Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever denied - malaria, poisoning confirmed

[alert]

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,88168

Archive Number 20110424.1280
Published Date 24-APR-2011
Subject PRO/AH/EDR> Yellow fever - Africa (14): Kenya (BA), susp, RFI

YELLOW FEVER - AFRICA (14): KENYA (BARINGO), SUSPECTED, REQUEST FOR
INFORMATION
*******************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 24 Apr 2011
Source: Sunday Nation [edited]
<http://www.nation.co.ke/News/Yellow+fever+scare+as+man+50++dies+/-/1056/1149818/-/gxca7n/-/index.html>


Health personnel in Baringo are on high alert after a 50 year old man
succumbed to a condition suspected to be yellow fever [YF] in Kapluk
area. Baringo North District medical officer of health Felix Atisa,
however, dismissed the claim that the man was killed by yellow fever.
"A blood specimen taken to the Kenya Medical Research Institute
(KEMRI) did not reveal any traces of yellow fever, but he may have
died of haemorrhagic fever," said Dr Atisa. Addressing the press in
Kabarnet on Saturday [23 Apr 2011], Dr Atisa said a team of disease
surveillance officials had been deployed to the area to monitor the
situation.

"We urge the locals who develop symptoms of the disease like
headache, joint aches, and fever to seek medical attention
immediately," said the medical officer, who added that all health
facilities had been stocked with enough drugs in case of any
emergency. He said that a mass vaccination programme will soon be
rolled out in the area. The last time such an exercise was carried out
in Baringo and Elgeyo Marakwet was in 2001.

Dr Atisa's sentiments contradicted those of Kabarnet District
Hospital medical superintendent Robert Pukose, who said the man died
from haemorrhagic fever "which is common among patients with yellow
fever." Addressing the press in his office, Dr Pukose said that a
postmortem examination at Moi Teaching and Referral Hospital in
Eldoret confirmed the cause of death to be yellow fever. Dr Pukose
said investigations on another person who died on Friday last week
indicated that he suffered from hepatitis B, which co-exists with
yellow fever.

Yellow fever is an acute viral haemorrhagic disease transmitted by
infected mosquitoes. The "yellow" in the name refers to the jaundice
that affects some patients. According to the World Health
Organization, there is no cure for yellow fever. Treatment aims at
reducing the symptoms for the comfort of the patient. Vaccination is
the most important preventive measure against the disease. Yellow
fever vaccines provide immunity for a period of 10 years.

Residents of Salawa, Kapluk, Barwessa, and Seretunin claimed 5 people
have died within the last 5 months with yellow fever-related symptoms.
But Dr Pukose dismissed the claim, saying that they were based on
hearsay. "The victim from Seretunin died after taking rat poison and a
child from Salawa died from severe malaria; there is no evidence that
they died from yellow fever," said the medic.

Dr Pukose said the lower regions of Baringo and Elgeyo Marakwet were
particularly prone to yellow fever and appealed to the government to
conduct another mass vaccination against the disease this year. He
advised the residents to ensure that bushes and empty cans around
their compounds were cleared since they were conducive environments
for the breeding of mosquitoes.

According to Dr Pukose, yellow fever symptoms include fever,
headache, backache, joint and muscle pains and yellowness of the eyes
in severe cases.

--
communicated by:
ProMED-EAFR

[This situation is not clear. The diagnostic tests used by KEMRI (a
WHO Collaborating Center for Arbovirus and Hemorrhagic Fever Reference
and Research) that discarded YF as the etiologic agent in this case
are not specified, nor is the basis on which the postmortem
examination at Moi Teaching and Referral Hospital confirmed YF virus
infection. ProMED-mail would be interested in receiving additional
information about this case, or any new hemorrhagic fever cases, as it
becomes available.

In any event, given that this is an area subject to sporadic YF
outbreaks, a vaccination campaign is prudent, especially if the last
campaign was 10 years ago, and children born since then, as well as
those missed by that earlier campaign, are at risk of YF virus
infections.

 

[Ronan Kelly]

Kenya: Yellow Fever Scare As Man, 50, Dies

Kenya: Yellow Fever Scare As Man, 50, Dies

Kenya: Yellow Fever Scare As Man, 50, Dies
Wycliffe Kipsang
23 April 2011

:
Nairobi ? Health personnel in Baringo are on high alert after a 50-year-old man succumbed to a condition suspected to be yellow fever in Kapluk area.

Baringo North District Medical Officer of Health Felix Atisa, however, dismissed the claim that the man was killed by yellow fever.

"A blood specimen taken to the Kenya Medical Research Institute (Kemri) did not reveal any traces of yellow fever, but he may have died of haemorrhagic fever," said Dr Atisa.

Addressing the press in Kabarnet on Saturday, Dr Atisa said a team of disease surveillance officials had been deployed to the area to monitor the situation.

