Vaccine could help tame cholera cases - experts

Food being prepared on top of a sewer line at Muthurwa market in Nairobi. [Dennish Ochieng, Standard]

Ministry of Health's announcement of a cholera outbreak in six counties is turning focus to how the country can use vaccines to tame the disease.

Dr Patrick Amoth, Health acting director-general, has warned that the outbreak might worsen due to drought. The outbreak occurred in Kiambu, Nairobi, Uasin Gishu, Kajiado, Nakuru and Murang'a counties.

The last cholera outbreak happened in Wajir, Embu and Meru.

But Kenya has cholera vaccine which has been pre-qualified and licensed by the World Health Organisation.

Dr Mohan Lumba, former chairman of Kenya Paediatric Consortium, says the jabs should be used alongside other prevention and control strategies in endemic areas.

"Immunisation should not disrupt the provision of other high-priority health interventions to control or prevent cholera outbreaks and spread. Immunisation provides a short-term solution that can bring about an immediate response while the longer term interventions of improving water and sanitation conditions, which involve large investments, are put into place", he says, adding that pre-emptive or reactive vaccination should cover as many eligible people as possible.

The oral cholera vaccines have demonstrated efficacy in large-scale clinical trials among 700,000 people in Kolkata, India. Results indicated that protection conferred by two doses was 65 per cent five years after vaccination, the longest protection on record among currently available cholera vaccines.

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"The vaccine given from one year to all ages and mass immunisation campaign in response to an outbreak in other African countries has achieved positive results," says Dr Lumba.

He says oral cholera vaccines should be used alongside already-implemented treatment and prevention strategies and health education such as the distribution of soaps and chlorine for household, water treatment.

Prof Charles Chunge, an expert in tropical and travel diseases, says the two-dose schedule is required and helps those in remote rural settings and the highly mobile population.

But, the two-dose regiment might be costly to most Kenyans as costs Sh5,000 and "given the low-income status among the high-risk groups in the society, Sh5, 000 for two doses within a fortnight is not possible for many of them," says Richard Kavila, a social worker.