90 Years and Waiting

     

May 19, 2016

Dear Colleagues,

Yellow fever was detected in Angola late in December 2015 and confirmed by the Institut Pasteur Dakar on 20 Jan 2016. Since then, the disease has spread rapidly: there have been over 2,267 suspected yellow fever cases and close to 300 deaths. Despite vaccination campaigns in the capital and major cities, circulation of the virus persists. A separate outbreak is occurring in rural areas of Uganda, and yellow fever cases imported from Angola have been reported in China and Kenya.

Since the beginning of the year, ProMED has published over 100 reports on these yellow fever outbreaks. Each report vetted and analyzed by prominent virologists. Where else can you get this level of news about topics you need to know about? If you appreciate accuracy, reliability, and timeliness, please help keep ProMED-mail streaming into your inbox.

Once one of the world's most feared epidemic diseases, a safe, effective vaccine was developed in 1937. Mass vaccination campaigns in the mid-20th century brought yellow fever under control for over 40 years. But since the late 1980s, the disease has returned. Yellow fever is now endemic in parts of South America and Africa, causing as many as 170,000 infections and at least 60,000 deaths annually. The Yellow Fever Initiative, undertaken by WHO, UNICEF, and the GAVI Alliance, launched in 2006 aiming to dramatically reduce the risk of yellow fever outbreaks in 12 endemic countries in Africa through the vaccination of 48 million people and increases in the amount of vaccine produced and stockpiled each year.

The number of yellow fever cases has been decreasing over the past 10 years since the launch of the initiative, but today the world's annual vaccine production of just over 40 million doses may not be sufficient to replenish emergency stockpiles and contain outbreaks if yellow fever follows the same path as dengue, chikungunya, and Zika, also spread by Aedes mosquitoes. In South America, urban outbreaks of the disease are almost unheard of; yellow fever has never previously taken hold in Asia. But if yellow fever spreads to the crowded cities of countries like Brazil or infects China, the shortfall of available vaccine will be catastrophic. We have the effective prevention; when will we have the effective plan to produce and administer it?

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Best regards,

Larry Madoff, MD
Editor

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