A public health risk assessment for yellow fever vaccination: a model exemplified by an outbreak in the state of S?o Paulo,Brazil

We propose a method to analyse the 2009 outbreak in the region of Botucatu in the state of São Paulo (SP), Brazil, when 28 yellow fever (YF) cases were confirmed, including 11 deaths. At the time of the outbreak, the Secretary of Health of the State of São Paulo vaccinated one million people, causing the death of five individuals, an unprecedented number of YF vaccine-induced fatalities. We apply a mathematical model described previously to optimise the proportion of people who should be vaccinated to minimise the total number of deaths. The model was used to calculate the optimum proportion that should be vaccinated in the remaining, vaccine-free regions of SP, considering the risk of vaccine-induced fatalities and the risk of YF outbreaks in these regions.     

Surveillance for Yellow Fever Virus in Non-Human Primates in Southern Brazil, 2001–2011: A Tool for Prioritizing Human Populations for Vaccination

In Brazil, epizootics among New World monkey species may indicate circulation of yellow fever (YF) virus and provide early warning of risk to humans. Between 1999 and 2001, the southern Brazilian state of Rio Grande do Sul initiated surveillance for epizootics of YF in non-human primates to inform vaccination of human populations. Following a YF outbreak, we analyzed epizootic surveillance data and assessed YF vaccine coverage, timeliness of implementation of vaccination in unvaccinated human populations. From October 2008 through June 2009, circulation of YF virus was confirmed in 67 municipalities in Rio Grande do Sul State; vaccination was recommended in 23 (34%) prior to the outbreak and in 16 (24%) within two weeks of first epizootic report. In 28 (42%) municipalities, vaccination began more than two weeks after first epizootic report. Eleven (52%) of 21 laboratory-confirmed human YF cases occurred in two municipalities with delayed vaccination. By 2010, municipalities with confirmed YF epizootics reported higher vaccine coverage than other municipalities that began vaccination. In unvaccinated human populations timely response to epizootic events is critical to prevent human yellow fever cases.     

A Support Tool for Air Pollution Health Risk Management in Emerging Countries: A Case in Brazil

This study evaluated the health risk due to air pollution in São Paulo State, Brazil, comparing Brazil's standards and the World Health Organization (WHO) air quality guidelines. New methodology was applied considering, as hazard parameters, the maximum average concentrations of SO₂, NO₂, O₃, CO, and PM₁₀ from 2007 to 2011. As exposure parameters, population density and location sensitivity were considered. A health risk index based on fuzzy logic was performed to integrate the selected parameters, giving the likelihood of reaching different risk levels. Data gathering and spatial representation of parameters and risk scores were performed by means of geographic information system (GIS). Highest values of risk were observed in the Metropolitan Area of São Paulo and near the cities of Cubatão and Piracicaba, associated to vehicular and industrial emissions and sugar cane burning. Discussions about the need to revise national air quality standards have intensified over the past years. Generally, indices used for air quality do not consider the population exposed. This study showed the integration of GIS with fuzzy logic methodology to be a useful tool for health risk assessment. When evaluating the risk, exposure parameters must be intrinsically considered to enhance the importance of population vulnerability when assessing environmental problems, especially in emerging economies.     

Yellow Fever Outbreaks in Unvaccinated Populations,Brazil, 2008–2009

Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.     

Cases and distribution of visceral leishmaniasis in western São Paulo: A neglected disease in this region of Brazil

