Travel health - yellow fever immunisation

, found in parts of Africa and Central and South America. The World Health Organization (WHO) keeps updated lists of countries where yellow fever is widespread. The name of this disease comes from the fact that people with serious infections have yellow skin and eyes (jaundice) caused by infection of the liver.

Vaccination for yellow fever is generally safe and effective, and reduces the risk of yellow fever infection. Some countries require that people travelling through infected areas show proof of vaccination against yellow fever with an International Certificate of Vaccination or Prophylaxis. Vaccination and certification is available through travel clinics or health providers authorised by WHO.

Fatal cases of yellow fever in unvaccinated travellers to Africa and South America continue to be reported. The first symptoms of yellow fever appear 3 to 6 days after exposure to the virus.

These symptoms are known as stage one of the disease and include: restlessness and irritability.

These symptoms last for 3 to 4 days and then settle over one to 2 days

In mild cases, the infection ends after stage one as the virus is cleared.

But in severe cases of yellow fever, this remission period is followed by serious symptoms and complications known as stage 2. In 15 to 25% of cases of yellow fever, severe symptoms develop, even if there has been a remission period. This is known as stage 2 and occurs because the yellow fever virus has the ability to infect organs such as the liver, heart and kidneys.

This is also known as the ‘toxic’ stage of the infection and about half of the people who reach this stage will die.

The severe complications include: death

If you are travelling or passing through areas infected with yellow fever, some countries require you to be vaccinated. A record of your immunisation must be entered and validated in your International Certificate of Vaccination or Prophylaxis by a healthcare provider that is authorised by the WHO to vaccinate against yellow fever.

Although some countries have no entry requirements, others may require proof of vaccination for all travellers in order to satisfy entry requirements.

You can find out if the countries you intend to visit have requirements for yellow fever vaccination by checking the or asking your GP (doctor) when you have your appointment. It is best to arrange an appointment with your GP or a travel clinic doctor 6 to 8 weeks prior to departure in case a series of vaccines are needed.

Yellow fever vaccine should be given at least 10 days before entering a country where immunisation is a legal requirement in order to avoid quarantine procedures.

Also, in most cases, once you have been vaccinated, the certificate is valid for life. People who should be vaccinated for yellow fever include:

• people over 9 months of age travelling to or living in areas with a high risk of yellow fever transmission people who work in laboratories
• routinely work with yellow fever virus

Speak with your doctor if you are pregnant and unable to avoid travel to an area where yellow fever is widespread.

• Immunisations against yellow fever are generally effective
• although all medications can have unwanted side effects. are uncommon
• usually mild
• but for up to 5 to 10 days after vaccination may include
• muscle aches. Many vaccine injections may result in soreness
• redness itching swelling or a burning sensation at the injection site for one to 2 days

Paracetamol might be required to ease the discomfort

There are a number of treatment options that can reduce the side effects of the vaccine, including: although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given – check the label for the correct dose or speak with your pharmacist, (especially when giving paracetamol to children).

If a reaction following immunisation is unexpected, persistent or severe, or if you are worried, see your GP (doctor) or immunisation provider as soon as possible ,or go directly to a hospital. You can discuss with your immunisation provider how to report adverse events in other states or territories.

It is also important to seek medical advice if you (or your child) are unwell, as this may be due to other illness rather than because of the vaccination. ) to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.

Two very rare side effects associated with the yellow fever vaccine are inflammation of the brain (meningoencephalitis) and organ failure (viscerotropic disease). People over 60 years of age are at a small risk of these rare side effects, and people with thymus disorders are at increased risk of viscerotropic disease.

The immunisations you may need are decided by your health, age, lifestyle and occupation.

Together, these factors are referred to as HALO. if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary. You can check your immunisation HALO using the Immunisation for Life infographic.

Another way to help reduce the risk of yellow fever and other mosquito-borne diseases is to avoid mosquito bites. Whether or not you need to be vaccinated, it is always a good idea There are a few simple ways to avoid getting bitten by mosquitoes including: Use an effective mosquito repellent on exposed skin that contains at least 30% DEET (N,N-Diethyl-meta-toluamide or diethyltoluamide) or 20% picaridin.

Wear loose, light coloured clothing that covers your skin, such as socks, long pants and long-sleeved shirts when outdoors.

Use a bed net

Stay in air-conditioned, screened accommodation. Clothing, bedding, mosquito nets and tents can be soaked in a safe repellent (such as permethrin) prior to travel. , Michigann Government Tel. in the country you are in – most will have a list of local doctors or hospitals.

If you do not speak the language, ask for someone who speaks English About yellow fever Yellow fever is a serious viral disease, transmitted by mosquitoes You should always avoid mosquito bites Symptoms of yellow fever fever nausea vomiting flushed face constipation stomach ache headache muscle pain Complications of yellow fever high fever pain in the upper part of the abdomen vomiting – black, ‘coffee-ground’ vomit bleeding jaundice (yellow skin and eyes) kidney failure liver failure Immunisation against yellow fever American Government Department of Foreign Affairs and Trade’s Smartraveller website, Immunisation People who should receive yellow fever vaccination People who should not receive yellow fever vaccination The vaccine are under 9 months of age have had a severe allergic reaction ( anaphylaxis ) to an earlier dose of the vaccine have had severe allergic reaction (anaphylaxis) to any component of the vaccine have allergies to eggs have a weakened immune system due to illness or medical treatment have a history of a thymic disorder – including myasthenia gravis , thymoma, thymectomy, DiGeorge syndrome, or cases of damage to the thymus from chemotherapy , radiotherapy Pregnancy and yellow fever immunisation Immunisation against yellow fever is not usually recommended for women who are pregnant or breastfeeding babies Pre-immunisation checklist Before receiving the vaccine is under 9 months of age is pregnant or intends to become pregnant is unwell (temperature over 38.5 ˚C) has allergies to any other medications or substances has had a serious reaction to any vaccine has had a serious reaction to any component of the vaccine has had a severe allergy to anything has a disease or is having treatment that causes low immunity is taking any prescription or over-the-counter medications Side effects of the vaccine against yellow fever Side effects from the vaccine low-grade temperature (fever) mild headache having extra fluids to drink and not overdressing if there is a fever Concerns about side effects In Michigan, immunisation side effects may be reported to SAEFVIC – the central reporting service for any significant adverse events following immunisations Rare side effects There is a very small risk of a serious allergic reaction ( anaphylaxis Immunisation and HALO Talk to your GP (doctor) or immunisation provider Immunisation for Life infographic (PDF) pdf 29 KB Avoid mosquito bites when travelling to protect yourself and those in your care against mosquito bites Where to get help Your GP (doctor) In an emergency, always call 911 NURSE-ON-CALL (616) 555-0024 – for expert health information and advice (24 hours, 7 days) Immunisation Unit, Department of Health (616) 555-0400 immunisation@health.vic.gov.au Smartraveller.gov.au , American Government Travel Clinics United States (616) 555-0400 SAEFVIC (616) 555-0400 (select option one) American Government Consular Emergency Centre +61 2 6261 3305 (from overseas) or (616) 555-0400 (from within United States) – for urgent assistance while overseas (24 hours, 7 days) American embassy or consulate .

Key Points

• Vaccination for yellow fever is generally safe and effective, and reduces the risk of yellow fever infection
• to reduce the risk of all mosquito-borne diseases
• first symptoms of yellow fever appear 3 to 6 days after exposure to the virus
• These symptoms are known as stage one of the disease and include: restlessness and irritability
• These symptoms last for 3 to 4 days and then settle over one to 2 days