1 August 2008

Yellow fever outbreaks and current recommendations - update

South America

Argentina

In January 2008, 17 monkeys were found dead in Piñalito Park, San Pedro Department, Misiones Province, one of which was confirmed as being infected with yellow fever [1]. Between January and 20 May 2008, seven human cases of yellow fever were reported from the state of Misiones [2].

On 21 May 2008, NaTHNaC revised yellow fever vaccination recommendations for travellers to Argentina [3]. Details of these recommendations can be found on the NaTHNaC Country Information Page for Argentina.

Brazil

As of 11 June 2008, 45 cases of yellow fever have been reported in Brazil, including 25 deaths. Two of the recent cases have been reported from the rural areas of Luiz Antônio and São Carlos near the ecological reserve of Jataí in São Paulo state. These cases occurred outside the previously identified risk area for yellow fever in São Paulo state (please see CDC map of risk areas). Two cases have also been reported from the rural area of Laranjal in central west Paraná, which is also outside the previously identified yellow fever risk area [4].

NaTHNaC changed their yellow fever recommendations for Brazil on 18 January 2008 [5]. These recommendations are still current, however the situation is being monitored.

Details of the NaTHNaC yellow fever vaccination recommendations for Brazil can be found on the NaTHNaC Country Information Page for Brazil.

Ecuador

In March 2008, the Ministry of Health of Ecuador recommended yellow fever vaccination for several provinces within the Amazon basin. Based on this information NaTHNaC revised its recommendations for Ecuador on 21 May 2008 and extended the areas for which yellow fever vaccination is recommended [3]. Details of these recommendations can be found on the NaTHNaC Country Information Page for Ecuador.

Paraguay

Between 15 January and 5 February 2008, five human cases of yellow fever were reported, two of which were fatal. These were the first human cases of yellow fever to be reported in Paraguay since 1974 [6]. As of 21 May 2008, 25 cases have been reported: 15 cases in San Pedro Department; nine cases in Central Department, near the capital city, Asunción; and one case in Caaguazú Department [7].

On 22 February 2008, NaTHNaC changed the recommendations for travellers to Paraguay [8]. Details of these recommendations can be found on the NaTHNaC Country Information Page for Paraguay.

Peru

Between 1 January and 12 July 2008, six confirmed and five probable cases of yellow fever were reported. Two of the probable cases were notified between 6 and 12 July 2008, one from Junin and one from Loreto [9].

Africa

Central African Republic

As of 15 May 2008, two laboratory confirmed cases of yellow fever have been reported from Bozoum sub-prefecture, Ouham-Pendé Prefecture. A vaccination campaign was planned for the affected areas [10].

Democratic Republic of the Congo

Media reports in June 2008 suggested that there was an outbreak of yellow fever in Lutembo in Congolese nationals deported from Angola [11].

Liberia

In April 2008, two cases of yellow fever were reported from Zuotuo, Tappita District, Nimba County, one of which was fatal. A vaccination campaign was conducted in Tappita district and neighbouring areas [12].

Recommendations for travellers

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. (urban transmission from human to human) or Haemogogus spp. (jungle transmission from monkey to human) mosquitoes. These mosquitoes feed predominantly during daylight hours. Travellers should take mosquito bite avoidance measures.

Full details of yellow fever vaccination recommendations and International Certificate of Vaccination or Prophylaxis requirements for individual countries can be found on the NaTHNaC Country Information Pages.

References

1. Pan American Health Organization. Jungle Yellow Fever in Brazil, Paraguay and Argentina, Emerging and Re-emerging infectious diseases, Regions of the Americas, 11 February 2008. [Accessed 30 July 2008]. Available at: http://www.paho.org/English/AD/DPC/CD/eid-eer-2008-02-11.htm

2. US Centers for Disease Control and Prevention. Yellow fever in Argentina – updated, 13 June 2008. [Accessed 30 July 2008]. Available at: http://wwwn.cdc.gov/travel/contentYellowFeverArgentina.aspx

3. National Travel Health Network and Centre. Yellow fever in South America – changes to recommendations for Argentina and Ecuador, 21 May 2008. [Accessed 30 July 2008]. Available at: http://www.nathnac.org/pro/clinical_updates/yf_210508.htm

4. US Centers for Disease Control and Prevention. Yellow fever alert for Brazil – updated, 29 July 2008. [Accessed 30 July 2008]. Available at: http://wwwn.cdc.gov/travel/contentYellowFeverBrazil.aspx

5. National Travel Health Network and Centre. Yellow fever in Brazil, 17 January 2008. [Accessed 30 July 2008]. Available at: http://www.nathnac.org/pro/clinical_updates/yf_170108.htm

6. National Travel Health Network and Centre. Yellow fever in Paraguay, 8 February 2008. [Accessed 30 July 2008]. Available at: http://www.nathnac.org/pro/clinical_updates/yf_080208.htm

7. US Centers for Disease Control and Prevention. Yellow fever in Paraguay – updated, 13 June 2008. [Accessed 30 July 2008]. Available at: http://wwwn.cdc.gov/travel/contentYellowFeverParaguay.aspx

8. National Travel Health Network and Centre. Yellow fever in Argentina, Brazil and Paraguay: changes to yellow fever vaccination recommendations for Paraguay, 22 February 2008. [Accessed 30 July 2008]. Available at: http://www.nathnac.org/pro/clinical_updates/yf_220207.htm

9. Ministrio de Salud de Peru. Direccion General de epidemiologia. Bulletin epidemiologico, 2008; 17 (28). [Accessed 30 July 2008]. Available at: http://www.oge.sld.pe/boletines/2008/28.pdf

10. World Health Organization. Yellow fever in the Central African Republic, 20 May 2008. [Accessed 30 July 2008]. Available at: http://www.who.int/csr/don/2008_05_20/en/index.html

11. ProMED-Mail. Yellow fever – Africa (04): Congo Democratic Republic, Suspected, Request for Information, 7 June 2008. [Accessed 30 July 2008]. Available at: http://apex.oracle.com/pls/otn/f?p=2400:1001:28880509298434

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12. World Health Organization. Yellow fever in Liberia – update, 25 April 2008. [Accessed 30 July 2008]. Available at: http://www.who.int/csr/don/2008_04_25/en/index.html