Purpose of review: This decade has seen a resurgence of yellow fever (YF) that has also affected travelers with a record number of international travelers infected by YF virus including the first documented importation of YF into Asia.
Recent findings: The recent resurgence of YF has been attributed largely to sub-optimal vaccination coverage along with waning population-level immunity. New lessons have been learnt with regard to the clinical management of severe YF as a result of the Brazilian outbreak. With increasing YF cases in travelers, travel medicine providers need to familiarize themselves with the diagnosis and clinical management of severe YF. Prevention remains the mainstay, and all efforts need to be taken that travelers do not circumvent the International Health Regulations. More than 80 years of experience with YF vaccine reinforce the generally acceptable safety profile of YF vaccine but highlight the unique serious adverse events of viscerotropic and neurotropic disease, in particular in first-time vaccinees. Continued physician and traveler education regarding the risks and benefits of YF vaccination is needed, with an urgent need to better define "significant and unavoidable risk" for improved benefit-risk assessments.
Keywords: Neurotropism; Risk-benefit assessment; Travel; Viscerotropic adverse events.