Yellow fever in Africa

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i3764 (Published 15 July 2016) Cite this as: BMJ 2016;354:i3764
  1. Helen C F Maguire, consultant medical epidemiologist1,
  2. David L Heymann, senior fellow2
  1. 1National Infection Service, Public Health England, London, UK
  2. 2Chatham House Centre on Global Health Security, London, UK
  1. Correspondence to: D L Heymann david.heymann{at}phe.gov.uk

Vaccines protect only when governments commit

In the late 19th century, when major outbreaks of yellow fever halted work on the Panama Canal, intensive study by Walter Reed led to understanding of its transmission by the Aedes aegypti mosquito. Larval control—destruction of A aegypti breeding sites—was then the primary strategy for managing yellow fever outbreaks in the Americas.1

By the 1940s, the viral aetiology of yellow fever had been confirmed and a yellow fever vaccine had been developed, providing a tool to both prevent infection and contain epidemics.2 In 1969 yellow fever vaccination was included in the International Health Regulations as one of the measures that could be required from international passengers arriving from countries with ongoing outbreaks.3 By 1988, recommendations were made to include yellow fever vaccine in routine childhood immunisation programmes in African countries at risk of yellow fever.4 And …

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