Yellow Fever In Africa

Yellow Fever in Africa occurs in a belt across the central zone of the continent. Fortunately it is one of the few arbovirus infections that has an available vaccine.


Yellow Fever Map
Yellow areas = Yellow Fever vaccination recommended - CDC 2017

Yellow Fever Facts

  • Yellow Fever caused by a virus, which is spread via the bite of an infected mosquito. It is found in tropical areas of Africa.
  • Yellow Fever in Africa is recognised in two different forms - urban and jungle. 'Urban Yellow Fever' occurs when an infected person enters a densely populated area and is spread from person to person by any type of mosquito. 'Jungle Yellow Fever' is essentially a disease of monkeys living in tropical rainforests is spread to humans by rainforest mosquitoes.
  • The Yellow Fever vaccine prevents the disease.

Yellow Fever Symptoms

  • Yellow Fever symptoms may be mild at first and go unrecognized - headaches, fevers, abdominal pain.
  • After a short while though, things may get get serious with shock, bleeding, kidney and liver failure. The liver failure is associated with jaundice - hence the name Yellow Fever.

Yellow Fever Shot Reactions

  • As with any vaccination there maybe mild reaction symptoms to yellow fever shots like soreness at the injection site, fever and aches.
  • Rarely there are severe allergic responses which need prompt medical attention.
  • Elderly people are considered to have a slightly increased risk of serious side effects from the Yellow Fever vaccination. It is important they take their physician's advice on this.

Yellow Fever Vaccination Exemption

  • If your physician confirms there is a medical contraindication to yellow fever vaccination, a medical waiver can be issued. In this case, the provider should fill out and sign the Medical Contraindications to Vaccination section of the ICVP (International Certificate of Vaccination or Prophylaxis). Also, it is the provider's responsibility to counsel the traveller about the risks of travelling without vaccination to a country with risk of yellow fever virus transmission and about personal protective methods against mosquito bites. Travellers in this situation should be advised that the safest alternative is to avoid or postpone travel.
  • Additionally the physician who grants a medical waiver should provide a signed and dated exemption letter on letterhead stationery, clearly stating that the vaccine is contraindicated on medical grounds. This letter should also display the centre's official yellow fever vaccination stamp. Medical exemption letters should be written for the current trip only.

Yellow Fever Revaccination

  • In 2014, the WHO Strategic Advisory Group of Experts on Immunization concluded that a single primary dose of YF vaccine provides sustained immunity and lifelong protection against YF disease and that a booster dose is not needed.
  • As of 11 July 2016 the IHR (International Health Regulations) were officially amended to specify that a completed International Certificate of Vaccination or Prophylaxis (ICVP or “yellow card”) is valid for the lifetime of the vaccinee, and countries cannot require proof of revaccination (booster) against YF as a condition of entry, even if the last vaccination was >10 years prior.
  • However, ACIP (Advisory Committee on Immunization Practices) also stated that a single dose of YF vaccine provides long-lasting protection and is adequate for most travellers but specify that additional doses of YF vaccine are recommended for specific groups of travellers such as women who were pregnant when they received their initial dose, those who have HIV and those who have had stem cell transplants.
  • So CDC recommends considering administering a booster dose for travellers who received their last dose of YF vaccine over 10 years previously who will be going to higher-risk settings based on season, location, activities and duration of travel.
  • Although booster doses of YF vaccine are not recommended for most travellers, and despite the recent changes to the IHR, clinicians and travellers should nonetheless review the entry requirements for destination countries.
  • It is uncertain whether all countries with YF vaccination entry requirements will fully adopt this change. Even if countries modify their official policies to extend the validity period of the YF vaccination from 10 years to the lifetime of the vaccinee, there is no guarantee that all national border officials will be aware of such policy change or be able to enforce it.
  • Read more from the WHO

Summary For African Travellers and Hunters

  • Any hunter or traveller going to areas where Yellow Fever is endemic is at risk.
  • Hunters should obtain the necessary yellow fever vaccination when travelling to endemic areas of the world.
  • Yellow Fever vaccine may only be obtained at approved vaccination centres.
  • Confusion still exists as to which countries require a compulsory Yellow Fever certificate. A Yellow Fever Certificate is the ONLY internationally regulated certificate. The WHO recommends it for all travellers to endemic areas, as well as for those coming from an endemic area to an area of potential transmission. The purpose of the certificate is not only to protect the traveller but to also protect those in areas of the world where infection is possible.
  • It is essential to plan ahead if you know you need the yellow fever shot, due to occasional shortages of the vaccine.
  • Take the usual precautions against mosquito bites - cover exposed skin and use effective insect repellents.

2015 - South Africa will no longer require travellers entering the country from Zambia or Tanzania, (also Eritrea, Somalia. São Tomé and Principe) to produce proof of vaccination against yellow fever. Read full SA Government Yellow Fever Policy

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Page Updated: Jan 2020




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