29 February 2008

Yellow fever in South America – Changes to vaccination recommendations for travellers to Argentina

 

Changes to yellow fever recommendations for travellers

Due to the ongoing outbreaks of yellow fever in humans in Brazil and Paraguay and notified cases in monkeys in Argentina, changes have been made to the yellow fever vaccination recommendations for travellers.

Argentina

As of 29 February 2008, yellow fever vaccination should be given to those 9 months of age and older travelling to the regions of Argentina bordering Paraguay and Brazil in the provinces of Chaco, Corrientes, Formosa, Salta provinces and to all areas of Misiones province, including Iguaçu Falls. This follows advice given by the Ministry of Health of Argentina on 22 February 2008 [1].

Brazil

On 17 January 2008, NaTHNaC revised its yellow fever vaccination recommendations for travellers to Brazil [2]; these recommendations remain current and can be found on the NaTHNaC Country Information page for Brazil.

Paraguay

On 22 February 2008, NaTHNaC revised its yellow fever vaccination recommendations for travellers to Paraguay [3]; these recommendations remain current and can be found on the NaTHNaC Country Information page for Paraguay.

Other countries in South America

There are currently no changes to yellow fever vaccination recommendations or requirements for travellers to other South American countries, including Bolivia and Ecuador. Travellers who are vaccinated should make sure they carry their International Certificate of Vaccination or Prophylaxis in the event that documentation of vaccination is requested.

Specific advice regarding recommendations for vaccination and certificate requirements for travellers to South America can be found on the NaTHNaC Country Information Pages.

Update on outbreaks of yellow fever in Argentina, Brazil and Paraguay

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. A vaccination campaign is underway for people living in or travelling to the affected areas. There have been no human cases reported [4] and as of 28 February 2008, no suspected cases in animals have been reported for 15 days [5].

Brazil

As of 26 February 2008, 33 confirmed cases of yellow fever in humans including 17 deaths have been reported from the states of Distrito Federal, Goiás, Mato Grosso and Mato Grosso do Sol. An additional four suspected cases are currently under investigation and yellow fever has been ruled out in 23 previously suspected cases. The first confirmed case was reported on 16 December 2007 and the last suspected case was reported on 15 February 2008 [6]. A vaccination campaign is underway in the affected areas.

Paraguay

As of 23 February 2008, 16 confirmed cases of yellow fever in humans have been reported. Seven cases were reported from the San Pedro Department, all of which had visited rural areas of the department. Nine confirmed cases were reported from San Lorenzo in Central department, close to Asuncion. A further 15 suspected cases are under investigation. The Ministry of Health, in cooperation with the Pan American Health Organization, has initiated enhanced surveillance of cases of fever and jaundice, vector control and vaccination in the affected areas [7].

Yellow fever

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.

Yellow fever vaccination

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, Argentina. El Ministerio de Salud de la Nacion duspuso un Nuevo cenrto de vacunacion contra la fiebre amarilla en el hospital Frances, 22 February 2008. Accessed 29 February 2008. Available at: http://www.msal.gov.ar/htm/Site/noticias_plantilla.asp?Id=1197  

2. National Travel Health Network and Centre. Yellow fever in Brazil, 17 January 2008. Accessed 29 February 2008. Available at: http://www.nathnac.org/pro/clinical_updates/yf_170108.htm

3. NaTHNaC. Yellow fever in Argentina, Brazil and Paraguay: Changes to yellow fever vaccination recommendations for Paraguay, 22 February 2008. Accessed 29 February 2008. Available at: http://www.nathnac.org/pro/clinical_updates/yf_220207.htm

4. 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 29 February 2008. Available at: http://www.paho.org/English/AD/DPC/CD/eid-eer-2008-02-11.htm

5. Ministry of Health, Argentina. Ocana:“Hay que delinear estrategias conjubtas para eliminar definitivamente el riesgo de la fiebre amarilla”, 28 February 2008. Accessed 29 February 2008. Available at: http://www.msal.gov.ar/htm/Site/noticias_plantilla.asp?Id=1200

6. Ministry of Health, Brazil. Situação da Febre Amarela Silvestre no Brasil, 2007 e 2008, 26 February 2008. Accessed 29 February 2008. Available at: http://portal.saude.gov.br/portal/arquivos/pdf/boletimfa_260208.

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7. World Health Organization. Yellow fever in Paraguay – Update, 28 February 2008. Accessed 29 February 2008. Available at: http://www.who.int/csr/don/2008_02_28a/en/index.html