2012 yellow fever outbreak in Darfur, Sudan

Last updated

In late 2012, a yellow fever outbreak occurred in the Darfur region of Sudan that was the largest yellow fever epidemic to strike Africa in two decades. [1] On 10 January 2013, the Sudan Federal Ministry of Health and the World Health Organization (WHO) reported that there had been 847 suspected cases since 2 September 2012, including 171 deaths, for an estimated case fatality rate of 20%. A mass vaccination campaign was launched in mid-November. [2] By early January, the five states of Darfur were free of any new cases.

Contents

Epidemiology

The first cases of yellow fever occurred in early September, but the first blood samples for confirmation were not sent to the Institut Pasteur reference laboratory in Dakar, Senegal until 30 October. On 9 November, WHO Sudan reported 266 suspected cases and 85 deaths for a case fatality rate of 32%. Most cases were in Central Dafur state (51.5 percent, reported in March 2013), but the outbreak later expanded to the four other states of North Darfur (21 percent), West Darfur (17.4 percent) and South Darfur (9.5 percent), including refugee camps related to the ongoing war in Darfur. [3] Laboratory confirmation of yellow fever came on 13 November. [4] [5] Most of the cases were among nomads, which contributed to the rapid spread. [6]

According to newspaper reports, about 10 000 workers from the gold mines of Jebel Amer fled to Nyala, the capital of South Darfur, after more than 60 deaths in the gold mining area. One newspaper reported: "The spread of the disease in South Darfur is a disaster and the epidemic requires organizations and the international community to address the disease and provide enough vaccines to vaccinate all citizens of the state." [7] Hundreds of patients had accumulated at the Nyala Teaching Hospital, some sleeping outside, and there was a shortage of medical personnel and supplies. By early December the number of deaths had reached 164. [8]

Health authorities in China began scanning travelers and Chinese citizens returning from Sudan. [9] As many as a million Chinese workers are employed in oil, mining and construction in Africa. The introduction of yellow fever into Asia, where it has never appeared, is a serious concern. [10]

Vaccination Campaign

On 13 November, the government of Sudan requested help from the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG) in starting a mass vaccination campaign. [11] Besides the WHO, the YF-ICG consists of representatives of the United Nations Children's Fund (UNICEF), Médecins sans Frontières (MSF) and the International Federation of Red Cross and Red Crescent Societies (IFRC). The United Nations–African Union Mission in Darfur (UNAMID) airlifted the first batches of vaccines from Khartoum to Darfur on 18 November. [12] Mass vaccination began on 20 November. [13] Efforts were also undertaken to eliminate mosquitoes. A team from the Naval Medical Research Unit Three (NAMRU-3) and the WHO Collaborating Center was deployed from Cairo to help collect and test samples and train local personnel. The vaccination campaign, from late November 2012 through early January 2013, covered more than 3 million people and halted the outbreak. A new phase of the campaign beginning in January covered more than 2 million more people at risk. [14] One of the difficulties was maintaining a cold chain for vaccine viability while transporting vaccine by donkey into remote areas. [15]

A situation report released on 10 January 2013 reported that 171 people had died of the disease as of 9 January 2013. [16] The number of suspected cases since 2 September 2012 was 847. The Minister of Health had announced on 5 January that no additional cases had appeared in the previous 3 weeks. [17]

Related Research Articles

<span class="mw-page-title-main">Typhoid fever</span> Disease caused by the bacteria Salmonella Typhi

Typhoid fever, also known as typhoid, is a disease caused by Salmonella serotype Typhi bacteria. Symptoms vary from mild to severe, and usually begin six to 30 days after exposure. Often there is a gradual onset of a high fever over several days. This is commonly accompanied by weakness, abdominal pain, constipation, headaches, and mild vomiting. Some people develop a skin rash with rose colored spots. In severe cases, people may experience confusion. Without treatment, symptoms may last weeks or months. Diarrhea may be severe, but is uncommon. Other people may carry it without being affected, but are still contagious. Typhoid fever is a type of enteric fever, along with paratyphoid fever. S. enterica Typhi is believed to infect and replicate only within humans.

<span class="mw-page-title-main">Yellow fever</span> Viral disease common in tropical Africa and South America

Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains – particularly in the back – and headaches. Symptoms typically improve within five days. In about 15% of people, within a day of improving the fever comes back, abdominal pain occurs, and liver damage begins causing yellow skin. If this occurs, the risk of bleeding and kidney problems is increased.

<span class="mw-page-title-main">Measles</span> Viral disease affecting humans

Measles is a highly contagious, vaccine-preventable infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes. Small white spots known as Koplik's spots may form inside the mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Common complications include diarrhea, middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression. Less commonly seizures, blindness, or inflammation of the brain may occur. Other names include morbilli, rubeola, red measles, and English measles. Both rubella, also known as German measles, and roseola are different diseases caused by unrelated viruses.

