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Viral Outbreaks During COVID-19While COVID-19 has received much attention in the global health discussion, many developing countries continue to fight other viral outbreaks. This highlights why foreign aid is so crucial. Although COVID-19 has affected every nation, some countries will suffer more than others. This article will highlight three of the deadliest viral outbreaks during the COVID-19 pandemic that have been announced by the WHO in 2020 and the current, global efforts to combat them.

Ebola in the Democratic Republic of Congo (DRC)

Since the largest Ebola outbreak killed 11,000 people in West Africa during 2014–2016, the virus has been successfully contained in most countries. This, thanks to the efforts of front-line workers and organizations, such as the WHO.

However, the DRC has been fighting its 10th outbreak since August 2018. As of June 2020, the Ebola Virus Disease (EVD) has infected 3,470 and killed 2,280 people. In 2019, the WHO named the viral outbreak a global health emergency. Then, in April 2020, just as the Ministry of Health neared the end of the countdown to end EVD, there was a new outbreak in the city of Mbandaka.

In the DRC, EVD has a current fatality rate of more than 60%, which is more than five times that of the new coronavirus or influenza. However, the transmission rate is much lower. Advancements in vaccines and “CUBE” containment rooms have helped stop the spread of the Ebola virus. By vaccinating more than 14,000 health workers in neighboring countries, the WHO contained the disease in the DRC. Yet notably, the organization stresses that controlling the epidemic requires more international collaboration and support.

Measles in Africa, South and Central America and Beyond

In addition to COVID-19 and Ebola, the DRC is also battling the world’s largest measles epidemic. Another of the viral outbreaks, which started during COVID-19 (in 2019) and infected around 300,000 people. Since then, the numbers are fewer in the DRC. In 2020 however, more measles outbreaks surfaced in Burundi and the Central African Republic. Additionally, new outbreaks resurfaced in Mexico, while Brazil still recovered from an outbreak of measles in 2019 that infected over 50,000 people in Sao Paulo. The virus has also emerged in Asia and Eastern Europe in 2019.

Similar to the new coronavirus, the measles virus has a high transmission rate and causes complications in a minority of infected individuals. War and displacement also contribute to the spread of the disease. In Burundi, the outbreak started in a refugee camp where refugees from the DRC were thought to have carried it into the country. Other factors such as malnutrition also contributed to the increased mortality rate of measles in these areas.

Yellow Fever in Africa

This mosquito-spread disease is endemic to tropical parts of Africa as well as South and Central America. However, the majority of outbreaks occur in sub-Saharan Africa where 610 million people are at risk of contracting the virus. Yellow fever has long been a challenge in these areas where it infects around 200,000 and kills 30,000 — every year. For instance, in 2020 alone, reports indicated new viral outbreaks of yellow fever in five African countries.

A safe and effective vaccine has been developed and helped reduce outbreaks in the 20th century. However, due to shortages of the vaccine and poor government implementation, the majority of the population does not receive it. Alternatively, it is usually only compulsory for travelers. Furthermore, since the virus is re-occurring, more research is required to keep adapting the vaccine to different strains of yellow fever.

The Takeaway

As evidenced by the COVID-19 pandemic, viral outbreaks are disruptive and have major economic and social consequences. Poor health reduces the life-span, productivity and life satisfaction of any population. These effects usually fall hardest on the world’s poor — who have less access to treatments or safe water access and sanitation.

Due to the commoditization of the pharmaceutical industry, the populations that need medical intervention most receive it the least. This is simply because they can not afford such expensive treatment. Specific antiviral treatments rarely exist. The best method to reduce the impact of viral outbreaks in impoverished countries is by building better healthcare systems and reducing poverty. As stated by Tedros Adhanom, director of the WHO, “Unless we address [the] root causes – the weak health system, the insecurity and the political instability – there will be another outbreak.”

