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A review of the 1992-1993 Yellow Fever outbreak in Kenya and future management options

机译：回顾1992-1993年肯尼亚的黄热病爆发和未来的管理方案

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In 1992-1993 Kenya saw its first outbreak of yellow fever in 50 years in the Rift Valley Province. By March 1993, 55 cases of suspected yellow fever were identified, with 34 deaths. This is likely to be an underestimate of infected cases. This has immeasurable impact on the villages of the region, and economic repercussions for the nation. This report examines the management of the outbreak. Following identification of the causative agent, a mass vaccination campaign and follow-up surveillance was initiated. However, more prompt action could have led to earlier detection of the emerging infection and perhaps limited its extent. There was considerable delay in responding to the initial reports of an unknown haemorrhagic fever. The initial surveillance system omitted a key hospital in the affected region where cases had presented earlier and there was little effort to control the vector mosquito, Aedes africanus. A more efficient reporting and response system may have allowed for earlier recognition of the emerging epidemic. A greater awareness of the clinical syndrome of yellow fever and appropriate early collection of samples for diagnostic confirmation would facilitate the public health response. An education campaign on mosquito avoidance and control could have been directed at the immediate at-risk population. Reliance on an emergency mass vaccination campaign, driven by economic factors in impoverished nations, may allow for temporary control, but sub-optimal immunisation rates allow the opportunity for future outbreaks.
机译：在1992-1993年，肯尼亚在裂谷省发生了50年来的第一次黄热病暴发。到1993年3月，已查明55例怀疑黄热病病例，其中34人死亡。这可能是被感染病例的低估。这对该地区的村庄产生了不可估量的影响，并对国家产生了经济影响。该报告检查了爆发的管理。确定病原体后，开始了大规模疫苗接种运动并进行了后续监测。但是，更迅速的行动可能导致更早地发现新出现的感染，并且可能会限制其程度。对未知出血热的最初报道作出响应的时间相当长。最初的监视系统省略了受灾地区的一家重点医院，那里的病例较早，而且几乎没有控制病媒蚊子伊蚊的努力。更加有效的报告和响应系统可能允许更早地识别新出现的流行病。对黄热病临床综合征的更多认识以及适当的早期采集样本以进行诊断确认将有助于公众健康应对。关于灭蚊和控制蚊子的教育运动本来可以针对眼前的高危人群。在贫困国家中，由经济因素驱动的紧急大规模疫苗接种运动可能会得到临时控制，但次优的疫苗接种率可能会给未来的爆发提供机会。

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