Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar 13;8(3):e2740.
doi: 10.1371/journal.pntd.0002740. eCollection 2014 Mar.

Yellow Fever outbreaks in unvaccinated populations, Brazil, 2008-2009

Alessandro Pecego Martins Romano  1 , Zouraide Guerra Antunes Costa  2 , Daniel Garkauskas Ramos  2 , Maria Auxiliadora Andrade  3 , Valéria de Sá Jayme  3 , Marco Antônio Barreto de Almeida  4 , Kátia Campomar Vettorello  4 , Melissa Mascheretti  5 , Brendan Flannery  6
Affiliations

Yellow Fever outbreaks in unvaccinated populations, Brazil, 2008-2009

Alessandro Pecego Martins Romano et al. PLoS Negl Trop Dis. .

Abstract

Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Notifications of suspected cases of human yellow fever and epizootics among non-human primates.
Rio Grande do Sul state (Figures 1a and 1b) and São Paulo state (Figures 1c and 1d). Data from the national yellow fever surveillance system according to week of occurrence, October 2008–June 2009, and final classification of cases and epizootics: confirmed, discarded (laboratory negative) and unconfirmed (classified as death of non-human primate when no specimens were available for testing).
Figure 2
Figure 2. Location of confirmed epizootic events and human cases of yellow fever, Brazil, 2008–2009 (insets: states of São Paulo and Rio Grande do Sul).
Figure 3
Figure 3. Evolution of geographic risk classification for yellow fever vaccination recommendations in Brazil, 2001–2010.
See this image and copyright information in PMC

References

    1. Monath TP (2001) Yellow fever: an update. Lancet Infect Dis 1: 11–20. - PubMed
    1. Monath TP, Cetron MS, Teuwen DE (2008) Yellow fever vaccine. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines, 5th ed. Philadelphia, PA: Elsevier. pp. 959–1055.
    1. World Health Organization (2013) Vaccines and vaccination against yellow fever: WHO Position Paper – June 2013. Weekly Epidemiological Record 88: 269–284. - PubMed
    1. Jentes ES, Poumerol G, Gershman MD, Hill DR, Lemarchand J, et al. (2011) The revised global yellow fever risk map and recommendations for vaccination, 2010: consensus of the Informal WHO Working Group on Geographic Risk for Yellow Fever. Lancet Infect Dis 11: 622–632. - PubMed
    1. Soper F (1936) Jungle yellow fever. A new epidemiological entity in South America. Revista de Hygiene e Saúde Pública 10: 107–144.

Publication types

MeSH terms

Substances

LinkOut - more resources