Resurgence of yellow fever in Brazil: Overview and possible control options

Abstract

Dear Editor, Brazil is one of the few countries with warm humid tropical weather, offering conducive environment to the nourishment of tropical pathogens [1, 2]. Following the footprints of dengue [1] and Zika virus [2], yellow fever has recently emerged as the new public health menace. The responsible agent of the infection is an RNA virus of genus Flavivirus known as yellow fever virus. Prominent symptoms comprise fever, loss of appetite, fatigue, nausea, and in severe cases, bleeding and jaundice. Since December 2016, Brazil is confronted with a new wave of yellow fever outbreak [3]. The reckoned affectees include 586 confirmed cases along with 190 confirmed deaths (Table I) [4] (as of April 5, 2017). Furthermore, 450 incidence cases and 49 suspected deaths are under investigation, making the ongoing outbreak as the deadliest in the history of Brazil. In addition, 1,324 epizootic deaths in primates have been reported to Ministry of Health, Brazil [5]. By now, human yellow fever cases have originated in multiple states including Minas Gerais, Espirito Santo, Rio de Janeiro, and Sao Paulo. All cases reported till date have been associated with jungle mosquitoes Haemagogus and Sabethes [5]. With the preexisting burden of Zika virus [2] and dengue [1], yellow fever outbreak is another setback for country's health and economic sector. The immunization pace has been amplified and a total of 18.8 million doses of yellow fever vaccine have

Systematic review: Yellow fever control through environmental management mechanisms

“…However, these methods would benefit from further investigation via controlled trials to provide data for efficacy, costs, acceptability and feasibility. Sutter, 2016 [30] Waste management Waste management Pearce, 1978 [31] Tauil, 2010 [35] Knaut, 1997 [26] Sutter, 2016 [30] Unspecified Unspecified Havard, 1901 [32] Hargett, 1944 [22] White, 1910 [21] Anderson, 1957 [36] Pearce, 1978 [31] House destruction Cueto, 1992 [25] Use of screens Use of screens Guiteras, 1909 [24] Khan, 2017 [37] Pearce, 1978 [31] Carmo Cupertino, 2019 [33] Stern, 2007 [27] Improvement of air circulation Knaut, 1997 [26] a Note that one article may describe more than one method, hence being mentioned in different categories. Thus, the total number is also not equal to the total number of articles included.…”

“…The methods used to achieve these reductions could be classified into two categories: (i) the elimination of breeding sites, mainly through water management in the form of covering water containers and the creation and monitoring of a sewerage system with no stagnant water, and (ii) the application of screens to houses. Several articles strongly supported the use of screens in particular [20, 23–31, 33, 37].…”

“…The study by Carmo Cupertino [33] described water drainage from the streets and the application of screens to windows, recommending the latter as an alternative way to protect oneself from being bitten by a potentially infected mosquito. The recommendation of an environmental method in the remaining seven studies [21,23,24,[34][35][36][37] was based on the personal opinion of the authors.…”

“…Waste management methods were only described by Tauil [35] with the request for a regular garbage collection and for a regular clean-up of the land and the yards. The application of screens was recommended after 1937 by Khan [37] and Carmo Cupertino [33] with it being used also on windows. More detailed information can be found in Table S1.…”

Imported Zika virus infections in Hungary between 2016 and 2018

“…Not DENV is the only important flavivirus to consider when it comes to serological analysis of a possible ZIKV infection. YFV is reemerging in South America [44][45][46] and Africa [47][48][49], and a great number of travelers are immunized with the live attenuated vaccine just few weeks prior to the journey to endemic countries. In addition, a majority of the European territories are affected by one or more flaviviruses: TBEV, WNV, and USUV [16,17,30]; thus, these infections are mainly asymptomatic or have subclinical manifestation with no alarming symptoms [50,51].…”