Juba, 26 October 2020 - It's a busy Saturday morning and the second day of the reactive yellow fever vaccination campaign in Kajo-keji County, Central Equatoria State. At exactly 8:00 am, when the vaccination team opened the center, Mr Basenso Loro eagerly waiting to receive his first-ever dose of the vaccines walked in majestically with his four children and his wife to receive the vaccines they have longed for.
"When I was reliably informed by my friend that cases of yellow fever have been confirmed in Kajo-keji, as a parent, I became so worried, I thought that I and my family members were going to be infected," said Mr Loro a 53-year-old resident of Rego village, Nyepo Payam, Kajo-keji County which is one of the five counties where the yellow fever vaccines are being administered.
"On Friday when I heard the vaccines have reached our village and we were to receive it for free, I became very excited and wanted to be the first to receive along with my family members. I'm so excited the vaccines came at the right time. I'm also confident that I'm protected from this disease" Mr Loro narrated.
"We never knew this vaccine was being brought to us, some of my friends crossed to neighboring Uganda where similar vaccination is ongoing to receive the vaccines" Loro added.
Ensuring the community is protected
Despite the COVID-19 pandemic, the Ministry of Health with support from Eliminate Yellow Fever Epidemics (EYE) partners including Gavi, the Vaccine Alliance, WHO, UNICEF and other partners launched a reactive yellow fever vaccination campaign in Kajo, Keji, Central Equatoria State.
The campaign aims to protect over 90 000 individuals aged 9 months to 60 years from yellow fever infection in Kajo Keji County. Vaccination is the primary means for prevention and control of yellow fever and a single dose of WHO approved yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against yellow fever disease.
The 5-day campaign that started on 23 October 2020 is being implemented within the national and WHO guidelines for implementing mass vaccination campaigns in the context of COVID-19.
In February this year, the Ministry of Health, with support from WHO, commissioned a cross-border outbreak investigation in Kajo-keji county after a yellow fever outbreak was declared in the bordering Moyo district, Uganda. A total of two laboratory-confirmed yellow fever cases were reported in March 2020 after the completion of comprehensive investigations in Kajo Keji County.
The plans to conduct an emergency yellow fever campaign were delayed after South Sudan confirmed the first COVID-19 cases in early April 2020. The campaign plans were reactivated in August 2020 following the completion of guidelines on conducting vaccination campaigns in the context of COVID-19. Consequently, the International Coordinating Group (ICG) on yellow fever vaccines approved 103 230 doses of yellow fever vaccines for the emergency campaign in Kajo-keji.
The reactive yellow fever vaccination is part of the global strategy to Eliminate Yellow Fever Epidemics by 2026. Based on the EYE strategy initiative, South Sudan is classified as a high risk country and thus, the strategic yellow fever control requirements entail: maintaining high population immunity; monitoring population immunity; case-based surveillance and laboratory testing; rapid response to outbreaks; targeting travelers in compliance with IHR (2005); and strengthening health systems readiness.
South Sudan last experienced yellow fever outbreak in November 2018 in Sakure Payam, Western Equatoria State. In response to the outbreak, the Ministry of Health with support from WHO, UNICEF and partners vaccinated over 19 500 individuals aged 9 months to 65 years against yellow fever.
In the last couple of years, WHO in collaboration with the Ministry of Health, UNICEF and partners intensified the preventive measures for high-risk areas, including the inclusion of the yellow fever vaccine into the national childhood routine immunization, review application process to fund implementation of country control strategies and review as well as update the national yellow fever vaccination requirements for international travelers.
In line with the EYE strategy requirement to mitigate the risk of cross-border yellow fever spread from high risk countries, WHO has supported the Ministry of Health with an additional 2,000 doses of yellow fever vaccines for international travelers.
"Yellow fever vaccination is mandated by the International Health Regulations (IHR 2005)", said Dr Olushayo Olu, WHO Representative for South Sudan. "The yellow fever vaccines, which is being delivered with support from Gavi, the Vaccine Alliance, will protect against the yellow fever virus and prevent the spread of the virus.
Yellow fever is a mosquito-borne acute viral hemorrhagic disease and has an incubation period of 3-6 days following infection. The infection can range from mild to severe.
Mild symptoms of yellow fever include fever, nausea, vomiting, headache, abdominal and muscle pains. More severe symptoms include hepatitis and hemorrhagic fever. Vaccination is the best protection against the virus and provides lifelong immunity.
In line with the IHR (2005) and the EYE strategy, the South Sudan Ministry of Health continues to implement yellow fever surveillance and response activities within the context of the Integrated Disease Surveillance and Response (IDSR) strategy. The IDSR strategy supports case based surveillance, testing, and response to suspect and confirmed yellow fever cases. The implementation of IDSR in South Sudan is supported by WHO with funding from United States Agency for International Development (USAID) and EU Humanitarian Aid (ECHO).
Dr Wamala Joseph Francis, Country Preparedness & IHR (CPI) Officer, Email: wamalaj [at] who.int
Mr Julu Louis Kenyi Joseph, WHO State Coordinator,Central Equatoria State, Email:louisju [at] who.int