Brazil: Yellow fever outbreak Yellow fever risk areas continue to expand in Brazil, initiating broader vaccination recommendations in Rio de Janeiro and Sao Paulo states in addition to other endemic risk areas. In this current outbreak, cases have been confirmed in the states of Espirito Santo, Minas Gerais, Rio de Janeiro and Sao Paulo. Suspected cases are also under investigation in the states of Bahia, Goias, Rio Grande do Norte and Tocantins. The Knights and Dames visiting any area at risk of yellow fever should be vaccinated at least ten days prior to arrival. People who have not been vaccinated against yellow fever should avoid risk areas within Brazil. In addition, some travellers to and from Brazil are required to show proof of vaccination to gain entry.