Yellow Fever: Brazil

[Sally Furniss]

Yellow fever alert alarms Brazil
By Gary Duffy
BBC News, Sao Paulo

The Brazilian government has confirmed that a man who died in hospital in the capital, Brasilia, was suffering from yellow fever.

Hundreds of thousands of people have been queuing for vaccinations for the disease in parts of Brazil, after 12 suspected cases in recent weeks.

Eight of those cases, three of them fatal, are still being investigated.

Yellow fever is transmitted by infected mosquitoes and is generally confined to rural or jungle areas of Brazil.

In the last 12 years, the country has reported 349 cases of the disease, with 161 deaths.

Brazil has not had a case of urban yellow fever since 1942 but now this man has died in hospital in the capital with the disease.

However, the latest victim spent the New Year's holiday in a rural area in the neighbouring state of Goias and the authorities are working on the belief he was infected outside the city.

Monkey scare

Since the recent alert, more than 560,000 people have been vaccinated against yellow fever and the government says there is no risk of an epidemic.

Public concern was initially raised when two monkeys were found dead in a public park in Brasilia, but tests on one of the animals have shown it did not have the disease.

During this busy holiday period in Brazil the government is issuing reminders to tourists, both from home and abroad, to check on the need for vaccinations, depending on their travel plans.

The authorities here are currently dealing with another public health concern, with a sharp rise in cases of dengue fever, which is also spread by mosquitoes.

In the first seven months of 2007, more than 438,000 cases of dengue fever were reported in Brazil, with 98 deaths.

There is no vaccination for dengue and health officials have to rely instead on encouraging the public to avoid a build-up of pools of water in outside areas, which encourages mosquitoes to breed.

http://news.bbc.co.uk/2/hi/americas/7184421.stm

[Sally Furniss]

Re: Yellow Fever: Bazil

HEALTH-BRAZIL: Yellow Fever - Epidemic or False Alarm?
By Fabiana Frayssinet

RIO DE JANEIRO, Jan 14 (IPS) - The Brazilian Health Ministry is fighting a war on two fronts. It is taking measures to prevent an outbreak of sylvatic (or jungle) yellow fever while countering speculation in the press about an imminent epidemic of the disease. There have been no cases of urban yellow fever in the country since 1942.

In all, 24 cases of yellow fever have been reported to the ministry since December. Two have been confirmed by laboratory tests, and five have been ruled out, leaving 17 suspected cases, according to the Health Ministry.

In the first two weeks of 2008, three patients have died. One of the victims was confirmed to have contracted yellow fever, and the others are suspected to have died of the illness on the basis of clinical assessments that have not yet been confirmed by laboratory tests, which take several days.

"There is exaggerated alarm, because we have only had rare sporadic cases," Valdineia Veloso, the head of the Evandro Chagas Research Institute, part of the Oswaldo Cruz Foundation (FioCruz), said in an interview with IPS.

Veloso, a specialist in infectious diseases, is one of the official spokespersons charged with denying stories about an outbreak of yellow fever.

Yellow fever is a haemorrhagic viral disease transmitted by Aedes aegypti mosquitoes, the same species of insect that transmits dengue fever. It is present in 18 out of the 27 Brazilian states -- in the north, west-centre and south -- according to the Health Ministry.

But Veloso stressed that this is not an urban variety of the virus, like the one that caused the epidemic prior to 1942, but a sylvatic strain, confined to jungles and forests and mainly infecting monkeys.

"We are not experiencing an outbreak of urban yellow fever. What we have are suspected cases of sylvatic yellow fever in persons who travelled to at-risk areas and may have become infected with the disease," the expert said.

Even if it were confirmed that these are cases of yellow fever, "which occur sporadically in Brazil," what really matters is ascertaining whether these infections were contracted in urban areas, according to Veloso.

She said that in the case of all three fatalities, "there was a history of having visited jungle areas where sylvatic yellow fever is an established risk."

