The current yellow fever epidemic that has claimed hundreds of lives in Africa could exhaust vaccine supplies and catalyze a global health emergency, according to a viewpoint authored by two experts and published in JAMA.
The yellow fever outbreak in Angola began in December 2015. As of April 26, there have been 2,023 suspected cases and 258 deaths related to the epidemic. China, the Democratic Republic of Congo and Kenya have also reported travel-related cases of yellow fever.
Initial symptoms of yellow fever include fever, chills, severe headache, back pain, general body aches, nausea and vomiting. Though the majority of those infected experience no illness or only mild illness, approximately 15 percent of cases progress into a more serious form of the disease. Of those that develop more severe illness, 20 to 50 percent may die.
Licensed, live attenuated yellow fever vaccination provides 90 percent of people lifelong protection from the virus. More than 7 million Angolans have been vaccinated, and the Democratic Republic of Congo announced plans on May 2 to vaccinate 2 million people. However, the vaccine supply is limited, partially due to need for specific pathogen-free chicken eggs for production.
In the JAMA viewpoint, Daniel Lucey, MD, and Lawrence O. Gostin from the O'Neill Institute for National and Global Health Law of Georgetown University in Washington, D.C., argue that the yellow fever vaccine supply should be safeguarded. The experts suggest dosage levels should be reduced to one-fifth, though they acknowledge the duration of efficacy and level of immunity provided by such dosage levels are unknown. The experts also state that production efforts should be ramped up and that research into non-egg vaccines should be conducted.
The World Health Organization serves as the secretariat for the International Coordinating Group. The ICG oversees yellow fever vaccine provisions.
In their article, Dr. Lucey and Mr. Gostin urge the WHO to implement a new structural response to international health threats for fast proliferating viruses like yellow fever.
"Prior delays by the WHO in convening emergency committees for the Ebola virus, and possibly the ongoing Zika epidemic, cost lives and should not be repeated. Acting proactively to address the evolving yellow fever epidemic is imperative," wrote the authors.
The Aedes aegypti mosquito is responsible for the spread of yellow fever in Angola — the same pest responsible for the current Zika outbreak affecting the Americas.
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