KENYA – The country’s Ministry of Health has identified Enterotoxigenic Escherichia coli (E.coli) and Salmonella as the two culprits behind the recent adverse food poisoning cases in Mukumu Girls High School.

On April 1, 2023, the Ministry sent a national level inquiry team to assist the Kakamega County team.

“The team was further backed by a high-level visit of a multi-agency team led by the Cabinet Secretary for Health, and included the Principal Secretary for the State Department of Basic Education, the Governor of Kakamega County, Western Regional Commissioner and the County Health, Education and Security teams,” said Acting Director General for Health Patrick Amoth in a press release.

Dr Francis Kuria, the Director of Public Health in the Ministry of Health, said traces of human faecal matter had been found in samples of water collected from the school storage tanks for analysis.

“The Ministry wishes to inform the general public that this disease is likely to be a mixture of E. coli and Salmonella typhi which usually occurs if water sources are contaminated with these micro-organisms,” read the statement.

A creek next to some houses for workers across the Kakamega-Kisumu road is thought to be the cause of the contamination.

Water at the school is stored in an underground reservoir before it’s pumped to the main storage tank at school.

The construction of sewage manholes on a higher ground, a short distance from the water stream, has exposed the water to contamination, reports Nation. Manholes leak untreated sewage onto the ground.

To rule out aflatoxicosis, samples of grains and pulses were tested for aflatoxin. However, the results turned out negative.

“Laboratory tests for Viral Hemorrhagic Fevers (VHFs) including Ebola Virus Disease (EVD), Marburg Virus Disease (MVD), Leptospirosis and Crimean- Congo Hemorrhagic Fever (CCHF), Dengue Fever, Rift Valley Fever (RVF) and West Nile Virus have all turned negative.

“The Ministry is conducting further analysis on these samples to ascertain any other potential cause of this illness, and will communicate the finding of these tests,” Amoth said.

Comprehensive investigations, he said, are still being conducted, but data analysis to date has shown that the ailment appears to have started on March 1, 2023.

According to the DG, 19 students are currently under treatment in seven hospitals around the nation, and as of April 14 there had been 627 individuals admitted with illnesses. He said those admitted are in a stable condition.

Thus far, four students have succumbed to the infections, with the latest fatality being that of the school’s boarding mistress.

“We at the Ministry of Health send our heartfelt condolences to the families who have lost their loved ones,” Amoth said.

The Ministry urged the public to practice good personal hygiene by washing their hands with soap and running water, treating or boiling any water used for drinking and cooking, and other practices.

It also reminded them to thoroughly cook all food and consume it while it is still hot, as well as to use the toilet to appropriately dispose of human waste.

“We appeal to the public to be vigilant, and requests that anyone experiencing fever, abdominal pains/cramps, diarrhea and vomiting to seek immediate treatment at the nearest health facility for assessment and prompt management,” the DG concluded.

Education Cabinet Secretary Ezekiel Machogu revealed that his Ministry had allocated Sh6 million (U.S$ 44,559) for the installation of a water purifier at the school and the drilling of a new borehole.

Mukumu Girls had earlier been shut down to allow room for investigations. This was later followed by a similar outbreak in Butere boys, also leading to closure. Mukuuni Boys’ in Tharaka Nithi County is the most recent of the closures after students exhibited cholera-like symptoms.

More than 40 students who were experiencing stomach pain, diarrhea, and vomiting were taken to Chuka County Reference Hospital and Chuka Nursing Home.

The school administration fears that the institution’s water supply may be contaminated by hazardous materials due to an ongoing road construction project nearby.

E.coli/Samonella infections

E. coli is a bacteria commonly found in the lower intestine of warm-blooded organisms that can cause food poisoning.

The symptoms of E. coli infections include severe stomach cramps and diarrhea, which is often bloody but often varies for each person. Some patients may also have a fever.

Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor.

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients.

Salmonella enterica typhi is a gram-negative bacterium that is responsible for typhoid fever.

It can cause serious food poisoning, with symptoms including vomiting, diarrhoea, stomach cramps and a fever. Symptoms usually start 6 hours to 6 days after infection with a recovery period of 4 to 7 days without antibiotic treatment for mild cases.

The CDC estimates that Salmonella bacteria cause approximately 1.35 million human infections and 26,500 hospitalizations in the United States every year.

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