The World Health Organisation has asked countries not to impose travel restrictions as the cholera pandemic continues to spread.
The advisory comes as a top researcher from the Kenya Medical Research Institute said the bacteria that causes cholera has become resistant to some commonly used antibiotics.
The disease has now spread to at least 18 countries this year, including Kenya, where the disease has killed 83 people.
Health CS Susan Wafula said by Saturday, 15 counties had reported an outbreak and a total of 4,566 patients.
WHO asked neighbouring countries to share information rapidly to prevent cross-border infections.
“WHO does not recommend any travel or trade restrictions on member states based on the currently available information,” the organisation said in a statement.
No country has hinted it may bar visitors from countries with outbreaks, but many developed nations have advised their citizens against travelling there.
According to humanitarian group MSF, Cholera is caused by food and water contaminated by faces and is easily cured by rehydration salts and medication.
"In its severe form, cholera is characterised by a sudden onset of acute voluminous watery diarrhoea that can rapidly lead to dehydration and death if left untreated," Dr Nitya Udayraj, the MSF medical coordinator in Kenya, told journalists.
Researchers say a major concern with cholera is its high rate of fatalities. The average case fatality ratio for cholera is 1.9 per cent, but in Africa, it is 2.9 per cent.
In 2021, 23 countries reported cholera outbreaks, mainly in Africa and the eastern Mediterranean.
This trend continued into 2022 when 30 countries around the world reported cholera cases or outbreaks.
“As of February 1. 2023, at least 18 countries continue to report cholera cases,” WHO said.
Dr Udayraj says symptoms begin anytime between 12 hours and five days but most people will develop no or mild to moderate symptoms.
The disease is easily treatable with a rehydration solution, and can be prevented with an oral vaccine.
Udayraj attributes the current surge to many factors including climate change, natural disasters, drought, cyclones, floods, and monsoons.
"Others are people displacement, conflict, political instability and multiple ongoing emergencies such as Covid-19, measles, monkeypox, Ebola, and dengue," she told journalists at a meeting organised by MSF and the MESHA, a Kenyan science journalists association.
Zimbabwean public health lobbyist Maria Chiwera told the meeting response from the government is key in tackling cholera outbreaks.
She noted in the last outbreak in 2018 the Zimbabwean government declared a national emergency just five days from the first reports.
" This was important because the denialism in 2008 meant that responses from NGOs and other stakeholders were also delayed. In 2018 NGOs like MSF were quickly deployed to hotspots offering treatment, sanitizers," she said. Chiwera works with Women Action Group (WAG).
In Kenya, an assessment conducted by the Ministry of Health in collaboration with the affected counties identified several risk factors driving the ongoing spread.
They include outsourcing of food from food vendors with poor hygiene standards and congestion in the refugee camps leading to overstretching of sanitary facilities.
Others include poor sanitation in informal urban settlements, and the spreading of unregulated water vendors.
“Prolonged drought has led to the scarcity of safe drinking water in Asals. forcing communities to fetch water from contaminated shallow wells,” CS Wafula said on Saturday.
“For us to fast-track containment of the outbreak, we must all rise up and collectively address these drivers. This calls for a stronger multi-sectoral, multi-agency involvement.”
Samuel Kariuki, the director of the centre for microbiology research at Kemri, recently said all oral cholera vaccines have an effectiveness rate of between 60 per cent to 80 per cent but require a yearly booster.
“There’s not been a concerted vaccination campaign in many countries, however, because governments are not taking the prevention and control of the disease seriously,” he said in an article appearing in the journal 'Conversation'.
He was part of a team that carried out a study in a study in Kenya which found that the bacteria that causes cholera has become resistant to some antibiotics.
“The overuse of antibiotics also contributes to drug resistance. Government agencies should develop ways to monitor the use of antibiotics and restrict their prescription,” Dr Kariuki said.
He said in the longterm African countries need improved water hygiene infrastructure, housing and enhanced socioeconomic conditions.
“But there must be a strong will by relevant government ministries to work together to realise these goals,” he said.
(Edited by V. Graham)