...

http://allafrica.com/stories/201104250130.html

 

[alert]

Re: Baringo, Kenya: Two die of hemorrhagic illnesses - yellow fever ruled out -non-infectious causes suspected

Re: Baringo, Kenya: Two die of hemorrhagic illnesses - yellow fever ruled out -non-infectious causes suspected

Given the date of death, we are well beyond even a 21-day incubation period on any contacts of the first individual (50M). It is difficult to even begin to speculate on what illness he may have had, but malaria and typhoid are both possible. Post #1 indicates that the patient had chronic Hepatitis B, which causes liver dysfunction, and so almost any illness could provide such a presentation.

The second indivdual appears to have died of chemical poisoning.

Update: Cross referencing this article with post #1 (Seretunin) indicates the chemical in question is rat poison, which is an anticoagulant, and would explain hemorrhage.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,88182

Archive Number 20110425.1290
Published Date 25-APR-2011
Subject PRO/AH/EDR> Yellow fever - Africa (15): Kenya (BA), NOT

YELLOW FEVER - AFRICA (15): KENYA (BARINGO), NOT
************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 25 Apr 2011
From: Dr. David Mutonga [edited]
<dmutonga@ddsr.or.ke>


On 13 Apr [2011], we received a report from the acting Director
Clinical Services at Moi Teaching and Referral Hospital about 2
patients who had been referred to the hospital and later died there
from what the hospital thought was possible yellow fever [YF]. On
receiving the report, the surveillance teams immediately conducted
field investigations and gathered the following information about the
2 patients.

The 1st patient was a 50-year-old male from Kapluk village, Kabut Kei
Division, Baringo North District. Reported date of onset of illness
was on 18 Mar 2011 and died on 29 Mar 2011. Clinical presentation at
various stages of the illness included nose bleeding, headache,
malaise, and fever. There was no history of jaundice. Active case
search by the District Health Management Team [DHMT] in the case
household, neighbouring facilities and communities revealed that no
unusual cases of fever, jaundice, bleeding or any other unusual
illness had been detected.

Laboratory tests - ELISA and PCR tests done at KEMRI [Kenya Medical
Research Institute] were negative for yellow fever [virus] and the
other arboviruses.

The 2nd patient was a 26-year-old male from Seretunin Village, Ewalel
Division, Baringo Central District. The patient had a history of
chemical poisoning before onset of this illness. The reported date of
onset was 3 Apr 2011 and died on 5 Apr 2011. There was no history of
jaundice. A visit to the patient's home, local community and health
facilities by the DHMT did not reveal any other patient having a
similar presentation, nor unusual occurrence of fever cases.

Conclusion: As per the country surveillance guidelines, these
patients are unlikely to have died of yellow fever or the other viral
haemorrhagic fevers. As of now there is no known suspected or
confirmed yellow fever case or outbreak in Baringo County or any other
County in the country at the moment. However, the ministry has alerted
the district health authorities and communities in Baringo county to
be on high alert and to report and investigate any suspected case of
yellow fever or any other epidemic prone disease immediately as per
the surveillance guidelines.

There is adequate laboratory capacity in Kenya to confirm yellow
fever cases when they occur. Health workers are required to collect
specimens and send them to the KEMRI Arbovirus laboratory as soon as
they suspect a case of yellow fever.

The ministry will continue to strengthen the Integrated Disease
Surveillance and Response System to ensure that health authorities
respond immediately and appropriately to any case of epidemic
disease.

Baringo county is a yellow fever high risk county and routine
vaccination is done at 9 months of age through the Expanded Programme
of Immunization (EPI). Catch-up campaigns are done once every 10
years. The last campaign was done in 2002 and the next one is
scheduled for 2012.

--
Dr David M. Mutonga
Head, Division of Disease Surveillance and Response
Department of Disease Prevention and Control
Kenya Ministry of Public Health and Sanitation
<dmutonga@ddsr.or.ke>

[ProMED is grateful to Dr. Mutonga for his rapid response to the
suspected YF cases, in which he provides information that rules out YF
virus infection in these 2 cases. His report provides an excellent
example of field epidemiological surveillance and timely, effective
laboratory support. KEMRI, which provided the laboratory support, is a
WHO Collaborating Center for Arbovirus and Hemorrhagic Fever Reference
and Research.

 

[Shiloh]

Re: Baringo, Kenya: Two die of hemorrhagic illnesses - yellow fever ruled out - different causes suspected

Re: Baringo, Kenya: Two die of hemorrhagic illnesses - yellow fever ruled out - different causes suspected

Source: http://allafrica.com/stories/201104260041.html

Kenya: Mass Yellow Fever Jabs in Baringo
Mathews Ndanyi
25 April 2011

The government will carry out emergency mass vaccination in Baringo county, following fears of an outbreak of yellow fever. Medics in the area have been put on high alert and surveillance teams deployed after reports that one person had died of yellow fever while three people had been admitted to hospital with symptoms of the contagious disease.

