South Sudan health workers face worst Kala-azar outbreak

South Sudan is facing the worst outbreak of Kala-azar in the past 10 years as health workers from Servant's Heart Relief (http://servantsheartrelief.org) race against the clock to stop the spread of the deadly disease.

Also known as visceral leishmaniasis, leishmania infection, Black Death, black fever, or Dumdum fever, Kala-azar is a chronic and typically fatal disease that attacks the liver, spleen, lymph nodes and bone marrow. External symptoms of Kala-azar include sores on the body, fever, inflamed spleen, abdominal pain, headaches, and joint pain.

The disease is spread by sand fly bites that infect the bitten with a parasite called Leishmania donovani. South Sudan is currently facing one of its worst dry seasons in a decade, leading to higher than normal populations of sand flies, which are smaller than mosquitoes, and very difficult to detect or see.

Currently there is no vaccine for prevention of the disease. The only prevention is "do not get bitten by a sand fly".

Left untreated, more than 95% of people infected with Kala-azar die within two to three months.

More than 300 confirmed cases

South Sudan is the world's newest country, and is expected to gain independence from Sudan in July 2011. In the regions of South Sudan that Servant's Heart Relief serves medically, more than 300 people have been confirmed to have the Kala-azar infection, with an additional seven to ten new cases being confirmed each day. Approximately 30% of the identified patients are pregnant women or malnourished children. Regions being served by other relief groups are reporting similar findings.

"Kala-azar is highly contagious and each untreated person can infect up to a dozen others," said Christopher Plante, Board Secretary, Servant's Heart Relief. "There is a time lag of three to five days between infection and the appearance of symptoms, so an infected person can infect others before realizing they have contracted the disease. At the current rate, the number of infections is expected to double in less than two weeks, which means we are in a desperate race to prevent an outbreak of exponential proportions."

Treatment

Servant's Heart Relief has established two Primary Health Care Centers (PHCC) to treat Kala-azar patients. In addition, Servant's Heart Relief health workers travel throughout the region to diagnose and treat patients who are unlikely to know they have the disease until they are too sick to travel by foot to the PHCCs.

There is currently no vaccine to prevent infection of Kala-azar. The standard treatment for Kala-azar is for 3 injections of Sodium Stibogluconate (SSG), administered over the course of 3 days. SSG injections, however, can be fatal for pregnant women and malnourished children, so these individuals are treated with an IV drug over 15 days.

The Government of South Sudan Ministry of Health has provided the SSG medication, but Servant's Heart Relief has had to purchase the syringes to administer the treatments. Additionally, Servant's Heart Relief is hopeful that the Ministry of Health will be able to provide the IV medication in the next several days. However, Servant's Heart Relief must purchase the related IV tubing and IV bags of saline. Servant's Heart Relief has already purchased the IV needles with its own funds.

With early diagnosis and treatment, the survival rate for Kala-azar is over 90%. "It is the lack of emergency funds that are hampering our efforts to address the logistics, treatment and transport for remote patients," Mr. Plante said.

Emergency funds requested

Servant's Heart Relief is in need of at least $75,000 to help contain the Kala-azar outbreak and treat the infected patients.

The special funding will help purchase additional medical supplies that are directly related to the diagnosis and treatment of the disease. The funds will also cover the costs of hiring additional health workers to assist in the diagnosis and treatment, and the costs of transporting medicines and personnel to key treatment locations throughout the region.

If Servant's Heart Relief is able to raise more than $75,000, these vital funds will be used to purchase chemically-treated bed nets, and to spray areas around huts and medical clinics.