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2016 Angola and DR Congo yellow fever outbreak

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in Luanda province with the aim of vaccinating at least 80% of the population at risk of infection. The vaccine supply began to run low by late March, with the director of the CDC, Tom Friedman, warning that "It's possible we could run out of vaccine." The goal of the vaccination campaign in Luanda province was to vaccinate 88 percent of the population (5 804 475 of 6 583 216); ProMED reported that the total national stock of yellow fever vaccine as of 29 Mar 2016 was 1 032 970 doses. As of 10 April 2016, almost 6 million people had been vaccinated in Luanda. On 19 April, the WHO reported that the campaign had been extended into the provinces of Huambo and Benguela where local transmission was reported. On 23 May, the WHO reported that 7.8 million people (91.1%) had been vaccinated in the three provinces. On 23 May, the WHO announced that coverage of an additional 2.7 million people in 5 provinces had reached 55% after 6 days of vaccination.
237:, about a 1000 kilometers south, and the provinces of BiΓ©, Benguela, Cunene, Cabinda, Hula, Huambo, Malange, Kwanza Sul, Uige, Zaire and Kwanza Norte. As of 9 March 2016, the WHO reported that there were 65 confirmed cases, 813 suspected cases, and 138 deaths in Angola. On 22 March, WHO reported that cases had occurred in 6 of the 18 provinces of Angola, and that transmission was ongoing. Suspected and confirmed cases totaled 1,132, with 375 cases laboratory confirmed and 168 deaths. The situation report of 28 October 2016 reported the most recent number of suspected cases and laboratory-confirmed cases; total deaths and 31: 360:), and particularly for countries in Asia, where until recently yellow fever has never appeared. Urban populations and mosquito-infested slums in Asia and Africa are much larger than in the past. A commentary and accompanying article published in May stressed the potential for spread to Asia by international air travel. Other parts of the world where yellow fever is present but usually in the quiescent jungle cycle, and where there is regular air travel, such as Brazil, may also be vulnerable. They stressed that 134: 483:
so food poisoning was initially suspected as the cause of the mystery illness. It was more than a month before blood samples from the Eritreans reached the Pasteur Institute lab and yellow fever was recognized. Public health experts identified that as one factor that delayed the response to the outbreak, which came close to being a much larger disaster, if vaccine supplies had not been successfully raised in time, or the disease had spread to other countries and continents. The concurrent
463:, the capital of DR Congo, had been completed in record time and before the beginning of the rainy season in September when the mosquito population expands. The campaign required 10 million specialized syringes and training of 40,000 vaccinators, using the dose sparing strategy of 1/5 the usual dose. Later studies found that the one-fifth-dose vaccine was just as protective as the full dose, even 10 years after the vaccination. 225:, WHO Regional Director for Africa, stated: "The current battle against yellow fever in Angola and the Democratic Republic of the Congo is coming to a close, ... But the broader war against the disease is just getting started." ProMED-mail moderator Tom Yuill noted that maintaining vaccination coverage in the two countries will be the next challenge. Approximately 30 million people were vaccinated in the two countries. 3117: 3103: 221:. On 31 August, the decision to not declare a PHEIC was re-confirmed. By 2 September 2016, WHO announced there had been no new cases in either Angola or DR Congo in over a month due to a massive vaccination campaign. On 25 November 2016, WHO announced that four months had passed without a new case. The last case in Angola was on 23 June and the last case in DR Congo was on 12 July. Dr 482:
In June 2016, a WHO representative in Luanda said that the initial investigation of the outbreak was thrown off course because the first cases in December 2015β€”the sick Eritrean visitorsβ€”had what were later identified as fake yellow fever vaccination certificates. All had been to the same restaurant,
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would have been insufficient to protect the millions of people that would need to be vaccinated to curb an epidemic. As an emergency measure, experts suggested the dose-sparing strategy to extend existing supplies of vaccine, which the WHO could provide under the Emergency Use Assessment and Listing
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is of concern because of the large and densely packed population. As of 8 July, WHO was notified of 1798 suspected cases, with 68 confirmed cases (59 imported from Angola) and 85 deaths. In the WHO situation report of 23 September, the last confirmed non-sylvatic or urban case had symptom onset on 12
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On June 22, the WHO announced plans to launch a pre-emptive emergency vaccination campaign beginning in July in highly trafficked borders areas of Angola and DR Congo and in densely populated Kinshasa. On 20 July, the DR Congo government launched a campaign to deliver 1 million doses of yellow fever
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have been exhausted in the vaccination campaign against the outbreak in Angola. If yellow fever spread to the 18 countries in Asia where the mosquito vector is present, more than 2 billion people would be at risk. They stated: "Apocalyptic forecasts of the numbers of fatalities from Ebola turned out
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including vector control and vaccination in Viana in the first week of February. However, the minister reported that the government had enough vaccine for routine vaccination, but not enough to contain an outbreak. The WHO was supporting the Angolan government in immunization of 6.7 million people
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and the Pasteur Institute in Dakar. Forty-six of the 52 cases were imported from Angola; 2 were classified as autochthonous. Local transmission was still ongoing in urban areas in Angola and DR Congo. WHO classified the outbreak in DR Congo as a Grade 2 Emergency. On 30 May, the
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In August it was reported that of the 6 million vaccine doses shipped by WHO to Angola in February, one million doses went missing, resulting in shortages to fight the spreading epidemic in DR Congo. Vaccine and syringes might have been diverted for sale in private markets.
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announced the launch of a mass vaccination campaign in DR Congo, but as of 22 June, vaccine was in short supply. On 20 June, the health minister declared the outbreak of yellow fever in three provinces, including the capital of DR Congo, Kinshasa. Transmission within
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can become endemic in a new geographic area when local mosquitoes become infected by feeding on an imported case. Between 18 March and 22 April, the WHO was notified of 11 imported cases in China. Officials in Asia were concerned about the threat of yellow fever.
410:. The fake cards are sold to people who are required to have proof of vaccination after travel to areas where yellow fever is endemic. On 11 February 2016, the Pasteur Institute (WHO) in Senegal warned of fake yellow fever vaccine on the international market. 257:, some in a province that borders Angola. As of 31 May, 700 suspected cases and 63 deaths had been reported to WHO through the national surveillance system. As of 31 May, 52 cases were laboratory confirmed by the National Institute for Biomedical Research in 343:
by the Chinese CDC. The strain closely matched a 1971 strain, indicating that the yellow fever virus may have been circulating in the region for at least 45 years. The finding was consistent with earlier phylogenetic analyses performed during the outbreak.
