•It is a deadly but treatable and preventable virulent disease and can kill within hours of infection.
•Persons with low immunity, such as malnourished children, those with underlying illnesses or people living with HIV are at a greater risk of death if infected.
Cholera is a severe intestinal diarrheal infection occasioned by ingestion of food or water contaminated with Vibrio Cholera bacterium, often from faeces.
Notably, the bacteria can remain in the stool of an infected person for a fortnight and many times returns to the environment when one defecates.
It is a deadly but treatable and preventable virulent disease and can kill within hours of infection. Persons with low immunity, such as malnourished children, those with underlying illnesses or people living with HIV are at a greater risk of death if infected.
The disease can be endemic or epidemic. A cholera endemic area is where confirmed cases were detected during the last 3 years with evidence of local transmission.
An outbreak or epidemic can occur in both endemic counties where the illness does not regularly occur. Speed remains of the essence in the response to save lives and contain an outbreak.
Over 7000 people have been affected by Cholera in 30 counties, since the outbreak on 19th October last year. Consequently, over 122 people have lost lives.
Data from International Federation of Red Cross(IFRC), indicates from June to July 2023, 19 counties out of the 30 initially affected have achieved control in managing the outbreak.
Yearly, the number of Cholera cases reported to WHO continues to be high. In 2020, 323,369 cases, 857 deaths were reported from 24 countries.
The discrepancy between these figures and the estimated burden of the disease might be due to limitations in surveillance systems and fear of impact on trade and tourism.
Kenya is not yet off the hooks and ill effects of Covid-19. A resurgence of isolated cases of Covid-19 are being reported, with symptoms of the variant appearing to soar.
Researchers have estimated that each year there are 1.3 to 4.0 million cases of Cholera and 21,000 to 143,000 deaths worldwide due to Cholera. The situation needs to be pugnaciously curbed lest it spirals to undesirable intensity.
Inadequate environmental management and humanitarian crises like disruption of water and sanitation systems or the displacement of populations to inadequate and overcrowded camps increases the risk of Cholera transmission in the event of an outburst. Typical at-risk areas include peri-urban slums, where basic infrastructure is either not available or over stretched.
A recent Kenya Health Demographic Health System survey indicates, Counties like Wajir and Garissa reported 76.7% and 48.2% of its population defecating in the open as compared to Uasin Gishu’s 1.8% with the national average at 43%.
A multifaceted approach is salient in curbing Cholera and reducing deaths. A combination of surveillance, water, sanitation and hygiene, social mobilisation, treatment and oral cholera vaccines by and large should be adopted.
Cholera surveillance should be part of an integrated disease surveillance system that encompasses feedback at the local and information sharing at the Counties and national levels.
Long term solution for cholera lies in economic development and universal access to safe drinking water and adequate sanitation. There is a need to champion actions targeting the environment to adapt long term sustainable WASH solutions.
These will boost the use of safe water, basic sanitation and good hygiene practices in the hotspot counties. Such interventions prevent a wide range of other water borne illnesses such as Hepatitis A, Dysentery, Typhoid fever, Salmonella and Giardia.
Local cultural practices and beliefs remain central in promoting and adopting protective hygiene measures such as hand washing with soap, safe preparation and storage of food as well as proper disposal of the faeces.
The ministry of health relaunched a 10-day Cholera vaccine uptake and awareness campaign targeting eight sub-counties. The drive aims at vaccinating 1.7 million individuals. This is laudable and citizens should heed to the call.
Let us be cautious within our midst right from food vendors to learning institutions, social gathering places like, churches, mosques, eateries and entertainment joints, funerals and weddings by maintaining increased levels of hygiene standards.
County governments should not relent in setting up robust responsive measures to ensure high rates of access to health care and WASH services. The unemployed, largely the youths, should be utilised in implementing programs geared towards environmental sanitation.
The Division of Disease Surveillance and Response (DDSR), Field Epidemiology and Laboratory Program(FELP) and County departments of health should be fully supported in their Cholera responsive measures that includes field investigations, enhanced surveillance, laboratory testing and case management to prevent further spread of the disease and optimally manage outbreaks.
The vaccination and awareness drives should be progressive. Prudently nurturing the culture of being sensitive to the environment will impact positively towards taming the Cholera menace.