WHO supports Ministry of Health to contain Chikungunya outbreak
January 17, 2018: World Health Organization, WHO, is helping the government to contain an outbreak of Chikungunya in Mombasa following reports from clinicians of increased unknown febrile illness that presented with very high fever, joint pains and general body weakness. The tests were found malaria negative and sometimes dengue fever negative.
The outbreak has affected all the six-sub counties namely, Mvita, Kisauni, Nyali, Changamwe, Jomvu and Likoni. Most cases are found on the island, Mvita.
By January 4, 2018, the Ministry of Health had reported 69 cases of which 32 samples have been tested at the Kenya Medical Research Institute (KEMRI) Labs in Nairobi. Twenty-seven (27) of the cases were found positive while five were negative.
Chikungunya is a mosquito-borne viral disease characterized by an abrupt onset of fever frequently accompanied by joint pain. Other common signs and symptoms include muscle pain, headache, nausea, fatigue and rash. The joint pain is often very debilitating, but usually lasts for a few days or may be prolonged to weeks. The virus can cause acute, subacute or chronic disease.
The Ministry of Health is monitoring the situation and Kenya Medical Research Institute, KEMRI, has sent a rapid response team to support Mombasa County after initial lab examination found positive cases. Of the eight samples, 50% (4) were confirmed positive for chikungunya and 50% (4) for dengue. In addition, two (2) samples had both chikungunya and Dengue (Co infection). WHO is providing technical support and is monitoring the situation. An emergency officer is on the ground to do a rapid assessment and to support the teams, Country Representative Dr Rudi Eggers has said.
Reports of Chikungunya were first reported in mid-December and were rapidly followed up by collection of blood samples by the Disease Surveillance Unit. These were submitted to two private hospitals and to KEMRI labs in Nairobi for examination and confirmation. KEMRI then sent a rapid response team.
A batch of another 32 samples was collected and shipped to KEMRI labs by the team on January 4, 2018. The results indicate that majority, 27, of the cases were found positive of the disease while five were negative.
In response to the outbreak the Mombasa County has initiated various emergency and response activities which will continue for two weeks. These are:
Chikungunya control activities with regular review meetings initiated by the Mombasa County Outbreak Management Team;
Chikungunya outbreak alert and fact sheet issued to all sub counties and health facilities including private hospitals
Fliers have been developed and are distributed to households through the community health volunteers (This is integrated with cholera and control dengue activities
Vector Control activities have been strengthened
An emergency kitty has been established and budget approved by the County to accelerate activities
Vector control chemical, Mos n Roch, 200Ltrs has been procured to facilitate fogging.
Four fogging machines have been procured by the County and launched on January 8, 2018, by His Excellency the Governor, Ali Hassan Joho The intensified response and rapid assessment will help contain the outbreak and the public have been urged to visit health facilities for proper assessment and management. “We expect these cases to be contained as those affected report to health facilities for proper assessment and management,” Dr Eggers said.
The response is hampered by community members treating themselves at home hence few cases being seen in hospitals, existence of massive breeding sites in the affected areas and inadequate vector control chemicals.
Chikungunya is a preventable and self-limiting disease. Communities have a major role to play to control the outbreak and are encouraged to use personal protection measures to minimize human contact with mosquitoes in the form of mosquito repellent preparations over the exposed body parts, and insecticide-treated bed nets and window screens even while sleeping during the day. They should be advised to cooperate during spraying, fogging and destruction of larvae before they mature into full grown mosquitoes. Other measures that communities should take include:
Keeping the environment clean, eliminating mosquito breeding- Weeds and tall grasses in all premises should be chipped as adult mosquitoes look for these shady places to rest during the hot daylight hours;
Have infants and others required to sleep during the daytime do so under bed nets;
Intensify efforts to remove stagnant water from all junk items lying unattended in the peri-domestic area;
At the school level, school children should be imparted health education on all aspects of chikungunya fever, including what it is, how it spreads, the role of mosquitoes, where and how they breed/rest, and how they can be controlled.
”We support the call by the county to urge members of the public to report to health facilities for proper assessment and management and to clear bushes and garbage to avoid further breeding of the mosquitos” Dr Eggers added.