Cholera is the fastest killer disease in the world ahead of Ebola. It takes only four hours for an infected person to succumb to cholera infection. The recent outbreaks of cholera in Kenya caused the deaths of over 5 people. And this was a harsh loss to the country, which is also haunted by cattle rustling, banditry and terrorism.
The cholera outbreaks were so costly and a big burden to the affected families in terms of medical care costs and absenteeism from work and the psychological torture for kin of the sick. Usually, poor people staying in informal settlements are 10 times at risk of the disease compare to the middle and high classes in the society but this time it was a different game all together. The outbreaks have so far affected the rich more than the poor.
It requires successful anti poverty push and achievement of Sustainable Development Goals. To eradicate cholera requires improved water safety and sanitation. Preventing the disease’ annual outbreaks will be a milestone on our path to realizing economic growth and development. If the situation is not contained then the next thing you hear is banning of fish exports from Kenya by the European Union. And, this will be a disaster and a bad medicine to the country’s economy.
The fish exports ban is usually imposed on East Africa by EU whenever there is an outbreak of cholera. This is despite the World Health Organisation saying that there has been no cholera outbreak linked to commercially imported sea-foods. One way of preventing cholera is through vaccinations. And Kenya has had effective cholera vaccines for the last decade.
The WHO says there are two types of safe and effective oral cholera vaccines currently available in the market. Both are whole-cell killed vaccines, one with a recombinant B-sub unit, the other without. Both have sustained protection of over 50 percent lasting for two years in endemic settings. Both vaccines are WHO’s prequalified and licensed in over 60 countries.
Given the availability of 2 oral cholera vaccines and data on their efficacy, field effectiveness, feasibility and acceptance in cholera-affected populations, immunisation with these vaccines should be used in conjunction with other prevention and control strategies in areas where the disease is endemic and should be considered in areas at risk for outbreaks. Vaccination should not disrupt the provision of other high-priority health interventions to control or prevent cholera outbreaks.
Vaccines provide a short-term effect that can be implemented to bring about an immediate response while the longer term interventions of improving water and sanitation, which involve large investments, are put into place.
Preemptive or reactive vaccination should cover as many people as possible who are eligible to receive the vaccine, and should be conducted as quickly as possible to protect Kenyans from cholera menace.
The oral Cholera vaccine that is available in Kenya has demonstrated efficacy in a large-scale clinical trial among 70,000 residents in Kolkata, India. Results indicate that protection conferred by 2 doses was 65 percent five years after vaccination, the longest protection on record among currently available cholera vaccines.The vaccine given from 1 year to all ages.
It has also been used for Mass Vaccination Campaign in Response to an Outbreak in other African countries. The use of oral cholera vaccine should be alongside already-implemented treatment and prevention strategies and health education such as distribution of soap and chlorine for household water treatment. The Government should undertake this campaign to save the population. Two-dose schedule are required and this will help people in remote rural settings and the highly mobile population. Oral cholera vaccines are a promising new tool in the arsenal of cholera control measures, alongside efforts to improve provision of safe water and sanitation and access to cholera treatments.
The most at risk populations needs vaccination to prevent cholera and this is in addition to other preventive measures to help save lives. And, good news to Kenyans, a new oral cholera vaccine brand name Shanchol was recently launched in Kenya and is expect to be used alongside other interventions in the prevention of cholera menace, which continues to claim lives of many Kenyans especially those who live in the informal settlements,