By NewsDesk @infectiousdiseasenews
The Ministry of Health of South Sudan reported two confirmed yellow fever cases in Kajo Keni county, Central Equatoria State. The cases were identified through a cross-border rapid response team investigation mounted in response to the recently declared outbreak in bordering Moyo district, Uganda.

The public health response to the outbreak includes:
- The country rapidly mounted an in-depth multi-disciplinary investigation in Kajo Keji county in response to the cross-border notification of the outbreak in Moyo, Uganda. The investigations included enhanced surveillance, active case finding and entomological surveys from 12-18 February, supported by WHO country office and headquarters.
- Surveillance has been enhanced within the context of integrated disease surveillance and response (IDSR) through training of health workers and disseminating the yellow fever case definition to the health facilities to enhance case detection and reporting.
- The Ministry of Health, with support from the WHO Country office, has planned a reactive vaccination campaign in Kajo Keji country for which an International Coordination Group (ICG) request has been submitted.
- The Ministry of Health has also proposed implementation of preventive mass vaccination campaigns and introduction of yellow fever vaccination into the routine immunization schedule by 2022.
The World Health Organization says Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. Vaccination is the most important means of preventing the infection, which provides immunity for life.
The risk of ongoing and further transmission of yellow fever is concerning in South Sudan due to :
- Confirmed outbreak in the bordering area of Uganda, coupled with the continuous savannah and forest biome with common mosquito vectors and non-human primates;
- Gaps in surveillance and weaknesses in health services could delay rapid detection of additional yellow fever cases;
- Negligible population immunity;
- Ongoing resettlement in Kajo Keji including over 13,200 returnees to the county primarily from Uganda in recent weeks represents an influx of new susceptible population to the county;
- The ongoing COVID-19 related controls on borders (air/land) is anticipated; however, as the borders between Democratic Republic of the Congo, Uganda and South Sudan are highly porous with substantial cross border social and economic activities, risk of transmission cannot be excluded;
- The current rainy season which started in early March is anticipated to increase the vector burden in coming weeks, thereby increase the risk of ongoing yellow fever transmission.
Close monitoring of the situation with active cross-border coordination and information sharing is needed.
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