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dc.contributor.authorIngelbeen, B
dc.contributor.authorWeregemere, NA
dc.contributor.authorNoel, H
dc.contributor.authorTshapenda, GP
dc.contributor.authorMossoko, M
dc.contributor.authorNsio, J
dc.contributor.authorRonsse, A
dc.contributor.authorAhuka-Mundeke, S
dc.contributor.authorCohuet, S
dc.contributor.authorKebela, BI
dc.date.accessioned2019-07-17T15:03:54Z
dc.date.available2019-07-17T15:03:54Z
dc.date.issued2018-12-07
dc.date.submitted2019-07-16
dc.identifier.urihttp://hdl.handle.net/10144/619422
dc.description.abstractBackground Between December 2015 and July 2016, a yellow fever (YF) outbreak affected urban areas of Angola and the Democratic Republic of the Congo (DRC). We described the outbreak in DRC and assessed the accuracy of the YF case definition, to facilitate early diagnosis of cases in future urban outbreaks. Methodology/Principal findings In DRC, suspected YF infection was defined as jaundice within 2 weeks after acute fever onset and was confirmed by either IgM serology or PCR for YF viral RNA. We used case investigation and hospital admission forms. Comparing clinical signs between confirmed and discarded suspected YF cases, we calculated the predictive values of each sign for confirmed YF and the diagnostic accuracy of several suspected YF case definitions. Fifty seven of 78 (73%) confirmed cases had travelled from Angola: 88% (50/57) men; median age 31 years (IQR 25–37). 15 (19%) confirmed cases were infected locally in urban settings in DRC. Median time from symptom onset to healthcare consultation was 7 days (IQR 6–9), to appearance of jaundice 8 days (IQR 7–11), to sample collection 9 days (IQR 7–14), and to hospitalization 17 days (IQR 11–26). A case definition including fever or jaundice, combined with myalgia or a negative malaria test, yielded an improved sensitivity (100%) and specificity (57%). Conclusions/Significance As jaundice appeared late, the majority of cases were diagnosed too late for supportive care and prompt vector control. In areas with known local YF transmission, a suspected case definition without jaundice as essential criterion could facilitate earlier YF diagnosis, care and control.en_US
dc.language.isoenen_US
dc.publisherPublic Library of Sciencesen_US
dc.rightsWith thanks to the Public Library of Science.en_US
dc.titleUrban yellow fever outbreak—Democratic Republic of the Congo, 2016: Towards more rapid case detectionen_US
dc.identifier.journalPLOS Neglected Tropical Diseasesen_US
refterms.dateFOA2019-07-17T15:03:55Z


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