Medical Superintendent at the Kabarnet District Hospital Dr Robert Pokuse said tests have confirmed cases of yellow fever in the area and the government has to carry out emergency vaccination in the region.

Pokuse said they are keenly monitoring the situation and blood samples from some of the victims have been sent to Kenya Medical Research Institute in Nairobi for further tests.

Some medical experts in the county said three people have so far died from haemorrhagic fever and another one from Hepatitis B. The two diseases are closely associated with yellow fever.

Acting director of the Moi Referral Hospital, Eldoret Dr Omar Ali could not be reached for comment but sources at the hospital said a 50-year-old man had died of yellow fever.

Yellow fever is viral disease transmitted by mosquitoes. It causes victims' bodies to turn yellow and death occurs within days. It has no cure but it is prevented through vaccination.

 

[alert]

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed despite initial denial?

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed despite initial denial?

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,88293

Archive Number 20110502.1366
Published Date 02-MAY-2011
Subject PRO/AH/EDR> Yellow fever - Africa (16): Kenya (BA)

YELLOW FEVER - AFRICA (16): KENYA (BARINGO)
*******************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 2 May 2011
Source: All Africa [edited]
<http://allafrica.com/stories/201105021423.html>


Medical personnel in Baringo and Elgeyo-Marakwet counties have been
put on high alert after 9 out of 16 of people tested for yellow fever
[YF virus infection] turned out positive. The area had been put on
high alert last week after a 50-year-old man succumbed to a disease
suspected to be yellow fever in Kapluk area of North Baringo district,
bringing to 6 the number of people who have succumbed to the disease
since the beginning of the year. This prompted Kenya Medical Research
Institute (KEMRI) officials from Kisumu and Busia to be deployed to
the area to monitor the situation.

According to Baringo north district Medical Officer of Health (MOH)
Dr Felix Atisa, blood specimens for the victims from Kapluk Dispensary
and Kabarnet District Hospital taken for analysis at KEMRI
headquarters in Nairobi on Tuesday last week [26 Apr 2011] revealed
that they have the viral disease. Dr Atisa said that health personnel
in all health facilities in the area have been directed to be on the
lookout for the symptoms of the disease, which include chills, fever,
headache, backache, joint and muscle pains and yellowness of the eyes
in severe cases, which become noticeable within a period of 3-6 days
after the victim is bitten by the mosquito. The medic, however,
assured the locals that all health facilities in the area have been
stocked with enough drugs in case of any emergency.

He advised the residents to ensure that bushes and empty cans around
their compounds were cleared since they were conducive environments
for the breeding of mosquitoes. "We advise the people to take
precautionary measures to prevent mosquitoes breeding in their
compounds and also spraying insecticides. We also urge those who
develop any symptoms similar to those of yellow fever to seek
medication without delay," said Dr Atisa.

He said that health personnel have also been deployed to the high
risk areas to carry sensitization campaigns to the people. He said
that a mass vaccination of the entire population will soon be rolled
out in the area. The last time the exercise was carried out in Baringo
and Elgeyo Marakwet counties was in 2001. This was after 15 people
died of the disease, prompting the World Health Organization (WHO) to
intervene.

A senior health official who preferred anonymity warned that more
people will succumb to the deadly disease if no urgent measures are
taken by the government to roll out a mass vaccination exercise.
"Yellow fever vaccines provide immunity for a period of 10 years,
which have elapsed since the last vaccination in the area. To make the
matters worse, the area has not been mapped out to determine the
extend of the fatal disease," said the medic.

Local residents who spoke to the Nation claimed that many people from
areas such as Salawa, Kapluk, Barwessa and Seretunin were beginning to
develop the symptoms of the disease. Led by Mr Harold Kipchumba of
Bare Carea local CBO, the residents demanded that results from KEMRI
be made public by the government.

"Even if the economic impact of such a step is big, the life of our
people should come 1st," said Mr Kipchumba. He feared that the
situation will worsen with the expected downpour in the area. Baringo
and Elgeyo Marakwet counties, particularly the lower regions, are
prone to yellow fever.

Yellow fever is an acute viral haemorrhagic disease transmitted by
infected mosquitoes and can be transmitted from one person to another
by the mosquito that bites during the day. The "yellow" in the name
refers to the jaundice that affects some patients. According to the
World Health Organisation (WHO), there is no cure for yellow fever.
Treatment aims at reducing the symptoms for the comfort of the
patient. Vaccination is the most important preventive measure against
the disease.

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

[This situation is confusing in that the case of the 50-year-old man
from the Baringo district who was originally suspected as having YF
was subsequently discarded as a YF case after laboratory tests done at
KEMRI were negative. Is the above case the same one, as seems likely?
In any event, since 9 of 16 suspected YF cases have turned out to be
positive (by tests done at KEMRI?), there is a small YF outbreak going
on in the area and rapid implementation of a vaccination program is
needed urgently. ProMED would appreciate receiving additional field
and laboratory information as it becomes available.