Beti Sharew
Photo: Flickr

Yellow Fever in French GuianaFrench Guiana is a territory of France located on the northeastern coast of South America, bordering Suriname and Brazil. The territory has faced a history of oppression and neglect. Violent slave revolts shaped much of the land’s early history, its use as a penal colony shaped its recent past. This neglect has led to an overall sense of struggle, with issues arising in nearly all sectors of life. This sense of struggle becomes increasingly visible when regarding the recent cases of yellow fever in French Guiana.

Yellow Fever in French Guiana

In August of 2017, a Brazilian woman in her 40s contracted yellow fever in French Guiana. She was living in a clandestine gold mining village in the area of the dam lake Petit Saut. On August 2, she reported a fever, vomiting, lumbar and abdominal pain and intense asthenia. Her relatives reportedly witnessed hemorrhagic symptoms. On August 7, she was admitted to a hospital in Kourou. On August 8, she experienced multi-organ failure and was rushed to the intensive care unit of a hospital in Cayenne, the capital city of French Guiana. There, she was treated with intensive supportive therapy but showed no positive response. On August 9, she passed away.

In August of 2018, a Swiss man in his 40s, living in a forested area near the river Comté, developed a fever, body aches and mild myalgia. On August 5, a day after his symptoms began, he sought out medical attention. He was sent away with the diagnosis of an acute, dengue-like viral infection. In the days that followed, he experienced vomiting, prostration and a persisting fever. He returned to seek medical attention at the Cayenne hospital. He was admitted into the intensive care unit on August 8, and shortly thereafter, on August 9, he was transferred to a specialized transplant center outside of Paris and received a hepatic transplant. On August 10, blood tests confirmed that he had contracted yellow fever in French Guiana. On August 30, he passed away.

Yellow fever is a virus transmitted by the Aedes and Haemogogus species of mosquitos, the same species responsible for the spreading of Zika and Dengue. Yellow fever is endemic in French Guiana. Many of the infected do not experience symptoms, but those who do typically report some combination of a fever, an aching in the back and head, a loss of appetite, nausea and vomiting. A small percentage of those who do experience the initial wave of symptoms will later experience a second wave, referred to as the toxic phase. Those in the toxic phase will likely experience the development of jaundice, a darkening of the urine, vomiting and abdominal pain. Approximately half of all those who enter the toxic phase will die within seven to 10 days.

The endemic status of yellow fever in French Guiana says volumes on the state of the territory as a whole. Although there have been improvements in vaccination rates, with an estimated 80 to 90 percent of the population receiving the yellow fever vaccine, a lack of infrastructure and health care options thoroughly ostracize those living in more rural settings. 

Some communities, such as Maripasula, the most isolated town in French Guiana and France as a whole, takes three days to reach. One must travel by boat down the Amazon. The people of Maripasula have long demanded a road be put in, but as of now, no road exists. This greatly reduces their ability to combat fast-acting diseases such as yellow fever.

The government that rules over French Guiana is the same that rules mainland France, and yet, the GDP of those living in French Guiana is roughly half that of their European counterparts. A shocking 40 percent of citizens live in poverty, and over 20 percent are unemployed.

In 2018, USA Today listed France as the 24th richest country in the world. 

The disparity in income and quality of life between mainland France and French Guiana is drastic, to say the least. In 2017, French Guiana was overcome with protests and social unrest, with many of its citizens participating in mass strikes. The French government apologized for its neglectful treatment of French Guiana and promised to allocate 3 billion euros to the South American territory. This money was meant to be dispersed throughout a variety of sectors, with healthcare and education at the forefront. As of May 2019, this monetary promise remains largely unfulfilled.

Austin Brown
Photo: Flickr

Top Diseases in Iraq
The people of Iraq face many obstacles to their safety. When discussing the middle eastern country, many focus on the physical threats of violence, terrorism and forceful opposition. Health is also a hazard. Diseases spread in many ways. Infection can be airborne, blood born or spread through food and water. Blood-borne diseases, such as Hepatitis A and B, are a risk in Iraq. The two main transmission types in Iraq are food or water-borne and vector-borne. Here are some of the top diseases in Iraq.

