Yellow fever primary prevention: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Changes made per Mahshid's request)
 
(26 intermediate revisions by one other user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Yellow fever}}
{{Yellow fever}}
{{CMG}}
{{CMG}}; {{AE}} {{AL}}
==Overview==
The two methods to prevent yellow fever are vaccination and vector control.  Yellow fever vaccine is recommended for persons aged ≥9 months who are traveling to or living in areas at risk for yellow fever virus transmission in South America and Africa.  Yellow fever vaccine may be required for entry into certain countries.  The best way to prevent mosquitoborne diseases, including yellow fever, is to avoid mosquito bites.


==Primary Prevention==
==Vaccination==
In 1937 Max Theiler working at the Rockefeller Foundation developed a [[vaccine]] for yellow fever that gives a ten-year or more immunity from the disease and effectively protects people traveling to affected areas, while at the same time being a means to control the disease. Woodcutters working in tropical areas should be particularly targeted for vaccination. [[Insecticide]]s, protective clothing, and screening of houses are helpful but not always sufficient for mosquito control; people should always use an insecticide spray while in certain areas. In affected areas mosquito control methods have proven effective in decreasing the number of cases.<ref>{{cite web|url=http://www.epa.gov/pesticides/health/mosquitoes/mosquitojoint.htm#programs |title= Joint Statement on Mosquito Control in the United States from the U.S. Environmental Protection Agency (EPA) and the U.S. Centers for Disease Control and Prevention (CDC) |accessmonthday= June 25 |accessyear=2006 |date= 2000-05-03| |format=PDF |publisher=Environmental Protection Agency |}}</ref>
Yellow fever vaccine is a live-virus vaccine which has been used for several decades. A single dose protects against disease for 10 years or more. If a person is at continued risk of infection, a booster dose is recommended every 10 years.
Recent studies have noted the increase in the number of areas affected by mosquito-borne viral infections and have called for further research and funding for vaccines.<ref name=Pugachev_2005>{{cite journal | author=Pugachev KV, Guirakhoo F, Monath TP | title=New developments in flavivirus vaccines with special attention to yellow fever | journal=Curr Opin Infect Dis | year=2005 | pages=387-94 | volume=18 | issue=5 | id=PMID 16148524}}</ref><sup>,</sup><ref name=Petersen_2005>{{cite journal | author=Petersen LR, Marfin AA | title=Shifting epidemiology of Flaviviridae | journal=J Travel Med | year=2005 | pages=S3-11 | volume=12 Suppl 1 | id={{PMID|16225801}} }}</ref>


===Vaccination===
====Indication====
====Indications====
*People aged ≥9 months who are traveling to or living in [[Yellow fever primary prevention#Countries with Increased Risk of Yellow Fever|areas with risk for yellow fever virus]] transmission in South America and Africa.


*Persons 9 months of age or older traveling to or living in a country that requires yellow fever vaccination for certain travelers. Check with your health-care provider.  
====Vaccine Administration====
*For all eligible people, a single injection of reconstituted vaccine should be administered subcutaneously.
*'''Name: 17D yellow fever vaccine'''
*''' Trade Name: YF-Vax®'''
*'''Dose: 0.5 mL²'''
*'''Route: SC'''
*The International Health Regulations (IHR) published by the World Health Organization (WHO) require revaccination at 10-year intervals.
* Recommendations for storage of yellow fever vaccine include the following:
:* The vaccine should be transported and stored between +2°C (35°F) and+8°C (46°F).
:* Manufacturer's recommendations for vaccine storage must be observed.
:* The vaccine should not be used after the expiration date printed on the vial.
* Since YF-VAX® does not contain a preservative, all reconstituted vaccine and containers must be appropriately discarded if they are not used within 1 hour. This includes the multi-dose (5-dose) vials.