 

[alert]

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed?

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed?

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,88309

Archive Number 20110504.1377
Published Date 04-MAY-2011
Subject PRO> Yellow fever - Africa (17): Kenya, background

YELLOW FEVER - AFRICA (17): KENYA, BACKGROUND
*********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 4 May 2011
From: Paul Reiter <paul.reiter@pasteur.fr> [edited]


The 1st recorded outbreak of yellow fever [YF] in Kenya occurred from
mid-1992 through March 1993. Nearly all confirmed infections were
acquired between 1500-1800 m [4900-5900 ft] in the Tugen Hills
[Baringo district, Rift Valley province], not far from the present
outbreak area.

Transmission appeared to be entirely sylvatic, that is, all confirmed
cases were independent of other human cases and had acquired their
infection by contact with mosquitoes that had been infected by feeding
on viraemic monkeys. Infected mosquitoes (_Aedes africanus_ and _Ae.
keniensis_) were captured close to a cluster of human cases at ca.
1700m [5577 ft].

A team comprised of Kenya Government/KEMRI/WHO/CDC specialists found
that _Ae. aegypti_ was absent in the villages, hard to find in the
small local town of Kabarnet [Baringo district] (population 10 000)
but abundant in Kakamega [Western province] (population 73 000) and
Kisumu [Nyanza province] (current population estimated at 0.5
million), Kenya's 3rd most populous city. There was an excellent road
from the area to Kisumu; the drive took about 4 hours without
speeding.

The population in the outbreak area was small but included the
ancestral village of the then-president, Arap Moi. We were told that
this had enabled many local people to obtain jobs in Nairobi and other
parts of the country.

All this to emphasize the obvious: the region of transmission was
once quite remote but today there is a real and present danger that
such outbreaks could metastasise to urban areas in other parts of the
country and beyond, with potentially catastrophic consequences.
Pro-active vaccination of the local population would greatly reduce
this danger and thereby evade anxieties over adverse impact on
tourism.

Lastly, although there are virtually no records of yellow fever in
other parts of the country, older men in the local community
remembered a large epidemic of fever, haemorrhage, and jaundice that
had occurred in the area during World War II, perhaps in 1941 or
1942.

References
----------
1. Sanders EJ, Marfin AA, Tukei PM, et al: First recorded outbreak of
yellow fever in Kenya, 1992-1993. I. Epidemiological Investigations.
Am J Trop Med Hyg, 59(4): 644-9 [available at
<http://www.ajtmh.org/cgi/reprint/59/4/644>].
2. Reiter P, Cordellier R, Ouma JO, et al: First recorded outbreak of
yellow fever in Kenya, 1992-1993 II. Entomologic investigations. Am J
Trop Med Hyg, 59(4): 650-6 [available at
<http://www.ajtmh.org/cgi/reprint/59/4/650>].

--
Paul Reiter
<paul.reiter@pasteur.fr>

[ProMED-mail thanks Dr Reiter for his interesting comments on YF in
Kenya. His concern about potential spread of YF virus to other parts
of Kenya is serious and one hopes that a prompt vaccination campaign
in the affected areas will prevent spread to other areas.

 

[alert]

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed or denied? - conflicting reports

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed or denied? - conflicting reports

This agrees with the email to ProMED from a local authority, and disagrees with the previous article. It mentions the same sixteen suspects, but says they are all negative, whereas the above article says 9 tested positive. And it reduces the number of them who have died from 6 above to 2 here.

No clue which source might be correct.

http://allafrica.com/stories/201105050280.html

Kenya: Govt Allays Fears Over Yellow Fever
Joy Wanja
4 May 2011

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Nairobi — The government has dispelled fears over the presence of Yellow Fever in Baringo and the country in general.

Public health minister Beth Mugo said Wednesday that currently there are no laboratory-confirmed cases of the disease, allaying fears on the prevalence of the fever-disease.

"I assure the general public that those intending to visit the country that there are no known cases that meet the case definition standard or are laboratory confirmed to be yellow fever," she told journalists at a media briefing at her Afya House office.

However, she cited Baringo, Koibatek, Keiyo and Marakwet as yellow fever high-risk areas in the country though vaccination of the disease was routinely administered at nine months for children in these areas.

On the suspected cases of sixteen patients from Baringo county, she said that initial confirmatory tests had all turned negative for the disease though a second set of confirmatory tests had been requested.

The results will be released by the end of this week, she said.

"We also conduct Catch-up vaccination campaigns every ten years with the last one having been done in 2002 and the next one due in 2012," the minister said adding that the upcoming campaign was not triggered by the current yellow fever scares in the area.

