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Yellow fever fact sheets

Yellow fever - general fact sheet

Yellow fever is a viral disease of short duration and varying severity that is transmitted primarily by various mosquito species. This fact sheet covers: background; occurrence; vaccination requirement for travel; treatment; avoidance; quarantine measures; yellow fever vaccination certificate.

In this section:

What is yellow fever?

Yellow fever is a viral disease of short duration and varying severity that is transmitted primarily by mosquitoes. The infection is so named because of the yellow skin colour (known as ‘jaundice’) observed in people with a serious case of yellow fever infection.

What are the symptoms of yellow fever?

Symptoms of yellow fever can be mild but often increase in severity with the sudden onset of fever, muscle pain, nausea, vomiting, headache and prostration. The disease may progress to visible haemorrhage (bleeding), jaundice (yellowing of eyes and skin), and kidney and liver failure. The death rate in unvaccinated people who contract yellow fever may be as high as 50 per cent.

How do humans become infected with yellow fever virus?

Yellow fever is transmitted to humans by the bite of infected mosquitoes from a variety of species, principally the Aedes and Haemagogus species. The disease occurs in two forms – urban and sylvatic (jungle) yellow fever. Both forms are caused by the same virus.

In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkeys carried out by mosquitoes. The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes.

The symptoms may take 3-6 days to appear. Human blood is infectious to mosquitoes shortly before the onset of fever and for the first 3-5 days of the illness. Some infections do not cause symptoms, but most lead to acute illness characterised by two phases. In the first phase there is a sudden onset of fever, muscle pain, nausea, vomiting, headache and prostration. About 15-25 per cent of those with yellow fever progress to the second phase (visible haemorrhage, jaundice, kidney and liver failure) of which half die within 10-14 days after onset of illness.

How can people protect themselves against contracting yellow fever?

By getting vaccinated

Yellow fever is preventable by a safe and effective (approaching 100 per cent) vaccine. With few exceptions, vaccination is recommended for all travellers to countries or areas where there is a risk of yellow fever transmission.

By taking mosquito avoidance measures

The mosquitoes that transmit yellow fever are usually active during the daylight hours. All who travel to or live in yellow fever endemic countries are advised to take mosquito avoidance measures such as using insect repellents, coils and sprays; using mosquito nets (preferably those that have been treated with an insecticide); and ensuring adequate screening of residential premises.
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How is yellow fever infection treated?

There is no specific treatment for yellow fever, though medicines can be used to relieve the symptoms, and this may improve the outcome for seriously ill patients.

Does yellow fever occur in Australia?

Yellow fever is not prevalent in Australia, but mosquitoes (Aedes aegypti) that can transmit the disease are common in the coastal regions of northern Queensland.

What is the occurrence of yellow fever worldwide?

The World Health Organization (WHO) closely monitors reports of yellow fever infection. Yellow fever is considered to be endemic in 32 African and 13 Central and South American countries.

Australia’s list of yellow fever declared places has been updated to include 24 new countries and the Misiones Province of Argentina. The update will ensure that the list correlates with the World Health Organization’s list of yellow fever endemic countries and takes into account recent outbreaks of yellow fever in South America. The new list will take effect on 1 August 2009 and is provided below:

Table
Africa South America & Central America
Angola* Guinea-Bissau Argentina – Misiones Province
Benin* Kenya Bolivia*
Burkina Faso* Liberia* Brazil*
Burundi Mali Colombia*
Cameroon* Mauritania Ecuador excluding Galapagos Islands*
Central African Republic Niger French Guiana*
Chad Nigeria* Guyana
Congo, Democratic Republic of the* Rwanda Panama
Congo, Republic of the Sao Tome and Principe Paraguay
Cote d’Ivoire (Ivory Coast)* Senegal Peru*
Equatorial Guinea Sierra Leone* Suriname
Ethiopia Somalia Trinidad and Tobago
Gabon* Sudan* Venezuela*
Gambia* Tanzania  
Ghana* Togo  
Guinea* Uganda  

(* Denotes countries which are already included in Australia’s list of declared yellow fever places.)
The countries were listed on the Federal Register of Legislative Instruments on 30 June 2009. (F2009L02573 – Quarantine (declared Places – Yellow Fever) Declaration 2009).



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Who can have a yellow fever vaccination?

The yellow fever vaccine is recommended for:
  • persons who are nine months of age or older travelling or living in any country in West Africa, regardless of where they will be in that country; and
  • persons who are nine months of age or older travelling or living outside the urban areas of all other yellow fever endemic countries.

    Do I need a yellow fever vaccination?

    The quarantine requirements for yellow fever vaccination differ from country to country. Travellers should check with their travel agent or a travel health clinic or the diplomatic representative in Australia of the country they intend to visit to obtain this information.

