As seen in our article on recommended vaccines for workers posted abroad, an essential part of the risk assessment process before a business mission abroad is undoubtedly the assessment of health risks. Consequently, it is important to check for the need for certain vaccinations, either to protect your employees or because vaccinations are required by the country.
Among the compulsory vaccinations that can be found, yellow fever is certainly present, as it is required bya number of countries, as will be seen below.
First of all, a few words must be said about yellow fever so as to get a picture of the situation. Indeed, it is not a disease endemic to Europe and therefore it is not commonly found.
What is yellow fever?
Yellow fever is a serious disease caused by a virus belonging to the Flavivirus genus, to which viruses such as Zika virus, West Nile virus and Japanese encephalitis virus also belong.
The virus is transmitted through the bite of infected Aedes and Haemagogus mosquitoes. These are diurnal mosquitoes that are found in domestic areas such as dwellings, but also in semi-domestic habitats such as near forests and green areas.
Yellow fever is a disease that mainly affects humans and primates. It may have severe consequences and, in addition, is a high-risk disease. This means that it can easily and rapidly spread internationally, thus posing a threat to global health security.
Every year, an estimated 84,000 to 170,000 new cases of yellow fever are reported.
What are yellow fever symptoms?
The disease can manifest itself in various forms from mild to severe, and in extreme cases can even result in death (30/60% of cases).
In some cases, it occurs asymptomatically or with flu-like complaints.
When symptomatic, symptoms appear suddenly about 3-6 days after infection, progressing discontinuously. In the first phase of the disease, we see the most severe symptoms, i.e. high temperatures, chills, muscle pain, nausea and vomiting. In this phase, there is also the appearance of jaundice, i.e. the typical yellowish skin, eyes and mucous membranes, from which the disease takes its name. This acute phase of the disease usually lasts only a few days, subsequently beginning its remission phase until complete recovery.
Having a rapid diagnosis of yellow fever can be difficult as it is often confused with other diseases with similar symptoms. Therefore, it is important to see a doctor quickly to proceed with specific examinations, especially if you have recently been in risk areas. A rapid diagnosis helps prevent more serious symptoms.
At this point, it is appropriate to focus on where the disease is endemic.
What countries are high risk for yellow fever?
As mentioned above, Europe is not at risk of yellow fever, as the disease is endemic in other areas of the world. In particular, yellow fever is endemic in tropical areas of Africa, Central and South America.
According to the WHO in 2023, 34 countries in Africa, e.g. Angola, Benin, Togo, and 13 countries in Central and South America (such as Ecuador, Trinidad and Tobago, and Suriname) were either endemic or had yellow fever endemic regions. However, the problem may be greater: the WHO estimates that the actual number of cases is 10 to 250 times what is now being reported.
Consequently, countries where the disease is endemic have provided for mandatory yellow fever vaccine for travel and entry into the country.
Yellow fever vaccine for travel: when it is mandatory
At this point, we cannot help but asking when yellow fever vaccination is mandatory.
In general, vaccination is mandatory when:
- One must enter a country where yellow fever is endemic;
- One comes from a country where the disease is endemic. Regarding this point, a clarification must be made. According to the World Health Organisation, vaccination is also required if the traveller has had a stopover, 10 to 12 hours, in an endemic country. So, assuming that a group of Italian citizens has to travel to Benin via a stopover in Angola, even though they are not from an endemic country, they will still have to undergo the vaccination.
However, it should be remembered that country requirements may be subject to change without notice.
Once the vaccination has been carried out, you will receive the yellow fever vaccination certificate. Remember that this must conform to the model approved by the World Health Organisation and only issued by a legally authorised vaccination centre.
Where to get yellow fever vaccine for travel?
You can get yellow fever vaccination for travel at your local health authority by appointment or at an international vaccination centre.
As mentioned in the previous paragraph, it is necessary to check that the centre is legally authorised in order to issue a certificate valid for travel. In this regard, please note that the Italian Ministry of Health website provides a list of authorised vaccination centres for consultation; the list is constantly being updated.
How long before travel should you have yellow fever vaccination?
With regards to timing, in order to provide effective protection and thus have time to develop the appropriate antibodies, it is advisable to administer the vaccine at least 10 days before the date of departure. In fact, the vaccine has been shown to be 95% effective 7 days after administration.
Please note that certain categories of people are excluded from vaccination, namely:
- Children under 6 months of age;
- Persons with allergies to vaccine components or with immunodeficiency;
- Pregnant women.
Please remember that before getting any vaccine, you should consult a doctor to check your state of health and compatibility with administration.
Support from Studio A&P
We have therefore seen that yellow fever vaccination is required for entry into several countries on various continents and that the World Health Organisation’s directives may be continually updated.
To make sure that you are always informed and to protect your employees in the best possible way, Studio A&P’s Risk Assessment team can check any health obligations before you travel so as to provide you with complete and up-to-date information.
Learn more about our Risk Assessment services for companies.