Via Scientific American: Could Yellow Fever Become the Next Pandemic? Excerpt:
In the doorway of a one-room yellow fever ward in downtown Kinshasa, a toddler named Julia is slung over her mother’s shoulder. Moments later a nurse directs mother and child to the last vacant bed and inserts an intravenous line into the girl’s wrist. Her lemon-yellow eyes staring vacantly ahead, Julia does not flinch as the needle punctures her skin. She could be awaiting a hand massage or a manicure.
In the bed adjacent to her, 12-year-old Elohim has one knee propped up like a tent stake. His palms and the skin under his fingernails are yellow with jaundice. His gaze trails up a fluid line that coils around the bed net up to his IV bag as he watches it drain.
“Suspected case,” the 50-year-old nurse, Paul Djonga, mutters in French—jabbing his thumb over his shoulder toward the headboard where the boy is draped. “Suspected?” I ask, certain that a diagnosis could be easily confirmed with a lab test. Djonga nods. “They’re all only ‘suspected,’” he says. The necessary blood tests to verify a diagnosis have not been conducted.
The lack of confirmation will not, for the most part, make much of a difference for Julia, Elohim or any of the other patients on the ward. Health care workers give the patients fluids, oxygen and other standard treatments designed to keep them going until their own immune systems either fight off the virus or they die.
But nevertheless, the missing diagnoses have troubling implications for the rest of the world. They mean the yellow fever outbreak that began creeping through Angola in December 2015 and then spread to the neighboring Democratic Republic of the Congo (DRC) earlier this year is nowhere near as well controlled as it should be at this point—eight months into the outbreak.
Indeed, yellow fever could be on the verge of exploding out of central Africa and spreading to Asia, which has never before suffered a major outbreak. The most likely route of transmission: any one of the thousands of unvaccinated Chinese expatriates who are building roads, dams and other big projects in the region. Health authorities already know of at least a dozen workers who returned to China earlier this year and turned out to be sick with yellow fever. How many more infected workers might escape official notice and quarantine, thereby allowing the mosquito-borne virus to gain a toehold in a new part of the world?