21 November 2005

Yellow fever in Sudan

Beginning in mid-October, 2005, reports of haemorrhagic fever cases in Southern Kordofan State in Sudan were received by the Sudanese Federal Ministry of Health [1]. As of 18 November 2005, a total of 424 cases of haemorrhagic illness with 121 deaths (case fatality rate 29%) have been reported [2]. The highest attack rates have been in the Dilling locality.

Initially these were felt to be cases of dengue fever as preliminary testing in Khartoum indicated dengue virus as the etiology. However, due to the possibility of cross reaction between dengue and other viruses in the same flavivirus family (e.g. yellow fever), the samples were sent for further testing at a World Health Organization (WHO) laboratory in Egypt. Testing by polymerase chain reaction (PCR) determined that yellow fever virus was the causative agent. It remains possible that both dengue and yellow fever are circulating in this area.

The United Nations (UN) has responded to the outbreak, which is being coordinated by WHO and the United Nations Children’s Fund (UNICEF). WHO and UNICEF are investigating undiagnosed cases, training medical personnel to facilitate clinical diagnosis, and providing supplies such as yellow fever vaccine, insecticide, intravenous fluids, oral rehydration solution and insecticide treated nets.

All travellers to yellow fever endemic areas, including Sudan, are recommended to receive vaccination against yellow fever in the absence of medical contraindication.

For advisability about travel to Sudan, the Foreign and Commonwealth Office travel advice should be consulted.

There is no vaccine to protect against dengue. Travellers should be advised to take insect bite avoidance measures.

Further information on yellow fever can be found on the NaTHNaC yellow fever information sheet.

Further information on dengue can be found on the NaTHNaC dengue information sheet.

References

1. World Health Organization and United Nations Children’s Fund. Emergency response yellow fever outbreak in the Sudan. November 2005. Available at: http://www.emro.who.int/eha/pdf/YellowFever-Proposal.pdf

2. World Health Organization, Sudan. Epidemiologic update yellow fever outbreak. 17-18 November 2005. Available at http://www.emro.who.int/sudan/pdf/

Yellow%20fever%20outbreak%20update%2017-18Nov05.pdf

Link

WHO Country Office in Sudan: http://www.emro.who.int/sudan/