Visceral leishmaniasis (VL) is one of the most prevalent parasitic diseases worldwide. In 2019, 97% of the total numbers of cases in Latin America were reported in Brazil. In São Paulo state, currently 17.6% of infected individuals live in the western region. To study this neglected disease on a regional scale, we describe the spread of VL in 45 municipalities of the Regional Network for Health Assistance11(RNHA11). Environmental, human VL (HVL), and canine VL (CVL) cases, Human Development Index, and Lutzomyia longipalpis databases were obtained from public agencies. Global Moran’s I index and local indicators of spatial association (LISA) statistics were used to identify spatial autocorrelation and to generate maps for the identification of VL clusters. On a local scale, we determined the spread of VL in the city of Teodoro Sampaio, part of the Pontal of Paranapanema. In Teodoro Sampaio, monthly peri-domicile sand fly collection; ELISA, IFAT and Rapid Test serological CVL; and ELISA HVL serum surveys were carried out. In RNHA11 from 2000 to 2018, Lu. longipalpis was found in 77.8%, CVL in 69%, and HVL in 42.2% of the 45 municipalities, and 537 individuals were notified with HVL. Dispersion occurred from the epicenter in the north to Teodoro Sampaio, in the south, where Lu. longipalpis and CVL were found in 2010, HVL in 2018, and critical hotspots of CVL were found in the periphery. Moran’s Global Index showed a weak but statistically significant spatial autocorrelation related to cases of CVL (I = 0.2572), and 11 municipalities were identified as priority areas for implementing surveillance and control actions. In RNHA11, a complex array of socioeconomic and environmental factors may be fueling the epidemic and sustaining endemic transmission of VL, adding to the study of a neglected disease in a region of São Paulo, Brazil.     

Using Species Distribution Models to Predict Potential Landscape Restoration Effects on Puma Conservation

A mosaic of intact native and human-modified vegetation use can provide important habitat for top predators such as the puma (Puma concolor), avoiding negative effects on other species and ecological processes due to cascade trophic interactions. This study investigates the effects of restoration scenarios on the puma’s habitat suitability in the most developed Brazilian region (São Paulo State). Species Distribution Models incorporating restoration scenarios were developed using the species’ occurrence information to (1) map habitat suitability of pumas in São Paulo State, Southeast, Brazil; (2) test the relative contribution of environmental variables ecologically relevant to the species habitat suitability and (3) project the predicted habitat suitability to future native vegetation restoration scenarios. The Maximum Entropy algorithm was used (Test AUC of 0.84 ± 0.0228) based on seven environmental non-correlated variables and non-autocorrelated presence-only records (n = 342). The percentage of native vegetation (positive influence), elevation (positive influence) and density of roads (negative influence) were considered the most important environmental variables to the model. Model projections to restoration scenarios reflected the high positive relationship between pumas and native vegetation. These projections identified new high suitability areas for pumas (probability of presence >0.5) in highly deforested regions. High suitability areas were increased from 5.3% to 8.5% of the total State extension when the landscapes were restored for ≥ the minimum native vegetation cover rule (20%) established by the Brazilian Forest Code in private lands. This study highlights the importance of a landscape planning approach to improve the conservation outlook for pumas and other species, including not only the establishment and management of protected areas, but also the habitat restoration on private lands. Importantly, the results may inform environmental policies and land use planning in São Paulo State, Brazil.     

Association of insecticide use and alteration on Aedes aegypti susceptibility status

Dengue and dengue hemorrhagic fever, vector-borne diseases transmitted by the mosquito Aedes aegypti, are presently important public health problems in Brazil. As the strategy for disease control is based on vector control through the use of insecticides, the development of resistance is a threat to programs efficacy. The objective of this study was to compare the Aedes aegypti susceptibility in nine vector populations from the state of S?o Paulo and seven from Northeast region of Brazil, since there was a difference on group of insecticide used between the areas. Bioassays with larvae and adult were performed according to the World Health Organization methods. The results showed higher resistance levels to organophosphates group in populations from the Northeast region where this group was used for both larvae and adult control than in S?o Paulo where organophosphates were used for larvae and pyretroids for adult control. Resistance to pyretroids in adults was widespread in S?o Paulo after ten years of use of cypermethrin while in vector populations from the Northeast region it was punctual. The difference in resistance profile between the areas is in accordance to the group of insecticide used.     

