17 June 2009

Yellow fever in Brazil – expansion of risk areas

This updates the yellow fever risk areas in Brazil (see map below). NaTHNaC previously reported on this in the News item: Yellow fever in Brazil – expansion of risk areas, 29 April 2009.

In 2009, yellow fever cases in monkeys and humans have been reported from areas of Brazil that were not considered risk areas for yellow fever. This illustrates that the situation for yellow fever in Brazil is dynamic. Health professionals and travellers should check the NaTHNaC website regularly for the latest information on all risk areas for yellow fever.

Rio Grande do Sul State

Between November 2008 and 25 May 2009, 19 human cases of yellow fever and 7 deaths have been confirmed by state authorities [1, 2]. The most recent case was reported from Santa Cruz do Sol [2]. In response, as of 28 April 2009, the Brazilian Ministry of Health has added a number of municipalities within the state of Rio Grande do Sul to the list of risk areas. This includes the state capital of Porto Alegre [1], an area not previously considered a risk for yellow fever.

São Paulo State

As of 26 May 2009, 26 human cases of yellow fever and 9 deaths have been confirmed by state authorities [3]. Cases have been reported from the municipalities of Buri, Itatinga, Pirajú and Sarutaiá, areas outside the previously reported risk area. These areas are not within the boundaries of the city of São Paulo.  A state-wide vaccination campaign is ongoing.

Map of recent yellow fever activity in Brazil and expansion of risk areas

This map is based on NaTHNaC interpretation of reports of the Ministry of Health of Brazil and the Secretary of State of Rio Grande do Sul and São Paulo.

Advice for travellers

NaTHNaC recommends yellow fever vaccination for travellers over nine months of age visiting the newly expanded risk areas of Rio Grande do Sul and São Paulo states.  This is consistent with the advice issued by the Secretariats of Health of the states of Rio Grande do Sul and São Paulo. Full vaccination recommendations for travellers to Brazil can be found on the NaTHNaC Country Information Pages.

Yellow fever is transmitted via the bite of an infected mosquito. In South America, the virus is transmitted by Aedes spp. mosquitoes (urban transmission from mosquito to humans) or Haemogogus spp. (jungle transmission from monkey to mosquito to human) and Aedes spp. mosquitoes in Africa.

The mosquitoes that transmit yellow fever feed predominantly during daylight hours. Yellow fever can be prevented by taking mosquito bite avoidance measures and by vaccination.

Details of yellow fever vaccination recommendations because of risk, and requirements under International Health Regulations (2005) can be found on the NaTHNaC Country Information Pages.

References

1. Governo do Estado, Rio Grande do Sul. Febre Amarela Silvestre, Rio Grande do Sul, 2008 e 2009. BOLETIM SEMANAL ENCERRADO. 28 April 2009. [Accessed 15 June 2009]. Available at: http://portal.saude.gov.br/portal/arquivos/pdf/Boletim_FARS_280

409.pdf

2. Secretaria da Saúde. Secretaria da Saúde confirma mais um caseo de fibre amerela. 25 May 2009. [Accessed 15 June 2009]. Available at http://www.saude.rs.gov.br/wsa/portal/index.jsp?menu=noticias

&cod=42723

3. Secretaria da Estado Saúde. Febre Amarela Silvestre, Estado de São Paulo, 2009. BOLETIM DE ATUALIZAÇÃO – ENCERRADO. 26 May 2009. [Accessed 15 June 2009]. Available at: http://portal.saude.gov.br/portal/arquivos/pdf/boletim_fasp_2605

2009.pdf