Emergencies preparedness, response

Yellow Fever – China

Disease Outbreak News
22 April 2016

Between 4 and 12 April 2016, the National IHR Focal Point of China notified WHO of 2 additional imported cases of yellow fever (YF). To date, a total of 11 laboratory-confirmed YF cases imported from Angola have been reported in China.

The tenth imported case is an 18-year-old male from Fujian Province, China, who had been living in Angola. On 12 March, he had onset of fever and other symptoms, and visited a local hospital in Angola. On 27 March 2016, the patient travelled to Fuzhou City, Fujian Province, China via Dubai, United Arab Emirates and Beijing, China. He was afebrile on arrival in China. On 28 March, the patient sought medical care. Yellow fever infection was confirmed by polymerase chain reaction (PCR) at the Fujian International Travel Health Centre. Test results were corroborated by the Fujian Centers for Disease Control (CDC). The patient was hospitalised in Fuzhou and remains under treatment.

The eleventh imported case is a 29-year-old male from Jiangsu Province, China, who had been working in Angola. On 5 April, he had onset of fever and other symptoms, and sought medical care at a local hospital in Angola. On 9 April, the patient was reported to have tested positive for YF in Angola by PCR. He flew back to China via Dubai, arriving in Beijing on 10 April. On arrival, the patient was transferred by ambulance to a hospital. His sample was tested at Beijing CDC and found to be positive for YF by PCR. On 12 April, expert consultation organised by the Beijing Health and Family Planning Commission confirmed the patient as an imported YF case based on the epidemiological history, clinical manifestations and laboratory findings. The case is currently stable.

Public health response

The Chinese government has taken the following measures:

  • intensifying multi-sectoral coordination and collaboration,
  • strengthening surveillance, vector monitoring and risk assessment,
  • enhancing clinical management of yellow fever cases,
  • conducting vector control activities,
  • carrying out public risk communication activities,
  • deploying a medical team to Angola to provide yellow fever vaccination to unvaccinated Chinese nationals.

WHO risk assessment

The report of yellow fever infection in non-immunized travellers returning from a country where vaccination against the disease is mandatory underlines the need to reinforce the implementation of vaccination requirements, in accordance with the International Health Regulations (2005). Furthermore, this report highlights the risk of international spread of yellow fever through non-immunized travellers. However, the risk of establishment of a local cycle of transmission in China is low due to the current climatic condition, which is unfavourable for the competent vector, the Aedes aegypti mosquito. WHO continues to monitor the epidemiological situation and conduct risk assessment based on the latest available information.

WHO advice

WHO urges Members States especially those where the establishment of a local cycle of transmission is possible (i.e. where the competent vector is present) to strengthen the control of immunisation status of travellers to all potentially endemic areas.

WHO does not recommend any travel or trade restriction to China based on the current information available.