Tag: GreatLakesNews

{Nairobi was on Thursday evening on high alert after three people who all met and ate at a wedding in Karen on Saturday died of cholera.}

Five others, including a foreigner, are being treated at various hospitals in the city.

The victims and patients were part of a larger group of about 400 guests who had attended the garden wedding in the area.

Food had been supplied by an outsourced caterer.

There are fears that the number of sick people could be higher and will likely affect other counties as some of the guests came from Mombasa and Eldoret.

Tana River and Dadaab in Garissa have confirmed cholera cases while Vihiga and Murang’a, traditionally Kenya’s cholera hotspots, are being monitored closely for possible outbreaks.

The Karen newlyweds, who wished to remain anonymous, cut short their honeymoon in Mombasa on Thursday and flew back to Nairobi to visit their ailing relatives and friends.

Nairobi County executive committee member for health Bernard Muia confirmed the cases but denied there were any deaths related to the disease. He said the reported cases were imported from elsewhere.

“I am advised by the county disease surveillance team that the patients admitted to Nairobi hospitals came from western Kenya,” he said.

However, this may not be the case, as a visiting German man, Alex Wolf, who attended the wedding alongside his Kenyan girlfriend, was being treated in isolation at Nairobi Hospital for the disease, which has created kidney complications.

{{Cholera complications }}

“This is my first time in Kenya,” said Mr Wolf from his hospital bed. “We came to Nairobi for the wedding and it was a lovely event. The food was good. I ate rice, fish and meatballs.

“But then I developed stomachache and diarrhoea on Saturday night and came to hospital on Monday. The tests confirm that I have cholera.”

As a result of the admission to hospital, Mr Wolf missed his flight back home on Thursday morning.

Close to his room was another patient, Liz Nerima Oganga, who at the time of the interview at 2pm on Thursday, was on her 16th drip of water and medication. She was admitted at midnight on Wednesday.

“I only ate a small piece of fish and spinach at the wedding. By Monday, however, I had severe bouts of diarrhoea accompanied by extreme fatigue.

“By Wednesday, I was crawling on my knees; the pain was unbearable. The doctors say the dehydration affected my kidneys,” she said. Her son has also been unwell and was on Thursday afternoon being attended to at the same hospital.

Another guest at the wedding, Pamela Kerre, a cousin of the groom, lost her brother Steve Musalia on Tuesday to cholera complications.

Earlier, on Monday this week, two other close relatives who had also attended the wedding died in Vihiga.

At the time of the interview, Ms Kerre was being discharged from Nairobi Hospital, where she had been hospitalised for two days due to the stomach infection.

{{‘Fell ill’}}

“They confirmed my brother had cholera,” she said. “He fell ill on Monday morning and his wife rushed him to a hospital in Komarock later in the day at 5pm.

“But we lost him on Tuesday morning, at 2am. The post-mortem report from Chiromo mortuary shows he died of severe dehydration and multiple organ failure.”

Family members who spoke to the Nation suspect their woes came from the food they ate at the ceremony. There are sketchy details about the hired cateress, who on Thursday refused to comment on the matter.

However, sources close to the company intimated to this newspaper that one of the people who served food at the wedding had been unwell with a stomach infection.

Eric Kibe, the programme director at SafiServe, an organisation that trains food service workers on how to protect consumers from food-borne risks, said Kenyans need to be careful about who cooks their meals.

“We are all food consumers and if you bring a caterer to your event, make sure that you have proof of their well-being,” he said.

“Do they have a food-handling certificate, for instance? This certificate expires every six months, therefore, you should watch out for this.

“But even in your own home, ensure personal hygiene, wash your hands with soap and boil or treat your water.”

Source:Daily Nation

{The number of suspected cases of Ebola has risen to 29 from nine in less than a week in an isolated part of Democratic Republic of Congo, where three people have died from the disease since April 22, the World Health Organization said on Thursday.}

The W.H.O. was criticized for responding too slowly to an outbreak in West Africa in 2014 that left more than 11,000 people dead, and Dr. Peter Salama, the executive director of the organization’s health emergencies program, said at a briefing that it was essential to “never, ever underestimate Ebola” and to “make sure we have a no-regrets approach to this outbreak.”

The risk from the outbreak is “high at the national level,” the W.H.O. said, because the disease was so severe and was spreading in a remote area in northeastern Congo with “suboptimal surveillance” and limited access to health care.

“Risk at the regional level is moderate due to the proximity of international borders and the recent influx of refugees from Central African Republic,” the organization said, but it nonetheless described the global risk as low because the area is so remote.

About a week ago, in addition to the nine suspected cases, 125 patients who had come into close contact with the disease were being monitored. Now about 400 patients are being followed, even as nine new cases were reported on Thursday, according to the W.H.O.

The Ebola virus causes fever, bleeding, vomiting and diarrhea, and it spreads easily by contact with bodily fluids. The death rate is high, often surpassing 50 percent, particularly with the Zaire strain, which has been confirmed in two cases in this outbreak.

The outbreak was reported in a densely forested part of Bas-Uele Province, near the border with the Central African Republic. Cases have occurred in four separate parts of a region called the Likati health zone.

Aid groups and the W.H.O. have struggled to reach the affected area, which has no paved roads and can be reached only by a motorcycle ride through the forest, or by helicopter or light aircraft.

The first known case occurred on April 22, when a 39-year-old man who had fever, vomiting, diarrhea and bleeding died on the way to a hospital in the Likati zone. The person caring for him and a motorcyclist who transported him also died.

The first six months of the response to the outbreak are expected to cost the W.H.O. and aid groups $10 million, Dr. Salama said at the briefing. He said telecommunications networks would have to be established and airstrips repaired so that aid workers can provide the necessary medical care.

