An outbreak of yellow fever has hit the Democratic Republic of Congo, just weeks after the Red Cross warned that another outbreak in neighbouring Angola risked sparking a “global crisis”. A total of 67 cases – five of them fatal – have been confirmed in three provinces while another 1,000 are being monitored, the country’s health minister said.

Felix Kabange said seven of the proven cases of the viral hemorrhagic disease, for which there is no treatment, had originated in DRC while 60 were imported from Angola.

The outbreak has raised alarm among global health officials because the stockpile of vaccinations has already been badly depleted by the Angola outbreak and others in Uganda and neighbouring Congo Brazzaville.

The current method for creating new vaccines, in chicken eggs, takes up to a year. Health officials are considering using smaller doses of the vaccine which provides temporary protection and could stave off a larger emergency.

There are fears that the virus, which like Zika is carried by mosquitoes but is considered more serious, could spread rapidly in the DRC’s densely-packed capital of Kinshasa, which has a population of 12 million and poorly-resourced and staffed hospitals.

It comes at a time where mineral-rich Congo is already on the edge over the commodity slump and plans by its current president, Joseph Kabila, to run for a controversial third term, resulting in violent protests.

Yellow fever has been raging since last December in Angola, and especially in the capital Luanda, killing more than 300 people in the country to date and infecting another 2,267.

In May the Red Cross raised concerns about the country’s porous borders, poor sanitation, weak disease surveillance systems and large migrant population could result in the disease spreading as far afield as China.

Julie Hall, health director for the International Federation of Red Cross and Red Crescent Societies, said urged international agencies and donors to react early to stave off another outbreak on the scale of Ebola, which killed more than 10,000 people in West Africa between 2013 and 2015.

“Unvaccinated travellers could transform this outbreak into a regional or international crisis if we don’t move quickly to protect vulnerable populations and help communities to reduce their risk of infection,” she said in a statement.

Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The “yellow” in the name refers to the jaundice that affects some patients.

Symptoms of yellow fever include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue.

A small proportion of patients who contract the virus develop severe symptoms and approximately half of those die within seven to ten days.

The virus is endemic in tropical areas of Africa and Central and South America.

Since the launch of the Yellow Fever Initiative in 2006, significant progress in combatting the disease has been made in West Africa and more than 105 million people have been vaccinated in mass campaigns.

Large epidemics of yellow fever occur when infected people introduce the virus into heavily populated areas with high mosquito density and where most people have little or no immunity, due to lack of vaccination. In these conditions, infected mosquitoes transmit the virus from person to person.

Yellow fever is prevented by an extremely effective vaccine, which is safe and affordable. A single dose of yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against yellow fever disease and a booster dose of the vaccine is not needed. The vaccine provides effective immunity within 30 days for 99% of persons vaccinated.

Good supportive treatment in hospitals improves survival rates. There is currently no specific anti-viral drug for yellow fever.

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