The enigma of yellow fever in East Africa

Brett R. Ellis, Alan Barrett

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Despite a safe and effective vaccine, there are approximately 200 000 cases, including 30 000 deaths, due to yellow fever virus (YFV) each year, of which 90% are in Africa. The natural history of YFV has been well described, especially in West Africa, but in East Africa yellow fever (YF) remains characterised by unpredictable focal periodicity and a precarious potential for large epidemics. Recent outbreaks of YF in Kenya (1992-1993) and Sudan (2003 and 2005) are important because each of these outbreaks have involved the re-emergence of a YFV genotype (East Africa) that remained undetected for nearly 40 years and was previously unconfirmed in a clinically apparent outbreak. In addition, unlike West Africa and South America, YF has yet to emerge in urban areas of East Africa and be vectored by Aedes (Stegomyia) aegypti. This is a significant public health concern in a region where the majority of the population remains unvaccinated. This review describes historical findings, highlights a number of disease indicators and provides clarification regarding the natural history, recent emergence and future risk of YF in East Africa.

Original languageEnglish (US)
Pages (from-to)331-346
Number of pages16
JournalReviews in Medical Virology
Volume18
Issue number5
DOIs
StatePublished - Sep 2008

Fingerprint

Yellow Fever
Eastern Africa
Yellow fever virus
Disease Outbreaks
Western Africa
Natural History
Sudan
South America
Aedes
Kenya
Periodicity
Vaccines
Public Health
Genotype
Population

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

The enigma of yellow fever in East Africa. / Ellis, Brett R.; Barrett, Alan.

In: Reviews in Medical Virology, Vol. 18, No. 5, 09.2008, p. 331-346.

Research output: Contribution to journalArticle

Ellis, Brett R. ; Barrett, Alan. / The enigma of yellow fever in East Africa. In: Reviews in Medical Virology. 2008 ; Vol. 18, No. 5. pp. 331-346.
@article{c37afdda3b3a4f40aa5928fe3b5138d2,
title = "The enigma of yellow fever in East Africa",
abstract = "Despite a safe and effective vaccine, there are approximately 200 000 cases, including 30 000 deaths, due to yellow fever virus (YFV) each year, of which 90{\%} are in Africa. The natural history of YFV has been well described, especially in West Africa, but in East Africa yellow fever (YF) remains characterised by unpredictable focal periodicity and a precarious potential for large epidemics. Recent outbreaks of YF in Kenya (1992-1993) and Sudan (2003 and 2005) are important because each of these outbreaks have involved the re-emergence of a YFV genotype (East Africa) that remained undetected for nearly 40 years and was previously unconfirmed in a clinically apparent outbreak. In addition, unlike West Africa and South America, YF has yet to emerge in urban areas of East Africa and be vectored by Aedes (Stegomyia) aegypti. This is a significant public health concern in a region where the majority of the population remains unvaccinated. This review describes historical findings, highlights a number of disease indicators and provides clarification regarding the natural history, recent emergence and future risk of YF in East Africa.",
author = "Ellis, {Brett R.} and Alan Barrett",
year = "2008",
month = "9",
doi = "10.1002/rmv.584",
language = "English (US)",
volume = "18",
pages = "331--346",
journal = "Reviews in Medical Virology",
issn = "1052-9276",
publisher = "John Wiley and Sons Ltd",
number = "5",

}

TY - JOUR

T1 - The enigma of yellow fever in East Africa

AU - Ellis, Brett R.

AU - Barrett, Alan

PY - 2008/9

Y1 - 2008/9

N2 - Despite a safe and effective vaccine, there are approximately 200 000 cases, including 30 000 deaths, due to yellow fever virus (YFV) each year, of which 90% are in Africa. The natural history of YFV has been well described, especially in West Africa, but in East Africa yellow fever (YF) remains characterised by unpredictable focal periodicity and a precarious potential for large epidemics. Recent outbreaks of YF in Kenya (1992-1993) and Sudan (2003 and 2005) are important because each of these outbreaks have involved the re-emergence of a YFV genotype (East Africa) that remained undetected for nearly 40 years and was previously unconfirmed in a clinically apparent outbreak. In addition, unlike West Africa and South America, YF has yet to emerge in urban areas of East Africa and be vectored by Aedes (Stegomyia) aegypti. This is a significant public health concern in a region where the majority of the population remains unvaccinated. This review describes historical findings, highlights a number of disease indicators and provides clarification regarding the natural history, recent emergence and future risk of YF in East Africa.

AB - Despite a safe and effective vaccine, there are approximately 200 000 cases, including 30 000 deaths, due to yellow fever virus (YFV) each year, of which 90% are in Africa. The natural history of YFV has been well described, especially in West Africa, but in East Africa yellow fever (YF) remains characterised by unpredictable focal periodicity and a precarious potential for large epidemics. Recent outbreaks of YF in Kenya (1992-1993) and Sudan (2003 and 2005) are important because each of these outbreaks have involved the re-emergence of a YFV genotype (East Africa) that remained undetected for nearly 40 years and was previously unconfirmed in a clinically apparent outbreak. In addition, unlike West Africa and South America, YF has yet to emerge in urban areas of East Africa and be vectored by Aedes (Stegomyia) aegypti. This is a significant public health concern in a region where the majority of the population remains unvaccinated. This review describes historical findings, highlights a number of disease indicators and provides clarification regarding the natural history, recent emergence and future risk of YF in East Africa.

UR - http://www.scopus.com/inward/record.url?scp=52649171434&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=52649171434&partnerID=8YFLogxK

U2 - 10.1002/rmv.584

DO - 10.1002/rmv.584

M3 - Article

C2 - 18615782

AN - SCOPUS:52649171434

VL - 18

SP - 331

EP - 346

JO - Reviews in Medical Virology

JF - Reviews in Medical Virology

SN - 1052-9276

IS - 5

ER -