Updated yellow fever 'green book' chapter published

The yellow fever chapter in the 'green book' (Immunisation against infectious disease) has been updated

UK Health Security Agency has published updated guidance on yellow fever vaccination in the 'green book' (Immunisation against infectious disease: Yellow fever. Chapter 35).

Key updates in this revised chapter include:

• new guidance on egg allergy and yellow fever vaccination.
• guidance from the Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) regarding the surgical procedures that may involve incidental thymectomy.

NaTHNaC are in the process of updating other related yellow fever resources. These will be posted on TravelHealthPro in due course.

Advice for health professionals

Egg allergy Is common in younger children, but the majority outgrow their allergy by school age. The new chapter provides guidance on situations where referral to an allergy specialist may be considered. Those with persistent egg allergy can receive vaccine in appropriate settings.

Published desensitisation protocols can be used in adults and school age children. Please note, yellow fever vaccination outside of a designated yellow fever centre requires an off-site application. Further details are available on off-site applications.

Thymectomy, including incidental thymectomy e.g. during cardiac surgery is considered a contraindication to yellow fever vaccine in the UK. For those with a history of cardiothoracic surgery, it is not always clear if the thymus gland may have been removed. The new chapter provides guidance for these situations.

Health professionals are reminded of the importance of taking a detailed medical history of past and present health issues as part of the risk assessment during a travel health consultation.

For specific information on the yellow fever risk in individual countries please go to our Country Information pages.