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See also CDC www2.ncid.cdc.gov/travel/  (excellent full information)
Patient vaccine information statement (side-effects, benefits & risks) .. copy (pdf)

YELLOW FEVER

Yellow Fever is a mosquito-borne acute infection currently restricted to parts of South America and Africa. (see maps) It has an incubation period of 3 to 6 days, and symptoms range from a clinically indeterminate condition to an illness of sudden onset with fever, vomiting and prostration, that may progress to haemorrhagic symptoms and jaundice. The case fatality rate in non indigenous individuals may be as high as 60%.
Two forms of yellow fever, urban and jungle, are distinguished epidemiologically. Clinically and aetiologically, they are identical.
There have been several significant epidemics in recent years. The disease is mainly transmitted in urban areas by the peri-domestic breeding mosquito Aedes aegypti. As this mosquito commonly enters buildings during the day to bite, mosquito-proof premises are particularly important in prevention.

CDC defines " Yellow Fever-endemic zones " as areas reporting cases but also includes areas where there is a potential risk of infection on account of the presence of vectors and animal reservoirs. Because there is a potential for infection for travellers to either endemic or infected zones, the best protection is to be vaccinated when visiting such areas. Many countries consider "Yellow Fever endemic zones" as "infected areas", and require travellers arriving from them to have a certificate of vaccination. This also includes passengers who have only been in transit through these endemic countries. Although there is no rational justification for this action, travellers will find this practice rigidly enforced. They will either be detained in isolation for 6 days [e.g. India], or in the precincts of the airport until they resume their journey [e.g. Indonesia, Malaysia, Singapore & Egypt., (age exemption is 1 year and below & 6months for India).]

Yellow fever-infected areas, by World Health Organization criteria, are areas reporting yellow fever cases.  The most current information on CDC yellow fever vaccination recommendations by country can be found at:

Yellow Fever vaccine is very effective and well tolerated. Side effects and adverse reactions are usually mild. 2-5% of vaccinees have mild headache, myalgia, low-grade fever, or other minor symptoms occurring 5 -10 days after vaccination. Contraindications are true egg allergy, cellular immunodeficiency (appears safe if CD4 count above 200) and pregnancy (except after 6 months gestation if the risk is high). In general, children should not he immunised below the age of 9 months. with an absolute lower limit of six months. See also:

Information mostly taken from: "International Travel and Health" (WHO year book - internet only)
Australian Immunisation Handbook, 8th Edition - 9/2003 - Part1 - Part 2 & Part 3 (large pdf files)
Centre for Disease Control, USA -  www.cdc.gov/travel Travel Health Seminar Oct 96, June 97,Feb 98, March 99, May 2000, August 2002 & March 2005 - Victorian Medical Postgraduate Foundation.
Manual of Travel Medicine, Melbourne, Oct 2004. Updated 3rd edition 2011.  Additional references & disclaimer.

 

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North East Valley Division General Practice, Victoria, Australia, Disclaimer 
Level 1, Pathology Building, Repatriation Campus, A&RMC, Heidelberg West VIC 3081. .. map
Phone: 03 9496 4333, Fax: 03 9496 4349,  Email: nevdgp@nevdgp.org.au
 
Please note: NEVDGP does not provide an on-line consultation