Cholera outbreak in Murang'a threatens ban on food hawking, public feasting 

The Murang'a County security committee has formed a team to combat a cholera outbreak.

This follows last Wednesday's report from the Ministry of Health that listed the county among six with the disease.

The committee warned that it may suspend food hawking, public feasting and open-air food kiosks as confirmed cases hit three by Sunday.

To avoid a ban, all players were warned to observe high levels of hygiene, especially frequent handwashing and using clean water to cook and wash dishes.

County Commissioner Karuku Ngumo said that "we have already taken heed and we have come together as the central and county governments in line with our public health officers, chiefs and their assistants, water service providers and community health volunteers to solidify our preparedness".

On Friday, the Kigumo courthouse was temporarily closed for fumigation.

Cholera is an acute enteric infection caused by the ingestion of the bacterium Vibrio cholerae found in contaminated water or food and is primarily linked to insufficient access to safe water and adequate sanitation.

It is considered a potentially serious infectious disease and can cause high morbidity and mortality. It can also spread rapidly, depending on the exposure frequency and population exposed.

Mr Ngumo said all wards were put on high alert for possible full-scale cholera outbreaks.

Deputy Director of Medical Services Dr Stephen Ngigi said teams were working to reactivate a disease outbreak management strategy at all levels and confirmed cases will be immediately isolated.

If cholera is detected “in one health facility, no referral should be authorized, so as to minimise morbidity and mortality,” he said.

Dr Ngigi added that the county had directed that case diagnosis and treatment be carried out at the source, “this calling for improved laboratory capacity for specimen collection and shipment”.

Reported serotype

He said the reported serotype is the Vibrio cholera-01-Ogawa.

Dr Ngigi said the raging drought in Kenya may worsen the outbreak.

To that end, he directed that the division of disease surveillance and response, that of epidemiology and the laboratory programme stay alert for emergency response.

"This is in line with the World Health Organisation's recommendation that readiness of counties and health facilities be upped to detect early and respond promptly to any cholera outbreak risk," he said.

All health facilities, he added, were directed to take special notice of patients exhibiting watery diarrhea of acute onset and thoroughly monitor such cases in communities

Governor Irungu Kang'ata said there was no cause for alarm because "related medical supplies have been procured and supplied to all health facilities".

He said work was continuing to keep the county alert.

Laboratory testing

“Those activities include field investigations, enhanced surveillance, contact tracing, laboratory testing, case management, risk communication, community engagement and environmental sanitation to prevent further spread of the disease,” Dr Kang'ata said.

Water company Muswasco has set aside Sh50 million to prevent a potential crisis in high-risk areas like markets, said Managing Director Mary Nyaga.

Mr Ngumo announced that holding people in police cells and correctional centres will be monitored.

“To that end, we are also advising our police station commanders and prison warders to be very cautious on hygienic levels in the cells as well as exercising due diligence in the cases they admit as guests of the state,” he said.

Cholera outbreaks have been reported every year, with large cyclical epidemics every five to seven years.

A major challenge in dealing with cholera outbreaks is primarily limited capacity for response and low access to safe water. The Public Health department has been accused of lax enforcement of food safety bylaws, especially those items that are hawked, and in eateries.

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