Does Water Hyacinth on East African Lakes Promote Cholera Outbreaks?

Daniel R. Feikin International Emerging Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute/Centers for Disease Control and Prevention Research and Public Health Collaboration, Kisumu, Kenya; Field Epidemiology and Laboratory Training Program, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; Kenya Marine and Fisheries Research Institute, Kisumu, Kenya

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Collins W. Tabu International Emerging Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute/Centers for Disease Control and Prevention Research and Public Health Collaboration, Kisumu, Kenya; Field Epidemiology and Laboratory Training Program, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; Kenya Marine and Fisheries Research Institute, Kisumu, Kenya

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John Gichuki International Emerging Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute/Centers for Disease Control and Prevention Research and Public Health Collaboration, Kisumu, Kenya; Field Epidemiology and Laboratory Training Program, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; Kenya Marine and Fisheries Research Institute, Kisumu, Kenya

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Cholera outbreaks continue to occur regularly in Africa. Cholera has been associated with proximity to lakes in East Africa, and Vibrio cholerae has been found experimentally to concentrate on the floating aquatic plant, water hyacinth, which is periodically widespread in East African lakes since the late 1980s. From 1994 to 2008, Nyanza Province, which is the Kenyan province bordering Lake Victoria, accounted for a larger proportion of cholera cases than expected by its population size (38.7% of cholera cases versus 15.3% of national population). Yearly water-hyacinth coverage on the Kenyan section of Lake Victoria was positively associated with the number of cholera cases reported in Nyanza Province (r = 0.83; P = 0.0010). Water hyacinth on freshwater lakes might play a role in initiating cholera outbreaks and causing sporadic disease in East Africa.

Author Notes

*Address correspondence to Daniel Feikin, KEMRI/Centers for Disease Control and Prevention, Kisumu, Kenya. E-mail: dfeikin@ke.cdc.gov

Authors' addresses: Daniel Feikin and Collins Tabu, KEMRI/CDC, P.O. Box 1578, Kisumu Kenya, E-mails: dfeikin@ke.cdc.gov and ctabu@ke.cdc.gov. John Gichuki, Kenya Marine and Fisheries Research Institute, P.O. Box 1881, Kisumu, Kenya, E-mail: gichukij@yahoo.com.

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