VZCZCXRO8566
RR RUEHDE RUEHROV RUEHTRO
DE RUEHNR #0919/01 0580923
ZNR UUUUU ZZH
R 270923Z FEB 07
FM AMEMBASSY NAIROBI
TO RUEHC/SECSTATE WASHDC 7771
INFO RUCNSOM/SOMALIA COLLECTIVE
RUEHRN/USMISSION UN ROME 0107
RHEHNSC/NSC WASHDC
RHMFIUU/CJTF HOA
RHMFIUU/CDR USCENTCOM MACDILL AFB FL
RUEKJCS/SECDEF WASHDC
RUEKJCS/JOINT STAFF WASHINGTON DC

UNCLAS SECTION 01 OF 04 NAIROBI 000919 
 
SIPDIS 
 
AIDAC 
 
USAID/DCHA FOR MHESS, WGARVELINK, LROGERS 
DCHA/OFDA FOR KLUU, GGOTTLIEB, AFERRARA, ACONVERY, 
KCHANNELL 
DCHA/FFP FOR WHAMMINK, JDWORKEN 
AFR/AFR/EA FOR JBORNS 
STATE FOR AF/E, AF/F AND PRM 
STATE/AF/E FOR NGARY 
STATE/F FOR ASISSON 
STATE/PRM FOR AWENDT, MMCKELVEY 
NSC FOR TSHORTLEY 
USUN FOR AMAHONEY 
BRUSSELS FOR PLERNER 
GENEVA FOR NKYLOH 
USMISSION UN ROME FOR RNEWBERG 
 
SIPDIS 
 
E.O. 12958:  N/A 
TAGS: EAID PHUM PREL
 
SUBJECT: REGIONAL RIFT VALLEY FEVER UPDATE 
 
REF:  NAIROBI 00483 
 
NAIROBI 00000919  001.2 OF 004 
 
 
SUMMARY 
 
¶1.  A Rift Valley fever (RVF) outbreak in East Africa 
has mostly affected Kenya, with smaller outbreaks in 
Somalia and Tanzania, although weather conditions 
threaten to cause the spread of RVF further south and 
west.  Through a combination of factors, including 
information campaigns and favorable weather in some 
areas, the outbreak has not been particularly severe to 
date, however scientists fear that this strain may be 
more virulent than in past outbreaks.  Additional 
research is required to understand transmission 
mechanisms, fatality risk factors, and effectiveness of 
animal vaccination programs.  Improved monitoring and 
early detection, and the development of standard 
response strategies by governments are needed to boost 
capacity to deal with future outbreaks.  End summary. 
 
BACKGROUND 
 
¶2.  RVF is a viral disease that causes spontaneous 
abortions, sudden collapse, or death in ruminants and 
camels.  In humans, RVF presents symptoms often 
confused with influenza or malaria and can lead to 
acute hemorrhagic disease, blindness, neurological 
damage, and death in severe cases. 
 
¶3.  RVF in East Africa is associated with cyclical and 
predictable periods of heavy rains in arid and semi- 
arid zones, leading to temporary flooding, and areas 
previously affected are extremely susceptible to future 
outbreaks.  The disease is transmitted between animals 
via mosquito and from animal to human through contact 
with contaminated tissue at time of slaughter or 
through consumption of milk or poorly cooked meat 
products.  Given its predictable nature, RVF is highly 
preventable through early use of vaccines for animals. 
 
¶4.  Early and thorough vaccination can minimize the 
economic impact of the disease.  Successful vaccination 
campaigns require a high coverage rate, broad targeting 
of all breeds of animals, and must occur prior to an 
outbreak to avoid spreading the disease via 
contaminated needles, however, vaccinating pregnant 
animals may cause abortion and is not recommended. 
 
¶5.  Following recent flooding, RVF in livestock has 
spread across eastern Kenya, into Somalia (REFTEL), and 
Tanzania.  There are no confirmed cases in Ethiopia to 
date, although experts fear the disease may spread 
south and west to Rwanda, Mozambique, and southern 
Africa. 
 
OVERVIEW OF RVF VACCINATION CAMPAIGNS 
 
¶6.  As of February 2007, the global supply of RVF 
vaccines has been purchased for Kenya, and the outbreak 
may be nearly over before additional supplies can be 
produced by the sole supplier in South Africa and 
transported to affected areas.  The US Centers for 
Disease Control and Prevention (CDC) indicate that an 
additional 4 million vaccines may be available by mid 
April, and CDC experts are testing a diluted form of 
the vaccine in order to extend the current supply, 
although initial results are not promising. 
 
 
NAIROBI 00000919  002.2 OF 004 
 
 
¶7.  Health agencies, including the CDC, are considering 
moving some vaccines to other affected countries, but 
no decision has been reached to date.  Regardless, this 
approach would not necessarily prevent further spread 
of RVF due to the time required for CDC testing and 
transport of supplies.  Experts are hoping diminished 
rainfall will slow the spread of RVF in many areas. 
 
STATUS OF RVF IN KENYA 
 
¶8.  Kenya has been the worst-affected country during 
the recent outbreak.  USAID's Office of US Foreign 
Disaster Assistance (OFDA) responded by providing the 
Ministry of Livestock and Fisheries Development (MoLFD) 
with 1,250,000 vaccines as part of MoLFD's overall 
vaccination campaign, along with complementary in-kind 
support through CDC.  CDC and the Walter Reed project 
have also contributed substantially to this campaign 
through provision of staff and other resources. 
Vaccination programs are ongoing in Kenya. 
 
