Nigerian govt confirms new yellow fever case, Sept 2017

A case of Yellow Fever has been confirmed in Oke Owa in Ifelodun Local Government Area of Kwara State, says the Federal Ministry of Health.

In a press statement released on Monday, the ministry said the case was confirmed in a young girl from the community after a laboratory diagnosis at the Lagos University Teaching Hospital at the Institut Pasteur, Dakar, Senegal on the September 12.

Following the confirmation of the case, the Minister of Health, Isaac Adewole, said the State Epidemiology Team has begun investigation into the affected area and neighbouring communities.

“A joint team from the Nigeria Centre for Disease Control, National Primary Health Care Development Agency and the World Health Organisation Country Office has been deployed to support the State in carrying out a detailed investigation and risk analysis,” he said

Mr. Adewole added that an Outbreak Control Team had also been constituted to ensure rapid and coordinated decision-making.

He assured the public that all the agencies of the Federal Ministry of Health and their partners would work together to support the government of Kwara to respond in order to prevent spread.

Yellow fever is an acute viral haemorrhagic disease transmitted by infected aedes mosquitoes.

The disease is preventable, the most important measure to in prevention being vaccination against the disease.

A single dose of Yellow Fever vaccine is part of Nigeria’s routine immunisation schedule given to children at nine months and the dose is sufficient to confer sustained protection of up to 10 years.

It is meant to be given free at all primary healthcare centres and other children immunisation point .

According to fact sheets on the disease from the World Health Organization, yellow fever virus is endemic in tropical areas of Africa and Central and South America.

The international health agency said a small proportion of patients who contract the virus develop severe symptoms and approximately half of them die within seven to 10 days.

But since the launch of the Yellow Fever Initiative in 2006, significant progress has been made in combatting the disease in West Africa and more than 105 million people have been vaccinated in mass campaigns.

There is currently no specific anti-viral drug for yellow fever.

Mr. Adewole said a vaccination campaign is already being planned in the affected area in Kwara State to prevent spread.

Symptoms of the disease include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue.

Some infected people may, however, not experience any of these symptoms. In severe cases, bleeding may occur from the mouth, nose, eyes or stomach.

Other methods of prevention include using insect repellent, sleeping under a long-lasting insecticide treated net, ensuring proper sanitation and getting rid of stagnant water or breeding space for mosquitoes.

Mr. Adewole advised health care workers to practise universal care precautions while handling patients at all times and also urged to be alert and maintain a high index of suspicion.

Source

H7N9 Avian Flu Continues to Spread, Worsen in China, Medscape Sept 2017

The latest epidemic of Asian lineage avian influenza A (Asian H7N9) in China infected almost as many patients as the four previous outbreaks combined and gave rise to a variant less susceptible to available treatments and vaccines, researchers report in an article  published in the September 8 issue of the Morbidity and Mortality Weekly Report.

The fifth annual epidemic, which occurred from October 1, 2016, through July 31, 2017, included 759 patients and 281 deaths (37%). The cumulative mortality for all five Asian H7N9 outbreaks since February 2013 is 39% (605 of 1557 patients).

"Although human infections with Asian H7N9 viruses from poultry are rare and no efficient or sustained human-to-human transmission has been detected, when human infections do occur, they are associated with severe illness and high mortality," write James C. Kile, DVM, from the Influenza Division at the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and colleagues. "Continued vigilance is important to identify changes in the virus that might have epidemiologic implications, such as increased transmission from poultry to humans or transmission between humans."

The fifth outbreak involved all but three of 33 provinces, regions, and municipalities in China. All infected patients had either lived in or traveled to these areas, and most (90%) infections were associated with poultry exposure, especially at live bird markets.

The authors note, however, that the increase in infections was the result of wider geographic spread and higher prevalence of Asian H7N9 viruses among poultry, not increased poultry-to-human or human-to-human transmission.

Notably, during the fifth epidemic, some Asian H7N9 strains acquired mutations that turned them from low-pathogenic to high-pathogenic strains. Twenty-seven patients were infected with high-pathogenic avian influenza strains that had acquired mutations.

Sequencing data from 166 viral isolates collected during the fifth epidemic uncovered genetic markers of resistance to amantadine and rimantadine. In addition, researchers found significant changes in surface proteins among some of the high-pathogenic avian influenza strains, making them less similar to previous candidate vaccine viruses.

These factors contributed to the CDC's decision to classify Asian H7N9 as the virus with the highest potential pandemic risk among all viruses evaluated using the Influenza Risk Assessment Tool.

The government of China is trying to minimize Asian H7N9 spread by promoting large-scale farming and centralized slaughtering, improving poultry product handling, and routinely closing, cleaning, and disinfecting live poultry markets and enhancing surveillance for influenza-like illness.

The authors write, "CDC has partnered with China CDC, and other China government organizations, United Nations organizations, and surrounding countries to enhance surveillance and laboratory capacity to detect and respond to Asian H7N9 in animals and humans."

One coauthor holds two US patents for influenza vaccines. The other authors have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2017;66:928-932. Full text  

Source

Yellow Fever Vaccine Shortage Affects Arkansas Travelers, Sept 2017

FAYETTEVILLE, Ark. -- - Yellow fever is a viral disease transmitted by infected mosquitos. 

 

The depletion of the US-made vaccine means an alternative vaccine,manufactured in France, will have to be imported. 

 

"We are down to our last few right now so we will have to refer students and faculty who are in need of the vaccine to other clinics who do stock the current yellow fever vaccine that is there," Executive Director, Pat Walker Health Center Mary Alice Serafini.  

 

The disease impacts people in almost 50 countries, including South America and Africa. 

 

Health officials say if you're told to get the vaccine before visiting a certain country, do it. 

 

"Not only is the person at risk for yellow fever once they are there, but it is possible that they could be infected and bring it back," Medical Director for Immunizations, Arkansas Dept. of Health Dr. Jennifer Dillaha said. "Although we do not have yellow fever currently the united states, we have had serious yellow fever epidemics in history."

 

The shortage is so widespread, the only clinic with the vaccine in the state is in Little Rock. 

 

"Any travel clinic is equipped and trained on these types of things and make recommendations for the kind of health risks people will encounter and how they should overcome the health risks," Dr. Dillaha said. 

 

Travelers in Northwest Arkansas include study abroad students from the university. 

 

"We send a lot of students to Central and South America and Africa," Assistant Director, Office of Study Abroad at The University of Arkansas Brian Poepsel said. "Those students are going to have to work a little bit harder to obtain it. "

http://www.nwahomepage.com/news/yellow-fever-vaccine-shortage-affects-arkansas-travelers/803087986

Brazil declares end to yellow fever outbreak that killed 261, Sept 2017

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AO PAULO — Brazil’s Health Ministry has declared an end to a yellow fever outbreak that killed more 250 people over the past nine months.

The ministry said Wednesday that the last case of the mosquito-borne disease was in June. In total, 777 people were infected, of whom 261 died.

The outbreak was highly unusual in a country that typically sees a handful of cases each year. The disease also occurred in areas not previously considered at risk and where vaccination rates were low.

In response, Brazil mounted a massive vaccination campaign, sending out more than 36.7 million doses. Vaccination efforts are continuing since the ministry says the average coverage rate in areas that bore the brunt of the outbreak is around 60 percent, below the target of 95 percent.

https://www.statnews.com/2017/09/06/yellow-fever-outbreak-brazil-over/