Public health round-up

The World Health Organization (WHO) and its partners despatched 1.9 million doses of yellow fever vaccine to Angola last month to quell a large outbreak, amid fears it could spread to other parts of central and eastern Africa. Since the outbreak was first reported in the capital Luanda in December 2015, it has spread to at least five of the country’s 18 provinces. As of 10 April, 582 people were confirmed to have yellow fever and 242 of them had died in Angola. Imported cases of yellow fever have been reported in other parts of Africa – the Democratic Republic of the Congo and Kenya – as well as in China. “There is a risk that the outbreak in Angola could spread to other parts of central and eastern Africa, where the virus is endemic and where most people are not vaccinated,” said Dr Sergio Yactayo, an epidemic diseases expert at WHO. Yellow fever is endemic in 34 countries in Africa and 13 countries in the Americas – countries where monkeys are the natural reservoir for the virus and there is a high risk of transmission to humans. Since 2006 more than 105 million people in West Africa have been vaccinated and no yellow fever outbreaks were reported there last year. However, mass vaccination campaigns for yellow fever have not been conducted in central and eastern Africa. WHO and its partners in the International Coordination Group (ICG) for vaccine provision sent 9.4 million doses of yellow fever vaccine from their emergency stockpiles to Angola in February and March. Yactayo, a member of the ICG, said that Angola had requested a further 3.2 million doses to respond to outbreaks in some of its provinces and that the 1.9 million doses were sent in response but that more vaccine was needed. WHO is discussing the possibility of diverting vaccine shipments for national immunization programmes in other countries to Angola, until the outbreak is under control. Yellow fever virus is transmitted by mosquitoes. Symptoms include fever, headache, muscle pain, nausea, vomiting and fatigue and in a proportion of cases complications can be fatal. WHO classed the outbreak as a grade 2 (out of three levels) emergency and has deployed around 65 experts in epidemiology, vector control and community engagement to Angola to support the vaccination campaign. There are several sources of funding for the outbreak response. WHO’s Contingency Fund for Emergencies released US$ 500 000 and WHO’s African Public Health Emergency Fund has provided US$ 289 383. The United Nations Central Emergency Response Fund has agreed to provide US$ 3 million to help purchase the vaccines. The Angolan government has committed US$ 15 million for the purchase of the yellow fever vaccine, in addition to the payment of 50% of the cost of the vaccines already received for the province of Luanda. http://www.who.int/csr/don/13april-2016-yellow-fever-angola