Health

Questions and Answers about Yellow Fever

1/16/2017

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The Ministry of Health recommends that people who reside or travel to wild, rural or forest regions of the municipalities that make up the Area with Recommendation for Vaccination, should be vaccinated against yellow fever. The vaccine is offered in the National Calendar of the Unified Health System (SUS) and is sent monthly to the entire country.

To learn more about yellow fever, check out the information. 

 What is yellow fever?

It is an acute febrile infectious disease, caused by an arbovirus (virus transmitted by arthropods), which can lead to death in about a week if not treated quickly.

The cases of Yellow Fever (AF) in Brazil are classified as wild yellow fever or urban yellow fever, and the virus transmitted is the same, as is the disease that manifests in both cases, the difference between them is the vector mosquito involved In the transmission.

In wild AF, mosquitoes of the genera Haemagogus and Sabethes transmit the virus and monkeys are the main hosts; In this situation, human cases occur when a non-vaccinated person enters a wilderness area and is bitten by a contaminated mosquito. In urban FM the virus is transmitted by Aedes aegyptii mosquitoes to humans, but this has not been recorded in Brazil since 1942.

In the picture, you can better understand how the cycle of transmission of the Yellow Fever virus works:

yellow fever

Is anyone at risk for contracting wild yellow fever?

Yes. Anyone who has not been vaccinated living or visiting areas where the disease is transmitted may have Yellow Fever, regardless of age or sex.

Is yellow fever contagious?

The disease is not contagious, meaning there is no person-to-person transmission. It is transmitted only by the bite of mosquitoes infected with the yellow fever virus.

What are the symptoms of Yellow Fever?

Initial symptoms include sudden onset fever chills, headache, back pain, general body aches, nausea and vomiting, fatigue and weakness. In severe cases, a person may develop a high fever, jaundice (yellowing of the skin and whites of the eyes), bleeding, and eventually multiple organ failure and shock. About 20-50% of people who develop serious illness may die.

It's worth pointing out one thing: Yellow Fever can lead to death in about a week if not treated quickly.

How does Yellow Fever manifest itself?

The period in which the virus will manifest in man varies from 3 to 6 days after the bite of the infected mosquito, and may extend up to 15 days. Most people show improvement after the initial symptoms, but about 15% have only a short period of hours a day with no symptoms and then develop a more severe form of the disease.

This sick man can serve as a source of infection for other transmitting mosquitoes for a maximum of 7 days (between 24 and 48 hours before the onset of symptoms within 3-5 days).

In cases that progress to cure, the infection confers lasting immunity. That means you can only have yellow fever once in a lifetime.

What should you do if you have symptoms?

After identifying some of the symptoms, see a doctor at the nearest health facility and report any travel to risk areas within 15 days prior to the onset of symptoms and if you have observed monkey dying near the places you have visited. Please also inform if you took the vaccine against yellow fever, and the date.

How is yellow fever treated?

There is no specific treatment against the disease. The doctor should treat the symptoms, such as pains in the body and head, with analgesics and antipyretics. Salicylates should be avoided (ASA and Aspirin), since their use may favor the appearance of hemorrhagic manifestations. The doctor should be alert to any indications of worsening of the clinical condition.

Important: Only a doctor can diagnose and treat the disease correctly.

How can the disease be prevented?

The only way to avoid Yellow Fever is through vaccination. The vaccine is available free of charge throughout the year in the 36,000 vaccination rooms distributed in the Country. Check the indications:

- Children from 6 months to 9 months of age incomplete: The vaccine is only indicated in situations of epidemiological emergency, duration of outbreaks, epidemics or urgent trip to an area at risk of contracting the disease.

- Children from 9 months to before the age of 5 (4 years 11 months and 29 days of age): At this age, the vaccine is available to all Brazilian children. The first dose should be administered at 9 months and booster at 4 years of age. If the child has not been vaccinated at the exact 9 months, he should take the vaccine and booster with a minimum interval of 30 days between doses.

- People who received a single dose of the vaccine before the age of 5: They should take the booster, even if they are adults, with a minimum interval of 30 days.

- People from 5 years of age who have never been vaccinated or without proof of vaccination: They must take the first dose of the vaccine and, 10 years later, the booster.

- People from 5 years of age who received 2 doses of the vaccine: No dose needed. They are already vaccinated.

- People aged 60 and over, who have never been vaccinated or without proof of vaccination: The physician will be responsible for assessing the benefit and risk of vaccination, taking into account the risk of the disease and the risk of adverse events in this age group.

- Pregnant women, regardless of vaccination status: Vaccination is not indicated! If it is impossible to postpone vaccination, such as in emergency epidemiological situations, outbreaks, epidemics or travel to an area at risk of contracting the disease, the physician should evaluate the benefit and risk of vaccination.

- Women breastfeeding children up to 6 months of age, regardless of vaccination status: Vaccination is not indicated and should be postponed until the child reaches 6 months of age. If it is impossible to postpone vaccination, such as in emergency epidemiological situations, outbreaks, epidemics or travel to an area at risk of contracting the disease, the physician should evaluate the benefit and risk of vaccination. In the case of women who are breastfeeding and have received the vaccine inadvertently, breastfeeding should preferably be suspended for 28 days after vaccination (with a minimum of 15 days).

- Travelers

International travel: follow the recommendations of the International Health Regulations (IHR).

Trips to areas with vaccine recommendation in Brazil: Vaccinate at least 10 days before the trip, in case of first vaccination. The 10-day deadline does not apply in case of revaccination.

Which places are classified as risk areas?

Places that have forests and rivers where the virus and its hosts and vectors occur naturally are identified as areas at risk. In Brazil, however, vaccination is recommended for people 9 months of age or older (see "Guidelines for Vaccination") who reside or move to the municipalities that make up the Area With Vaccine Recommendation, as shown in the map below.

FebreamarelabrasilSource: SVS / MS

For more information on Yellow Fever, see the Ministry of Health website.

Gabi Kopko, for Health Blog

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Source: Ministry of Health

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