*Persons 9 months of age or older traveling to a country that does not require yellow fever vaccination but is located in an area where the risk of yellow fever is known to exist. Check with your health-care provider.
====Contraindications and Precautions for Vaccination====
{| style="border: 0px; font-size: 85%; margin: 3px; width:600px;" align=center
|valign=top|
|+
!style="background: #4479BA; color:#FFF;  width: 300px;" | Contraindications
! style="background: #4479BA; color:#FFF;  width: 300px;" | Precautions
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Allergy to vaccine component
* Age <6 months
* Symptomatic HIV infection or CD4 T-lymphocytes <200/mm3 (or <15% of total in children aged <6 years)1
* Thymus disorder associated with abnormal immune-cell function
* Primary immunodeficiencies
* Malignant neoplasms
* Transplantation
* Immunosuppressive and immunomodulatory therapies
| style="padding: 5px 5px; background: #F5F5F5;" |
* Age 6–8 months
* Age ≥60 years
* Asymptomatic HIV infection and CD4 T-lymphocytes 200–499/mm3 (or 15%–24% of total in children aged <6 years)1
* Pregnancy
* Breastfeeding
|}


Information about known or probable infected areas is available from the World Health Organization (http://www.who.int), the Pan American Health Organization (http://www.paho.org), and CDC (http://www.cdc.gov/travel).
====Adverse Reactions====
*Reactions to yellow fever vaccine are generally mild and include headaches, myalgia (muscle aches), and low-grade fevers.  
*There have been reports of rare but serious events following yellow fever vaccination; These events include anaphylaxis, yellow fever vaccine-associated viscerotropic disease (YEL-AVD, disease affecting certain internal organs), and yellow fever vaccine-associated neurologic disease (YEL-AND, disease affecting the nervous system).


If you continue to live or travel in yellow fever-endemic areas, you should receive a booster dose of yellow fever vaccine after 10 years. Yellow fever vaccine may be given at the same time as most other vaccines.
{| style="border: 0px; font-size: 85%; margin: 3px; width:900px;" align=center
|valign=top|
|+
! style="background: #4479BA; color:#FFF;  width: 400px;" |  Yellow fever vaccine–associated neurologic disease (YEL-AND)
! style="background: #4479BA; color:#FFF;  width: 400px;" |  Yellow fever vaccine–associated viscerotropic disease (YEL-AVD)
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
*YEL-AND represents a conglomerate of different clinical syndromes, including meningoencephalitis, Guillain-Barré syndrome, acute disseminated encephalomyelitis, and rarely, bulbar and Bell palsies.
*Historically, YEL-AND was seen primarily among infants as encephalitis, but more recent reports have been among people of all ages.
*The onset of illness for documented cases is 3–28 days after vaccination, and almost all cases were in first-time vaccine recipients.
*YEL-AND is rarely fatal. The incidence of YEL-AND in the United States is 0.8 per 100,000 doses administered.
*The rate is higher in people aged ≥60 years, with a rate of 1.6 per 100,000 doses in people aged 60–69 years and 2.3 per 100,000 doses in people aged ≥70 years.
| style="padding: 5px 5px; background: #F5F5F5;" |
*YEL-AVD is a severe illness similar to wild-type disease, with vaccine virus proliferating in multiple organs and often leading to multisystem organ failure and death.
*Since the initial cases of YEL-AVD were published in 2001, >60 confirmed and suspected cases have been reported throughout the world.
*YEL-AVD has been reported to occur only after the first dose of yellow fever vaccine; there have been no reports of YEL-AVD following booster doses.
*The median time from YF vaccination until symptom onset for YEL-AVD cases was 4 days (range, 0–8 days).
*The case-fatality ratio for all reported YEL-AVD cases worldwide is 63%. The incidence of YEL-AVD in the United States is 0.4 cases per 100,000 doses of vaccine administered.
*The rate is higher for people aged ≥60 years, with a rate of 1.0 per 100,000 doses in people aged 60–69 years and 2.3 per 100,000 doses in people aged ≥70 years.
|-
| style="padding: 0px 5px; background: #F5F5F5;" colspan=2| Adapted from CDC <ref>{{cite web|url=http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/yellow-fever| title= CDC Yellow Book 2014. Chapter 3 Infectious Diseases Related To Travel - Yellow Fever}}</ref>
|}
===Countries with Increased Risk of Yellow Fever===
{|
|valign=top|
{| style="float:right; border: 0px; font-size: 85%; margin: 3px; width:400px;"
|valign=top|
|+'''Countries with risk of yellow fever virus (YFV) transmission'''
! style="background: #4479BA; color:#FFF;  width: 400px;" colspan=2 |  Africa
! style="background: #4479BA; color:#FFF;  width: 200px;" |  Central and South America
|-
| style="padding: 5px 5px; background: #F5F5F5; width: 180px;" |
* Angola
* Benin
* Burkina Faso
* Burundi
* Cameroon
* Central African Republic
* Chad†
* Congo
* Côte d’Ivoire
* Democratic Republic of the Congo†
* Equatorial Guinea
* Ethiopia†
* Gabon
* Gambia
* Ghana
| style="padding: 5px 5px; background: #F5F5F5; width: 180px;" |
* Guinea
* Guinea-Bissau
* Kenya†
* Liberia
* Mali†
* Mauritania†
* Niger†
* Nigeria
* Rwanda
* Senegal
* Sierra Leone
* Sudan†
* South Sudan
* Togo
* Uganda
| style="padding: 5px 5px; background: #F5F5F5;" |
* Argentina†
* Bolivia†
* Brazil†
* Colombia†
* Ecuador†
* French Guiana
* Guyana
* Panama†
* Paraguay
* Peru†
* Suriname
* Trinidad and Tobago†
* Venezuela†
|-
| style="padding: 5px 5px; background: #F5F5F5;" colspan=3 |<small>†These countries are not holoendemic (only a portion of the country has risk of yellow fever transmission).  <br>Table adapted from CDC <ref name=CDC>{{cite web| url=http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/yellow-fever| title= CDC Travelers' Health - Chapter 3: Infectious Diseases Related To Travel - Yellow Fever}}</ref></small>
|}
|<br>