<span class="mw-page-title-main">MMR vaccine</span> Any of several combined vaccines against measles, mumps, and rubella

The MMR vaccine is a vaccine against measles, mumps, and rubella, abbreviated as MMR. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection.

<span class="mw-page-title-main">Mpox</span> Infectious viral disease

Mpox is an infectious viral disease that can occur in humans and some other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.

<span class="mw-page-title-main">Crimean–Congo hemorrhagic fever</span> Disease of humans and other animals

Crimean–Congo hemorrhagic fever (CCHF) is a viral disease. Symptoms of CCHF may include fever, muscle pains, headache, vomiting, diarrhea, and bleeding into the skin. Onset of symptoms is less than two weeks following exposure. Complications may include liver failure. Survivors generally recover around two weeks after onset.

<span class="mw-page-title-main">Epidemiology of chikungunya</span>

Chikungunya is a mosquito-borne alpha virus that was first isolated after a 1952 outbreak in modern-day Tanzania. The virus has circulated in forested regions of sub-Saharan African in cycles involving nonhuman primate hosts and arboreal mosquito vectors. Phylogenetic studies indicate that the urban transmission cycle—the transmission of a pathogen between humans and mosquitoes that exist in urban environments—was established on multiple occasions from strains occurring on the eastern half of Africa in non-human primate hosts. This emergence and spread beyond Africa may have started as early as the 18th century. Currently, available data does not indicate whether the introduction of chikungunya into Asia occurred in the 19th century or more recently, but this epidemic Asian strain causes outbreaks in India and continues to circulate in Southeast Asia.

<span class="mw-page-title-main">Polio eradication</span> Effort to permanently eliminate all cases of poliomyelitis infection

Polio eradication, the permanent global cessation of circulation of the poliovirus and hence elimination of the poliomyelitis (polio) it causes, is the aim of a multinational public health effort begun in 1988, led by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Rotary Foundation. These organizations, along with the U.S. Centers for Disease Control and Prevention (CDC) and The Gates Foundation, have spearheaded the campaign through the Global Polio Eradication Initiative (GPEI). Successful eradication of infectious diseases has been achieved twice before, with smallpox in humans and rinderpest in ruminants.

<span class="mw-page-title-main">United Nations–African Union Mission in Darfur</span> Peacekeeping mission

The African Union-United Nations Hybrid Operation in Darfur was a joint African Union (AU) and United Nations (UN) peacekeeping mission formally approved by United Nations Security Council Resolution 1769 on 31 July 2007, to bring stability to the war-torn Darfur region of Sudan while peace talks on a final settlement continue.

<span class="mw-page-title-main">Eradication of infectious diseases</span> Elimination of a disease from all hosts

The eradication of infectious diseases is the reduction of the prevalence of an infectious disease in the global host population to zero.

Sudan is still one of the largest countries in Africa even after the split of the Northern and Southern parts. It is one of the most densely populated countries in the region and is home to over 37.9 million people.

<span class="mw-page-title-main">Measles vaccine</span> Vaccine used to prevent measles

Measles vaccine protects against becoming infected with measles. Nearly all of those who do not develop immunity after a single dose develop it after a second dose. When rate of vaccination within a population is greater than 92%, outbreaks of measles typically no longer occur; however, they may occur again if the rate of vaccination decrease. The vaccine's effectiveness lasts many years. It is unclear if it becomes less effective over time. The vaccine may also protect against measles if given within a couple of days after exposure to measles.

<span class="mw-page-title-main">Yellow fever vaccine</span> Vaccine that protects against yellow fever

Yellow fever vaccine is a vaccine that protects against yellow fever. Yellow fever is a viral infection that occurs in Africa and South America. Most people begin to develop immunity within ten days of vaccination and 99% are protected within one month, and this appears to be lifelong. The vaccine can be used to control outbreaks of disease. It is given either by injection into a muscle or just under the skin.

<span class="mw-page-title-main">2016 Angola and DR Congo yellow fever outbreak</span> Disease outbreak in Africa

On 20 January 2016, the health minister of Angola reported 23 cases of yellow fever with 7 deaths among Eritrean and Congolese citizens living in Angola in Viana municipality, a suburb of the capital of Luanda. The first cases were reported in Eritrean visitors beginning on 5 December 2015 and confirmed by the Pasteur WHO reference laboratory in Dakar, Senegal in January. The outbreak was classified as an urban cycle of yellow fever transmission, which can spread rapidly. A preliminary finding that the strain of the yellow fever virus was closely related to a strain identified in a 1971 outbreak in Angola was confirmed in August 2016. Moderators from ProMED-mail stressed the importance of initiating a vaccination campaign immediately to prevent further spread. The CDC classified the outbreak as Watch Level 2 on 7 April 2016. The WHO declared it a grade 2 event on its emergency response framework having moderate public health consequences.

