VZCZCXRO9440
RR RUEHDE RUEHROV RUEHTRO
DE RUEHNR #0477/01 0261143
ZNR UUUUU ZZH
R 261143Z JAN 07
FM AMEMBASSY NAIROBI
TO RUEHC/SECSTATE WASHDC 7041
INFO RUCNSOM/SOMALIA COLLECTIVE
RUEHRN/USMISSION UN ROME 0067
RHEHNSC/NSC WASHDC
RHMFIUU/CJTF HOA
RHMFIUU/CDR USCENTCOM MACDILL AFB FL
RUEKJCS/SECDEF WASHDC
RUEKJCS/JOINT STAFF WASHDC

UNCLAS SECTION 01 OF 04 NAIROBI 000477 
 
SIPDIS 
 
AIDAC 
 
AID/DCHA FOR MHESS, WGARVELINK, LROGERS 
DCHA/OFDA FOR KLUU, GGOTTLIEB, AFERRARA, ACONVERY, 
CGOTTSCHALK, KCHANNELL 
DCHA/FFP FOR WHAMMINK, JDWORKEN 
AFR/AFR/EA FOR JBORNS 
STATE FOR AF/E AND PRM 
STATE/AF/E FOR NGARY 
STATE/F FOR ASISSON 
STATE/PRM FOR AWENDT, MMCKELVEY 
NSC FOR TSHORTLEY 
USUN FOR TMALY 
BRUSSELS FOR PLERNER 
GENEVA FOR NKYLOH 
USMISSION UN ROME FOR RNEWBERG 
 
SIPDIS 
 
E.O. 12958:  N/A 
TAGS: EAID PREF PHUM PREL SO
 
SUBJECT:  SOMALIA DART SITUATION REPORT 9 RIFT VALLEY 
FEVER UPDATE 
 
REFS:  A) NAIROBI 00255 
 
NAIROBI 00000477  001.2 OF 004 
 
 
SUMMARY 
 
¶1.  On January 23, the first human case of Rift Valley 
fever (RVF) in Somalia was confirmed.  Animal sampling 
is currently targeting Afmadow District and Dobley near 
the Kenya border.  To date, no animal samples have been 
tested or confirmed for RVF.  RVF Task Force members 
report that local radio stations are broadcasting 
public health messages, some Somali medical staff have 
been trained in case identification and management, and 
protocols for sampling animal and human cases have been 
established.  Currently, the fluid security situation 
limits surveillance teams' access to affected areas, 
hinders transport of samples, and prevents additional 
Kenya-based medical and veterinary staff from assisting 
in RVF response efforts.  The USG Disaster Assistance 
Response Team (DART) reports that coordination between 
the UN Food and Agriculture Organization (FAO) and the 
UN World Health Organization (WHO) needs to rapidly 
improve to ensure timely dissemination of information, 
rapid sample collection and transport, adequate disease 
surveillance in humans and livestock, and 
implementation of intervention activities.  End 
Summary. 
 
¶2.  The Somali Support Secretariat has mobilized a RVF 
Task Force including UN agencies and health and 
livestock sector non-governmental organizations (NGOs). 
The purpose of the WHO-chaired RVF Task Force is to 
share information and coordinate response plans. 
(REFTEL) DART members have attended the weekly Task 
Force meetings and are concerned that critical 
information tracking systems of WHO and FAO need to be 
improved. 
 
STATUS OF EPIDEMIC IN SOMALIA 
 
¶3.  On January 23, one of two human samples taken in 
the Medecins Sans Frontieres (MSF)-supported Marare 
Hospital in Jilib District, Middle Juba Region, tested 
positive for RVF in laboratory tests conducted in 
Nairobi.  This is the first confirmed human case in 
Somalia.  The patient traveled from Dobley, the same 
area where the first RVF-suspected deaths were reported 
in early December, to Marare.  Three other samples 
tested the week of January 15 were negative for RVF, 
although the cold chain was broken during transport of 
the samples.  From December 12 to January 17, WHO has 
reported a total of 84 suspected RVF cases, including 
49 deaths in Somalia. 
 