  1. Food or Waterborne
    Hepatitis A is spread through a fecal-oral path. This route of disease infection occurs when fecal matter from an infected person is in the food or water consumed by another person, thus infecting the recipient of the food or water. This is why sanitation is the best precaution other than immunization. The spread of this disease occurs because of poor sanitation in food preparation. The risk of infection is much higher in developing or poor countries due to a lack of proper sanitation, which is why Hepatitis A is one of the top diseases in Iraq.Another food or waterborne disease that contributes to the top diseases in Iraq is Typhoid fever. Typhoid is a bacterial disease that contributes very high fevers. Like Hepatitis A, this is spread through fecal-contaminated food or water. Typhoid fever has a higher mortality rate. If the disease is not treated, one in five do not survive.
  2. Vector-borne
    Vector-borne diseases are spread through animals, insects or parasites. One of the top diseases in Iraq is malaria. Malaria is spread by mosquito bites. The disease causes parasites to accumulate in the liver and attack red blood cells. This often leads to death from interrupted blood supply to vital organs.Another top disease in Iraq is yellow fever. This, again, is spread through the bite of a mosquito. Although the severity varies, there is a mortality rate of 20 percent.

These top diseases in Iraq are less common in developed countries, as there are vaccines available. The economic infrastructure in Iraq does not allow for many of its citizens’ access to such life-saving precautionary medication.

Nate Harris

Photo: Flickr

An epidemic of yellow fever has recently emerged in rural areas of Brazil, with over 3,192 suspected cases reported, 758 cases confirmed and 426 deaths from the disease. The fatality rate for confirmed cases has risen to 35 percent as of May 18. Although it is not normally among the common diseases in Brazil, yellow fever poses a growing threat to Brazilian public health.

Yellow fever is an acute viral hemorrhagic disease that includes symptoms such as black vomit and bleeding from the naval cavities. The Aedes aegypti species of mosquito currently transmits the disease, mainly in rural areas of the country.

However, Brazil could face an even greater problem if the mosquito species that live in densely populated cities, such as Rio de Janeiro, contracts the disease and begins to spread it. Already Brazil has had to request 3.5 million doses of the yellow fever vaccine from the International Coordinating Group on Vaccine Provision. Only six million doses currently exist in the emergency stockpile for the vaccine; for perspective, Rio de Janeiro had an estimated 12 million residents in and around the city in 2016.

While country officials deal with the yellow fever endemic, there are several other diseases which continue to affect its citizens, especially those living in poverty. Other common diseases in Brazil include:

Ischemic Heart Disease
Ischemic heart disease ranks the highest among common diseases in Brazil. In 2015, it was the leading cause of death in Brazil at 18.8 percent, and it has frequently been the leading cause of death globally. Ischemic heart disease is especially prevalent among low- and middle-income countries, as living in poverty often correlates with some of the most common behavioral risk factors. These factors include an unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. Due to the success of Brazil’s universal public health system, however, the mortality rates for cardiovascular diseases decreased by 24 percent between 2000 and 2011.

Diabetes
Diabetes was the fifth leading cause of death in Brazil in 2015, which was a rise from its previous position at seventh in 2005. Approximately 12 million Brazilians suffered from diabetes in 2015. Diabetes is a chronic disease in which the body struggles to produce or respond to the insulin hormone. One way that the Brazilian Ministry of Health attempts to combat the increasing prevalence of diabetes is by offering free drugs to all people with diabetes and related conditions. They also support education and awareness activities.

