Definition of Disease...
Yellow fever occurs only in Africa and South America. In
South America sporadic infections occur almost exclusively
in forestry and agricultural workers who are exposed occupationally
in or near forests. In Africa the virus is transmitted in
three geographic regions:
- Principally and foremost, in the moist savanna zones
of West and Central Africa during the rainy season.
- Secondly, outbreaks occur occasionally in urban locations
and villages in Africa.
- And finally, to a lesser extent, in jungle regions.
Yellow fever is a viral disease transmitted between humans
by a mosquito. Yellow fever is a very rare cause of illness
in travelers, but most countries have regulations and requirements
for yellow fever vaccination that must be met prior to entering
General precautions to avoid mosquito bites should be followed.
These include the use of insect repellent, protective clothing,
and mosquito netting.
Yellow fever vaccine is a live virus vaccine. A single dose
confers long-lived immunity lasting 10 years or more. Administration
of immune globulin does not interfere with the antibody response
to yellow fever vaccine. This vaccine has been used for several
decades and has a very low rate of adverse reactions associated
One dose of yellow fever vaccine may be administered to adults
and children over 9 months of age. This vaccine is only administered
at designated yellow fever centers, usually your local health
department. Consult your local health department for yellow
fever vaccination sites near you. The CDC does not keep a
list of registered yellow fever vaccination sites. If at continued
risk of yellow fever infection, a booster dose is needed every
WHO SHOULD NOT RECEIVE THE VACCINE
The vaccine generally is associated with few side effects;
fewer than 5% of vaccinees develop mild headache, muscle pain,
or other minor symptoms 5 to 10 days after vaccination.
Under almost all circumstances, there are four groups of
people who should not receive the vaccine unless the risk
of yellow fever disease exceeds the small risk associated
with the vaccine. In most cases, these people should obtain
either a waiver letter prior to travel or their travel to
an area with active yellow fever transmission should be delayed:
- Yellow fever vaccine should never be given to infants
under 6 months of age due to a risk of developing viral
encephalitis. In most cases, vaccination should be deferred
until 9 to 12 months of age, unless the risk of yellow fever
infection outweighs the risk of vaccine side effects in
very young infants.
- Pregnant women should not be vaccinated because of a
theoretical risk that the developing fetus may become infected
from the vaccine unless the risk of yellow fever infection
outweighs the risk of live virus vaccine side effects to
- Persons hypersensitive to eggs should not receive the
vaccine because it is prepared in embryonated eggs. If vaccination
of a traveler with a questionable history of egg hypersensitivity
is considered essential, an intradermal test dose may be
administered under close medical supervision. [Notify your
doctor prior to vaccination if you think that you may be
allergic to the vaccine or to egg products.
- Persons with an immunosuppressed condition associated
with AIDS or HIV infection, or those with their immune system
altered by either diseases such as leukemia and lymphoma
or through drugs and radiation should not receive the vaccine.
People with asymptomatic HIV infection may be vaccinated
if exposure to yellow fever cannot be avoided.
If you have one of these conditions, your doctor will be
able to help you decide whether you should be vaccinated,
should delay your travel, or should obtain a waiver.
In all cases the decision to immunize an infant between 6
and 9 months of age, a pregnant woman, or an immunocompromised
patient should be made on an individual basis. The physician
should weigh the risks of exposure and contracting the disease,
against the risks of immunization, and possibly consider alternative
means of protection.
Office hours are Monday through Friday:
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C. Michael Lewis, D.O.
G-8195 S. South Saginaw Street
Suite B, Grand Blanc, MI 48439
Phone: (810) 694-5393
Toll Free: 800-966-5393
Fax: (810) 694-5394