Re: Sudan: Unknown Fever up to 98 fatalities - report of haemorrhagic symptoms- Yellow Fever
Re: Sudan: Unknown Fever up to 98 fatalities - report of haemorrhagic symptoms- Yellow Fever
Published Date: 2012-10-31 16:37:19
Subject: PRO/AH/EDR> Yellow fever - Africa (09): Sudan (Darfur)
Archive Number: 20121031.1381886
YELLOW FEVER - AFRICA (09): SUDAN (DARFUR)
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[1]Date: 31 Oct 2012
Source: MiNews 26 [edited]
http://www.minews26.com/content/?p=20693
A previously unknown disease which has claimed more than 30 lives in Sudan's troubled Darfur region this month [October 2012] has been identified as yellow fever, the World Health Organization (WHO) said on Tuesday [30 Oct 2012]. Preparations for a mass vaccination campaign are now underway.
The outbreak was 1st detected early this month [October 2012] when a number of people in the central and southern regions of Darfur became ill and eventually died. Sudanese media said the victims suffered from a number of symptoms, including diarrhea, vomiting, and bleeding from both the mouth and nose.
Tarik Jasarevic, a spokesman for the World Health Organization (WHO), on Tuesday [30 Oct 2012] said it had been informed by Sudan's Federal Ministry of Health (FMoH) that the outbreak is being caused by yellow fever. Since the 1st week of October [2012], a total of 84 suspected cases, including 32 deaths, have been reported in the districts of Azoom, Kass, Mershing, Nertiti, Nyala, Wadi Salih and Zalingei.
"FMoH said that the immediate priority is to control the vector, reinforcing the disease surveillance system and raising public awareness on the prevention and control of this disease," Jasarevic said. "Preparations for a mass vaccination campaign are underway to vaccinate the at risk population in Darfur."
According to Darfur radio station Dabanga, however, at least 37 people are believed to have died as a result of the disease, while 125 others have been infected. The radio station quoted a resident as saying that local authorities were slow to react and did not immediately take necessary action to contain the outbreak.
"FMoH, WHO, as well as health partners are working on ground to ensure timely containment of the outbreak," Jasarevic added.
There is no cure for yellow fever, which is an acute viral haemorrhagic disease transmitted by infected mosquitoes. Treatment is aimed at reducing the symptoms for the comfort of patients, and measures often taken include supportive care to treat dehydration and fever and blood transfusion if needed.
"It is a preventable disease with symptoms and severity varying from case to case," Jasarevic explained. "Protective measures like the use of bed nets, insect repellent and long clothing are considered the best methods to contain an outbreak. Vaccination is the single most important measure for preventing yellow fever."
It is estimated some 200 000 people are infected by yellow fever each year, killing approximately 30 000 of them [worldwide estimates]. The virus is endemic in tropical areas of Africa and Latin America, which have a combined population of over 900 million people. Up to half of severely affected persons will die from the disease without treatment.
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[2]
Date: 31 Oct 2012
Source: Reuters AlertNet [edited]
http://www.trust.org/alertnet/news/mass-vaccination-against-yellow-fever-planned-in-darfur
The World Health Organization (WHO) is preparing to vaccinate millions of people in Sudan's troubled Darfur region to stem an outbreak of yellow fever that has led to 84 suspected cases, including 32 deaths, since the 1st week of October [2012].
Yellow fever is a viral infection that is transmitted by mosquitoes in tropical regions leading to fever, vomiting, liver inflammation and jaundice. It can cause bleeding from the nose, mouth, stomach or eyes.
Five cases per day have been detected for the last week, according to the WHO representative in Sudan, Anshu Banerjee. "Every day, we have a few new districts that are affected," he told AlertNet. "It has affected a number of localities in Central Darfur. It affected 2 districts in South Darfur, and now we have reports that it also affected 2 districts in West Darfur."
On Wednesday [31 Oct 2012], WHO sent a sample to Senegal to reconfirm the Sudanese ministry of health's diagnosis. Once this is confirmed, which is expected late next week, it will draw up a vaccination plan.
The last outbreak of yellow fever in Sudan was in South Kordofan in 2005, where there were 604 cases including 163 deaths over a 4-month period.
There is no specific treatment for yellow fever, only supportive care to treat dehydration and fever and blood transfusion if needed. Vaccination is the main preventative measure.
War has ravaged Darfur since rebels took up arms in 2003, saying the central government had neglected the region. Conflict has continued despite the presence of the world's largest peacekeeping operation, the United Nations-African Union Mission in Darfur (UNAMID), with humanitarian workers often targeted.
"There are of course a lot of security constraints," said Banerjee. "We sometimes need support from UNAMID escorts, things like that, but it doesn't mean we are actually not able to conduct the campaigns."
It can also be hard to reach remote, mountainous villages in the Jebel Marra region of central Darfur, far from health centres.
Banerjee also said Sudan has a "well-functioning immunisation programme."
It gets significant funding from the Global Alliance for Vaccines and Immunisation and from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
In October [2012], a WHO vaccination campaign against meningitis reached the majority of Darfur's 8 million people.
"There is a lot of institutional support from the government," said Banerjee. "The difficulties from a security point of view in Darfur will not prevent us from being able to conduct the campaign."
[Byline: Katy Migiro]
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[On 8 Oct 2012, ProMED-mail posted a report on an as yet undiagnosed outbreak, with fatalities in Zalingei. At that time, the clinical presentation of the cases was described as headaches, vomiting, and fatigue. There were "at least 10 people who died," with cases also being seen in Korley, Tur Kolmey, and Doudou. Cases occurred among gold miners. On 23 Oct 2012, ProMED-mail posted another report on another undiagnosed outbreak associated with fever, with reports of 16 cases and 6 deaths, occurring in South Darfur state. No additional information on the cases, clinical presentation or epidemiologic studies were provided in that report, but given the ongoing outbreaks of viral hemorrhagic fevers (VHF) in neighboring Uganda and the Democratic Republic of the Congo, a VHF etiology to the 2 outbreaks in Sudan was a possibility.
The southern part of Sudan and South Sudan are in the yellow fever (YF) belt of Africa (see
http://www.cdc.gov/yellowfever/maps/africa.html. Given the security constraints in the region, it is not surprising that the identification of yellow fever virus as the etiology of these outbreaks took approximately one month to establish. The remoteness of the involved areas combined with the security challenges and the fact that many of the cases are learned of postmortem (and post burial) means adequate specimens for laboratory testing are difficult to obtain.
The only treatment for yellow fever at present is supportive care, but the disease is a vaccine preventable disease. Hopefully, the security constraints will not impede the needed vaccination campaign to control the outbreak. - Mod.MPP]
