Yellow Fever in Brazil

Updated: July 14, 2008

• Travel Health Notice
• About Yellow Fever
• Recommendations
• As a reminder...
• Additional information

Travel Health Notice

The Public Health Agency of Canada (PHAC) continues to monitor the occurrence of yellow fever in Brazil. Travellers are recommended to get vaccinated against yellow fever and protect themselves from mosquito bites when going to certain areas of Brazil. 
A map of these areas is available at:
(http://www.phac-aspc.gc.ca/tmp-pmv/2008/gfx/YellowFeverBrazilPHAC080714-eng.pdf)

Table 1:  Areas at risk for yellow fever

State	Specific Areas
Acre	entire state
Amapa	entire state
Bahia	western and southern regions
Amazonas	entire state
Distrito Federal (including Brasilia);	entire state
Espirito Santo	northern region
Goias	entire state
Maranhao	entire state
Mato Grosso	entire state
Mato Grosso do Sul	entire state
Minas Gerais	entire state
Para	entire state
Parana	western region
Piaui	southwestern region
Rio Grande do Sul	western region
Rondonia	entire state
Roraima	entire state
Santa Catarina	western region
Sao Paulo	north western region and the municipalities of Cravinhos, Guatapara, Luiz Antonio, Sao Simao, Santa Rita do Passa Quatro, Americo Brasiliense, Araraquara, Descalvado, Ibate, Motuca, Porto Ferreira, Rincao, Santa Lucia and Sao Carlos
Tocantins	entire state

As of June 11, 2008 the Brazilian Ministry of Health has confirmed 45 human cases of yellow fever, including 25 deaths.

About Yellow Fever

Yellow fever is a serious viral infection, which affects all people differently, often very severely. It is caused by a virus that is spread to humans through mosquito bites. An infected day-time biting mosquito can spread the virus to a human when it bites. Symptoms take three to six days to appear and include sudden onset of fever with chills, headache, muscle pain, loss of appetite, nausea and vomiting. In severe cases, yellow fever can lead to shock, bleeding, organ failure, jaundice (yellowing of skin and eyes) and even death.
For additional information on yellow fever, see PHAC’s Disease Information Backgrounder: Yellow Fever.

Recommendations

PHAC recommends the following personal-protective measures to avoid mosquito bites: 

• Apply insect repellent to exposed skin. Use DEET-based products.  Remember to apply carefully:
• Do not apply to cuts, abrasions or irritated skin;
• Do not spray repellent directly on the face;
• Wash hands after application, to avoid contact with lips and eyes; and,
• Do not use DEET and sunscreen combination products.  If application of sunscreen and DEET is required, apply the sunscreen first and let it soak into the skin for about 20 minutes before applying DEET.
• Cover up. The less exposed skin you have, the less likely you are to be bitten. Wear light-coloured, long-sleeved shirts and long pants.
• Use mosquito netting treated with insecticide.  This should be considered especially in playpens, cribs or strollers to protect babies under six months;
• Consider your accommodations. When possible, remain in well-screened or completely enclosed, air-conditioned areas.

For more detailed information on protecting yourself and your family against mosquito bites, refer to PHAC’s Statement on Personal Protective Measures to Prevent Arthropod Bites.

B.    Get vaccinated – it is the single most important measure for preventing yellow fever

The single-dose vaccine against yellow fever is safe, effective and recommended for individuals nine months of age and older.  For some people, the vaccine is not recommended (e.g. pregnant women, people with weakened immune systems). See your  physician or visit a travel clinic to determine if the vaccine is right for you. Plan ahead. The vaccine becomes protective only after 10 days, so leaving vaccination to the last minute will not protect you. The vaccine provides immunity for 10 years or more. In Canada, the vaccine is available only at designated Yellow Fever Vaccination Centres.

As a reminder…

PHAC strongly recommends that you consult a health care provider or visit a travel health clinic at least six weeks prior to international travel, regardless of your destination.  Meeting with a health care provider will help you understand your individual health needs and safety risks. The health care provider can suggest steps to take to prevent illness and injury while traveling and recommend appropriate vaccinations and preventative medications.

Travellers who get sick while traveling or become sick after returning to Canada should inform their health care provider.  Without being asked, travellers should tell their health care provider where they have been and what, if any, treatment or medical care they received while traveling (e.g., blood transfusions, injections, dental care, and surgery).

• Know before you go!
  General travel health advice

• Food and Water Precautions
  PHAC strongly recommends key principles regarding food and water precautions to minimize the risk of exposure to disease.

Additional information:

Information on Yellow Fever from the Public Health Agency of Canada,
http://www.phac-aspc.gc.ca/tmp-pmv/info/yf-fj-eng.php

World Health Organization – Yellow Fever:
http://www.who.int/topics/yellow_fever/en/

Foreign Affairs and International Trade Canada Travel Report on Brazil:
http://www.voyage.gc.ca/dest/report-en.asp?country=38000