Reemergence of yellow fever in Ethiopia after 50 years, 2013: epidemiological and entomological investigations
Reemergence of yellow fever in Ethiopia after 50 years, 2013: epidemiological and entomological investigations
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DOI：
10.1186/s12879-017-2435-4
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发表时间：
2017-05-15
影响因子：
3.7
通讯作者：
Mengesha, Debritu
中科院分区：
文献类型：
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作者：
Lilay, Abrham;Asamene, Negga;Mengesha, Debritu
背景：黄热病是一种由伊蚊传播的病毒性出血性疾病。全世界每年约有20万例病例和3万例死亡。在埃塞俄比亚，最后一次爆发是在1966年，有2200例病例和450例死亡。从2012年11月开始，南阿里县报告了一些不明发热性疾病死亡病例。进行了调查，以确定病原体，爆发的来源，并建议适当的interventions.Methods：医疗记录进行了审查，病人和临床医生参与管理的情况下进行了采访。按时间、地点和人员进行描述性数据分析。采集血清样本进行血清学分析，使用酶联免疫吸附试验进行初步筛选，并使用空斑减少和中和试验进行确证试验。结果：2012年11月至2013年10月，南奥莫区共报告疑似YF病例141例，死亡43例，病死率为30.5%。所有年龄组均受影响（平均27.5岁，范围1-75岁）。黄疸占85.1%，发热占56.7%。在21份样本中，有7份样本的YF病毒IgM呈阳性。经鉴定，雀麦伊蚊和埃及伊蚊为黄热病的主要传播媒介。Arkisha和Aykamer Kebeles的Breteau指数分别为44.4%和33.3%，而容器指数分别为12.9%和22。结论：调查显示，埃塞俄比亚暴发疫情50年后再次出现。应在受影响的地区和邻近地区接种疫苗，并应启动基于病例的监测，以发现每一个病例。
Background: Yellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito species. Approximately, 200,000 cases and 30,000 deaths occur worldwide every year. In Ethiopia, the last outbreak was reported in 1966 with 2200 cases and 450 deaths. A number of cases with deaths from unknown febrile illness reported from South Ari district starting from November 2012. This investigation was conducted to identify the causative agent, source of the outbreak and recommend appropriate interventions.Methods: Medical records were reviewed and Patients and clinicians involved in managing the case were interviewed. Descriptive data analysis was done by time, person and place. Serum samples were collected for serological analysis it was done using Enzyme-linked Immunosorbent Assay for initial screening and confirmatory tests were done using Plaque Reduction and Neutralization Test. Breteau and container indices were used for the entomological investigation to determine the risk of epidemic.Results: A total of 141 Suspected YF cases with 43 deaths (CFR = 30.5%) were reported from November 2012 to October 2013 from South Omo Zone. All age groups were affected (mean 27.5, Range 1-75 Years). Of the total cases, 85.1% cases had jaundice and 56.7% cases had fever. Seven of the 21 samples were IgM positive for YF virus. Aedes bromeliae and Aedes aegypti were identified as responsible vectors of YF in affected area. The Breteau indices of Arkisha and Aykamer Kebeles were 44.4% and 33.3%, whereas the container indices were 12.9% and 22. 2%, respectively.Conclusion: The investigation revealed that YF outbreak was reemerged after 50 years in Ethiopia. Vaccination should be given for the affected and neighboring districts and Case based surveillance should be initiated to detect every case.