Reports are coming in of countries responding to Paraguay’s request for extra doses of yellow fever vaccines to help it roll out an expanded vaccination programme following its first outbreak in 34 years. According to the Associated Press (AP), 50,000 doses arrived from Brazil on Thursday, and Peru has promised to send 250,000 next week.

Paraguay’s Minister for Health and Wellbeing, Oscar Martínez Doldán, told the press that “additional requests” had been made to Taiwan and Cuba as well.

According to the World Health Organization (WHO), the Paraguay health authorities reported five confirmed cases of Jungle Yellow Fever on 15h January 2008, and four other suspected cases on 11th February. All cases were said to be in the San Pedro department which is about 100 kilometres north of the capital, Asuncion, in the middle region of the country.

Health Minister Doldán asked that people remain calm, following an angry protest near the capital, Asunción, where thousands of local people blocked a highway for several hours to protest against the shortage of vaccine.

The Paraguay health authorities have vaccinated about 35,000 people in the outbreak region and have asked the Pan American Health Organization to supply 600,000 doses to supplement the country’s 100,000 stock.

Paraguay newspaper Ultima Hora reported yesterday that former health ministers have formed a commission to work on a strategy to tackle the problem. They are expected to call on the president, Nicanor Duarte Frutos, to declare a state of national emergency in order to “intensify the task of prevention”.

Stories are also starting to break that two more cases of yellow fever, as yet unconfirmed by the health authorities, have occurred in the region of Laurelty in San Lorenzo, a city which is only 10 kilometres from Asunción. One man died in January and another woman, his neighbour, is seriously ill in a hospital in the capital, with similar symptoms, reported Xinhua news agency.

According to a Paraguayan national newspaper, La Nación, a local lawyer, Melitón Bittar, has issued a judicial order that requires all the residents of Laurelty be vaccinated. And a judge, Julián López, has ordered the Ministry for Health and Wellbeing to carry out a “massive and immediate” vaccination campaign in all neighbouring districts.

A vaccination programme was started in the area, but it ran out of doses after a few hours, and this was said to be the cause of the angry protest that blocked the highway.

Health officials tried to calm local people by assuring them that other countries were helping. The authorities were expecting hundreds of thousands of doses from Brazil and Peru, and requests had been made to the Pan American Health Organization.

The Vice Minister for Health and Wellbeing, Antonio Barrios is reported to have said “We are just as anguished and desperate as every other citizen.”

In the meantime, he asked local people to do all they can to destroy the habitats of the “aedes egypti” mosquito that carried yellow fever and dengue fever. He said there were a lot of these mosqito hatcheries in and around Asunción. Last year there was an outbreak of dengue fever that killed 17 people and infected 27,000, said Xinhua news agency.

Paraguay is one of South America’s poorest nations, and has a population of 6.1 million people. The country’s economy relies on agriculture, which is being increasingly commercialized, leading to a massive rural to urban drift as the numbers of landless families increases. About 60 per cent of Paraguayans live in poverty and the numbers living in shanty towns is increasing rapidly.

According to the WHO, around 30,000 people worldwide die from yellow fever, the symptoms of which include fever, vomiting, jaundice, and also hemorrhagic fever develops in 15-25 per cent of cases and causes bleeding in the mouth, nose, eyes and stomach. Case fatality is around 50 per cent.

Sources: Associated Press, Xinhua, La Nación (Paraguay), Ultima Hora (Paraguay), WHO, BBC.

Written by: Catharine Paddock, PhD