====Contraindications====
|valign=top|
<br>
{| style="border: 0px; font-size: 85%; margin: 3px; width:500px;" align=center
|valign=top|
|+
! style="background: #4479BA; color:#FFF;  width: 400px;" colspan=2 |  Countries that require proof of yellow fever vaccination from all arriving travelers
|-
| style="padding: 5px 5px; background: #F5F5F5; width: 180px;" |
* Angola
* Benin
* Burkina Faso
* Burundi
* Cameroon
* Central African Republic
* Congo, Repubic of the
* Côte d’Ivoire
* Democratic Republic of Congo
* French Guiana
| style="padding: 5px 5px; background: #F5F5F5; width: 180px;" |
* Gabon
* Ghana
* Guinea-Bissau
* Liberia
* Mali
* Niger
* Rwanda
* São Tomé and Príncipe
* Sierra Leone
* Togo
|-
| style="padding: 5px 5px; background: #F5F5F5;" colspan=3 |<small>Table adapted from CDC <ref name=CDC>{{cite web| url=http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/yellow-fever| title= CDC Travelers' Health - Chapter 3: Infectious Diseases Related To Travel - Yellow Fever}}</ref></small>
|}
|}


*Persons who have ever had a life-threatening allergic reaction to eggs, chicken, gelatin or to a previous yellow fever vaccine.
==Vector Control==
*Infants younger than 9 months of age. For infants 6 to 8 months of age who cannot avoid travel to a yellow fever area, discuss vaccination with their doctor. Under no circumstances should infants younger than 6 months of age be vaccinated.  
[[Insecticide]]s, protective clothing, and screening of houses are helpful but not always sufficient for mosquito control; people should always use an insecticide spray while in certain areas. In affected areas mosquito control methods have proven effective in decreasing the number of cases.<ref>{{cite web|url=http://www.epa.gov/pesticides/health/mosquitoes/mosquitojoint.htm#programs |title= Joint Statement on Mosquito Control in the United States from the U.S. Environmental Protection Agency (EPA) and the U.S. Centers for Disease Control and Prevention (CDC) |accessmonthday= June 25 |accessyear=2006 |date= 2000-05-03| |format=PDF |publisher=Environmental Protection Agency |}}</ref>
*Pregnant women and nursing mothers should avoid or postpone travel to a yellow fever area. If travel cannot be avoided, discuss vaccination with your doctor.  
*Check with your doctor before getting yellow fever vaccine if: you have a history of allergy to eggs, chicken, or gelatin; you have HIV/AIDS or another disease that affects the immune system; you have been under treatment for 2 weeks or longer with drugs that affect the immune system, such as steroids; you have any kind of cancer; you are taking cancer treatment with X-rays or drugs; your thymus gland has been removed, or if you have a history of problems with your thymus, such as myasthenia gravis, DiGeorge syndrome, or thymoma.  
*If you are 65 or older, discuss with your physician the risks and benefits of vaccination in the context of your risk for exposure to yellow fever virus based on your destination.  
*If you cannot get the vaccine because of a medical reason and proof of yellow fever vaccination is required for your travel, your doctor can give you a waiver letter. When planning to use a waiver letter, you should also obtain specific advice from the embassy of the country or countries you plan to visit.  
*If you cannot get the vaccine, discuss with your doctor other ways to prevent yellow fever.  


