Yellow fever could spread to Asia, and global officials are determining if they should declare a global emergency, according to a Los Angeles Times article published May 18 by Ann M. Simmons.
In the article, Simmons quoted an email from Lawrence Gostin, faculty director of Georgetown University’s O’Neill Institute for National and Global Health Law, who said, “In my view, calling an emergency committee for yellow fever is clearly the right thing to do. First, there is the potential for rapid spread to other countries and regions, threatening the health of large populations in Africa, Asia and elsewhere. Second, as the crisis escalates, global supplies of the yellow fever vaccine are dwindling and we could easily face a critical shortage.”
In the article, O’Neill Institute immunologist Daniel Lucey said, “The looming fear is a yellow fever outbreak in Asia.”
The World Health Organization released a report May 19 that called for:
● the acceleration of surveillance, mass vaccination, risk communications, community mobilization, vector control and case management measures in Angola and the Democratic Republic of Congo;
● the assurance of yellow fever vaccination of all travelers, and especially migrant workers, to and from Angola and Democratic Republic of Congo;
● the intensification of surveillance and preparedness activities, including verification of yellow fever vaccination in travelers and risk communications, in at-risk countries and countries having land borders with the affected countries.
People who develop a severe infection from yellow fever experience high temperatures, jaundice, bleeding and shock and failure of organs. The outbreak in Angola is at level 2, according to the CDC website, which states:
“At least 2,149 suspected and confirmed cases have been reported nationally, including 277 deaths. The majority of yellow fever cases and deaths have been in Luanda Province. However, cases have been reported throughout the country. The Ministry is working with the World Health Organization to control the outbreak and has been conducting an emergency vaccination campaign.
The government of Angola requires all travelers older than 9 months of age to show proof of yellow fever vaccination upon arrival. In addition, the CDC recommends that all travelers to Angola ages 9 months or older be vaccinated against yellow fever.”
The Los Angeles Times article also quoted Sylvie Briand, WHO’s director of the pandemic and epidemic diseases department, who told reporters at a Geneva briefing, “We are concerned for other countries that may have high densities of mosquitoes. You have trillions of mosquitoes and millions of people, so the capacity of transmission of the virus is multiplied enormously.”
Information for clinicians found on the CDC website stated that in its mildest form, yellow fever is a “self-limited infection characterized by sudden onset of fever and headache without other symptoms. Other patients experience an abrupt onset of a high fever (up to 104°F [40°C]), chills, severe headache, generalized myalgias, lumbosacral pain, anorexia, nausea, vomiting, and dizziness. The patient appears acutely ill, and examination might demonstrate bradycardia in relation to the elevated body temperature (Faget’s sign). The patient is usually viremic during this period, which lasts for approximately three days. Many patients have an uneventful recovery, but in approximately 15% of infected persons, the illness recurs in more severe form within 48 hours following the viremic period. Symptoms include fever, nausea, vomiting, epigastric pain, jaundice, renal insufficiency and cardiovascular instability.”
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