Diarrheal Disease
Diarrheal disease is both preventable and treatable, and yet globally it is the second leading cause of premature death in children under five. In Brazil, it was the seventh leading cause of death in 2013. The greatest risk factors for deaths related to diarrheal disease are child and maternal malnutrition. As malnutrition generally plagues impoverished populations the most, the poor in Brazil are the most likely to suffer from the diarrheal disease. Fortunately, a rotavirus vaccination for infants has resulted in a decline in under-five-year-old diarrhea-related mortality and a decrease in hospital admissions in Brazil after the vaccine’s introduction in 2006.

With the threat of yellow fever and the constant presence of other common diseases in Brazil, the Brazilian government faces a great deal of work to improve and ensure the health of its citizens, especially those living in high-risk areas due to poverty. For now, the universal public health system strives to make current advances in preventing these common diseases accessible to all people.

Lauren McBride

Photo: Pixabay


Yellow fever is a potentially fatal disease that is transmitted by mosquitoes. Though the disease can be treated, Brazil has experienced a number of deaths that have caused people to label the yellow fever outbreak that began in December of 2016 a state of emergency. Here are some important things to know about the yellow fever outbreak in Brazil:

What is yellow fever?

Yellow fever is a virus transmitted by infected mosquitoes. It is rare and usually includes mild symptoms, such as fever, muscle and back pain, headaches, shivers, loss of appetite and nausea or vomiting. Most people can recover after being monitored in a hospital and treated with fluids and rest. However, 15 percent of victims can develop into a second stage with more severe symptoms, such as high fever, jaundice, bleeding and organ failure. Almost 20-50 percent of those patients die.

How many people has the virus infected?

According to the Pan American Health Organization, there have been at least 320 confirmed cases and at least 220 deaths. There are more cases undergoing investigation. While the number might not seem drastic compared to the overall population, the World Health Organization (WHO) has stated that this is the worst case of a yellow fever outbreak since 2000.

What caused the outbreak?

A Mosquito species called “Aedes aegypti,” which is the same mosquito that caused the Zika outbreak in Brazil between 2015-16, has been spreading to monkeys in the jungles, which then passed on to humans. According to zoologists, the virus has killed 600 monkeys in the Atlantic rain forest region, and rare primate species are facing a threat to their survival rate.

Since the start of the yellow fever outbreak, around 64 cities in Brazil have called for a state of emergency, including the state of Minas Gerais. The Ministry of Health assisted the state with investigations, vector control and coordination of health services. There have also been house immunization campaigns in rural areas.

How can we curb this outbreak?

Brazil can still survive this yellow fever outbreak in the same way it handled the Zika outbreak. Brazil’s Health Ministry ordered 11.5 million doses of the yellow fever vaccine, yet a shortage remains. While the vaccines can be effective, they are not routinely offered in major urban cities. However, millions of people have already been vaccinated, so there is hope the disease will not spread much outside of the country or into parts of the United States. The World Health Organization recommended that travelers be vaccinated for yellow fever.

While there are major concerns about the recent yellow fever outbreak in Brazil, if the Ministry of Health can make sure nearly everyone is vaccinated, perhaps the disease can be put under control.

Emma Majewski

Photo: Flickr

Mosquito Death Ray: Technology That Could Save Millions
Mosquitos transmit various diseases including malaria, dengue, yellow fever and Zika. Although both bed nets and insecticides are helpful in fighting off these mosquitos, a new invention is working to completely eliminate these disease-infested bugs: the Mosquito Death Ray.

Developed by Intellectual Ventures, the Mosquito Death Ray zaps mosquitoes to death before they can make human contact. The photonic fence technology creates a force field that can be set up around the perimeter of different areas. These include villages, schools, buildings and fields.

The new technology is still in its beginning stages and is not available commercially. However, once completed and ready for implementation, the Mosquito Death Ray could potentially save the lives of millions.

The technology looks to detect female mosquitoes as the reproduction of more mosquitoes would be impossible without them. The gender of the mosquito is determined by their wing beat frequency — female mosquitoes have a lower wing beat frequency compared to male mosquitoes.

Eliminating mosquitoes is an important step in saving the lives of millions. Malaria, dengue and yellow fever account for millions of deaths and hundreds of millions of illnesses every year.