    The Department of Foreign Affairs and Trade (DFAT) web site lists contact details for diplomatic representatives of various foreign governments in Canberra. DFAT’s Smartraveller web site also provides detailed travel information for each country.

    If you have travelled through a yellow fever infected country, and you do not have a valid yellow fever vaccination certificate, you risk being refused entry into many countries. In others, you may be required to be vaccinated on arrival. You should note that the standards for administering vaccination in these countries may not be as robust as in Australia.

    What are the Australian quarantine requirements for yellow fever vaccination?

    Yellow fever is a quarantinable disease in Australia. People who are one year of age or older must hold an international vaccination certificate if, within six days before arriving in Australia, they have stayed overnight or longer in a declared yellow fever infected country in Africa or South America (see Table 2). Travellers should seek medical advice on vaccination for their individual medical circumstances, particularly about the suitability of yellow fever vaccine for infants, pregnant women and those who are immuno-compromised.

    Will I be allowed to enter Australia, if I travelled through yellow fever declared countries and do not have a yellow fever vaccination certificate?

    People arriving in Australia who are required to possess a yellow fever vaccination certificate but do not have one will be interviewed on arrival by Australian Quarantine and Inspection Service (AQIS) officers. AQIS officers will permit unvaccinated people to enter Australia if they agree in writing to notify health authorities if they develop any symptom of yellow fever infection in the six-day period following their departure from a declared yellow fever infected place. Anyone who is suspected or confirmed as having yellow fever may be placed under quarantine in a suitable medical facility.

    If a traveller is unvaccinated and contracts yellow fever, the consequences can be serious and may even result in death.

    Where do I get a yellow fever vaccination and the certificate to acknowledge the vaccination?

    Yellow fever vaccinations must be provided by an approved yellow fever vaccination clinic. These clinics will provide a vaccination certificate in the form approved by WHO and completed according to WHO requirements. A yellow fever vaccination certificate is valid for ten years and begins 10 days after vaccination. For details of your nearest yellow fever vaccination clinic, please contact your state or territory health department.
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    Australian Capital Territory

    Communicable Disease Control Unit
    ACT Health
    Phone: (02) 6205 8702

    New South Wales

    Immunisation Unit
    NSW Health
    Phone: (02) 9391 9196

    Northern Territory

    Centre for Disease Control
    Department of Health and Community Services
    Phone: (08) 8922 8825

    Queensland

    Communicable Disease Unit
    Queensland Department of Health
    Phone: (07) 3328 9700

    South Australia

    Communicable Disease Control Branch
    Department of Health
    Phone: (08) 8226 7192

    Tasmania

    Communicable Disease Prevention Unit
    Department of Health and Human Services
    Phone: (03) 6222 7726

    Victoria

    Disease Control and Research Section
    Department of Human Services
    Phone: 1300 882 008

    Western Australia

    Communicable Disease Control
    Health Department of Western Australia
    Phone: (08) 9388 4863

    If you require any information about travel vaccinations, please contact your general practitioner or travel doctor.

    Please contact the Department of Health and Ageing on (02) 6289 8638 during business hours (AEST) for information about Australian requirements for yellow fever vaccination.

    More Information

    1) International Travel and Health, World Health Organization Publication, 2005.
    2) WHO yellow fever fact sheet http://www.who.int/mediacentre/factsheets/fs100/en/
    3) CDC yellow fever fact sheet http://www.cdc.gov/ncidod/dvbid/yellowfever/index.htm
    4) World Health Organization. Yellow fever situation in Africa and South America, 2005. Weekly Epidemiological Record 2006; 81:317-24. http://www.who.int/wer/2006/wer8133.pdf
    5) MIMS online ‘Yellow fever vaccine’.
    http://www.mims.hcn.net.au/ifmx-nsapi/mims-data/?MIval=2MIMS_abbr_pi&product_code=4013&product_name=Stamaril
    5) Yellow Fever Vaccine, WHO http://www.who.int/vaccines/en/yellowfever.shtml
    6) Control of Communicable Diseases Manual, 18th Edition, 2004.
    7) The blue book: guidelines for the control of infectious diseases, 2005.
    8) International Health Regulations, 2005, WHO publication, Annex 6, 7
    http://www.who.int/gb/ebwha/pdf_files/WHA58/WHA58_3-en.pdf
    9) Government Gazette, Pages 701-702.
    http://www.ag.gov.au/portal/govgazonline.nsf/9EC39333E2EB41EECA256E610026C049/$file/GN12.pdf
    10) The Department of Foreign Affairs and Trade web site http://www.smartraveller.gov.au/zw-cgi/view/Advice/