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 that is transmitted primarily by mosquitoes. It is called ‘yellow fever’ because in serious cases, the skin turns yellow in colour. This is known as ‘jaundice’.

What are the symptoms of yellow fever?

Symptoms of yellow fever may take 3 to 6 days to appear. Some infections can be mild but most lead to serious illness characterised by two stages. In the first stage fever, muscle pain, nausea, vomiting, headache and weakness occur. About 15 to 25 per cent of those with yellow fever progress to the second stage also known as the’ toxic’ stage, of which half die within 10 to 14 days after onset of illness. Visible bleeding, jaundice, kidney and liver failure can occur during the second stage.

How do humans become infected with yellow fever virus?

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

In tropical rainforests, yellow fever occurs in monkeys that are infected by mosquitoes. The yellow fever virus is passed onto other mosquitoes that feed on infected monkeys. These infected mosquitoes bite humans that enter the forest, resulting in some cases of yellow fever. This form of the disease is known as ‘sylvatic’ or ‘jungle’ yellow fever.
In some parts of Africa mosquitoes that breed around households, can infect humans. Urban yellow fever happens when infected people introduce the virus into areas with high human populations. Mosquitoes carry the virus from person to person.

How can people protect themselves against contracting yellow fever?

By getting vaccinated

Yellow fever is preventable. The vaccine is safe and almost 100 percent effective. With few exceptions, vaccination is recommended for all travellers to countries or areas where there is a risk of yellow fever transmission.

By avoiding mosquitoes
The mosquitoes that transmit yellow fever are usually active during the day. All people who travel to or live in yellow fever endemic countries are advised to avoid mosquitoes. This can be done by taking the following measures:

Wear a mosquito repellent containing DEET or Picaridin
Wear light coloured, long-sleeved clothes when you’re outdoors
Avoid wearing perfume or cologne (some of these can attract mosquitoes)
Prevent mosquitoes entering your accommodation
Use a mosquito net at night-time (if mosquitoes are likely to be present)

How is yellow fever infection treated?

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

Does yellow fever occur in Australia?

Yellow fever does not occur 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 includes 45 countries. The list is guided by World Health Organization’s list of yellow fever endemic countries and also takes into account recent international surveillance data.

Australia's yellow fever declared places from 1 August 2009
Australia’s yellow fever declared places (from 1 August 2009)
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

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.

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.

Do I need a yellow fever vaccination?

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

Apart from yellow fever vaccination requirements for re-entry into Australia from yellow fever declared countries (see below), you should also consider the yellow fever entry requirements for all the countries you intend entering, including those which you will transit. The quarantine requirements for yellow fever vaccination differ markedly from country to country depending upon their relative risk exposure to the disease.

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 might 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.

It is strongly recommended that you check the entry requirements for yellow fever of all the countries you intend to enter or transit by contacting their foreign missions in Australia. The Department of Foreign Affairs and Trade (DFAT) web site lists contact details for diplomatic representatives of various foreign governments. DFAT’s Smartraveller web site also provides detailed travel information for each country.

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 yellow fever declared country (see list of yellow fever declared places in table above).

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 provided they agree in writing to notify health authorities if they develop any symptom of yellow fever in the six-day period following their departure from a declared yellow fever infected place. This measure is known as placing a traveller under ‘Quarantine Surveillance’. Anyone suspected or confirmed as having yellow fever may be placed under quarantine in a suitable medical facility.

Where do I get a yellow fever vaccination and vaccination certificate?

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

Australian Capital Territory
Communicable Disease Control
ACT Department of Health
Phone: (02) 6205 2155

New South Wales
Public Health Division
NSW Department of Health
Phone: (02) 9391 9000

Northern Territory
Centre for Disease Control
Department of Health and Families
Phone: (08) 8922 8044

Queensland
Communicable Diseases Branch
Queensland Health
Phone: (07) 3328 9724

South Australia
Communicable Disease Control Branch
Department of Health
Phone: (08) 8226 7177

Tasmania
Communicable Disease Prevention Unit
Department of Health and Human Services
Phone: 1800 671 738

Victoria
Communicable Disease Prevention and Control Unit
Department of Human Services
Phone: 1300 651 160

Western Australia
Communicable Disease Control Directorate
Department of Health Western Australia
Phone: (08) 9388 4999

Where do I get further information?

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.

International Travel and Health, World Health Organization, 2010: http://www.who.int/ith/chapters/en/index.html.
WHO yellow fever fact sheet: http://www.who.int/mediacentre/factsheets/fs100/en/index.html.
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.
Yellow Fever Vaccine, WHO: http://www.who.int/vaccines/en/yellowfever.shtml.
Control of Communicable Diseases Manual, 19th Edition, 2008. American Public Health Association.
The blue book: guidelines for the control of infectious diseases, 2005: http://www.health.vic.gov.au/ideas/bluebook.
International Health Regulations, 2005, WHO, Annex 6, 7 http://www.who.int/gb/ebwha/pdf_files/WHA58/WHA58_3-en.pdf.
Yellow Fever Declaration 2009 at the Commonwealth of Australia Law Website
The Department of Foreign Affairs and Trade web site http://www.smartraveller.gov.au/zw-cgi/view/Advice/.