====Risks of Vaccine====
====Use Insect Repellent====
A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of a vaccine causing serious harm, or death, is extremely small. Reactions are less likely to occur after a booster dose of yellow fever vaccine than after the first dose.
* When you go outdoors, use an EPA-registered insect repellent such as those containing [[DEET]], picaridin, IR3535, or oil of lemon eucalyptus on exposed skin.
* Even a short time outdoors can be long enough to get a mosquito bite. <ref name=CDCPrev>{{cite web|url=http://www.cdc.gov/yellowfever/prevention/index.html| title= CDC Prevention of Yellow Fever}}</ref>
====Wear Proper Clothing to Reduce Mosquito Bites====
*When weather permits, wear long-sleeves, long pants and socks when outdoors.  
*Mosquitoes may bite through thin clothing, so spraying clothes with repellent containing [[permethrin]] or another EPA-registered repellent will give extra protection.
*Clothing pre-treated with [[permethrin]] is commercially available.  
*Mosquito repellents containing [[permethrin]] are not approved for application directly to skin.<ref name=CDCPrev>{{cite web|url=http://www.cdc.gov/yellowfever/prevention/index.html| title= CDC Prevention of Yellow Fever}}</ref>


=====Mild Problems=====
====Be Aware of Peak Mosquito Hours====
*soreness, redness, or swelling where the shot was given
*The peak biting times for many mosquito species is dusk to dawn.  
*fever
*However, [[Aedes aegypti]], one of the mosquitoes that transmits yellow fever virus, feeds during the daytime.  
*aches
*Take extra care to use repellent and protective clothing during daytime as well as during the evening and early morning.  
*If these problems occur, they usually begin soon after the shot and last for 5-10 days. In studies, they occurred in as many as 25% of vaccine recipients.  
*Staying in accommodations with screened or air-conditioned rooms, particularly during peak biting times, will also reduce risk of mosquito bites.<ref name=CDCPrev>{{cite web|url=http://www.cdc.gov/yellowfever/prevention/index.html| title= CDC Prevention of Yellow Fever}}</ref>
 
=====Severe Problems=====
*Life-threatening allergic reaction (approximately 1 reported per 131,000 doses).
*Severe nervous system reactions (approximately 1 reported per 150,000-250,000 doses).
*Life-threatening severe illness with major organ system failure (approximately 1 reported per 200,000-300,000 doses, or 1 reported per 40,000-50,000 doses in people 60 years of age and older). More than half of the people who suffer these side effects die.
 
=====Moderate or Severe reaction=====
*Look for any unusual condition, such as a high fever, behavior changes, or flu-like symptoms that occur 1-30 days after vaccination. Signs of an allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat, or dizziness within a few minutes to a few hours after the shot.  
*Call a doctor, or get the person to a doctor right away.
*Tell your doctor what happened, the date and time it happened, and when the vaccination was given.  
*Ask your health care provider to file a Vaccine Adverse Event Reporting System (VAERS) form if you have any reaction to the vaccine. Or call VAERS yourself at 1-800-822-7967, or visit their website at http://vaers.hhs.gov.
 
====The National Vaccine Injury Compensation Program====
In the rare event that you or your child has a serious reaction to a vaccine, a federal program has been created to help pay for the care of those who have been harmed.
For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit the program's website at http://www.hrsa.gov/vaccinecompensation.


