Yellow Fever Outbreaks in Cameroon and Ghana Prompt Vaccination Campaigns

Northern Cameroon reported 23 cases of yellow fever in six districts since October. Seven patients have passed away. In an effort to curb the spread of the virus, the GAVI Alliance, UN Central Emergency Response Fund (CERF), and the International Coordinating Group on Yellow Fever Vaccine Provision (YF-ICG), are working together to fund a mass vaccination campaign.

The campaign, which began on January 23, targets eight high-risk health districts in Northern Cameroon that were not covered during a previous vaccination campaign in 2009. These districts have no history of yellow fever, and therefore these communities have no herd immunity against the disease. The campaign hopes to reach up to 1.2 million people in the country.

In Ghana, the Ministry of Health reported outbreaks of yellow fever in three different districts. Since October, two deaths and one new case have been confirmed. The index case was a 12-year-old boy from the Kassena-Nankana-West district who died within one week of displaying symptoms. 

Another vaccination campaign, supported by the YF-ICG and European Community Humanitarian Office (ECHO), began Monday, Feb. 6. The campaign hopes to target more than 235,000 people in the three affected districts.

The WHO and the UN share differing information regarding the immunization of pregnant women and children less than one year of age during the campaigns. While the WHO reports that pregnant women and very young children should be excluded from the vaccination campaign, the UN states that they are the key targets.  The CDC Guidelines for Vaccinating Pregnant Women say that the safety of the yellow fever vaccine has not yet been established, and therefore pregnant women should only be immunized if traveling to an endemic area. The WHO Yellow Fever fact sheet follows the same sentiment, but advises vaccinating pregnant women and children less than 6 months during an outbreak.

 Yellow fever, prevalent in many tropical areas of Latin America and Africa, is a mosquito-borne illness that cannot be transmitted from person to person. Initial symptoms usually develop within 3 to 6 days after infection and include fever, muscle pain, headache, shivers, loss of appetite, nausea, and vomiting. Most patients recover after the first phase, however 15 percent continue to a second, more toxic stage. These patients suffer from high fever, jaundice, and severe abdominal pain and vomiting. Patients may bleed from their mouth, nose, eyes, and stomach and experience bloody vomit and stool. Multi-organ failure may occur in the heart, liver, and kidneys. Approximately half of patients who enter this stage die, while the rest recover without significant organ damage.

Worldwide, there are approximately 200,000 cases and 30,000 deaths caused by yellow fever per year. There is no cure for yellow fever, and no specific treatment. However, the yellow fever vaccine is effective in 95 percent of the global population and provides immunity within one week. To prevent infection, the CDC recommends using mosquito repellent and wearing long sleeves when traveling to countries with a high risk of yellow fever.


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