Yellow Fever Alert!

The December 2015 outbreak of Yellow Fever (YF) in Angola should be of great interest and concern to health authorities in East Africa. According to the World Health Organization (WHO), “as of 7 April 2016, a total of 1,708 suspected cases, including 238 deaths (Case Fatality Rate: 13.9%), had been reported from 16 of the country’s 18 provinces.” The majority of cases have been around Luanda.

Of grave concern is that cases imported from Angola have been reported in Kenya, Congo Free State and China.

The WHO “urges Members States especially those where the establishment of a local cycle of transmission is possible (i.e., where the Aedes mosquitoes are present) to strengthen the control of immunization status of travellers to all potentially endemic areas and the surveillance of potential YF cases.”

In the context of an ongoing YF outbreak in Angola, special attention should also be placed on travellers returning from Angola and other potentially endemic areas. Travellers, particularly those arriving in Asia from Africa or Latin America should always have a certificate of YF vaccination.

Yellow Fever is a viral hemorrhagic zoonotic disease caused by a Flavivirus (family = Flaviviridae.)

Common Mosquito

Vector: Aedes mosquito (in Africa) and Haemagogus mosquito (in South America.)

The mosquitoes feed on infected Monkeys or humans and transmit the virus to other humans.

Endemic in Africa and South America. Most affected region in Africa : Draw a line from Senegal to Ethiopia, down to the Kenya-Tanzania border, across to Uganda, down to Burundi and Congo and across to Angola.

Clinical disease: Incubation period: 3-6 days. Acute with fever, nausea, vomiting, severe headache, muscle pain. Upper abdominal pain; liver disease with jaundice (yellow discoloration), kidney failure, bleeding, shock and death.

Deaths: 20% in Africa; 40-60% in South America.

Treatment: No effective antivirus treatment available. Supportive treatment only.

Prevention: Environment control measures and (2) a single dose live attenuated vaccine gives life-long immunity.

International Health Regulations (IHR) require all travellers to endemic regions to have YF certificate.


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