Rapid Spread of Vibrio cholerae O1 Throughout Kenya, 2005

Isaac Mugoya Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Samuel Kariuki Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Tura Galgalo Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Charles Njuguna Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Jared Omollo Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Jackson Njoroge Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Rosalia Kalani Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Charles Nzioka Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Christopher Tetteh Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Sheryl Bedno Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Robert F. Breiman Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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Daniel R. Feikin Field Epidemiology and Laboratory Training Program—Kenya, CDC, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya; Disease Outbreak Management Unit, Kenya Ministry of Health, Nairobi, Kenya; U.S. Army Medical Research Unit, Nairobi, Kenya; International Emerging Infections Program–Kenya, CDC, Nairobi, Kenya

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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.

Author Notes

Reprint requests: Daniel Feikin, CDC, Unit 64112, APO, AE 09831 (U.S. Postal Service), Telephone: +254-7222-00075, Fax: +254-572022981, E-mail: dfeikin@ke.cdc.gov.
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