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IMA yellow fever warning as deadly outbreak grows in Angola

Amid rising concern over a deadly outbreak of yellow fever spreading from Angola, IMA is urging travellers to the African country to get vaccinated. At least 258 people have been killed and there have been around 1,975 suspected cases of yellow fever since an epidemic erupted in December 2015. It has already grown to become the worst outbreak in decades.

India has the aedes mosquito but not the vector. Yellow fever is far more serious than dengue with death rates as high as 75 percent in severe cases requiring admission to hospital.

Angola's outbreak has already spread to other countries.

As per WHO yellow fever in people who travelled from Angola has been reported in China (11 cases), DRC Democratic Republic of Congo (10 cases with 1 in Kinshasa) and Kenya (2 cases). It said three further cases have been reported in Uganda, but these patients had no history of travel to Angola.

A nationwide vaccination program that began in Angola in February has reached 7 million people. 

IMA Point of View

1. Yellow fever is a viral illness spread to humans through aedes mosquito. It is most common in areas of Africa and South America. Symptoms develop several days after the mosquito bite and progress through phases. Most people recover after the initial symptoms, but some go on to develop more severe, life-threatening illness. Yellow fever is diagnosed by testing a blood sample for the presence of antibodies to the virus. Because there is not an effective antiviral medication against yellow fever, treatment consists of supportive care. A vaccine is available to prevent yellow fever, and vaccination is recommended (and often required) for high-risk groups. Taking measures to prevent mosquito bites provides additional protection.

2. Yellow fever disease is a public health emergency of International concern

3. All health measures are applied presently like disinfection of conveyances, vaccination requirements and quarantine of passengers and crew with no diplomatic immunity 

4. Start looking for yellow fever in visitors from Africa

5. Any passenger arriving in India from any yellow fever endemic country without a valid yellow fever vaccination prophylaxis certificate in original, is treated as suspects of carrying the Yellow fever Virus in their body and is quarantined for 6 days and the period is counted from the time of departure of the passenger from the Airport in the endemic country or till the time YF vaccination becomes valid (whichever is less).

6. World's stocks of yellow fever vaccines will be in shortage soon. India must procure its required travellers share. Think of shifting in strategy to use a tenth of the normal dose and aim to cover more people, if the crisis occur

7. Jaundice with renal failure look for yellow fever

8. All who want to visit Yellow fever endemic countries should be advised to take YF vaccination even though they may return to India within 6 day as they need to produce Yellow fever certificate of vaccination on their arrival in India to avoid enforcement of quarantine procedures/regulations.

9. The certificate becomes valid only after 10 days of vaccination as it takes 10 days for the body to develop immunity.

10. Any passenger arriving in India from a Yellow Fever endemic country within 10 days of vaccination against Yellow Fever needs to be quarantined for 6 days counting from the date and time of departure from the airport of the endemic country or the time when the certificate becomes valid, whichever is earlier.