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that began in 2013, and the mission to Angola was its first deployment. The team included "emergency medical teams, public health and medical coordination experts, mobile biosafety laboratories, medical evacuation planes and logistical support teams".
245:, transmission had been reported in 12 provinces as of 28 October. Confirmed cases had been reported in 16 of 18 provinces. No new cases were reported during July. The WHO congratulated the Angolan government on its effort to contain the outbreak. 279:
was deployed into Uganda, where there was ongoing transmission unrelated to the Angola outbreak. According to WHO, cases had been exported from Angola to China, DR Congo, and Kenya, as of 4 May 2016. One case had been reported in
2590: 373:. Starting on 26 April, ProMED-mail issued a series of posts on pre-planning information for countries at risk of importation of yellow fever, covering vaccination, mosquito control, quarantine and personal protection measures. 299:
On 13 March 2016, the Chinese government confirmed that a 32-year-old male Chinese citizen who had been in Angola had developed yellow fever on return. The case was the first imported yellow fever case in China in history.
2774: 1440: 173:, which can spread rapidly. A preliminary finding that the strain of the yellow fever virus was closely related to a strain identified in a 1971 outbreak in Angola was confirmed in August 2016. Moderators from 181:
classified the outbreak as Watch Level 2 (Practice Enhanced Precautions) on 7 April 2016. The WHO declared it a grade 2 event on its emergency response framework having moderate public health consequences.
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Monath, Thomas P; Woodall, Jack P; Gubler, Duane J; Yuill, Thomas M; Mackenzie, John S; Martins, Reinaldo M; Reiter, Paul; Heymann, David L (2016). "Yellow fever vaccine supply: a possible solution".
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at airports to detect passengers with elevated body temperatures. A Chinese medical team deployed to Angola vaccinated 120 Chinese nationals as part of epidemic research. More than 250,000
213:, a ProMED mail consultant, wrote an open letter to Dr. Chan requesting that the WHO emergency committee be reconvened to consider a PHEIC because of the continued spread of the disease in 356:
and Tom Yuill issued a strongly worded warning on the threat of yellow fever for countries that have endemic dengue fever (and thus the mosquito vector of yellow fever and dengue fever,
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launched another campaign to vaccinate more than 14 million people in Angola and DR Congo. On 2 September, WHO announced that the campaign to vaccinate the 7.7 million residents of
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has exploded in the Western hemisphere, we can't count on it." CDC said they could not assist as much in the outbreak because all its experts were involved in efforts against the
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At an emergency committee meeting in Geneva, Switzerland on 19 May 2016, the WHO declared that the outbreak was serious and might continue to spread, but decided not to declare a
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warned that "spread could make the Ebola and Zika epidemics look like picnics in the park!" and that "international action should start now." Chinese authorities strengthened
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In the situation report of 23 September, the WHO announced a second phase of the vaccination campaign in Angola and a planned pre-emptive vaccination campaign for the
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has never appeared in Asia even though the mosquito vector is present. Additional cases were later reported in people who first had symptoms while in Luanda.
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procedure. The WHO agreed to the recommendation in June 2016, authorizing one-fifth the usual dose during the ongoing outbreak in Angola and DR Congo, but
161:. The first cases (hemorrhagic fever suspected as being yellow fever) were reported in Eritrean visitors beginning on 5 December 2015 and confirmed by the 398:
to Angola on a two-week mission to help control the outbreak and assess the risk of further spread outside Angola. The medical corps was formed after the
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called for a scale-up in the response because of the lack of vaccine and other limitations amid the continuing spread of the outbreak. On 12 August 2016,
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Grobbelaar, Antoinette A.; Weyer, Jacqueline; Moolla, Naazneen; Vuren, Petrus Jansen van; Moises, Francisco; PawΔ™ska, Janusz T. (2016).
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on 9 May 2016, the Georgetown University Law Center called for the WHO to form an emergency committee to determine whether a
2989: 4323: 3980: 3924: 3749: 3696: 2405:"Yellow fever - Africa (15): Angola, fake vaccine, SE Asia, WHO alert 2016-02-24 13:32:43 Archive Number: 20160224.4047041" 3755: 3864: 3660: 3654: 3636: 3534: 3454: 3255: 361: 2851: 1884: 963: 3918: 3678: 3564: 2966: 1392: 157:
with 7 deaths among Eritrean and Congolese citizens living in Angola in Viana municipality, a suburb of the capital of
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In June 2016, the genetic sequence of a virus from a yellow fever infected Chinese traveler to Angola was posted to
4214: 4018: 3888: 3852: 3840: 3743: 3666: 2827:"Mass vaccination campaign to protect millions against yellow fever in Angola and Democratic Republic of the Congo" 436: 254: 214: 71: 2190: 2164:"Yellow fever - countries with dengue: alert 2016-03-28 20:39:56 Archive Number: Archive Number: 20160328.4123983" 1362: 938: 567: 4318: 4308: 4084: 4078: 4048: 3968: 3870: 3810: 3773: 3761: 3672: 3497: 3283: 2512: 484: 2749: 4196: 4184: 4178: 4166: 4160: 4154: 4042: 3986: 3956: 3944: 2826: 1225: 276: 773:"Meeting of the Emergency Committee under the International Health Regulations (2005) concerning Yellow Fever" 3912: 3828: 3430: 3073: 988: 448: 353: 309: 193:, director-general of WHO published a commentary on the bold action needed to prevent further spread of this 118: 2800: 2267:
Lucey, Daniel; Gostin, Lawrence O. (9 May 2016). "A yellow fever epidemic: A new global health emergency?".
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On 17 March, two cases, including one death, were reported in Kenya, imported from Angola. On 28 March, a
1783:"Yellow fever - China (05) ex Angola 2016-03-25 17:56:49 Archive Number: Archive Number: 20160325.4119422" 327:
Province, in a woman who returned from Angola on 12 March. Fujian is within the predicted distribution of
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Confirmed cases and deaths (cumulative) in the 2016 epidemic of yellow fever in Angola as of 21 July 2016
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stressed the importance of initiating a vaccination campaign immediately to prevent further spread. The
3846: 3515: 3485: 2535:"Yellow fever - Africa (34): Angola, WHO 2016-04-04 12:10:59 09:32:03 Archive Number 20160404.4137096" 3570: 3233: 888:"Red Cross calls for immediate scale-up in response to deadly yellow fever outbreak in Angola - IFRC" 419: 1103: 671:
Grobbelaar, AA; Weyer, J; Moolla, N; Jansen van Vuren, P; Moises, F; Paweska, JT (15 October 2016).
