RIFT VALLEY FEVER SPREADS IN TANZANIA, FROM

UNCLAS SECTION 01 OF 03 DAR ES SALAAM 000434

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TAGS: PGOV CASC PREL EAID PBTS TZ
SUBJECT: RIFT VALLEY FEVER SPREADS IN TANZANIA, FROM
NORTHERN TO CENTRAL REGION


Summary
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1. (SBU) Rift Valley Fever (RVF),an acute fever-causing
viral disease that affects livestock and humans, has spread
from northern to central Tanzania, with Dodoma Region the
hardest hit. While most RVF cases are not fatal, the 18
deaths in Tanzania since the February 2007 outbreak have
sparked fear among the population and seriously affected the
meat industry in Northern Tanzania. The Government of
Tanzania (GOT) has taken steps to address the outbreak
including ordering vaccines to protect the cattle around
infected areas. The Ministry of Livestock and Development
(MOL) and the Ministry of Health and Social Welfare (MOHSW)
have also presented a work plan for donor assistance to
increase health surveillance, public awareness and
vaccination coverage. Although the GOT is taking the right
measures, health and veterinary capacity is poor and there is
a significant risk that RVF will spread further. The Embassy
has issued two warden messages and post will continue to
monitor the situation closely. END SUMMARY.

Rift Valley Fever Spreads
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2. (U) According to the U.S. Centers for Disease Control and
Prevention (CDC),Rift Valley Fever (RVF) is an acute
fever-causing viral disease which affects domestic animals
such as cattle, buffalo, sheep, goats and camels, and humans.
RVF can be transmitted through mosquitoes, exposure to
uncooked or partially cooked meat, blood, and milk of
infected animals. In Kenya, RVF has killed about 170 people
after the outbreak in November 2006. In February 2007, the
GOT confirmed an outbreak of RVF in the northern region of
Tanzania, including Arusha. (Note: Although Dar es Salaam's
CDC Office does not currently have an official role with
respect to RVF, CDC Tanzania is currently playing an advisory
role to the GOT, coordinating technical assistance and
liaising with CDC Kenya for transport of samples for
laboratory diagnosis.)


3. (SBU) Since Tanzania's initial outbreak in February 2007,
RVF has killed 18 Tanzanians and hospitalized 79 others.
Although the number of fatalities is small, the virus is
spreading, creating fear among the Tanzanian population, and
affecting the food supply. Dodoma, the legislative capital
and a traditional livestock and meat packing area, has been
the hardest hit with 15 deceased and 60 hospitalized. Other
affected regions include Arusha (2 deceased; 12
hospitalized),Manyara (0 deceased; 6 hospitalized),and
Tanga (1 deceased; 1 hospitalized). RVF has also killed more
than 600 cattle in the Arusha region and over 4,000 animals,
mainly cattle, have aborted because of illness associated
with RVF. Dr. Mbuji, an epidemiologist with the MOHSW noted
that the nation's central slaughter house is located in
Dodoma, bringing in cattle from all different parts of the
country.


4. (SBU) Awareness about RVF and health surveillance of
affected areas appears to have increased. CDC Tanzania
reported that the first six cases of RVF in Tanzania were
only diagnosed post-mortem. An increasing number of
hospitalized patients suggests that health workers have been
able to detect cases earlier. (Note: Tanzania does not have
the laboratory capacity to diagnose RVF in humans and must
send all human samples to the CDC laboratory in Kenya for
diagnosis.) According to Dr. Mbuji, however, increased
health worker training and surveillance is critical because
evidence indicates that symptoms of the disease are changing,
with cases showing more central nervous system signs (e.g.
coma).

Fear Spreading Alongside Disease
--------------

5. (SBU) Fear and misinformation about RVF have also spread
in Tanzania. While there is no cure for RVF, the majority of
cases (approximately 90 percent) are not fatal. Responding
to the public's escalating fear, Deputy Minister of Health,
Dr. Aisha Kigoda, issued the following statement on March 14:
"The government has managed to contain the situation. I
repeat the situation is under control." According to Wesley

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Edwards, an American cattle ranger in Arusha, leaders of
various churches have been instructing congregations not to
drink milk and not to eat meat. At a press conference on
March 19, Minister of Health, Professor Mwakyusa, updated the
public about the spread of RVF and tried to clarify
misconceptions about not eating any meat or drinking milk.
He warned people to refrain from "drinking unboiled milk and
eating raw or uncooked meat."

