Plan ahead . . . FDA-approved shot is unavailable, and with limited availability of alternative vaccine, getting inoculated may be a journey in itself . . .
Following 10 cases of yellow fever linked to travel in Brazil that led to four deaths this year so far, the U.S. Centers for Disease Control and Prevention has expanded and added emphasis to its recommendation that travelers to some areas of Brazil get vaccinated against yellow fever, adding to the number of areas where transmission is occurring and saying all people planning travel to the country who have not previously received the shot, should get it before departing.
Of the 10 travelers reported with yellow fever, eight had gotten infected while visiting Ilha Grande, a forest preserve off the coast of Rio de Janeiro that has attracted increasing numbers of tourists. While yellow fever can be spread by the Aedes aegypti mosquito that also can transmit Zika, the current outbreak is being spread by forest-dwelling mosquitos, rather than the urban-dwelling mosquitos associated with the recent spread of Zika in the Western hemisphere, according to Dr. Lyle Peterson of the agency’s Division of Vector-Borne Diseases. In fact, a map accompanying the CDC travel alert on yellow fever in Brazil shows Recife, the heavily congested urban area hit hardest by the outbreak of Zika in Brazil, among the few parts of the country where the CDC is not recommending yellow fever vaccination. Both the size and number of areas where vaccination is required are growing though, said Dr. David Hamer, the lead author of a report detailing the recent outbreak in the CDC’s Morbidity and Mortality Weekly Report, with tourists venturing further into areas where the virus is being spread, and the vectors venturing further, as well, infecting monkeys in parks just outside Sao Paulo city limits at the Sao Paulo zoo.
With roughly 2.5 million journeys from the United States into Brazil occurring annually, CDC officials said, peak travel times generally coincide with peak yellow fever transmission times, when warmer temperatures lead to more outdoor exposure and mosquito activity.
But getting the vaccine, which is recommended at least 10 days in advance of travel could be challenging, the CDC notes, with manufacturing issues having taken YF-VAX, the one federally approved vaccine out of circulation, and the alternative vaccine available only at a limited number of clinics, listed by the CDC here.