EID Updates:

Emerging and Reemerging Infectious Diseases,
Region of the Americas

Vol. 5, No. 6 (25 February 2008)                             Main Updates index

Yellow Fever in Paraguay: Mobilization Continues

The Ministry of Health and Social Welfare ((Ministerio de Salud Pública y Bienestar Social / MSPBS) of Paraguay has confirmed 16 cases of yellow fever (YF), including 3 deaths. Cases have been reported in two different areas of the country:

1. San Pedro Department: Seven of the confirmed cases from this rural department are related to the jungle (sylvatic) cycle of the virus. All the cases are young males working or visiting the rural area of the department. Confirmation was done by laboratory (IgM +, viral isolation and/or PCR +) for four of them and by epidemiological link for the others. There is still one death under investigation in this area that is suspected to have occurred as a result of YF.
2. Central Department: Nine of the confirmed cases (including three deaths) occurred in the urban area of the municipality of San Lorenzo, about 15 km from the capital city of Asunción. Two of them were confirmed by laboratory viral isolation; the others, by epidemiological link. Additionally, there are two suspected cases (1 death) under investigation in this area.

Control Measures: The Ministry of Health has strengthened public health containment measures. Integrated control measures are underway involving mass vaccination for people living in, or travelling to, the affected area. The yellow fever vaccine shortage has been addressed by mobilizing vaccines available in the countries of the Region. In addition, the Ministry of Health has obtained two million vaccine doses from the WHO International Coordinating Group on Vaccine Provision (ICG). As of 23 February 2008, 1,045,501 doses were administered in the departments of San Pedro, Central, Capital, Itapuá, Cordillera, Paraguarí, Guairá, Boquerón, Presidente Hayes, Alto Paraná, Caazapá, Alto Paraguay, Caaguazu, Ñeembucú, and Canindeyú.

Vector Control: The Ministry of Health has also strengthened vector control activities in the urban area of San Lorenzo, where Aedes infestation rates turned out to be higher than expected. Syndromic surveillance is being implemented for the early detection of new cases.

International Support: A team of PAHO experts—including an epidemiologist, a clinician/virologist, a risk communicator, immunization advisers and emergency management experts—has been working in the country since 15 February 2008. A laboratory scientist from the Evandro Chagas Institute (Instituto Evandro Chagas / IEC, Brazil) is providing support to the national public health laboratory in YF diagnosis.

Source: Information from the country received by PAHO-Paraguay from the Ministry of Public Health and Social Welfare (Ministerio de Salud Pública y Bienestar Social / MSPBS), Paraguay.