Genetic characterization of cassava (Manihot esculenta) landraces in Brazil assessed with simple sequence repeats

Based on nine microsatellite loci, the aim of this study was to appraise the genetic diversity of 42 cassava (Manihot esculenta) landraces from selected regions in Brazil, and examine how this variety is distributed according to origin in several municipalities in the states of Minas Gerais, São Paulo, Mato Grosso do Sul, Amazonas and Mato Grosso. High diversity values were found among the five above-mentioned regions, with 3.3 alleles per locus on an average, a high percentage of polymorphic loci varying from 88.8% to 100%, an average of 0.265 for observed heterozygosity and 0.570 for gene diversity. Most genetic diversity was concentrated within the regions themselves (H_S = 0.52). Cluster analysis and principal component based scatter plotting showed greater similarity among landraces from São Paulo, Mato Grosso do Sul and Amazonas, whereas those from Minas Gerais were clustered into a sub-group within this group. The plants from Mato Grosso, mostly collected in the municipality of General Carneiro, provided the highest differentiation. The migration of human populations is one among the possible reasons for this closer resemblance or greater disparity among plants from the various regions.     

Some developments on the affected-pedigree-member method of linkage analysis.

Some improvements are presented for the affected-pedigree-member method of linkage analysis, which is a generalization of the sib-pair method. The test statistic is extended to include contrasts between affected and unaffected pedigree members, so that it now utilizes marker information from all typed pedigree members rather than just the typed affected members. Computer simulation using a sample pedigree of 14 individuals shows that this modification can substantially increase statistical power where there is a direct association between marker variation and disease and where disease risk is elevated in carriers of the disease allele. Data on Huntington disease in 16 British families, which were analyzed previously using only the affected individuals, are reanalyzed with the unaffected individuals included. Strong rejection of the null hypothesis of no association between Huntington disease and the HindIII polymorphism is confirmed, but the particular families in which the association is significant differs from that obtained through an analysis based only on affected individuals and reflects more closely the results obtained from a lod-score analysis. The test statistic is also modified here to incorporate contrasts between individuals of zero kinship, if needed. This enables contrasts between individuals from different pedigrees, as well as contrasts involving individuals sampled from the general population, to be incorporated into the test of association. For population data, the methodology reduces to a type of contingency-table analysis, in which the rows of the table correspond to different marker-locus genotypes and in which the two columns categorize subjects into an "affected" group versus an "unaffected," or control, group. This aspect of the methodology is illustrated using two population data sets, the first relating APO-E genotype to the frequency of individuals undergoing maintenance hemodialysis and the second relating APO-B genotype to the frequency of coronary artery disease. The present methodology confirms the lack of association between marker and disease in the former data set and confirms the presence of association in the latter. Finally, the methodology is formulated here in terms of ordinary, multiperson kinship coefficients rather than in terms of the generalized kinship coefficients originally proposed. This greatly reduces the number of coefficients to be calculated, thereby enhancing the computational efficiency of the computer program.     

Extinction risk of Chinese angiosperms varies between woody and herbaceous species

Aim

Understanding how species' traits and environmental contexts relate to extinction risk is a critical priority for ecology and conservation biology. This study aims to identify and explore factors related to extinction risk between herbaceous and woody angiosperms to facilitate more effective conservation and management strategies and understand the interactions between environmental threats and species' traits.

Location

China.

Taxon

Angiosperms.

Methods

We obtained a large dataset including five traits, six extrinsic variables, and 796,118 occurrence records for 14,888 Chinese angiosperms. We assessed the phylogenetic signal and used phylogenetic generalized least squares regressions to explore relationships between extinction risk, plant traits, and extrinsic variables in woody and herbaceous angiosperms. We also used phylogenetic path analysis to evaluate causal relationships among traits, climate variables, and extinction risk of different growth forms.

Results

The phylogenetic signal of extinction risk differed among woody and herbaceous species. Angiosperm extinction risk was mainly affected by growth form, altitude, mean annual temperature, normalized difference vegetation index, and precipitation change from 1901 to 2020. Woody species' extinction risk was strongly affected by height and precipitation, whereas extinction risk for herbaceous species was mainly affected by mean annual temperature rather than plant traits.

