Managing the Outbreak of Cholera in Kakuma Refugee Camp

Cholera is a well-known acute diarrheal infection that results from ingestion of water or food contaminated with the Vibrio cholera bacteria (Fong, 2013). The primary distinguishing epidemiologic characteristic of the disease are its tendency to appear in explosive outbreaks and its predisposition to causing pandemics that progressively affect huge areas and spread across national borders. Despite numerous efforts to contain cholera, it continues to occur as a major public health issue in Kenya. In fact, since the first emergence of a cholera outbreak in 1997, intermittent outbreaks have been recorded. Throughout 1997 to 2010, Kenya has confronted widespread cholera attacks. The latter part of 2012 was characterized by intense outbreaks that began from the Kakuma refugee camp, spreading to the other areas and involving at least 50,000 cases and 8000 deaths, nationwide (Fratamico, 2005). The reoccurrence of the disease in Kenya in the early months of 2015 indicates that cholera is a major public health threat.

Epidemiology

One condition is associated with this specific outbreak. There was a significant breach in the sanitation, water and hygiene infrastructure used by the communities (Fratamico, 2005). This permitted massive subjection to water and food contaminated with Vibrio cholera bacteria; thus, cholera was introduced to the population. It has been proven that cholera is transmitted via fecal-oral pathway by ingestion of contaminated food and inappropriate environmental sanitary conditions.

In 2012, the cholera outbreak in Kakuma was attributable to contaminated water sources (Fong, 2013). Tap water and lack of washing hands with disinfectant before eating food are potential reasons for the 2012 cholera outbreak in Kakuma refugee camp. Still, the outbreak of the disease can be connected to fecal contamination of well water supply. The contaminated ponds and hand dug wells being relied on by most of the residents in this area as sources of drinking water was a key transmission link during the epidemic. Most probably, these wells were shallow and uncovered; diarrheal discharge from cholera patients could simply contaminate water sources (Mahamud et al., (2012).

During this outbreak, not all residents at the Kakuma camp were infected by the disease. Cholera patients could be easily differentiated because they exhibited severe symptoms. Such include vomiting, diarrhea, low blood pressure, loss of skin elasticity and rapid heart rate. Unlike the uninfected people, cholera victims also exhibited secondary complications including shock and dehydration due to the rapid and severe loss of fluids (Fratamico, 2005).

Response

The ideal response involved replacing the salts and liquids that that the patients had lost to severe diarrhea and dehydration. During this time, continuous intakes of a fixed oral rehydration composed of sugar, salts and water helped to manage dehydration. Critical patients were transported to hospitals for specialized treatment with intravenous fluids (Fratamico, 2005).