World Wide Shortage Of Yellow Fever Vaccine May Affect World Cup Fans

The unavailability of the vaccine can mean that travelers to countries that require YF vaccination may be denied entry. Travelers to YF endemic countries that do not require vaccination not only put themselves at risk, but if they visit other countries while viremic and are exposed to vector mosquitoes, they run the risk of starting a YF outbreak. There is concern about football (soccer) fans attending the FIFA World Cup games [12 Jun-13 Jul 2014] in those parts of Brazil where YF virus is endemic, such as the Manaus area. One hopes that the shortage will indeed end in March 2014, providing enough time for football fans and players to receive the vaccine if they act promptly when the vaccine becomes available.

Those planning to attend one or more of the World Cup venues or other YF endemic areas in South America, Darien, Panama, or Africa should determine whether they are in the YF risk areas.

As noted in WHO's yellow fever vaccination requirements and recommendations (http://www.who.int/ith/chapters/ith2012en_countrylist.pdf?ua=1), yellow fever vaccination is "recommended for all travelers 9 months of age or older going to the following areas: the entire states of Acre, Amapa, Amazonas, Distrito Federal (including the capital city of Brasilia), Goias, Maranhao, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Para, Rondonia, Roraima, Tocantins; and designated areas of the following states: Bahia, Parana, Piaui, Rio Grande do Sul, Santa Catarina, and Sao Paulo (state). Vaccination is also recommended for travelers visiting Iguazu Falls. [It is] not recommended for travelers whose itineraries are limited to areas not listed above, including the cities of Fortaleza, Recife, Rio de Janeiro, Salvador, and Sao Paulo."

[Although the WHO guidelines say that vaccination is not required for Rio de Janeiro and other coastal cities, most Brazilian cities including Rio are suffering from dengue epidemics, which mean they are infested with _Aedes aegypti_ mosquitoes, the same mosquitoes that transmit yellow fever. So if a football fan or other tourist (either Brazilian or international) goes into the Amazon jungle and gets yellow fever, he or she could bring it back to Rio

Brazil also considers that there is no risk of YF transmission in the coastal areas of the states of Piaui, Ceara, Rio Grande do Norte, Paraiba, Pernambuco, Alagoas, Sergipe, Bahia, Espirito Santo, Rio de Janeiro, Sao Paulo, Parana, Santa Catarina, and Rio Grande do Sul.

Doctors in Sheffield [South Yorkshire, England] are urging people travelling to Africa and South America to get protected against yellow fever -- after taking delivery of a rare batch of the jab during a worldwide shortage.

Sheffield Travel Clinic, based at the Royal Hallamshire Hospital, has received a consignment of the drug, which is expected to remain scarce until the end of next month [March 2014].

Yellow fever is transmitted by mosquitoes in Africa, South America, and some parts of the Caribbean. Symptoms include fever, severe headaches, back pain, body aches, nausea, vomiting, and fatigue. Some patients also enter a second, more toxic phase, when jaundice and kidney failure can occur.

Source proMED-mail

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Travel Warning:Yellow Fever in Sudan

As of December 3, 2013, the World Health Organization (WHO) has reported 44 suspected cases of yellow fever, including 14 deaths, from October 3 to November 24, 2013. Some of the cases have been laboratory-confirmed. The outbreak is located in West and South Kordofan states of Sudan. Sudan’s Federal Ministry of Health and WHO are planning a mass yellow fever vaccination campaign in the affected areas to control the outbreak.

Yellow fever is a disease caused a virus, which is spread through mosquito bites. Symptoms take 3–6 days to develop and include fever, chills, headache, backache, and muscle aches. About 15% of people who get yellow fever develop serious illness that can lead to bleeding, shock, organ failure, and sometimes death.

How can travelers protect themselves?

Travelers can protect themselves from yellow fever by getting yellow fever vaccine and preventing mosquito bites. Learn more about CDC’s yellow fever recommendations for Sudan on the Sudan destination page.

Get yellow fever vaccine:

• Visit a yellow fever vaccination (travel) clinic and ask for a yellow fever vaccine.
• You should receive this vaccine at least 10 days before your trip.
• After receiving the vaccine, you will receive a signed and stamped International Certificate of Vaccination or Prophylaxis (ICVP, sometimes called the “yellow card”), which you must bring with you on your trip.
• The vaccine lasts for 10 years.
• In rare cases, the yellow fever vaccine can have serious and sometimes fatal side effects. People older than 60 years and people with weakened immune systems might be at higher risk of developing these side effects. Also, there are special concerns for pregnant and nursing women. Talk to your doctor about whether you should get the vaccine.

Prevent mosquito bites:

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent as directed.
• Higher percentages of active ingredient provide longer protection. Use products with the following active ingredients:
• DEET (Products containing DEET include Off!, Cutter, Sawyer, and Ultrathon)
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin) (Products containing picaridin include Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan [outside the US])
• Oil of lemon eucalyptus (OLE) or PMD (Products containing OLE include Repel and Off! Botanicals)
• IR3535 (Products containing IR3535 include Skin So Soft Bug Guard Plus Expedition and SkinSmart)
• Always follow product directions and reapply as directed:
• If you are also using sunscreen, apply sunscreen first and insect repellent second.
• Follow package directions when applying repellent on children. Avoid applying repellent to their hands, eyes, and mouth.
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself:
• Treated clothing remains protective after multiple washings. See the product information to find out how long the protection will last.
• If treating items yourself, follow the product instructions carefully.
• Do not use permethrin directly on skin.
• Stay and sleep in screened or air conditioned rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.