As of 13 February 2017, yellow fever virus transmission continues to expand towards the Atlantic coast of Brazil in areas not deemed to be at risk for yellow fever transmission prior to the revised risk assessment published by WHO in the Disease Outbreak News of 27 January 2017, and supported by the scientific and technical advisory group on geographical yellow fever risk mapping (GRYF).
The revised risk assessment was based on epidemiological evidence and ecological factors. The expanded areas at risk of yellow fever transmission remain the same as in the Disease Outbreak News of 27 January 2017 and the WHO travel advice of 31 January 2017, and include:
• Bahia State: extension of the areas at risk for yellow fever transmission with the inclusion of the following municipalities in the south and south-west of the state: 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.
• Espírito Santo State: at risk for yellow fever transmission with the exception of the urban area of Vitoria.
• Rio de Janeiro State: at risk for yellow fever transmission in the following northern municipalities bordering Minas Gerais and Espírito Santo States: Bom Jesus do Itabapoana; Cambuci; Cardoso Moreira; Italva; Itaperuna; Laje do Muriae; Miracema; Natividade; Porciuncula; Santo Antonio de Padua; São Fidelis; São Jose de Uba; Varre-Sai; Campos dos Goytacazes; São Francisco de Itabapoa; São João da Barra.
Currently there is no evidence of yellow fever virus transmission in the large metropolitan areas of the East Coast such as Rio de Janeiro, San Salvador, and Sao Paulo. The determination of new areas considered to be at risk for yellow fever transmission is preliminary and updates will be provided regularly.
In view of the evolving situation, and considering that travelers for the Carnival in the next few weeks may take side tours outside the main cities, the current advice by the WHO Secretariat for international travelers going to areas of Brazil deemed to be at risk, including the above mentioned ones, is the following:
Vaccination against yellow fever at least 10 days prior to the travel. Note that, as per Annex 7 of the International Health Regulations (2005), a single dose of a yellow fever vaccine approved by WHO is sufficient to confer sustained immunity and life-long protection against yellow fever disease. Travelers with contraindications for yellow fever vaccine (children below 9 months, pregnant or breastfeeding women, people with severe hypersensitivity to egg antigens, and severe immunodeficiency) or over 60 years of age should consult their health professional for advice; adoption of measures to avoid mosquito bites; awareness of symptoms and signs of yellow fever; seeking care in case of symptoms and signs of yellow fever, while travelling and upon return from areas at risk for yellow fever transmission.
For 2017 updates on yellow fever vaccination requirements and WHO vaccination recommendations for travelers see Annex and country list on the WHO International Travel and Health website.