4238: 4220: 2079: 2030: 1862: 1556: 317: 2457:"Yellow fever - Africa (07): Angola (LU) RFI 2016-02-01 14:32:42 Archive Number: 20160201.3984228" 320:. On 8 April 2016, ten North Korean workers in Angola were reported to have died of yellow fever. 4288: 4244: 4148: 4142: 3509: 3442: 3424: 3248: 720: 332: 242: 198: 30: 1259: 4190: 4136: 3950: 3541: 3527: 3344: 395: 4313: 4172: 4130: 3708: 3215: 1125: 288: 218: 1906: 406:
Efforts to prevent international spread are confounded by the practice of selling falsified
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ProMED mail reported that as of 3 Aug 2016, 193 cases of yellow fever were suspected in the
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to be wildly wrong, and we can hope that will again be the case here, but given the way
301: 170: 3993: 3900: 3648: 3479: 3448: 3241: 3049: 3024: 2731: 1957: 1932: 1614: 1579: 857: 697: 672: 238: 54: 2719: 1809: 1580:"Estimating the number of unvaccinated Chinese workers against yellow fever in Angola" 845: 423: 4250: 3731: 3396: 3333: 3054: 2994: 2723: 2284: 2119: 2111: 2060: 2052: 2011: 1962: 1829: 1619: 1601: 849: 702: 471: 162: 2735: 861: 4232: 3366: 3321: 3272: 3044: 3036: 3016: 2715: 2591:"Angola extends yellow fever vaccination campaign to Huambo and Benguela provinces" 2276: 2101: 2091: 2042: 2001: 1952: 1944: 1821: 1642: 1609: 1591: 1478: 1299: 841: 692: 684: 222: 487:
drew attention away from a potentially far more serious epidemic of yellow fever.
3816: 3372: 3327: 3300: 3108: 3020: 1810:"Zika Virus Spreads to New Areas β€” Region of the Americas, May 2015–January 2016" 1203: 210: 137:
Yellow fever cases by age group in Angola, from 5 December 2015 to 4 August 2016.
2682:"The world was running short of yellow fever vaccinesβ€”and millions were at risk" 217:, the lack of sufficient vaccine, and concern that it may be spreading into the 3308: 3122: 2096: 2047: 391: 378: 1596: 133: 4282: 4226: 3378: 3193:"Fighting yellow fever in the Democratic Republic of the Congo – in pictures" 2990:"Yellow fever outbreak: Health officials to weigh declaring global emergency" 2775:"Launch of emergency vaccination campaigns on the DR Congo and Angola border" 2115: 2056: 1825: 1605: 357: 328: 263: 253:
On 22 March 2016, the WHO was notified of 21 deaths from yellow fever in the
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still apply to travelers, who must obtain the full dose to quality for the
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78 confirmed cases (57 imported from Angola, 8 sylvatic, 13 autochthonous)
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Wasserman, Sean; Tambyah, Paul Anantharajah; Lim, Poh Lian (2016).
460: 268: 258: 92: 2750:"Lower doses of yellow fever vaccine could be used in emergencies" 2561:"Situation Report: Yellow fever outbreak in Angola, 10 April 2016" 1885:"Yellow Fever: Southeast Asia's next great outbreak? | GovInsider" 1501:"Yellow fever - Africa (92): WHO, Angola, Congo DR, letter to WHO" 1178:"Yellow fever - Africa (92): WHO, Angola, Congo DR, letter to WHO" 913:"Yellow fever - Africa (92): WHO, Angola, Congo DR, letter to WHO" 590:"Situation report: Yellow fever outbreak in Angola, 14 March 2016" 534:"Situation Report: Yellow fever outbreak in Angola, 5 August 2016" 2303:"EU sends new medical corps team to Angola yellow fever outbreak" 1415:"Yellow fever - Africa (24): Kenya ex Angola 2016-03-18 18:40:36" 447:
vaccine over 10 days. In August, the WHO with partners including
340: 281: 3074:"Yellow Fever Epidemic in Africa Shows Gaps in Vaccine Pipeline" 2651:"Situation Report: Yellow fever outbreak in Angola, 23 May 2016" 2621:"Situation Report: Yellow fever outbreak in Angola, 23 May 2016" 331:, the mosquito that transmits the yellow fever virus to humans. 207:
International Federation of Red Cross and Red Crescent Societies
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European Commissioner for Humanitarian Aid and Civil Protection
324: 158: 150: 44: 2191:"Yellow Fever Outbreak in Angola Strains Health Organizations" 1126:"Angola grapples with worst yellow fever outbreak in 30 years" 2513:"Yellow fever vaccine shortage as outbreak in Angola spreads" 1300:"Congo almost runs out of yellow fever vaccine amid epidemic" 347: 166: 104: 3116: 2216:"Yellow fever - pre-planning for at-risk countries: vaccine" 430:
If the epidemic were to spread, particularly into Asia, the
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By early February, suspected cases were being reported from
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Hennessey, Morgan; Fischer, Marc; Staples, J. Erin (2016).