¶9.  The UN Food and Agriculture Organization (FAO) and 
the Government of Kenya (GOK) Ministry of Agriculture 
are conducting surveillance and sampling suspected 
human and animal cases of RVF.  A CDC laboratory in 
Nairobi is analyzing human samples, and animal samples 
are being tested at the GOK Kabete laboratory.  Both 
facilities have the capacity to provide diagnostic 
testing on a regional level. 
 
¶10.  The experts believe the outbreak in Kenya has 
peaked, with the last confirmed case in Northeastern 
province reported on February 2, and the animal 
slaughter ban lifted on February 19.  Forecasts of 
decreased rainfall nationwide, including only a few mm 
expected in southeastern Kenya, suggest the continued 
decline of RVF in Kenya. 
 
RVF IN ETHIOPIA, SOMALIA, TANZANIA, AND MOZAMBIQUE 
 
¶11.  No cases of RVF have been reported in Ethiopia as 
of February 21, and forecasts for dry weather in the 
at-risk Somali region will likely minimize any spread. 
Texas A&M University and FAO are conducting 
surveillance and 1,400 samples from animals have been 
transported to Addis Ababa for testing. 
 
¶12.  In Somalia, three human RVF cases have been 
confirmed to date, and animal samples collected in 
January are at the Kabete laboratory for analysis. 
Rains have tapered off and affected areas along the 
Kenyan border are expected to remain dry, reducing the 
likelihood of new outbreaks.  Public health messages 
regarding RVF have been disseminated through FM radio 
and BBC Somalia. 
 
¶13.  In Tanzania, the CDC and the UN World Health 
Organization (WHO) are working with the Ministry of 
Health to investigate the potential spread of RVF.  Two 
confirmed human cases were reported in Arusha, 
additional human samples are in Nairobi for testing, 
and there are anecdotal reports of some animal deaths 
and abortions.  RVF may spread given forecasted 
rainfall over the next two weeks.  Since vaccines are 
not currently available, containment depends on the 
development of effective public health campaigns and 
bans on slaughter. 
 
 
NAIROBI 00000919  003.2 OF 004 
 
 
¶14.  Authorities are monitoring Mozambique for the 
appearance of RVF due to continued rains, flooding, and 
the endemic presence of RVF in the country. 
Agriculture and health officials are also monitoring 
for RVF in Rwanda and southern Africa. 
 
ONGOING CONCERNS 
 
¶15.  CDC and GOK scientists in Nairobi are concerned 
that surveillance data showing higher mortality rates 
among suspected cases than in previous outbreaks may 
indicate a more virulent strain of the virus.  UN, CDC, 
and GOK experts also note that the absence of RVF in 
camels this year may indicate that the virus is 
evolving. 
 
¶16.  There are no obvious risk factors for severe 
infection or mortality, making it difficult to predict 
the severity of an RVF outbreak.  There is some 
speculation that the slaughter of infected animals may 
lead to serious human illness and death, whereas 
mosquito bites or consumption of infected animal 
products may result in minor flu-like symptoms. 
 
¶17.  CDC/Kenya has requested that the GOK Ministry of 
Livestock collect milk samples to test whether 
consumption of raw milk can cause disease.  Anecdotal 
evidence suggests infections may result from 
contaminated goat milk.  CDC scientists would also like 
to test whether cooking kills the virus in meat. 
 
¶18.  There is no scientific evidence that vaccination 
is effective after an outbreak has begun.  Multiple 
outbreaks often occur simultaneously and infected 
mosquitoes generally transcend the area of infected 
animals, making a border of vaccinated animals 
ineffective at stopping the spread of the disease. 
 
¶19.  Acute outbreaks of RVF only occur every seven to 
ten years, making public information campaigns critical 
since communities at risk are likely to be unfamiliar 
with the disease.  Reports of panic and people 
consuming products from sick or deceased animals 
indicate insufficient knowledge of this public health 
emergency. 
 
MITIGATION AND PREVENTION OPPORTUNITIES 
 
¶20.  Active surveillance is essential to define the 
extent and severity of an outbreak, however, 
insufficient knowledge of the disease and its impacts 
has hindered consensus on appropriate response and 
prevention activities.  Improved early warning requires 
increased capacity of animal health services, including 
surveillance and monitoring high-risk areas.  Many of 
the requisite facilities and infrastructure would also 
benefit responses to avian influenza or other diseases 
transmitted between animals and humans.  A better 
understanding of RVF and its impact on human health, 
economics, and trade dynamics would also encourage 
appropriate future responses. 
 
¶21.  The Somalia Rift Valley Fever Task Force has made 
a good first step by discussing an action plan to 
resume livestock exports.  The plan addresses safety 
mechanisms and advocacy for standards and terms of 
trade for Somali livestock exports.  The GOK and other 
governments in the region should be encouraged to 
 
NAIROBI 00000919  004.2 OF 004 
 
 
develop written response strategies identifying 
triggers and corresponding mitigating steps, as serious 
delays result from uncertainty.  Response plans for 
high-risk areas could consider strategic pre-emptive 
vaccinations. 
 
RECOMMENDATIONS 
 
¶22.  Although response options are limited for the 
current outbreak since the vaccine supply is 
temporarily depleted and most livestock owners are 
aware of risk factors, ongoing monitoring and 
coordination amongst actors is critical.  Laboratory 
tests confirming the presence or absence of disease can 
inform decisions on slaughter bans, export policies, 
and market closures.  OFDA should consider funding CDC 
for the transfer of laboratory equipment to the GOK 
laboratory in Nairobi to enable regional testing 
capacities. 
 
¶23.  For mitigation purposes, OFDA is planning to 
support regional coordination and surveillance efforts 
through FAO and work to prevent further animal losses 
from unrelated diseases among already stressed herds. 
However, research into the effectiveness of vaccines to 
prevent further spread of the disease, and general 
impact assessments are also needed. 
 
RANNEBERGER