FELTP Residents investigate suspected Anthrax outbreak in Narok County, Kenya

A team of residents including; Mathew M. Mutiiria - Team Lead & Resident, Kenya-FELTP, Dr. Jack Omollo - Field Supervisor, Kenya-FELTP, Dr. Gerald Munai; Resident, Kenya-FELTP, Dr. Philip Ngere- EOC/DSRU, Fred Otieno – WSU and Dr. Grace Njeri- ZDU investigated a suspected Anthrax outbreak in Narok Country, Kenya.

Anthrax is a zoonotic disease of public health significance associated with human and livestock morbidity and mortality as well as decreased trade in livestock and derived products. These outbreaks in animals mostly occur during prolonged periods of hot, dry weather following heavy rain and flooding. Human infection is correlated with incidence of disease in domestic animals (Doganay et al., 2015). Majority of human cases occur in agricultural environment as a result of individuals coming into contact with dead or dying animal. In many impoverished regions, human behaviour and social construct force livestock owners into slaughtering animals at first sign of infection to salvage meat, skin and hides.

Due to its public health and economic impacts anthrax is categorized as notifiable disease. Therefore it is required that all suspected livestock and human cases within Kenya be reported to the government, which upon confirmation must formally inform the World Organization for Animal Health and the World Health Organization (WHO) respectively.

In Kenya recent anthrax outbreaks have been reported in many counties, these includes Tharaka Nithi, Meru, Muranga and Kiambu among other counties. Narok County reported deaths from suspected anthrax where two people died on 13 November 2018. The reports were received through integrated disease surveillance and response (IDSR). Narok county disease surveillance coordinator, reported that about seventeen (17) people presented with lesions on the skin, abdominal discomfort/pain, cough and difficulty in breathing. Two of the people who died were relatives (mother and son). It was reported that the mother was the one who slaughtered the goat.

Following sudden death of a goat in Nkoirero village, unknown number of people were suspected to have consumed the carcases, “The actual number of people who consumed the meat is not known but it’s estimated that over 100 people ate the meat as they were attending a function in the neighbourhood. No samples were collected for laboratory confirmation. However based on signs and symptoms (skin lesions, abdominal discomfort/pain, cough and difficulty in breathing) that patients presented with, anthrax was suspected. Establishing factors associated with exposure and spread of the outbreak will inform future prevention and control strategies.

The investigation was carried out in Oloolaimutia village, Siana ward as well as the health facilities that had reported cases of anthrax. Narok west Subcounty is one of the six sub counties of Narok County.

Together with county health and veterinary services the team visited four villages where public baraza was held. Members of public mostly targeting livestock farmers were sensitized on the issues of anthrax. The risk involved, control measures and what to do in case one feels unwell.

The veterinary services office was urged to consider provision of livestock vaccines and medication for other diseases of livestock. From the baraza, it was visible that the members of public had concern on anthrax disease and was willing to participate in the advised control measures.

The suspected outbreak occurred in November which generally a hot month was including October up to July when we had prolonged rains.

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