Kenya - MoH press release on an unknown disease in Kalamega county - 1 062 cases, 4 deaths - April 14, 2023 - Preliminary results positive for entero

[Shiloh]

Source: https://www.aa.com.tr/en/africa/unknown-disease-kills-4-in-kenya-health-ministry/2872618

Unknown disease kills 4 in Kenya: Health Ministry
Officials say 627 patients ill; 19 students admitted to 7 health facilities
Andrew Wasike | 15.04.2023 - Update : 15.04.2023


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Unknown disease kills 4 in Kenya: Health Ministry
Officials say 627 patients ill; 19 students admitted to 7 health facilities
Andrew Wasike | 15.04.2023 - Update : 15.04.2023


NAIROBI, Kenya

The Kenyan Health Ministry issued an alert Friday because of an outbreak of an unknown disease in western Kakamega County that has killed four people.

The disease was discovered in the Mukumu Girls and Butere Boys high schools, with 627 patients ill as of April 14, Director General for Health Patrick Amoth said in a statement.

“Unfortunately, we have lost 4 patients to this illness. We at the Ministry of Health send our heartfelt condolences to the families who have lost their loved ones,” said Amoth.

The Health Ministry said the disease presents fever, abdominal pain or cramps, vomiting and diarrhea.

Comprehensive investigations are currently underway to determine the cause. Data analyzed indicates that the disease seems to have started March 15.

The government has since closed the two affected schools as investigations continue. Meanwhile, 19 students suffering from the illness are in stable conditions at seven health facilities across the country.

The Ministry has taken several water, food and human tissue samples from affected areas for preliminary laboratory investigations.

The tests conducted have revealed similar symptoms to those seen in enterotoxigenic E. coli and salmonella typhi patients.

Laboratory tests for viral hemorrhagic fevers, including Ebola, Marburg, Leptospirosis and Crimean-Congo hemorrhagic fever, dengue fever, Rift Valley Fever and the West Nile virus have been negative...

 

[sharon sanders]

Ministry of Health

@MOH_Kenya
PRESS RELEASE ON AN OUTBREAK OF UNKNOWN DISEASE IN KAKAMEGA COUNTY


10:03 AM · Apr 14, 2023
·
70.9K
Views

 

[Pathfinder]

Mukumu Girls: Killer illness is severe typhoid from contaminated water

Saturday, April 15, 2023

By Angela Oketch
Health and Science reporter

Nation Media Group

A report on the disease outbreak that has so far killed four people at Mukumu Girls' Secondary School in Kakamega County indicates a case of severe typhoid from water contaminated with salmonella typhi. Results of tests shared by the Ministry of Health Friday also show that the infection that has seen three students and one teacher die this month is a mixture of both salmonella and enterotoxigenic e-coli bacteria.
...
When the outbreak first struck at Mukumu Girls', at least 246 students were hospitalised with vomiting, diarrhoea and dizziness, which are typically symptoms of a salmonella infection. At that stage, Ministry and county officials inspected the school and opened an investigation, which saw samples collected and taken to the Kenya Medical Research Institute (Kemri) for analysis.

In a statement on Friday, the Ministry said that the number had increased to 627, with patients from both Mukumu Girls' and Butere Boys'. It said 19 patients were at seven health facilities across the country and that they were all stable. The two schools were closed.

On Friday, a report from Kemri showed that the affected students suffered severe typhoid. Kemri said laboratory tests found water contamination by E. coli and Salmonella Typhi caused the illness.

Earlier, a post-mortem found that the third student who died at Kakamega General Hospital suffered from multiple organ failure due to a bacterial infection.
...

https://nation.africa/kenya/countie...evere-typhoid-from-contaminated-water-4199472

---------------

Kakamega Health Officials Step Up Measures To Manage Disease Outbreak

KNA3 April 15, 2023 Counties, Editor's Pick, Health, Kakamega0
...
Governor Barasa was speaking to the Media at the Kakamega General Hospital while giving updates on the management of the disease outbreak at Mukumu Girls High school that led to temporary closure of the school and has so far claimed 4 lives including 3 students and one teacher.

He urged parents and county residents to be calm and not to panic about the situation, but to ensure that they take their children to hospitals immediately, if they present symptoms related to the disease and any other disease symptoms.
...
The Governor disclosed that 350 cases were reported by the county surveillance team from the school as having symptoms of acute fever, diarrhea, vomiting and abdominal pains.

“Out of the 350 listed cases, 287 have been managed as outpatient while 63 were managed as inpatient at different sites in different facilities,” he pointed out.

Apart from Kakamega General Hospital, Governor Barasa said students who fell ill are undergoing medical treatment in various hospitals across 7 counties of Nairobi, Trans Nzoia, Kisii, Bungoma, Uasin Gishu, Bomet, and Vihiga.

