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The Lancet 2008; 371:786
DOI:10.1016/S0140-6736(08)60352-9Editorial
Yellow fever preparedness
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As WHO announced that an outbreak of Ebola fever had been contained in Uganda at the end of February, another feared viral haemorrhagic disease?yellow fever?was causing concern in South America.
So far this year, outbreaks of jungle yellow fever in humans have occurred in Brazil and Paraguay. And this week, Argentina confirmed a human case of the disease. More worryingly, Paraguay is also dealing with an outbreak of urban yellow fever?the first resurgence of this form of the disease in the Americas since the 1940s.
Millions of doses of yellow fever vaccine have been dispatched to Brazil and Paraguay for mass immunisation campaigns. But last week WHO announced that their global emergency stockpile of the vaccine (6 million doses) was depleted. A spokesman said the agency was now in an ?uncomfortable position? with regards to the vaccine supply for emergencies and for mass preventive campaigns in the Americas and the other region of the world where yellow fever is endemic?Africa.
In the coming years, inadequacy of vaccine supply is likely to become even more apparent since the conditions for the re-emergence of urban yellow fever are well established in many countries, especially in sub-Saharan Africa. The urban population in Africa is also predicted to triple in the next 40 years. Migration from rural to urban settings with high vector density and non-immune populations will further increase the risk of large outbreaks of urban yellow fever.
Yellow fever was a major scourge in the Americas and west Africa in the 18th and 19th centuries until an effective vaccine became available. But as the latest outbreak shows, the volume of vaccine currently produced is not enough to meet needs. Governments should realise that yellow fever?a greatly feared and disruptive disease?is a serious problem again, with social and economic, as well as health, implications. Political commitment to maintain a secure supply of vaccine is required to neutralise current and future threats from yellow fever and prevent the return of the major epidemics of the past.
The Lancet
DOI:10.1016/S0140-6736(08)60352-9Editorial
Yellow fever preparedness
Click to enlarge image
Getty Images
As WHO announced that an outbreak of Ebola fever had been contained in Uganda at the end of February, another feared viral haemorrhagic disease?yellow fever?was causing concern in South America.
So far this year, outbreaks of jungle yellow fever in humans have occurred in Brazil and Paraguay. And this week, Argentina confirmed a human case of the disease. More worryingly, Paraguay is also dealing with an outbreak of urban yellow fever?the first resurgence of this form of the disease in the Americas since the 1940s.
Millions of doses of yellow fever vaccine have been dispatched to Brazil and Paraguay for mass immunisation campaigns. But last week WHO announced that their global emergency stockpile of the vaccine (6 million doses) was depleted. A spokesman said the agency was now in an ?uncomfortable position? with regards to the vaccine supply for emergencies and for mass preventive campaigns in the Americas and the other region of the world where yellow fever is endemic?Africa.
In the coming years, inadequacy of vaccine supply is likely to become even more apparent since the conditions for the re-emergence of urban yellow fever are well established in many countries, especially in sub-Saharan Africa. The urban population in Africa is also predicted to triple in the next 40 years. Migration from rural to urban settings with high vector density and non-immune populations will further increase the risk of large outbreaks of urban yellow fever.
Yellow fever was a major scourge in the Americas and west Africa in the 18th and 19th centuries until an effective vaccine became available. But as the latest outbreak shows, the volume of vaccine currently produced is not enough to meet needs. Governments should realise that yellow fever?a greatly feared and disruptive disease?is a serious problem again, with social and economic, as well as health, implications. Political commitment to maintain a secure supply of vaccine is required to neutralise current and future threats from yellow fever and prevent the return of the major epidemics of the past.
The Lancet
