Yellow Fever Outbreak in Angola Incident Management
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YELLOW FEVER OUTBREAK WEEKLY SITUATION REPORT, INCIDENT MANAGEMENT TEAM—ANGOLA YELLOW FEVER OUTBREAK IN ANGOLA INCIDENT MANAGEMENT th Vol: 7-05 SITUATION REPORT W30, 29 July 2016 I. Key Highlights The objectives of the response during this phase are to maintain a strong surveillance and case finding system complete vaccination in strategic at- risk districts and continue vector control activities. This strategy will continue until at least one month without cases after the start of rains, expected in September The Joint Technical Review Mission debriefed with IMS partners and Angola MoH. A final report is expected this week. IMs and partners conducted a meeting to incorporate preliminary recommendations to operational plans The next vaccination phase targeting 3 million people in 18 districts is expected to start on August 10th. The Ministry of Health released a circular letter through its National Institute of Public Health reminding of the need to obtain ethical approval for all research activity and data collection, and the interdiction of sharing data relative to the outbreak without previous authorization MoH general coordination meetings have been suspended and will be held on specific occasions as needed. Technical meetings and sub-committee meetings will continue as usual II. Epidemiological Situation as of 2016 Table 1: National Summary of Yellow Fever Outbreak Week 30 statistics (22 to 28 July): Yellow Fever Outbreak Summary 22 — 28 July 2016, (W30) Of 69 suspected cases reported, 65 samples were laboratory tested. None were Reported cases 69 positive to yellow fever Samples tested 65 5 deaths were reported among the suspected cases Confirmed cases 0 26 districts in 10 provinces reported suspected cases of yellow fever. No Total Deaths 5 district was newly reporting and no districts reported local transmission for its Total provinces that reported cases 10 first time this week New provinces with confirmed cases 0 Total districts with reported cases 26 Cumulative statistics since 05 December: New districts with confirmed cases 0 New districts with documented local transmission 0 A total of 879 laboratory confirmed cases have been reported out of 3,818 Yellow Fever Outbreak Summary from 5 Dec 2015— 28 July 2016 suspected cases and 3,294 laboratory tests Total cases reported to central level 3,818 Overall, 369(CFR 9.7%) deaths were reported among suspected cases and 119 Total Samples Tested 3,294 (CFR 13.5%) among confirmed cases Total confirmed cases 879 Laboratory confirmed cases have been reported for 16 out of 18 provinces and Total deaths 369 for 80 out of 126 reporting districts. Luanda province reported the majority of Total deaths among confirmed cases 119 the confirmed cases 487 (55.5%), followed by Huambo 127 (14.5%) and Ben- Total provinces that have reported cases 18 guela 116 (13.2%) Total provinces with confirmed cases 16 No laboratory confirmed cases of yellow fever have been reported in Luanda or Total districts that have reported cases 126 Huambo since May Total districts with confirmed cases 80 Local transmission has been documented in 45 districts in 12 provinces Total provinces with documented local transmission 12 Total districts with documented local transmission 45 The majority of the confirmed cases are in males 15—19 yrs; 215 (20.8%), Total number of provinces in Angola 18 followed or 20—24 yrs; 173 (16.7%) Total number of districts in Angola 166 Fig.1. Yellow Fever Suspected and Confirmed Cases - Angola 5 Dec 2015— 28 July 2016 250 Confirmed cases Probable cases 200 Negative/discarded cases 150 113 96 58 100 36 77 27 26 39 50 14 27 85 84 14 79 18 9 18 56 62 66 9 5 5 16 24 52 41 46 29 27 33 25 29 29 37 26 8 12 