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Uganda, Sudan, South Sudan: Several possible cases of yellow fever - tests negative for yellow fever, positive for Hepatitis E

alert

Senior Moderator
http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,90440

Archive Number 20110926.2922
Published Date 26-SEP-2011
Subject PRO/AH/EDR> Yellow fever - Africa (19): Uganda ex southern Sudan, Sudan

YELLOW FEVER - AFRICA (19): UGANDA ex SOUTHERN SUDAN, SUDAN
***********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this report:
[1] Uganda ex Southern Sudan
[2] Sudan (North Darfur)

******
[1] Uganda ex Southern Sudan
Date: Mon 26 Sep 2011
Source: Afriquinfos [in French, trans. Corr.SB, summ. & edited]
<http://www.afriquinfos.com/articles/2011/9/26/brevesdafrique-187567.asp


The World Health Organization (WHO) and the Uganda Minister for Health
confirmed the outbreak of a yellow fever [YF] epidemic in northern
Uganda. Minister of State for Health, reached by telephone by Xinhua
on Sunday [25 Sep 2011], said that steps would be taken to prevent the
spread of the disease.

Emmanuel Tenywa, the WHO official, told Xinhua by phone that it was an
imported case from [the Republic of] Southern Sudan, discovered in
Palabek, Kitgum district [Uganda].

A Ugandan affected by yellow fever came from the city of Torit, the
capital of the state of Eastern Equatoria [Republic of Southern
Sudan]. "He had not been immunized and contracted the disease in the
[Republic of] Southern Sudan. All cases of yellow fever have to be
well examined," said Tenywa, recalling a campaign of mass vaccination
against yellow fever in Kitgum in January 2011.

According to WHO, there are about 200 000 cases of yellow fever each
year, with 30 000 deaths.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[It will be important to have this case, and those in the following
report, confirmed in the laboratory, since there are other causes of
hepatitis. It would also be important to know whether there are YF
virus mosquito vectors in the area where the patient came from in
Southern Sudan and where he was subsequently diagnosed in Uganda.
Surveillance for YF virus infections is essential in both areas.

A HealthMap/ProMED-mail interactive map showing the location of
Eastern Ecuatoria in Southern Sudan can be accessed at
<http://southernsudan.prm.ox.ac.uk/sudan_map.php>. - Mod.TY]

******
[2] Sudan
Date: Thu 15 Sep 2011
Source: All Africa [summ. & edited]
<http://allafrica.com/stories/201109160469.html


Residents of Zamzam and Abushok refugee camps in North Darfur
complained on Thursday [15 Sep 2011] of the prevalence of yellow
fever. Diseases are prevalent, especially among young children. One of
the refugees from Zamzam camp told Radio Dabanga that yellow fever had
spread steadily among the refugees in the past few days.

Dr Shafi Abdalhaf, of the epidemiology department in the El Fasher
hospital, acknowledged the rise in patients suffering from yellow
fever and diarrhea in the North Darfur camps mentioned above. However,
he stressed that there were only 4 registered cases of yellow fever in
the Zamzam camp.

"I have been sending blood samples of these patients to make sure of
what the disease is. The next step is to send a medical team to the
camp to verify the disease," Dr Shafi said. He also reported that
there would be further tests done by the medical team to check on the
extent of the spread of the disease.

The residents of Zamzam camp attributed the poor health in the camp to
deteriorating living conditions and lack of drinking water in the
camp. The refugees pleaded with the authorities to increase security
for the organizations that work in the area of water and sanitation.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[This report is nearly 2 weeks old. There have been no further reports
since 15 Sep 2011, suggesting that either there are no further YF
cases or very few, or that the YF diagnosis is not correct. ProMED
would appreciate receiving further reports, especially laboratory
confirmation (or not), as new information becomes available.

The Zamzam Refugee Camp in Darfur is one of the world's largest with
over 200 000 residents. Occurrence of YF in a camp like this one is
cause for significant concern. As for likely vectors, in ProMED-mail
archive no. 20051223.3665, Dr. Alan Kemp wrote about YF virus vectors
in Sudan: "_Aedes (Stegomyia) aegypti_ played a minor role in the 1940
outbreak, while _Aedes (Fredwardsius) vittatus_ and _Aedes
(Diceromyia) furcifer/taylori_ (may have included _Ae. (Dic.)
cordellieri_, which was described long afterwards) were believed to be
responsible for most of the transmissions. It is likely that water is
being stored in multiple places, providing potential breeding sites
for _Aedes_ mosquitoes. It is also likely that many of the camp
residents are not vaccinated against YF virus. A YF outbreak could
exacerbate an already tragic situation.

A map showing the location of Northern Darfur can be accessed at
<http://www.radiodabanga.org/node/18042>. - Mod.TY]
 
Re: Uganda, Sudan, South Sudan: Several possible cases of yellow fever

Re: Uganda, Sudan, South Sudan: Several possible cases of yellow fever

http://promedmail.org/pls/apex/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,90697

Archive Number 20111015.3092
Published Date 15-OCT-2011
Subject PRO/AH/EDR> Yellow fever - Africa (20): (Uganda ex Southern Sudan), corr., HEV

YELLOW FEVER - AFRICA (20): UGANDA ex SOUTHERN SUDAN, CORRECTION,
HEPATITIS E VIRUS
***********************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 28 Sep 2011
From: Dr. Joseph F. Walmala [edited]
<j_wamala@yahoo.com>


The lady from Torit turned out to be positive for HEV [hepatitis E
virus] IgM and IgG but negative for yellow fever markers, based on
laboratory results from the CDC Uganda Viral laboratory.

--
Joseph F. Walmala
<j_wamala@yahoo.com>
Senior Epidemiologist
Ministry of Health, Uganda

[The original report was of an imported yellow fever (YF) case from
the city of Torit, the capital of the state of Eastern Equatoria,
Republic of Southern Sudan, discovered in Palabek, Kitgum district,
Uganda (see ProMED-mail archive number 20110926.2922). The original
report indicated that the affected individual had YF. As noted above,
laboratory tests ruled out YF virus infection and diagnosed hepatitis
E virus infection, which can produce symptoms similar to YF virus
infection.

The US CDC states (<http://www.cdc.gov/hepatitis/HEV/index.htm>,
edited) "Hepatitis E is a serious liver disease caused by the
hepatitis E virus (HEV) that usually results in an acute infection. It
does not lead to a chronic infection. Hepatitis E is common in many
parts of the world. Transmission occurs through ingestion of fecal
matter, even in microscopic amounts. Outbreaks are usually associated
with contaminated water supply in countries with poor sanitation.
There is currently no FDA-approved vaccine for Hepatitis E."

A HealthMap/ProMED-mail interactive map showing the location of
Eastern Equatoria in Southern Sudan can be accessed at
<http://southernsudan.prm.ox.ac.uk/sudan_map.php>. - Mod.TY]

[see also:
Yellow fever - Africa (19): Uganda ex southern Sudan, Sudan
20110926.2922]
 
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