Cholera outbreak in Migori highlights WASH and cross-border gaps

Updated on March 10, 2025
by AFENET

From February 19–26, 2025, a team of field epidemiologists from the Kenya Field Epidemiology Training Program (KFELTP)—Annette Chesir, Dr. Fredrick Mutisya, Habiba Mohamed, and Onesmus Mmboyi—under the supervision of Dr. Maurice Owiny, conducted an in-depth investigation into a cholera outbreak in Migori County, Kenya. The team identified a total of 37 cholera cases, with 81.1% testing positive using Rapid Diagnostic Tests (RDTs). Laboratory analysis confirmed the presence of Vibrio cholerae O1 Ogawa in 7 out of 14 stool specimens tested. The case fatality rate (CFR) stood at 2.1%, exceeding the WHO threshold of less than 1%, signaling a critical public health concern. Key risk factors identified included:

Poor water, sanitation, and hygiene (WASH) practices, such as the use of unprotected water sources and inadequate sanitation facilities.
Cross-border movement between Kenya and Tanzania, which fueled disease transmission across communities.

The investigation concluded that the outbreak was closely linked to both substandard WASH conditions and uncontrolled cross-border population movement. To prevent future outbreaks, the team recommends:

Strengthening surveillance and early warning systems
Expanding access to clean and safe water
Intensifying hygiene promotion campaigns
Enhancing community engagement and cross-border collaboration

This investigation underscores the critical role of field epidemiologists in early detection and control of public health threats, and the importance of integrated, multisectoral responses to outbreaks.