<span class="mw-page-title-main">2017 Democratic Republic of the Congo Ebola virus outbreak</span> Disease outbreak in the Democratic Republic of the Congo

The Democratic Republic of the Congo (DRC) was identified by the World Health Organization (WHO) on 11 May 2017 as having one Ebola-related death.

<span class="mw-page-title-main">2018 Équateur province Ebola outbreak</span> Disease outbreak in the Democratic Republic of the Congo

The 2018 Équateur province Ebola outbreak occurred in the north-west of the Democratic Republic of the Congo (DRC) from May to July 2018. It was contained entirely within Équateur province, and was the first time that vaccination with the rVSV-ZEBOV Ebola vaccine had been attempted in the early stages of an Ebola outbreak, with a total of 3,481 people vaccinated. It was the ninth recorded Ebola outbreak in the DRC.

Daniel R. Lucey is an American physician, researcher, senior scholar and adjunct professor of infectious diseases at Georgetown University, and a research associate in anthropology at the Smithsonian National Museum of Natural History, where he has co-organised an exhibition on eight viral outbreaks.

<span class="mw-page-title-main">COVID-19 pandemic in Sudan</span> Ongoing COVID-19 viral pandemic in Sudan

The COVID-19 pandemic in Sudan was a part of the worldwide pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2. The virus was confirmed to have reached Sudan in March 2020.

References

  1. ↑ Yuill, Thomas M; Woodall, John P; Baekeland, Susan (2013). "Latest outbreak news from ProMED-mail. Yellow fever outbreak-Darfur Sudan and Chad". Int J Infect Dis. 17 (7): e476–e478. doi: 10.1016/j.ijid.2013.03.009 .
  2. ↑ "Targeting yellow fever in Sudan". World Health Organization. Archived from the original on December 12, 2012. Retrieved 28 June 2015.
  3. ↑ "PRO/EDR> Yellow fever - Africa (12): Sudan (Darfur) 2013-03-02 15:02:44 Archive Number: 20130302.1567578".
  4. ↑ "PRO/AH/EDR> Yellow fever - Africa (15): Sudan (Darfur) WHO 2012-11-13 18:01:32 Archive Number: 20121113.1407906" . Retrieved 28 June 2015.
  5. ↑ "Yellow Fever Outbreak in Sudan". HealthMap. The Disease Daily. 31 Oct 2012. Archived from the original on 1 July 2015. Retrieved 28 June 2015.
  6. ↑ "Sudan Begins Emergency Vaccinations to Fight Yellow Fever Outbreak". Voice of America. 7 December 2012. Retrieved 28 June 2015.
  7. ↑ "PRO/AH/EDR> Yellow fever - Africa (22): Sudan (Darfur) 2012-11-23 08:15:02 Archive Number: 20121123.1420747".
  8. ↑ "Yellow fever outbreak kills 164 in Sudan's Darfur: WHO". Reuters. Dec 3, 2012. Retrieved 28 June 2015.
  9. ↑ "Yellow Fever: China Plans to Scan Travelers From Sudan". New York Times. 7 January 2013. Retrieved 28 June 2015.
  10. ↑ Monath, TP; Vasconcelos, PF (March 2015). "Yellow fever". Journal of Clinical Virology. 64: 160–73. doi:10.1016/j.jcv.2014.08.030. PMID   25453327. S2CID   5124080.
  11. ↑ "Yellow fever in Sudan". World Health Organization. Archived from the original on August 10, 2014. Retrieved 28 June 2015.
  12. ↑ "Sudan: Unamid Lends Resources to Fighting Yellow Fever in Darfur". AllAfrica. 2 December 2012. Retrieved 28 June 2015.
  13. ↑ "Sudan Combats Darfur Outbreak". New York Times. 20 November 2012. Retrieved 28 June 2015.
  14. ↑ "PRO/AH/EDR> Yellow fever - Africa (06): Sudan (Darfur) 2013-01-25 10:43:16 Archive Number: 20130125.1513849". Pro-MED-mail. International Society for Infectious Diseases.
  15. ↑ "PRO/AH/EDR> Yellow fever - Africa (35): Sudan (Darfur) 2012-12-08 20:46:04 Archive Number: 20121208.1443535". International Society for Infectious Diseases.
  16. ↑ "PRO/AH/EDR> Yellow fever - Africa (04): Sudan (Darfur) 2013-01-11 16:16:14 Archive Number: 20130111.1493162". International Society for Infectious Diseases.
  17. ↑ "PRO/AH> Yellow fever - Africa (03): Sudan (Darfur) 2013-01-07 19:33:51 Archive Number: 20130107.1486073". Pro-MED-mail. International Society for Infectious Diseases.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.