Fighting halts effort to verify deadly fever

Fighting in southern Somalia has hampered efforts to confirm a possible spread of Rift Valley Fever (RVF) from neighbouring Kenya to the Lower Juba Region where seven people have died after showing symptoms of the rare, contagious haemorrhagic disease, Somali health officials said.

The deaths were reported in Dobley, 18 km north of the Kenyan border, in the last five days. "The dead are mainly nomadic herders," said Hassan Mursal, a clinical officer in nearby Afmadow hospital. "The number could be higher but because of the current insecurity in the area there is no way of getting the full picture."

Mahamud Haji Hassan Jabra, an epidemiologist with the European Union-funded Somali Animal Health Service Project, said numerous reports of animal abortions – a key indicator of the disease - had been received from the area. But plans to send two teams to verify the outbreak would only go ahead once the security situation allowed.

"Our focal point in the area has reported the clinical signs of the disease but we need to confirm this by testing the samples collected," he said. "If it turns out to be RVF it will have a devastating impact on the livelihoods of the pastoralists, who have suffered two years of drought followed by heavy flooding."

Dobley is close to the Kenyan border where fighting continues between Union of Islamic Courts (UIC) remnants and Ethiopian-backed Somali government soldiers, who have been chasing them since the UIC were forced out of Mogadishu and much of southern Somalia.

A humanitarian source in the area told IRIN on Tuesday that casualties had been reported when planes carried out air strikes in villages close to Dobley. "We have reports of 22 people killed by the bombing," he said. International media reported that the planes were American, targeting suspected al-Qaeda operatives.

"Most of those killed were in a convoy of donkeys carrying sugar to the outlying villages," which have been rendered inaccessible due to recent heavy rains, said the source, who requested anonymity. Another source told IRIN there were reports of a number of armed militia in the area. "We don’t know whether they belonged to the Islamic courts or not but some people are saying that they were there."

The bombardment took place in an area known as Jiiro, a "very good pastureland, with the highest concentration of cattle in the Juba valley", said the humanitarian source, adding that whether there were militants in the area or not, "civilians had been hit".

The fighting, he added, was making "it impossible to access the area and help the pastoralists".

Addressing the outbreak

An epidemic of RVF is first manifested in unexplained abortions among livestock. However, Jabra cautioned that "some of the symptoms of RVF, such as fever, headache and muscle pain are also common in flu and malaria".

According to the United Nations World Health Organization, the disease is endemic in Africa, naturally occurring in livestock but occasionally affecting humans. Animals are infected with the RVF virus by the Aedes mosquito. Characterised by bleeding from all orifices, it is spread to humans via infected mosquitoes; through contact with blood or other body fluids; or from the organs of infected animals.

The disease mainly occurs after heavy rainfall - southern Somalia has been experiencing El Niño-type rains, which flooded many parts of the country. "The conditions in Lower Juba region are conducive to an outbreak," said Jabra.

At least 60 people in Kenya's Northeastern Province have died from the disease and last week, health experts warned it may have begun to spread. "All evidence suggests that the disease is still spreading," said Kariuki Njenga, a virologist and laboratory director for the United States Centers for Disease Control (CDC) in Kenya.

The worst affected districts are Garissa, where 100 cases, including 40 deaths, have been reported; and Ijara, where 20 out of 42 people infected with RVF have died. The CDC has set up a field laboratory to test suspected cases and is helping the Kenyan government to develop a vaccination strategy.

A team from the UN Food and Agriculture Organisation is also working with Kenya, Somalia and Ethiopia to address the outbreak. "Together with officials from the WHO and various international aid agencies present in the area, the FAO team is helping to draw up preparedness, communication, surveillance and response activities," according to a FAO statement.

The last outbreak of RVF in Somalia was in 1997 and led to a ban on livestock from Somalia by the Arab Gulf States. Livestock exports had been the backbone of the Somali economy.

ah/mw/eo