Annals of Tropical Medicine and Public Health

EDITORIAL COMMENTARY
Year
: 2017  |  Volume : 10  |  Issue : 3  |  Page : 523--524

Yellow fever outbreak in Angola: The potential global threat and the prevailing challenges in the control of the disease


Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India




How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Yellow fever outbreak in Angola: The potential global threat and the prevailing challenges in the control of the disease.Ann Trop Med Public Health 2017;10:523-524


How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Yellow fever outbreak in Angola: The potential global threat and the prevailing challenges in the control of the disease. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 17 ];10:523-524
Available from: http://www.atmph.org/text.asp?2017/10/3/523/213169


Full Text

Dear Editor,

Yellow fever is an acute viral hemorrhagic disease, which is predominantly endemic across nations or regions of Africa or Central and South America. Nevertheless, it has the potential to spread to all parts of the world through non-immunised international travellers.[1] A major outbreak of the disease has been reported in Angola, with the first confirmed case being reported in December 2015.[2] Till now, three nations, namely the Democratic Republic of the Congo (DRC), China, and Kenya have reported imported cases from Angola.[2],[3]

The current estimates suggest that more than 5000 suspected cases (of which more than 940 have been confirmed) and 400 deaths have been attributed to the disease in Angola and DRC alone.[1],[4] Even though, the disease is endemic in the nation, the current outbreak requires immense public health attention as it's the first outbreak after almost 3 decades, is urban in nature, an extensive local transmission has been observed, exportation of cases has been reported, and is enormous in terms of number of caseload and death rates.[2],[3],[4],[5]

To promptly respond to the outbreak, the national health ministry has implemented the outbreak response activities in the region, with the help of different international partners.[2] Further, mass vaccination campaigns have been conducted to target the vulnerable population, with almost 18 million doses of vaccine being distributed till date for emergency vaccination.[1],[6] But, the vaccination campaigns have taken a toll due to the technical problems like health staff shortage, maintenance of cold chain, monetary constraints for vaccine procurement and operational costs, and shortage in vaccine supply.[6] To ensure that vaccine campaign successfully interrupt the transmission of the disease, it has to be completed within a couple of weeks, but it took almost 6 weeks to achieve 80% of the coverage in the capital city of the nation.[3],[6] Even now, most of the municipalities have not attained sufficient vaccine coverage levels, which is a serious concern.[5]

Another important aspect in the control of the disease is to promptly establish the right diagnosis, which is crucial to initiate appropriate treatment and avert deaths.[4] Clinically, it is difficult to establish the diagnosis, as the symptoms of the disease are quite similar to other hemorrhagic diseases. Hence, the ultimate aim to have a reliable and timely diagnosis depends on the approach adopted for sample collection or transportation of sample, and laboratory capacity in the affected regions.[1],[4] It is very important to understand that in earlier stages of the disease, the virus can be easily detected, while in later stages, there is a need for more sophisticated blood tests.[1],[4]

To meet this challenge and to fast-track the process of diagnosis, the World Health Organization has assisted in the deployment of a mobile laboratory in some of the worst affected regions.[4] This initiative will not only save loads of time, but will also provide the results to close to 100 patients within a day.[4] Further, the national laboratory system and surveillance mechanism has also been strengthened.[1],[2],[3] In addition, attention has been given towards vector control as well as towards minimizing the risk of national or international spread of the disease by strengthening of the International Health Regulations.[1],[2],[3],[4],[5]

To conclude, the current urban outbreak of the disease in Angola is a real global threat and it essentially requires implementation of prevention and control measures to ensure the containment as well as the interruption in the transmission of the disease.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization. Yellow fever-Fact sheet; 2016. Available from: http://who.int/mediacentre/factsheets/fs100/en/. [Last accessed on 2016 July 29].
2Woodall JP, Yuill TM. Why is the yellow fever outbreak in Angola a 'threat to the entire world'? Int J Infect Dis 2016;48:96-7.
3Nishino K, Yactayo S, Garcia E, Aramburu GJ, Manuel E, Costa A. Yellow fever urban outbreak in Angola and the risk of extension. Wkly Epidemiol Rec 2016;91:186-92.
4World Health Organization. Mobile labs deliver faster yellow fever test results; 2016. Available from: http://who.int/features/2016/yellow-fever-labs/en/. [Last accessed on 2016 July 30].
5Green A. Yellow fever continues to spread in Angola. Lancet 2016;387:2493.
6Barrett AD. Yellow fever in Angola and beyond-The problem of vaccine supply and demand. N Engl J Med 2016;375:301-3.