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YELLOW FEVER OUTBREAK IN CHAD

Yellow fever in Chad

14 FEBRUARY 2013 - The Ministry of Health of Chad is launching an emergency mass-vaccination campaign against yellow fever from 22 February 2013, following laboratory confirmation of two cases in the country in December 2012.

The two cases from Goz Beida and Guereda districts, were laboratory confirmation by a WHO regional reference laboratory for yellow fever, Institut Pasteur in Dakar, Senegal. They were identified through the national surveillance programme for yellow fever, following intensive surveillance which was triggered in response to the outbreak of yellow fever in neighbouring Sudan’s Darfur region. The intensive surveillance in Chad also reported 139 suspected cases and 9 deaths.

The vaccination campaign will be conducted in 3 districts bordering Darfur, Sudan, namely Goz Beida, Guereda and Adré, targeting over a million people, including inhabitants of refugee camps in the area.

Yellow fever in the Republic of Congo

 The Ministry of Health of the Republic of Congo is launching an emergency mass-vaccination campaign against yellow fever in Ewo District in Cuvette-Ouest region, beginning next week.

The emergency vaccination campaign aims to cover approximately 35,000 people in three health districts of Mbama, Ewo and Okoyo, all of which belong to the administrative district of Ewo.

The emergency vaccination campaign is being carried out after recent confirmation of a case with yellow fever virus infection that occurred in October 2012. The case was identified through the national surveillance programme for yellow fever.Laboratory confirmation was done at Institut National de Recherche Biomédicale Kinshasa (INRB), and reconfirmed by a WHO regional reference laboratory for yellow fever, Institut Pasteur, Dakar, Senegal.

JAPANESE ENCEPHALITIS VACCINE

We are happy to announce the availability of JAPANESE ENCEPHALITIS VACCINE ( JEEV ).
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Yellow fever in Sudan - update

22 NOVEMBER 2012 - The Federal Ministry of Health (FMOH) in Sudan began a 10-day mass vaccination campaign against yellow fever in Darfur on 20 November 2012, in response to the outbreak.

As of 17 November 2012, the outbreak is reported to have affected 26 localities, with a total of 459 suspected cases including 116 deaths. Two cases were confirmed by IgM ELISA test and RT-PCR by the WHO regional reference laboratory for yellow fever, the Institut Pasteur in Dakar, Senegal. An outbreak investigation team led by the Ministry of Health, with support from WHO are in the field to assess the extent of the outbreak and prioritize areas for the mass vaccination campaign.

With support from the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG), the Central Emergency Response Fund (CERF), and international non-governmental organizations (INGOs), the vaccination campaign will be carried out in the most affected 12 localities in Darfur region, targeting approximately 2.2 million people.

The YF-ICG is a partnership which manages stockpile of yellow fever vaccines for emergency response. It is represented by United Nations Children's Fund (UNICEF), Médecins Sans Frontières (MSF) and the International Federation of Red Cross and Red Crescent Societies (IFRC) and WHO, which also serves as the Secretariat.

Seven INGOs, including the International Committee of the Red Cross, MSF-Belgium, MSF-Spain, MSF-Swiss, Merlin, Save the Children-Swiss, and International Medical Corps are currently working in the 12 localities prioritized for the vaccination campaign. They will actively support the FMOH in this emergency response.

WHO is supporting the State Ministries of Health in conducting field investigations to better assess the epidemiological situation and the risk of disease spread, as well as on-the-job trainings for health staff to strengthen their disease surveillance systems and to improve collection of samples and laboratory diagnosis.

WHAT IS THE RISK OF INTERNATIONAL SPREAD OF YELLOW FEVER ?

The risk of international spread is greater than before. In the past devastating outbreaks occurred mainly in sea ports. Today, most cities are connected to most of the world by more rapid means of transport, train or plane. So far, the virus circulation has remained within the borders of historically endemic countries, but the virus could spread quickly and cause epidemics in areas with a high density of vectors and a non immune population.

Yellow fever resurgence : impact of mass vaccination campaigns

Historically yellow fever (YF) has caused devastating epidemics in Europe, Africa, South, Central and North America, but, for unknown reasons, yellow fever has not spread to Asia yet. The development of the live attenuated 17D vaccines in the 1930s was a turning point in the history of the disease. One dose of YF vaccine provides protection for at least 10 years and possibly lifelong. The vaccine is considered to be very safe.

Successful attempts to control yellow fever through compulsory immunization took place in the beginning of the 20th century : in some French speaking African countries (Benin, Burkina Faso, Cameroon, Chad, Cote d'Ivoire, Congo, Gabon, Guinea, Senegal, Togo) mass vaccination campaigns were carried out between 1933 and 1961 and resulted in the gradual disappearance of the disease.

Until the early 1990s, almost 30 years after the end of the mass preventive immunization campaigns, yellow fever remained only very sporadically active in the countries that benefited from those campaigns. However, during the same period, countries such as Ethiopia, Gambia, Ghana, Guinea Bissau, Liberia, Nigeria and Sierra Leone, which did not benefit from mass vaccination campaigns, experienced large epidemics.

Recently many small outbreaks have been reported in several countries, for the most part West African, indicating a re-emergence of yellow fever.

The interruption of regular mass vaccination campaigns in Africa has played a major role in the current resurgence of yellow fever. The resurgence began in equatorial Africa, with the 1990 epidemic in Cameroon (173 cases) in which 79% of the victims were children aged under 10 years. The disease then struck in West Africa and since 1995 this has been the region most affected by yellow fever.