17 Feb 2015

Yellow fever: Brazil

A new case of yellow fever has been reported in Brazil

As of 13 February 2015, a yellow fever case has been confirmed in a person who passed through the city of Alto Paraíso in Goiás State, Brazil. The individual was diagnosed and treated in Rio de Janeiro.

This was initially reported as an isolated case in an individual who had visited an endemic area (Goiás State) [1]. There is no risk of yellow fever in Rio de Janeiro.

As of 16 February 2015, authorities in Goiás confirmed a second case in Alto Paraíso; this case died.

Vaccination is the most important preventive measure against yellow fever [2].

Yellow fever in the Americas

In South and Central America, 13 countries are considered endemic for yellow fever (YF). These are listed by the World Health Organization (WHO) as countries with risk of YF transmission [3].

Over the last three decades, the majority of cases of YF in the Americas have been reported from Peru (54% of all cases), Bolivia (18%), Brazil (16%), and Colombia (7%) [4].

In the Americas, the virus is transmitted in jungle areas via the bite of the Haemagogus spp. mosquito. The preferred biting/feeding time for this mosquito is unknown. In towns, cities and rural areas the Aedes aegypti mosquito can also transmit YF. This mosquito feeds predominantly during daylight hours.

Advice for health professionals

When undertaking YF risk assessment, health professionals should refer to the individual country information pages where detail relating to risk areas, recommendation for YF vaccination and certificate requirements are available. A map of the current areas where YF vaccine is recommended in the Americas has been produced by the WHO. This provides a useful guide for the consultation, and health professionals are also encouraged to access the Outbreaks Surveillance, where verified and unverified outbreaks of YF are posted.

Under International Health Regulations (2005), countries are no longer required to automatically report yellow fever (YF) outbreaks to the WHO [5]; surveillance and reporting of YF in YF risk countries can be poor.

Advice for travellers

YF is transmitted to humans via the bite of an infected mosquito. You should take mosquito bite avoidance measures day and night.

If you are travelling to areas of Brazil with risk of YF, including Goiás State , vaccination is recommended for your personal protection.

Full details of YF vaccination recommendations can be found on the Country Information pages. Some travellers may require vaccination for certificate purposes.  Details of the countries that require proof of YF vaccination as a condition of entry under the International Health Regulations (2005) are also provided.

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