Is Sri Lanka prepared for yellow fever outbreaks? A case study.

www.thelancet.com/lancetgh Vol 4 December 2016 e909 These defi ciencies might be common to most countries in Asia, making them vulnerable to the ongoing yellow fever epidemic. The data show that tourists entering Sri Lanka from selected west African and South American countries, especially via irregular routes, pose the highest risk of infection. However, the cases of yellow fever in China were mainly from returning Chinese migrant workers from Angola. Information on the yellow fever vaccination status of these populations might not be available in many countries because of gaps in registration and surveillance systems. Without these data, risk assessment would be partial and inaccurate. With the emerging threat of yellow fever and increasing global migration trends, non-endemic countries with high densities of A aegypti might be better prepared for possible yellow fever outbreaks through the establishment or enhancement of border health information systems, surveillance, and regulatory capacities. State parties to the International Health Regulations are required to develop and maintain capacities to respond to public health events at points of entry. Assessing the vaccination status of travellers when they arrive from, or depart to, yellow fever-endemic countries remains crucial. At the time of writing, following the yellow fever outbreak in Angola, the Directorate of Quarantine and Epidemiological Unit of the Ministry of Health, in partnership with airport authorities, are establishing such measures.