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Friday, September 23, 2016

She never knew about yellow fever until she had to experience it herself

Published: 21 September 2016 23:01 CET
Bioma Julie shares her experience with a Red Cross volunteer after being treated for yellow fever. Mirabelle Enaka/IFRC

By Mirabelle Enaka Kima, IFRC
Bioma Julie is a young mother of two, she lives in the Massina I neighbourhood in Kinshasa. She was diagnosed some months back with yellow fever. Today, not only has she regained her health, but she is also well informed about the disease, thanks to the massive information dissemination and sensitization activities conducted by volunteers of the Red Cross of the Democratic Republic of the Congo ( DRC). As part of the preventive immunization campaign launched in the country in August, Red Cross volunteers visited remote communities and went door-to door to raise awareness about yellow fever, encouraged families to get vaccinated, distributed flyers, put up posters and banners with important information about the disease and engaged in dialogues with people through social media channels.
Yellow fever outbreak was declared in DRC in March. The outbreak originated from neighbouring Angola and quickly spread to the DRC, affecting people in six of the country's provinces, including the capital city Kinshasa, where more than 7.7 million people have been vaccinated following the launch of a preventive vaccination campaign.
The first round of the vaccination campaign, which started in May until the first week of June, was carried out in the Massina I health zone, where many cases were registered.
"When the vaccination campaign started in May, I was pregnant and could not receive the vaccine. Unfortunately, a few weeks later, I was diagnosed with yellow fever and was taken to the N'dili health centre where I received treatment," said Bioma Julie.
"My unhappy experience was a lesson for the rest of my family on the dangers of the disease, if proper preventive measures are not taken.
When a Red Cross team visited us and provided detailed information and advice on how to protect ourselves from the disease, my whole family decided to go in for the vaccination including my hesitant husband," added Julie
The Red Cross of DRC mobilized 3600 volunteers to increase awareness on yellow fever among vulnerable communities and encourage them to get vaccinated.
"From the onset of the operation, our volunteers were going door-to-door visiting vulnerable families to talk to them about the risks of yellow fever, monitoring and identifying new cases in the communities, as well as explaining how to prevent vector-borne diseases," said Dr Balelia Wema Jean Faustin, health coordinator of the Red Cross of the Democratic Republic of the Congo.
Violette Lakulu is one of the most experienced Red Cross volunteer In the social mobilization team. She spent hours in the Massina I health zone, where she delivered awareness messages to households, at places of worship and markets.
"It was crucial for us to talk directly with people. We realized that many people did not know what yellow fever was all about. We also identified people with physical disabilities who needed assistance. Depending on the situation, we help to arrange transport for them to get to the vaccination sites or give their home address to the nearest vaccination centre so that they could get vaccinated through a house visit," said Violette.
Outbreak under control
The World Health Organization (WHO) announced recently that the yellow fever outbreak is now under control following the vaccination campaigns in the Democratic Republic of the Congo and Angola. In the Democratic Republic of the Congo, no new cases have been recorded since 12 July.
As of 1 September, the number of people vaccinated in Kinshasa province exceeded the targeted number by 102 per cent, across the 32 targeted health zones.
"We are grateful to the Red Cross volunteers who have been able to mobilize 53 per cent of the population of Kinshasa during this reactive vaccination campaign. So far, the positive results are confirming the tremendous work done by Red Cross volunteers," said Dr Viviane Nzeusseu, IFRC health coordinator for Central Africa country cluster support team.
While the yellow fever outbreak is now under control, there are cholera and measles outbreaks in many areas of the country.
As part of the Red Cross response to the ongoing outbreaks, the International Federation of Red Cross and Red Crescent Societies (IFRC) has launched an emergency appeal for 2.2 million Swiss francs to enable the Red Cross of DRC to deliver emergency health support, provide safe water, adequate sanitation and promote safe hygiene practices.
With technical support and coordination with other partners National Societies provided by the IFRC Central Africa office, the DRC Red Cross is preparing for the upcoming cholera and measles vaccination campaigns, which will be launched at the end of September, despite the recent civil unrest in Kinshasa.
The appeal is currently 55 per cent funded. "Funding gap remains a major concern as the country goes through a re-emergence of cholera, which has a high case fatality rate, in endemic and epidemic areas," said Dr Viviane Nzeusseu .