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121 deaths among suspected cases (case fatality rate, 4.0%)
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16 deaths among confirmed cases (case fatality rate, 21.1%)
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377 deaths among suspected cases (case fatality rate, 8.7%)
2483:"Angola immunizes 6.7 million people against yellow fever" 1930: 1441:"Yellow fever – Uganda - WHO | Regional Office for Africa" 1066:"Angola immunizes 6.7 million people against yellow fever" 422:(WHO), the Angolan Ministry of Health began a campaign of 248: 4329:
Disease outbreaks in the Democratic Republic of the Congo
2138:"Opinion: Who's Afraid of Yellow Fever? Why We Should Be" 2705: 2902:"UN bungles response to Africa's yellow fever outbreak" 1807: 804:"W.H.O. Calls Yellow Fever in Africa 'Serious Concern'" 4304:
2016 disasters in the Democratic Republic of the Congo
2354:"Mobile labs deliver faster yellow fever test results" 1820:(3). Centers for Disease Control and Prevention: 1–4. 1758:"N. Korean workers die of yellow fever in Angola: RFA" 1325:"A yellow fever epidemic has broken out in the Congo" 830:"Yellow fever: the resurgence of a forgotten disease" 3098: 2080:"Yellow fever cases in Asia: primed for an epidemic" 1014:"Yellow fever - Africa (110): Angola, Congo DR, WHO" 2077: 1282:"Yellow fever - Africa (59): DR Congo, vaccination" 1577: 2959:"Yellow fever situation report 23 September 2016" 2379:"Yellow fever - Africa (06): Nigeria, fake cards" 1933:"Resurgence of Yellow Fever in Angola, 2015–2016" 1385:"Yellow fever situation report 23 September 2016" 1252:"Yellow fever – Democratic Republic of the Congo" 673:"Resurgence of Yellow Fever in Angola, 2015-2016" 294: 4280: 1571: 1288:. International Society for Infectious Diseases. 384:public health emergency of international concern 241:, with suspected and confirmed cases. Local, or 187:public health emergency of international concern 3015: 2541:. International Society for Infectious Diseases 2463:. International Society for Infectious Diseases 2437:. International Society for Infectious Diseases 2411:. International Society for Infectious Diseases 2385:. International Society for Infectious Diseases 2248:. International Society for Infectious Diseases 2222:. International Society for Infectious Diseases 2170:. International Society for Infectious Diseases 1789:. International Society for Infectious Diseases 1737:. International Society for Infectious Diseases 1693:. International Society for Infectious Diseases 1667:. International Society for Infectious Diseases 1533:. International Society for Infectious Diseases 1507:. International Society for Infectious Diseases 1421:. International Society for Infectious Diseases 1184:. International Society for Infectious Diseases 1046:. International Society for Infectious Diseases 1020:. International Society for Infectious Diseases 919:. International Society for Infectious Diseases 753:. International Society for Infectious Diseases 652:. International Society for Infectious Diseases 626:. International Society for Infectious Diseases 504:"Yellow fever situation report 28 October 2016" 1578:Wilder-Smith, A.; Massad, E. (17 April 2018). 95:cases are not considered part of the outbreak. 23:2016 Angola and DR Congo yellow fever outbreak 4254: 3249: 4294:2016 in the Democratic Republic of the Congo 2084:International Journal of Infectious Diseases 2035:International Journal of Infectious Diseases 2028: 1355:"Yellow fever situation report 15 July 2016" 727:. Centers for Disease Control and Prevention 560:"Yellow fever situation report 21 July 2016" 18: 2856:World Health Organization. 2 September 2016 2489:. World Health Organization. Archived from 2266: 1814:MMWR. Morbidity and Mortality Weekly Report 1636: 1555:. World Health Organization. Archived from 1102:. World Health Organization. Archived from 1072:. World Health Organization. Archived from 968:World Health Organization. 2 September 2016 477: 149:On 20 January 2016, the health minister of 3256: 3242: 3190: 1982:"Fears rise over yellow fever's next move" 362:world stocks of 7 million doses of vaccine 348:Potential for further international spread 3437:"Cocoliztli" epidemics in colonial Mexico 3072:McNeil, Donald G. Jr. (5 December 2016). 3048: 2875: 2105: 2095: 2046: 2005: 1956: 1613: 1595: 747:"Yellow fever - Africa (40): Angola, WHO" 696: 453:International Federation of the Red Cross 323:On 25 March 2016, a case was reported in 140: 132: 2679: 413: 249:Spread to neighboring African countries 228: 4281: 3168:"Timeline: Yellow fever outbreak 2016" 3071: 2189:McNeil, Donald G. Jr. (4 April 2016). 2188: 1979: 1755: 1226:"Congo Records 21 Yellow Fever Deaths" 989:"Winning the war against yellow fever" 801: 394:announced plans to send a team of the 3504:Great Plague in the late Ming dynasty 3237: 3212:"Resetting the yellow fever strategy" 2987: 2926: 2680:Merelli, Annalisa (4 November 2015). 