Talking Points: Yellow Fever in Brazil (April 14, 2017)
Talking Points – Yellow Fever in Brazil
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The following Talking Points can be used in conversations with the media and clients when discussing the recent outbreak of yellow fever and travel to Brazil. (April 14, 2017)
1. The Centers for Disease Control and Prevention (CDC) has updated its Level 2 Alert for Brazil, due to an ongoing outbreak of yellow fever. While the CDC does not warn against travel to Brazil, it recommends travelers should practice enhanced precautions.
2. There are basic precautions travelers can follow to limit their possible exposure while traveling in Brazil.
3. We are here to assist our clients; the safety and well-being of our clients is our top priority.
Below you will find additional information, supporting material, and statistics supporting each talking point.
1. The Centers for Disease Control and Prevention (CDC) has updated its Level 2 Alert for Brazil, due to an ongoing outbreak of yellow fever. While the CDC does not warn against travel to Brazil, it recommends travelers should practice enhanced precautions.
Brazil’s outbreak of yellow fever began in December 2016, and fatalities have occurred as a result of the disease.
o The CDC’s Alert – Level 2 says that the states of Espirito Santo, Rio de Janeiro, São Paulo and numerous parts of the southern and southeastern areas of the state of Bahia have been affected. Because of this, the CDC now recommends the yellow fever vaccine for all of the states of Espirito Santo, São Paulo (minus the city of São Paulo), Rio de Janeiro and much of Bahia.
It is important to note that although the state of São Paola have been affected by the yellow fever outbreak, the city of São Paulo is not part of this warning.
Vaccination is recommended for all of Rio de Janeiro state, including the city of Rio de Janeiro, although the city has not reported any yellow fever cases yet.
The World Health Organization (WHO) has announced that the areas where yellow fever is affecting Brazil is expanding.
o “As of 3 April 2017, yellow fever virus transmission continues to expand towards the Atlantic coast of Brazil in areas not deemed to be at risk for yellow fever transmission prior to the revised risk assessment.”
o “Epizootics [an epidemic-like disease event in an animal population] and human cases are under investigation from 3 April 2017 for yellow fever virus infection in Bahia State along the northern coastal area, including the urban area of Salvador, with an epizootic confirmed to be due to yellow fever virus infection in the municipality of Feira de Santana; epizootics associated with yellow fever virus infection were confirmed in the proximity of the urban area of Campinas in São Paulo State, with additional epizootics being under investigation in the same area; and, in Rio de Janeiro State, epizootics are under investigation for yellow fever virus infection in the proximity of the urban areas of Rio de Janeiro City and Niterói. These reports are consistent with the increased yellow fever activity
observed in the southern areas of Bahia State, bordering Espirito Santo and Minas Gerais States, and in the areas of Rio de Janeiro and São Paulo States, all sharing the same ecosystem – tropical and sub-tropical moist broad leaves forest.”
Yellow fever is spread by infected mosquitos and is typically found in tropical and subtropical areas in South America and Africa.
o It is a virus that usually causes symptoms 3-6 days after exposure.
o Symptoms include fever, chills, and head, back and muscle aches.
o Complications occur in about 15% of those afflicted, and can lead to organ failure and death.
On April 4, the Rio Times said that “Last week the state’s health department confirmed a sixth case of yellow fever, five from Casimiro de Abreu, in the interior of Rio de Janeiro in an area that stretches inland between Buzios and Macaé and another from São Fidelis, about 100km from Casimiro.”
o Due to this, “the expectation of state officials is to vaccinate, until the end of this year, the entire population of the state. This, say health authorities, will require between 8 and 9 million additional doses of the vaccine.”
STAT reports: “Although Brazil experiences what is known as a ‘sylvatic’ cycle of yellow fever — in which the virus is spread between mosquitoes and monkeys in the jungle — the current outbreak has fanned far beyond the Amazon jungle and out to the coast. It has confounded specialists, doctors, and health officials, and raised fears of an epidemic in Brazil’s urban areas that could be devastating if not quickly contained. It is the worst outbreak of yellow fever in this country in recent memory.”
In addition, the Los Angeles Times has reported that the sudden spread of yellow fever in Brazil and shortages of the vaccine is causing concern.
o “Doctors in the United States should be asking for travel histories from any patients who turn up after a brief, mild illness appeared to go away, but was quickly followed by the hallmark symptoms of yellow fever’s “intoxication stage” — high fevers, internal bleeding, severe liver dysfunction and jaundice (hence the name “yellow fever”), kidney failure, cardiovascular abnormalities, central nervous system dysfunction and shock.”
o “It’s a perilous moment, made more so by the fact that, while an effective vaccine against yellow fever has been around since 1937, worldwide stockpiles are all but depleted. In a series of yellow fever outbreaks in Angola and Democratic Republic of Congo two years ago, public health officials ran so short of the vaccine that they resorted to giving each person one-fifth of a dose.”
2. There are basic precautions travelers can follow to limit their possible exposure while traveling in Brazil.
Fortunately, there is a vaccine available for yellow fever.
o Due to the yellow fever vaccine shortage, anyone planning to travel to Brazil should consult their physician as soon as they can. The vaccine must be given 10 days before arrival in Brazil.
o All persons over the age of nine months should receive the vaccine when planning on traveling to an area with yellow fever.
o Normally, one dose of yellow fever vaccine per lifetime is sufficient.
o Travelers should consult their physician to see if they need a booster dose if they have previously been vaccinated, and are going to a high risk area.
Since yellow fever is spread via mosquitoes, preventing their bites can help protect against yellow fever. The CDC recommends:
o Cover exposed skin by wearing long-sleeved shirts and pants.
o Use an EPA-registered insect repellent containing DEET, picaridin, oil of lemon eucalyptus (OLE), IR3535, or 2-undecanone (methyl nonyl ketone).
o If you are also using sunscreen, apply sunscreen first and insect repellent second.
o Use permethrin-treated (clothing and gear (such as boots, pants, socks, and tents).
o Stay and sleep in screened or air conditioned rooms.
o Use a bed net if the area where you are sleeping is exposed to the outdoors.
3. We are here to assist our clients; the safety and well-being of our clients is our top priority.
We would not send our clients to a particular destination if we believe it to be unsafe. Should we become aware of an issue for a specific destination, we alert clients who may be planning to travel there and provide detailed information on the situation so they can make informed decisions for themselves if they still wish to travel.
We strongly encourage all of our clients, whether they are traveling domestically or internationally, to purchase travel insurance, particularly right at the same time as travel has been booked. Travel insurance offers an additional layer of protection for travelers and can potentially help save a traveler hundreds or thousands of dollars if a medical or travel emergency occurs.
We are advocates for our clients; and they know that by working with a true travel professional, we are there for them before, during, and after their trip should they need us – which gives them peace of mind.
By working with a trusted travel professional, we can provide providing alternative travel arrangements should the need arise.
Our business is founded on repeat customers. Therefore, we want to be sure everything goes off without a hitch.