The W.H.O., aid groups and the Congolese government are discussing the possibility of using an experimental Ebola vaccine, made by the American pharmaceutical company Merck, that proved effective in Guinea.

The response would involve a “ring vaccination,” in which contacts of patients, contacts of contacts, and health workers would be vaccinated. There would be no mass public vaccination.

The vaccine has not yet been licensed, and its use would require permission on several fronts. Nonetheless, Dr. Salama said that if permission were granted, the vaccine could be made available in a week or so. Other experimental antiviral drugs may also be considered.

The Ebola virus is considered endemic in the Democratic Republic of Congo, where eight outbreaks, the largest involving about 300 patients, have been recorded since 1976.

The country “has considerable experience and capacity in confronting these outbreaks,” Dr. Daniel Bausch, an Ebola expert at the W.H.O., said in an email. He added, “I think there is a very good probability that control can be rapidly achieved.”

Dr. Salama said that aid workers had reached a town in the Likati zone, which was as close as they had been able to come to the epicenter of the outbreak. He said aid groups were setting up centers for treatment and isolation, and mobile labs.

The first aid group to arrive was the Alliance for International Medical Action, which was already in the region, responding to cholera.

In a telephone interview from Conakry, Guinea, the group’s executive director, Matthew Cleary, said that seven people who were believed to have contracted Ebola had been taken to a district hospital in the Likati zone that was not equipped to deal with the virus.

“It’s urgent to get them into a proper isolation center,” Mr. Cleary said, adding that the group is preparing to build a treatment unit. It will include windows that allow families to see patients, a response to past outbreaks in which people feared and sometimes shunned sealed-up isolation units into which patients seemed to disappear.

Brienne Prusak, a spokeswoman for Doctors Without Borders said on Wednesday that the group had sent a team of about 20 doctors, nurses and other experts to the Likati zone, and that it was still trying to figure out how to reach the epicenter.

“Transport is extremely difficult in the area, and helicopter flights may be the only way to get there,” she said by email. “We considered motorbikes but are now thinking of helicopters because we need to get so many materials there. We’re expecting to get to the epicenter by the weekend.”

The Centers for Disease Control and Prevention in the United States is also sending a renowned Ebola expert, Dr. Pierre Rollin, to Congo, along with epidemiologists, a spokeswoman said.

Source:The New York Times

{The World Health Organization and outside experts are making arrangements to send an experimental Ebola vaccine to the Democratic Republic of Congo, should officials there say they need it to quell an outbreak there.}

The DRC has not yet formally requested the vaccine, and it’s unclear if or when it will. The country’s drug regulatory agency would also have to authorize emergency use of the vaccine, which is not yet licensed.

But the WHO and Gavi, the Vaccine Alliance, told STAT that preparations to have the experimental vaccine ready for use are being made on a parallel track with investigations in DRC into the scale of the outbreak.

“If the question is: Is it going to be used in this particular outbreak? It’s not clear yet,” said Dr. Seth Berkley, CEO of Gavi, a public-private partnership that provides vaccines to lower income countries.

“That being said, everything is being put in place to use the vaccine if it is requested or if it turns out the need accelerates.”

The outbreak, reported to the WHO last week, has grown to 20 suspected cases. Three of the infected have died.

This Ebola epidemic, the country’s eighth, is in a remote part of northern DCR, a province called Bas-Uele. It is a part of the country with few roads, which should help contain the epidemic. The three previous Ebola outbreaks in DRC involved dozens of cases as opposed to hundreds or thousands.

But the location also creates logistical difficulties. Transporting medical supplies and teams of investigators to the outbreak zone is slow work — as is getting patient samples back to the capital, Kinshasa, for testing.

It will also be challenging to get doses of vaccine to the area if the government decides to use it. The experimental Ebola vaccine must be stored at -80 Celsius, which would involve transporting it in freezers.

The vaccine, which goes by the working name rVSV-ZEBOV, is being developed by pharmaceutical giant Merck. Although there are other experimental Ebola vaccines at various stages of development, this is the only one so far which has been shown to protect people from the deadly virus.

That evidence comes from a clinical trial conducted in Guinea during the West African Ebola outbreak of 2014-2015. The trial showed the vaccine induced quick protection, a desirable characteristic for a vaccine designed for use in controlling outbreaks.

That study used what is known as a ring vaccination design, in which people who had been in contact with a confirmed case were vaccinated to prevent ongoing spread. The WHO has said if DRC uses the Ebola vaccine, it should vaccinate using the ring technique, said Tarik Jašarević, a spokesman for the WHO.

In an agreement with Gavi, Merck is required to have on hand at all times at least 300,000 doses of the Ebola vaccine. There is also currently a small number of doses — around 800 or 1,000 — in Geneva, Berkley said.

A spokeswoman for Merck said the company is in contact with WHO, Doctors without Borders — which has sent a response team to the outbreak site — and other organizations about the outbreak.

“We stand ready to ship our investigational vaccine for Ebola Zaire … once appropriate approvals are in place,” she said in an email.

Berkley pointed out that because the vaccine has not yet been licensed, there are regulatory hurdles to clear before it can be used, and that can take some time.

“It’s a little different than yellow fever vaccine, which can be stored in different places and used as a clinical vaccine pretty indiscriminately. There are some complexities with using this,” Berkley said.

So will this outbreak be the first in history where Ebola vaccine is used to help stamp out transmission? It’s too soon to say, he said.

“To be honest with you, I would hope that the epidemic would be over so quickly and there would be so few deaths that there would be no need to use it,” Berkley said.

“That’s the best-case scenario for everybody,” he said. “Of course, if the outbreak goes further or there’s an opportunity to use it, I would like to make sure we don’t have another large outbreak and that it does get used.”

Source:Stat