802:McNeil, Donald G. Jr. (19 May 2016). 408:yellow fever vaccination certificates 205:in previous centuries. On 8 June the 1715:. Xinhua/Liu Dawei. 16 February 2016 827: 646:"Yellow fever - Africa (18): Angola" 352:On 28 March, ProMED-mail moderators 3191:Wohlwender, Mark (26 August 2016). 2876:Soucheray, Stephanie (2018-11-26). 2029:Woodall, J.P.; Yuill, T.M. (2016). 386:should be declared. On 12 May, the 371:Zika virus outbreak in the Americas 13: 2988:Times, Los Angeles (18 May 2016). 1756:Herald, The Korea (8 April 2016). 1100:Emergencies preparedness, response 199:historically significant epidemics 53:121 deaths among confirmed cases ( 14: 4340: 3094: 2927:Times, Los Angeles (2016-08-04). 1232:. Associated Press. 12 April 2016 4209:encephalitis lethargica epidemic 3115: 3101: 1980:Butler, Declan (14 April 2016). 437:international health regulations 318:Chinese nationals live in Angola 255:Democratic Republic of the Congo 215:Democratic Republic of the Congo 163:Pasteur WHO reference laboratory 29: 3987:Gorakhpur Japanese encephalitis 3284:List of epidemics and pandemics 3065: 3009: 2981: 2951: 2920: 2894: 2869: 2844: 2819: 2793: 2767: 2742: 2699: 2673: 2643: 2613: 2583: 2553: 2527: 2505: 2475: 2449: 2423: 2397: 2371: 2346: 2321: 2295: 2260: 2234: 2208: 2182: 2156: 2130: 2071: 2022: 1973: 1924: 1899: 1877: 1847: 1801: 1775: 1749: 1727: 1705: 1679: 1653: 1630: 1545: 1519: 1493: 1463: 1433: 1407: 1377: 1347: 1317: 1292: 1274: 1244: 1218: 1196: 1170: 1148:"Yellow fever situation report" 1140: 1118: 1088: 1058: 1032: 1006: 981: 956: 931: 905: 880: 821: 795: 765: 295:Spread to China via air travel 2487:WHO Regional Office for Africa 1907:"Yellow fever virus in Angola" 1070:WHO Regional Office for Africa 739: 713: 664: 638: 612: 582: 552: 526: 496: 195:important communicable disease 1: 3312: 2720:10.1016/S0140-6736(16)30195-7 1641:. World Health Organization. 846:10.1016/S0140-6736(16)30620-1 490: 400:Ebola outbreak in West Africa 3029:Emerging Infectious Diseases 2904:. 2016-08-05. Archived from 1937:Emerging Infectious Diseases 1637:Vainio, J; Cutts, F (1998). 677:Emerging Infectious Diseases 7: 4324:Disease outbreaks in Angola 1128:. World Health Organization 10: 4345: 4097:2024 Latin American dengue 3877:Western African meningitis 3691:Pacific Northwest smallpox 3154:. University of Pittsburgh 3134:. University of Pittsburgh 2097:10.1016/j.ijid.2016.04.025 2048:10.1016/j.ijid.2016.05.001 441:certificate of vaccination 16:Disease outbreak in Africa 4121: 3797: 3718: 3703:Buenos Aires yellow fever 3623: 3614: 3601:Philadelphia yellow fever 3571:Great Plague of Marseille 3565:Great Northern War plague 3559:Iceland smallpox epidemic 3551: 3472: 3417: 3406: 3343: 3299: 3292: 3279: 3172:World Health Organization 2963:World Health Organization 2831:World Health Organization 2754:World Health Organization 2358:World Health Organization 1859:World Health Organization 1597:10.1186/s12879-018-3084-y 1475:World Health Organization 1389:World Health Organization 1359:World Health Organization 1256:World Health Organization 1206:. Allafrica. 17 July 2016 1152:World Health Organization 993:World Health Organization 943:World Health Organization 777:World Health Organization 564:World Health Organization 508:World Health Organization 420:World Health Organization 171:yellow fever transmission 4299:2016 disasters in Angola 4267:Mpox (clade Ib) epidemic 4261:Mpox (clade II) outbreak 4221:Seventh cholera pandemic 1826:10.15585/mmwr.mm6503e1er 721:"Yellow Fever in Angola" 478:Response to the epidemic 449:MΓ©decins sans FrontiΓ¨res 432:global supply of vaccine 4179:Fourth cholera pandemic 4161:Second cholera pandemic 4007:Γ‰quateur province Ebola 3595:North American smallpox 3510:Great Plague of Seville 1584:BMC Infectious Diseases 1096:"Yellow Fever – Angola" 828:Chan, Margaret (2016). 333:Mosquito-borne diseases 235:southern Huila province 4319:21st-century epidemics 4309:2016 disease outbreaks 4197:Sixth cholera pandemic 4185:Fifth cholera pandemic 4167:Third cholera pandemic 4155:First cholera pandemic 4137:Second plague pandemic 3697:Barcelona yellow fever 3542:Great Plague of Vienna 3528:Great Plague of London 3498:Massachusetts smallpox 3148:"YELLOW FEVER in ASIA" 3041:10.3201/eid2210.160875 2281:10.1001/jama.2016.6606 1949:10.3201/eid2210.160818 1855:"Yellow Fever – China" 1553:"Yellow Fever – China" 689:10.3201/eid2210.160818 396:European Medical Corps 146: 138: 38:As of 28 October 2016 4173:Third plague pandemic 4131:First plague pandemic 3925:Western African Ebola 3835:Chikungunya outbreaks 3787:Malaysian Nipah virus 3655:Great Plains smallpox 3218:on September 17, 2016 2969:on September 24, 2016 1395:on September 24, 2016 289:Republic of the Congo 219:Republic of the Congo 189:(PHEIC). On 30 May, 153:reported 23 cases of 144: 136: 4233:Russian flu pandemic 3975:Angolan yellow fever 3726:San Francisco plague 3679:Broad Street cholera 3577:Great Plague of 1738 2714:(10028): 1599–1600. 