Yellow fever 'could go global,' Save the Children warns

One of the largest yellow fever outbreaks in decades could soon spread globally, aid group Save the Children warns as WHO prepares for one of the largest emergency vaccination campaigns ever attempted in Africa.

Health officials expect to vaccinate 14 million people over the next 10 days

Thomson Reuters · Posted: Aug 16, 2016 12:35 PM EDT | Last Updated: August 16, 2016

A Congolese child is vaccinated during an emergency campaign of vaccination against yellow fever in Kinshasa, Congo, in July. (Kenny Katombe/Reuters)

Congo and Angola began one of the biggest ever emergency vaccination campaigns in Africa this week, working with the World Health Organization (WHO) to curb a yellow fever epidemic that has killed hundreds this year.

Health officials expect to vaccinate 14 million people over the next 10 days including some 8.5 million in the densely populated Congolese capital, Kinshasa, where the disease's presence has sparked fears of a far wider spread.

There is no known cure for yellow fever and it could go global.- Heather Kerr

Vaccinations started in Angola on Monday and about 41,000 health workers have been deployed across more than 8,000 sites with 17.3 million syringes available regionally, WHO said on Tuesday. There are about 6,000 suspected cases in the region.

A small but significant fraction of cases die from jaundice, bleeding and multiple organ failure. More than 400 people have died of the virus since December.

The campaign is being accelerated to try to stop it spreading before the rainy season starts in September and makes more remote parts of the region inaccessible. Other challenges include a lack of reliable power to keep vaccines cold.

Congolese civilians queue at a soccer pitch to be vaccinated in Kinshasa in July. So far, two million people have been vaccinated in Kinshasa. The WHO said it plans to vaccinate at least eight million people there. (Kenny Katombe/Reuters)

"By the end of this vaccination campaign … we are going to put an end to the progression of yellow fever," Congo's Minister of Health, Felix Kabange Numbi Mukwampa, told reporters on Tuesday at a ceremony to mark the start of the campaign.

But supplies of the vaccine are limited. The more than 18 million vaccines that have been sent to the continent are far short of the 40 million doses some experts think are needed to contain the outbreak, according to a recent Associated Press investigation.

WHO says it must now use one-fifth the standard vaccine dose, which lasts about a year.

"Protecting as many people as possible is at the heart of this strategy. With a limited supply, we need to use these vaccines very carefully," said William Perea, WHO's Coordinator for the Control of Epidemic Diseases Unit.

Possible spread to Americas

Save The Children, which is sending a rapid reaction unit to support vaccinations in Congo, warned the epidemic could soon spread to the Americas, Asia and Europe and other cities in Africa.

"There is no known cure for yellow fever and it could go global," said Heather Kerr, Save the Children's country director for Congo.

Yellow fever is not highly contagious and is easily prevented with vaccines. The mostly mosquito-spread virus was largely wiped out from the West following the development of two vaccines in the 1930s, but still sparks epidemics in Africa and Latin America.

Jonathan Kangu, 3, sits on his hospital bed in Kinshasa in July, showing symptoms of yellow fever. (Jerome Delay/Associated Press)

Outbreak spread to China by workers

China and Japan, the World Bank, WHO and the UN Children's Fund as well as the Global Alliance for Vaccines and

Immunization are financing the campaign, WHO spokesman in Congo, Eugene Kabambi, said.

About 2 million people were vaccinated in Kinshasa during campaigns in May and July. Overall, some 13 million people in Angola and 3 million in Congo have been vaccinated this year.

The outbreak has spread as far as China, carried by workers returning from Angola, but WHO spokesman Tarik Jasarevic said on Tuesday he was optimistic it could be contained.

"The WHO Emergency Committee will reconvene in coming weeks [and] will re-evaluate the situation but we think that the outbreak is manageable if we can protect enough people with the vaccine," he told reporters in Geneva.

The campaign also marks the first time that fractional doses of the vaccine will be given in order to stretch limited supplies amid a global shortage.

The one-fifth dose, which will be used in Kinshasa, protects for at least 12 months but does not give lifelong immunity.

The virus is transmitted by the same species of mosquito that spreads Zika, dengue, and chikungunya. Once infected, people often fall ill with fever and muscle pain, but many recover after several days.

WHO in February announced the outbreak of yellow fever in Angola's capital, Luanda.

With files from Associated Press

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