Emergency Operations and Workforce Development Programs Impact National Cholera Response

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In 2017, Kenya experienced a surge in cholera cases across the country, including urban outbreaks in the capital city, Nairobi. A total of 3,967 cases including 76 deaths were reported across 20 of 47 counties (43%) in the country. By the end of the year, seven counties continued to have active cholera outbreaks. Although Kenya experiences cholera outbreaks every year, 2017 included a number of point source outbreaks in affluent sections of Nairobi, including at a wedding, a high-end hotel and at a large conference. As the number of reported cholera cases increased substantially, the Government of Kenya (GOK) established a national task force to coordinate response activities. CDC Kenya was one of many partner agencies who provided technical support. The Kenya MOH developed a national response plan to scale-up response activities such as surveillance, case management, and social mobilization. The GOK also initiated strict food hygiene standards and promoted safe food handling requirements in addition to scaling-up of water, sanitation, and hygiene (WASH) activities.

Following guidance from CDC Kenya and WHO, the MOH activated the Public Health Emergency Operating Centre (PHEOC) for the first time and identified an Incident Manager to coordinate the response. FELTP residents were assigned to the PHEOC where they updated line lists, analyzed data, developed situation reports, called contacts and other persons of interest and were part of rapid response teams. In Nairobi, FELTP residents were also placed at the four main cholera treatment centers (CTCs) where they provided epidemiological support and served as a link between the PHEOC and the CTCs. The residents also participated in other specific investigations including:

  • Case control study in Nairobi,
  • Investigation of the cholera outbreak at a health conference, a nursing school and among police officers in Nairobi,
  • Knowledge, attitudes and practice study among health workers and community members in four sub-counties in Nairobi, and
  • Outbreak investigation in Siaya County in western Kenya.

Measures to end the outbreaks are ongoing across the country, including timely case management in cholera treatment centers and key public health communication messages.