One of the deceased patients was Graco Abubakir, a computer technologist from Brasilia, who had travelled to Piren?polis, a historic city in the central state of Goi?s, which has forested areas.

Another was Almir Rodrigues da Cunha, a member of the business community who died in Maring?, a city in the southern state of Paran?, after spending the New Year holidays with his family in Novas Caldas, another city in Goi?s.

The third victim was Salvador P?rez, a Spaniard, who died on Sunday in Goiania, the capital of Goi?s. He too had travelled to the interior of Goi?s before falling ill.

"This tale that urban yellow fever is back is a lie. I personally guarantee that there is no possibility of urban yellow fever anywhere in the country," Health Minister Jos? Gomes Temporao said last week.

"The situation is absolutely under control. There is no danger of an epidemic," he told a press conference. He repeated this message in a television appearance Sunday.

The minister made his statements last week after his ministry issued an international alert through the Foreign Ministry and Tourism Ministry, recommending that foreigners be vaccinated against yellow fever before visiting this country.

At the same time as he was trying to calm the population, Temporao announced that two million additional doses of yellow fever vaccine were being distributed. Production of the vaccine is being doubled.

According to Veloso, this is a "routine" measure, taken whenever there is a suspected case of yellow fever. The vaccine is part of the regular immunisation schedule for Brazilians over the age of nine who live in at-risk areas, she said.

The vaccines are produced by FioCruz, which was already increasing output because vaccination in risk areas has been expanding since 1998, Veloso said.

Brazil also exports the vaccine to other countries.

Temporao said that people who are planning to visit at-risk areas should be vaccinated at least 10 days in advance, so that the body has time to build up antibodies against the virus.

Immunity lasts 10 years, and the vaccine is available at all health centres, although because of the scare, there are temporary shortages in some places.

"What?s happening is an over-reaction," the minister said. "People are caught up in a frenzied rush to be vaccinated. There is no reason to panic. People who have already been vaccinated and are still immune are lining up unnecessarily to be revaccinated," he said. There are long lines at health posts around the country.

According to Health Ministry statistics, there were 349 cases of sylvatic yellow fever between 1996 and 2007, with 161 deaths. Brazil?s total population is over 188 million.

Last year six people were infected, two in the state of Amazonas, two in Goi?s, one in Roraima and the other in Par?, in the northwest, centre and north of the country, respectively. Five of them died. Yellow fever has a high mortality rate in serious cases, Veloso said.

The present alert follows an earlier warning by health authorities in December, when wild monkeys were found dead near urban areas in Goi?s and the Federal District surrounding the capital, Brasilia.

Between Dec. 29, 2007 and Jan. 12, health personnel vaccinated 892,982 people in the Federal District, which has an estimated total population of 2.4 million. Vaccine coverage was over 90 percent before the alert, according to the Health Ministry, indicating that a large number of people were presenting for revaccination.

The disease is caused by the yellow fever virus, which attacks the liver and other organs, and is fatal in approximately 50 percent of toxic cases. Treatment is limited to supportive measures.

Veloso said that the symptoms -- which are easily confused with those of dengue, malaria or other acute febrile illnesses -- include muscular pain, debility, nausea, vomiting and, in serious cases, haemorrhages.

http://www.ipsnews.net/news.asp?idnews=40790

[hawkeye]

Millions in Brazil seek shots in yellow fever scare

Millions in Brazil seek shots in yellow fever scare
Tue Jan 15, 2008 8:21am EST

By Isabel Versiani

BRASILIA, Jan 15 (Reuters) - Millions of Brazilians are lining up at hospitals and clinics to receive yellow fever shots as deaths and suspected cases fuel fears of a resurgence of the deadly disease.

The death of a man in Brasilia last week prompted concerns yellow fever could swamp urban centers, from where it has been eradicated in the 1940s.

A second person from a rural area of the central state of Goias also died of the disease, officials said on Monday. More than 20 other suspect cases, including a Spanish citizen who died in Goias during the weekend, are being investigated.

