<html><body style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space; "><blockquote type="cite" class=""><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-size: 14px; ">Date: Fri, 13 Jun 2008 15:28:04 -0400 (EDT)<br>From: ProMED-mail <<a href="mailto:promed@promed.isid.harvard.edu">promed@promed.isid.harvard.edu</a>><br>Subject: PRO/AH/EDR> Leishmaniasis, visceral - Kenya: (NE)<br><br>LEISHMANIASIS, VISCERAL - KENYA: (NORTH EAST)<br>*********************************************<br>A ProMED-mail post<br><<a href="http://www.promedmail.org/">http://www.promedmail.org</a>><br>ProMED-mail is a program of the<br>International Society for Infectious Diseases<br><<a href="http://www.isid.org/">http://www.isid.org</a>><br><br>Date: Wed 11 Jun 2008<br>Source: UN Integrated Regional Information Networks (IRIN), Early Warning <br>[edited]<br><<a href="http://www.irinnews.org/Report.aspx?ReportId=78687">http://www.irinnews.org/Report.aspx?ReportId=78687</a>><br><br><br>An outbreak of visceral leishmaniasis -- also known as kala azar or black <br>fever -- has been reported in Isiolo and Wajir in north eastern Kenya. <br>According to a senior health official 4 people have died.<br><br>Shahnaaz Sharif, the senior deputy director of medical services in Kenya's <br>health ministry, said 66 people had been infected in the outbreak that was <br>first reported in Wajir in April 2008. Sharif said the most affected age <br>group was children between the age of one and 5 "This is due to lowered <br>immunity and the prevailing malnutrition problem in the northern region," <br>he said.<br><br>The most affected areas in Wajir are the districts of Wajir West with 50 <br>per cent of the total cases (in the localities of Arbijahan, Eldas, <br>Giristu, Wara, and Malale), Wajir East, and Wajir North. In Isiolo, the <br>Merta Alba area was the most affected.<br><br>Sharif said the health ministry and other stakeholders were carrying out <br>case management and distributing drugs to the sick in treatment centres in <br>Wajir and Isiolo. The affected communities are also being provided with <br>health education on disease prevention and control, while therapeutic <br>feeding of malnourished children is also taking place.<br><br>Control measures for kala azar include the use of insecticide treated bed <br>nets and skin repellents as well as early diagnosis, complete treatment, <br>and effective surveillance. Sharif said it had not been possible to reach <br>all of those potentially affected by the outbreak as some had travelled in <br>search of water and pasture for their livestock. Isiolo and Wajir are <br>located in Kenya's pastoral-nomadic region.<br><br>Kala azar is endemic in northern Kenya and outbreaks are common in times of <br>drought. Once it enters the body, the leishmaniasis parasite, which is <br>carried by sand flies, migrates to internal organs and bone marrow. If an <br>infection progresses to disease and is left untreated, it almost always <br>results in death.<br><br>Sand flies thrive in the cracks of mud-covered dwellings, in cow dung, rat <br>burrows, anthills, dry riverbeds, and vegetation. In Wajir, the flies often <br>bite people as they dig for water in the bed of the Ewaso Nyiro River or <br>graze their livestock on nearby bushes. The most effective methods of <br>diagnosing kala azar can only be conducted in large hospitals located far <br>from the worst-affected areas.<br><br>- -- <br>communicated by:<br>ProMED-mail<br><<a href="mailto:promed@promedmail.org">promed@promedmail.org</a>><br><br>[Please see the extensive moderator's comment from the ProMED-mail posting <br>on VL (visceral leishmaniasis) in northern Kenya date 21 Jul 2006 (archive <br>no. 20060721.2007). The comment concluded that, "The present increase in <br>cases is most probably part of a larger outbreak of the entire region <br>including eastern Ethiopia, Somalia, and north eastern Kenya." The comment <br>posted 23 Jul 2006 (archive no. 20060723.2030) from Ellicott McConnell <br>emphasized the connection between outbreaks of VL and malnutrition. It <br>seems that malnutrition is still part of the problem and the situation has <br>not changed since 2006. - Mod.EP<br><br>A map of Kenya is available at <br><<a href="http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf">http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf</a>>. - CopyEd.MJ]<br></span></blockquote></body></html>