yellow fever outbreak in darfur, sudan situation report no...
TRANSCRIPT
Highlights
As of 19 December 2012, 26% of Nyala’s targeted population as well as 88% of the targeted population of
Forbranga locality in West Darfur were vaccinated against yellow fever during Phase II of the vaccination
campaign. The campaign commenced on 9 December in West Darfur, 17 December in South Darfur, and on
18 December in Central Darfur.
The outbreak has now affected 34 localities in Central, South, West, North, and East Darfur. As of 19 December,
the total number of suspected cases has reached 836, including 168 deaths (case fatality rate of 20.1%).
As part of the emergency response plan, WHO recommended the third phase of vaccination campaign for
approximately 2 million people residing in Kabkabyaia, Edd Elfursan (including Kabum locality), Elwihda,
Shaeriya (including Yassin locality), Eldaen, Rokiro and Um Dukhun.
United Kingdom’s Department for International Development (DFID) is supporting Phase-III of the yellow fever vaccination campaign with USD2.9 million and the United States Agency for International Development (USAID) with USD 500,000. Phases I and II have been supported by CERF, ECHO and the Government of Sweden.
To further asses the epidemic risks in other areas of the country, the national yellow fever risk assessment commenced on 12 December. The final report is expected to be released in February 2013.
Epidemiology Out of 64 localities in Darfur, 34 localities are affected by the yellow fever outbreak. Between 2 September and 19 December, the total number of suspected yellow fever cases has reached 836,
including 168 deaths (CFR 20.1%). About 52.2% of the reported cases are from Central Darfur, 9.5% are from South Darfur, 17.4% are from West
Darfur and 20.3% are from North Darfur. 1.1% of the reported cases are in the age group 0-1.9, 2% is in the age group 2-4.9, 18.3% are in the age group
5-14.9, 54.5% are in the age 15-29.9 and 17.1% are 30-44.9 years and 7% are in the age group of 45 years and above.
In the presence of Sudan’s Health Minister Bahr Idriss Abu-Garda, a memorandum of understanding between DFID and WHO regarding UK’s support for Phase III of the vaccination campaign amounting to £1.8 million (USD2.9 million) was signed by DFID’s Head in Sudan Ben Mellor and WHO Representative in Sudan Dr Anshu Banerjee. Photos courtesy of DFID
Yellow Fever Outbreak in Darfur, Sudan
Situation Report No 14, 20 December 2012 Federal Ministry of Health | World Health Organization
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Suspected cases of yellow fever by date of onset in Central , South, West, East and North Darfur between 2 September to 19 December, 2012 (Source FMoH)
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W 36 W 37 W 38 W 39 W 40 W 41 W 42 W 43 W 44 W 45 W 46 W 47 W 48
no
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s
Epid Week (W 32--)
Suspected cases of Yellow fever and reported deaths in Central and South Darfur in the period W 36 to W 48 (Source FMoH)
DEATHS
CASES
Table below shows the number of sentinel sites reporting daily and percentage represented against the total number of surveillance sites in Greater Darfur (19 December 2012):
State No. of sentinel sites % of daily surveillance report
Central Darfur 45 84.4%
South Darfur 120 96.7%
West Darfur 88 81.8% North Darfur 68 57.4%
East Darfur 25 100% Total 346 83.8%
Table below shows attack rate (AR), case fatality rate (CFR) and status of laboratory samples per locality in affected localities in Greater Darfur between 2 September and 19 December 2012.