The government has denied the country faces an epidemic of yellow fever, which is spread by mosquitoes, but authorities are warning tourists traveling to Brazilian forests, national parks and rural areas to vaccinate at least 10 days before the trip.

More than half of Brazil's 27 states are partially or entirely considered yellow fever risk areas, including the Amazon and the nation's capital Brasilia. Most of the coast, which attracts the bulk of tourists, is considered free of the disease.

As fears of an outbreak grew among Brazilians all over the country, the Health Ministry gave states more than 3.2 million doses of yellow fever vaccines this year, more than three times the average monthly distribution in 2007.

People in Sao Paulo stood in line on Sunday for more than four hours at an airport health station to receive shots, according to local media.

In Brasilia, hospitals temporarily ran out of vaccines last week as demand surged.

Health Minister Jose Temporao said on Sunday that all suspected cases involved people with no vaccination who were in forest areas.

"There is no risk of an epidemic," he said.

Symptoms of the disease include high fever, headache, vomiting and muscular pain. (Reporting by Isabel Versiani; Editing by Bill Trott)

[Treyfish]

Re: Yellow fever profile

EID Updates:

Emerging and Reemerging Infectious Diseases,
Region of the Americas

Vol. 5, No. 2 (14 January 2008) Main Updates index

<HR>

Yellow Fever in Brazil

Since April 2007, the National Yellow Fever Alert System in Brazil has registered an increase of epizootics (animal epidemics) in monkeys in nine states considered at risk for the yellow fever (YF) virus, including Goi?s State, where the national capital of Bras?lia is located and where animal cases have been laboratory confirmed for YF.
During December 2007 and January 2008, a further significant increase in reports of epizootics has been taking place in Goi?s, involving 23 new municipalities, some of them considered of interest for national and international tourism. Animal cases have also been registered in the Federal District (Distrito Federal or DF, i.e. the city of Bras?lia).
Six human cases of jungle yellow fever (JYF) were confirmed in Brazil between April and November 2007 in four different states, including one in Goi?s (April 2007). Between December 2007 and January 2008, 24 human cases of YF (including 3 suspected deaths) were reported in the States of Goi?s, S?o Paulo, Minas Gerais, and the DF. Two of these cases have been confirmed. One involved a resident of the DF who died following a history of having travelled to Piren?polis (Goi?s); and the other, a resident of S?o Paulo State who has recovered and whose probable locale of infection was the State of Mato Grosso do Sul. Of the 24 cases, 5 were discarded.
Considering the potential human public health risk in Goi?s and the DF, the Ministry of Health and local health authorities in Goi?s have declared a state of alert and have launched control measures to avoid the occurrence of human cases and to assure the early detection of human cases in the region. At present, the Ministry of Health does not consider that there is any risk of a yellow fever epidemic.
The following activities have been planned by the Ministry of Health to deal with the situation:

1. Intensification of the YF vaccine campaign for all persons 6 months and older who have not already been vaccinated or who were vaccinated more than 10 years ago.
2. Vaccination for tourists at least 10 days before the date of travel, for persons working in ecotourism, and for rural migrant workers.
3. Vector control measures in urban areas close to locations where affected primates have been found.

During 2007, about 520,000 people in Goias and 320,000 in Brasilia were vaccinated against YF. The Ministry of Health is now deploying 2,267,500 more vaccine doses for the area.
Additional information (in Portuguese) can be found on the website of the Secretariat of Health Surveillance of the Ministry of Health of Brazil:

• Nota t?cnica 09/01/2008: Ocorr?ncia de mortes de macacos (epizootias) no Brasil, 2007 e 2008 (Technical Note 9 January 2008: Occurrence of Monkey Deaths [Epizootics] in Brazil, 2007 and 2008)
• Nota para a imprensa, 10.1.2008 (Press Release, 10 January 2008)
• Nota para a imprensa, 13.1.2008 (Press Release, 13 January 2008)

