Global & Disaster Medicine

Despite fewer cases, Brazil has confirmed 2 cases of yellow fever in a city just 83 miles away from Rio de Janeiro.

ECDC

17 Mar 2017

Yellow fever is a mosquito-borne viral infection present in some tropical areas of Africa and South America.

In South America, there are two transmission cycles of yellow fever:
– A sylvatic cycle, involving transmission of the virus between Haemagogus or Sabethes mosquitoes and primates. The virus is transmitted by mosquitoes from primates to humans when humans are visiting or working in the forest.
– An urban cycle, involving transmission of the virus between Aedes aegypti mosquitoes and humans. The virus is usually introduced in an urban area by a viraemic human who was infected in the forest.

Brazil has been experiencing an outbreak of yellow fever since December 2016. The outbreak was notified on 6 January 2017.

Weekly Summary
Between 6 and 16 March 2017, Brazil reported 20 additional cases of yellow fever, mostly in Espírito Santo and Minas Gerais. On 15 March 2017, the state of Rio de Janeiro reported its two first confirmed autochthonous cases in the municipality of Casimiro de Abreu, located 135 km from the city of Rio de Janeiro.

On 10 March 2017, the Netherlands reported a confirmed case of yellow fever in a traveller returning from Suriname.

During week 10 of 2017, Ecuador reported a confirmed case of yellow fever in the province of Sucumbios, which borders Colombia. Prior to this case, the last confirmed yellow fever case in Ecuador was reported in 2012 in the province of Napo.

Epidemiological Summary
On 6 January 2017, Brazil reported an outbreak of yellow fever. The index case had onset of symptoms on 18 December 2016. The first laboratory confirmation was notified on 19 January 2017.

Between 6 January and 16 March 2017, Brazil has reported 1 357 cases (933 suspected and 424 confirmed), including 249 deaths (112 suspected and 137 confirmed). The case-fatality rate is 18.3% among all cases and 32.3% among confirmed cases.

States reporting suspected and confirmed autochthonous cases:
– Minas Gerais has reported 1 074 cases (749 suspected and 325 confirmed), including 189 deaths (78 suspected and 111 confirmed).
– Espírito Santo has reported 243 cases (150 suspected and 93 confirmed), including 48 deaths (26 suspected and 22 confirmed).
– São Paulo has reported 15 cases (11 suspected and four confirmed), including four deaths (one suspected and three confirmed).
– Rio de Janeiro has reported three cases (one suspected and two confirmed), including one confirmed death.

States reporting suspected autochthonous cases:
– Bahia has reported eight suspected cases, including one fatal.
– Tocantins has reported six suspected cases, including one fatal.
– Rio Grande do Norte has reported one suspected case, fatal.
– Goiás has reported three suspected cases, not fatal.

In addition, investigations are ongoing to determine the probable infection site of four further suspected cases.

On 16 March 2017, authorities in the state of Rio de Janeiro identified 47 municipalities as a priority for the vaccination campaign, including the municipality of Casimiro de Abreu, where the two confirmed cases are reported.

The Ministry of Health of Brazil has launched mass vaccination campaigns in addition to routine vaccination activities. As of 16 March 2017, 16.15 million extra doses of yellow fever vaccine had been sent to five states: Minas Gerais (7.5 million), São Paulo (3.25 million), Espírito Santo (3.45 million), Rio de Janeiro (1.05 million) and Bahia (900 000).

 


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