RIFT VALLEY FEVER SPREADS IN TANZANIA, FROM

UNCLAS SECTION 01 OF 03 DAR ES SALAAM 000434 SIPDIS SIPDIS DEPT FOR OES/IHA ALSO AF/E FOR BYODER, AF/RSA FOR MBITTRICK PASS TO USAID FOR E/AF FOR KDESGRANGES E.O. 12958: N/A TAGS: PGOV CASC PREL EAID PBTS TZ SUBJECT: RIFT VALLEY FEVER SPREADS IN TANZANIA, FROM NORTHERN TO CENTRAL REGION Summary -------------- ¶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 -------------- ¶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 DAR ES SAL 00000434 002 OF 003 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. DAR ES SAL 00000434 003 OF 003 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