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Confirmation of yellow fever case in French Guiana

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  • Confirmation of yellow fever case in French Guiana

    Translation Google

    Confirmation of yellow fever case in Guyana

    Press release
    Public Health 22 August 2017

    The Institut Pasteur of French Guiana yesterday confirmed a yellow fever virus infection in Guyana, for the first time since 1998.

    According to the initial investigations of the ARS, this person could have been contaminated in the border zone of Oiapoque in Brazil. The patient, with a history of forest stay near St Elie and in the Oyapock Valley, died on August 9th.

    The Regional Health Agency and its local partners have put in place all the management measures (investigation, mosquito control, etc.) and information necessary to prevent the emergence of new cases and recall that vaccination is the main preventive measure against Yellow fever.

    Yellow fever: transmission to humans, symptoms and treatments

    Yellow fever is an acute viral disease transmissible from the animal (monkey) to man and man to man by various mosquitoes (genus Aedes, but also other genera circulating in the forest). The yellow fever virus is transmitted by the bite of an infected mosquito.

    After an incubation period of about one week, the disease is characterized by fever, chills, muscle pain, headache, nausea, vomiting. Severe forms (hemorrhage, liver disorders, kidney problems) can develop in 15% of cases.

    Vaccination is the main prevention measure against yellow fever. The vaccine is safe, and very effective, a single dose is usually enough to give lasting immunity and lifetime protection against the disease. In 30 days, it gives an effective immune protection to 99% of the vaccinated subjects.

    In case of yellow fever, symptomatic treatment may be proposed (rehydration, administration of medicines to limit fever, vomiting and pain, antibiotics for superinfections).

    The Regional Health Agency and its partners

    Without awaiting confirmation of the contamination, the Department of Demobilization of the Territorial Collectivity of Guyana has already started, whenever possible, its mosquito control operations around the identified places of transit of the deceased patient. Among the identified places of transit, we can count to date: the Hospital Center of Cayenne, the Medical-surgical Center of Kourou; The surrounding forest of Saint Elias; Degradation of Petit Saut; The lower Oyapock.

    The ARS recommends that unvaccinated persons presenting symptoms and have visited these premises since August 15, 2017, should consult their physician without delay. Unvaccinated persons can be vaccinated at most general practitioners and at the following centers: CPS of the Red Cross, CDPS of the Center Hospitalier de Cayenne, PMI centers of the CTG, consultation of the traveler at the Cayenne Hospital Center. The LRA informed health professionals about this case and the implementation of these provisions.

    The list of doctors and centers is available on the site ARS Guyane: https://www.guyane.ars.sante.fr/fievre-jaune

    Protecting yourself individually and collectively against mosquitoes

    The mobilization of all against the mosquito is essential. The Regional Health Agency recommends the adoption of a number of individual and collective measures:

    Destroy larvae and potential mosquito breeding habitats around and in the habitat (by removing saucers under the flowerpots and emptying at least once a week all containers containing stagnant water: detritus, Gutters ...);
    In urbanized areas, as well as in the forest, to protect themselves from mosquito bites by wearing long clothes, using cutaneous repellents (respecting precautions for use, especially in children and pregnant women) and mosquito nets. Particular cradle in newborn and infant;
    Protecting the habitat (mosquito nets, electric diffusers, twists ...).


    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2
    Source: http://www.who.int/csr/don/30-august...nch-guiana/en/
    Yellow fever – France – French Guiana

    Disease outbreak news
    30 August 2017

    On 22 August 2017, the National IHR Focal Point for France notified a confirmed fatal case of yellow fever in a 43-year-old Brazilian woman in French Guiana, with an unknown vaccination status.
    The patient was hospitalized on 7 August 2017 and died on 9 August 2017 at the Cayenne hospital from fulminant hepatitis. She may have visited a gold mining area near St. Elie (North center of the country). Investigations are currently ongoing in order to identify the patient's travel route.
    On 21 August 2017, the case was laboratory confirmed at the national reference center for arboviruses, Institut Pasteur Cayenne by RT-PCR. This is the first confirmed case diagnosed in this territory since 1998.
    In French Guiana, yellow fever is considered endemic. The overall immunization coverage is good as yellow fever vaccination is mandatory but immunization coverage might be low in specific populations like clandestine and illegal workers. Therefore, vaccination catch-up will be implemented in legal and illegal gold prospecting areas.
    Public health response

    French Guiana health authorities are implementing several public health measures:
    • An initial investigation was performed and further investigations are ongoing.
    • Vector control interventions are being implemented, especially in specific zones that the case visited. These include health facilities in Cayenne and Kourou, localities of the interior around Saint Elie, and in the Bas-Oyapock river area.
    • The feasibility of vaccination catch-up targeting workers in legal and illegal gold mining areas is considered.
    • Communication and messages on prevention measures for yellow fever are being disseminated in French Guiana, including to people who live in those areas.

    WHO risk assessment

    Yellow fever is an acute viral hemorrhagic disease that has the potential to spread rapidly and cause serious public health impacts in unimmunized populations. Vaccination is the most important means of preventing the infection.
    French Guiana is considered at risk for yellow fever transmission. A yellow fever vaccination certificate is required for travelers over one year of age. Vaccination coverage in French Guiana is optimal, however, the coverage in some populations such as clandestine workers, in mining areas could be sub-optimal and therefore at risk for yellow fever infections.
    While the exact place of infection remains under investigation, the most likely geographic area of infection appears to be around the border between French Guiana and Brazil along the Oyapock river.
    At this stage and according to the preliminary data, this case is not epidemiologically linked to the sylvatic yellow fever outbreaks reported from Brazil since January 2017. Sequencing and comparison with yellow fever virus strains from other countries is needed to understand the potential link between the different outbreaks and the evolution of yellow fever virus. Based on the information currently available regarding epidemiological situation and early public health actions, the potential for large epidemic and international spread exists but is limited and could be further reduced by vaccination.
    WHO advice

    Advice to travelers planning to visit areas at risk for yellow fever transmission in South America includes:
    • Vaccination against yellow fever at least 10 days prior to the travel. A single dose of yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against yellow fever disease. A booster dose of the vaccine is not needed.
    • Observation of measures to avoid mosquito bites.
    • Awareness of symptoms and signs of yellow fever in general population.
    • Promotion of health care seeking behavior while traveling and upon return from an area at risk for yellow fever transmission, especially to a country where the establishment of a local cycle of transmission is possible (i.e. where the competent vector is present).

    This case report illustrates the importance of maintaining awareness of the need for yellow fever vaccination, especially in areas with favorable ecosystem for yellow fever transmission.
    Yellow fever can easily be prevented through immunization provided that vaccination is administered at least 10 days before travel. A single dose of yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against Yellow fever disease and a booster dose of the vaccine is not needed.
    WHO, therefore, urges Members States to strengthen the control of immunization status of travelers to all potentially endemic areas. Viraemic returning travelers may pose a risk for the establishment of local cycles of yellow fever transmission in areas where the competent vector is present. If there are medical grounds for not getting vaccinated, this must be certified by the appropriate authorities.
    WHO does not recommend that any general travel or trade restriction be applied on French Guiana based on the information available for this event.

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