"Hans-Georg Michna" wrote in message
news:jb4rr0d91i12p7ec4rv1cmjk3tj65i23fc@4ax.com...
> On Fri, 10 Dec 2004 11:46:31 +0100, "riverman"
> wrote:
>
>>From
>>http://patients.uptodate.com/topic.asp?file=viral_in/13180&title=Travel+Advice
>>Yellow fever in expatriates and travelers to Africa and South America has
>>been rare since the introduction of routine vaccination after World War
>>II.
>>Since that time, eleven recorded cases have been published, including two
>>fatal cases in 1996 in unvaccinated American and Swiss tourists who
>>acquired
>>the infection in Brazil and died after returning home. An additional fatal
>>case was reported in an unvaccinated Californian who had traveled in the
>>rainforests of Venezuela with six others; five of these six companions had
>>been vaccinated against yellow fever. A tenth (fatal) case occurred in a
>>German tourist in 1999. An eleventh fatal case occurred in November 2001
>>in
>>an unvaccinated Begian tourist exposed to yellow fever in the Gambia. A
>>previously healthy Texan who traveled with a group to fish on the Rio
>>Negro
>>in rural Brazil was also reported to have died with yellow fever on March
>>14, 2002; the patient had not been vaccinated against yellow fever. These
>>events emphasize the risk of exposure in the endemic zone, where:
>>
>> a.. The virus may circulate silently between nonhuman primates and
>>mosquitoes
>> b.. Surveillance for human disease is minimal
>> c.. The indigenous population may be protected by vaccination.
>>--riverman
>>Google under "yellow fever tourist deaths"
>
> Riverman,
>
> thanks for the good find! We have at least some data now.
>
> The numbers are extremely low, apparently not a single one was
> reported from east Africa in that article. It would be
> interesting to set them in relation to other tourist deaths.
> (Actually nothing related to anything is still nothing, as far
> as east Africa is concerned, so we cannot, for example,
> calculate the cost of a saved life.)
>
> Data on deaths and debilitating sickness from vaccination side
> effects will be much more difficult to come by, because there is
> a very strong interest from all sides (doctors, pharma
> industry), not to let them be known.
>
> Yet another factor is how well you protect yourself from
> mosquito bites. The more conscientious you are, the less likely
> you will get yellow fever.
>
> And finally yellow fever usually comes in known outbreaks that
> are published, at least in Kenya. If there is no such outbreak,
> your risk is again lower.
>
> I think that's all we can do here. Everybody who read this
> thread has all information and even opinions from all sides and
> can now make up his mind in an educated way.
Another thing we really haven't explored, and which is VERY relevant, is the
bureaucracy a traveller will encounter in many places when they see a visa
from an 'at risk' country but no yellow fever stamp, and they try to explain
that they do not actually a YF stamp. Also, the situation when a
traveller is in-country, and decides to take a side trip to somewhere that
YF is known, and they are forced to get the vaccine from some doctor
in-country. I'd be much more concerned about having a doc in Nariobi stick
me with a needle than one in GB or the US.
OK: good debate.
--riverman
--riverman
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