Yellow Fever Travel Advisory
February 22, 2017
The CDC has issued a Level 2 Travel Alert for Yellow Fever in areas of Brazil.
Yellow fever is a viral disease found in tropical regions of Africa and the Americas that mainly affects humans and monkeys and is transmitted by the same type of mosquito that spreads dengue and the Zika virus.
Hundreds of thousands of people died from it in the Americas before a vaccine was developed in 1938.
YELLOW FEVER – AMERICAS (24): BRAZIL, CARNIVAL, TRAVEL ALERT
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases <http://www.isid.org>
Date: Tue 21 Feb 2017
Source: The Rio Times [edited]
The federal government of Brazil has issued emergency situations for
63 cities in Minas Gerais and one in Espírito Santo due to the outbreak of yellow fever. Since the beginning of the year  authorities have confirmed 44 people died of the disease and over 70 other suspected deaths are being investigated.
Federal officials are sending extra doses of yellow fever vaccines to the affected area in fear that the virus may spread during the great flux of tourists coming into the affected areas due to the Carnival festivities [beginning 24 Feb 2017].
“(States of) Minas Gerais, Espírito Santo, and São Paulo confirmed cases of the disease. In total, 12.8 million extra doses were sent to states with case records, in addition to others located in the neighboring areas that have reported cases,” said the note released by the Ministry on [Mon 20 Feb 2017].
Earlier this month [February 2017], Minas Gerais governor Fernando Pimentel had declared a public health emergency in 152 municipalities in the state.
Last week [week of 13 Feb 2017], the federal government authorized disbursements of BRL 13.8 million [USD 1 233 646] to intensify vaccination efforts against yellow fever in the states of Bahia, Espírito Santo, Minas Gerais, Rio de Janeiro, and São Paulo.
According to Brazil’s Ministry of National Integration, among the criteria for recognizing the emergency situation is the difficulty in controlling the disease, the existence of considerable human deaths.
The US Center for Disease Control (CDC) warned American citizens to take extra precautions if traveling to the affected areas.
“Because of the ongoing outbreak, travelers to the Brazilian states of Minas Gerais, Espírito Santo, and parts of Bahia, São Paulo, and Rio de Janeiro states may consider getting a booster if their last yellow fever vaccination was more than 10 years ago,” said the CDC alert issued by the health entity.
[Byline: Lise Alves]
ProMED-mail from HealthMap Alerts
[The occurrence of cases so close in time to Carnival is of real concern. Although all cases of human yellow fever (YF) in Brazil during this outbreak have been attributed to spill-over from the sylvan (forest) cycle of transmission, from monkeys to humans and not _Aedes aegypti_ urban, human-mosquito-human transmission, the risk of initiation of an urban cycle is real. The mass vaccination campaign will be helpful in protecting people in Brazil, but it takes 10 days post-vaccination to for immunity to be achieved. Visitors to the areas of the current outbreak from any country, not just the USA, should heed the CDC recommendation and be vaccinated 10 or more days before travel.
Although not mentioned in the report above, there have been accounts of hundreds of monkeys dead of YF virus infection in the affected areas. Not only is this YF outbreak a locally declared public health emergency, it is a wildlife conservation threat as well. Some of the affected monkey species are endemic to the area (found only in those
ecosystems) and they are in danger of extinction. Controlling YF in its sylvan cycle is not possible. Unfortunately, there have been reports of local residents killing monkeys in an attempt to halt transmission of the virus.
Maps of Brazil can be seen at
<http://s13.postimg.org/jumnalk87/map_of_Brazil.gif> and <http://healthmap.org/promed/p/6>. – Mod.TY]
Yellow fever – Americas (23): Brazil, PAHO/WHO http://promedmail.org/post/20170218.4848786.
Yellow fever – Americas (22): Brazil
Yellow fever – Americas (21): Bolivia (LP) comment
Yellow fever – Americas (20): Brazil comment
Yellow fever – Americas (18): PAHO/WHO
Yellow fever – Americas (17): Brazil, monkeys
Yellow fever – Americas (16): Brazil
Yellow fever – Americas (15): Brazil, WHO
Yellow fever – Americas (14): Brazil, CDC Advisory
Yellow fever – Americas (13): Brazil (MG)
Yellow fever – Americas (12): Brazil, human, monkey
Yellow fever – Americas (11): Brazil (MG) link to deforestation susp.
Yellow fever – Americas (10): Brazil
Yellow fever – Americas (09): Brazil
Yellow fever – Americas (08): Brazil (MG, ES)
Yellow fever – Americas (07): Brazil, PAHO/WHO
Yellow fever – Americas (06): Brazil (MG,ES)
Yellow fever – Americas (05): Brazil (MG)
Yellow fever – Americas (04): Brazil (MG)
Yellow fever – Americas (03): Brazil (MG)
Yellow fever – Americas (02): Brazil (MG, SP)
Yellow fever – Americas (01): PAHO/WHO 2016 http://promedmail.org/post/20170110.4753504]
 Minas Gerais, São Paulo: new human cases
Date: Mon 30 Jan 2017
Source: Fox News, Associated Press (AP) report [edited] <http://www.foxnews.com/health/2017/01/30/brazil-confirms-more-yellow-fever-cases-over-100-infected.html>
The vast majority of [yellow fever] cases are in the southeastern state of Minas Gerais, where authorities had confirmed 97 cases as of [Fri 27 Jan 2017]. Of those, 40 died.
The Health Department of São Paulo on [Mon 30 Jan 2017] said it has now confirmed 6 cases of the disease, 4 of whom became infected in Minas Gerais. All of the patients died.
Much of Brazil is considered at risk for yellow fever, but the country has not seen this large an outbreak since 2000. The World Health Organization has said it expects the mosquito-borne to spread to more states.–