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  1. 1

    Yellow fever in Africa and South America, 2011-2012.

    Releve Epidemiologique Hebdomadaire. 2013 Jul 12; 88(28):285-96.

    This epidemiologic record discusses recent data about yellow fever outbreaks and cases in Africa and South America between 2011 and 2012. During this period, major outbreaks were reported in Sudan and Uganda while significant clusters of cases were reported in Cameroon, Chad and Cote d’Ivoire, necessitating an extended vaccination response. In addition, some isolated cases occurred in districts reporting high yellow fever vaccination coverage (Burkina Faso, Central African Republic, Togo), for which no vaccination response was undertaken. In South America, the World Health Organization American Region reported 32 cases (2011-2012), including 9 deaths, in Brazil, Ecuador, Plurinational State of Bolivia and Peru. As of 2012, most countries in the Caribbean and Latin America with enzootic areas had introduced the yellow fever vaccine into their national routine immunization schedules. The 2008 outbreaks in the Southern Cone expanded the area considered at risk to include northern Argentina and Paraguay. Building upon the yellow fever investment case strategy, which has reduced the frequency and size of disruptive outbreaks, the Yellow Fever Strategic Framework 2012-2020 prioritizes endemic countries according to their epidemic risk. This framework will enable WHO and partners to identify the populations’ high priority needs through a systematic approach so that limited resources can be allocated most effective to reduce the burden of yellow fever in Africa. Following a request from the countries, a form of yellow fever experts met in Panama to discuss how countries can make scientific evidence-based risk assessments and suggested that endemic countries should strive to enhance yellow fever surveillance systems.
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  2. 2

    Meeting of the Strategic Advisory Group of Experts on immunization, April 2013 - conclusions and recommendations.

    Releve Epidemiologique Hebdomadaire. 2013 May 17; 88(20):201-6.

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  3. 3
    Peer Reviewed

    An evaluation of infant immunization in Africa: Is a transformation in progress?

    Arevshatian L; Clements CJ; Lwanga SK; Misore AO; Ndumbe P

    Bulletin of the World Health Organization. 2007 Jun; 85(6):449-457.

    The objective was to assess the progress made towards meeting the goals of the African Regional Strategic Plan of the Expanded Programme on Immunization between 2001 and 2005. We reviewed data from national infant immunization programmes in the 46 countries of WHO's African Region, reviewed the literature and analysed existing data sources. We carried out face-to-face and telephone interviews with relevant staff members at regional and subregional levels. The African Region fell short of the target for 80% of countries to achieve at least 80% immunization coverage by 2005. However, diphtheria-tetanus-pertussis-3 coverage increased by 15%, from 54% in 2000 to 69% in 2004. As a result, we estimate that the number of nonimmunized children declined from 1.4 million in 2002 to 900 000 in 2004. In 2004, four of seven countries with endemic or re-established wild polio virus had coverage of 50% or less, and some neighbouring countries at high risk of importation did not meet the 80% vaccination target. Reported measles cases dropped from 520 000 in 2000 to 316 000 in 2005, and mortality was reduced by approximately 60% when compared to 1999 baseline levels. A network of measles and yellow fever laboratories had been established in 29 countries by July 2005. Rates of immunization coverage are improving dramatically in the WHO African Region. The huge increases in spending on immunization and the related improvements in programme performance are linked predominantly to increases in donor funding. (author's)
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  4. 4

    District guidelines for yellow fever surveillance.

    World Health Organization [WHO]. Division of Emerging and Other Communicable Diseases Surveillance and Control; World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    Geneva, Switzerland, WHO, Division of Emerging and Other Communicable Diseases Surveillance and Control, 1998. 59 p. (WHO/EPI/GEN/98.09)

    Yellow fever is a viral haemorrhagic fever transmitted by mosquitos infected with the yellow fever virus. The disease is untreatable, and case fatality rates in severe cases can exceed 50%. Yellow fever can be prevented through immunization with the 17D yellow fever vaccine. The vaccine is safe, inexpensive and reliable. A single dose provides protection against the disease for at least 10 years and possibly life-long. There is high risk for an explosive outbreak in an unimmunized population—and children are especially vulnerable—if even one laboratory-confirmed case of yellow fever occurs in the population. Effective activities for disease surveillance remain the best tool for prompt detection and response to an outbreak of yellow fever especially in populations where coverage rates for yellow fever vaccine are not high enough to provide protection against yellow fever. The guidelines in this manual describe how to detect and confirm suspected cases of yellow fever. They also describe how to respond to an outbreak of yellow fever and prevent additional cases from occurring. The guidelines are intended for use at the district level. (excerpt)
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  5. 5

    Yellow fever -- Technical Consensus Meeting, Geneva, 2-3 March 1998.

