East Africa tightens travel to contain yellow fever spread

It may soon be harder to cross the border into any East African country without a yellow fever certificate if a new policy to reintroduce the stringent measures of old is adopted.

According to the new guidelines, East Africans planning to go to any of the six countries within the EAC will be required to show proof that they have been vaccinated against yellow fever 10 days before their actual travel date.

This, therefore, means that anyone without a valid yellow fever vaccination certificate will be denied entry to either Kenya, Tanzania, Uganda, Rwanda, Burundi or Sudan, explained Dr Michael Katende, the acting head of the health department at the East African Community Secretariat in Arusha.

“We continue to have our surveillance system in place, and shall continue to insist on the yellow fever certificate especially if you are coming from a country which has been known to have few outbreaks,” said Dr Katende.

The request for the certificates and insistence on using the vaccination is for protection, Dr Katende said, was prompted by the recent increased in outbreaks in the region.

“We are also alive to the fact that by virtue of the EAC region bordering DRC, a country with a huge forest cover and biodiversity, we need to heighten our surveillance,” he said.

Yellow fever is a viral infection spread by a type of mosquito. The infection is most common in Africa and South America, affecting travellers to and residents of those areas.

ROUTINE SURVEILLANCE

Two weeks ago, Ugandan Health Ministry declared a yellow fever outbreak after laboratory test confirmed cases were reported from Koboko and Masaka districts, located in the northern and central regions of the country, according to a bulletin from the WHO African regional office.

Officials identified two cases of yellow fever in March, when routine surveillance showed the virus in an 80-year-old woman and a 10-year-old girl, neither of whom had been vaccinated against it.

“On May 14, the Ministry of Health notified WHO of a yellow fever outbreak in the Koboko and Masaka districts located in the Northern and Central region of the country respectively. The outbreak was declared in-country on May 6 following laboratory confirmations from the regional yellow fever reference laboratory, the Uganda Virus Research Institute,” says the WHO status report.

In mild cases, yellow fever causes a fever, headache, nausea and vomiting. But it can become more serious, causing heart, liver and kidney problems along with bleeding (haemorrhaging). Up to 50 per cent of people with the more-severe form of yellow fever die of the disease.

DEADLY AND MOSQUITO-BORNE

Although there is no specific treatment for yellow fever, getting vaccinated before travelling to an area in which the virus is known to exist can protect you from the disease.

Rapid response teams were sent to the villages of both patients and found an additional seven cases of yellow fever, and a “substantial population of unvaccinated individuals due to immigration and missing the yellow fever reactive vaccination campaign, which was conducted in 2016.”

“Although the occurrences are on and off, we still have outbreaks of the disease. We already have enough outbreaks within East Africa, prompting us to maintain their surveillance,” added Dr Katende.

The region has been on high alert since 2016 when there was an outbreak in Angola.

Last year, the disease seemed to get inches closer after the deadly mosquito-borne disease killed 10 people in southwestern Ethiopia forcing the World Health Organisation to release more than a million doses of yellow fever vaccine from its emergency stockpile.

In Africa, Tanzania and South Africa require a valid yellow fever certificate from all citizens and non-citizens (over one year of age) travelling from a yellow fever risk country.

In South Africa, if a traveller is unable to produce a valid yellow fever vaccination certificate at the point of entry, entry is denied and the traveller is placed under quarantine until they are vaccinated.

In East Africa, only Tanzania demands proof of vaccination against yellow fever from visitors upon arrival at the airport. Uganda, however, tightened its rules in 2016 following a WHO recommendation that the country review its yellow fever vaccination policy, and that people from high-risk countries show proof of vaccination.

Kenya followed suit by putting the country on high alert.

Vaccination certificates are routinely checked at points of entry for travellers arriving from countries designated as high risk for yellow fever transmission. Persons who have been in transit exceeding 12 hours through the airport of a country with high risk of yellow fever transmission are also required to produce proof of vaccination upon arrival.

Travellers with an exemption certificate due to medical reasons will be allowed entry, but will be placed under quarantine and/or will be required to report any fever or other symptoms to health authorities.

The WHO guidelines require countries at risk of yellow fever to obtain vaccination certificates from individuals travelling from areas determined by the WHO to be at risk; it also recommends disinfecting aircraft, ships, tyre-casing consignments and other modes of transportation coming from a risk area.