Yellow fever affects more than 120 million people in regions including Africa, India and the Americas.

Over 2 billion people worldwide are affected by dengue fever, which affects one’s ability to function in day to day activities.

Malaria is extremely prevalent in 91 countries and impairs the working capacity of millions of people, linking it to poverty and developmental issues. There are over 500 million cases each year with the majority of the cases infecting Africans. Each year, malaria kills 2.7 million people.

Without mosquitos transmitting these diseases from person to person, people and children could focus more on their educations and careers allowing countries to develop at a quicker pace.

Casey Marx

Photo: Flickr

Yellow Fever in the DRC
While mosquito bites are rarely more than a summer nuisance for the average American, they can be carriers of dangerous illnesses. This year, the Democratic Republic of Congo (DRC) is facing an outbreak of yellow fever.

By August, there were 5,000 suspected cases and 400 reported deaths across the DRC and Angola. Yellow fever is difficult to diagnose because symptoms closely resemble other illnesses and vary from patient to patient.

Fortunately, World Health Organization (WHO) and the European Union announced that they have created a mobile lab to quickly diagnose and vaccinate people to stop the disease in the DRC.

The mobile lab was dispatched in mid-July with five technicians from Italy and Germany. Quick, accurate blood tests are crucial.

This mosquito-transmitted disease can become so prolific because most infected people never show symptoms, and risk exporting the illness or continuing to allow mosquitoes to spread it in crowded subtropical areas. Now tests can be done on site, which reduces the time wasted for transporting samples.

Those who develop symptoms after the incubation period experience fever, chills, aches, nausea and weakness. Unfortunately, 15 percent of people develop a serious form of the disease that leads to bleeding, jaundice, organ failure and death in 20 to 50 percent of cases. There is no cure, only prevention and palliative treatment.

The technicians have a tough job because of the sheer number of people affected by yellow fever in the DRC. Unfortunately, preventative measures like bug repellent and protective clothing only go so far against the persistent parasite.

The good news is a vaccine that provides lifelong immunity exists. To keep the disease out of the DRC, visitors are required to get the vaccine before entering the country.

The bad news is that the vaccine is expensive and the epidemic is straining the supply. Currently, there are only 6 million doses of the vaccine and it will take a year to make more. Reuters ominously reports that time and resources are not on the EU’s side in the face of this epidemic.

WHO and the EU remain positive. The mobile labs can get results to 50 to 100 people in a day. WHO is training lab technicians in DRC and Angola to continue accurate testing after the EU’s program ends.

Dr. Formerly explains, “Aside from getting patients on the right treatment, faster diagnosis helps to plan the response better, such as identifying where to conduct mass vaccination campaigns in the affected countries.”

Mass vaccinations have been effective in slowing the spread and tests will help. Without a cure, prevention is the only way to stop the disease.

The EU and WHO have been splitting each dose into fifths. While this does not provide lifelong immunity to yellow fever that the full vaccine provides, it does protect recipients for a year. The mobile lab program is a great step towards ending this epidemic.

Jeanette I. Burke

Photo: Flickr

 Diseases in Angola
Life expectancy in Angola is estimated to be 53 years–almost 20 years lower than the world average. While the prevalence of HIV/AIDS within Angola is relatively low compared to other sub-Saharan African countries, there are a number of diseases in Angola that require continued international aid and attention:

Yellow Fever

The World Health Organization is currently planning to launch emergency vaccination campaigns against yellow fever in Angola in response to a vaccine shortage. The CDC has placed the current outbreak of the disease at level two out of three, which encourages the public to practice enhanced precautions. Those who have not been vaccinated against yellow fever are discouraged from visiting Angola.

Yellow fever is spread through mosquitos and develops three to six days following contact. The CDC reports that only 15 percent of those who are infected present serious symptoms. Yellow fever can also cause mild symptoms such as fever, headaches and nausea. However, severe cases of the illness can be fatal: it is estimated that 347 people have died due to yellow fever in Angola since December.

