OPEN International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases | 10 May 2016
S Wasserman, PA Tambyah and PL Lim
There is currently an emerging outbreak of yellow fever in Angola. Cases in infected travellers have been reported in a number of other African countries, as well as in China, representing the first ever documented cases of yellow fever in Asia. There is a large Chinese workforce in Angola, many of whom may be unvaccinated, increasing the risk of ongoing importation of yellow fever into Asia via busy commercial airline routes. Large parts of the region are hyperendemic for the related Flavivirus dengue and are widely infested by Aedes aegypti, the primary mosquito vector of urban yellow fever transmission. The combination of sustained introduction of viraemic travellers, a conducive ecology for local transmission, and an unimmunised population raises the possibility of a yellow fever epidemic in Asia. This represents a major global health threat, particularly in the context of a depleted emergency vaccine stockpile and untested surveillance systems in the region. In this review we discuss the potential for a yellow fever outbreak in Asia with reference to the ecological and historical forces that have shaped global yellow fever epidemiology. We also highlight the limitations of surveillance and vector control in the region, and suggest priorities for outbreak preparedness and response.
* Data courtesy of Altmetric.com