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 (jaundice) observed in people with serious illness.
Symptoms of infection 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, jaundice, kidney and liver failure. The death rate in unvaccinated people may be as high as 50 per cent.
 No cases of yellow fever infection have been recorded in Australia but a mosquito (Aedes aegypti) capable of carrying and transmitting the yellow fever virus to humans is common in the coastal regions of North Queensland. The objective of Australian quarantine precautions is to prevent the introduction of yellow fever virus into Australian mosquitoes.
As there is no specific treatment for Yellow Fever the primary preventative measure is to be vaccinated against this viral disease.
Occurrence
The disease is found in urban and rural areas of tropical zone countries in Africa and South America. Yellow fever has not been reported in Asia.
The World Health Organization (WHO) closely monitors reports of yellow fever infection and previously published a list of countries where the disease occurs. On 21 January 2002 the WHO published this list for the last time with the following countries mentioned:
•In Africa: Angola, Benin, Burkina Faso, Cameroon, Cote d'Ivoire (Ivory Coast), Democratic Republic of Congo (formerly Zaire), Gabon, Gambia, Ghana, Guinea, Liberia, Nigeria, Sierra Leone, Sudan
•In South America: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Peru, Venezuela.
The 2002 WHO list of infected countries where yellow fever occurs, is in line with the list of countries signed off by the Minister for Health and Ageing, the Hon Mr Tony Abbott MP, on 16 March 2004, as being yellow fever declared places under the Quarantine Act 1908. T
In addition to countries where the disease has been reported, there are other countries where yellow fever could occur because of the occurrence of suitable environmental factors. The WHO international travel and health 2005 publication. states that areas where yellow fever virus is present far exceed those officially reported. The WHO recommends vaccination against yellow fever for travellers who intend to move outside urban areas in the following countries, even if these countries have not officially reported the disease:
In Africa:
- Burundi,
- Central African Republic,
- Chad,
- Congo,
- Equatorial Guinea,
- Ethiopia,
- Guinea Bissau,
- Kenya,
- Mali,
- Niger,
- Sao Tome and Principe,
- United Republic of Tanzania,
- Rwanda,
- Senegal,
- Somalia,
- Togo,
- Uganda,
- Zambia.
In South America:
- Guyana,
- Panama,
- Suriname.
Vaccination requirements for travel
The quarantine requirements for yellow fever vaccination for international travel depend on the countries to be visited. Travellers should check with their travel agent, a travel health clinic, or the government representative in Australia of the countries in Africa or South America they intend to visit to obtain this information. The Department of Foreign Affairs and Trade has a guide to diplomatic representation by foreign governments in Canberra with their contact details.
Many countries, particularly those in Asia, will refuse permission to enter to any person who has recently been in a yellow fever infected country and who does not possess a valid yellow fever vaccination certificate. Some countries will only allow unvaccinated persons to enter if they agree to be vaccinated at their border. In this situation, you may not be able to ensure the sterility of the items used to administer the vaccine.
Yellow Fever is a quarantinable disease in Australia. Australia requires any person over one year of age to hold an international yellow fever vaccination certificate if, within the six days prior to their arrival in Australia, they have stayed overnight or longer in a declared yellow fever infected country in Africa or South America (see yellow fever declared places list above). This information only concerns Australian quarantine requirements. Travellers should seek medical advice on vaccination needs for their individual medical circumstances, particularly regarding the suitability of yellow fever vaccine for infants and pregnant women.
Australian travellers who do not receive the approved yellow fever vaccine from an approved vaccination centre in Australia risk being refused permission to enter many countries, or being required to accept the vaccine in a potentially unsafe manner.
Persons arriving in Australia who are required to possess a yellow fever vaccination certificate but do not, will be interviewed on their arrival by officers from the Australian Quarantine Inspection Service (AQIS). AQIS officers may only 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. Any person who is suspected or confirmed as having yellow fever may be placed under quarantine and provided with supportive treatment in a suitable medical facility.
If a traveller is unvaccinated and contracts yellow fever the consequences can be serious and may result in death.
Treatment
There is no specific treatment for yellow fever infection.
Avoidance
The primary preventative measure is to be vaccinated. The vaccine is almost 100 per cent effective against yellow fever and tolerance of the vaccine is excellent. The vaccine provides protection against yellow fever infection for at least 10 years, commencing 10 days after it is administered.
Travellers in yellow fever infected countries should also take measures to avoid being bitten by mosquitos. These measures include wearing loose fitting long sleeved clothing, applying effective mosquito repellent containing DEET or picaridin to exposed areas, and living in mosquito proof accommodation.
Yellow fever vaccination certificate
To obtain a valid international yellow fever vaccination certificate you must be given a yellow fever vaccine that has been approved by the WHO from a vaccination provider who has been approved by a national health authority. The certificate must be in a form that has been approved by the WHO and be completed according to WHO requirements.
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