Main conclusions

Woody species were more likely to have higher extinction risks than herbaceous species under climate change and extinction threat levels varied with both plant traits and extrinsic variables. The relationships we uncovered may help identify and protect threatened plant species and the ecosystems that rely on them.     

Estimation of morbid risk and age at onset with missing information.

Investigators of genetic illnesses are currently employing life-table techniques to estimate the lifetime risk of disease and the age-at-onset distribution. This methodology assumes that onset ages are known for affected individuals and that censoring ages are known for unaffected individuals. We extend these methods to incorporate affected individuals with unknown onset ages and unaffected persons with unknown censoring ages and illustrate how conventional life-table methods can produce seriously biased estimates, particularly of lifetime risk. The methodology is not restricted to genetic illnesses and can be applied to more complex illnesses with unknown etiology. We present an example for Huntington disease, which is generally assumed to be a Mendelian autosomal dominant disease, yielding estimates of lifetime risk of .503 +/- .70 and mean onset age of 47.7 +/- 3.1 years for offspring with a single affected parent. When conventional life-table techniques are employed, these estimates are .238 +/- .032 and 43.2 +/- 2.2.     

Identification of sex pheromones of Lutzomyia longipalpis (Lutz & Neiva, 1912) populations from the state of São Paulo, Brazil

In Brazil, four populations of Lutzomyia longipalpis each producing different sex pheromones are recognised. It has been suggested that these chemotype populations represent true sibling species. In this study we present the results of an analysis, by coupled gas chromatography-mass spectrometry, of the pheromones of males L. longipalpis from two different municipalities of the state of S?o Paulo. Our study showed that L. longipalpis from these two municipalities produced different sex pheromones from each other. This coupled with the remarkable difference between the epidemiological situation in Ara?atuba and Espírito Santo do Pinhal, suggests that the (S)-9-methylgermacrene-B and cembrene-1 populations may have different vectorial capacities.     

Teaching of microbiology in Brazil: progress or stagnation?

There is a severe shortage of trained microbiologists in Brazil which is hampering the development and expansion of microbiology/biotechnology research, the development of the biotechnology industries and environmental control agencies. Even some medical areas are affected. The reason for this situation lies in the deficient teaching of microbiology, where undergraduate courses in the biological sciences contain little or no microbiology, and in the low number of professionals that are produced. There are a few post-graduates courses in microbiology but these have high costs and little capacity for expansion. There is a need for incentives for the establishment of more undergraduate university courses, more practical training in specific areas, courses for retraining or updating of professionals already at work and specific programmes by the funding agencies.The objective of this article is to encourage discussion about the present state and the future of the teaching of Microbiology in Brazil. It may also be useful for other countries in the same situation.J.R. Jardim Freire is with the Department of Soil Science, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 7712, 91540-000 Porto Alegre, RS, Brazil; W. Gambale is with the Department of Microbiology, Institute of Biomedical Science, University of São Paulo, Av. Lineu Prestes 1374, 05508-900, São Paulo, SP, Brazil.     

Physio-climatic classification of South Africa's woodland biome

In an effort to develop more holistic ecosystem approaches to resource assessment and management, landscapes need to be stratified into homogeneous geographic regions. These regions can then be used in a monitoring framework to develop reliable estimates of ecosystem productivity. A regional characterization of the woodland biome has been developed for South Africa, delineated by satellite imagery and using environmental data and a rigorous statistical methodology. Distribution maps of key environmental variables are analyzed by factor analysis, an iterative clustering technique and maximum likelihood classification to quantify and identify homogeneous physio-climatic units.A spatial clustering technique was used to identify regions, which are statistically different with regard to five physiographic, climatic and edaphic variables deemed important within southern African savanna woodlands. The woodland biome of South Africa at 1km resolution was successively divided. Thirty year mean monthly temperature, total plant-available water balance of soil, elevation, landscape topographic position, and landscape soil fertility were used as input classification variables.The map data were submitted to a factor analysis and varimax axis rotation. The factor analysis removes correlations from the input variables, reduces the dimensionality, and normalizes the axis measurements. A cluster analysis was performed on the three principal factor scores using a modified iterative optimization clustering procedure to determine the finest level of classes statistically permitable. Twenty-seven identified unimodal cluster signatures were then submitted to a maximum likelihood classification where the statistical probability of the GIS cell assignment is carried out to determine class membership. The final map of custom physio-climatic regions is described, and these custom regions are compared with a vegetation potential map of the woodland types identified in the South African summer rainfall zone.     

