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CAB Reviews

A reviews journal covering agriculture, global health, nutrition, natural resources and veterinary science

CAB Review

The threat of urban yellow fever in tropical America.

Abstract

Yellow fever (YF) is an infectious disease caused by the YF virus (YFV) that, in its most severe form, is characterized by jaundice, fever, liver and renal failure, and neurologic and haemorrhagic manifestations. In the Americas, the virus has two well-established cycles of transmission: the wild (sylvatic) and the urban cycle. Urban YF will occur when the transmission cycle in a specific area is maintained only between humans and Aedes aegypti mosquitoes. Factors that increase the risk of urban YF are the increased number of sylvatic cases, YF-infected individuals making the transition from wooded areas to the urban environment, the high density of Ae. aegypti population in urban areas and the low vaccination coverage. Although possible, the risk to the development of urban YF may be reduced to a minimum, if all the approaches to control this disease are applied in the context of a sylvatic YF outbreak. Here, using the current Brazilian sylvatic YF outbreak as an example, we discuss the tools health-care officials have to use in order to avoid the development of an urban outbreak of YF.

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