Angola and the Democratic Republic of Congo are suffering a devastating yellow fever epidemic that has claimed the lives of more than 400 people and has sickened thousands. The World Health Organization (WHO) and the government of those countries are struggling to control the disease due to a vaccine shortage. To compensate the lack of vaccines, people are receiving just part of the dose, which could save them from yellow fever for a year.
According to The New York Times, the outbreak is believed to have begun in late 2015 in Luanda, Angola. The Angolan government and the WHO had tried to stop the spread of yellow fever since it was first reported. The problem is that it takes more time to produce the vaccine than the disease’s pace of transmission. Making a batch involves an ancient technique involving eggs, and it could take up to six months.
The 17D vaccine was developed by Max Theiler and his colleagues in 1930, and the process they invented to prevent people of getting the disease -there is no cure for yellow fever- involves embryonated chicken eggs and technology that has little changed since 1940.
Currently, there are six manufacturers of yellow fever vaccines in the world, and collectively they produced 50 million to 100 million doses each year. This is not enough to fight the outbreak in Africa and has let the virus spread to thousands.
The problem is that of those six companies, only four are “prequalified” by the WHO to distribute the doses internationally. The other two manufacturers make vaccines for the domestic market, and they are located in the United States and China. The World Health Organization said last month that the organization was short about nine million doses, although Angola received nearly 12 million vaccines.
The Associated Press reported that could not supply a million of vaccines that were sent by manufacturers, showing the missteps of the WHO and governments in the way they confront infectious diseases.
On May 20, 2016, there were 2,420 suspected cases, including 298 deaths, only in Angola. Unfortunately, the virus has spread to other countries including the Democratic Republic of Congo (DRC), Kenya, and even China, which reveals that there is a weakness in the current International Health Regulations that prevent people from entering a country with potential for yellow fever outbreaks without evidence of immunization.
Due to the outbreak in Angola and the DRC, the WHO convened an emergency committee under the International Health Regulations to review the situation of the virus in those regions. The committee decided that the yellow fever outbreak is a serious public health concern, but it does not reach the status of Public Health Emergency of International Concern as Zika does, The New England Journal of Medicine reports.
Mosquitoes are not only infecting us with Zika, now they started the yellow fever outbreak, and the virus could kill us
The spreading disease is caused by the yellow fever virus, a mosquito-borne flavivirus mostly found in sub-Saharan Africa and tropical South America. The bite of Aedes aegypti mosquitoes can infect a human and could be the cause of the cases reported in Angola and the DRC.
Approximately, one billion people in 46 countries are vulnerable to contract the virus that could make you look yellow and lead you to death. Once you have yellow fever, there is no cure. The vaccine only helps to prevent it. That is why the outbreak is out of control.
Only 15 percent of people that get yellow fever progress to a severe form. If yellow fever symptoms progress, people suffer from jaundice, meaning that their skin, mucous membranes or eyes will turn yellow, because the virus affects the levels of bilirubin in the body. Between 20 to 50 percent of those who get truly affected by the disease, die.
Usually, the virus manifests itself in the jungle in a yellow fever cycle of monkey-mosquito-monkey, where humans are accidental the hosts of the condition. But in Angola and the DRC, yellow fever cases have been reported in cities, complicating the cycle to an urban manner. An urban yellow fever cycle means that the disease is spreading almost exclusively by the Aedes aegypti mosquito.
How is the WHO and the countries affected managing the yellow fever outbreaks?
The World Health Organization is giving people one-fifth of the standard dose to compensate the lack of vaccines for Angola and the DRC population. With a full dose, the person is believed to be immune for a lifetime or at least more than 30 years. With a fifth of the vaccine, people can avoid yellow fever for around 12 months.
Last week, health officials started a campaign against the virus that set a goal of 14 million vaccinated people before the beginning of the raining season, which begins next month, The New York Times says.
According to the WHO, since the campaign started, there has not been new cases reported in Angola in July and August. But what concerns experts if it yellow fever has already passed to neighboring countries.
Source: The New England Journal of Medicine