==References==
==References==
Line 57: Line 191:
[[Category:Disease]]
[[Category:Disease]]
[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Infectious disease]]
 
[[Category:Viral diseases]]
[[Category:Viral diseases]]
[[Category:Flaviviruses]]
[[Category:Flaviviruses]]

Latest revision as of 19:30, 18 September 2017

Yellow fever Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Yellow Fever from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Future or Investigational Therapies

Treatment

Case #1

Yellow fever primary prevention On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Yellow fever primary prevention

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Yellow fever primary prevention

CDC on Yellow fever primary prevention

Yellow fever primary prevention in the news

Blogs on Yellow fever primary prevention

Directions to Hospitals Treating Yellow fever

Risk calculators and risk factors for Yellow fever primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

The two methods to prevent yellow fever are vaccination and vector control. Yellow fever vaccine is recommended for persons aged ≥9 months who are traveling to or living in areas at risk for yellow fever virus transmission in South America and Africa. Yellow fever vaccine may be required for entry into certain countries. The best way to prevent mosquitoborne diseases, including yellow fever, is to avoid mosquito bites.

Vaccination

Yellow fever vaccine is a live-virus vaccine which has been used for several decades. A single dose protects against disease for 10 years or more. If a person is at continued risk of infection, a booster dose is recommended every 10 years.

Indication

Vaccine Administration

  • For all eligible people, a single injection of reconstituted vaccine should be administered subcutaneously.
  • Name: 17D yellow fever vaccine
  • Trade Name: YF-Vax®
  • Dose: 0.5 mL²
  • Route: SC
  • The International Health Regulations (IHR) published by the World Health Organization (WHO) require revaccination at 10-year intervals.
  • Recommendations for storage of yellow fever vaccine include the following:
  • The vaccine should be transported and stored between +2°C (35°F) and+8°C (46°F).
  • Manufacturer's recommendations for vaccine storage must be observed.
  • The vaccine should not be used after the expiration date printed on the vial.
  • Since YF-VAX® does not contain a preservative, all reconstituted vaccine and containers must be appropriately discarded if they are not used within 1 hour. This includes the multi-dose (5-dose) vials.

Contraindications and Precautions for Vaccination

Contraindications Precautions
  • Allergy to vaccine component
  • Age <6 months
  • Symptomatic HIV infection or CD4 T-lymphocytes <200/mm3 (or <15% of total in children aged <6 years)1
  • Thymus disorder associated with abnormal immune-cell function
  • Primary immunodeficiencies
  • Malignant neoplasms
  • Transplantation
  • Immunosuppressive and immunomodulatory therapies
  • Age 6–8 months
  • Age ≥60 years
  • Asymptomatic HIV infection and CD4 T-lymphocytes 200–499/mm3 (or 15%–24% of total in children aged <6 years)1
  • Pregnancy
  • Breastfeeding

Adverse Reactions

  • Reactions to yellow fever vaccine are generally mild and include headaches, myalgia (muscle aches), and low-grade fevers.
  • There have been reports of rare but serious events following yellow fever vaccination; These events include anaphylaxis, yellow fever vaccine-associated viscerotropic disease (YEL-AVD, disease affecting certain internal organs), and yellow fever vaccine-associated neurologic disease (YEL-AND, disease affecting the nervous system).
Yellow fever vaccine–associated neurologic disease (YEL-AND) Yellow fever vaccine–associated viscerotropic disease (YEL-AVD)
  • YEL-AND represents a conglomerate of different clinical syndromes, including meningoencephalitis, Guillain-Barré syndrome, acute disseminated encephalomyelitis, and rarely, bulbar and Bell palsies.
  • Historically, YEL-AND was seen primarily among infants as encephalitis, but more recent reports have been among people of all ages.
  • The onset of illness for documented cases is 3–28 days after vaccination, and almost all cases were in first-time vaccine recipients.
  • YEL-AND is rarely fatal. The incidence of YEL-AND in the United States is 0.8 per 100,000 doses administered.
  • The rate is higher in people aged ≥60 years, with a rate of 1.6 per 100,000 doses in people aged 60–69 years and 2.3 per 100,000 doses in people aged ≥70 years.
  • YEL-AVD is a severe illness similar to wild-type disease, with vaccine virus proliferating in multiple organs and often leading to multisystem organ failure and death.
  • Since the initial cases of YEL-AVD were published in 2001, >60 confirmed and suspected cases have been reported throughout the world.
  • YEL-AVD has been reported to occur only after the first dose of yellow fever vaccine; there have been no reports of YEL-AVD following booster doses.
  • The median time from YF vaccination until symptom onset for YEL-AVD cases was 4 days (range, 0–8 days).
  • The case-fatality ratio for all reported YEL-AVD cases worldwide is 63%. The incidence of YEL-AVD in the United States is 0.4 cases per 100,000 doses of vaccine administered.
  • The rate is higher for people aged ≥60 years, with a rate of 1.0 per 100,000 doses in people aged 60–69 years and 2.3 per 100,000 doses in people aged ≥70 years.
Adapted from CDC [1]