2515:. CNN. 25 March 2016 1158:on December 19, 2016 514:on December 19, 2016 414:Vaccination campaign 229:Spread within Angola 83:2987 suspected cases 60:4347 suspected cases 4139:(1348–19th century) 4067:New Zealand measles 3895:Darfur yellow fever 3738:LA pneumonic plague 3355:Plague of Justinian 1998:2016Natur.532..155B 1762:www.koreaherald.com 424:preventive measures 418:With help from the 277:rapid response team 239:case fatality rates 50:884 confirmed cases 4149:Influenza pandemic 4143:Influenza pandemic 4091:Bangsamoro measles 4073:Singaporean dengue 4037:Pacific NW measles 4031:Philippine measles 4019:Madagascar measles 4001:Kerala Nipah virus 3994:Saudi Arabian MERS 3907:Singaporean dengue 3853:Zimbabwean cholera 3823:Singaporean dengue 3667:Copenhagen cholera 3649:Groningen epidemic 3443:Influenza pandemic 3425:Influenza pandemic 3078:The New York Times 2246:www.promedmail.org 2220:www.promedmail.org 2195:The New York Times 1505:www.promedmail.org 1286:www.promedmail.org 1182:www.promedmail.org 1018:www.promedmail.org 917:www.promedmail.org 808:The New York Times 147: 139: 125:11 confirmed cases 55:case fatality rate 4276: 4275: 4117: 4116: 4113: 4112: 4049:Kuala Koh measles 3963:South Korean MERS 3951:Polio declaration 3939:Madagascar plague 3871:Gujarat hepatitis 3859:Madagascar plague 3811:Midwest monkeypox 3762:Yugoslav smallpox 3732:Manchurian plague 3673:Stockholm cholera 3610: 3609: 3397:Sweating sickness 3385:Japanese smallpox 3334:Plague of Cyprian 3273:disease outbreaks 2995:Los Angeles Times 2933:Los Angeles Times 2601:on April 20, 2016 2493:on March 18, 2016 1992:(7598): 155–156. 1865:on April 23, 2016 1335:on August 9, 2016 1106:on March 26, 2016 1076:on March 18, 2016 840:(10034): 2165–6. 725:Traveler's Health 683:(10): 1854–1855. 540:on 15 August 2016 472:Republic of Congo 376:In an article in 197:that caused many 131: 130: 110:2 confirmed cases 4336: 4256: 4043:New York measles 3997: 3957:Indian swine flu 3945:Odisha hepatitis 3935: 3889:Pakistani dengue 3841:Pakistani dengue 3790: 3756:WrocΕ‚aw smallpox 3709:Hong Kong plague 3643:Caragea's plague 3621: 3620: 3538: 3431:Mexican smallpox 3415: 3414: 3367:Plague of Sheroe 3322:Plague of Athens 3317: 3314: 3297: 3296: 3258: 3251: 3244: 3235: 3234: 3227: 3225: 3223: 3214:. Archived from 3207: 3205: 3203: 3187: 3185: 3183: 3178:on June 18, 2016 3174:. Archived from 3163: 3161: 3159: 3143: 3141: 3139: 3125: 3120: 3119: 3111: 3106: 3105: 3104: 3089: 3088: 3086: 3084: 3069: 3063: 3062: 3052: 3023:(October 2016). 3013: 3007: 3006: 3004: 3002: 2985: 2979: 2978: 2976: 2974: 2965:. Archived from 2955: 2949: 2948: 2946: 2944: 2935:. Archived from 2924: 2918: 2917: 2915: 2913: 2908:on 6 August 2016 2898: 2892: 2891: 2889: 2888: 2873: 2867: 2866: 2864: 2862: 2848: 2842: 2841: 2839: 2837: 2823: 2817: 2816: 2814: 2812: 2797: 2791: 2790: 2788: 2786: 2781:on June 24, 2016 2777:. Archived from 2771: 2765: 2764: 2762: 2760: 2746: 2740: 2739: 2703: 2697: 2696: 2694: 2692: 2677: 2671: 2670: 2668: 2666: 2657:. Archived from 2655:www.afro.who.int 2647: 2641: 2640: 2638: 2636: 2627:. Archived from 2625:www.afro.who.int 2617: 2611: 2610: 2608: 2606: 2597:. Archived from 2595:www.afro.who.int 2587: 2581: 2580: 2578: 2576: 2571:on 15 April 2016 2567:. Archived from 2565:www.afro.who.int 2557: 2551: 2550: 2548: 2546: 2531: 2525: 2524: 2522: 2520: 2509: 2503: 2502: 2500: 2498: 2479: 2473: 2472: 2470: 2468: 2453: 2447: 2446: 2444: 2442: 2427: 2421: 2420: 2418: 2416: 2401: 2395: 2394: 2392: 2390: 2375: 2369: 2368: 2366: 2364: 2350: 2344: 2343: 2341: 2339: 2325: 2319: 2318: 2316: 2314: 2299: 2293: 2292: 2264: 2258: 2257: 2255: 2253: 2238: 2232: 2231: 2229: 2227: 2212: 2206: 2205: 2203: 2201: 2186: 2180: 2179: 2177: 2175: 2160: 2154: 2153: 2151: 2149: 2134: 2128: 2127: 2109: 2099: 2075: 2069: 2068: 2050: 2026: 2020: 2019: 2009: 1977: 1971: 1970: 1960: 1928: 1922: 1921: 1919: 1918: 1903: 1897: 1896: 1894: 1892: 1881: 1875: 1874: 1872: 1870: 1861:. Archived from 1851: 1845: 1844: 1842: 1840: 1805: 1799: 1798: 1796: 1794: 1779: 1773: 1772: 1770: 1768: 1753: 1747: 1746: 1744: 1742: 1731: 1725: 1724: 1722: 1720: 1709: 1703: 1702: 1700: 1698: 1683: 1677: 1676: 1674: 1672: 1657: 1651: 1650: 1634: 1628: 1627: 1617: 1599: 1575: 1569: 1568: 1566: 1564: 1559:on April 2, 2016 1549: 1543: 1542: 1540: 1538: 1523: 1517: 1516: 1514: 1512: 1497: 1491: 1490: 1488: 1486: 1477:. Archived from 1467: 1461: 1460: 1458: 1456: 1447:. Archived from 1445:www.afro.who.int 1437: 1431: 1430: 1428: 1426: 1411: 1405: 1404: 1402: 1400: 1391:. Archived from 1381: 1375: 1374: 1372: 1370: 1365:on July 16, 2016 1361:. Archived from 1351: 1345: 