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October 2001

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Yellow fever vaccine stocks still low as fears of new outbreaks grow

THE World Health Organization has appealed to the international community for funds to stockpile scarce yellow fever vaccine after a mass immunization campaign in Côte d’Ivoire. The campaign, successfully completed in Abidjan earlier this month, immunized an estimated 2.6 million people in under 2 weeks, in an effort to control the first urban outbreak of yellow fever in Africa in a decade. Worldwide, there are now at most 1 million remaining doses of vaccine available for the coming month.

"The vaccine supply situation is very bad," said Michel Zaffran, of the World Health Organization’s Department of Vaccines and Biologicals. "If there were another urban outbreak we would need to do a similar campaign and there would not be enough vaccine right now." As Immunization Focus went to press, there were unconfirmed reports of a second outbreak of yellow fever in Conakry, Guinea. Officials are concerned at the possibility of outbreaks in larger population centres in West Africa.

Until now, only two manufacturers – Aventis Pasteur and the Institut Pasteur in Dakar, Senegal – have supplied the international market. A third in Brazil, Biomanguinhos, has this month received WHO official quality approval – or "prequalification" – for its vaccine. Julie Milstien in the WHO Department of Vaccines and Biologicals said this would ease the situation somewhat, but warned that the new supplies would not be available for another month.

Yellow fever is responsible for an estimated 200,000 cases of illness and 30,000 deaths each year. It is caused by a virus which is spread by several species of mosquito. Most outbreaks are relatively small and confined to forested areas or villages. The more dangerous urban outbreaks occur when infected people introduce the virus into a densely populated area, where it is rapidly spread by Aedes aegypti mosquitoes. As of 10 October, Côte d’Ivoire's ministry of health had reported 203 suspected cases of the disease and 21 deaths in the current outbreak, although actual numbers are likely to be much higher.

Marko Kokic/International Red Cross - Red Cross Worker
Come and get it:
a Red Cross volunteer appeals to the public in Côte d’Ivoire to attend vaccination centres

Ideally, says WHO, countries should offer routine immunization against yellow fever, with catch-up campaigns where necessary. So far, however, only a minority of countries at risk have invested in routine immunization against the disease.

For the outbreak in Côte d’Ivoire, WHO, UNICEF, the Red Cross and other donors have spent US $1.1 million on vaccine and supplies. "Additional funds are urgently needed to complete financing of the operation," said WHO.


Phyllida Brown


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