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Yellow Fever Outbreak in Angola Situation Report 26 February 2016

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YELLOW FEVER OUTBREAK IN ANGOLA SITUATION REPORT 26 FEBRUARY 2016 Summary • A cluster of hemorrhagic fever cases iniated in early December was idenfied on 30 December 2015 in Viana district Luanda Angola" was confirmed by the yellow fever reference laboratory in Instute Pasteur in Dakar (IPD) on (anuary 20 2016. The high risk of transmission of the disease in the province of Luanda was then confirmed by a -.O e0pert mission. A massive vaccinaon was launched on 02 1ebruary 2016 in Viana district. -.O classified this outbreak as a 2rade 2 Emer4 gency according to Emergency Response 1ramework (ER1) criteria and an Incident 6anager and a .74A1RO Task 1orce were deployed to together with -.O Angola Team support the country in the fight against the 81 outbreak. • 9p to 26 1ebruary 2016 (Epid -eek 8 ;E-84 ) a total of 644 suspected cases (using a -.O case definion that includes the criterion of link with the main area of transmission i.e. the Km 30 market in Viana district) shows a sharp increase since E- 3. Considering the final classificaon cases there are 19 confirmed cases: 1A from Luanda and two imported cases from the provinces of .uambo (01) and CuanBa Sul (01). • Currently main intervenons include a massive vaccinaon campaign in Viana and Delas districts the first two districts idenfied with 81 virus transmission. The campaign will connue (Eust arrived more vaccines) in the remaining districts with infecon unl compleon in all the province of Luanda . Outbreak invesgaon in .uambo is completed and is on4 going in .uila and will start in CuanBa Sul this weekend. A Fuick survey for the impact of the vaccinaon in the trend of suspected cases and deaths in Viana district will start soon. I. Surveillance • Since 30 December 2015 and 24 1ebruary 2016 595 suspected cases with 119 deaths were nofied at country level. Of them 449 cases (A5G) Vaccinaon campaign 02 1eb and A8 deaths (66G) were reported in Luanda Province • AHer reviewed the laboratory results and the epidemiological database the final classificaon is as follow: ⇒ There are a total of 19 confirmed cases. 1A cases are from the province of Luanda (12 from Viana 2 from Delas and 1 from the districts of 6aianga CaBenga and SambiBanga respecvely). The two other cases are one from the province of .uambo and an4 other from the province of KwanBa Sul. ⇒ All the confirmed cases from provinces are imported from Luanda and no local transmission is confirmed aHer the invesgaon in .uambo. The invesgaon in CuanBa Sul is sll pending. Yellow fever vaccination campaign in Belas and Viana districts Luanda Province 02 to 25 February 2016 District Target Vaccinated G population up to advance 24/02/2016 B elas* 1 046 A13 A 15 4A 2 6 8 G Viana** 1 500 381 1 A98 019 1 20 G Luanda 6 626 200 2 281 424 3 8 G * initiated on 19 Feb 2016 **initiated on 02 Feb 20 data II.- Response • VACCIIATIOI ⇒ The campaign was conducted without the parcipaon of Army sanitary teams. There were not enough vaccinaon points due to the reduced personnel. Security and logiscs issues connued and eJecve hours of vaccinaon were reduced due to severe rains in the city. OrganiBaon constraints related to low availability of funds to cover operaonal costs connued and is a big concern for the oncoming phases of vaccinaon in the province. ⇒ 6O. has not provided complete informaon about the use of about 29G (1/3) of the total vaccine doses received by the country. InsuLcient supervision low Fuality vaccinaon and incomplete logisc supports are the current is4 sues. • CASE INVESTIGATION ⇒ Since the 26th 1eb. 2016 there is availability of yellow fever PCR tesng with the support of CDC Atlanta. ⇒ A commiMee created for issue final classificaon of cases is receiving the assistance of the 81 -.O focal point. ⇒ An invesgaon team is deployed to CuanBa Sul a province with a confirmed cases imported from Luanda and will cover two districts ⇒ The invesgaon team returned from .uambo province and found that the case with posive PCR 81 test has not received vaccine previously. Preliminary report indicate high entomological indicators in 6/A of the visited districts COORDINATION— CDC is developing a matri0 to capture the minutes of the naonal coordinaon as so far there is no record available. Sharing informaon and inputs to take informed decisions is crical on idenfied priories by the 6O. and partners. SOCIAL MOBILIZATION— Acvies developed include: 4 radio and TV spots finiliBed and approved 4 training of 50 Red cross social mobiliBaon acvists in Viana 4 agreement with 9IITEL for diJusion of S6S message about prevenon and control of 81 by cellphones 4producon of Nyers to support social mobiliBaon acvies in the districts. GAPS AND CHALLENGES • The high proporon of non reported vaccine doses in the count of populaon vaccinated connued to be a big con4 cern. -ith the new arrival of vaccines idenfy and deliver control measures in diJerent level become crical. • 9navailability of funds for operaonal costs threats not only the Fuality of vaccinaon campaign but also the delivery of the vaccinaon in the other district of the province. Preparaon of district reliable plans is a pending issue to veri4 fy. • The connue number of suspected cases reFuires an in4depth invesgaon to rule out other causes of morbidity and mortality in the populaons specially of the district of Viana. STRATEGIC ANALYSIS • Suspected cases nofied by Luanda (specially Viana and Delas) as well as in provinces (those classified as imported) need a carefully evaluaon to idenfy risk factors (pocket of vulnerable populaon and/or hotspots areas with vec4 tor with high capacity of transmission). This informaon will enable further intervenon necessary to reduce case4 load and e0pansion in new areas • Luanda is not prepared enough to deliver a Fuality campaign to complete the vaccinaon in this area • 1und raising is a high priority factor to be addressed in the short term WHO SUPPORT - During it first 3 Level TC on 1riday the 26 1eb. 2016 resource mobiliBaon for addional funds was thoroughly discussed. Several sources of funds were idenfied and the CO was invited to e0plore all of them. 1und raising and advocacy meeng with donors and stakeholders were suggested. Two members of the I6S will parcipate in the case invesgaon mission of the Province of CuanBa Sul PARTNERS SUPPORT.– 6S1 oJer to 6O. to organiBe and deliver the vaccinaon in an area of Luanda to be idenfied. CDC completed the preparaon of the Iaonal Public .ealth Instute laboratory for the test of PCR for 81. It is currently available RESOURCE MOBILIZATION — -.O is developing an appeal of 500 000 9SD for the Conngency 1und for Emergency (C1E) to cover some financial gaps of the vaccinaon campaign. Connue fundraising search to e0tend source of funding. .
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