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For the first time ever, Brazil is attempting a nationwide immunization campaign against yellow fever. Yellow fever is a mosquito-borne disease. An ongoing outbreak has killed hundreds of people over the last two years. And the deaths have occurred mostly in parts of Brazil where yellow fever didn't used to be a threat. NPR's Jason Beaubien reports.
JASON BEAUBIEN, BYLINE: Up until recently, Brazil's health ministry recommended yellow fever vaccination primarily in the hot, tropical, inland parts of the South American nation. The belief was that the risk of getting yellow fever in most of the east and the south of the country, including around the megacities of Rio de Janeiro and Sao Paulo, was extremely low. But this current outbreak has changed that.
MARTIN CETRON: I mean, monkeys were dying off in the parks and forested areas, you know, right on the outskirts of Sao Paulo city.
BEAUBIEN: That's Martin Cetron, the head of the Centers for Disease Control and Prevention's Division of Global Migration and Quarantine.
CETRON: There is an expanding number of hotspots in Brazil where yellow fever virus is being transmitted. And these are atypical areas in large states that have not previously seen this amount of viral activity in decades.
BEAUBIEN: In a normal year, Brazil gets hit with at most a few dozen cases of yellow fever. But since 2016 the country has confirmed more than 1,900 human cases, and 590 people have died. Almost all of these have been in rural areas around Sao Paulo and Rio de Janeiro that the government in the past didn't think were at risk from yellow fever. Brazil is now attempting to inoculate more than a tenth of its population by the end of April, and then expand the program to cover the rest of the country by the summer of 2019.
Unfortunately, there's a global shortage of vaccine right now. And even though Brazil is one of the world's largest producers of the serum, they don't have enough to go around. People have been desperate to get it. In February, a gang leader went so far as to kidnap two vaccinators and had them inoculate people in his favela in Rio. Social media hailed him as a modern-day Robin Hood.
TOM YUILL: Yeah, that was really kind of ironic and folkloric. Yeah, they had a vaccine program kind of at gunpoint, I guess, to get coverage in these slum areas.
BEAUBIEN: Tom Yuill is a virologist who monitors disease outbreaks, including yellow fever, for ProMED at the International Society of Infectious Diseases. The Brazilian Ministry of Health has resorted to dividing single doses of vaccine into fifths to stretch their limited stockpile. This practice of splitting doses appears to offer at least some short-term immunity to yellow fever. Yuill says the current campaign to try to get 23 million people vaccinated in the coming weeks is a huge challenge.
YUILL: So they've got a lot of ground to make up to try to get adequate vaccine coverage, shooting for between 80 and 90 percent in areas of risk. And that requires an awful lot of vaccine and the logistical organization to be able to get the vaccine into the people in a timely way.
BEAUBIEN: This yellow fever outbreak in Brazil started a year after zika first exploded in the country. The head of the country's virology society says while Brazil probably overreacted to zika, it's now in trouble because it underplayed the threat of yellow fever. Jason Beaubien, NPR News.
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