Temporal and spatial distribution of malaria within an agricultural settlement of the Brazilian Amazon

Malaria has reemerged in tropical regions with rapid population growth and deforestation. The dynamics of malaria transmission in agricultural settlements of the Amazon have been poorly defined. We studied the spatial distribution of malaria incidence in Roraima, Brazil, using multi regression analysis on 12 parameters that described social, housing, and behavioral variables. Malaria cases were associated with the proximity of Anopheles darlingi breeding sites, the main vector in these areas. During the dry season, transmission was enhanced near a temporary river. Cases occurred throughout the year near fish‐farming dams. Epidemiological models derived from urban or riverine malaria are probably inadequate for describing disease transmission in agricultural settlements, where cases are clustered near breeding sites, while the majority of the population remains unaffected. Identification of these areas, associated with residual insecticide spraying or surveillance, may considerably decrease the costs of control efforts.     

Racial classification regarding semen donor selection in Brazil

Brazil has not yet approved legislation on assisted reproduction. For this reason, clinics, hospitals and semen banks active in the area follow Resolution 1358/92 of the Conselho Federal de Medicina, dated 30 September 1992. In respect to semen donation, the object of this article, the Resolution sets out that gamete donation shall be anonymous, that is, that the donor and recipients (and the children who might subsequently be born) shall not be informed of each other's identity. Thus, since recipients are unaware of the donor's identity, semen banks and the medical teams involved in assisted reproduction become the intermediaries in the process. The objective of this article is to show that, in practice, this represents disrespect for the ethical principles of autonomy, privacy and equality. The article also stresses that the problem is compounded by the racial question. In a country like Brazil, where racial classification is so flexible and goes side by side with racist attitudes, the intermediary role played by semen banks and medical teams is conditioned by their own criteria of racial classification, which are not always the same as those of donors and semen recipients. The data presented in this paper were taken from two semen banks located in the city of São Paulo (Brazil). At the time of my research, they were the only semen banks in the state of São Paulo and supplied semen to the capital (São Paulo city), the state of São Paulo, and to cities in other Brazilian states where semen banks were not available.     

Sediment quality assessment in the delta of rivers Rhine and Meuse based on field observations,bioassays and food chain implications

The quality of sediment was assessed in 46 sites in the delta of the rivers Rhine and Meuse (The Netherlands) by means of physical-chemical analysis, field observations on the macrobenthic community structure, accumulation studies and bioassays using Chironomus riparius, Daphnia magna and Photobacterium phosphoreum. The results of chemical analyses were classified using national criteria for sediment quality. Results of field studies and bioassays were classified using criteria derived from research in reference areas or based on data from literature. Risk assessment was carried out according to the sediment quality triad and by means of multi criteria analysis (MCA). The Triad approach was used to demonstrate causal relations between effects on the macrozoobenthos community structure, effects demonstrated in bioassays and sediment pollution. This was done by making a comparison of sediment contamination levels with toxicity data from literature for the test organisms of the bioassays. Using the MCA method, for each site a numerical value was derived for total environmental risk in the present situation, based on observed effects. In this way, a relative risk ranking of all sites was realized. The MCA values for the present situation were also compared with MCA scores based on estimated risks after remediation in 1995, in order to set priorities for sites where remediation is expected to cause a significant reduction in environmental risk. In most of the 46 sites studied so far, the macrofauna community was poorly developed, judged by a low number of benthic species, low abundances and a high dominance of species regarded as relatively tolerant to chemical pollution. In bioassays high sediment toxicity was demonstrated for 24 sites. Using the sediment quality triad approach, 25 sites were identified as areas where pollution can be held responsible for the effects observed in the field. From a comparison of contaminant concentrations in different types of food with maximum tolerable risk levels, and the application of a bioaccumulation model it was concluded that the sediment pollution also implies high risks for plant-, benthos- or fish-eating birds (secondary poisoning of top predators). In the Nieuwe Merwede highest MCA risk scores were found for shallow parts where highly polluted sediments are found. It is concluded that the sediment quality triad and the MCA provide additional information which can be used to establish priorities for remedial action. Based on an ecotoxicological evaluation of the improved quality of new sediments that will be deposited after removal of the polluted sediments in the Nieuwe Merwede, it is concluded that in this upstream part of the Rhine delta remedial action will be effective.     

