The Brazil Ministry of Health (computer translated) puts the confirmed yellow fever cases in the current outbreak at 448, with 144 deaths as of late last week. The outbreak began in December 2016.

Public domain image/Deyvid Aleksandr Raffo Setti
Public domain image/Deyvid Aleksandr Raffo Setti

The State Health Department of Rio de Janeiro confirmed the third yellow fever case in the state this year, all three patients are from Casimiro de Abreu, in the interior of Rio de Janeiro in an area that stretches inland between Buzios and Macaé, the Rio Times reports.

On Wednesday, the Centers for Disease Control and Prevention (CDC) updated their original Feb. 1 travel notice yesterday to say the following:

The first cases were reported in the State of Minas Gerais, but confirmed cases have since been reported in the neighboring states of Espirito Santo, São Paulo, and Rio de Janeiro (not Rio de Janeiro City). Cases have occurred mainly in rural areas, with most cases being reported from Minas Gerais state.

In response to this outbreak, health authorities have recently expanded the list of areas in which yellow fever vaccination is recommended for travelers. The expanded list of areas in which yellow fever vaccination is now recommended includes: the entire State of Espirito Santo; the State of Rio de Janeiro, with the exception of the urban areas of Rio de Janeiro City and Niterói; the State of São Paulo, with the exception of the urban areas of São Paulo City and Campinas.

Also included are the following municipalities in the southern and southeastern parts of the State of Bahia:

Alcobasa; Belmonte; Canavieiras; Caravelas; Ilheus; Itacare; Mucuri; Nova Visosa; Porto Seguro; Prado; Santa Cruz Cabralia; Una; Urusuca; Almadina; Anage; Arataca; Barra do Chosa; Barro Preto; Belo Campo; Buerarema; Caatiba; Camacan; Candido Sales; Coaraci; CondeUba; Cordeiros; Encruzilhada; Eunapolis; Firmino Alves; Floresta Azul; Guaratinga; Ibicarai; Ibicui; Ibirapua; Itabela; Itabuna; Itagimirim; Itaju do Colonia; Itajuipe; Itamaraju; Itambe; Itanhem; Itape; Itapebi; Itapetinga; Itapitanga; Itarantim; Itororo; Jucurusu; Jussari; Lajedao; Macarani; Maiquinique; Mascote; Medeiros Neto; Nova Canaa; Pau Brasil; Piripa; Planalto; Posoes; Potiragua; Ribeirao do Largo; Santa Cruz da Vitoria; Santa Luzia; São Jose da Vitoria; Teixeira de Freitas; Tremedal; Vereda; Vitoria da Conquista.

The Brazilian Ministry of Health maintains a list of all other municipalities in Brazil for which yellow fever vaccination continues to be recommended (not including recently added municipalities). It is located HERE

Note: because yellow fever vaccination was previously recommended and continues to be recommended in western parts of the states of São Paulo and Bahia, some municipalities in each of these states are included on this older list.

Anyone 9 months or older who travels to these areas should be vaccinated against yellow fever. People who have never been vaccinated against yellow fever should not travel to areas with ongoing outbreaks. CDC no longer recommends booster doses of yellow fever vaccine for most travelers. However, a booster dose may be given to travelers who received their last dose of yellow fever vaccine at least 10 years ago and who will be in a higher-risk setting, including areas with ongoing outbreaks. Because of the ongoing outbreak, travelers to the Brazilian states of Minas Gerais, Espirito Santo, Sao Paulo, Rio de Janeiro, and parts of Bahia may consider getting a booster if their last yellow fever vaccination was more than 10 years ago. Travelers should consult with a yellow fever vaccine provider to determine if they should be vaccinated. For more information on booster shots, see “Clinician Information,” below.

Because of a shortage of yellow fever vaccine, travelers may need to contact a yellow fever vaccine provider well in advance of travel.

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