Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study

Introduction: The Ministry of Health, Kenya (MOH) investigated a report on acute watery diarrhea (AWD) cases at a city hotel to confirm the cause, characterize, and identify associated factors. Methods: A suspected case of cholera was defined as AWD in any person aged >2 years at the hote...

Full description

Saved in:
Bibliographic Details
Main Authors: Philip Ngere, Elvis Oyugi, Alexis Niyomwungere, Scolastica Wabwire, Adi Dahabo, Daniel Langat, Raphael Muli, Maurice Owiny
Format: Article
Language:English
Published: African Field Epidemiology Network 2022-01-01
Series:Journal of Interventional Epidemiology and Public Health
Subjects:
Online Access:https://www.afenet-journal.net/content/article/5/3/full/
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850268535192813568
author Philip Ngere
Elvis Oyugi
Alexis Niyomwungere
Scolastica Wabwire
Adi Dahabo
Daniel Langat
Raphael Muli
Maurice Owiny
author_facet Philip Ngere
Elvis Oyugi
Alexis Niyomwungere
Scolastica Wabwire
Adi Dahabo
Daniel Langat
Raphael Muli
Maurice Owiny
author_sort Philip Ngere
collection DOAJ
description Introduction: The Ministry of Health, Kenya (MOH) investigated a report on acute watery diarrhea (AWD) cases at a city hotel to confirm the cause, characterize, and identify associated factors. Methods: A suspected case of cholera was defined as AWD in any person aged >2 years at the hotel from August 31, 2017, to September 6, 2017. We took rectal swabs for laboratory confirmation and summarized the AWD data by person, place, and time. We defined a cohort of hotel staff with those who ate dinner on August 31, 2017, considered exposed and conducted a retrospective cohort study. We calculated attack rates (AR) and risk ratios (RR) with 95% confidence interval. Variables with p<0.1 at bivariate analysis were entered into a multivariate model and those with p<0.05 in the final model considered independently associated with the AWD. Results: Vibrio cholera was isolated from seven (10.1%) out of 69 samples. Line listed 139 cases with a median age of 32 years (Range: 20–58 years) included 127 (91.4%) male and 127 (91.4%) guests. Index case was reported on August 31, 2017, cases peaked at 95 cases on September 3, 2017, and declined to three on September 6, 2017. A total of 30 (81.1%) of 37 hotel staff were exposed with 17 (56.7%) cases. Food specific ARs were: steamed spinach 78.6% and pineapples 26.3%. Spinach (RR: 3.0 (95%CI: 1.76-72.97)) was a risk factor while pineapples (RR: 0.4 (95%CI: 0.01-0.58)) was protective. Conclusion: This was a point source cholera outbreak likely due to eating contaminated spinach.
format Article
id doaj-art-a1bfa91f1ab744d8bc6eecaa7cdb9f2c
institution OA Journals
issn 2664-2824
language English
publishDate 2022-01-01
publisher African Field Epidemiology Network
record_format Article
series Journal of Interventional Epidemiology and Public Health
spelling doaj-art-a1bfa91f1ab744d8bc6eecaa7cdb9f2c2025-08-20T01:53:26ZengAfrican Field Epidemiology NetworkJournal of Interventional Epidemiology and Public Health2664-28242022-01-0151https://doi.org/10.37432/jieph.2022.5.1.51Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort studyPhilip Ngere0Elvis Oyugi1Alexis Niyomwungere2Scolastica Wabwire3Adi Dahabo4Daniel Langat5Raphael Muli6Maurice Owiny7Field Epidemiology and Laboratory Training Program, Ministry of Health, Kenya; Department of Disease Surveillance and Epidemic Response, Ministry of Health, KenyaField Epidemiology and Laboratory Training Program, Ministry of Health, KenyaField Epidemiology and Laboratory Training Program, Ministry of Health, KenyaField Epidemiology and Laboratory Training Program, Ministry of Health, KenyaField Epidemiology and Laboratory Training Program, Ministry of Health, KenyaDepartment of Disease Surveillance and Epidemic Response, Ministry of Health, KenyaDepartment of Health Services, County Government of Nairobi, KenyaField Epidemiology and Laboratory Training Program, Ministry of Health, KenyaIntroduction: The Ministry of Health, Kenya (MOH) investigated a report on acute watery diarrhea (AWD) cases at a city hotel to confirm the cause, characterize, and identify associated factors. Methods: A suspected case of cholera was defined as AWD in any person aged >2 years at the hotel from August 31, 2017, to September 6, 2017. We took rectal swabs for laboratory confirmation and summarized the AWD data by person, place, and time. We defined a cohort of hotel staff with those who ate dinner on August 31, 2017, considered exposed and conducted a retrospective cohort study. We calculated attack rates (AR) and risk ratios (RR) with 95% confidence interval. Variables with p<0.1 at bivariate analysis were entered into a multivariate model and those with p<0.05 in the final model considered independently associated with the AWD. Results: Vibrio cholera was isolated from seven (10.1%) out of 69 samples. Line listed 139 cases with a median age of 32 years (Range: 20–58 years) included 127 (91.4%) male and 127 (91.4%) guests. Index case was reported on August 31, 2017, cases peaked at 95 cases on September 3, 2017, and declined to three on September 6, 2017. A total of 30 (81.1%) of 37 hotel staff were exposed with 17 (56.7%) cases. Food specific ARs were: steamed spinach 78.6% and pineapples 26.3%. Spinach (RR: 3.0 (95%CI: 1.76-72.97)) was a risk factor while pineapples (RR: 0.4 (95%CI: 0.01-0.58)) was protective. Conclusion: This was a point source cholera outbreak likely due to eating contaminated spinach.https://www.afenet-journal.net/content/article/5/3/full/acute watery diarrheacholeravibrio choleraekenya
spellingShingle Philip Ngere
Elvis Oyugi
Alexis Niyomwungere
Scolastica Wabwire
Adi Dahabo
Daniel Langat
Raphael Muli
Maurice Owiny
Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
Journal of Interventional Epidemiology and Public Health
acute watery diarrhea
cholera
vibrio cholerae
kenya
title Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
title_full Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
title_fullStr Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
title_full_unstemmed Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
title_short Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
title_sort cholera outbreak at a city hotel in kenya 2017 a retrospective cohort study
topic acute watery diarrhea
cholera
vibrio cholerae
kenya
url https://www.afenet-journal.net/content/article/5/3/full/
work_keys_str_mv AT philipngere choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy
AT elvisoyugi choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy
AT alexisniyomwungere choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy
AT scolasticawabwire choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy
AT adidahabo choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy
AT daniellangat choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy
AT raphaelmuli choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy
AT mauriceowiny choleraoutbreakatacityhotelinkenya2017aretrospectivecohortstudy