> Every once in a while it’s worth talking about the public health story
> behind YF vaccination. Unlike all other travel vaccines YF vaccination is
> only partly intended to reduce YF risk in a traveler.
> Consider that the risk of YF is FAR FAR higher in Cameroon or Cote
> d’Ivoire than in Tanzania or South Africa, and travel associated YF is
> extraordinarily rare in South America. The issue is that many countries
> have mosquitoes competent to transmit yellow fever, but they do not have
> cases. All of tropical Asia is like this — there are vector competent
> mosquitoes throughout S and SE Asia, but no yellow fever, it’s not endemic
> or even enzootic there.
> So countries have vaccination policies to endure that potential index
> cases aren’t arriving, bringing viremia to a pool of competent mosquitoes.
> Think about the historical YF epidemics in Philadelphia and New Orleans,
> this is exactly what happened.
> So vaccinating an elderly traveler may seem to give unnecessary INDIVIDUAL
> risk, but I would stress that the public health rationale is independent of
Paul M. Lantos, MD
> Hospital Medicine
> Pediatric Infectious Diseases
> Duke University Medical Center
Excerpted from a reply given on ISTM server discussion list.
Comment: I believe this becomes very topical if we view the current shortage of Stamaril vaccine in India. Not only is the individual traveler at risk when traveling to Africa/ South America, BUT alarmingly so are potentially millions of people in India at risk due to the lack of availability of this vaccine !!