State Locality
No of cases
Attack rate/10000 population
Deaths CFR Laboratory samples Total(+ve YF)(-ve YF) Pd
South Darfur
S.Algabal 9 6.0 7 77.8% 2 0 0 2 Kass 25 11.8 13 52% 11 5 4 2 Mershing 3 1.5 1 33.3% 2 1 0 1 Kubum 8 2.6 1 12.5% 11 0 8 3 Nyala 11 2 1 9.1% 18 2 3 13 Ed Elfirsan 12 4.4 1 8.3% 7 1 2 4 R. Albirdy 5 1.7 1 20% 2 0 1 1 Shataia 1 2.4 0 0% 0 0 0 0 Alsalam 4 4.1 1 25% 4 1 2 1 Tulus 1 0.8 0 0% 1 0 1 0 Belail 1 0.5 0 0% 0 0 0 0 Sub Total 80 2.4 26 32.5% 58 10 21 27
Central Darfur
Zalingei 153 50.1 29 19% 9 4 5 0 Wadisalih 57 32.8 14 24.6% 5 5 0 0 Azoom 73 161.5 24 32.9% 6 4 2 0 Nertity 101 73.1 24 23.8% 19 4 6 9 Mukjer 18 18.5 0 0% 1 1 0 0 Bendisi 13 24.9 1 7.7% 1 1 0 0 Um Dukhun 16 11.9 3 18.8 % 0 0 0 0 Rokoro 6 5.0 0 0% 0 0 0 0 Sub Total 437 40.9 95 21.7% 41 19 13 9
West Darfur
Genaina 27 9 6 22.2% 8 3 5 0 Beidha 34 9.8 10 29.4% 2 2 0 0 Habila 17 35.2 12 70.6% 2 1 1 0 Kernik 51 68.1 7 13.7% 7 4 2 1 Forbranga 9 13 0 0% 5 3 2 0 Jebel Moon 3 6.8 0 0% 2 0 1 1 Sirba 5 7.5 1 20% 3 0 3 0 Sub Total 146 14.7 36 24.7% 29 13 14 2
North Darfur
Saraf Omra 8 6.2 1 12.6% 5 3 2 0 Alseraif 157 223.5 8 5.1% 40 7 22 11 Kebkabyia 2 0.9 0 0% 28 2 22 4 Waha 1 2.9 0 0% 0 0 0 0 Elfashir 2 0.3 0 0% 1 0 1 0 Sub Total 170 5.3 9 7.3% 74 12 47 15
East Darfur
Assalaya 1 1.1 1 100% 1 0 1 0 Elddaen 1 3.4 1 100% 1 1 0 0 Yassin 1 3.4 0 0% 1 1 0 0 Sub Total 3 3.4 2 66.7% 3 2 1 0
Grand Total 836 9.9 168 20.1% 205 56 96 53
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%
fever bleeding vomiting headache joint pain Jaundice
Patients presented to health facilities with common symptoms. The most frequent symptoms are fever which is present in 95.3 % of the cases, bleeding in 45.3%, and jaundice in 45.5%. Figure (below) shows details of frequently reported symptoms.
Actions taken As of 19 December 2012, 19% of South Darfur targeted population (Nyala, Elsalam, Belail), 88% of the targeted
population of West Darfur (Forbranga), Bendisi 4% and Mukjer 5% of Central Darfur were vaccinated against
yellow fever during Phase II of the vaccination campaign. The campaign commenced on 17 December in South
Darfur, on 9 December in West Darfur and on 18December in Central Darfur.
Non-government organizations (ADRA, ARC, ICRC, IMC, Merlin, MSF-B, MSF-CH, MSF-E, SC-S, WVI) supported
Phase 1 and are supporting Phase 2’s operational costs for yellow fever vaccination campaigns. Till date they have contributed around USD 450,000.
Technical support teams from FMoH remain on ground in Central, South and West Darfur to continually conduct active search for new cases, as well as entomological surveys in affected areas. Blood banks in affected areas and localities where most cases are referred to have been prepositioned with required blood units, as well as laboratory supplies necessary for blood transfusion.
State Phase-I Phase-II
Locality coverage % Locality coverage %
West Darfur
Habila 94% Forbranga 88% Krenik
Geneina Beidha
North Darfur
Saraf Omra 97% - Alseref
Central Darfur
Azum 96% Mukjer 5% Wadi Salah Bendisi 4% Zalengei Nertiti
South Darfur
Kass 98% Nyala 26% Elsalam 14%
Jebel Marra Belail 8%
The national yellow fever risk assessment to explore the epidemic risk in other areas of the country started on 12 December and field work will continue until 29 December. Laboratory analysis will be done at the Central Public Health Laboratory with support from WHO Collaborating Centre Pasteur Institute in Dakar. The final report is expected to be released in February 2013.
The table below shows donors' support till date for the yellow fever vaccination campaign and case management.
Donor Amount
Central Emergency Response Fund (CERF) 2.6 million USD ECHO (European Commission’s Humanitarian Aid) 775,000 Euros Government of Sweden 1.5 million USD United Kingdom’s Department for International Development (DFID)
2.9 million USD
United States Agency for International Development (USAID)
500,000 USD
Recommendations There is a need to increase the sampling rate of suspected cases from all localities in order to better
characterize the outbreak, its spread and inform on vaccine need. WHO recommends that a detailed analysis and synthesis of all accumulated data be done as soon as possible
to determine the extent of YF virus circulation and guide further interventions.