    World Health Organization [WHO]. Division of Emerging and Other Communicable Diseases Surveillance and Control

    Geneva, Switzerland, WHO, Division of Emerging and Other Communicable Diseases Surveillance and Control, 1998. 31 p. (WHO/EPI/GEN/98.08)

    The Yellow Fever Technical Consensus Meeting, organized jointly by EMC and GPV, was held in Geneva March 2-3, 1998 to examine the reasons for the dramatic re-surgence of outbreaks within the past 10-15 year period. Participants reviewed the strategies for the prevention and control of yellow fever in Africa and South America and identified the present barriers to implementation of effective programmes. The recommendations from this meeting will serve as the basis for action plans to reduce morbidity and mortality from yellow fever. With the recent increase in epidemics, yellow fever is once again a major public health concern. One important reason for the re-emergence of the disease is low immunization coverage in countries where the disease is present. Some reasons for poor coverage are lack of adequate funds for vaccine and injection equipment, lack of interested partners, and lack of political will and commitment for inclusion of yellow fever vaccine in the routine EPI. Where yellow fever has been included in EPI programmes, the overall performance of these programmes in some countries has not been adequate. Factors contributing to the spread of yellow fever outbreaks include an increase in the distribution and density of the mosquito vectors, and economic development that has caused increased intrusion of man into forested areas, substandard water systems that provide breeding sites for the vector, and widespread international air travel. Immunization coverage of less than 60% is not high enough to prevent epidemics. Depending on vegetation, vector efficiency, and vector density in the area, coverage of 80% or more may be needed to prevent disease outbreaks. Using these factors along with the interval since the last epidemic, urban to rural ratio, frequency of epidemics, and history of previous yellow fever immunization programmes, countries could be placed in order of priority for resources and financial assistance. (excerpt)
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  6. 6

    International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control. Report of the seventh meeting, Geneva, Switzerland, 18-19 September 2001.

    World Health Organization [WHO]. Department of Communicable Disease Surveillance and Response

    Geneva, Switzerland, WHO, 2002. 52 p. (WHO/CDS/CSR/GAR/2002.2)

    The seventh meeting of the International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control (ICG) was held on 18 and 19 September 2001 at the Palais des Nations, Geneva at the invitation of the WHO. This ICG meeting follows a scientific consultation meeting on the emergence of Neisseria meningitidis serogroup W135 as a public health problem. Dr Guenael Rodier, Director of the WHO Department of Communicable Disease Surveillance and Response, welcomed the participants. In his opening address Dr Rodier outlined the structure and the successes of the ICG partnership. He underlined some of the challenges that had arisen in recent times: the global vaccine shortage and the misunderstanding of countries about the goal of the ICG, which is to facilitate the timely supplies from a global buffer stock upon urgent request from countries affected by epidemic meningococcal disease. Although epidemic meningococcal disease is not one of the three priority communicable diseases for WHO, namely tuberculosis, HIV/AIDS and malaria, it remains a major public health problem in the African meningitis belt area. Disappointment was expressed that major vaccine manufacturers were absent from the meeting, however the report of the meeting will be shared with them and communications with these manufacturers will continue. The preliminary agenda was adopted by the meeting. Dr. Max Hardiman was elected chairman, with Steve Edgerton as rapporteur. (excerpt)
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  7. 7

    EPI Information System: global summary, August 1997.

    World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    Geneva, Switzerland, WHO, EPI, 1997. viii, 190 p. (WHO/EPI/GEN/97.02)

    The Expanded Program on Immunization Information System (EIS) collects, compiles, and distributes statistics on immunization coverage and communicable disease incidence. This document, based on reports submitted to the World Health Organization by Member States, contains three sections: 1) regional and global summaries for 1980-96 of immunization coverage with Bacille Calmette Guerin vaccine, the third dose of diphtheria toxoid-tetanus toxoid-pertussis vaccine, measles vaccine, the third dose of oral polio vaccine, the second and subsequent doses of tetanus toxoid vaccine, and yellow fever vaccine; 2) featured issues, including immunization program performance and countries in greatest need of improved performance; and 3) a reference section with country profiles and disease incidence and coverage tables. The country profiles also include data on population, newborns, child survival, the female literacy rate, and the per capita gross national product.
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