Is the Yellow Fever Outbreak in Brazil the New Zika?

  • Is the Yellow Fever Outbreak in Brazil the New Zika?

Is the Yellow Fever Outbreak in Brazil the New Zika?

"In an era of frequent global travel, any marked increase in domestic cases in Brazil raises the possibility of travel-related cases", they wrote.

But an increasing number of people have also been infected, making it Brazil's worst yellow fever outbreak among humans in decades.

Yellow fever outbreaks could conceivably also occur in US territories, they write, "just as the recent Zika epidemic reached Puerto Rico, causing a significant outbreak there and leading to thousands of travel-related cases and more than 250 locally transmitted cases in the continental United States".

There is a vaccination against yellow fever, according to the World Health Organization, which provides lifetime protection against the disease. Zika started in Brazil in 2015 and has spread to about 60 countries.

"In an era of frequent global travel, any marked increase in domestic cases in Brazil raises the possibility of travel-related cases and local transmission in regions where yellow fever is not endemic", Fauci and Paules wrote.

An outbreak of yellow fever in rural Brazil is raising concerns that the sometimes deadly virus could spread to the U.S. Since December, the virus has killed a little more than 200 people, along with over 300 confirmed cases and more than 900 suspected cases in clusters on the eastern side of Brazil. Although PANO confirmed 101 people in Brazil have died from yellow fever since December, officials are still reviewing 109 other deaths that may be connected to the virus.

"In an era of frequent worldwide travel, any marked increase in domestic cases in Brazil raises the possibility of travel-related cases and local transmission in regions where yellow fever is not endemic", the team wrote.

Fauci said it was important that his office "puts it on the radar screens" of public health authorities and physicians.

So far confirmed cases have been reported in three of Brazil's states: Minas Gerais, Espirito Santo, and Sao Paulo.

Worryingly, the number of suspected and confirmed cases is Brazil's highest since 2000.

They are urging clinicians, particularly those in the United States and other places where yellow fever is uncommon, to inform themselves about yellow fever symptoms and to adopt a high index of suspicion for this diagnosis, particularly when examining travellers returning from affected regions.

A yellow fever outbreak in Angola and the Democratic Republic of Congo in 2016 exhausted the world's emergency vaccine stockpile.

Over the past few weeks, the Latin American country has seen an uptick in yellow fever cases in some of its rural areas. Early symptoms include a fever that can mimic flu, followed by a period of remission, and then a stage called "intoxication" - high fever, liver dysfunction and jaundice, and even kidney failure, heart and nervous system dysfunction, and shock.

To prevent a similar occurrence during a future yellow fever outbreak in Brazil or elsewhere, the authors note that "early identification of cases and rapid implementation of public health management and prevention strategies, such as mosquito control and appropriate vaccination, are critical".