The Travel Health and Vaccine Specialists

Health Alert


LEVEL 2 - PRACTICE ENHANCED PRECAUTIONS

Yellow Fever in Brazil

Updated January 22, 2018

In early 2017, the Brazilian Ministry of Health reported outbreaks of yellow fever in several eastern states, including areas where yellow fever was not traditionally considered to be a risk. Although virus spread decreased by mid-2017, yellow fever cases have reappeared in several states since the end of 2017, especially in São Paulo State, including areas close to the city of São Paulo. In early 2018, the GeoSentinel Surveillance System reported a case of yellow fever in an unvaccinated Dutch traveler who had stayed near the São Paulo metropolitan region.

In response to the outbreak, the World Health Organization expanded the list of areas where yellow fever vaccination is recommended for international travelers to Brazil. Most recently, the city of São Paulo was added to this expanded list (below). Please note that this list contains temporary expanded vaccine recommendations.

In addition to areas in Brazil where yellow fever vaccination has been recommended since before the recent outbreaks, it is now also recommended for people who are traveling to or living in:

All of Espirito Santo State.
All of Rio de Janeiro State, including the city of Rio de Janeiro.
All of São Paulo State, including the entire city of São Paulo.
A number of cities in Bahia State.

State of Bahia: new areas in which yellow fever vaccination is recommended for travelers Expand expand Collapse

The Brazilian Ministry of Health maintains a regular list of all other cities in Brazil for which yellow fever vaccination has been recommended since before the recent outbreaks. This list does not include recently added areas above. It is located at http://portalsaude.saude.gov.br/images/pdf/2015/novembro/19/Lista-de-Municipios-ACRV-Febre-Amarela-Set-2015.pdf.

Note: Because yellow fever vaccination was previously recommended (and continues to be recommended) in western parts of the states of São Paulo and Bahia, some cities in each of these states are included on the regular list.

Who should get this vaccine?
Anyone 9 months or older who travels to or lives in these areas should be vaccinated against yellow fever. Because of current limitations in the availability of yellow fever vaccine in the United States, travelers may need to contact a yellow fever vaccine provider well in advance of travel.

Expanded Yellow Fever Vaccine Recommendation Areas in Brazil

Vaccine recommended
Vaccine recommended due to current outbreak Vaccine recommended
Low elevation Vaccine recommended due to current outbreak
High elevation Vaccine not recommended

Clinician Information:
Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015
Yellow Fever in CDC Health Information for International Travel -“Yellow Book” Clinical and Laboratory Guidance
Diagnostic Testing
Testing for Vaccine Adverse Events
Additional Information:
FAQ’s about Yellow Fever
Yellow Fever Vaccine Information Statement (VIS)
Authorized U.S. Yellow Fever Vaccine Centers
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Page created: February 01, 2017
Page last updated: January 26, 2018
Page last reviewed: January 26, 2018
Content source: Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Division of Global Migration and Quarantine (DGMQ)