1344: 1342: 1340: 1331:. Archived from 1329:Business Insider 1321: 1315: 1314: 1312: 1310: 1296: 1290: 1289: 1278: 1272: 1271: 1269: 1267: 1258:. Archived from 1248: 1242: 1241: 1239: 1237: 1222: 1216: 1215: 1213: 1211: 1200: 1194: 1193: 1191: 1189: 1174: 1168: 1167: 1165: 1163: 1154:. Archived from 1144: 1138: 1137: 1135: 1133: 1122: 1116: 1115: 1113: 1111: 1092: 1086: 1085: 1083: 1081: 1062: 1056: 1055: 1053: 1051: 1036: 1030: 1029: 1027: 1025: 1010: 1004: 1003: 1001: 999: 985: 979: 978: 976: 974: 960: 954: 953: 951: 949: 935: 929: 928: 926: 924: 909: 903: 902: 900: 898: 884: 878: 877: 875: 873: 864:. Archived from 825: 819: 818: 816: 814: 799: 793: 792: 790: 788: 779:. Archived from 769: 763: 762: 760: 758: 743: 737: 736: 734: 732: 717: 711: 710: 700: 668: 662: 661: 659: 657: 642: 636: 635: 633: 631: 616: 610: 609: 607: 605: 596:. Archived from 594:www.afro.who.int 586: 580: 579: 577: 575: 570:on July 22, 2016 566:. Archived from 556: 550: 549: 547: 545: 536:. Archived from 530: 524: 523: 521: 519: 510:. Archived from 500: 223:Matshidiso Moeti 96: 33: 19: 4344: 4343: 4339: 4338: 4337: 4335: 4334: 4333: 4279: 4278: 4277: 4272: 4109: 3992: 3930: 3913:Swansea measles 3865:Bolivian dengue 3793: 3785: 3774:Indian smallpox 3744:Croydon typhoid 3714: 3606: 3547: 3533: 3468: 3409: 3402: 3373:Plague of Amwas 3346: 3339: 3328:Antonine Plague 3315: 3288: 3275: 3262: 3231: 3221: 3219: 3210: 3201: 3199: 3181: 3179: 3166: 3157: 3155: 3146: 3137: 3135: 3130: 3121: 3114: 3109:Medicine portal 3107: 3102: 3100: 3097: 3092: 3082: 3080: 3070: 3066: 3035:(10): 1859–60. 3014: 3010: 3000: 2998: 2986: 2982: 2972: 2970: 2957: 2956: 2952: 2942: 2940: 2925: 2921: 2911: 2909: 2900: 2899: 2895: 2886: 2884: 2874: 2870: 2860: 2858: 2850: 2849: 2845: 2835: 2833: 2825: 2824: 2820: 2810: 2808: 2799: 2798: 2794: 2784: 2782: 2773: 2772: 2768: 2758: 2756: 2748: 2747: 2743: 2704: 2700: 2690: 2688: 2678: 2674: 2664: 2662: 2661:on 17 June 2016 2649: 2648: 2644: 2634: 2632: 2631:on 17 June 2016 2619: 2618: 2614: 2604: 2602: 2589: 2588: 2584: 2574: 2572: 2559: 2558: 2554: 2544: 2542: 2533: 2532: 2528: 2518: 2516: 2511: 2510: 2506: 2496: 2494: 2481: 2480: 2476: 2466: 2464: 2455: 2454: 2450: 2440: 2438: 2429: 2428: 2424: 2414: 2412: 2403: 2402: 2398: 2388: 2386: 2377: 2376: 2372: 2362: 2360: 2352: 2351: 2347: 2337: 2335: 2327: 2326: 2322: 2312: 2310: 2301: 2300: 2296: 2265: 2261: 2251: 2249: 2240: 2239: 2235: 2225: 2223: 2214: 2213: 2209: 2199: 2197: 2187: 2183: 2173: 2171: 2162: 2161: 2157: 2147: 2145: 2144:. 22 April 2016 2136: 2135: 2131: 2076: 2072: 2027: 2023: 2007:10.1038/532155a 1978: 1974: 1929: 1925: 1916: 1914: 1905: 1904: 1900: 1890: 1888: 1883: 1882: 1878: 1868: 1866: 1853: 1852: 1848: 1838: 1836: 1806: 1802: 1792: 1790: 1781: 1780: 1776: 1766: 1764: 1754: 1750: 1740: 1738: 1733: 1732: 1728: 1718: 1716: 1711: 1710: 1706: 1696: 1694: 1685: 1684: 1680: 1670: 1668: 1659: 1658: 1654: 1635: 1631: 1576: 1572: 1562: 1560: 1551: 1550: 1546: 1536: 1534: 1525: 1524: 1520: 1510: 1508: 1499: 1498: 1494: 1484: 1482: 1469: 1468: 1464: 1454: 1452: 1439: 1438: 1434: 1424: 1422: 1413: 1412: 1408: 1398: 1396: 1383: 1382: 1378: 1368: 1366: 1353: 1352: 1348: 1338: 1336: 1323: 1322: 1318: 1308: 1306: 1298: 1297: 1293: 1280: 1279: 1275: 1265: 1263: 1262:on June 3, 2016 1250: 1249: 1245: 1235: 1233: 1224: 1223: 1219: 1209: 1207: 1202: 1201: 1197: 1187: 1185: 1176: 1175: 1171: 1161: 1159: 1146: 1145: 1141: 1131: 1129: 1124: 1123: 1119: 1109: 1107: 1094: 1093: 1089: 1079: 1077: 1064: 1063: 1059: 1049: 1047: 1038: 1037: 1033: 1023: 1021: 1012: 1011: 1007: 997: 995: 987: 986: 982: 972: 970: 962: 961: 957: 947: 945: 937: 936: 932: 922: 920: 911: 910: 906: 896: 894: 886: 885: 881: 871: 869: 868:on May 31, 2016 826: 822: 812: 810: 800: 796: 786: 784: 783:on May 20, 2016 771: 770: 766: 756: 754: 745: 744: 740: 730: 728: 719: 718: 714: 669: 665: 655: 653: 644: 643: 639: 629: 627: 618: 617: 613: 603: 601: 600:on 7 April 2016 588: 587: 583: 573: 571: 558: 557: 553: 543: 541: 532: 531: 527: 517: 515: 502: 501: 497: 493: 480: 416: 350: 314:thermal imaging 297: 251: 231: 211:Daniel R. Lucey 91: 17: 12: 11: 5: 4342: 4332: 4331: 4326: 4321: 4316: 4311: 4306: 4301: 4296: 4291: 4289:2016 in Angola 4274: 4273: 4271: 4270: 4264: 4258: 4248: 4242: 4241:(1981–present) 4236: 4230: 4224: 4218: 4212: 4206: 4200: 4194: 4188: 4182: 4176: 4170: 4164: 4158: 4152: 4146: 4140: 4134: 4127: 4125: 4119: 4118: 4115: 4114: 4111: 4110: 4108: 4107: 4106: 4105: 4094: 4093:(2023–present) 4088: 4085:Jamaica dengue 4082: 4076: 4070: 4064: 4058: 4052: 4046: 4040: 4034: 4028: 4022: 4016: 4010: 4004: 3998: 3990: 3984: 3981:Yemeni cholera 3978: 3972: 3966: 3960: 3954: 3948: 3942: 3936: 3932:DR Congo Ebola 3928: 3922: 3916: 3910: 3904: 3898: 3892: 3886: 3880: 3874: 3868: 3862: 3856: 3850: 3844: 3838: 3832: 3826: 3820: 3814: 3808: 3801: 3799: 3795: 3794: 3792: 3791: 