A lecture about Defining Yellow Fever Risk in Endemic Areas, D.R. Hill.
A YF Risk Mapping Working Group has recently been convened. The recognition of severe adverse events associated with yellow fever (YF) vaccine and the changing epidemiology of YF, emphasise the importance of clearly defining areas at risk for YF transmission. The use of sophisticated computerized mapping programs and the inclusion of ecologic data should lead to an improved YF risk map. All countries in Africa, South America, Central America and the Caribbean that were considered potentially at risk for YF transmission were individually reviewed. In South America, areas above 2,300 meters are considered no risk. Much of the Amazon basin remains endemic, and a transitional risk has now been assigned to eastern Paraguay and northeastern Argentina following the recent introduction of YF. In Africa, areas north of the Sahara are considered no risk. Sub-Saharan countries in West Africa remain endemic. Tanzania and eastern Kenya have now been assigned low risk designation. Improved determination of YF risk will help travel medicine practitioners more accurately target YF vaccination, help to avoid adverse events from vaccination, and inform country policies on YF vaccination requirements for entering and departing individuals.