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Health

Angola's yellow fever outbreak exposes vaccine supply dilemma

The worst yellow fever outbreak in decades has killed 250 people in Angola and is straining global vaccine supplies, posing a dilemma for health officials who fear it could spread further in Africa and possibly into Asia.

Death rates as high as 75% in severe cases requiring admission to hospital

The worst yellow fever outbreakin decades has killed 250 people in Angola and is strainingglobal vaccine supplies, posing a dilemma for health officialswho fear it could spread further in Africa and possibly intoAsia.

Some experts have called for a radical switch in strategy touse just one-tenth of the usual vaccine dose to conserve scarcestocks but the World Health Organization (WHO) says it can't besure this would work.

Yellow fever is transmitted by the same mosquitoes thatspread the Zika and dengue viruses.

Most patients improve and their symptoms disappear after 3 to 4 days, according to the World Health Organization.

But death rates from yellow fever as high as 75 per cent in severecases requiring admission to hospital.

The condition, which takes its name from the jaundicedcolour of some patients, has spread to the Democratic Republicof Congo and there is concern it could gain a foothold for thefirst time in Asia.

The WHO says cases of yellow fever imported into China,which has close commercial ties with oil-rich Angola, show that"this outbreak constitutes a potential threat for the entireworld."

Low-dose vaccine proposed

And it is warning that further spread elsewhere in Africaand Asia would increase the squeeze on vaccine supplies and
could interrupt routine immunization.

Adding to the problem is the complicated process of makingyellow fever vaccine, which means there is no quick way to boostsupplies. Manufacturers, including the Institut Pasteur,government factories in Brazil and Russia, and French drugmakerSanofi, use a time-consuming method involving sterile chickeneggs.

A short-term solution could be to slash the dose, sinceresearch suggests just one-tenth can produce the same immuneresponse as a full dose, according to Jack Woodall, a retiredvirologist who formerly worked for the WHO and the U.S. Centersof Disease Control and Prevention.

"We need to get a low-dose vaccine authorized as soon aspossible because if we keep using full doses we will never catchup," he said.

Woodall and colleagues laid out the case for the emergencyuse of a one-tenth dose in an article in The Lancet medical
journal on April 16.

The WHO, however, is not convinced. A spokesman said moreresearch was needed to measure immune response in children andduration of protection. The availability of suitable syringesfor delivering a smaller dose was also a limiting factor, hesaid.

With files from CBC News