Yellow Fever Vaccination: An Issue for Non-endemic Tropical Countries

Document Type : Letter to Editor


1 Hainan Medical University, Hainan, China

2 Dr DY Patil University, Pune, India

3 Faculty of Medicine, University of Nis, Nis, Serbia


Yellow fever is an important mosquito-borne infection. This disease is endemic in several tropical countries in Africa and South America. It is serious and can result in death. This disease can be prevented, and the best preventive measure is vaccination. At present, yellow fever vaccination is mandatory for people living in endemic countries, and it is the rule for travelers to endemic countries. An interesting concern is the practice of vaccinating travelers from non–endemic areas for yellow fever.1 The situation in tropical Southeast Asia where yellow fever is non-endemic should be discussed. Interestingly, mosquitoes can be vectors for yellow fever, and it is feasible for the virus to be transmitted by them in tropical Southeast Asia. In addition, the climate in tropical Southeast Asia is the same as that of tropical Africa and South America. Hence, if a traveler from Southeast Asia visits an endemic area and carries the disease back to his/her home, there is a chance of further transmission. To date, there has been no report of this disease being imported from an endemic area to Southeast Asia. Nevertheless, a recent report described the disease being imported in China, a country neighboring Southeast Asia.2 At present, the availability of the yellow fever vaccine is limited in Southeast Asia. Here, a case study from Thailand, a tropical, non-endemic country in Southeast Asia, is discussed. Thailand has fewer than 10 medical centers that can perform the yellow fever vaccination. Moreover, Thailand has only a limited number of specialists in travel medicine. General practitioners usually lack knowledge of yellow fever and its vaccine due to a lack of content in the present medical curriculum. Immigration focuses on disease control; thus, strict control is available at international airports, but not at land border posts... (Read more...)

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