Although it's "highly unlikely" there will be yellow fever outbreaks in the continental United States, the increase in domestic cases in Brazil and frequency of worldwide travel could lead to travel-related cases occurring in warmer parts of the United States, in the Gulf Coast states, and outbreaks in Puerto Rico and other US territories, where Zika has spread explosively, primarily through infected Aedes aegypti mosquitoes. In Brazil specifically, 292 cases have been reported so far, the Pan-American Health Organization (PANO) said, while 920 suspected cases in the country are still being investigated by health officials. The National Institute of Allergy and Infectious Diseases published an essay writing that yellow fever can spread through traveling, especially along the Gulf Coast. However, the advent of outbreaks near urban centers "raises concern that, for the first time in decades, urban transmission of yellow fever will occur in Brazil", they explained.
An uncommon spike in the number of yellow fever cases in the country has raised concerns that it could also increase travel-related cases.
Experts fear spread of the disease may resemble that of the Zika virus, which emerged in Brazil in 2015 and later spread to more than 60 countries including the U.S., causing local outbreaks in Florida.
The team said dengue, chikungunya, and Zika had demonstrated how Aedes aegypti mosquitos can infect populations and spread rapidly due to human travel.
Out of a total 1,500 suspected yellow fever cases, 371 have been confirmed, 966 are still being examined and the rest ruled out. Most doctors have never seen yellow fever, which made its most frightening mark in the United States in Philadelphia in the fall of 1793. With the recent outbreak, Brazilians health workers are now urging people to get vaccinated right away.
Top infectious disease specialists are warning that a yellow fever outbreak in the jungles of Brazil could bring the disease to the United States. Among the confirmed cases, 220 people have died, according to the Pan American Health Organization.
Yellow fever has a relatively high death rate and "is the most severe [insect-transmitted] virus ever to circulate in the Americas", Fauci and Paules wrote.
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Its driver escaped unhurt but in shock, the agency said. "It hit the tower and crashed by spinning", he said. The Sikorsky S-76 helicopter had taken off from Istanbul's main Ataturk airport with seven people on board.
Luckily for Americans today, the yellow fever vaccine - first developed in 1937 - is effective in preventing illness.
The recent yellow fever outbreak in Angola and the Democratic Republic of the Congo underscored the risk of worldwide spread and exhausted the world's emergency vaccine stockpile, the two noted, adding that early identification, public health preparedness, and prevention strategies are critical.
Rio state was not in that at-risk area for this outbreak and it has not had any cases.
"In light of the serious nature of this historically devastating disease, public health awareness and preparedness are critical", wrote Paules and Fauci. It's taking place primarily in jungle areas, where forest-dwelling mosquitoes are spreading the virus mainly to monkeys. They also warned that yellow fever outbreaks could occur in U.S. territories.
Those include good surveillance by doctors and public health officials to detect even small outbreaks; the capacity to ramp up vaccine production quickly; and a "public health emergency fund" so that government officials can take urgent measures to stamp out disease transmission before an epidemic takes hold.
The fearsome disease starts like a common flu, with symptoms of headache, fever, muscle pain, nausea and vomiting.