Friday, September 2, 2016

Yellow fever outbreak still serious, WHO says - Sep 2016

(CNN)The World Health Organization said Wednesday that the ongoing yellow fever outbreak in Angola and the Democratic Republic of Congo still does not constitute a public health emergency at this time, but caution is still necessary.
"Although the yellow fever situation is improving, the event continues to be serious and requires sustained, controlled measures," said Oyewale Tomori, chairman of the WHO Emergency Committee and a professor of virology at Redeemer's University in Nigeria.
    All told, the WHO estimates that there have been 6,000 suspected cases and 1,000 laboratory-confirmed cases of yellow fever, a viral hemorrhagic disease transmitted by infected mosquitoes. More than 400 people have died since the epidemic began in December.
    But there is reason to be optimistic. Though suspected cases continue to be reported, the last confirmed cases were reported June 23 in Angola and July 12 in Congo, said Dr. Peter Salama, executive director of the WHO Health Emergency Program.
    "The health and epidemiology are pointing in the right direction," Salama said.
    The epicenter of the outbreak was Angola, which first reported cases in its capital city, Luanda, in late December. From there, the fever spread to 16 of the country's 18 provinces. In Congo, the outbreak was declared April 23, with health officials confirming cases in eight of its 26 provinces, some imported directly from Angola.
    Symptoms include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue. A small proportion of patients develop severe symptoms, and nearly half of these die within 10 days.
    Salama said the WHO's yellow fever vaccination stockpile remains intact, with 6 million current doses ready to be accessed in case it's needed. The WHO official said the stockpile is expected to total 20 million doses by the end of this year thanks to scaled-up production by the four major companies that manufacture the effective inoculation.
    Both of the WHO representatives pointed to success in Kinshasa, the capital and largest city of Congo, where the health ministry and the WHO launched the most ambitious yellow fever vaccination campaign ever undertaken. They coordinated with Médecins sans Frontières, the International Federation of the Red Cross and UNICEF. "In just 10 days, 7.7 million people were vaccinated using fractionated doses," Tomori noted.
    "Fractionated dosing," using just one-fifth the standard dose of the vaccine, was recommended this month by an advisory group as the best way to maximize the limited supply of vaccines, which requires at least six months to manufacture. Health officials had warned that a vaccine supply shortage could jeopardize the ability to end the outbreak.
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    During the recent campaigns in both countries, Angola vaccinated 22 million people, and Congo inoculated 14 million people, Salama said. He said there have been "operational challenges" around getting vaccines to rural parts of the countries and the "unprecedented situation" of urban outbreaks. But he said the vaccination campaign had not been mismanaged.
    "As the rainy season is imminent in Central and East Africa, we also have to be aware there may be further cases, there may be further outbreaks, and we need to remain vigilant and able to respond robustly," Salama said.

    Monday, August 22, 2016

    CDC releases new guidance on caring for infants with congenital Zika Infection

    by Melissa Jenco · News Content Editor
    Children with congenital Zika virus infection could have an array of difficulties and will need careful evaluation and follow-up, according to federal health officials.
    The Centers for Disease Control and Prevention (CDC) has released crucial new guidance for pediatricians and other pediatric clinicians that was developed in consultation with the Academy and other experts.
    "We felt there was an urgent need to develop guidance for pediatric health care providers on how to evaluate and manage babies born with congenital Zika virus infection (in order) to give those kids the best chance to reach their full potential," said co-author Sonja A. Rasmussen, M.D., M.S., FAAP, a pediatrician and clinical geneticist at the CDC.
    The report "Update: Interim Guidance for the Evaluation and Management of Infants with Possible Congenital Zika Virus Infection – United States, August 2016" was published Friday in the Morbidity and Mortality Weekly Report.
    This guidance comes just one week after the U.S. declared a public health emergency in Puerto Rico where 10,690 people have become infected with the mosquito-borne virus including 1,035 pregnant women, according to the U.S. Department of Health and Human Services. In U.S. states, 2,260 cases have been reported, including 529 pregnant women, according to the CDC.
    Experts from around the country gathered at the CDC in July to discuss how to evaluate and care for infants with congenital Zika virus infection, which can causemicrocephaly and other issues such as vision and hearing difficulties, contractures and developmental delay.
    "Developmental screening and expeditious referral to early intervention when indicated are critical," said Fan Tait, M.D., FAAP, AAP associate executive director and director of the Department of Child Health and Wellness. "Following the diagnosis, families will need both emotional and psychosocial support."
    The new guidance calls for all infants whose mothers were infected with Zika during pregnancy to have a comprehensive physical exam, neurologic assessment, postnatal cranial ultrasound, standard hearing screen and Zika testing.
    Babies who are found to be infected also should have a comprehensive eye exam and hearing assessment by auditory brainstem response testing before 1 month of age regardless of whether abnormalities are apparent at birth.
    If abnormalities are detected, infants will need to be evaluated by an infectious disease specialist, neurologist, endocrinologist, ophthalmologist and geneticist. The primary care pediatrician and these specialists will need to provide coordinated ongoing examinations that are detailed in the guidance.
    "We really emphasized in this guidance some of the ... AAP tenets that these babies need a medical home, they need someone to help them coordinate their care," Dr. Rasmussen said.
    Those who are not born with obvious, identifiable abnormalities will need careful monitoring for any that may present later in life such as those resulting in seizures or troubles with vision or hearing.
    "It's going to be important to follow those children for neurodevelopmental abnormalities as they would any child but probably with just more focused attention on the potential for developmental regression or development delays," said Edwin Trevathan, M.D., M.P.H., FAAP, a member of the AAP Section on Neurology and a pediatric neurologist at Vanderbilt University Medical Center.
    The CDC continues to encourage women with Zika infection to breastfeed their infants, saying the benefits outweigh any possible risks. The agency will continue to update guidance on caring for infants as experts learn more, and Dr. Trevathan emphasized the importance of pediatricians staying up to date.
    "I think we will be better off as a pediatric community and our children will be better for it," he said.
    Pediatricians should report suspected congenital Zika cases to their state, local, tribal or territorial health officials and provide clinical information to the U.S. Zika Pregnancy Registry or Puerto Rico Zika Active Pregnancy Surveillance System so the CDC can monitor outcomes and adjust recommendations accordingly.
     Copyright © 2016 AAP News

