Requirements: Required if traveling from Angola or the Democratic Republic of Congo and ≥9 months of age.
Recommended for all travelers ≥9 months of age going to the following areas: the entire states of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, and Tocantins, and designated areas (see Map 3-20) of the following states: Bahia, Paraná, Piauí, Rio Grande do Sul, Santa Catarina, and São Paulo (state). Vaccination is also recommended for travelers visiting Iguaçu Falls.
Not recommended for travelers whose itineraries are limited to areas not listed above, including the cities of Fortaleza, Recife, Rio de Janeiro, Salvador, and São Paulo (see Map 3-20).
Areas with malaria: All areas of the states of Acre, Amapá, Amazonas, Rondonia, and Roraima. Also present in the states of Maranhão, Mato Grosso, and Para, but rare cases in their capital cities. Rare cases in the rural areas of the states of Espirito Santo, Goias, Mato Grasso do Sul, Piaui, and Tocantins. Rare cases in the rural forested areas of the states of Rio de Janeiro and São Paulo. No malaria in the cities of Brasilia, Rio de Janeiro, São Paulo, and none at Iguaçu Falls (see Map 3-21).
Estimated relative risk of malaria for US travelers: Low.
Recommended chemoprophylaxis: States of Acre, Amapá, Amazonas, Rondonia, and Roraima. States of Maranão, Mato Grosso, and Para (but not their capital cities): Atovaquone-proguanil, doxycycline, or mefloquine.
Areas with rare cases: Mosquito avoidance only.
Map 3-20. Yellow fever vaccine recommendations in Brazil 1