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Cdc warns against travel to mexico, brazil and 127 more countries due to covid-19 risk, nearly 130 countries are now listed as ‘level 4: very high,’ per cdc.

Mary Claire Patton , Digital Journalist

A dozen countries, including Mexico and Brazil, have been added to the Centers for Disease Control and Prevention’s list for the highest level of risk associated with COVID-19.

Nearly 130 countries are now listed as “Level 4: Very High” in the CDC’s travel recommendations .

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According to Reuters , the following countries were upgraded to the highest risk level on Monday:

• French Guiana
• Philippines
• Saint Vincent

The CDC recommends avoiding travel to all destinations listed under Level 4.

“If you must travel to these destinations, make sure you are fully vaccinated before travel,” the CDC website states.

More than 50 countries are listed under “Level 3: High,” which recommends travelers be fully vaccinated before visiting. Unvaccinated travelers are advised to avoid traveling to these destinations.

Less than 20 countries are listed on the CDC website as “Level 2: Moderate” and “Level 1: Low.”

On Monday, the U.S. State Department issued an advisory that says people should not travel to Mexico due to COVID-19.

Since mid-December, the U.S. government has added more than 60 countries and territories to its list of places to avoid, according to Reuters.

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U.S. CDC warns against travel to Mexico, Brazil, Singapore over COVID-19

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Don't go to Brazil without a yellow fever vaccine, CDC warns

Federal health officials strengthened their warnings about travel to Brazil on Friday, saying anyone planning to travel there needs to get a yellow fever vaccine.

An outbreak of yellow fever among monkeys has worsened and spread, and 10 travelers have caught the virus, the Centers for Disease Control and Prevention said.

Four of them died, including two people from Chile, one from Switzerland and one from Germany.

“None of the 10 travelers had received yellow fever vaccination,” the CDC said.

The CDC has been warning about yellow fever in Brazil for more than a year but said the outbreak is even worse than before, affecting areas that usually don’t see yellow fever.

“There is an expanding number of hotspots in Brazil where yellow fever is being transmitted,” said Dr. Marty Cetron, director of CDC’s Division of Global Migration and Quarantine.

health CDC issues yellow fever alert for Brazil

At least three of the infected travelers appear to have caught the virus on Ilha Grande, a popular island tourist destination right off Rio de Janeiro.

“In light of the expanding outbreak, we encourage travelers to take the extra time and extra steps in order to be vaccinated,” Cetron told reporters in a telephone briefing.

Yellow fever is a relative of the dengue and Zika viruses, but is far deadlier. Most people don’t even know they are infected, but 15 percent can develop serious illness and as many as 60 percent of those who do get severely ill will die.

It’s carried by mosquitoes — both the Aedes aegypti mosquitoes that spread dengue and Zika — and also by jungle-dwelling Haemagogus mosquitoes.

"I would not want to take a trip down there now without a vaccine."

There are vaccines that protect against yellow fever, but the U.S.-made vaccine is not available. The federal government has imported a French-made vaccine but it can be hard to find, the CDC said.

Since last July, 920 yellow fever cases have been confirmed in Brazil and 300 people have died, the Pan American Health Organization says.

People planning to travel to Brazil need to take the time to find and get it before they go, Cetron said.

“We know this has been and will continue to be inconvenient for some travelers,” he told reporters.

CDC has a tool for finding vaccines on its yellow fever website.

The CDC says 2.2 million people travel from Brazil to the U.S. each year. The agency is alerting doctors and clinics to think yellow fever if they see patients with fevers who have recently been to Brazil.

health WHO agrees to dilute yellow fever vaccine

There’s a small potential for travelers to carry yellow fever to the U.S.

“It can spread from person to mosquito,” said Dr. Lyle Petersen, who heads CDC’s Division of Vector-Borne Diseases. “That is what we fear could potentially happen.”

The last time yellow fever spread in the U.S. was 100 years ago, Petersen said. “We are not too worried about yellow fever being transmitted in the United States,” he added.

That’s because even though parts of the southern U.S. are home to Aedes mosquitoes that can spread yellow fever, the odds of someone coming back infected and spreading the virus to a local mosquito are low.

“We do have the Aedes aegypti mosquito here in the United States,” Petersen said. “There is a small potential for some local transmission. We think it’s a low risk,” he added.

“We learned that from Zika. Thousands of people came to the U.S. with Zika, which is carried by the same mosquito, and we only saw small pockets of local transmission in southern Texas and in the Miami area.”

But Brazil is a different story. The mosquitoes are more common there and the virus circulates among monkeys in the forests.

“Monkeys were dying off in the parks and forested areas right on the outskirts of Sao Paulo city,” Cetron said. “It wouldn’t be very hard to walk to an area where there is this forest-related transmission. I would not want to take a trip down there now without a vaccine."

