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Yellow fever epidemic on course for Asia?

by / 0 Comments / 28/06/2016

Another potentially deadly epidemic ravages lives in Africa, causing fears that it has all the signs of spreading to Asia

 

Last week, the World Health Organisation declared that there was a yellow fever epidemic in Kinshasa, the capital and the most heavily populated city in the Democratic Republic of Congo. With an urban population of over 11 million — the third-largest in Africa — this spells disaster for the rest of the continent.

Yellow fever is a debilitating disease — a viral infection spread by mosquitoes which act as a vector.  Symptoms include a high temperature, vomiting, muscle pain and loss of appetite — which if left untreated, could develop into jaundice, bleeding and could be fatal.  There’s no specific cure, but if symptoms are treated and managed, approximately 85 per cent of people go on to make a full recovery. Preventative measures include vaccinations, but in the case of this epidemic, vaccines were given not to prevent people from getting the disease, but to stop an existing one from spreading.

Yellow fever spread to Kinshasa from Angola, with whom it shares a southern border. In Angola — as in the majority of other African countries — it’s Malaria that’s the mosquito-borne virus which people need to worry about. Malaria claims the most lives in Angola, not yellow fever, the spread of which died down significantly from the last serious outbreak in the country in 1971 until there were zero cases reported in the region. Therefore, Angola was not considered at risk, and vaccinations were no longer being administered to the people the way they once were.

This new outbreak however, has caught the country unawares. In the last seven months, 345 people have already died. In an effort to stop yellow fever from spreading further to neighbouring countries, 18 million doses of the vaccine were given in Congo, but the virus had already spread, claiming the lives of 71 people. There have also been suspected cases of yellow fever in Kenya, sparking fears that the virus is once again spreading across the continent.

Why has yellow fever erupted all of a sudden? The virus may be becoming more virulent and developing different strains — strains that differ from the dead strains given in vaccinations.

Another reason could be the general health of the majority of Africa’s population. According to United Nations’ statistics, 75 per cent of the poorest countries in the world are in Africa, with the Democratic Republic of Congo being the poorest. This means disease causes high mortality rates — perhaps immunity levels are dropping too, which means that people can’t stave off diseases such as yellow fever (a disease that can only be fought off by the immune system).

A further reason for the spread of yellow fever could be the absence of a stringent vaccination program. Angola wasn’t at risk, and so therefore vaccination rules were relaxed. It is compulsory for babies in Angola to be vaccinated at the age of nine months, but not everyone follows this policy. Vaccination certificates are readily available, and for some reason, many people prefer to buy a fake certificate rather than get their baby vaccinated.

It’s suspected that yellow fever has already spread to Asia. Approximately 1.8bn throughout Asia live in regions with the Aedes mosquitoes — the vector for the virus, placing people in these areas at potential risk. There have already been cases of yellow fever reported in China, brought into the country by 11 workers returning from Angola.

In other countries such as the Indian capital, Delhi, yellow fever may manifest in certain individuals, but not be treated. Jaundice — a common symptom of yellow fever, is already commonplace in Delhi, a city where hepatitis is rife. It’s therefore unlikely to be recognised as yellow fever and will remain untreated, creating a greater likelihood of the virus spreading.

Many countries in Africa and Asia don’t have the lab facilities to confirm potential cases of the disease — a worrying reality as this may hinder further preventative measures.

It’s not yet certain how serious the yellow fever threat is in a continent consisting of 60 per cent of the world’s population. The epidemic needs to be controlled in Africa first if we’re to replicate the containment of yellow fever, as it was done in the 1960s.