Yellow fever expands in Angola; vaccination set for DRC, Uganda
Local yellow fever transmission in under way in six of Angola's other highly populated provinces, with the mosquito-borne disease spreading to new provinces and districts, according to the WHO. Weak surveillance systems are struggling with identifying newly affected areas, especially in remote locations such as Cabinda province.A related outbreak in urban areas of neighboring Democratic Republic of Congo (DRC) underscores the threat of international spread, especially to Namibia and Zambia where borders are porous and populations aren't usually vaccinated against yellow fever, the WHO said.
New developments since last week's report include confirmed cases and local spread in Angola's Namibe province, which borders Namibia. At the end of April, Namibia reported a suspected yellow fever case imported from Angola, but the patient tested negative for the disease on May 6. Namibia has requested 450,000 doses of yellow fever vaccine to use for travelers and refugees.
Also, the WHO said the DRC has reported imported cases from two Angolan provinces where local transmission hasn't been reported: Cabinda and Zaire. Cabinda is separated from the rest of Angola by a narrow strip of land belonging to DRC, and the spread of yellow fever there threatens both DRC and the Republic of Congo, the province's neighbor to the north.
In a backgrounder Q and A report yesterday on Angola's outbreak, the WHO said the location of Africa's yellow fever outbreaks since 2010 has shifted from West Africa—where vaccination programs have has made significant progress with disease control—to central and East Africa, where no mass immunization campaigns have been conducted.
Red Cross Says Angola Yellow Fever Outbreak May Spark 'Global Crisis'The International Federation of Red Cross and Red Crescent Societies (IFRC) urged immediate action with health director Julie Hall warning that limited vaccine supplies, inadequate disease surveillance systems, poor sanitation and continuous movement across Angola's borders "could turn a national outbreak into a global crisis."
"Unvaccinated travelers could transform this outbreak into a regional or international crisis if we don't move quickly to protect vulnerable populations and help communities to reduce their risk of infection," she said in a statement.
WHO calls emergency meeting on yellow fever outbreak
The World Health Organisation will hold an emergency meeting on Thursday on the yellow fever outbreak that has hit hardest in Angola but risks spreading further if vaccinations are not ramped up.Such meetings from the UN agency are often held before the declaration of an international health emergency, as happened amid the Ebola outbreak in West Africa, and the current surge in neurological disorders linked to the spread of Zika virus in the Americas.
As of May 12, Angola had reported 2,267 suspected yellow fever cases and 293 deaths (
12.9%) in an outbreak that began in December and is most heavily concentrated in the capital Luanda (
population: 2.776 million).
Eleven people have tested positive for yellow fever in China after returning from Angola, "highlighting the risk of international spread through non-immunised travellers," WHO has said
WHO: Yellow fever outbreak is 'serious and of great concern'Yellow fever, a viral hemorrhagic illness, is transmitted to people when a mosquito becomes infected from biting an infected monkey and then bites a person.
Symptoms usually begin three to six days after a bite from an infected mosquito and last about three or four days. They include fever, muscle pain, nausea, vomiting and loss of appetite. Yellow fever can be confused as dengue fever, malaria or another illness.
Fifteen percent of infected individuals experience a second phase of illness within 24 hours of when they first become sick. This can include jaundice and bleeding from the eyes, nose, mouth, stomach and, eventually, bloody vomit and feces.
There is no treatment for yellow fever. Those who are sick are given supportive care, which can include fluids, pain management and monitoring. Fifty percent of patients who experience this second phase of illness die within 10 to 14 days.
Health officials to weigh declaring global emergency as yellow fever strikes southwest AfricaAn explosion of yellow fever is not farfetched given the challenges of controlling the spread of the virus. While more than 105 out of 700 million Africans have been vaccinated since 2006 when WHO launched a yellow fever initiative, several African nations still are not completely protected against the disease.
Combating yellow fever is made more challenging because victims don't show definitive symptoms until the disease has progressed, making early detection difficult.
... Also, there is the potential for rapid spread to other countries and regions, threatening the health of large populations in Africa, Asia and elsewhere," Gostin said. "Second, as the crisis escalates, global supplies of the yellow fever vaccine are dwindling and we could easily face a critical shortage.
The outbreak in Angola is particularly worrisome because it is happening in urban areas, such as the capital city Luanda, where the first cases in the country were detected, health officials said.
"You have trillions of mosquitoes and millions of people, so the capacity of transmission of the virus is multiplied enormously,” said Briand. The virus is far easier to fight in sparsely populated rural areas, she said.
“Those urban settings are very well connected with the rest of the world,” said Briand of WHO. “Unfortunately, many people don’t take seriously enough the issue of vaccinations for travelers. This is why we have had many cases exported.”
“The looming fear is a yellow fever outbreak in Asia,” where the disease is not currently endemic, said Lucey, the Georgetown immunologist.
Ten dead from haemorrhagic fever outbreak in South Sudan: WHOMystery Disease? "A total of 51 suspected cases, including 10 deaths, had been reported," the WHO said in a statement on Thursday. Cases are from the northeastern Aweil region, with the last recorded death in late February.
"The most frequent symptoms include unexplained bleeding, fever, fatigue, headache and vomiting," WHO said. "The symptoms do not seem to be severe and rapidly resolve following supportive treatment." Samples tested were all negative for Ebola and Marburg virus diseases.
Yellow Fever Concerns Put 1878 Memphis Outbreak In Spotlight... Memphis had its own yellow fever outbreak nearly 140 years ago that devastated the city. The Bluff City lost three quarters of its population in less than two months back in 1878 when 25,000 people fled the city and more than 5,000 died from the virus.
Shelby County historian Jimmy Ogle says the virus caused people to "deteriorate" very quickly.
"We had filthy conditions here in Memphis, carcasses in the streets of animals, burials... like 200 a day at Elmwood Cemetery," says Ogle.
... The yellow fever vaccine can have life threatening side effects especially in the elderly, so Dr. Threlkeld doesn't recommend it unless you're traveling to a country where the virus is prevalent.
