Rosemary Sang on lessons from RVF outbreak

Rosemary Sang led a session on Rift Valley Fever (RVF) and the lessons learned from the major RVF outbreak in Kenya in 2006-07 where 155 people died.

RVF is a vector=borne viral disease that comes after heavy persistent rains and flooding. People get RVF from handling livestock and their products or through infected mosquitos or secondary vectors.

Rosemary explained the sequence of events from October 2006 when the heavy rains first started (providing the breeding ground for the vectors that transmit RVF) through to the first veterinary cases (17 Nov) to the first human case (30 Nov) to the first medical response (11 Dec) to the peak of the outbreak (24 Dec) to the first veterinary intervention (14 Jan) (see figure below for dates).

How could we move the first response time back to October when all the signs were there?

The reality is that there are few health facilities in the area where people and animals were getting sick and dying. There is no mobile phone network either in the more remote regions. Rosemary explained that trying to get to the sick people was a major challenge. The heavy rains had cut off roads and when the medical response team got 5km out of Garissa town in northern Kenya, they found themselves out of mobile phone network range.

But it can be argued that more people were saved this time compared with the 1998 outbreak in the same area where 600 people died. What helped in this case was a ban slapped on slaughtering animals which prevented RVF being transmitted to more people. There's many lessons we can learn, said Rosemary, including the need for closer interaction between the veterinary and medical communities.

Patti Kristjanson explained that the workshop organizing committee had chosen RVF as a case study because it has all the complexities that we are dealing with in this challenge dialogue and how to have better response to disease.

Keith Jones summarised lessons learned:

• accessing information from community important


• prediction-related; how to improve; how to communicate better;


• importance of working together; 'one health' concept
  
• role of communications/ICTs and possibilities
  
• economic-related: tourism, trade, livelihoods, etc are all impacted; not just people's and animal's health
  
• evidence - need more basic science (eg still biological gaps including controversy over the vector!); priority research issues can be identified.

In the discussion that followed Chris Wood said that with the basic poverty and lack of health facilities in these remote area, it's hard to get people to spend time and energy thinking of how to prevent future problems when their current problem is how to survive their poverty.

Christian Borgemeister said you have 10-14 days after the start of the rains to kill mosquitos in their breeding sites.