Yellow Fever in Brazil

Updated:  January 20, 2009

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• Travel Health Notice
• About Yellow Fever
• Recommendations
• Don't Forget...
• Additional information

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Travel Health Notice

Brazil has announced that there are changes to the areas of risk for yellow fever. You  should get vaccinated against yellow fever and protect yourself from mosquito bites when going to certain areas of Brazil. 

Table 1:  Areas at risk for yellow fever

State	Specific Areas
Acre	entire state
Amapa	entire state
Bahia	north-western and western regions
Amazonas	entire state
Distrito Federal (including Brasilia);	entire state
Goias	entire state
Maranhao	entire state
Mato Grosso	entire state
Mato Grosso do Sul	entire state
Minas Gerais	entire state
Para	entire state
Parana	central and western regions
Piaui	southwestern region
Rio Grande do Sul	northwestern and west central regions
Rondonia	entire state
Roraima	entire state
Santa Catarina	western region
Sao Paulo	north western region and the municipalities of Cravinhos, Guatapara, Luiz Antonio, Sao Simao, Santa Rita do Passa Quatro, Americo Brasiliense, Araraquara, Descalvado, Ibate, Motuca, Porto Ferreira, Rincao, Santa Lucia and Sao Carlos
Tocantins	entire state

About Yellow Fever

• Yellow fever is a serious viral infection, which affects everyone differently, often very severely.
• It is caused by a virus that is spread to humans by infected mosquitoes that bite during daytime hours.  
• Symptoms take three to six days to appear.  They include sudden onset of fever with chills, headache, muscle pain, loss of appetite, nausea and vomiting.
• In severe cases, yellow fever can lead to shock, bleeding, organ failure, jaundice (yellowing of skin and eyes) and even death.

For additional information on Yellow Fever, see PHAC's Disease Information Backgrounder: Yellow Fever.

Recommendations

1. Protect yourself from mosquito bites:
1. Cover up: wear light-coloured, long-sleeved, tucked-in shirts, long pants, shoes (not sandals), and a hat
2. Use insect repellent on exposed skin
1. Insect repellents that contain DEET are the most effective
2. Use as directed by the manufacturer
3. Do not apply to cuts, scrapes, abrasions or irritated skin
4. Do not spray directly on your face
5. Wash your hands after you apply insect repellent to avoid contact with your lips and eyes
6. Do not use products that contain both insect repellent and sunscreen
7. If you want to use sunscreen and an insect repellent with DEET, apply the sunscreen first.  Let it soak into your skin for about 20 minutes, then apply repellent with DEET
8.  Wash off repellent at the end of the day, before you go to bed.
3. Sleep under an insecticide-treated bed net
1. Make sure there are no tears or large holes in the net
2. Tuck it under the mattress
3. Ensure it is not touching you (or you still may be bitten through the net)
4. Consider your accommodations:
   1. Stay in a well-screened or completely enclosed air-conditioned room
5. Apply a permethrin insecticide to tents and bed nets for greater protection
   1. Permethrin-treated clothing is effective for up to two weeks or six washings.  Although permethrin isn't available in Canada, travel health clinics can advise you how to purchase permethrin and pre-treated gear before or during your trip.
2. Get vaccinated
1. It is strongly recommended that you get the yellow fever vaccine before you travel to an area where there is a risk of yellow fever, even though Brazil does not currently require a vaccination for yellow fever to enter the country.
2. The single-dose vaccine against yellow fever is safe, effective and recommended for most people who are over nine months of age. 
3. For some people, the vaccine is not recommended (e.g. pregnant women, people with weakened immune systems and children under the age of nine months).
4. See your physician or visit a travel clinic to determine if the vaccine is right for you. It takes 10 days before the vaccine takes effect and will begin protecting you, so leaving vaccination to the last minute will leave you at risk. The vaccine provides immunity for 10 years or more. In Canada, the vaccine is available only at designated Yellow Fever Vaccination Centres.

More information on precautions to take to avoid mosquito bites while travelling: Statement on Personal Protective Measures to Prevent Arthropod Bites - Update

Don't Forget …

1. Consult a health care provider or visit a travel health clinic at least six weeks before you travel.
2. What to do if you get sick when you are travelling
3. What to do if you get sick after you return to Canada
4. Know what vaccines you need and when to get them

Additional information:

• Information on Yellow Fever from the Public Health Agency of Canada
• World Health Organization – Yellow Fever
• Foreign Affairs and International Trade Canada Travel Report on Brazil