Christof Maletsky
9 April 2008
Windhoek — The World Health Organisation (WHO) has warned that Namibia, already ravaged by the floods and outbreaks of cholera and malaria, might have to deal with an outbreak of deadly Rift Valley Fever (RVF).
A team of UN experts visited the North recently to assess the quality of response to the cholera epidemic, data collection, recording and analysis, reporting, dissemination, feedback and the overall health situation caused by the floods that affected more than 62 000 people and left 4 000 in camps. "In view of the fact that flooding may also be associated with other outbreaks like malaria and Rift Valley Fever (RVF), and considering that RVF affected Kenya, Tanzania and South Africa recently, surveillance should be heightened and preparedness plans be put in place," the WHO said in a statement.
More than two thirds of the flooded areas in the northern parts are still submerged in floodwater. Last week officials said cholera and malaria had claimed a combined 15 lives so far.
RVF is a viral disease which primarily affects animals but has the capacity to infect humans. Infection can cause severe illness in both animals and humans, leading to high death rates. The disease was first detected among sheep on a farm in the Rift Valley of Kenya and since then outbreaks have spread in sub-Saharan Africa and in most parts of Asia and Europe.
The vast majority of human infections result from direct or indirect contact with the blood or organs of infected animals.
The virus can be transmitted to humans through the handling of animal tissue during slaughtering or butchering, assisting with animal births, conducting veterinary procedures, or from the disposal of carcasses or foetuses. Certain occupational groups such as herders, farmers, slaughterhouse workers and veterinarians are therefore at higher risk of infection.
There is some evidence that humans may also become infected with RVF by ingesting the unpasteurised or uncooked milk of infected animals. The early symptoms of RVF include flu-like fever, muscle pain, joint pain and headache. Some patients develop neck stiffness and vomiting, and the disease may be mistaken for meningitis.
In severe cases, RVF can affect the eyes, brain, or - in the worst-case scenario - take the form of a hemorrhagic fever characterised by bleeding from the nose and gums and vomiting or passing blood in the stool.
To date, no human-to-human transmission of RVF has been documented, and no transmission of RVF to healthcare workers has been reported when standard infection control precautions have been put in place.
WHO said their team found that health information from relocation camps and outreach points were not collected and thus did not facilitate timely detection of eventual outbreaks and clear understanding of the pattern of diseases prevalent in the camps.
"Likewise, data on the current cholera outbreak is not being monitored on a weekly basis by age, sex, place or residence. Appropriate case management of cholera cases is being done. However, infection control measures need to be stepped up if the epidemic is to be contained," the WHO warned.
It said there was an urgent need to adapt the surveillance system to emergency mode through the collection of data on a daily or weekly basis. "Containment of cholera can only be achieved if, in addition, social mobilisation, adequate public health information, education and communication are strengthened and the provision of safe drinking water and appropriate sanitation facilitation are urgently improved," WHO said.
Cholera cases have shot up to about 945 in the flood-stricken northern parts of Namibia.
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