An acute viral haemorrhagic fever, yellow fever is transmitted by the bite of a mosquito. Among the symptoms are jaundice, a yellowing of the skin and eyes - hence yellow fever - but there is no treatment for the disease. A number of severe outbreaks around the world in the 19th and 20th centuries led to the development of a highly effective vaccine. Systematic vaccination campaigns considerably reduced yellow fever epidemics. However, low vaccination coverage across several countries in Africa has recently allowed new outbreaks of the disease to emerge.
In 2016, we vaccinated more than a million people in DRC as part of the Ministry of Health’s response to an outbreak that began in Angola. The outbreak exposed the fragility of the vaccine supply. More than 10 million people needed to be vaccinated, but only six million doses of the vaccine were available globally, and manufacturers could only produce three million doses a month. The decision was made to administer a fraction of the normal dose, most likely giving enough protection to last until the end of the outbreak.
Deploying the highly effective yellow fever vaccine is key to preventing further outbreaks. But the supply of the vaccine is limited and must be used efficiently. Efforts are being made to replenish the global stockpile but there are concerns that global supplies could be depleted if a large outbreak ignites.
Yellow fever is difficult to diagnose, especially during the early stages. More severe cases can be confused with severe malaria, leptospirosis, viral hepatitis, other haemorrhagic fevers, infection with other flaviviruses (e.g. dengue fever), and poisoning. Blood tests can sometimes detect the virus in the early stages of the disease. In later stages, laboratory testing to identify antibodies is needed, which is not readily available in resource-limited settings and in many countries.
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