EAST PROVIDENCE – A large, ongoing outbreak of yellow fever that recently reached level 2 alert status in multiple states in Brazil has prompted about 135 countries to require vaccination against the mosquito-borne illness before allowing travelers to enter.
The vaccine is in short supply nationwide because Sanofi Pastuer, the only producer in the United States, is upgrading its facility and has stopped making it in the interim, said Wayne Estes at Atmed Treatment Center in Johnston, where their supply of the vaccine has run out.
Rhode Island Travel Clinic in Coventry is also out. Estes said Brown Medicine is the only center with a supply of the vaccine. Nearby New Englanders have been traveling to the East Providence center to square their travel plans.
“We’re seeing patients from southern Connecticut and Cape Cod traveling to our clinic to get vaccinated,” said Dr. Maria Mileno, infectious disease specialist of the Brown Medicine Travel Clinic located at 375 Wampanoag Trail, Suite 201, in East Providence. “Travelers should receive their vaccine at least 10 days before planned travel, and to take precautionary measures to prevent mosquito bites, such as using repellant spray containing DEET and limiting outdoor activity at dusk.”
Unvaccinated travelers should avoid travel to areas where vaccination is recommended, Mileno said.
The yellow fever virus is transmitted by the Aedes genus of mosquito, which can also carry Zika, dengue fever and a host of other diseases. The clinical disease begins with nonspecific symptoms such as fever, chills, nausea and muscle pain followed by severe vomiting, bleeding from the mouth, nose and eyes, jaundice and, ultimately, organ failure of the liver and kidneys leading to death.
Because the vaccine is a live virus, people with an immune system compromised by HIV and chemotherapy treatments or who take steroids or other immunomodulatory agents to suppress chronic illnesses such as rheumatoid arthritis should not receive the vaccine. The risk of fatality from the vaccine is extremely rare but is estimated at roughly 1 to 1.1 case per 100,000 for patients over the age of 60 – far less than the risk of acquiring yellow fever illness during an outbreak, according to Brown Medicine.
A single dose of the vaccine provides lifetime immunity to yellow fever and is the basis of World Health Organization requirements for cross-border travel.
Mileno urged people traveling to certain areas of Africa and South America to get the vaccine.
“Yellow fever should be taken very seriously, even for the casual weekend traveler to Rio de Janeiro or other major cities, particularly in South America. We’re seeing countries such as Aruba changing recommendations for travelers just passing through, particularly if their journey includes a location where the outbreak has occurred. It’s a moving target now, as our outbreak maps show an expanding geographic scope.”
The CDC has posted the full list of countries requiring the vaccine for travelers entering their borders.
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.
