Yellow fever situation report
5 August 2016
A yellow fever outbreak was detected in Luanda, Angola late in December 2015. The first cases were confirmed by the National Institute for Communicable Diseases (NICD) in South Africa on 19 January 2016 and by the Institut Pasteur Dakar (IP-D) on 20 January. Subsequently, a rapid increase in the number of cases has been observed.
Angola: 3818 suspected cases
In Angola, as of 28 July 2016 a total of 3818 suspected cases have been reported, of which 879 are laboratory confirmed. The total number of reported deaths is 369, of which 119 were reported among confirmed cases. Suspected cases have been reported in all 18 provinces and confirmed cases have been reported in 16 of 18 provinces and 80 of 126 reporting districts.
Mass reactive vaccination campaigns that first began in Luanda have expanded to cover most of the other affected parts of Angola and recently have focused on border areas with the Democratic Republic of The Congo (DRC). The next vaccination phase targeting three million people in 18 districts is expected to start on 16 August.
Democratic Republic of the Congo: 2051 suspected cases
The recent technical difficulties at the national laboratory in DRC have been resolved and laboratory analysis of backlog samples is ongoing. As of 27 July, eight patients have tested positive among 700 samples tested and investigations are ongoing to collect additional information.
Since the beginning of the outbreak, DRC has reported (as of 27 July) a total of 2051 suspected cases including 76 confirmed cases and 95 reported deaths. Cases have been reported in 22 Health Zones in five of 26 provinces. Of the 76 confirmed cases, 67 are reported as imported from Angola, two are sylvatic (not related to the outbreak) and seven are autochthonous. The number of suspect cases is increasing in Kinshasa, Kongo Central, Kwango, Tshuapa and Lualaba provinces in the week ending 16 July.
In DRC, reactive vaccination campaigns started on 20 July and finished on 29 July in Kisenso Health Zone in Kinshasa province and in Kahemba, Kajiji and Kisandji Health Zones in Kwango province. Preparations are ongoing for the preventive vaccination campaigns planned to begin at end of August in 32 Health Zones in Kinshasa province and 15 Health Zones in border areas with Angola.
Fractional dosing will be implemented in a pre-emptive mass vaccination campaign in DRC in Kinshasa.
As of 4 August 2016, 21.2 million vaccine doses have been approved for Angola, 11.5 million for DRC and 0.8 million in Uganda.
The number of vaccines currently available for the emergency response is 5.1 million through the ICG and WHO. The amount of doses already allocated to respond to the outbreak is not included in this number.
- The outbreak in Angola is receding and no confirmed case has been reported in the country during July (as of 28 July). However, a high level of vigilance needs to be maintained throughout the country, and the pre-emptive mass vaccination campaign will be implemented as planned
- In DRC, there is a need for heightened vigilance as the outbreak has spread to new Health Zones in the three affected provinces. Further cases are expected to be confirmed in the next days or weeks due to the backlog at the national laboratory which stemmed from technical issues that are now resolved. The outbreak might spread to other provinces as more suspected cases have been reported in Lualaba and Kasai provinces. Given the presence and activity of the vector Aedes in the country and low immunity of the population, the outbreak might extend to other provinces.
- Transmission of yellow fever in Angola and DRC is mainly concentrated in cities; however, there is a high risk of spread and local transmission to other provinces, especially in DRC where the vaccinated population is much lower.