title: Rapid spread of Vibrio cholerae O1 throughout Kenya, 2005.
abstract: Between January and June 2005, 5 distinct cholera outbreaks occurred in Kenya. Overall, 990 cases and 25 deaths (2.5%) were reported. Four outbreaks occurred in towns along major highways, and 1 occurred in a refugee camp near the Sudanese border, accessible to Nairobi by daily flights. Matched case-control studies from 2 outbreaks showed that failure to treat drinking water and storing drinking water in wide-mouthed containers were significantly associated with disease. Isolates from all 5 outbreaks were Vibrio cholerae O1, Inaba serotype, and had genetically similar PFGE patterns of SfiI-digested chromosomal DNA. Linkage of the outbreak locations by major transportation routes, their temporal proximity, and similar PFGE patterns of isolates suggests the outbreaks might have been linked epidemiologically, showing the speed and distance of cholera spread in countries like Kenya with pockets of susceptible populations connected by modern transportation. Prevention measures remain implementation of point-of-use safe water systems and case finding and referral.
authors.affiliation: Field Epidemiology and Laboratory Training Program-Kenya, CDC, Nairobi, Kenya. ikmugoya@gmail.com
authors.forename: Isaac
authors.initials: I
authors.lastname: Mugoya
authors.forename: Samuel
authors.initials: S
authors.lastname: Kariuki
authors.forename: Tura
authors.initials: T
authors.lastname: Galgalo
authors.forename: Charles
authors.initials: C
authors.lastname: Njuguna
authors.forename: Jared
authors.initials: J
authors.lastname: Omollo
authors.forename: Jackson
authors.initials: J
authors.lastname: Njoroge
authors.forename: Rosalia
authors.initials: R
authors.lastname: Kalani
authors.forename: Charles
authors.initials: C
authors.lastname: Nzioka
authors.forename: Christopher
authors.initials: C
authors.lastname: Tetteh
authors.forename: Sheryl
authors.initials: S
authors.lastname: Bedno
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D014734:Vibrio cholerae / Q000145:classification*