Current Situation

Since the beginning of 2009, there has been an expansion in areas of yellow fever virus transmission in Brazil. Two states, Rio Grande do Sul and São Paolo, have recently designated expanded areas of risk following confirmation of new human cases of yellow fever within their boundaries. This demonstrates the particular intensity of yellow fever virus activity in the southern part of the country.

During mid December 2008 through April 2009, the state of Rio Grande do Sul, on the southern tip of Brazil, reported 13 confirmed human cases of yellow fever infection. Six of these people died. This is the first time since 1966 that human yellow fever cases have been reported in Rio Grande do Sul. In response to the situation, the Brazilian Ministry of Health has added a number of municipalities to the yellow fever risk area for this state. For a map and list of the municipalities in Rio Grande do Sul where yellow fever vaccine is currently recommended, see the April 9, 2009, update from the health secretariat in Rio Grande do Sul (PDF) (in Portuguese).

Since February 2009, the state of São Paolo in Southern Brazil has reported 22 confirmed human cases of yellow fever, including 9 deaths. These cases have occurred in the municipalities of Itatinga, Sarutaiá, Buri, and Piraju, which lie outside the previously reported risk area. These cases represent an expansion of yellow fever transmission in São Paolo. For a map of the expanded area of yellow fever risk in the state of São Paolo and a list of new municipalities where vaccination is recommended, see page 5 of the April 8, 2009, bulletin from the Brazilian Ministry of Health   (PDF) (in Portuguese).

Yellow Fever Risk Areas in Brazil

Currently, Brazil recommends yellow fever vaccination for travelers to the following states: All areas of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, Tocantins, and designated areas of the following states: northwest and west Bahia, central and west Paraná, southwest Piauí, northwest and west central Rio Grande do Sul, far west Santa Catarina, and north and south central São Paulo.

In late 2008 the Brazilian Ministry of Health (MOH) announced that the southern, coastal area of Bahia state and the state of Espírito Santo are no longer considered risk areas for yellow fever transmission.

Please refer to the CDC yellow fever risk map for Brazil to see the areas with risk for yellow fever transmission.

Recommendations for US Travelers

Brazil currently does not require yellow fever vaccination for entrance into the country. However, travelers are strongly urged to get the yellow fever vaccine before traveling to an area of Brazil with risk of yellow fever transmission. For additional information, see CDC yellow fever vaccination recommendations and requirements for Brazil.

Since yellow fever is spread by the bite of an infected mosquito, travelers are also reminded to take steps to prevent mosquito bites:

• When outdoors or in a building that is not well screened, use insect repellent on uncovered skin. Always apply sunscreen before insect repellent.
  • Look for a repellent that contains one of the following active ingredients: DEET, picaridin (KBR 3023), Oil of Lemon Eucalyptus/PMD, or IR3535. Always follow the instructions on the label when you use the repellent.
  • In general, repellents protect longer against mosquito bites when they have a higher concentration (%) of the active ingredient. However, concentrations above 50% do not offer a marked increase in protection time. Products with less than 10% of an active ingredient may offer only limited protection, often just 1-2 hours.
  • The American Academy of Pediatrics approves the use of repellents with up to 30% DEET on children over 2 months old.
  • Protect babies less than 2 months old by using a carrier draped with mosquito netting with an elastic edge for a tight fit.
  • For more information about the use of repellent on infants and children, please see the “Insect and Other Arthropod Protection” section in Traveling Safely with Infants and Children in CDC Health Information for International Travel 2008 and the “Children” section of CDC’s Frequently Asked Questions about Repellent Use.
  • For more information on the use of insect repellents, visit Insect and Arthropod Protection in CDC Health Information for International Travel 2008.
• Wear loose, long-sleeved shirts and long pants when outdoors.
  • Clothing may also be sprayed with repellent containing permethrin or another EPA-registered repellent for greater protection. (Remember: Don't use permethrin on skin.)

  Visit the Brazil destination page on the CDC Travelers’ Health website for information about other steps to take to ensure a safe and healthy trip to Brazil.
 

Additional Information

For more information about the yellow fever situation in Brazil, see these resources from the Brazil Ministry of Health:

• Notice listing municipalities in Brazil where yellow fever vaccine is recommended (PDF) (in Portuguese)
• Updates on yellow fever disease status (in Portuguese)

For more information about the yellow fever situation in South America, see:

• CDC Announcement: Yellow Fever in South America and the Caribbean—Evolving Situation
• World Health Organization notice: Americas – Yellow Fever.

For more information about yellow fever risk and yellow fever vaccine, see the Yellow Fever section of CDC Health Information for International Travel 2008.