She urged the public in the high risk areas preventive measures to keep the disease at bay.

"Protect yourselves from mosquito bites by wearing long sleeved clothing, sleeping under insecticide treated nets and using mosquito repellents," the minister advised the public.

The minister said that one of the two patients suspected to have died of Yellow Fever three weeks ago at Moi Teaching and Referral Hospital had their blood sample tested negative for the disease at Kemri laboratories.

"No specimen was taken from the second patient because it was established that he had drank poison prior to the onset of haemorrhage," Mrs Mugo said.

However the minister said a team from Kemri's centre for Infectious and Parasitic Diseases Control research in Busia had visited Baringo county last week and randomly collected 14 blood samples from patients presenting with fever at Kapluk dispensary and Kabarnet district hospital and all tested negative for the disease.

Yellow fever is a an acute fever disease transmitted through the bite of a female Aedes mosquito.

The mosquito transmits the virus from one host to another, primarily between monkeys, from monkeys to humans and from the person to person.

The symptoms of the disease include fever, muscle pain with prominent backache, headache, shivers and loss of appetite.

For most patients the symptoms disappear after three to four days even without treatment though approximately 15 per cent of patients enter a second more toxic phase within 24 hours of the initial treatment.

According to the World Health Organisation, there is no cure for the disease. Treatment aims at reducing the symptoms for the comfort of the patient. Vaccination is the most important preventive measure against the disease.

Yellow Fever vaccines provide immunity for a period of 10 years.

Also present at the briefing was Public Health Permanent Secretary Mark Bor and other health officials.

 

[alert]

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed or denied? - conflicting reports

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed or denied? - conflicting reports

Here's a bit of clarification as to where the confusion might be coming from.

http://eafr.promedmail.org/eafr

Most Recent Alert
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Published Date: 2011-05-05 16:49:52
SubjectRO/EAFR> Yellow fever - Kenya (03): (Rift Valley), susp.
Archive Number: 20110505.221751

YELLOW FEVER - KENYA (03): (RIFT VALLEY), SUSPECTED
***********************************************

A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org


[1]
Date: Tue 3 May 2011
Source: Ministry of Public Health and Sanitation, Republic of Kenya [edited]

Press Statement by the Director of Public Health and Sanitation, Dr. SK. Sharif on Media Reports of Yellow Fever Outbreak in Baringo County, 3rd May 2011
-----------------------------------
I wish to draw your attention to reports appearing in some sections of the media indicating that 9 out of 16 patients tested at KEMRI have turned positive for yellow fever. This report follows similar reports which have been appearing in various print and electronic media over the last 3 weeks indicating there is an outbreak of yellow fever and the country is preparing for a yellow fever vaccination campaign.

In view of these reports, the ministry wishes to clarify the following:

One of the 2 patients suspected to have died of yellow fever in Moi Teaching and Referal Hospital over 3 weeks ago was tested in Kemri Arborvirus lab, and all the tests were negative for yellow fever and all other arboviruses. Further still, clinical information of the 2 cases reported by Moi Teaching and Referral Hospital did not in any way suggest infection by yellow fever virus.

Following the reports which appeared in the media, a team from KEMRI (Busia Centre for Virus Research) visited Baringo County on 26 Apr 2011 and randomly collected 14 blood samples from patients presenting with fever in 2 health facilities, namely Kapluk Dispensary and Kabarnet District Hospital. All of these patients did not meet the standard case definition recommended for detecting suspected cases of yellow fever in the country.

No confirmatory tests have so far been conducted on the samples, which were collected from the field. Processing of these tests is still ongoing in Kemri. Screening (serological) tests were conducted on the samples. The tests so far conducted were a mixture of IgG, M, A and D antibodies. These tests are not confirmatory of yellow fever or the other arboviruses and are not relied on in confirming outbreaks in the country.

The Kemri Arborvirus laboratory is the Central Reference Laboratory for testing yellow fever and other viral haemorrhagic fevers in the country. These tests were not conducted in this laboratory.

Laboratory test results on yellow fever and other viral hemorrhagic fevers are usually confirmed by another laboratory before they are released to the public. This was not done in this case.

In view of the above, the ministry would like to inform the general public that tests are ongoing to confirm whether the cases referred to in the media are due to yellow fever. Therefore, as of now, there are no confirmed yellow fever cases in Baringo County or any other part of the country.

Baringo County is one of the yellow fever high-risk counties in the country. Yellow fever vaccination is already incorporated in the routine immunization program and administered routinely at 9 months of age. Catch up campaigns are conducted every 10 years. The last campaign was conducted in 2002, and the next one is due in 2012.

