Yellow Fever Vaccines in Toronto

Yellow Fever is a virus infection transmitted from humans or primates to humans through the bite of infected mosquitoes. Yellow Fever occurs in parts of South America and Africa. Symptoms of Yellow Fever include fever, chills, headache, backache, muscle aches, nausea, and vomiting. Approximately 15% of cases progress to develop a more serious or toxic form of the disease with yellowing of the skin and eyes, bleeding and eventually shock and multi-system organ failure.

Risk Estimates for Travelers

For a 2-week stay, the risks for illness and death due to yellow fever for an unvaccinated traveler traveling to an endemic area of

• West Africa are 50 per 100,000 and 10 per 100,000, respectively
• South America are 5 per 100,000 and 1 per 100,000, respectively

TREATMENT

No specific treatments have been found to benefit patients with yellow fever. Treatment is symptomatic. Rest, fluids, and use of analgesics and antipyretics may relieve symptoms of fever and aching. Care should be taken to avoid certain medications, such as aspirin or other non-steroidal anti-inflammatory drugs, which may increase the risk for bleeding.

Yellow Fever Risk Zones in South America
(see mapsbelow)

YELLOW FEVER ZONES IN SOUTH AMERICA

YELLOW FEVER ZONES IN AFRICA

Yellow Fever Vaccine

Yellow fever is preventable by a relatively safe, effective vaccine. All yellow fever vaccines currently manufactured are live attenuated viral vaccines. Because it is a live vaccine it carries very small but significant risks that are outlined below.

Safety and Adverse Reactions To The Vaccine

Common Adverse Events

• Reactions to yellow fever vaccine are generally mild, with 10%-30% of vaccinees reporting mild adverse events.
• Reported events typically include low-grade fever, headache, and muscle aches that begin within days after vaccination and last 5-10 days.

Severe Adverse Events.....3 types

• 1. Hypersensitivity

  Immediate hypersensitivity reactions, characterized by rash, hives, or asthma or a combination of these, are uncommon. Anaphylaxis following yellow fever vaccine is reported to occur at a rate of 1.8 cases per 100,000 doses administered.

• 2. Yellow Fever Vaccine-Associated Neurologic Disease (YEL-AND)

  • YEL-AND represents a conglomerate of different clinical syndromes, including meningoencephalitis, Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), bulbar palsy, and Bell's palsy.
  • Historically, YEL-AND was seen primarily among infants as encephalitis, but more recent reports have been among persons of all ages.
  • The onset of illness for documented cases ranges 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 over 60 years of age, with a rate of 1.6 per 100,000 doses in persons 60-69 years of age and 2.3 per 100,000 doses in persons over 70 years of age.

• 3. Yellow Fever Vaccine-Associated Viscerotropic Disease (YEL-AVD)

  • YEL-AVD is a severe illness similar to wild-type disease, with vaccine virus proliferating in multiple organs and often leading to multi-system organ failure and death.
  • Since the initial cases of YEL-AVD were published in 2001, more than 40 confirmed and suspected cases have been reported throughout the world.
  • The onset of illness for YEL-AVD cases averaged 3.5 days (range: 1-8 days) after vaccination. YEL-AVD appears to occur after the first dose of yellow fever vaccine rather than with booster doses.
  • The case-fatality ratio for reported YEL-AVD cases is 53%.
  • 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 persons over 60 years of age, with a rate of 1 per 100,000 doses in persons 60-69 years of age and 2.3 per 100,000 doses in persons aged over 70 years of age.

To get your Yellow Fever vaccine call the GTA Travel Clinic and Vaccination Centre at 905 303 1900. We cover the Toronto, Richmond Hill and Woodbridge areas for Yellow Fever vaccine.

Please note: The information in this document is provided for general information purposes only. Nothing takes the place of speaking with a travel doctor. This information and your receipt thereof is not intended to be, nor shall be deemed to be, informed consent by you to any medical care or treatment whatsoever. Please consult our doctor's at the GTA Travel Clinic and Vaccination Centre for a proper pre-travel medical assessment.

Please note that the vaccine is not a benefit of O.H.I.P.

If you have PRIVATE HEALTH INSURANCE through work or school you may be covered for vaccines. Upon your payment we will issue you a PAID invoice so you can claim your expenses back from your insurance company.

To find out if you have insurance coverage, please have your Drug Identification Numbers ready when you call your insurance company. Click here to find the names and phone numbers of major Insurance Companies.