¶4.  FAO reported on January 25, that more than 200 
samples from small ruminants and cattle were in Afmadow 
and Marare awaiting transport to Nairobi for testing. 
To date, no animal samples have been tested or 
confirmed for RVF. 
 
¶5.  WHO reports that there are 13 hospitals that can 
provide care for RVF patients, with at least one 
hospital in each region.  The hospitals identified for 
RVF care are Marare, Kismayo, Merka, Medina, Keynsey, 
Luug, Garbaharey, Khalil, Dinsor, Baidoa, Hudur, 
Jowhar, and Belet Weyne. 
 
DISEASE SURVEILLANCE EFFORTS: HUMAN AND LIVESTOCK 
 
NAIROBI 00000477  002.2 OF 004 
 
 
 
¶6.  Human case surveillance is being conducted by WHO 
polio surveillance teams, non-governmental organization 
(NGO) health clinics, and regional hospitals.  The 
majority of RVF cases are being reported by WHO polio 
teams that have 147 district officers supporting RVF 
surveillance in the field.  However, 99 percent of the 
team members who are referring suspected cases to 
health facilities are not medical staff and do not have 
adequate training to collect samples from suspected RVF 
cases, according to members of the RVF Task Force. 
Health clinics, maternal and child health facilities, 
and NGOs have also contributed to surveillance efforts 
when access allows or when suspected cases are referred 
to their health facilities.  WHO has trained some 
Somali medical staff in surveillance, case 
identification, and case management. 
 
¶7.  MSF-Holland has played a key role in the 
surveillance efforts at Marare health clinic, which is 
accessible to people in Afmadow District.  MSF has a 
team trained in managing RVF cases, collecting samples, 
and MSF uses their own planes to transport the samples 
to the U.S. Centers for Disease Control and Prevention 
(CDC) laboratory in Nairobi. 
 
¶8.  FAO, the Somali Animal Health Services Program 
(SAHSP), Cooperazione Internazionale (COOPI), and 
Veterinaires Sans Frontieres (VSF)-Swiss are 
coordinating animal field surveillance activities. 
SAHSP plans to conduct an animal serological survey at 
the end of January and results from this survey will 
guide future interventions, according to FAO. 
 
¶9.  The DART notes that disease surveillance is 
hindered by the unpredictable security situation, 
limiting movement of surveillance teams.  On January 
23, the UN Office for the Coordination of Humanitarian 
Affairs (OCHA) reported that efforts to obtain written 
assurances of safety for a WHO-led medical mission to 
Kismayo to assess the health situation, including the 
possible presence of RVF, have so far been 
unsuccessful.  At the first RVF Task Force meeting in 
Nairobi, an NGO representative commented that with the 
Somalia-Kenya border closed, transport of samples from 
Lower Juba Region to Kenya via road was impossible. 
 
SAMPLE COLLECTION 
 
¶10.  The traveling time of the human samples from 
Somalia to Nairobi has been increased by insecurity, 
lack of humanitarian flights, and the Kenya-Somalia 
border closure.  During the transport of the first 
three human samples, the cold chain was broken as the 
sample was in transit for two days without adequate 
levels of refrigeration.  This made the results, which 
were negative for RVF, inconclusive.  WHO reports that 
insecurity has limited access, forcing health staff to 
focus on collecting samples from the most probable 
cases and not all suspected cases in the affected 
areas. 
 
¶11.  The approach with human cases has been to only 
obtain samples from probable cases rather than 
suspected cases (probable cases have both fever and 
bleeding).  If RVF is confirmed in a particular area, 
sampling may be broadened to include all suspected 
 
NAIROBI 00000477  003.2 OF 004 
 
 
cases. 
 
¶12.  FAO reports that collection of animal specimens 
has to take place in potentially infected areas (in 
contrast to the human sample collection that occurs at 
medical facilities).  On January 23, the SAHSP reported 
that two teams were collecting samples near the Kenya- 
Somalia border and the riverine areas near Marare.  FAO 
reports that 200 samples from small ruminants and 
cattle collected in Hayo and Qoqani are in the freezer 
at Afmadow.  Other samples are in cold chain storage at 
Marare.  SAHSP is currently processing the Government 
of Kenya (GOK) biological material entry permits needed 
to transport the samples to Nairobi for laboratory 
testing. 
 
