In Democratic Republic of Congo (DRC), Doctors Without Borders/Médecins Sans Frontières (MSF) is vaccinating the entire population of the city of Matadi, while mosquito treatment and yellow fever vector control activities are under way in Kinshasa and in Kongo Central Province. In Angola, MSF supports the Ministry of Health in treating patients.
Following the outbreak of yellow fever in Angola in December and the subsequent confirmation of dozens of cases in DRC, MSF teams deployed in both countries to help contain the spread of the virus. On May 19, the World Health Organization found that the outbreak, though serious and of grave concern, does not currently constitute a public health emergency of international concern. MSF teams are using the highly effective yellow fever vaccine to prevent the spread of the virus. However, the limited supply of the vaccine must be used efficiently.
In DRC, 48 cases of yellow fever have been confirmed since the end of February. The majority of cases are among people arriving from Angola, but three indigenous cases were identified in locations near the Angolan border such as Kinshasa, Kongo Central Province, and Kwango Province.
On May 26, MSF teams collaborated with the Congolese Ministry of Health (MoH) to launch a vaccination campaign for 350,000 residents of Matadi, the capital of Kongo Central Province. This vaccination campaign aims to target two million people in two health districts of Kinshasa and nine health districts in Kongo Central.
Also in cooperation with the MoH, MSF launched vector control measures in Kinshasa and Kongo Central, which will decrease malaria and yellow fever by reducing the levels of transmission by mosquitoes. Homes are being sprayed or fumigated to kill mosquitoes and mosquito breeding sites such as refuse or items containing stagnant water are being destroyed. These measures are being carried out in locations with confirmed cases and in vulnerable locations such as hospitals, schools, and markets. MSF is also treating patients, providing medical supplies to health centers, and training staff in yellow fever treatment.
“To eliminate any risk of the disease spreading, it is vital to be vigilant and responsive,” says Elisabetta Maria Faga, MSF emergency coordinator. “There is no specific treatment for yellow fever. Prevention through targeted vaccination and vector control measures therefore remains the best weapon against the disease.”
Treating Yellow Fever in Angola
Since mid-February, MSF has been working with Angola’s MoH in supporting yellow fever case management. MSF teams treat yellow fever patients in the capital, Luanda, as well as in Huambo, Huila, and Benguela provinces. To date, MSF has treated 299 patients in Angola.
MSF deployed 70 people in different teams in Angola to provide diagnostics and treatment and train national medical staff in case management. MSF also supports the implementation of the national protocol responding to the disease and vaccination preparedness. Angola has so far reported 2,420 suspected cases, with 736 confirmed cases (including 298 deaths). Of the confirmed cases, 459 were in Luanda alone, with the rest in 13 other provinces. Angola’s MoH is conducting a vaccination campaign in the provinces, having already concluded a campaign in Luanda.
Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The “yellow” in the name refers to the jaundice that affects some patients. The Aedes aegypti mosquito is the principal vector of yellow fever, which also transmits dengue, chikungunya, and Zika.
There is no treatment for yellow fever and vaccination is the most effective method of prevention. Symptoms include fever, headache, and muscle pain, with some patients experiencing a more severe phase of high fever and internal bleeding. Up to 50 percent of severely affected patients die within 14 days, according to the World Health Organization.