Reemergence of yellow fever in Ethiopia after 50 years, 2013: epidemiological and entomological investigations

Abrham Lilay, Negga Asamene, Abyot Bekele, Mesfin Mengesha, Milliyon Wendabeku, Israel Tareke, Abiy Girmay, Yonas Wuletaw, Abate Adossa, Yamar Ba, Amadou Sall, Daddi Jima, Debritu Mengesha, Abrham Lilay, Negga Asamene, Abyot Bekele, Mesfin Mengesha, Milliyon Wendabeku, Israel Tareke, Abiy Girmay, Yonas Wuletaw, Abate Adossa, Yamar Ba, Amadou Sall, Daddi Jima, Debritu Mengesha

Abstract

Background: Yellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito species. Approximately, 200,000 cases and 30,000 deaths occur worldwide every year. In Ethiopia, the last outbreak was reported in 1966 with 2200 cases and 450 deaths. A number of cases with deaths from unknown febrile illness reported from South Ari district starting from November 2012. This investigation was conducted to identify the causative agent, source of the outbreak and recommend appropriate interventions.

Methods: Medical records were reviewed and Patients and clinicians involved in managing the case were interviewed. Descriptive data analysis was done by time, person and place. Serum samples were collected for serological analysis it was done using Enzyme-linked Immunosorbent Assay for initial screening and confirmatory tests were done using Plaque Reduction and Neutralization Test. Breteau and container indices were used for the entomological investigation to determine the risk of epidemic.

Results: A total of 141 Suspected YF cases with 43 deaths (CFR = 30.5%) were reported from November 2012 to October 2013 from South Omo Zone. All age groups were affected (mean 27.5, Range 1-75 Years). Of the total cases, 85.1% cases had jaundice and 56.7% cases had fever. Seven of the 21 samples were IgM positive for YF virus. Aedes bromeliae and Aedes aegypti were identified as responsible vectors of YF in affected area. The Breteau indices of Arkisha and Aykamer Kebeles were 44.4% and 33.3%, whereas the container indices were 12.9% and 22.2%, respectively.

Conclusion: The investigation revealed that YF outbreak was reemerged after 50 years in Ethiopia. Vaccination should be given for the affected and neighboring districts and Case based surveillance should be initiated to detect every case.

Keywords: Ethiopia; Mosquito; Outbreak; Yellow fever.

Figures

Fig. 1
Fig. 1
Distribution of Yellow Fever cases by epidemiological weeks – South Omo Zone, November 2012 – October 2013
Fig. 2
Fig. 2
Distribution of cases and deaths of Yellow Fever in affected Kebeles by district - South Omo Zone, November 2012 – October 2013

References

    1. Onyango CO, Grobbelaar AA, Gibson GVF, Sang RC, Sow A, Swanepoel R, et al. Yellow fever outbreak, Southern Sudan, 2003. Emerg Infect Dis. 2004;10(9):2003–2005. doi: 10.3201/eid1009.030727.
    1. WHO Revised recommendations for yellow fever vaccination for international travellers, 2011. Wkly Epidemiol Rec. 2011;No. 37, 20(37):401–416.
    1. Barnett ED. Yellow fever: epidemiology and prevention. Clin Infect Dis. 2007;44(6):850–856. doi: 10.1086/511869.
    1. WHO . Yellow fever fact sheet N°100. WHO media Center. 2007. pp. 1–4.
    1. Ellis BR, Barrett ADT. The enigma of yellow fever in East Africa. Rev Med Virol. 2008;(18):331–46.
    1. WHO. Global Health Situation and Projections Estimates. 1992;(WHO/HST/92.1):1–94.
    1. Robertson SE, Hull BP, Tomori O, Bele O, LeDuc KE JW. Yellow fever: a decade ofReemergence. JAMA. 2015;276(14):1158–1162.
    1. Andral L. Etudes sur la fievre jaune en Ethiopie. Bull Wld Hlth Org. 1968;38:855–861.
    1. Alhakimi HA, Mohamed OG, Salah H, Kho E. Epidemiological , clinical and entomological characteristics of yellow fever outbreak in Darfur 2012. AIMS Public Heal. 2015;2(1):132–141. doi: 10.3934/publichealth.2015.1.132.
    1. Gould LH, Osman MS, Farnon EC, Griffith KS, Godsey MS, Karch S, et al. An outbreak of yellow fever with concurrent chikungunya virus transmission in South Kordofan , Sudan , 2005. Trans R Soc Trop Med Hyg. 2008;102:1247–1254. doi: 10.1016/j.trstmh.2008.04.014.
    1. Henderson BE, Metselaar D, Cahill K, Timms GL, Tukei PM, Williams MC. Yellow fever immunity surveys in northern Uganda and Kenya and eastern Somalia , 1966-67. Bull Wld Hlth Org. 1968;38:229–237.
    1. Wamala JF, Malimbo M, Okot CL, Atai-omoruto AD, Tenywa E, Miller JR, et al. Epidemiological and laboratory characterization of a yellow fever outbreak in northern Uganda, October 2010–January 2011. Int J Infect Dis. 2012;16(7):e536–e542. doi: 10.1016/j.ijid.2012.03.004.
    1. Sanders EJ, Marfin A, Tukei PM, Kuria G, Ademba G, Agata NN, et al. First recorded outbreak of yellow fever in Kenya, 1992-1993. I. Epidemiologic investigations. AmJTrop Med Hyg. 1998;59(4):644–649. doi: 10.4269/ajtmh.1998.59.644.
    1. Sérié C, Andral L, Poirier A, Lindrec A, Neri P. Studies on yellow fever in Ethiopia: epidemiologic study. Bull World Health Organ. 1968;38(6):879–884.
    1. Monath TP. Yellow fever as an endemic/epidemic disease and priorities for vaccination. Bull Soc Pathol Exot. 2006;99(5):341–347.
    1. Erin Staples J, Mark Gershman MF. Yellow fever vaccine recommendations of the advisory committee on immunization practices (ACIP) Morb Mortal Wkly Rep. 2010;59(RR-7):4.
    1. Lindrec A, Neri P. Yellow fever epidemic: observations preliminaires. Bull Wld Hlth Org. 1964;30:299–319.
    1. Arbovirus Y, Haven N. Etudes sur la fievre jaune en Ethiopie. Bull Eld org. 1964;38:873–877.
    1. Williams MC. Etudes sur la fievre jaune en Ethiopie 2. Bull Wld Hlth Org. 1968;38:843–854.
    1. Rozendaal JA. Vector control: Methods for use by individuals and communities [internet]. Geneva: WHO; 1997. pp. 1–412. Available from: .
    1. Huang Y-M. The subgenus Stegomyia of Aedes in the Afrotropical region with keys to the species (Diptera: Culicidae) Magnolia Zealand, New: Zootaxa 700, Press; 2004. pp. 1–120.
    1. Vainio J, Cutts F. Yellow fever. Geneva; 1998;(WHO/EPI/98.11):57. Available from: .
    1. Ethiopian Health and Nutrition Research Institute. Public Health Emergency Management Guideline [Internet]. Addis Ababa: Ethiopian Public Health Institute; 2012. pp. 43–44. Available from: .

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren