Four people have died and more than 600 were sickened at two schools in Kenya recently.

The Ministry of Health (MOH) is investigating a suspected gastroenteritis outbreak at Mukumu Girls and Butere Boys high schools in Kakamega County.

The illness appears to have started on March 1 and as of April 14, 627 patients are sick with 19 students admitted to seven health facilities across the country. Symptoms include fever, abdominal pain, cramps, vomiting, and diarrhea. One teacher and three students have died.

Both schools have been closed by the Ministry of Education and Kakamega County government while investigations are ongoing.

Lab testing results
Preliminary lab analysis of water, food, and human samples has revealed Enterotoxigenic E. coli (ETEC) and Salmonella Typhi. Testing of grains and pulses has not found aflatoxin. Lab tests for various other diseases have also been negative. Typhoid fever is a bacterial infection caused by Salmonella Typhi.

ETEC is a major cause of diarrheal disease in lower-income countries, especially among children. It is transmitted by food or water contaminated with animal or human feces. Illness develops one to three days after exposure and usually lasts three to four days.

Country representatives from the World Health Organization (WHO) have also been contacted to help handle the incident.

The Ministry of Health received a request to support investigations into an outbreak at Mukumu Girls High School from Kakamega County government officers at the end of March. Field investigations pointed to possible contamination at the water reservoir.

The agency said the illness is likely to have been caused by a mixture of E. coli and Salmonella Typhi which can occur if water sources are contaminated. Person-to-person spread has also probably been involved due to the close proximity of people.

Advice to the public included maintaining high standards of personal hygiene by washing hands with soap and running water, treating or boiling all water for drinking or cooking, and properly cooking all food and eating it while it is still hot.

Anyone experiencing fever, abdominal pains, diarrhea, or vomiting should seek treatment at their nearest healthcare facility, said public health officials.