Malaria

Malaria is another disease spread via mosquitos. It is common in tropical regions throughout the world. Just as in most sub-Saharan African countries, malaria is widespread throughout Angola.

Symptoms of malaria include fever, nausea, vomiting and other flu-like symptoms. Severe or untreated malaria can lead to various health complications such as organ failure and even death.

Malaria causes almost half of under-five deaths in Angola, making it a major problem within the country. UNICEF has distributed 44,000 mosquito nets throughout Angola that have been effective in warding off the disease.

Typhoid Fever and Hepatitis A

Typhoid Fever and Hepatitis A are transmitted through contaminated food or water. In Angola, over nine million people do not have access to safe drinking water, which contributes to the prevalence of typhoid and other water-based illnesses. While these diseases are endemic to the country, those who travel to Angola should get vaccinated prior to entering Angola.

USAID and WaterAid are currently involved in Angola in an effort to increase safe water access. Through community and government level involvement, there is hope for a decrease in the prevalence of water-born diseases.

With continued support from the World Health Organization, UNICEF, USAID, WaterAid and the greater international community, the prevalence of these and other fatal diseases in Angola can be reduced significantly.

Saroja Koneru

Photo: Flickr

yellow fever in the developing world
Despite increased understanding of the mosquito-transmitted disease since it presented in the 15th century, yellow fever in the developing world continues to have a widespread effect. The World Health Organize  estimates that there are 200,000 cases of yellow fever every year, with 30,000 deaths, 90 percent of which occur in Africa. In Africa and Latin America, 900 million people are at risk of infection as the disease spreads without a cure.

When a mosquito bites a person and transmits yellow fever, there are two paths the disease can take. It will either present as flu like symptoms with fever, aching and nausea, before going away in three to four days. However, 15 percent of patients take the second path. Symptoms worsen rapidly, as the patient develops jaundice, bleeding and increased vomiting. Half of these patients die within 14 days, and those who survive suffer from severe organ damage.

The fight against yellow fever is challenging for a few reasons. For starters, in the early stages, it is difficult to diagnose the disease, as its symptoms are similar to diseases like malaria, viral hepatitis and poisoning. Once the disease can be identified, it is often too far along to effectively control.

Additionally, yellow fever has no treatment. Though it can be prevented, there is no vaccine to cure it. Patients are often treated for secondary conditions that result from yellow fever, which can be effective in helping the patient survive the disease.

Despite the lack of treatment, there are myriad methods to prevent yellow fever. The GAVI Alliance, which has brought together the efforts of the WHO, UNICEF, the World Bank, the Bill and Melinda Gates Foundation and various other governmental agencies, has been successful in administering preventative vaccines worldwide. Since GAVI got involved, an estimated 64 million children have had the vaccine, and 17 of the 33 countries at risk have received routine vaccinations.

In addition to vaccination, protection from mosquitoes can be effective in preventing yellow fever, whether it be insecticide treated nets, clothing that covers as much skin as possible or remaining indoors at night when the mosquitoes are in abundance.

The WHO has been involved beyond its participation in the GAVI Alliance, acting as Secretariat for the International Coordinating Group for Yellow Fever Vaccine Provision. The ICG is adamant about maintaining a stockpile of yellow fever vaccinations in case of a sudden outbreak. Additionally, the WHO along with UNICEF and national governments has led the Yellow Fever Initiative which focuses its vaccination efforts in Africa, targets infants younger than nine months and works to monitor outbreaks to minimize damage.

Preventing yellow fever is very much dependent on efficient healthcare and sanitation, things that are difficult to achieve in impoverished areas. The efforts of GAVI, as well as the individual organizations, are crucial to control the number of yellow fever cases every year.

– Maggie Wagner

Sources: Gavi Alliance, NCBI, WHO
Photo: Gavi Alliance