SUMMARY
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.As of 1 June 2016, Angola has reported 2893 suspected cases of yellow fever with 325 deaths. Among those cases, 788 have been laboratory confirmed. Despite extensive vaccination campaigns in several provinces, circulation of the virus persists.
Cunene and Malanje provinces have reported, for the first time since the beginning of the outbreak, 5 autochthonous cases.
On 22 March 2016, the Ministry of Health of DRC confirmed cases of yellow fever in connection with Angola. The government officially declared the yellow fever outbreak on 23 April. As of 1 June, DRC has reported three probable cases and 52 laboratory confirmed cases: 44 of those are imported from Angola, reported in Kongo Central,
Kinshasa and Kwango (formerly Bandundu) provinces, two are sylvatic cases in Northern provinces, and two other autochthonous cases in Ndjili (Kinshasa) and in Matadi (Kongo Central). The possibility of locally acquired infection is under investigation for at least four non-classified cases.In Uganda, the Ministry of Health notified yellow fever cases in Masaka district on 9 April 2016. As of 1 June, 68 suspected cases, of which three are probable and seven are laboratory confirmed, have been reported from three districts: Masaka, Rukungiri and Kalangala. According to sequencing results, those clusters are not epidemiologically linked to Angola.
The virus in Angola and DRC is largely concentrated in main cities; however there is a high risk of spread and local transmission to other provinces in both countries. There is also a high risk of potential spread to bordering countries especially those previously classified as low-risk for yellow fever disease (i.e. Namibia, Zambia) and where the population, travellers and foreign workers are not vaccinated against yellow fever.
Three countries have reported confirmed yellow fever cases imported from Angola:
Democratic Republic of The Congo (DRC) (44 cases), Kenya (two cases) and People’s Republic of China (11 cases). This highlights the risk of international spread through nonimmunised travellers.A further three countries have reported suspected cases of yellow fever: Republic of Congo (one case), Sao Tome and Principe (two cases) and Ethiopia (22 cases).
Investigations are ongoing to identify the vaccination status of the cases and determine if they are linked with Angola.Following the advice of the Emergency Committee (EC) convened on 19 May 2016, WHO Director-General decided that urban yellow fever outbreaks in Angola and DRC are serious public health events which warrant intensified national action and enhanced international support. The events do not at this time constitute a Public Health Emergency of International Concern (PHEIC). The statement can be found on the WHO website.