For a summary of yellow fever cases and deaths reported to PAHO, visit the Yellow Fever Page.
Source: Information received by PAHO-Brazil from the Secretary of Health Surveillance (Secretaria de Vigil?ncia em Sa?de / SVS), Ministry of Health (Minist?rio da Sa?de / MS), Brazil. http://www.paho.org/English/AD/DPC/C...2008-01-14.htm

[Sally Furniss]

Re: Yellow Fever: Brazil

Brazil suspends exports of yellow fever vaccine to satisfy domestic demand


RIO DE JANEIRO, Jan. 15 (Xinhua) -- The Brazilian government has suspended exports of the yellow fever vaccine to satisfy domestic demand after two patients were reported to have died of the disease in the country this year, local media reported Tuesday.

The report was confirmed by the Oswaldo Cruz Foundation (Fiocruz), the world's largest producer of the vaccine, which exported 15.5 million doses to over 30 countries in 2007.

According to Fiocruz's laboratory Bio-Manguinhos, the exports were suspended at the end of last year in order to "better satisfy the internal demand" for the vaccines.

The lab stressed in a statement that demand for the vaccine has intensified, especially by "people who do not need it," such as those who do not live in the endangered areas and those who have already taken it less than 10 years ago.

The announcement of alleged deaths linked to yellow fever in Brazil has generated a rush to public health units where the vaccines are offered, leading supplies of the medicine to become scarce in some places.

Up to now only two deaths have been confirmed. Computer technician Graco Abubakir died on Jan. 8, but his infection was only confirmed some days later.

It was revealed Monday that another victim, a 24-year-old man, whose identity was kept secret at the family's request, died on Jan. 2.

Apart from the casualties, a female patient at a hospital in Sao Paulo was also confirmed to be infected with the disease.

The Ministry of Health has recommended mass vaccination in all states in mid-western Brazil where the two patients died, and in the Amazon rainforest region, as well as in some areas in the northeastern, southeastern and southern regions.

Citizens planning to visit those places are also advised to take the vaccine 10 days before their trip.

Minister of Health Jose Gomes Temporao made a speech on national TV Sunday, denying the risk of a yellow fever outbreak in the country. Seventeen cases are still being investigated, such as the death of Spanish tourist Salvador Perez de la Cal, 41, who was vacationing on a farm in Goias, in mid-western Brazil.

http://news.xinhuanet.com/english/2008-01/16/content_7430801.htm

[Sally Furniss]

Re: Yellow Fever: Brazil

Five confirmed killed by yellow fever in Brazil

Brazil's Health Ministry on Tuesday confirmed another two people died because of yellow fever, bringing the total number of victims to five in the country.

A sixth person was found contracted with the viral disease, but was recovering under intense treatment, the ministry said in a statement. Another 20 suspected cases were also under investigation.

The Brazilian government assured that no risk of an epidemic in the country's famous tour destinations such as Sao Paulo, Rio de Janeiro and coastal areas was in sight.

Meanwhile, the government has ordered millions of doses of vaccinations to meet people's demand.

At present, all cases to date are so-called wild yellow fever, which does not spread from person to person.

Yellow fever is a viral disease that is transmitted to humans through the bite of infected mosquitoes. It has caused extensive epidemics in Africa and the Americas.

http://english.people.com.cn/90001/90782/90880/6339373.html

[Sally Furniss]

Re: Yellow Fever: Brazil

Brazil confirms seven deaths from yellow fever

Brazil's health authorities on Wednesday confirmed four more cases of yellow fever in the country, which brought the total number of infections to 10 and the death toll to seven.

These were the worst scenario concerning the yellow fever in Brazil since 2003, when 64 cases were registered and 23 of the infected died.

Twelve cases are still being investigated. Further diagnosis has so far ruled out seven suspected cases.

One patient was confirmed died from the fever on Wednesday.

Also on Wednesday, a hospital in Sao Paulo reported the first case this year. Doctors said the condition of the patient, who was sent home after 10 days of treatment, had "evolved satisfactorily" in hospital.

