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Epidemiological Update - Yellow Fever - 25 January 2019

Situation Report
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Situation summary in the Americas

Between January 2017 and December 2018, six countries and territories in the Region of the Americas reported confirmed cases of yellow fever: Bolivia, Brazil, Colombia, Ecuador, French Guiana, and Peru. The number of cases reported during this period in the Region of the Americas exceeded the number reported in several decades.

In 2019, Brazil and Peru reported confirmed cases that occurred between December 2018 and January 2019. The following is a summary of the epidemiological situation in both of these countries.

In Brazil, it is currently the period which has historically been recognized as having the highest transmission (seasonal period), which occurs between December and May. The expansion of the historical area of yellow fever transmission to areas previously considered risk-free led to two waves of transmission (Figure 1), one during the 2016-2017 seasonal period, with 778 human cases, including 262 deaths, and another during the 2017-2018 seasonal period, with 1,376 human cases, including 483 deaths.

In the current seasonal period (2018-2019), 12 confirmed human cases, including 6 deaths, have been reported in the municipalities of Eldorado (9 cases), Jacupiranga (1 case), Iporanga (1 case), and Cananeia (1 case), all of which are located in the southern part of São Paulo State. Among these confirmed cases, 83% (10/12) are male, the median age is 45 years, and 83% (10/12) are rural workers. Additionally, the Paraná Secretariat of Health reported that the tests performed on dead monkeys in Antonina, on the Paraná coast, were positive for yellow fever.

Human cases reported during the current 2018-2019 seasonal period in four municipalities in São Paulo State, as well as the confirmation of epizootics in the state of Paraná, mark the beginning of what could be a third cycle and a progression of the outbreak towards the Southeast and South regions of the country (Figure 2).