Kenya: Mandera Cholera Outbreak Emergency Plan of Action Final Report DREF n° MDRKE038

A. Situation analysis

Description of the disaster Kenya reported cholera outbreak that affected 30 of its 47 counties. The outbreak begun on 26 December 2014, in Nairobi County and was later reported in other counties with the latest being in Mandera and Tana River counties.
Mandera County had also been experiencing a febrile illness presenting with joint pains that begun in May 2016.

Based on past outbreaks of dengue fever experienced in the county, health officials suspected it to be another dengue fever outbreak, however laboratory tests conducted by KEMRI, confirmed it to be Chikungunya fever.

Situation in Mandera

Cholera Outbreak

Mandera County is in the North-Eastern Region of Kenya. It was the latest county to report cholera outbreak. Diarrhoea has been the leading cause of morbidity especially during the dry season, when water is scarce and the wet season, when water sources are contaminated.
The outbreak was first reported in March 2016, with 894 cases reported by 12 April 2016. By the end of the response, 1629 cases had been reported with 18 deaths recorded - Case Fatality Rate (CFR) of 1.1%. KRCS reached a total of 391,941 people through awareness sessions conducted in house to house visits including revisits, demonstration of hand washing and hand washing facilities. This represented almost double the target population due to revisits and the huge population affected by the outbreaks. The cases admitted at the CTCs were given a discharge package which included sensitization and distribution of soaps, buckets and water treatment chemicals. The response by the KRCS, MoH and other partners helped contain the outbreak within Mandera East Sub County.

Chikungunya outbreak

Chikungunya fever was confirmed in Mandera East sub-county on 20 May 2016. In total 1574 cases were documented, with no deaths reported. Cases with severe debilitating joints pains were managed as short stay inpatients for 5 days, however most the cases were however treated as outpatients.

A KRCS surge team was deployed on standby due to the high risk of personnel getting infected with the Chikungunya virus. Measures were put in place through provision of mosquito repellents to protect the staff from bites by infected mosquitoes. During the response period, six of the KRCS personnel deployed were infected with the virus.

Meetings to discuss means of containing the outbreak were held with Mandera county, national government and Somalia (Somalia experienced outbreaks of Cholera and Chikungunya). The borders had to be closed to reduce number of cases.