The ministry is working closely with KEMRI and the US Centres for Disease Prevention and Control Kenya to ensure any suspected cases are tested and confirmed immediately. The ministry wishes to advise all Kenyans and especially those in high risk districts to protect themselves from mosquito bites by wearing long sleeved clothing, using mosquito repellents and sleeping under insecticide treated nets. Yellow fever, which is an acute febrile viral disease, is transmitted by the bite of a female_Aedes_ mosquitoes. The mosquito transmits the virus from one host to another, primarily between monkeys, from monkeys to humans, and from person to person. The mosquitoes bite mainly during the day, especially at dawn and dusk

The ministry further requests the general public and health workers to be alert and report any suspected cases to the health officials for further investigation.

Dr SK. Sharif Director of Public Health and Sanitation
-- Communicated by: ProMED-EAFR


******
[2]
Date: Wed 4 May 2011 Source: All Africa, Daily Nation report [edited] http://allafrica.com/stories/201105050280.html

The government has dispelled fears over the presence of yellow fever in Baringo and the country in general.

Public health minister Beth Mugo said Wednesday [4 May 2011] that currently, there are no laboratory-confirmed cases of the disease, allaying fears on the prevalence of the fever-disease.

"I assure the general public and those intending to visit the country that there are no known cases that meet the case definition standard or are laboratory confirmed to be yellow fever," she told journalists at a media briefing at her Afya House office.

However, she cited Baringo, Koibatek, Keiyo and Marakwet as yellow fever high-risk areas in the country, though vaccination of the disease was routinely administered at 9 months for children in these areas.

On the suspected cases of 16 patients from Baringo county, she said that initial confirmatory tests had all turned negative for the disease, though a 2nd set of confirmatory tests had been requested. The results will be released by the end of this week [week ending 8 May 2011], she said.

"We also conduct catch-up vaccination campaigns every 10 years with the last one having been done in 2002 and the next one due in 2012," the minister said, adding that the upcoming campaign was not triggered by the current yellow fever scares in the area.

She urged the public in the high risk areas to take preventive measures to keep the disease at bay. "Protect yourselves from mosquito bites by wearing long sleeved clothing, sleeping under insecticide treated nets and using mosquito repellents," the minister advised the public.

The minister said that one of the 2 patients suspected to have died of yellow fever 3 weeks ago at Moi Teaching and Referral Hospital had their blood sample tested negative for the disease at Kemri laboratories. "No specimen was taken from the 2nd patient because it was established that he had drank poison prior to the onset of haemorrhage," Mrs Mugo said.

However, the minister said a team from Kemri's centre for Infectious and Parasitic Diseases Control research in Busia had visited Baringo county last week [week ending 1 May 2011] and randomly collected 14 blood samples from patients presenting with fever at Kapluk dispensary and Kabarnet district hospital, and all tested negative for the disease.

The symptoms of the disease include fever, muscle pain with prominent backache, headache, shivers and loss of appetite. For most patients, the symptoms disappear after 3-4 days even without treatment, though approximately 15 per cent of patients enter a 2nd, more toxic phase within 24 hours of the initial treatment.

According to the World Health Organisation, there is no cure for the disease. Treatment aims at reducing the symptoms for the comfort of the patient. Vaccination is the most important preventive measure against the disease. Yellow fever vaccines provide immunity for a period of 10 years.

Also present at the briefing was Public Health Permanent Secretary Mark Bor and other health officials.

[Byline: Joy Wanja]

-- Communicated by: ProMED-EAFR


******
[3]
Yellow fever Alert, Baringo Date: Mon 2 May 2011 Source: All Africa, Daily Nation report [edited] http://allafrica.com/stories/201105021423.html

Medical personnel in Baringo and Elgeyo-Marakwet counties have been put on high alert after 9 out of 16 people tested for yellow fever [YF virus infection] turned out positive. The area had been put on high alert last week [week of 25 Apr 2011] after a 50-year-old man succumbed to a disease suspected to be yellow fever in Kapluk area of North Baringo district, bringing to 6 the number of people who have succumbed to the disease since the beginning of the year [2011]. This prompted Kenya Medical Research Institute (KEMRI) officials from Kisumu and Busia to be deployed to the area to monitor the situation.

According to Baringo north district medical officer of health (MOH), Dr Felix Atisa, blood specimens for the victims from Kapluk Dispensary and Kabarnet District Hospital taken for analysis at KEMRI headquarters in Nairobi on Tuesday last week [26 Apr 2011] revealed that they have the viral disease. Dr Atisa said that health personnel in all health facilities in the area have been directed to be on the lookout for the symptoms of the disease, which include chills, fever, headache, backache, joint and muscle pains, and yellowness of the eyes in severe cases, which become noticeable within a period of 3-6 days after the victim is bitten by the mosquito. The medic, however, assured the locals that all health facilities in the area have been stocked with enough drugs in case of any emergency.

He advised the residents to ensure that bushes and empty cans around their compounds were cleared since they were conducive environments for the breeding of mosquitoes. "We advise the people to take precautionary measures to prevent mosquitoes breeding in their compounds and also spraying insecticides. We also urge those who develop any symptoms similar to those of yellow fever to seek medication without delay," said Dr Atisa.

