An Old Disease with New Life: Yellow Fever in Uganda

Yellow fever has not existed in the US for a long, long time. However, Uganda is now facing an outbreak of one of the most feared viruses in history. Yellow fever has already infected an estimated 30 people in Uganda, with 7 confirmed deaths. If left unchecked, the outbreak could turn into a deadly epidemic.

Yellow fever is a hemorrhagic fever. The disease is transmitted by the aedes aegypti mosquito and is a member of the flavivirus family. Most people infected with the disease only show mild symptoms, but the lucky few who get full-on yellow fever experience delightful symptoms like fever, chills, pain, nausea, vomiting, fatigue and weakness. There is a period of remission (after which most patients recover). About 15% however, will go on to the severe form of the disease and contract jaundice (hence “yellow” fever), high fever, bleeding, and eventually organ failure. All in all, not really a disease you want to get.

The good news is that there is a vaccine for yellow fever. However, it simply has not been available in the quantities needed in Africa.  Only recently has Uganda been able to start vaccinating people in the area near where cases have been reported. This is disheartening since the first case was confirmed back in March. Additionally, the vaccines have reportedly been selling for 100,000 Ugandan shillings, or about 30 USD. Given that the average income for a Ugandan citizen is about 730 USD, this is a steep cost. It is unlikely than many people who need the vaccine will be able to afford it, even if the government is able to procure more vaccines.

Currently the WHO advises residents of member countries to avoid Uganda (it’s part of what’s called the “Yellow Fever Belt” which sounds NOT fun) and to make sure they are vaccinated if they must travel to the region. Hopefully the current outbreak will remain small. But since the Ugandan government is being really responsible with their vaccine pricing and policy, it’s questionable whether or not this will be the case.

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