Angola yellow fever update: 1,132 suspected and confirmed cases, 168 deaths - March 2016

The yellow fever outbreak that began in Viana, Luanda province, Angola last December has grown to more than 1,000 cases nationwide, according to a World Health Organization update.

Angola/VoodooIsland

As of 21 March, 16 of the country’s 18 provinces have reported YF suspected cases – 13 of these provinces have reported imported cases linked to Luanda. Local transmission of the disease was documented in 2 of the 11 municipalities of Huambo province. Other provinces have reported autochthonous suspected cases with no epidemiological links to Luanda.

To date, at least 1,132 suspected and confirmed cases have been reported nationally, including 168 deaths. A total of 375 cases have been laboratory-confirmed. Luanda, the outbreak epicentre, remains the main affected province with 818 cases (281 confirmed confirmed), including 129 deaths. However, the number of cases reported in provinces other than Luanda is apparently increasing.

On 12 February, WHO declared this outbreak a “grade 2 emergency”, in accordance with the Emergency Response Framework (ERF). Since then, 65 WHO multidisciplinary experts have been deployed to provide high-level technical support to the country.
The Immunization campaign in Luanda, which started on 2 February in Viana, is still ongoing and has so far been implemented in 6 municipalities out of the targeted 12.

Three municipalities are reporting high coverage rates (≥90%) while other municipalities are reporting even higher rates (136% in Viana and 113% in Bela) probably due to people coming from other districts of Luanda as well as other provinces.

Yellow fever is a viral disease, found in tropical regions of Africa and the Americas. The “yellow” in the name refers to the jaundice that affects some patients. It principally affects humans and monkeys, and is transmitted via the bite of Aedes mosquitoes. It can produce devastating outbreaks, which can be prevented and controlled by mass vaccination campaigns.

Large scale outbreaks occur every 3 to 10 years in villages or cities in the absence of large scale immunization. Sporadic cases can occur regularly in endemic areas.

The incubation period of the virus is 3 to 6 days after a bite from an infected mosquito. About 15% of infections progress to fever and jaundice. While only the minority of cases are severe, case fatality rate may be 25% to 50% among patients with syndrome of haemorrhage, jaundice, and renal disease.

Vaccination is the most important preventive measure against yellow fever. The vaccine is safe, affordable and highly effective. A single dose of yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against yellow fever disease and a booster dose of yellow fever vaccine is not needed. The vaccine provides effective immunity within 30 days for 99% of persons vaccinated.

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China Strengthens Yellow Fever Quarantine after imported Yellow Fever case - March 2016

A staff worker of inspection and quarantine administration looks at the screen of body temperature monitoring equipment at Guangzhou Baiyun International Airport in Guangzhou, south China's Guangdong Province, on February 16, 2016. [Photo: Xinhua]

China will tighten quarantine measures against the yellow fever virus, authorities said on Monday, one day after the nation's first imported case was confirmed.

Travellers from Angola, the affected region, should make themselves known to quarantine staff when entering China and show their certificates of vaccination for yellow fever, said the General Administration of Quality Supervision, Inspection and Quarantine(AQSIQ).

Measures must be taken to eliminate mosquitoes from vehicles and containers from the affected area.

A 32-year-old man from east China's Zhejiang Province experienced stage one symptoms of yellow fever, including fever and chills, on March 8 while in Luanda, capital of Angola. He sought medical treatment after returning to China on March 10 and was confirmed as the first imported case on March 13.

By Feb. 8, a total of 37 Angolans had died during the current outbreak, according to the World Health Organization.

Yellow fever is an acute viral disease transmitted by mosquitoes and mostly found in tropical regions of Africa, and Central and South America.

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Comment: The death toll in Angola is said to have reached 250 already and is climbing. Kenya has also reported Yellow Fever cases recently. All travelers from India MUST ensure that they take the Yellow Fever vaccination before going to African countries

Zika virus: Fact versus fiction

Posted: Wednesday, March 9, 2016 7:19 pm | Updated: 7:20 pm, Wed Mar 9, 2016.

Lauren Hanna Contributing writer | 0 comments

If you have been paying attention to your social media feeds or picking up the paper lately, you may be familiar with Zika virus It’s this year’s Ebola, and the paranoia is spreading quicker than the disease. 

Last May, the virus broke out for the first time in the Western Hemisphere and has been causing panic among expecting mothers in the affected regions and those wishing to travel. The first confirmed case was in Brazil, and since then the virus has traveled to 20 different countries across three continents. 

But what most people don’t know is that the Zika virus has been recorded almost every year since 1949, when the first case was discovered in the Zika Forest in Uganda. 

The infection is transmitted through the bite of the Aedes (or yellow fever) mosquito. It is closely related to Yellow and Dengue Fever and is relatively harmless to healthy adults. 

The majority of patients affected with the disease don’t show any symptoms, and thus have nothing to worry about. The virus passes through the bloodstream within two weeks, most of the time without the patient’s knowledge. The only side effects seem to be mild fatigue, joint pain, and slight fever, if any at all. 