Meat Industry in Arusha at Standstill
--------------

6. (SBU) According to Edwards, the livestock industry in
Northern Tanzania has suffered a major set back over the past
two months. In early February, the GOT closed livestock
markets in Arusha. "What that means is that all the people
that used to sell animals, are no longer able to. Butchers
have no access to meat and therefore are not selling it,"
Edwards told PolOff on March 20. He noted that some cattle
were being sold to Arusha's municipal slaughter house and
that the slaughter house claimed to check cattle for RVF. In
the past Arusha's slaughter house killed about 150 cattle per
day, while now it is killing about ten. Edwards also
confirmed that the demand for meat and milk has declined and
that the price had dropped significantly.

GOT Actions to Address RVF
--------------

7. (SBU) Both Tanzania's MOL and the MOHSW have moved to
respond to the RVF outbreak. In February, the Ministry of
Livestock placed restrictions on the movement of cattle and
took 195 blood samples from cattle for testing at a
laboratory in Temeke, Dar es Salaam. The MOL has also
started vaccinating cattle around affected areas. The MOHSW
has conducted surveillance in Northern Tanzania and increased
training of health workers to collect samples, identify, and
treat the disease. According to CDC Tanzania, however, closer
MOL and MOHSW collaboration is needed for a unified response.


8. (SBU) On March 12, the MOHSW's Director of Preventative
Services hosted a meeting with representatives from the
MOHSW, MOL, Office of the Prime Minister, CDC Tanzania, and
the United Nations (UN) Regional Operations Office. The
MOHSW and MOL presented a joint work plan and budget
identifying key areas where the GOT requires assistance to
respond to RVF: surveillance training for health workers,
public awareness campaigns, and vaccinations. The UN
Regional Operations representative will present the GOT work
plan to the Development Partners Group, of which USAID is a
member, to obtain support for the effort. UNICEF has already
agreed to support RVF public awareness campaigns in Tanzania.

Key Challenge: Lack of Vaccines
--------------

9. (SBU) At the March 19 press conference, Health Minister
Mwakyusa announced that the GOT had ordered two million
vaccines and had already started vaccinating cattle in
certain areas. The strategy, he explained, is to vaccinate
cattle in a ring around infected areas to prevent further
spread. Rebecca Martin, a health specialist with Dar es
Salaam's CDC office, noted that the GOT hopes to use
vaccinations as quickly as possible to contain the spread
south.


10. (SBU) Martin clarified, however, that obtaining enough
RVF vaccines will not necessarily be easy or quick. Kenya,
she explained, bought all vaccines available on the market.
"Tanzania currently only has about 486,000 doses of vaccines
and will have to wait for more to become available as they
are manufactured in South Africa," Martin said. The
Permanent Secretary at MOL, Mr. Nyamarunda, explained that
MOL had started the process of inoculations but that an
estimated 30 million vaccines total were needed to vaccinate
livestock across the country. Wesley Edwards noted that he
had purchased vaccines through a private company to protect
his cattle. He stressed that the vaccinations require a cold
chain and that effectiveness could deteriorate in more
remote, rural locations without proper refrigeration and
storage.


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Comment: Quick, Unified Action Needed to Curb RVF Spread
-------------- --------------

11. (SBU) While the GOT is taking the right steps to address
the RVF outbreak, the virus is spreading. Increasing
surveillance for early detection, public awareness and
vaccinations are all critical to preventing the spread of RVF
throughout Tanzania. However, the Deputy Minister of
Health's announcement that the situation was "completely
under control," was an overstatement. Health and veterinary
capacity is weak; obtaining and administering vaccinations
will likely be a slow, arduous process; and coordination
between GOT agencies could be improved. The MOHSW focal
point on RVF, for example, was not able to speak about the
vaccination situation since it was covered by MOL. It does
appear that with the spread to Dodoma - in the heart of
Tanzania with parliamentary session due to open in two weeks,
- that GOT officials are increasingly concerned, vocal, and
ready to pursue a comprehensive containment strategy. Post
will continue to monitor the situation closely. END COMMENT.
DELLY