The first case of an extremely rare mad cow disease, which affects the nervous system and is usually fatal, was reported in Kenya.
The case of sporadic Creutzfeldt-Jakob disease (sCJD) referred to a large teaching hospital in Nairobi is the first to be reported in East Africa.
“We report the case of a 57-year-old man with a three-week history in which he lost direction while driving home and had visual hallucinations that were seen as rainbows,” said the treating doctors.
While other variants have been suspected in the country, doctors say it is the first time this extremely rare form, called the Heidenhain variant, has been recorded in East Africa.
“We are presenting the first reported case of the Heidenhain variant of sCJD from the East Africa region that is referred to our regional tertiary neurology referral center in Nairobi,” the experts say.
CJD is the human version of the mad cow disease bovine spongiform encephalopathy (BSE), which was first identified in the UK in 1986.
180,000 cows were affected during the outbreak and since then it has been recorded in more than a dozen countries.
At least 28 human deaths were reported in the UK outbreak, believed to have been transmitted through consumption of contaminated beef.
However, the case of people in Kenya reported in the International Medical Case Reports Journal earlier this month (February 2) has an unknown cause.
Aside from eating contaminated beef, the disease can be inherited or transmitted during some medical procedures that include organ transplants, tissue transplants, hormone treatments, or contaminated surgical equipment.
The Kenyan patient with diabetes and high blood pressure has not had an organ transplant or hormone treatment in the past. “The patient also had no familial dementia or rapid cognitive decline.”
Initially, the patient was treated for probable epilepsy, but in less than a month he was readmitted with worsening symptoms. These included memory problems, aggression, balance disorders, language problems, and seizures.
Further tests carried out at home and abroad had suggested a probable sCJD-Heidenhain variant. The patient was then given palliative care at a local hospice where he died approximately three months after symptoms appeared.
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“Our case demonstrates the presence of a rare form of sCJD and the diagnostic challenges in our resource-constrained environment,” the doctors concluded.
Due to the rare occurrence, the team has now implemented a standard protocol for investigating suspected CJD cases.
While doctors describe this as the first recorded case of the rare form of sCJD disease in Kenya, other people may have the incurable disease.
In a 2015 study by Adam Mohamed Adam, a consulting neurologist and lecturer at the University of Nairobi urged colleagues to look out for the disease in Kenya.
By reviewing the records and including active cases, Pro Adam had identified 13 CJD-likely patients who had been treated at the same facility for 14 years.
On average, the patients were 63 years old and survived about five months after symptoms appeared. They came from different ethnic communities in Kenya.
“The patients belonged to different ethnic groups. There were no family, tribal, or regional clusters, ”wrote Prof. Adam in the journal Tropical Medicine and International Health.
The cases involved three Kikuyu, two Asians, two Swahili and one each from Somali, Kisii, Luo, Kalenjin, Kamba and Giriama, suggesting that no family was inherited.
According to the report, none of the patients had traveled to the UK as the study coincided with the mad cow disease outbreak in the UK.
The study also ruled out the possibility that the disease was caused by a medical procedure, as none of the 13 had records of organ transplants, hormone treatments, or tissue transplants. all known causes of CJD.
However, the authors caution that although most cows in Kenya feed on grass, unlike developed countries where feed from animal sources is common, local doctors should keep an eye out for the deadly disease.
“Cattle in East Africa are grass-fed, but neurologists should watch out for CJD,” says the study, which predicts that cases could increase as life expectancy in Kenya increases.