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"The outbreak is affecting areas in close proximity to major urban centers [in Brazil] where yellow fever vaccine is not routinely administered," Fauci and Paules warned.The authors stressed that there's no evidence yet that mosquitoes are transmitting yellow fever between infected people.As families arrive at this sea of shelters following a long, hard journey, these people offering polio vaccines are the first sign that they have reached a place of protection.
Both viruses are spread by the same mosquito species.
To prevent the Brazil outbreak from spreading, "early identification of cases and rapid implementation of public health management and prevention strategies, such as mosquito control and appropriate vaccination, are critical," Fauci and Paules concluded.
As she emerges from the door of a shelter, he hears her reminding the family within to get their children vaccinated against polio, but also for the whole family to be vaccinated against yellow fever.
With weakened health system in parts of north eastern northern Nigeria, the infrastructure that is already on the ground to stop polio is providing the volunteers needed to support the yellow fever vaccination campaign.
No such cases have emerged in the United States, but international travel means unvaccinated people might bring the illness back home after visiting an endemic area.
The yellow fever outbreak comes as the Zika virus continues to affect countries throughout the Americas.
More than eight million people are being targeted with yellow fever vaccines in the states of Borno, Zamfara Kwara and Kogi states in 2018.
By providing both polio and yellow fever vaccinations, the polio infrastructure protects everyone – the young children vulnerable to polio, as well as the whole population at risk of yellow fever.
And in the current Brazilian outbreak, there have so far been hundreds of cases and dozens of confirmed deaths, according to health authorities.
More ominous in the Brazilian outbreak is the fact that the illness appears to be moving from its typical rural setting towards the cities.