Yellow fever in Brazil continues to spread: vaccination recommendation for travelers
After a long-term outbreak of a Zika epidemic in Brazil, yellow fever infections are currently on the rise in the South American country. Vacationers are also affected. Health experts advise travelers to be vaccinated.
Increase in yellow fever virus activity in Brazil
After the long-lasting Zika epidemic, Brazil is struck by another tropical disease: "Since December 2016, Brazil has recorded an increase in yellow fever virus activity," the World Health Organization (WHO) wrote in a recent message, which states that now the metropolis of São Paulo is declared a risk area for yellow fever. The background is a renewed outbreak of the infectious disease in various states in the South American country.
Vaccination recommendation expanded
"After the yellow fever vaccination recommendation of the World Health Organization (WHO) was extended to the entire state of Rio de Janeiro and the state of São Paulo with the exception of the city of São Paulo in March / April 2017, the recommendation is now being extended to the city of São Paulo" reports the Robert Koch Institute (RKI).
The reason is accordingly yellow fever cases in monkeys, which indicate a circulation of the yellow fever virus transmitted by mosquitoes in the region.
This is one of the reasons why inner-city parks in São Paulo and nearby forest areas were closed at the end of 2017.
In addition, at the beginning of the year, several human yellow fever diseases were recorded in people in the greater São Paulo area, presumably after staying in the nearby city of Mariporá. A European traveler was also affected.
Sick back from vacation
According to a message from the CRM Center for Travel Medicine, this was a 46-year-old Dutchman who returned to the Netherlands in January after spending several weeks in Maripora.
He was reported to have high fever, headache, muscle aches, diarrhea, nausea, and vomiting.
In a clinic in Rotterdam the suspicion of yellow fever was confirmed, against which the traveler was not vaccinated.
"The case in Holland shows how important a vaccination against yellow fever is when traveling to Brazil - especially when traveling to areas that were previously considered yellow fever free," said Professor Dr. Tomas Jelinek, scientific director of the CRM Center for Travel Medicine.
Infections can be fatal
Yellow fever is transmitted by day and night active mosquitoes. The infection suddenly starts with a high fever and general symptoms. The disease usually heals afterwards.
However, there can also be a dramatic worsening of jaundice and bleeding, followed by heart, circulatory, liver and kidney failure. These complications often lead to death.
"Yellow fever infections can be fatal," explained Professor Jelinek, "The vaccination against it is highly effective and offers reliable protection."
Already ten days after vaccination, the average is 80 to 100 percent, 30 days afterwards there is practically 100 percent immunity.
"We therefore recommend travelers to destination Brazil to be vaccinated against yellow fever at least ten days before departure," said the expert.
"The vaccination must be carried out according to the international health agreements in state-approved yellow fever vaccination centers," explains the RKI on its website.
"The vaccination is documented in the yellow international vaccination card."
Avoid mosquito bites
"In addition, you should, for example, as part of a travel medical consultation, find out what measures you can take to avoid mosquito bites," said Professor Jelinek.
Wearing light-colored clothing and using mosquito nets are measures that help against annoying mosquitoes.
Above all, the chemical defense is effective. Agents with the active ingredient DEET (diethyltoluamide) are recommended as mosquito repellent. (ad)