Countries with Increased Risk of Yellow Fever

Countries with risk of yellow fever virus (YFV) transmission
Africa Central and South America
  • Angola
  • Benin
  • Burkina Faso
  • Burundi
  • Cameroon
  • Central African Republic
  • Chad†
  • Congo
  • Côte d’Ivoire
  • Democratic Republic of the Congo†
  • Equatorial Guinea
  • Ethiopia†
  • Gabon
  • Gambia
  • Ghana
  • Guinea
  • Guinea-Bissau
  • Kenya†
  • Liberia
  • Mali†
  • Mauritania†
  • Niger†
  • Nigeria
  • Rwanda
  • Senegal
  • Sierra Leone
  • Sudan†
  • South Sudan
  • Togo
  • Uganda
  • Argentina†
  • Bolivia†
  • Brazil†
  • Colombia†
  • Ecuador†
  • French Guiana
  • Guyana
  • Panama†
  • Paraguay
  • Peru†
  • Suriname
  • Trinidad and Tobago†
  • Venezuela†
†These countries are not holoendemic (only a portion of the country has risk of yellow fever transmission).
Table adapted from CDC [2]


Countries that require proof of yellow fever vaccination from all arriving travelers
  • Angola
  • Benin
  • Burkina Faso
  • Burundi
  • Cameroon
  • Central African Republic
  • Congo, Repubic of the
  • Côte d’Ivoire
  • Democratic Republic of Congo
  • French Guiana
  • Gabon
  • Ghana
  • Guinea-Bissau
  • Liberia
  • Mali
  • Niger
  • Rwanda
  • São Tomé and Príncipe
  • Sierra Leone
  • Togo
Table adapted from CDC [2]

Vector Control

Insecticides, protective clothing, and screening of houses are helpful but not always sufficient for mosquito control; people should always use an insecticide spray while in certain areas. In affected areas mosquito control methods have proven effective in decreasing the number of cases.[3]

Use Insect Repellent

  • When you go outdoors, use an EPA-registered insect repellent such as those containing DEET, picaridin, IR3535, or oil of lemon eucalyptus on exposed skin.
  • Even a short time outdoors can be long enough to get a mosquito bite. [4]

Wear Proper Clothing to Reduce Mosquito Bites

  • When weather permits, wear long-sleeves, long pants and socks when outdoors.
  • Mosquitoes may bite through thin clothing, so spraying clothes with repellent containing permethrin or another EPA-registered repellent will give extra protection.
  • Clothing pre-treated with permethrin is commercially available.
  • Mosquito repellents containing permethrin are not approved for application directly to skin.[4]

Be Aware of Peak Mosquito Hours

  • The peak biting times for many mosquito species is dusk to dawn.
  • However, Aedes aegypti, one of the mosquitoes that transmits yellow fever virus, feeds during the daytime.
  • Take extra care to use repellent and protective clothing during daytime as well as during the evening and early morning.
  • Staying in accommodations with screened or air-conditioned rooms, particularly during peak biting times, will also reduce risk of mosquito bites.[4]

References

  1. "CDC Yellow Book 2014. Chapter 3 Infectious Diseases Related To Travel - Yellow Fever".
  2. 2.0 2.1 "CDC Travelers' Health - Chapter 3: Infectious Diseases Related To Travel - Yellow Fever".
  3. "Joint Statement on Mosquito Control in the United States from the U.S. Environmental Protection Agency (EPA) and the U.S. Centers for Disease Control and Prevention (CDC)" (PDF). Environmental Protection Agency. 2000-05-03. Unknown parameter |accessmonthday= ignored (help); Unknown parameter |accessyear= ignored (|access-date= suggested) (help)
  4. 4.0 4.1 4.2 "CDC Prevention of Yellow Fever".


Template:WikiDoc Sources