He said that health personnel have also been deployed to the high risk areas to carry out sensitization campaigns to the people. He said that a mass vaccination of the entire population will soon be rolled out in the area. The last time the exercise was carried out in Baringo and Elgeyo-Marakwet counties was in 2001. This was after 15 people died of the disease, prompting the World Health Organization (WHO) to intervene.

A senior health official who preferred anonymity warned that more people will succumb to the deadly disease if no urgent measures are taken by the government to roll out a mass vaccination exercise. "Yellow fever vaccines provide immunity for a period of 10 years, which have elapsed since the last vaccination in the area. To make matters worse, the area has not been mapped out to determine the extent of the fatal disease," said the medic.

Local residents who spoke to the Nation claimed that many people from areas such as Salawa, Kapluk, Barwessa, and Seretunin were beginning to develop the symptoms of the disease. Led by Mr Harold Kipchumba of Bare Care local CBO [community based organization], the residents demanded that results from KEMRI be made public by the government.

"Even if the economic impact of such a step is big, the life of our people should come first," said Mr Kipchumba. He feared that the situation will worsen with the expected downpour in the area. Baringo and Elgeyo-Marakwet counties, particularly the lower regions, are prone to yellow fever.

Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and can be transmitted from one person to another by the mosquito that bites during the day. The "yellow" in the name refers to the jaundice that affects some patients. According to the World Health Organisation (WHO), there is no cure for yellow fever. Treatment aims at reducing the symptoms for the comfort of the patient. Vaccination is the most important preventive measure against the disease.

[Byline: Wycliff Kipsang]

-- Communicated by: ProMED-EAFR
[ProMED would like to thank Dr. David Mutonga, the Head of the Division of Disease Surveillance and Response and other officials from the Kenyan Ministry of Public Health and Sanitation for providing this press statement in response to our request for a clarification on the media reports that had earlier on indicated a confirmed outbreak of yellow fever in Baringo county.

In our last update on this subject [see ProMED EAFR 20110425.221355]

 

[alert]

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed or denied? - conflicting reports

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever confirmed or denied? - conflicting reports

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,88367

Archive Number 20110508.1422
Published Date 08-MAY-2011
Subject PRO/AH/EDR> Yellow fever - Africa (18): Kenya (BA) not

YELLOW FEVER - AFRICA (18): KENYA (BARINGO) NOT
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Fri 6 May 2011
From: David Mutonga <dmutonga@ddsr.or.ke>[edited]


KEMRI [Kenya Medical Research Institute] has completed the testing of
the samples collected from Baringo. We have received the following
results from KEMRI Arbovirology/VHF lab, Center for Virus Research --
the central reference laboratory for yellow fever in Kenya.

Summary of results
------------------
1. All samples were negative by IgM ELISA (NO evidence of acute
yellow fever [virus] infection)
2. One sample was weakly positive by IgG ELISA (evidence of previous
exposure or vaccination)
3. All samples were negative by RT-PCR (flavivirus, YF [yellow
fever], DEN [dengue], and WN [West Nile viruses]). NO evidence of
acute infection by any of these viruses.

--
Dr David Mutonga,
for The Director Ministry of Public Health and Sanitation
Kenya
<dmutonga@ddsr.or.ke>

[ProMED-mail thanks Dr Mutonga for this official information. It
dispels the confusion reflected in the earlier reports of YF cases
from this area in Kenya. The suspected YF cases have turned out to be
negative for this virus infection. Apparently, the earlier report of 9
of 16 samples positive for YF virus infection was not accurate.

Maps of Kenya can be accessed at
<http://www.ogiek.org/photo-gallery/kenya-map-big.jpg> and
<http://healthmap.org/r/0JN_>. - Mod.TY]

******
[2]
Date: Wed 4 May 2011
Source: AllAfrica, Daily Nation (Kenya) report [edited]
<http://allafrica.com/stories/201105050280.html>


The government has dispelled fears over the presence of yellow fever
in Baringo and the country in general. Public health minister Beth
Mugo said on Wednesday [4 May 2011] that currently there are no
laboratory-confirmed cases of the disease, allaying fears on the
prevalence of the fever-disease. "I assure the general public that
those intending to visit the country that there are no known cases
that meet the case definition standard or are laboratory confirmed to
be yellow fever," she told journalists at a media briefing at her Afya
House office. However, she cited Baringo, Koibatek, Keiyo, and
Marakwet as yellow fever high-risk areas in the country though
vaccination of the disease was routinely administered at 9 months [of
age] for children in these areas.

