Abstract
Yellow fever (YF) is a haemorrhagic viral disease with a high case fatality rate. It is considered a reemerging infectious disease of remarkable importance. During the last outbreaks in Brazil (2016-2017), many cases of YF emerged despite high YF vaccination coverage in some areas. However, there are many areas and populations worldwide where vaccination coverage has been low for years (e.g. Nigeria), which increases the risk of major epidemics in such areas, as would be the case in many of the American territories. Several factors, including the vast border and migratory status of Brazil, the widespread distribution of Aedes mosquitoes and the lack of efficient health policies and surveillance systems, favor this complex epidemiological scenario of reemergence. Therefore, mass vaccination of the population at risk, public health awareness and preparedness are urgently needed in this region. This opinion article describes the current global epidemiological situation of YF, focusing especially on the Americas, as well the risk and vulnerabilities in the region that would be of concern for major expansion to other countries apart from Brazil. Also, imported risk from endemic area outside of Americas (i.e. Africa) are of current concern.
Highlights
Yellow fever (YF) is a haemorrhagic viral, vector-borne disease with a high case fatality rate (CFR), spread by infected mosquitoes caused by the YF virus, an arbovirus belonging to the genus Flavivirus, family Flaviviridae
There seems to be an almost imminent risk of YF outbreaks turning into a large epidemic[9]
Unvaccinated travelers heading to the affected states in Brazil are at risk of spreading the virus in to areas where YF risk factors are present
Summary
Kansas State University, Manhattan, USA Juergen Richt, Kansas State University, Manhattan, USA Juergen Richt, College of Veterinary Medicine, Kansas State University, Manhattan, USA. Epidemics, Africa, Americas, Brazil, vector-borne disease, arbovirus. This article is included in the Emerging Diseases and Outbreaks gateway. Any reports and responses or comments on the article can be found at the end of the article. This new version considered the interesting comments of both reviewers regarding the situation of yellow fever in Brazil, and has been carefully revised and extended, attending all the suggestions. The data regarding the ongoing epidemiological, ecological and entomological scenario in Brazil has been updated, and its implications for expansion to other countries in the Americas
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