Nairobi — The start of what meteorologists predict will be El Nino-strength rains marks the beginning of a truly challenging period for the region.

Going by what happened a decade ago, virtually all sectors, from transport to education and agriculture, will be affected by the rains.

Like in the 1997/1998 period, however, by far the most devastating effects of the predicted extreme weather are likely to be on public health unless urgent disease prevention and surveillance measures are instituted.

Already, all five EAC countries have reported deadly outbreaks of the intestinal infection cholera, which is associated with the kind of poor sanitation that arises from flooding.

Last week, one Nairobi informal settlement alone had a dozen deaths from the disease.

In Tanzania, about 60 people have died of cholera in the past two months, mostly in the low-lying coastal region of Tanga.

Among the measures authorities across the region must take now is to put existing disease surveillance systems on a high alert so that outbreaks are detected early.

The respective health ministries must also establish or reinforce specialist quick response units with the logistical capacity to respond to far-flung outbreaks, possibly in conditions that will not be motorable.

A key component of these response systems must be the purchase and pre-positioning of strategic stockpiles of medicines and vaccines in predicted hotspots.

In the past, many lives have been lost needlessly as local governments wait for agencies such as the World Health Organisation and Unicef to ship in medicines they themselves should have bought in the first place.

This should not happen this time round.

Elsewhere, public health officials must renew their efforts to raise awareness on the need for people to adopt simple disease prevention measures such as boiling drinking water and sleeping under insecticide-treated bed-nets as the rains could see vectors move to new locales.

A comprehensive approach to the impeding health challenges will save lives.