All the patients diagnosed as the disease were allegedly infected in the state of Goias in western Brazil. Two died in the federal district of Brasilia, which neighbors Goias. In both cases, the patients visited the state recently.

Yellow fever is a viral disease that is transmitted to humans through the bite of infected mosquitoes. It has caused extensive epidemics in Africa and the Americas.

http://english.people.com.cn/90001/90782/90880/6340182.html

[Sally Furniss]

Re: Yellow Fever: Brazil

Brazil confirms 8th death from yellow fever; officials say no risk of epidemic

RIO DE JANEIRO, Brazil - An outbreak of yellow fever has killed eight people in Brazil, but officials insist there is no risk of an epidemic.

The government news agency Agencia Brasil reports that a woman died of yellow fever Friday in the midwestern farming state of Goias.

The report says tests today showed that a Goias farmworker who died on Jan. 4 also had the mosquito-borne disease.

Since the outbreak was reported last month, 12 cases of yellow fever have been confirmed and seven other patients remain in observation.

Symptoms can include fevers, vomiting, jaundice and bleeding from the mouth, nose, eyes and stomach

The World Health Organization says that an estimated 30,000 people around the world die annually from the viral disease.

Health Minister Jose Gomes Temporao said this week that there was no danger of an outbreak in cities, where most Brazilians live, but he urged people to be vaccinated against yellow fever 10 days before visiting rural areas.

The vaccine is effective for 10 years, but the outbreak has caused a run on health posts and many Brazilians have unnecessarily repeated the dose. State health officials have reported 31 cases of overdosing that caused side effects.

http://canadianpress.google.com/article/ALeqM5jU0OkpOUrEeRsrOwSc26rnkdAv-w

[Sally Furniss]

Re: Yellow Fever: Brazil

<table class="lan18" align="center" border="0" cellpadding="0" cellspacing="0" width="97%"><tbody><tr><td class="hei22" height="25" valign="bottom"> Brazil health officials report ninth yellow fever death
</td> </tr> <tr> <td bgcolor="#ffffff" height="4">
</td> </tr> </tbody></table> <table align="center" border="0" cellpadding="0" cellspacing="0" width="50%"> <tbody><tr> <td height="8">
</td> </tr> </tbody></table> <table style="width: 388px; height: 5px;" align="center" border="0" cellpadding="0" cellspacing="0"> <tbody><tr> <td width="48%">
</td> <td class="hui12" align="center" width="26%">
</td> <td class="hui12" align="center" width="12%">
</td> </tr> </tbody></table> <table border="0" cellpadding="0" cellspacing="0" width="80%"> <tbody><tr> <td height="20">
</td> </tr> </tbody></table> BRASILIA, Jan. 23 (Xinhua) -- Authorities in central Brazilian state Goias confirmed on Wednesday that a December death there was from yellow fever, raising the total number of confirmed fever deaths to nine in the last 30 days.
Cairo de Freitas, head of Goais's health department, said the man, a guard at the Federal University of Goias, had died on Dec. 30 but tests results had only become available on Wednesday.
Most of the 35 people infected by the mosquito-borne disease were in Goias, the state that surrounds national capital Brasilia. Last month's death toll is now nearly double the five fatal cases seen in a similar outbreak a year earlier.
Also on Wednesday Brazil's central government repeated a public call not to panic, saying that the nation does faces neither an outbreak nor an epidemic.
However, numbers seeking a yellow fever vaccine have soared throughout the region and last week 31 people were hospitalized with symptoms of overdosing on their daily or weekly vaccine doses.
The central government's Health Ministry has called on people living in high-risk areas to vaccinate themselves.
In Brasilia, around 100 soldiers and close to 1,000 state health workers have begun a campaign targeting the Aedes Aegypti mosquito, which is the only mosquito species that spreads dengue fever as well as being one of three mosquitoes species that carry yellow fever.

http://news.xinhuanet.com/english/2008-01/24/content_7483229.htm