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WHO - Senegal: yellow fever case in the Touba district, onset of illness June 24, 2020

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  • WHO - Senegal: yellow fever case in the Touba district, onset of illness June 24, 2020

    Week 34: 17 - 23 August 2020
    Data as reported by: 17:00; 23 August 2020

    Yellow fever

    1 Cases
    0 Deaths
    0.0% CFR


    The National Focal Point of the International Health Regulations (NFPIHR)
    for Senegal was informed of a yellow fever case in the Touba
    district on 21 July 2020 after a sample sent to Institut Pasteur Dakar was
    returned positive for yellow fever by IgM antibody testing.

    The case patient is a five-year-old girl living in the Darou Marnane Ndia
    area, the third of five siblings, whose yellow fever vaccinations are not up
    to date. The onset of illness was on 24 June 2020, when she presented
    with fever, myalgia (muscle aches) and abdominal pain. She was taken
    to a traditional healer and given an unknown substance. On 1 July 2020,
    because her symptoms persisted, she was taken to the Daou Marnane
    Health Centre, where a rapid diagnostic test for malaria was negative.
    She was treated empirically with ceftriaxone and paracetamol and no
    biological workup was done. On the same day a blood sample was taken
    as part of the sentinel surveillance for arboviruses in the syndromic
    sentinel surveillance network (4S network), which was sent to Institut
    Pasteur Dakar on 12 July 2020. The delay was due to diversion of
    resources to the COVID-19 response. The child is recovering well with
    symptomatic treatment as an outpatient.

    Active case searching at household level identified 28 contacts, two of
    whom, the mother and one sister, were sampled but tested negative. At
    the same time, an active search through records reviews were conducted
    in the Darou Marnane Health Centre and the other five facilities close
    to this centre, covering the period from May 2020 to 31 July 2020. No
    suspected cases were found. A total of 10 children from the home of the
    case patient were vaccinated.

    A larval survey for vectors was carried out in 30 areas and 190 housing
    units and 144 potential sites were identified, including ponds, water
    storage containers, abandoned containers, tyres and animal drinking
    troughs. Infestation rates were above 22%, mainly in water storage
    containers and ponds. A high proportion of the mosquitoes identified
    were Aedes aegypti, a proven vector of yellow fever.


    On 21 July 2020 a district team, made up of the District Chief
    Medical Officer, the Surveillance Focal Point, the Primary Health
    Care Supervisor and the Head of the Touba Hygiene Sub-brigade
    met to determine the next steps in outbreak investigation.

    A support mission was carried out by the AFENET/FETP programme
    manager in collaboration with the Chief Medical Officer of the Touba

    An extended team was formed at central level on notification of
    the case to conduct a fact-finding mission at district level between
    13-18 August 2020.

    A full epidemiological, entomological and environmental
    investigation of the yellow fever outbreak was carried out in the


    Health authorities in Senegal have confirmed a case of yellow fever in
    Darou Marnane Ndia area, Touba. The area in which this case occurred
    is known to have low vaccine coverage rate compared to the rest of
    the district. In addition, the COVID-19 outbreak is known to have had a
    serious impact on the use of health services in general and vaccination
    services in particular, increasing the number of children who are
    vulnerable to vaccine-preventable diseases. Authorities in Touba
    are to be commended on their prompt and efficient response to this
    case. However, continued follow-up of the contacts to the index case
    is required, as is strengthening of routine and sentinel surveillance.
    Catch up vaccination campaigns are required, along with reinforcement
    of vector control, which should destruction of breeding sites. Health
    personnel need to be trained in the identification of A. aegypti breeding
    areas, which are distinct from the shallower water used by Culex spp.
    Authorities should remain vigilant to ensure that there are no further
    cases of yellow fever and work with the COVID-19 response to improve
    surveillance of other infectious diseases in the area.

    "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