2016 Angola and DR Congo yellow fever outbreak

2016 Angola and DR Congo yellow fever outbreak
As of 28 October 2016[1]
Angola
  • 884 confirmed cases
  • 121 deaths among confirmed cases (case fatality rate, 13.7%)
  • 4347 suspected cases
  • 377 deaths among suspected cases (case fatality rate, 8.7%)
DR Congo
  • 78 confirmed cases (57 imported from Angola, 8 sylvatic, 13 autochthonous)
  • 16 deaths among confirmed cases (case fatality rate, 21.1%)
  • 2987 suspected cases
  • 121 deaths among suspected cases (case fatality rate, 4.0%)

(Sylvatic cases are not considered part of the outbreak.)

Kenya
  • 2 confirmed cases
China (not on map)
  • 11 confirmed cases
Yellow fever cases by age group in Angola, from 5 December 2015 to 4 August 2016.[2]
Confirmed cases and deaths (cumulative) in the 2016 epidemic of yellow fever in Angola as of 21 July 2016[3]

On 20 January 2016, the health minister of Angola reported 23 cases of yellow fever with 7 deaths among Eritrean and Congolese citizens living in Angola in Viana municipality, a suburb of the capital of Luanda. The first cases (hemorrhagic fever suspected as being yellow fever) were reported in Eritrean visitors beginning on 5 December 2015 and confirmed by the Pasteur WHO reference laboratory in Dakar, Senegal in January.[4][5] The outbreak was classified as an urban cycle of yellow fever transmission, which can spread rapidly.[6] A preliminary finding that the strain of the yellow fever virus was closely related to a strain identified in a 1971 outbreak in Angola was confirmed in August 2016.[7] Moderators from ProMED-mail stressed the importance of initiating a vaccination campaign immediately to prevent further spread. The CDC classified the outbreak as Watch Level 2 (Practice Enhanced Precautions) on 7 April 2016.[8] The WHO declared it a grade 2 event on its emergency response framework having moderate public health consequences.[9]

At an emergency committee meeting in Geneva, Switzerland on 19 May 2016, the WHO declared that the outbreak was serious and might continue to spread, but decided not to declare a public health emergency of international concern (PHEIC).[10][11] On 30 May, Margaret Chan, director-general of WHO published a commentary on the bold action needed to prevent further spread of this important communicable disease that caused many historically significant epidemics that took many lives in previous centuries.[12] On 8 June the International Federation of Red Cross and Red Crescent Societies called for a scale-up in the response because of the lack of vaccine and other limitations amid the continuing spread of the outbreak.[13] On 12 August 2016, Daniel R. Lucey, a ProMED mail consultant, wrote an open letter to Dr. Chan requesting that the WHO emergency committee be reconvened to consider a PHEIC because of the continued spread of the disease in Democratic Republic of the Congo, the lack of sufficient vaccine, and concern that it may be spreading into the Republic of the Congo.[14] On 31 August, the decision to not declare a PHEIC was re-confirmed.[15] By 2 September 2016, WHO announced there had been no new cases in either Angola or DR Congo in over a month due to a massive vaccination campaign.[16] On 25 November 2016, WHO announced that four months had passed without a new case. The last case in Angola was on 23 June and the last case in DR Congo was on 12 July. Dr Matshidiso Moeti, WHO Regional Director for Africa, stated: "The current battle against yellow fever in Angola and the Democratic Republic of the Congo is coming to a close, ... But the broader war against the disease is just getting started."[17] ProMED-mail moderator Tom Yuill noted that maintaining vaccination coverage in the two countries will be the next challenge. Approximately 30 million people were vaccinated in the two countries.[18]

  1. ^ "Yellow fever situation report 28 October 2016". World Health Organization. Archived from the original on December 19, 2016. Retrieved 8 December 2016.
  2. ^ "Situation Report: Yellow fever outbreak in Angola, 5 August 2016". Archived from the original on 15 August 2016. Retrieved 15 August 2016.
  3. ^ "Yellow fever situation report 21 July 2016". World Health Organization. Archived from the original on July 22, 2016. Retrieved 23 July 2016.
  4. ^ "Situation report: Yellow fever outbreak in Angola, 14 March 2016". www.afro.who.int. Archived from the original on 7 April 2016. Retrieved 5 April 2016.
  5. ^ "Yellow fever - Africa (16): Angola 2016-02-27 10:11:59 Archive Number: 20160227.4053826". Pro-MED-mail. International Society for Infectious Diseases. Retrieved 17 March 2016.
  6. ^ "Yellow fever - Africa (18): Angola". Pro-MED-mail. International Society for Infectious Diseases. Retrieved 15 April 2016.
  7. ^ Grobbelaar, AA; Weyer, J; Moolla, N; Jansen van Vuren, P; Moises, F; Paweska, JT (15 October 2016). "Resurgence of Yellow Fever in Angola, 2015-2016". Emerging Infectious Diseases. 22 (10): 1854–1855. doi:10.3201/eid2210.160818. PMC 5038398. PMID 27536787.
  8. ^ "Yellow Fever in Angola". Traveler's Health. Centers for Disease Control and Prevention. Retrieved 8 April 2016.
  9. ^ "Yellow fever - Africa (40): Angola, WHO". Pro-MED-mail. International Society for Infectious Diseases. Retrieved 15 April 2016.
  10. ^ "Meeting of the Emergency Committee under the International Health Regulations (2005) concerning Yellow Fever". World Health Organization. Archived from the original on May 20, 2016. Retrieved 19 May 2016.
  11. ^ McNeil, Donald G. Jr. (19 May 2016). "W.H.O. Calls Yellow Fever in Africa 'Serious Concern'". The New York Times. Retrieved 19 May 2016.
  12. ^ Chan, Margaret (2016). "Yellow fever: the resurgence of a forgotten disease". Lancet. 387 (10034): 2165–6. doi:10.1016/S0140-6736(16)30620-1. PMID 27229187. S2CID 41390168. Archived from the original on May 31, 2016. Retrieved 4 June 2016.
  13. ^ "Red Cross calls for immediate scale-up in response to deadly yellow fever outbreak in Angola - IFRC". www.ifrc.org. Retrieved 12 June 2016.
  14. ^ "Yellow fever - Africa (92): WHO, Angola, Congo DR, letter to WHO". www.promedmail.org. International Society for Infectious Diseases. Retrieved 15 August 2016.
  15. ^ "Second meeting of the Emergency Committee under the International Health Regulations (2005) concerning yellow fever". World Health Organization. Retrieved 1 September 2016.
  16. ^ "Millions protected in Africa's largest-ever emergency yellow fever vaccination campaign". World Health Organization. 2 September 2016. Retrieved 3 September 2016.
  17. ^ "Winning the war against yellow fever". World Health Organization. Retrieved 28 November 2016.
  18. ^ "Yellow fever - Africa (110): Angola, Congo DR, WHO". www.promedmail.org. International Society for Infectious Diseases. Retrieved 28 November 2016.