8 February 2008

Yellow fever in Paraguay

Between 15 January and 5 February 2008, five human cases of yellow fever were reported, two of which were fatal [1]. All five of the cases originated from the area of Estanislao in the department of San Pedro and had participated in hunting activities. None of the cases had been vaccinated against yellow fever. One of the cases has been laboratory confirmed and the other four are being treated as confirmed cases due to their epidemiological link with the laboratory confirmed case [2]. A further eight suspected cases have also been reported from the same area. These are the first human cases of yellow fever to be reported in Paraguay since 1974 [3, 4]. The Ministry of Health of Paraguay, in cooperation with the Pan American Health Organization, has initiated enhanced surveillance of cases of fever and jaundice, and a vaccination campaign is underway in the affected area.

Revised recommendations for travellers to Paraguay

Travellers should take mosquito bite avoidance measures. Aedes mosquitoes feed predominantly during daylight hours.

Yellow fever vaccine should be given to those over 9 months of age travelling to the forested areas in the east and west of Paraguay. In addition, yellow fever vaccine should also now be given to those over 9 months of age travelling to the department of San Pedro.

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.

Specific advice regarding recommendations for vaccination and certificate requirements can be found in the NaTHNaC Country Information Pages.

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

References

1. Institut National de Veille Sanitaire, France. Bulletin Hebdomadaire International. Fièvre Jaune Argentine – Paraguay - Bréesil, 6 February 2008. Accessed 8 February 2008. Available at: http://www.invs.sante.fr/international/bhi/bhi_060208.pdf

2. World Health Organization. Personal Communication. 7 February 2008.

3. World Health Organization. Yellow fever reported cases 1980 – 2005, 22 December 2006. Accessed 8 February 2008. On-line resource available at: http://www.who.int/immunization_monitoring/en/globalsummary/

timeseries/tsincidenceyel.htm

4. World Health Organization. WHO report on Global Surveillance of Epidemic-prone infectious diseases, 2000. Accessed 8 February 2008. Available at: http://whqlibdoc.who.int/hq/2000/WHO_CDS_CSR_ISR_2000.1.

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