28 Apr 2022

Yellow fever: outbreaks in West and Central Africa

Outbreaks reported in areas across West and Central Africa at risk of yellow fever transmission Yellow fever: outbreaks in West and Central Africa
  • This updates the news item of 29 December 2021

Yellow fever (YF) is a viral haemorrhagic disease, transmitted to monkeys and humans by forest or urban dwelling mosquitoes. There is a risk of YF in West and Central Africa and countries in this region reported human laboratory confirmed cases of YF in 2021 [1] and continue to do so in 2022 [2]. The World Health Organization (WHO) state the overall YF vaccination coverage in this area is not sufficient to provide herd immunity and prevent outbreaks. According to the WHO, the upward trend of cases and outbreaks, is indication of ongoing intense YF virus transmission in the region and represents a persistent and growing risk to all unvaccinated people living or visiting YF risk countries [1].

Since September 2017, Nigeria has experienced a re-emergence of YF, with outbreaks reported across the country. Between 1 January 2021 and 28 February 2022, a total of 2,456 suspected cases have been reported across all 37 Nigerian states [2].

Ghana reported an outbreak that started in October 2021 [3], with cases and deaths reported in 13 regions in 2022 [2]. This outbreak started in largely unvaccinated nomadic populations who moved from Nigeria into a forest in the Savannah region, north-west Ghana, also a popular destination for tourists [3].

Outbreaks or confirmed cases have also been reported in Burkina Faso, Cameroon, Central African Republic, Chad, Côte d'Ivoire, Democratic Republic of Congo, Gabon, Kenya, Niger, Republic of Congo and Uganda [1,2].

YF cases reported in Kenya for 2022 are the first confirmed locally acquired YF cases reported in the country since 1995 [4].

In response to YF outbreaks, public health measures, including risk communication to raise awareness, catch-up vaccination programmes, enhanced surveillance and tightening of border controls to prevent international spread are usually implemented [5].

The overall burden of YF in Africa is thought to be underestimated. This is due to a combination of factors, including low vaccination rates, a lack of comprehensive surveillance and difficulties in confirming the disease in some regions. Laboratory diagnosis exists, but availability and lack of diagnostic capacity are major challenges for some African countries [6].

A comprehensive global strategy to eliminate YF epidemics (EYE) has been developed by global partners, with the aims to protect at risk populations, prevent international spread and contain outbreaks quickly [7].

The WHO recommends YF vaccination for all travellers aged nine months and older visiting areas with risk of YF transmission [8], unless the vaccine is contraindicated for medical reasons.

Travellers should be aware that if a country does not have a requirement for an International Certificate of Vaccination or Prophylaxis (ICVP) for YF that does not necessarily mean that there is no risk of YF in that country. Specific YF information on risk, vaccine recommendations and certificate requirements are available on TravelHealthPro Country Information pages.

TravelHealthPro does not report all individual YF cases reported in endemic countries on the Outbreak Surveillance Database but does report outbreaks and unusual YF activity.

All travellers to Africa should follow mosquito bite avoidance guidance.

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