In the face of continuing misinformation on the current yellow fever situation in Brazil, I’ve dedicated some time to gather together a few facts about the crisis. The following text has been written by me and it is based on reliable Brazilian sources (listed at the end of the entry). Hope it clarifies all the doubts you might have.
- There hasn’t been a new outbreak of yellow fever in Brazil insofar as yellow fever is endemic in the country.
- There have been no cases of yellow fever in areas of Brazil where the disease wasn’t present before.
- Yellow fever is only present in rural areas. Since 1942 there are no cases of yellow fever in the towns and cities of Brazil.
- Only those visiting risk areas need to get vaccinated against yellow fever.
- Tourists visiting risk-free areas do not need to take the vaccine. The vaccine has a series of well-documented side effects.
- For the vaccine to be effective, it needs to be taken at least 10 days prior to travel.
- NEW: Brazilian authorities are not asking at the moment for an International Certificate of Vaccination Against Yellow Fever regardless of where the passenger comes from.
- Yellow fever is transmitted through a mosquito bite.
- The main symptoms of yellow fever are: fever, muscle pain, headache, shivers, nausea or vomiting. Symptoms appear between three and six days after becoming infected.
- Treatment of yellow fever is supportive only. There is no specific medication to treat yellow fever. Victims of yellow fever need to be treated in hospital.
1. There has not been a new outbreak of yellow fever in Brazil insofar as yellow fever is endemic in the country. Cases are recorded every single year.
– in 2000: 85 cases, resulting in 40 deaths;
– in 2001: 41 cases, resulting in 22 deaths;
– in 2002: 15 cases, resulting in 6 deaths;
– in 2003: 64 cases, resulting in 23 deaths;
– in 2004: 5 cases, resulting in 3 deaths;
– in 2005: 3 cases, resulting in 3 deaths;
– in 2006, 2 cases, resulting in 2 deaths;
– in 2007, 6 cases, resulting in 5 deaths.
In recent years the number of cases of yellow fever had decreased considerably. The number of cases recorded in the first three weeks of 2008 outnumbers the figures for the last four years together. Yellow fever seems to be back in force in 2008.
2. There have been no cases of yellow fever in areas of Brazil where the disease wasn’t present before. The cases registered in 2008 were of people who were not vaccinated and got infected in risk areas.
3. Yellow fever is only present in rural areas. Since 1942 there are no cases of yellow fever in the towns and cities of Brazil. The measures taken by Brazilian authorities aim at preventing the reappearence of urban yellow fever. For that to happen, someone would have to be bitten my a mosquito in a rural area. That person would then travel to an urban area, and would be bitten again by another mosquito that would, from then on, carry the yellow fever virus.
4. Only those visiting risk areas need to get vaccinated against yellow fever.
The Brazilian authorities have recently changed their advice. Previously, they divided the country in four different areas (risk areas, potential risk areas, transition areas and risk-free areas). Now the split is much more simple, just the two areas: risk areas and risk-free areas. ONLY those travelling to risk areas should be vaccinated.
- risk areas. Those where yellow fever is endemic and the virus is at large in rural areas. The states included in this group are Acre, Amazonas, Amapá, Distrito Federal (Brasilia), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima and Tocantins. In December 2008 there were new additions to the list: the western part of the states of Paraná (including the area of the Iguassu Falls), Piaui, Santa Catarina and São Paulo. The western part of the state of Rio Grande do Sul as well as Porto Alegre and part of its metropolitan area are included too.
- risk-free areas. Areas where there have been no cases recorded and the likelihood of them happening is null. This area includes the entire Brazilian coast from Rio Grande do Sul up to Piaui (both states included). The state of Espírito Santo and the south of the state of Bahia are now declared risk-free.
5. Tourists visiting risk-free areas do not need to take the vaccine. The vaccine has a series of well-documented side effects.
Suddenly, everyone wants to get vaccinated against yellow fever, regardless of whether they are planning to visit risk zones or not. All vaccines have side effects, and the vaccine against yellow fever is no exception. Getting vaccinated for the sake of it is being discouraged.
6. For the vaccine to be effective, it needs to be taken at least 10 days prior to travel.
In Brazil at least, people embarking on trips to risk areas are taking the vaccine as they are about to begin their journey. You need to take the vaccine at least 10 days before you begin your journey to risk areas. The vaccine is valid for ten years. You should *not* get a booster before the end of that 10-year period.
7. Brazilian authorities are NOT asking at the moment for an International Certificate of Vaccination Against Yellow Fever regardless of where the passenger comes from.
Not long ago the certificate was being asked to passengers coming from a series of countries. That is no longer the case, at least for the time being. The official document from the Brazilian authorities stating a certificate is not needed is here: Certificado Internacional de Vacinação (see paragraph 3, unfortunately in Portuguese only). Basically, the certificate was only asked to passengers coming from countries where there was yellow fever, countries that were a potential threat to other countries. Anvisa (the Brazilian state agency responsible for disease control) states in the document that right now there are no countries posing a threat of spreading yellow fever. Anvisa also states in the document that if the risk should reappear, an alert would be issued.
8. Yellow fever is transmitted through a mosquito bite.
You can’t catch yellow fever from a fellow human being. In the rural areas, the Haemagogus mosquito is the carrier of the yellow fever virus. In urban areas, it is the notorious Aedes aegypti mosquito, responsible as well for transmitting dengue fever to humans.
9. The main symptoms of yellow fever are: fever, muscle pain, headache, shivers, nausea or vomiting. Symptoms appear between three and six days after becoming infected.
In 15% of the cases symptoms can include also jaundice, bleeding and a series of complications. Yellow fever symptoms are very similar to those of dengue fever. For that reason, the diagnosis can only be confirmed after a series of lab tests.
10. Treatment of yellow fever is supportive only. There is no specific medication to treat yellow fever. Victims of yellow fever need to be treated in hospital.
VERY IMPORTANT: the medical information contained on this entry has been put together with responsible care. However, I am no health professional, and medical advice must be sought from doctors and other health professionals.
On the Portal da Saúde from the Brazilian Ministry of Health up-to-date information on the yellow fever crisis can be found (in Portuguese only). There is a page in English, hidden under a subdomain at the same site, with basic information on yellow fever – but no specific mention to the current crisis (Febre amarela).
In Tourist Support Recommendations: Vaccines from the Brazilian Tourism portal there are general recommendations from the Brazilian authorities to tourists travelling to the country.
The US’s CDC is essential reading too: Yellow Fever in Brazil.
10 facts about dengue fever in Brazil
Sites That Link to this Post
- Global Voices Online » Brazil: Ten facts about yellow fever in Brazil | January 21, 2008