He noted that preliminary investigations by both the county and national government reveal that the disease could have been caused by a bacterial infection due to contamination of food and water directing the school administration to destroy all foodstuff and clean and chlorinate all water facilities.

By Moses Wekesa

https://www.kenyanews.go.ke/kakamega-health-officials-step-up-measures-to-manage-disease-outbreak/

 

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 18: 24-30 April 2023
Data as reported by: 17:00; 30 April 2023
...

Kenya

Gastroenteritis outbreak

1 062 Cases
4 Deaths
0.4% CFR

EVENT DESCRIPTION

On 31 March 2023, the Kenyan Ministry of Health was
notified of a disease outbreak of unknown aetiology
presenting with features of gastro enteritis from a girls
boarding school in Kakamega County. On 28 March 2023,
a large cluster of 124 high school students presented to
the school clinic and a nearby hospital where they were
eventually referred to Kakamega County Hospital.

This prompted the school principal to formally inform
the county health authority of the unusual disease in the
school on 31 March 2023. The school was closed on 3
April 2023 by the authority of the Ministry of Education
and the students were sent home, which students come
from all over the country.

Overall, more than 300 students have been treated as
outpatients while at least 39 students were admitted at
the Kakamega County Hospital from this outbreak.
Retrospective investigations revealed that the initial
outbreak cases emerged on 1 March 2023 when 13
students presented to the school nurse with fever,
abdominal pain, vomiting, diarrhoea and other symptoms.

As of 20 April 2023, a total of 1 062 case-patients have
been reported including four deaths (CFR 0.4%). The
deaths occurred among three students and one teacher.
Overall, 1 004 (94.5%) of the cases were students and 28
were staff (2.6%). The attack rate among students was
49.8% for a population of 2 018 students. The average
age of cases affected was 15.8 years.

Analysis has been conducted on human, water, and
food samples with preliminary results showing positive
findings for enterotoxigenic E. coli and Salmonella
Typhi. However, further analyses are being conducted to
consider other possible causes such as contamination
from heavy metals or pesticides and long-term exposure
of other compounds which might be contributing to the
sequelae of the disease process.

The epidemic curve shows the evolution of the outbreak,
which began in early March and progressed with
multiple increasing peaks reaching the highest amount of
cases on 28 March 2023. The amount of cases started
declining and thereafter more rapidly following the closure
of school on 3 April 2023. The last documented new case
was reported on 16 April 2023.

The propagated nature of the epidemiologic curve
suggests that the outbreak was caused by person-to
person transmission and has a short incubation period.
However, cases that were reported following the closure
of the school on 3 April, suggest that other pathogens with
longer incubation periods might also be causative agents.

The same day the girls high school was closed, another
school in Kakamega County reported a similar outbreak
in a boys high school about 40 km away. On 3 April
2023, students started reporting diarrhoea, abdominal
pain, and vomiting immediately after breakfast. Following
preliminary analysis of human, environmental, and food
samples, E. coli has also been found, however other
analyses are still being conducted. The outbreak was
said to be unrelated to the outbreak in the girls school,
nonetheless the boys school was also closed on 4 April
2023. As of 20 April 2023, 179 cases and no deaths had
been reported from the boys school. All cases have now
recovered.

PUBLIC HEALTH ACTIONS

National-level and county-level outbreak coordination
is active where teams are based at their respective
Public Health Emergency Operations Centres

The outbreaks were investigated by county-level
response teams

National-level teams were also supported by partners
to conduct further investigations and risk assessments

National call lines are active for parents to obtain
guidance regarding the outbreak and the well-being
of their children

Response teams were actively following-up cases by
phone since students were sent home and dispersed
throughout the country

There were ongoing daily engagements between the
County health team and infectious disease experts
for guided case management

Treatment guidelines for enterotoxigenic Escherichia
coli and salmonella typhi were established and
distributed

Coordination of sample collection, packaging,
shipment, and follow-up with the testing laboratories
is ongoing

Water, sanitation, and food hygiene team from the
national-level was deployed to the girls school to
investigate and collect samples

Radio talk shows have been aired about the girls
school outbreak

Risk communication activities have occurred at the
local churches for the girls school outbreak

Information, education, and communication materials
have been developed and shared on social media
platforms

Psychosocial support has been provided to 49
teaching and non-teaching staff

Rumour tracking is ongoing to help guide the response
of the outbreak.

SITUATION INTERPRETATION

An outbreak at a girls high school in Kakamega County
has affected almost half of the student population.
Laboratory findings have produced some leads to the
causal agent with E. coli and Salmonella typhi being
the main considerations. However, further laboratory
analyses are being conducted on both the girls and boys
high schools that were affected. Investigatory findings
also suggest that the causal agent in the girls school
was from communicable transmission with a possible
short incubation period with perhaps some underlying
pathogen with a longer incubation period.
...
https://apps.who.int/iris/bitstream/handle/10665/367498/OEW18-2430042023.pdf​