CHOLERA AND TYPHOID OUTBREAKS IN KENYA IN THE PAST 40 YEARS Cholera is an infection of the small intestine caused by the bacteria Vibrio cholerae.Its main symptoms are watery diarrhoea and vomiting.Vibrio cholerae are free-living organisms found in fresh and brackish water. Cholera infections are most commonly acquired from drinking water in which the Vibrio cholerae is found naturally or into which it has been introduced from the faeces of a symptomatic or asymptomatically infected person. Another common vehicle is contaminated fish and shellfish. Transmission from person-to-person, including to healthcare workers during epidemics, has been documented but is uncommon. Kenya has had numerous outbreaks of cholera since the first case was reported in Turkana in the year 1971.Fifteen discrete outbreaks of cholera were documented during 1971–2010.From 1974 to 1989, Kenya reported cholera cases every year with an average fatality rate of 3.5%.The largest epidemic started in 1997 and lasted until 1999 with more than 33,400 reported cases. The 1997 outbreak started in June along the Lake Victoria and spread to Kenya's third largest city (Kisumu) in mid-October; it had spread to Siaya District by early November. From 2000 to 2006, cases were reported each year ranging from 1,157 to 816 except for 2002, with 291 cases. Cholera outbreaks affected 4 provinces in 2007: Rift Valley, Coast, North Eastern and Nyanza, with 625 cases and a case fatality rate of 5.6%; and 4 provinces in 2008: Nyanza, North Eastern, Western and Rift Valley, with a cumulative number of cases nationwide of 1,243 and 67 deaths. In western Kenya during January–April 2008, the cholera outbreak affected 10 administrative districts in Nyanza Province (adjacent to Lake Victoria), resulting in 790 cases and 53 deaths (case-fatality rate 6.7%).The peak of the outbreak (January 2008) occurred after the December 2007 presidential election in Kenya, which had disputed results that triggered periods of...
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