JEMA : Your Health Promotion Experts

What is the current situation?

The Ministry of Health in the Democratic Republic of the Congo (DRC) has reported an outbreak of yellow fever. At least 39 laboratory-confirmed cases have been reported since March 2016. All cases have been reported from provinces close to the border with Angola, where there is a large yellow fever outbreak. Most yellow fever cases in DRC were acquired in Angola, but several infections were acquired in DRC. The Ministry of Health is working with the World Health Organization to control the outbreak and is planning an emergency vaccination campaign.

The government of DRC requires all travelers older than 1 year of age to show proof of yellow fever vaccination upon arrival. In addition, the Centers for Disease Control and Prevention (CDC) recommends that all travelers to DRC aged 9 months or older be vaccinated against yellow fever.

Since there is currently a shortage of yellow fever vaccine(http://wwwnc.cdc.gov/travel/news-announcements/yellow-fever-vaccine-shortage-2016), travelers may need to contact a yellow fever vaccine provider well in advance of travel. CDC no longer recommends booster doses of yellow fever vaccine for most travelers. However, DRC is currently a higher-risk setting because of the outbreak, so travelers to DRC may consider getting a booster if their last yellow fever vaccine was more than 10 years ago. For more information, see http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a5.htm.

What is yellow fever?

Yellow fever is a disease caused by a virus that 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.

Get yellow fever vaccine:

• Visit a yellow fever vaccination (travel) clinic(http://wwwnc.cdc.gov/travel/yellow-fever-vaccination-clinics/search.htm) 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(http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/yellow-fever#4735) (ICVP, sometimes called the “yellow card”), which you must bring with you on your trip.
  • For most travelers, one dose of the vaccine lasts for a lifetime. Consult a travel medicine provider to see if additional doses of vaccine may be recommended for you based on specific risk factors.
  • In rare cases, the yellow fever vaccine can have serious and sometimes fatal side effects. People older than 60 years of age 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 and pants.
• Use an EPA-registered insect repellent containing DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535. Always use as directed.
  • If you are also using sunscreen, apply sunscreen first and insect repellent second.
  • Pregnant and breastfeeding women can use all EPA-registered insect repellents, including DEET, according to the product label.
  • Most repellents, including DEET, can be used on children aged >2 months.
  • 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-in or air-conditioned rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

Clinician Information:

• Yellow Fever(http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/yellow-fever.htm)
• Clinical and Laboratory Guidance
• Diagnostic Testing
• Testing for Vaccine Adverse Events
• Yellow Fever Vaccine Booster Doses

Additional Information:

• FAQ’s about Yellow Fever
• Avoid Bug Bites(http://wwwnc.cdc.gov/travel/page/avoid-bug-bites)
• Insect Repellent Use and Safety
• Yellow Fever Vaccine Information Statement (VIS)
• Authorized US Yellow Fever Vaccine Centers(http://wwwnc.cdc.gov/travel/yellow-fever-vaccination-clinics/search.htm)