathogen.
He said the pathogen is not only resistant to third generation medicines, but also a 67 per cent successful hostility to quinolones, a stronger, more effective group of antibiotics.
Public hospitals therefore will be forced to move to stronger antibiotics, which may be expensive.
However, according to public health director at the Ministry of Health, Kepha Ombacho, cholera cases can be averted provided people have access to clean drinking water and observe hygiene.
Dr Ombacho said what the country needs to do is to prioritise preventive measures.
“Where they feel residents have a problem with access to clean drinking water, they should provide them with water treatment drugs, dig boreholes and educate them on hygiene,” Dr Ombacho told the Sunday Nation.
AWARENESS
He said when residents are aware of hygiene, there would be no cholera deaths.
“We do not want to lose a life. That is why we work hard to provide counties with guidelines and standards of eradicating the disease,” he said.
While attributing the recurrence of the outbreak to lack of proper sanitation, Dr Ombacho stressed the importance of information and proper infrastructure.
“Most of the affected counties lack toilets, clean water and adequate information about hygiene,” he said.
However, many county governments are building toilets, discouraging open defecation and creating hygiene awareness.
“Most of the cases we are seeing are a result of people drinking contaminated water," Mr Denis Mbae, a cholera programme coordinator at Médecins Sans Frontières (Doctors Without Borders), said.
“Even rivers are being contaminated. Many water sources are drying up and lack of sufficient human waste disposal means there is a high potential for the spread of the disease.”