¶13.  FAO also reports that it is working closely with 
the Somali Transitional Federal Government (TFG) Chief 
Veterinary Officer, sharing information and seeking TFG 
input into response plans. 
 
ANIMAL VACCINATION AND OTHER INTERVENTIONS 
 
¶14.  In the meetings attended by the DART, health and 
livestock agencies have debated on whether animal 
vaccination should be part of an intervention strategy 
in Somalia.  All experts agree that vaccination in 
Somalia is not the control method of choice within the 
declared infected zone.  FAO plans to vaccinate in 
areas that do not have RVF and are deemed to be at high 
risk for the disease, such as wetlands. 
 
¶15.  FAO also plans to treat livestock with insecticide 
to minimize contact with mosquitoes that transmit RVF. 
FAO will support WHO with public education messages on 
RVF prevention. 
 
¶16.  The UN Children's Fund (UNICEF) and WHO are 
distributing approximately 200,000 insecticide-treated 
mosquito nets to partner agencies, health facilities, 
and other groups in high-risk regions.  The 
distribution is part of the ongoing flood response as 
well as a RVF prevention measure. 
 
SOCIAL MOBILIZATION ACTIVITIES 
 
¶17.  WHO reports that the Jowhar radio station 
broadcasts daily messages to the community about case 
definition and prevention of RVF.  WHO has distributed 
health education and surveillance materials to Jowhar 
Hospital staff, the Italian NGO INTERSOS, Somali Red 
Cross Society (SRCS), MSF, the UN Development Program 
(UNDP), and UNICEF.  WHO has also discussed community 
mobilization strategies with MSF, SRCS head nurses, and 
health officers in Galgadud Region.  WHO plans to 
conduct a workshop for partners in Nairobi to increase 
awareness of RVF prevention in the next week and will 
replicate the workshops in Kismayo, Mogadishu, Wajid, 
Garowe, and Hargeisa in the coming weeks. 
 
ECONOMIC IMPLICATIONS 
 
¶18.  According to FAO, an outbreak of RVF in 1997 and 
1998 lead to a livestock export ban imposed by 
important markets in the Middle East, which caused a 
loss of revenue for producers and traders.  FAO 
estimates that approximately 3 to 4 million head of 
 
NAIROBI 00000477  004.2 OF 004 
 
 
livestock are exported annually from Somalia to 
countries on the Arabian Peninsula.  Somalia is 
expected to suffer greater economic loss than Kenya, 
because Somalia exports more livestock. 
 
¶19.  It is not yet clear if the United Arab Emirates 
will impose a ban on livestock imports from the Horn of 
Africa but they are reported to be testing animals to 
determine if any are carrying RVF. 
 
USAID RESPONSE ACTIVITIES 
 
¶20.  USAID's Office of U.S. Foreign Disaster Assistance 
(OFDA) has funded the purchase of animal vaccines in 
Kenya.  OFDA is reviewing an FAO funding request for 
interventions in Somalia and other parts of the region. 
At this time, WHO has not requested USAID funding for 
assistance with human RVF interventions. 
 
¶21.  OFDA is deploying a livestock specialist to assist 
in developing a regional approach with the key 
stakeholders in Kenya, Somalia, and Ethiopia. 
 
¶22.  OFDA is coordinating efforts with other USG 
offices, such as CDC, USAID/Kenya, and USAID/East 
Africa to plan RVF response efforts.  Additionally, 
OFDA is emphasizing a regional approach to RVF response 
and is supporting efforts in Kenya, Ethiopia, and 
Somalia. 
 
¶23.  The DART notes that coordination among the Somalia 
RVF Task Force agencies needs to be quickly improved. 
Improved coordination will expedite data and sample 
collection, as well as transport of samples to Nairobi 
for testing.  Additionally, WHO and FAO need to 
disseminate accurate, timely, and comprehensive 
information on number of cases in human and animals 
(similar to the information provided on RVF in Kenya by 
WHO). 
 
RANNEBERGER