Yellow Fever Outbreak Hits Paraguay

Yellow fever, a disease most typically found in the tropical regions of Africa and Latin America, is on the rise in both humans and monkeys in many South American countries.

In early February, 2008, Paraguay, a nation of nearly 6 million people, confirmed its first case of yellow fever in thirty-four years. The nation has been in a state of emergency ever since. As of March 23, 2008, there have been twenty-four confirmed cases of the disease in Paraguay, including 8 deaths, as reported by the Paraguay Ministry of Health to the World Health Organization.

The rural, forested areas of Paraguay are known risk areas for what is known as the jungle type of yellow fever. Jungle yellow fever occurs when mosquitoes transmit the virus from monkeys to humans. Thirteen confirmed cases in San Pedro, located in the east central region of Paraguay, are most likely of the jungle fever type.

When the virus is introduced into urban areas the danger is that it can be rapidly transmitted and spread by mosquitoes from one human to another. Earlier this week the U. S. Centers for Disease Control reported that 10 cases of the type that is most probably urban yellow fever have been confirmed near Paraguay’s capital city, Asuncion.

In the town of San Lorenzo, twelve miles from the capital, 7 deaths from urban yellow fever have been reported. Because of this, the Paraguay Ministry of Health has strengthened containment measures, implementing yellow fever vaccination of people living in or traveling to the affected areas. The World Health Organization is stepping in to help, and plans to send 2 million vaccines to the country this week. Brazil has already sent 1 million vaccines to help out their neighbor. Since December, 2007, the disease has also killed at least 13 people in Brazil.

Because there is no treatment, vaccination is the only answer. People are desperate for the vaccine, and unrest has developed because of insufficient supplies. When word circulated that health workers were vaccinating certain politicians in their homes, a rumor that was flatly denied, protesters closed roads and started fires. Elsewhere citizens waited in long lines, in the sweltering heat, in hopes of receiving the vaccine.

People who contract yellow fever suffer from not just a fever, but also muscle pain, headaches, shivering, nausea, and vomiting. Most people improve after 3 or 4 days; however, some go into a second more “toxic” stage where not just fever, but jaundice and blood in the vomit is present. Half of the people who go into this second stage die within 10 days.

As for travelers from the United States to Paraguay, the CDC recommends vaccination for all people older than 9 months. It cautions that complications from the vaccination are greater for those younger than 9 months or older than 60 years, for pregnant women, or those whose immune systems are compromised. Travelers are also reminded to use insect repellent, and to wear long sleeved shirts and long pants when outdoors. Further disease prevention advice, and other up-to-date information concerning the subject can be found on the CDC’s web site.