Yellow Fever [to 9 July 2016]
http://www.who.int/emergencies/yellow-fever/en/

.

Yellow Fever – Situation Report – 8 July 2016
Full Report: http://apps.who.int/iris/bitstream/10665/246189/1/yellowsitrep-8Jul2016-eng.pdf?ua=1
Excerpt:
…The risk of spread
Two additional countries have reported confirmed yellow fever cases imported from Angola: Kenya (two cases) and People’s Republic of China (11 cases). These cases highlight the risk of international spread through non-immunised travellers.

Seven countries (Brazil, Chad, Colombia, Ghana, Guinea, Peru and Uganda) are currently reporting yellow fever outbreaks or sporadic cases not linked to the Angolan outbreak.

Vaccination
WHO Strategic Advisory Group of Experts (SAGE) on Immunization reviewed existing evidence that demonstrates that using a fifth of a standard vaccine dose would still provide protection against the disease for at least 12 months and possibly longer. This approach, known as fractional dosing, is under consideration as a short-term measure, in the context of a potential vaccine shortage in emergencies.

Risk assessment
The outbreak in Angola remains of high concern due to:
:: Persistent local transmission despite the fact that approximately 15 million people have been vaccinated;
:: Local transmission has been reported in 12 highly populated provinces including Luanda.
:: The continued extension of the outbreak to new provinces and new districts.
:: High risk of spread to neighbouring countries. As the borders are porous with substantial cross-border social and economic activities, further transmission cannot be excluded. Viraemic travelling patients pose a risk for the establishment of local transmission especially in countries where adequate vectors and susceptible human populations are present;
:: Risk of establishment of local transmission in other provinces where no autochthonous cases are reported;
:: High index of suspicion of ongoing transmission in hard-to-reach areas like Cabinda;

In DRC, the outbreak has spread to three provinces. Given the limited availability of vaccines, the large Angolan community in Kinshasa, the porous border between Angola and DRC, and the presence and the activity of the vector Aedes in the country, the outbreak might extend to other provinces, in particular Kasai, Kasai Central and Lualaba.

The virus in Angola and DRC is largely concentrated in main cities; however, there is a high risk of spread and local transmission to other provinces in both countries. In addition, the risk is high for potential spread to bordering countries, especially those classified as low-risk (i.e. Namibia, Zambia) and where the population, travelers and foreign workers are not vaccinated for yellow fever.

Some African countries (Chad, Ghana, Guinea, Republic of Congo and Uganda) and some countries in South America (Brazil, Colombia and Peru) have reported cases of yellow fever in 2016. These events are not related to the Angolan outbreak, but there remains a need for vaccines in those countries, which poses additional strain on the limited global yellow fever vaccine stockpile.

.

IFRC appeals for 1.4 million Swiss francs to help stop yellow fever outbreak in Angola
Published: 6 July 2016
Luanda/Geneva, 6 July 2016 – The International Federation of Red Cross and Red Crescent Societies (IFRC) today launched a 1.4 million Swiss franc emergency appeal to support the Angola Red Cross respond to the worst yellow fever outbreak in the country in 30 years…

“Angola Red Cross volunteers and staff are conducting door-to-door visits, engaging people in radio debates and providing advice on what people can do to reduce the risk of falling ill with yellow fever. This includes suggesting measures in the home and community to eliminate sites where mosquitoes can breed.

“Red Cross volunteers are also explaining why vaccination is important and the need for a vaccination campaign.”

Community-based solutions to tackle yellow fever are at the forefront of the Red Cross response. Angola Red Cross volunteers and staff have close links with the local communities and long-standing experience in responding to vector-borne diseases such as malaria, dengue and chikungunya.

The IFRC appeal will support the Angola Red Cross to scale up its activities and reach 9 million people through community engagement, health care, and hygiene promotion.

“The need for a large-scale community engagement approach is increasingly important as vaccination campaigns scale up,” said Dr Julie Lyn Hall, IFRC Director of Health. “As much as we try to provide solutions, it is the communities who are the drivers of the response and are the key to the success of it.

“Efforts will focus on effective and sustained two-way communication and engagement with communities, as the most effective means to tackle yellow fever and build a lasting community understanding of how to prevent and control it,” Dr Hall added…