This outbreak has caused major concern, however, because of what the virus can do to a fetus. Researchers at the World Health Organization (WHO) and the Centers for Disease Control (CDC) have linked it to microcephaly in newborns. The disease is characterized by the abnormally small heads of affected infants, the result of retardation in neural development during pregnancy. 

Children born with this condition often have intellectual deficiencies, hearing loss, and developmental delays. Microcephaly can also be caused by Yellow or Dengue Fever, the German measles (Rubella), or consumption of alcohol during gestation.

Normally, Brazil deals with 150 cases of microcephaly a year. This year alone over 4,000 newborns have been diagnosed with this condition. Last November, the WHO declared this an international public health emergency. 

In recent months, other health conditions have been connected to the rise of the Zika virus, including Guillain-Barre Syndrome in Latin and South America, which might also be linked to contracting Zika. The syndrome causes an infected individual’s immune system to attack the myelin sheath, a protective coating around the nerves. In healthy people, this coating allows nerves to fire rapidly. Without it, the electrical signals being fired between your nerves never reach their proper destination. The result is temporary numbness or paralysis in the outer extremities, which can move up the limbs if not treated in time. 

Researchers at the UW and elsewhere are looking to develop drugs to stave off disease, but at this time, there is no cure. The CDC has put out a traveler’s warning for expectant mothers who plan on going somewhere tropical for the holidays. 

With spring break fast approaching, and most tropical locations an airplane ride away, health officials are concerned about an outbreak. People who are pregnant or may become pregnant are advised to take protective measures, including the use of birth control or avoiding areas of outbreak. 

As our world gets more interconnected, diseases like Zika, Ebola, and Swine Flu can easily jump from continent to continent and create a global pandemic. The only way to slow that process down is to understand the preventative measures and take them seriously. 

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Reach contributing writer Lauren Hanna at development@dailyuw.com. Twitter: @Lauren_A_Hanna

What is yellow fever? Everything you need to know about the Angola outbreak

Since the month of December 2015, Angola has been struggling with a deadly outbreak of yellow fever. The country had not faced an outbreak of this scale in 20 years.

On Friday 26 February, the country has announced that 125 people had already died from the virus. In total, more 664 suspected cases have been reported. The worst affected area is the capital Luanda with 92 deaths.

An immunization campaign has been launched at the beginning of February, targeting more than 1.5 million people.

What is yellow fever?

Yellow fever is an acute viral haemorrhagic disease transmitted the aedes andHaemogogus mosquitoes. It is not always easy to diagnose, especially at the beginning, since its symptoms can often be confused with those of malaria, dengue fever, or other haemorrhagic fever. However, some patients will suffer from a jaundice specific to the disease, which explains why the term "yellow" is used.

The virus incubates for 3 to 6 days before the first symptoms are observed. The infection can occur in one or two phases. The first one is called the "acute phase". It is characterized by fever, muscle pains, nausea and vomiting, or headaches. After 3 or 4 days a majority of patients recovers.

However, 15% of them fall even sicker, less than 24 hours after their recovery and enter the second phase of the infection. It is in this phase that the jaundice appears. Vomiting, abdominal pains and bleeding are also seen, and kidney function deteriorates. The patient can die, and half of those who reach the second phase of the infection eventually do.

The infection is diagnosed with a blood test which can detect either the antibodies produced by the body to fight off the infection or actual traces of the virus.

Who is affected by the disease?

World Health organization estimates suggest close to 200 000 cases of yellow fever occur each year worldwide, leading to around 30 000 death. Like with the recent Angola outbreak, most of the cases, up to 90% occur in the African continent.

There, 31 countries are considered "endemic", with 508 million people at risk of contracting the virus. The other big region affected by yellow fever is Latin America, with 13 countries there described as "endemic".

What can be done against yellow fever?

To date, there is no treatment against yellow fever. Water and medicines can be given to target the symptoms, such as fever or dehydration.

Vaccination is the best option to prevent outbreaks of the disease and to protect people against it. The vaccine has been proved to be both safe and effective, providing 99% immunity after only 30 days. A single dose can protect a person throughout her life.

However, for outbreaks to stop coverage must reach between 60 and 80% minimum of the population, in an endemic region. In many cases, vaccination coverage remains too low, especially in Africa.

Other strategies to combat the disease include mosquito population control, with the large scale use of pesticides and mosquito nets, as well as the treatment of stagnant water sources.

Recommendations for UK travellers

People who travel to endemic countries like Angola must be vaccinated, under WHO regulations. They will be asked to show a vaccination certificate in order to go to the country.

The traveller should be vaccinated at least 10 days before the departure, to allow the body some time to develop the necessary protection.

The vaccine was to offer a 10 years protection, but recently the WHO has found that a single dose can be enough to protect for a life time and as from June 2016, receiving booster doses after 10 years will not be necessary.

The nearest centre offering yellow fever vaccination can be found on theNational Travel Health network website, and the list of countries where vaccination is needed on the WHO's website.

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