SUMMARY
From the beginning of the outbreak on 15 December 2015 to 8 June 2016, Angola has reported 2954 suspected cases of yellow fever including 328 deaths. Among those cases, 819 have been laboratory confirmed. Despite extensive vaccination campaigns in several provinces, circulation of the virus persists.
As of 8 June 2016 three new provinces in Angola have reported local transmission, bringing the total number of districts with local transmission to 33 in 11 provinces, including Luanda.
The total number of reported cases in Angola increased from 11 April 2016 onwards, while the number of laboratory confirmed cases remains stable. This can be attributed to the intensification of surveillance activities in most provinces.
From the beginning of the outbreak on 22 March 2016 to 8 June 2016, the Democratic Republic of The Congo (DRC) has reported three probable cases and 57 laboratory confirmed cases: 51 of those are imported from Angola, reported in Kongo Central, Kinshasa and Kwango provinces, two are sylvatic cases in Northern provinces, and four are autochthonous cases in Ndjili and Kimbanseke districts, in Matadi (Kongo Central) and in Kwango province.
From the beginning of the outbreak on 9 April 2016 to 8 June 2016, the Ministry of Health of Uganda, has reported 68 suspected cases, of which three are probable and seven are laboratory confirmed. Confirmed cases have been reported from three districts: Masaka (five cases), Rukungiri (one case) and Kalangala (one case). 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: DRC (51 cases), Kenya (two cases) and People’s Republic of China (11 cases). This highlights the risk of international spread through non-immunised travellers.
A further three countries have reported suspected cases of yellow fever: Ethiopia (one probable case), Ghana (four suspect cases) and Republic of Congo (one suspect case). Investigations are ongoing to identify the vaccination status of the cases and determine if they are linked with Angola. The two suspect cases previously reported in Sao Tome and Principe have been discarded.
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.