Four of Ten International Travelers Visiting Brazil Died After Contracting Yellow Fever Virus

Yellow Fever outbreak has been reported in Rio de Janeiro, Espírito Santo, São Paulo, and Bahia states
rio country side
South America (Vax Before Travel)

Brazil is in the midst of a yellow fever outbreak, with the mosquito-borne virus now reaching popular tourist destinations.

As a result, on January 16, 2018, the World Health Organization (WHO) said travelers should plan ahead and get vaccinated against yellow fever at least 10 days before departing for affected areas in Brazil.

The yellow fever outbreak has been reported in Rio de Janeiro state, Espírito Santo state, São Paulo state, and Bahia state, according to an article co-authored by a Boston University School of Public Health (BUSPH) researcher.

The BUSPH article noted that most people who contract yellow fever do not have symptoms, but among the 15 percent of patients who develop a severe illness, the fatality rate is between 20 percent and 60 percent.

Additionally, the Centers for Disease Control and Prevention (CDC) have issued a Level 2 Travel Alert for Brazil and are urging travelers to get the yellow fever vaccination 10 days before their travels.

Since January 2018, 10 cases of yellow fever have been confirmed in international travelers visiting Brazil, including four deaths.

Eight of the ten international travelers with confirmed cases of yellow fever acquired the disease on Ilha Grande, a forested island off the Rio de Janeiro coast.

ProMed reported five cases among travelers to Ilha Grande, in two travelers from Argentina and three from Chile. Two of the travelers from Chile died. GeoSentinel reported cases in a Dutchman who traveled to São Paulo state; a French woman who traveled to Minas Gerais state; and a Romanian man, a Swiss man, and a German man who all visited Ilha Grande.

The men from Switzerland and Germany later died from the disease.

"Given the potential severity of yellow fever and a substantial risk of dying from the disease, travelers should make sure that they are vaccinated," says lead author Davidson Hamer, professor of global health at BUSPH.

"It may take several weeks to make an appointment, and potentially substantial travel time to reach a clinic in some parts of the country," Hamer says.

These were the first yellow fever cases reported by GeoSentinel, which was initiated in 1995 by the International Society of Travel Medicine with support from CDC and now consists of 70 specialized travel and tropical medicine clinical sites in 31 countries around the world. Hamer is the principal investigator for GeoSentinel.

In addition to underscoring the importance of vaccination, authors wrote that clinicians should be aware and vigilant of yellow fever signs and symptoms in patients returning from Brazil.

Providers and patients may also visit the CDC Travelers' Health for information about which countries require yellow fever vaccination for entry.

In the USA, Sanofi Pasteur received FDA approval to distribute the STAMARIL® Yellow Fever Vaccine through an Expanded Access Investigational New Drug Program during the YF-VAX vaccine shortage, which may end in late 2018.

Various pharmacies offer the STAMARIL and YF-VAX vaccines, as well as other travel vaccines.

The CDC Vaccine Price List provides the private sector prices and general information, and discounts can be found here.