Chad
Central African Republic
North Darfur
South DarfurEast Darfur
Central Darfur
West Darfur
Kutum Mellit
El Radoom
Sunta
Sheiria
Klaimendo
Bahr El Arab
El Kuma
Um Dafug
Katayla
El Taweisha
Gerida
Tawilla
KornoiKulbus
Buram
Niteaga
Um Buru
Alwehda
El Ferdous
Dar El Salam
Umm Keddada
El FasherCases: 2,
Lab_Sample: 1,+Ve_YF: 0
Wadi SalihCases: 57,
Lab_Sample: 5,+Ve_YF: 5
MukjarCases: 18,
Lab_Sample: 1,+Ve_YF: 1
ZalingeiCases: 152,
Lab_Sample: 9,+Ve_YF: 4
Ailliet
KereinikCases: 49,
Lab_Sample: 5,+Ve_YF: 4
El SireafCases: 157,
Lab_Sample: 22,+Ve_YF: 7
Dimsu
Rahad El BerdiCases: 5,
Lab_Sample: 2,+Ve_YF: 0
Ed DaeinCases: 1,
Lab_Sample: 1,+Ve_YF: 1
El SalamCases: 4,
Lab_Sample: 3,+Ve_YF: 1
Umm DukhunCases: 16,
Lab_Sample: 0,+Ve_YF: 0
KebkabiyaCases: 2,
Lab_Sample: 2,+Ve_YF: 2
YassinCases: 1,
Lab_Sample: 1,+Ve_YF: 1
KassCases: 25,
Lab_Sample: 8,+Ve_YF: 5
El Malha
Ed El FursanCases: 11,
Lab_Sample: 15,+Ve_YF: 1
Jebel MoonCases: 3,
Lab_Sample: 1,+Ve_YF: 0
BielelCases: 1,
Lab_Sample: 1,+Ve_YF: 0
AzumCases: 72,
Lab_Sample: 6,+Ve_YF: 4
KubumCases: 8,
Lab_Sample: 9,+Ve_YF: 0
El Tina
Sharq Jabel MarraCases: 9,
Lab_Sample: 0,+Ve_YF: 0
NertitiCases: 101,
Lab_Sample: 10,+Ve_YF: 4
SirbaCases: 5,
Lab_Sample: 4,+Ve_YF: 0
Abu Karinka
Abu Jabra
El GeneinaCases: 27,
Lab_Sample: 8,+Ve_YF: 3
BindisiCases: 13,
Lab_Sample: 1,+Ve_YF: 1
HabilaCases: 17,
Lab_Sample: 2,+Ve_YF: 1
BeidaCases: 34,
Lab_Sample: 3,+Ve_YF: 2
MarshangCases: 3,
Lab_Sample: 2,+Ve_YF: 1
RokoroCases: 6,
Lab_Sample: 0,+Ve_YF: 0
Saraf OmraCases: 8,
Lab_Sample: 3,+Ve_YF: 3
ShattaiCases: 1,
Lab_Sample: 0,+Ve_YF: 0
AssalayaCases: 1,
Lab_Sample: 1,+Ve_YF: 0Tullus
Cases: 1,Lab_Sample: 0,
+Ve_YF: 0
Foro BarangaCases: 9,
Lab_Sample: 5,+Ve_YF: 3
Nyala NorthNyala
Cases: 9,Lab_Sample: 8,
+Ve_YF: 2
Yellow Fever outbreak in Darfuras of 18 December 2012
Disclaimer: The presentation of material on the map contained herein does not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or areas or its authorities of its frontiers of boundaries.IMPORTANT:This map is used for planning purposes ONLY, state boundaries between West and Central, South and East Darfur States ARE NOT FIELD VERIFIED, and have been demarcated based on the locality boundaries stated by the Government of Sudan website (www.sudan.gov.sd). Localities boundaries ARE NOT FIELDVERIFIED and continuously being updated.
HISU-SUDANMap Ref.:2012-0053
North Darfur
South DarfurEast Darfur
West Darfur
Red Sea
SudanChad
Ethiopia
LibyaEgypt
Eritrea
Saudi Arabia
Central African Republic
NorthernNile
Red Sea
Northern KordofanGedaref
Kassala
Southern Kordofan
Sennar
Blue Nile
White NileEl Gezira
Khartoum
South Sudan
LegendYF-Cases
1 Dot = 1Cases
States Boundary-UnverifiedInternational BoundaryOther Darfur Locality
VaccinationVaccinated LocalityVaccination Target Phase 2Vaccination Target Phase 3
0 10 20 30 405 Kilometers
Data Source: Epidemiology and Zoonotic Diseases Directorate -Sudan Federal Ministry of Health &WHO- CDC Dec 2012.Printing Date: Dec 19,2012For further information or comments please contact us at:[email protected]. F