Earlier this week, Brazil registered its first case of yellow fever to occur within a city. It occurred in São Bernardo do Campo, an urbanized area in the immediate vicinity of São Paulo. The region’s 35-year-old resident was hospitalized after visiting a high-risk area of the city, Mairiporã.
Deaths from the virus in five Brazilian states have prompted the federal government to help state governments offer vaccinations. Although confirmed cases and deaths have thus far all occurred in more rural areas, fears that the virus could spread has led to high demand for vaccination in Rio de Janeiro, São Paulo, Minas Gerais, Espírito Santo, and Bahia.
Authorities reaffirmed earlier statements that Brazil does not have an urban outbreak of the virus on its hands, and that the last such outbreak was in 1942. The Ministry of Health released a statement emphasizing its control program for the Aedes aegypti mosquito, responsible for the spread of dengue, zika, and chikungunya, in addition to yellow fever.
The Ministry of Health’s statement also asserted that there is “good coverage in the areas of vaccine recommendation, and very sensitive surveillance to detect early virus circulation” in new risk areas.
“The reason that this outbreak is so big and reaching so many people, while not yet being urban, is because it’s occurred in very populated areas,” Dr. Fernando Rosado Spilki, vice president of the Brazilian Virology Society (SBV), explained to The Brazilian Report. “The Southeast is very populous. To stop this happening, there have to be vaccinations.”
The recent outbreak of yellow fever began shortly after Brazil’s government declared the end of the previous outbreak in September last year. However, the Pan American Health Organization (PAHO) recently called the new outbreak “the biggest in decades” in the Americas.
Vaccine shortages mean that states are administering fractional doses, which last for just one year as opposed to eight. However, Dr. Spilki stressed that vaccination is important to prevent outbreaks similar to those in recent decades.
“Towards the end of the last century, and at the beginning of this century, you had cities like Campinas losing huge numbers of people to yellow fever,” he explained. However, he adds, while the SBV’s position is that vaccinations should have begun with the first monkey outbreaks in 2016, Brazil is still better prepared this time round and high death tolls are unlikely to occur.
“In theory, I’m not saying we’re facing an imminent urban outbreak of yellow fever,” Dr. Spilki concluded.