13 February 2008

Yellow fever in Brazil - update

As of 8 February 2008, 26 confirmed human cases including 13 deaths have been reported in the states of Distrito Federal, Goiás and Mato Grosso do Sol; five suspected cases including three deaths are under investigation. A further two suspected cases, both fatal, are under investigation in Mato Grosso state. Yellow fever has been ruled out in 21 previously suspected cases. The first confirmed case was reported on 17 December 2007 and the last suspected case was reported on 28 January 2008 [1].

The Ministry of Health have received vaccine from the global emergency stockpile managed by the International Coordinating Group on Vaccine Provision for Yellow Fever Control, and a vaccination campaign is underway in the affected areas [1, 2].

This outbreak of yellow fever follows an increase in reported outbreaks of yellow fever in monkeys between December 2007 and January 2008 in 23 municipalities of Brazil [2]. Between 1 January and 8 February 2008, confirmed outbreaks of yellow fever in monkeys have been reported from the states of Distrito Federal, Goiás, Minas Gerais, Mato Grosso do Sol, Tocantins and São Paulo [1].

The recent cases of yellow fever in Brazil highlight the importance of yellow fever vaccination for travellers to areas with a risk of yellow fever transmission.

Yellow fever is a serious viral disease affecting monkeys and humans in the tropical regions of the Americas and sub-Saharan Africa. In South America, the virus is transmitted via the bite of Aedes spp. or Haemogogus spp. mosquitoes. These mosquitoes feed predominantly during daylight hours.

Current recommendations for travel to Brazil

On 17 January 2008, NaTHNaC revised their yellow fever vaccine recommendations for travellers to Brazil [3]. Specific advice regarding recommendations for vaccination and certificate requirements for Brazil can be found in the NaTHNaC Country Information Pages.

Travellers should also take mosquito bite avoidance measures.

There are specific contraindications and adverse events associated with yellow fever vaccine. A careful risk assessment should be made before administration and specialist advice sought as appropriate.

Health care professionals are reminded that all YF vaccinations given after 15 December 2007 should be documented in the International Certificate of Vaccination or Prophylaxis (ICVP).

References

1. Ministry of Health, Brazil. Situação da Febre Amarela Silvestre no Brasil, 2007 e 2008, 8 February 2008. Accessed 12 February 2008. Available at: http://portal.saude.gov.br/portal/arquivos/pdf/boletim_febre_ama

rela_%2008_02_2008.pdf

2. World Health Organization. Yellow fever in Brazil, 5 February 2008. Accessed 12 February 2008. Available at: http://www.who.int/csr/don/2008_02_07/en/index.html

3. National Travel Health Network and Centre. Yellow fever in Brazil, 17 January 2008. Accessed 12 February 2008. Available at: http://www.nathnac.org/pro/clinical_updates/yf_170108.htm