2 1 3 6 11 25 12 6 7 No. of Reprted yellow Fever Cases Fever yellow No.of Reprted 0 0 10 10 0 0 4 7 2 3 05 06 09 05 02 W-6 W-1 W-2 W-3 W-4 W-5 W-7 W-8 W-9 W-18 W-30 W-49 W-50 W-51 W-52 W-53 W-10 W-11 W-12 W-13 W-14 W-15 W-16 W-17 W-19 W-20 W-21 W-22 W-23 W-24 W-25 W-26 W-27 W-28 W-29 Jan Feb Mar Apr May Jun Jul 2015 2016 Week of onset Incomplete data Source: MOH, Angola 1 YELLOW FEVER OUTBREAK WEEKLY SITUATION REPORT, INCIDENT MANAGEMENT TEAM—ANGOLA 180 Fig.2 Yellow Fever Suspected and Confirmed Cases - Luanda Province 5 Dec 2015— 28 July 2016 160 Confirmed cases Probable cases Negative/discarded cases 140 120 100 75 80 85 47 27 19 60 54 15 40 27 15 58 56 57 50 6 20 40 41 10 No. of Reprted yellow Fever Cases Fever yellow of Reprted No. 17 28 3 27 21 4 9 4 20 17 2 2 14 6 7 3 7 11 8 9 0 20 01 01 10 0 3 5 6 6 5 4 04 0 01 0 01 02 0 02 02 W-1 W-2 W-3 W-4 W-5 W-6 W-7 W-8 W-9 W-49 W-50 W-51 W-52 W-53 W-10 W-11 W-12 W-13 W-14 W-15 W-16 W-17 W-18 W-19 W-20 W-21 W-22 W-23 W-24 W-25 W-26 W-27 W-28 W-29 W-30 Jan Feb Mar Apr May Jun Jul 2015 2016 Week of onset Incomplete data Fig.3 Yellow Fever Suspected and Confirmed Cases - Huambo province 5 Dec 2015— 28 July 2016 60 Confirmed cases Probable cases Negative/discarded cases 50 40 30 3 20 8 4 9 5 10 20 6 4 0 7 7 15 1 1 12 4 11 9 2 8 3 No. of Reprted yellow Fever Cases Fever yellow Reprted of No. 8 6 8 7 7 1 1 3 4 4 4 2 4 0 0 0 0 1 2 0 0 01 2 20 1 1 0 0 0 0 0 0 0 W-1 W-2 W-3 W-4 W-5 W-6 W-7 W-8 W-9 W-10 W-11 W-12 W-13 W-14 W-15 W-16 W-17 W-18 W-19 W-20 W-21 W-22 W-23 W-24 W-25 W-26 W-27 W-28 Jan Feb Mar Apr May Jun Jul 2016 Incomplete data Week of onset Fig.4 Yellow Fever Suspected and Confirmed Cases - Benguela province 5 Dec 2015— 28 July 2016 50 45 Confirmed cases Probable cases Negative/discarded cases 40 35 30 25 20 0 15 1 2 1 10 3 4 4 17 0 13 12 12 3 No. of Reprted yellow Fever Cases Fever yellow of Reprted No. 5 0 0 2 9 9 0 0 7 7 1 4 5 0 4 2 0 4 0 0 1 3 3 3 2 2 1 1 0 2 0 1 1 1 0 1 1 1 0 0 0 0 0 W-3 W-4 W-5 W-6 W-7 W-8 W-9 W-10 W-11 W-12 W-13 W-14 W-15 W-16 W-17 W-18 W-19 W-20 W-21 W-22 W-23 W-24 W-25 W-26 W-27 W-28 W-29 Feb Mar Apr May Jun Jul Week of onset Incomplete data 2 Source: MOH, Angola YELLOW FEVER OUTBREAK WEEKLY SITUATION REPORT, INCIDENT MANAGEMENT TEAM—ANGOLA Table 2. Provinces with Yellow Fever Laboratory Confirmation up to 28 July, 2016 Fig.5: Yellow Fever Cases with Local Transmission and Vaccination Provinces & Districts in Angola, 5 Dec 2015— 28 July 2016 Cumulative (5 Dec 2015— 28 July 2016) Discarded, Districts vaccinated or ongoing Province Lab with High risk districts or with local transmission not vaccinated Notified Tested Confirmed Vacc. History Other districts reporting cases Cases No % No % Districts with no case Luanda 2010 1649 82 487 24 124 Bengo 25 25 100 6 24 0 Benguela 417 397 95 116 28 22 Bie 36 34 94 16 44 0 Cabinda 43 37 86 1 2 0 Cuando Cubango 9 8 89 1 11 0 Cuanza Norte 79 69 87 11 14 1 Cuanza Sul 132 127 96 16 12 0 Cunene 58 57 98 15 26 0 Huambo 613 557 91 127 21 26 Huila 142 93 65 33 23 0 Lunda Norte 72 71 99 26 36 1 Lunda Sul 13 12 92 0 0 1 Malange 28 27 96 7 25 0 Moxico 6 6 100 0 0 0 Namibe 14 14 100 2 14 0 Uige 82 80 98 9 11 0 Zaire 39 31 79 6 15 0 TOTAL 3818 3294 86 879 23 175 Fig. 6. Age group distribution of Yellow Fever cases in Angola 900 Negative/Discarded 800 Probable 700 Confirmed 600 430 500 349 400 358 333 300 146 258 162 115 200 194 No. of Reprted Yellow Fever Cases Yellow Reprted of No. 92 112 95 71 71 100 215 48 173 45 101 105 91 45 81 56 0 0 - 4Y 5 - 9Y 9 - 14Y 15 - 19Y 20 - 24Y 25 - 29Y 30 - 34Y 35Y+ Fig.7: National Trend of Yellow Fever Suspected and Confirmed Cases in Angola out of Luanda Province 5 Dec 2015— 28 July 2016 2500 Negative/Discarded Probable 2000 Confirmed 1500 1000 460 500 No. of Reprted yellow Fever Cases Fever yellow of Reprted No.