Considering the increased level of yellow fever virus activity observed across the state of São Paulo, the WHO Secretariat has determined that, in addition to the areas listed in previous updates, the entire state of São Paulo should also be considered at risk for yellow fever transmission.
Consequently, vaccination against yellow fever is recommended for international travellers visiting any area in the state of São Paulo.
Although virus spread decreased by mid-2017, yellow fever cases have reappeared in several states since the end of 2017, especially in São Paulo State, including areas close to the city of São Paulo. In early 2018, the GeoSentinel Surveillance System reported a case of yellow fever in a Dutch traveler who had stayed near the São Paulo metropolitan region.
In response to the outbreak, the World Health Organization expanded the list of areas where yellow fever vaccination is recommended for international travelers to Brazil. Most recently, the city of São Paulo was added to this expanded list
In addition to areas in Brazil where yellow fever vaccination has been recommended since before the recent outbreaks, it is now also recommended for people who are traveling to or living in:
- All of Espirito Santo State.
- All of Rio de Janeiro State, including the city of Rio de Janeiro.
- All of São Paulo State, including the entire city of São Paulo.
- A number of cities in Bahia State.