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C.D.C. May Warn Pregnant Women Against Travel to Countries With Zika Virus

By Donald G. McNeil Jr.

• Jan. 13, 2016

Federal health officials are debating whether to warn pregnant women against travel to Brazil and other Latin American and Caribbean countries where mosquitoes are spreading the Zika virus, which has been linked to brain damage in newborn babies.

Officials say it could be the first time the Centers for Disease Control and Prevention advises pregnant women to avoid a specific region during an outbreak.

Some infectious disease specialists say such a warning is warranted, although it could have a devastating effect on travel and tourism. A spokesman for the C.D.C. said the agency hoped to make a final announcement Thursday or Friday.

“We can’t make these decisions in a vacuum,” said the spokesman, Thomas Skinner. “We’re consulting with other experts outside.”

The virus first appeared on the South American continent in May. Although it often causes only mild rashes and fevers, women who have had it, particularly in the first trimester of pregnancy , appear to be much more likely to have children with small heads and damaged brains, a condition called microcephaly .

Dr. Lyle R. Petersen, director of vector-borne diseases for the C.D.C., said Wednesday that the agency had found Zika virus in tissue from four Brazilian infants, two of whom had microcephaly and died shortly after birth, and two of whom died in the womb.

Microcephaly has several other causes, including genetic defects or rubella or cytomegalovirus in the mother during pregnancy. Samples from the fetuses “looked like what you’d see if an infection was the cause,” Dr. Petersen said.

Previously, Brazilian scientists had found the virus in tissue or amniotic fluid from three malformed fetuses. “This certainly provides much stronger evidence of the linkage,” Dr. Petersen said.

Although the travel advice would most obviously apply to Brazil, which is struggling with an alarming surge in newborns with microcephaly, it could soon apply to much of tropical Latin America and the Caribbean.

Local transmission of Zika virus has been found in 14 Western Hemisphere countries and territories: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Puerto Rico, Paraguay, Suriname and Venezuela.

A few isolated cases have been found in the United States, including one in Texas last wee k . However, all were in people who had just returned from overseas. No transmission within the 50 states has been found. Only one case has been confirmed in Puerto Rico, but because testing is rare and many cases involve mild or no symptoms, doctors assume there are many more there.

Some American virologists are already warning women who are pregnant or trying to have children to avoid such areas. “If my daughter was planning to get pregnant, I’d advise her not to go the Caribbean,” said Dr. Peter J. Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine.

“This is going to decimate Caribbean tourism,” he added. “But we can’t wait to act until nine months from now, when congenital defects turn up in the labor and delivery suites.”

Press officers at three cruise lines — Royal Caribbean, Carnival and Princess — said this week that they had never heard of Zika virus and referred a reporter to their trade group, the Cruise Lines International Association .

An association spokeswoman, Elinore Boeke, said travelers should check with public health officials about destinations they planned to visit and cited the C.D.C.’s current travel advisories, which suggest only that all visitors avoid mosquito bites by using repellent and long clothes.

Cruise ships publish daily fliers on health and safety and instruct passengers on how to avoid bites, Ms. Boeke added.

Reports of surging rates of microcephaly have already unnerved some travelers. On Tuesday, Ashley D’Amato Staller, 33, a lawyer in Haddonfield, N.J., who is pregnant with her fourth child, backed out of a planned February trip to Puerto Rico with 17 members of her extended family after reading articles about Zika arriving there.

“Part of me feels you have to live your life, so let’s go,” she said. “I could skip going and still get hit by a car or catch West Nile, or someone could sneeze on me. On the other hand, this is my baby, and nothing’s more important.”

Officials in Brazil said Tuesday that they were investigating more than 3,500 cases of microcephaly in newborns. Until last year, the country normally had about 150 cases of microcephaly each year.

There is no vaccine for Zika, but the National Institute of Allergy and Infectious Diseases has been working on one for the past month, said Dr. Anthony S. Fauci, the institute’s director.

Dr. Stanley Plotkin, a leading vaccine inventor, said a Zika vaccine “should not be extremely difficult to make” because the disease is closely related to yellow fever and Japanese encephalitis, for which there are effective vaccines.

Epidemiologists estimate that more than 1.5 million Brazilians have been infected. The alarm about microcephaly was raised in October, when doctors in the northern state of Pernambuco noticed unusual numbers of small-headed babies.

Although Brazil has strongly advised all pregnant women to avoid mosquito bites, a leading health official went further two weeks ago, suggesting that women in the hard-hit northeast region postpone having children .

“If she can wait, then she should,” said Cláudio Maierovitch, the ministry’s chief of infectious disease surveillance.

On Tuesday, the health minister of the Dominican Republic reportedly advised women there not to have children. Later, another ministry official clarified that statement: If local transmission of Zika is detected in the country, he said, the ministry would give that advice.

Sandra E. Garcia contributed reporting.

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