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26 Jan 2017

#Outbreak of #yellowfever in #Brazil, 25 January 2017 (@ECDC_EU, summary)

 

Title: #Outbreak of #yellowfever in #Brazil, 25 January 2017.

Subject: Sylvatic Yellow Fever virus outbreak in Brazil, ECDC risk assessment.

Source: European Centre for Disease Control and Prevention (ECDC), full PDF file: (LINK). Summary.

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RAPID RISK ASSESSMENT

Outbreak of yellow fever in Brazil, 25 January 2017

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Suggested citation: European Centre for Disease Prevention and Control. Outbreak of yellow fever in Brazil – 25 January 2017. Stockholm: ECDC; 2017. 

© European Centre for Disease Prevention and Control, Stockholm, 2017

 

Conclusions and options for response

  • The risk of yellow fever transmission in the EU/EEA is currently very low as it depends on the virus being introduced by viraemic travellers to an area with an established, competent and active mosquito vector population. 
  • In Brazil, the authorities have reported only sylvatic cases in 2016 and 2017.
  • However, this outbreak should be carefully monitored as the establishment of an urban yellow fever cycle would have the potential to quickly affect a large number of people.
  • Therefore, EU/EEA Member States should consider a range of options for response. EU citizens who travel to, or live in, areas where there is evidence of periodic or persistent yellow fever virus transmission, especially those in outbreak-affected regions, are advised to:
    • Be aware of the risk of yellow fever in endemic areas of Brazil, particularly in the states with confirmed autochthonous cases: Minas Gerais, Espírito Santo and São Paulo;
    • Check their vaccination status and get vaccinated if necessary. Vaccination against yellow fever is recommended from nine months of age for people visiting, or living in yellow fever risk areas.
    • An individual risk benefit analysis should be conducted prior to vaccination, taking into account the season (December to July in Brazil), destination, duration of travel and the likelihood of exposure to mosquitoes (e.g. rural areas, forests).
      • WHO publishes a list of countries, territories and areas with yellow fever vaccination requirements and recommendations [1], which includes the Brazilian states of Minas Gerais, Acre, Amapá, Amazonas, Distrito Federal (including the capital Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Pará, Rondônia, Roraima and Tocantins, and designated areas of Bahia, Paraná, Piauí, Rio Grande do Sul, Santa Catarina and São Paulo.
      • Vaccination is also recommended for travellers visiting Iguazu Falls. 
      • Given the geographical extension of the outbreak to states previously considered low risk, such as Espírito Santo, in addition to considering recommending vaccination in line with the WHO recommendations on yellow fever vaccination related to the states listed above, Member States should also consider recommending yellow fever vaccination for travellers aged over nine months going to rural areas in Espírito Santo State.
    • Take measures to prevent mosquito bites indoors and outdoors, especially between sunrise and sunset when Aedes mosquito vectors are most active.
      • These measures include:
        • the use of mosquito repellent in accordance with the instructions indicated on the product label;
        • wearing long-sleeved shirts and long trousers;
        • sleeping or resting in screened or air-conditioned rooms, or using mosquito nets at night and during the day.
    • To reduce the risk of adverse events following immunisation, healthcare practitioners should be aware of the contraindications and follow the manufacturers’ advice on precautions before administering yellow fever vaccine [2]. 
  • ECDC will publish and update regularly a map and a list of states reporting confirmed cases of yellow fever in Brazil related to the current outbreak at the following link: http://ecdc.europa.eu/en/healthtopics/yellow_fever/currenttransmission/Pages/yellow-fever-map.aspx

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Keywords: ECDC; Updates; Yellow Fever; Brazil.

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