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Rift Valley fever outbreak--Kenya, November 2006-January 2007.

Article Excerpt
In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By December 20, a total of 11 deaths had been reported. Of serum samples collected from the first 19 patients, Rift Valley fever (RVF) virus RNA or immunoglobulin M (IgM) antibodies against RVF virus were found in samples from 10 patients; all serum specimens were negative for yellow fever, Ebola, Crimean-Congo hemorrhagic fever, and dengue viruses. The outbreak was confirmed by isolation of RVF virus from six of the specimens. Humans can be infected with RVF virus from bites of mosquitoes or other arthropod vectors that have fed on animals infected with RVF virus, or through contact with viremic animals, particularly livestock. Reports of livestock deaths and unexplained animal abortions in NEP provided further evidence of an RVF outbreak. On December 20, an investigation was launched by KMOH, the Kenya Field Epidemiology and Laboratory Training Program (FELTP), the Kenya Medical Research Institute (KEMRI), the Walter Reed Project of the U.S. Army Medical Research Unit, CDC-Kenya's Global Disease Detection Center, and other partners, including the World Health Organization (WHO) and Medecins Sans Frontieres (MSF). This report describes the findings from that initial investigation and the control measures taken in response to the RVF outbreak, which spread to multiple additional provinces and districts, resulting in 404 cases with 118 deaths as of January 25, 2007.

Teams of investigators conducted patient interviews and reviewed medical records from December 1 forward in major health-care facilities in the districts from which cases were first reported. The teams detected additional cases by meeting with elders, other leaders, and health-care providers in villages where cases had been reported and in adjacent villages. Blood samples from patients with suspected RVF were collected and maintained at 39.2[degrees]F (4.0[degrees]C). Samples from NEP and surrounding areas were transported to a field laboratory established at Garissa Provincial Hospital by CDC, KEMRI, and KMOH; samples from other areas were sent to KEMRI laboratories in Nairobi and to a laboratory in Malindi that was supported by a team from Health Canada.

A suspected case was defined as acute onset of fever (>99.5[degrees]F [>37.5[degrees]C]) with headache or muscle and joint pain since December 1 in a person who...

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