Traveler's Recital

Yellow Fever – Be Aware, But Not Afraid

During the 19th century, Yellow Fever was considered one of the most dangerous infectious diseases in the world. Today, with a readily available vaccine, the typical traveler has very little to worry about. That does not mean you can ignore the disease. Not only does some risk still exist even if you are vaccinated, but there are mandatory immunizations required by some countries. Safe traveling means being aware of your surroundings at all times and the existence of disease is one component of those surroundings.

About Yellow Fever

Yellow Fever is virus found in tropical regions of the world; primarily central Africa and the northern two-thirds of South America. There have been only rare cases in the United States. However, it is spread by certain species of mosquito and last month one of those species (Aedes aegypti) was discovered in Fresno, California. This could be another example of global warming enabling species typically found in the tropics to journey outside of their normal habitat. Even though Aedes aegypti is present in Asia and the Middle East, the disease does not occur there; the reason for this is not known. The World Health Organization estimates there are 200,000 cases of the disease every year (almost entirely in the unvaccinated population) with 90% of them being in central Africa (See the CDC maps). It is responsible for nearly 30,000 deaths each year. Persons infected with Yellow Fever often exhibit flu like symptoms such as fever, chills, anorexia, nausea, muscle pain, backache and headache. Most time these symptoms are self-limiting and last only 3-5 days. However, there is a more virulent form of the disease that can cause liver damage, bleeding, and death.

Prevention

Prevention comes in two forms: avoiding mosquito bites and vaccination. The standard methods are effective for avoiding being bitten:

  • Use insect repellant with DEET, picaridin, IR3535 or oil of lemon eucalyptus
  • Wear long sleeved shirts and long pants. Apply insect repellant to your clothes too.
  • Be especially careful at dusk and dawn when mosquitos are most active
  • Use insect netting on your bed if available
  • When possible sleep in air conditioned rooms with screens on the windows

 Vaccination

Anyone over 9 months of age should be vaccinate at least 10 days prior to traveling to a high risk area in South America or Africa. The vaccine provides protection for about 95% of people and according to the WHO, a single vaccination provides life-long immunity. The vaccine is a “live virus” that has been treated to avoid causing actual infection. However, as with any live virus vaccine, there are risks and only those likely to be exposed to the disease should be vaccinated. There have been rare cases of deaths resulting from the vaccine. The cost of the vaccine in the Unites States ranges from $60 – $80. I have heard it is free of charge if you happen to be in Buenos Aires.

Immunization Requirements

Besides the obvious benefit of being protected from the disease, certain countries require immunization before they permit entry. Other countries require proof of immunization if you arriving from a high risk area of the world. For country-specific information see the CDC’s site (CLICK HERE).

To Learn More

The CDC and WHO make huge amounts of information available on this disease. Here are some resource for those wanting to know more.

Yellow Fever Fact Sheet – WHO

Yellow Fever – Wikipedia

Infectious Diseases Related to Travel (Yellow Fever) – CDC

Travel Vaccines and Malaria Information, by Country – CDC

Yellow Fever Vaccine – CDC

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