On the suspected cases of 16 patients from Baringo county, she said
that initial confirmatory tests had all turned negative for the
disease though a second set of confirmatory tests had been requested.
The results will be released by the end of this week, she said. "We
also conduct catch-up vaccination campaigns every 10 years with the
last one having been done in 2002 and the next one due in 2012," the
minister said adding that the upcoming campaign was not triggered by
the current yellow fever scares in the area.

She urged the public in the high risk areas preventive measures to
keep the disease at bay. "Protect yourselves from mosquito bites by
wearing long sleeved clothing, sleeping under insecticide treated nets
and using mosquito repellents," the minister advised the public.

The minister said that one of the 2 patients suspected to have died
of yellow fever 3 weeks ago at Moi Teaching and Referral Hospital had
their blood sample tested negative for the disease at KEMRI
laboratories. "No specimen was taken from the 2nd patient because it
was established that he had drank poison prior to the onset of
haemorrhage," Mrs Mugo said. However the minister said a team from
KEMRI's centre for Infectious and Parasitic Diseases Control research
in Busia had visited Baringo county last week [week of 25 April] and
randomly collected 14 blood samples from patients presenting with
fever at Kapluk dispensary and Kabarnet district hospital and all
tested negative for the disease.

[byline: Joy Wanja]

--
communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

******
[3]
Date: Thu 5 May 2011
Source: Daily Nation [edited]
<http://www.nation.co.ke/News/Yellow+fever+in+Kenya+No+way+says+minister+/-/1056/1157170/-/5j461o/-/index.html>


Public health minister Beth Mugo said on Thursday [5 May 2011] there
were no laboratory-confirmed cases of the disease. "I assure the
general public and those intending to visit the country that there are
no known cases that meet the case definition standard or are
laboratory confirmed to be yellow fever," she told a media briefing at
her Afya House office.

Last week [week of 25 April], Baringo North District medical officer
of health Felix Atisa also dismissed claims that a man had died of
yellow fever in the area although the Kabarnet District Hospital
medical superintendent Robert Pukose had said the man died from
haemorrhagic fever, "which is common among patients with yellow
fever."

Dr Pukose told journalists that a post-mortem examination at Moi
Teaching and Referral Hospital in Eldoret confirmed the cause of death
to be yellow fever. He named Baringo, Koibatek, Keiyo, and Marakwet as
yellow fever high-risk areas, although vaccination was routinely
administered at 9 months [of age] for children in these areas.

On the suspected 16 cases from Baringo County, the minister said,
initial tests had all turned negative for the disease [YF virus
infection], although a 2nd set of confirmatory tests had been
requested. The results will be released by the end of this week, she
said.

"We also conduct catch-up vaccination campaigns every 10 years with
the last one having been done in 2002 and the next one due in 2012,"
the minister said. The upcoming campaign, she said, was not triggered
by the current yellow fever scare in the area.

Mrs Mugo urged the public in the high-risk areas to take preventive
measures to keep the disease at bay. "Protect yourselves from mosquito
bites by wearing long sleeved clothing, sleeping under insecticide
treated nets, and using mosquito repellants," the minister told the
public.

She said that one of the 2 patients suspected to have died of yellow
fever 3 weeks ago at Moi Teaching and Referral Hospital had their
blood sample tested at KEMRI laboratories and the result was negative
for the disease. "No specimen was taken from the 2nd patient because
it was established that he had drank poison prior to the onset of
haemorrhage," Mrs Mugo said.

A team from KEMRI's Centre for Infectious and Parasitic Disease
Control research in Busia had visited Baringo last week [week of 25
Apr 2011] and collected 14 blood samples from patients presenting with
fever at Kapluk Dispensary and Kabarnet District Hospital and all
tested negative for the disease.

 

[alert]

Re: Baringo, Kenya: Several die of hemorrhagic illnesses - yellow fever denied - malaria, poisoning confirmed

The article as a whole is about the Ebola outbreak in Uganda, but contains this blurb resolving this situation.

http://www.capitalfm.co.ke/news/Kenyanews/Kenya-is-Ebola-free,-experts-say-13159.html

[snip]


The Public Health Director also disputed claims that there was an outbreak of yellow fever in some parts of Rift Valley saying those reports were misleading.

He explained that only one case tested positive for yellow fever because the virus had been introduced to his body when he was being immunised. Samples of the patient?s blood work were also taken to the Kenya Medical Research Institute for further tests and turned out negative.

?These rumours have been creating a lot of anxiety among people. The first cases that were reported were from the Moi Teaching and Referral hospital and they turned to be malaria and poisoning,? he said.

?We have been yellow fever free for the last 10 years; someone just assumed it was yellow fever without even testing,? he added.

Dr Sharif also said that Kenya would be breaching international laws if it did not report such an outbreak to the WHO and CDC. All countries are required to report any international health threats to these bodies or face sanctions.



Read more: http://www.capitalfm.co.ke/news/Kenyanews/Kenya-is-Ebola-free,-experts-say-13159.html#ixzz1P14OTdWA
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