3783: 3777: 3771: 3765: 3759: 3753: 3747: 3741: 3735: 3729: 3722: 3720: 3716: 3715: 3713: 3712: 3706: 3700: 3694: 3688: 3682: 3676: 3670: 3664: 3658: 3652: 3646: 3640: 3637:Maltese plague 3634: 3631:Ottoman plague 3627: 3625: 3618: 3612: 3611: 3608: 3607: 3605: 3604: 3598: 3592: 3589:Persian Plague 3586: 3583:Russian plague 3580: 3574: 3568: 3562: 3555: 3553: 3549: 3548: 3546: 3545: 3539: 3535:Maltese plague 3531: 3525: 3519: 3516:Maltese plague 3513: 3507: 3501: 3495: 3492:Italian plague 3489: 3486:Maltese plague 3483: 3476: 3474: 3470: 3469: 3467: 3466: 3464: 3458: 3455:Maltese plague 3452: 3446: 3440: 3434: 3428: 3421: 3419: 3412: 3404: 3403: 3401: 3400: 3394: 3388: 3382: 3376: 3370: 3364: 3358: 3351: 3349: 3341: 3340: 3338: 3337: 3331: 3325: 3319: 3309:Hittite plague 3305: 3303: 3294: 3290: 3289: 3287: 3286: 3280: 3277: 3276: 3261: 3260: 3253: 3246: 3238: 3229: 3228: 3208: 3188: 3164: 3144: 3127: 3126: 3123:Viruses portal 3112: 3096: 3095:External links 3093: 3091: 3090: 3064: 3008: 2980: 2950: 2919: 2893: 2868: 2843: 2818: 2807:. 20 July 2016 2792: 2766: 2741: 2698: 2672: 2642: 2612: 2582: 2552: 2526: 2504: 2474: 2448: 2422: 2396: 2370: 2345: 2320: 2294: 2275:(24): 2661–2. 2259: 2233: 2207: 2181: 2155: 2129: 2070: 2021: 1972: 1943:(10): 1854–5. 1923: 1898: 1876: 1846: 1800: 1774: 1748: 1726: 1704: 1678: 1652: 1629: 1570: 1544: 1518: 1492: 1481:on May 1, 2016 1471:"Yellow fever" 1462: 1432: 1406: 1376: 1346: 1316: 1304:news.trust.org 1291: 1273: 1243: 1217: 1195: 1169: 1139: 1117: 1087: 1057: 1031: 1005: 980: 955: 930: 904: 879: 820: 794: 764: 738: 712: 663: 637: 611: 581: 551: 525: 494: 492: 489: 479: 476: 415: 412: 392:European Union 349: 346: 296: 293: 250: 247: 230: 227: 129: 128: 127: 126: 114: 113: 112: 111: 100: 99: 88: 87: 84: 81: 78: 67: 66: 65: 64: 61: 58: 51: 40: 39: 35: 34: 26: 25: 15: 9: 6: 4: 3: 2: 4341: 4330: 4327: 4325: 4322: 4320: 4317: 4315: 4312: 4310: 4307: 4305: 4302: 4300: 4297: 4295: 4292: 4290: 4287: 4286: 4284: 4268: 4265: 4262: 4259: 4253:(2019–present 4252: 4249: 4246: 4243: 4240: 4237: 4234: 4231: 4228: 4227:Hong Kong flu 4225: 4222: 4219: 4216: 4213: 4210: 4207: 4204: 4201: 4198: 4195: 4192: 4189: 4186: 4183: 4180: 4177: 4174: 4171: 4168: 4165: 4162: 4159: 4156: 4153: 4150: 4147: 4144: 4141: 4138: 4135: 4132: 4129: 4128: 4126: 4124: 4120: 4103: 4100: 4099: 4098: 4095: 4092: 4089: 4086: 4083: 4080: 4077: 4074: 4071: 4068: 4065: 4062: 4059: 4056: 4055:Tonga measles 4053: 4050: 4047: 4044: 4041: 4038: 4035: 4032: 4029: 4026: 4025:Samoa measles 4023: 4020: 4017: 4014: 4011: 4008: 4005: 4002: 3999: 3995: 3991: 3988: 3985: 3982: 3979: 3976: 3973: 3970: 3967: 3964: 3961: 3958: 3955: 3952: 3949: 3946: 3943: 3940: 3937: 3933: 3929: 3926: 3923: 3920: 3917: 3914: 3911: 3908: 3905: 3902: 3899: 3896: 3893: 3890: 3887: 3884: 3883:Haiti cholera 3881: 3878: 3875: 3872: 3869: 3866: 3863: 3860: 3857: 3854: 3851: 3848: 3847:Iraqi cholera 3845: 3842: 3839: 3836: 3833: 3830: 3829:Indian dengue 3827: 3824: 3821: 3818: 3815: 3812: 3809: 3806: 3803: 3802: 3800: 3796: 3788: 3784: 3781: 3778: 3775: 3772: 3769: 3766: 3763: 3760: 3757: 3754: 3751: 3748: 3745: 3742: 3739: 3736: 3733: 3730: 3727: 3724: 3723: 3721: 3717: 3710: 3707: 3704: 3701: 3698: 3695: 3692: 3689: 3686: 3685:Guam smallpox 3683: 3680: 3677: 3674: 3671: 3668: 3665: 3662: 3659: 3656: 3653: 3650: 3647: 3644: 3641: 3638: 3635: 3632: 3629: 3628: 3626: 3622: 3619: 3617: 3613: 3602: 3599: 3596: 3593: 3590: 3587: 3584: 3581: 3578: 3575: 3572: 3569: 3566: 3563: 3560: 3557: 3556: 3554: 3550: 3543: 3540: 3536: 3532: 3529: 3526: 3523: 3522:Naples Plague 3520: 3517: 3514: 3511: 3508: 3505: 3502: 3499: 3496: 3493: 3490: 3487: 3484: 3481: 3480:London plague 3478: 3477: 3475: 3471: 3465: 3462: 3461:London plague 3459: 3456: 3453: 3450: 3449:London plague 3447: 3444: 3441: 3438: 3435: 3432: 3429: 3426: 3423: 3422: 3420: 3416: 3413: 3411: 3405: 3398: 3395: 3392: 3389: 3386: 3383: 3380: 3379:Plague of 664 3377: 3374: 3371: 3368: 3365: 3362: 3359: 3356: 3353: 3352: 3350: 3348: 3342: 3335: 3332: 3329: 3326: 3323: 3320: 3310: 3307: 3306: 3304: 3302: 3298: 3295: 3291: 3285: 3282: 3281: 3278: 3274: 3270: 3266: 3259: 3254: 3252: 3247: 3245: 3240: 3239: 3236: 3232: 3217: 3213: 3209: 3198: 3194: 3189: 3177: 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Index


Angola
case fatality rate
DR Congo
Sylvatic
Kenya
China


Angola
yellow fever
Luanda
Pasteur WHO reference laboratory
Dakar
yellow fever transmission
ProMED-mail
CDC
public health emergency of international concern
Margaret Chan
important communicable disease
historically significant epidemics
many lives
International Federation of Red Cross and Red Crescent Societies
Daniel R. Lucey
Democratic Republic of the Congo
Republic of the Congo
Matshidiso Moeti
southern Huila province
case fatality rates
autochthonous

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