    Friday, August 19, 2016

    No high alert for yellow fever, says Kenya Cabinet Secretary

    More by this Author
    Kenya has not put in place new measures to tackle yellow fever, a disease that has so far claimed more than 440 lives in Angola and Democratic Republic of Congo.
    Instead, Kenya has beefed up national surveillance of the viral disease at points of entry such as airports and border towns, Health Cabinet Secretary Cleopa Mailu told Nation on Tuesday.
    Dr Mailu said the surveillance was “keeping track of the trend of the infection and we are planning appropriately”.
    “As there are no other cases since the last two in March this year, we are continuing with routine checks,” he said.
    Both cases were male Kenyans in their early 30s working in Luanda, Angola and showed symptoms of the disease on arrival in the country between March 12 and 18.
    Both had never been vaccinated. One succumbed to multiple organ failure and the other was treated and later discharged.
    The Health CS added: “We are also letting the public know that the yellow fever vaccine is for life and not 10 years as initially thought.”
    The Ministry of Health has listed 23 centres where Kenyans can get the vaccine.
    These are ports of entry like Kilindini Port (Mombasa), all airports (Jomo Kenyatta International Airport, Moi, Eldoret, Kisumu, Malindi, Lokichogio, Wajir and Wilson airports), one-stop border posts (Taveta, Lungalunga, Namanga, Isebania, Malaba, Busia and Loitoktok).
    It is also available at Kenyatta National Hospital, Armed Forces Memorial Hospital and at health facilities operated by county health authorities and at county headquarters in Nairobi, Mombasa, Kisumu and Eldoret.
    This comes as an emergency vaccination programme is under way in DR Congo, targeting three million people in a desperate move to curb the spread of the disease caused by the same mosquito that causes Zika, Aedes Egypti.
    The first yellow fever cases were detected in Luanda, Angola, late last December and were confirmed by the National Institute for Communicable Diseases in South Africa on January 19, 2016 and by the Institut Pasteur Dakar on January 20.
    The DRC has reported 1,798 suspected and 68 confirmed cases with 85 reported deaths as at June 24.
    In Angola, the Health ministry reported 3,625 suspected cases from December 5, 2015 to July 8, 2016, of which 876 were laboratory confirmed. The number of reported deaths is 357, of which 117 were among confirmed cases.
    What is worrying is that there is persistent local transmission in the country despite approximately 15 million people having been vaccinated.
    Save the Children, a British charity, has warned that a yellow fever outbreak — currently the largest global one in three decades — in the Democratic Republic of Congo and Angola could soon spread to Europe, the Americas and Asia.
    Kenya and the People’s Republic of China reported two and 11 cases respectively, all imported from Angola.
    Seven countries — Brazil, Chad, Colombia, Ghana, Guinea, Peru and Uganda — are currently experiencing yellow fever outbreaks or sporadic cases not linked to the Angolan one.