Local environmental risk assessment of anticancer drugs in a developing country

Abstract

Anticancer drugs used in cancer treatment are excreted unchanged or as metabolites by feces and urine in hospitals and households. These drugs enter the municipal sewage system but wastewater treatment plants are not capable of removing all of these micro pollutants. In many countries such as Brazil, sanitation departments do not provide service, nor have access to all of the population, therefore most sewage is still released into untreated receiving bodies. This study analyzes the consumption of anticancer drugs in a Brazilian hospital located in one of the 10 municipalities with the best sanitation index in the country. It estimates its environmental risk in aquatic matrixes by the European Guideline on the Environmental Risk Assessment of Medicinal Products for Human Use. Among the 20 drugs analyzed, the three most consumed (cyclophosphamide, 5-fluoruracil, and cytarabine) show a predicted environmental concentration value greater than the action limit of 0.01?µg/L recommended by the guideline. The risk assessment was performed on all pharmaceuticals consumed to get a greater awareness of risk. Results do not indicate local environmental risk but, considering that the study was performed under the best sanitation scenario, it cannot be extrapolated in the other municipalities. The study highlights that development of suitable methodologies should be considered to perform environmental risk assessment of pharmaceuticals in developing countries sanitation conditions.     

Why Did Bluetongue Spread the Way It Did? Environmental Factors Influencing the Velocity of Bluetongue Virus Serotype 8 Epizootic Wave in France

Understanding where and how fast an infectious disease will spread during an epidemic is critical for its control. However, the task is a challenging one as numerous factors may interact and drive the spread of a disease, specifically when vector-borne diseases are involved. We advocate the use of simultaneous autoregressive models to identify environmental features that significantly impact the velocity of disease spread. We illustrate this approach by exploring several environmental factors influencing the velocity of bluetongue (BT) spread in France during the 2007-2008 epizootic wave to determine which ones were the most important drivers. We used velocities of BT spread estimated in 4,495 municipalities and tested sixteen covariates defining five thematic groups of related variables: elevation, meteorological-related variables, landscape-related variables, host availability, and vaccination. We found that ecological factors associated with vector abundance and activity (elevation and meteorological-related variables), as well as with host availability, were important drivers of the spread of the disease. Specifically, the disease spread more slowly in areas with high elevation and when heavy rainfall associated with extreme temperature events occurred one or two months prior to the first clinical case. Moreover, the density of dairy cattle was correlated negatively with the velocity of BT spread. These findings add substantially to our understanding of BT spread in a temperate climate. Finally, the approach presented in this paper can be used with other infectious diseases, and provides a powerful tool to identify environmental features driving the velocity of disease spread.     

Seasonal and inter-annual drivers of yellow fever transmission in South America

In the last 20 years yellow fever (YF) has seen dramatic changes to its incidence and geographic extent, with the largest outbreaks in South America since 1940 occurring in the previously unaffected South-East Atlantic coast of Brazil in 2016–2019. While habitat fragmentation and land-cover have previously been implicated in zoonotic disease, their role in YF has not yet been examined. We examined the extent to which vegetation, land-cover, climate and host population predicted the numbers of months a location reported YF per year and by each month over the time-period. Two sets of models were assessed, one looking at interannual differences over the study period (2003–2016), and a seasonal model looking at intra-annual differences by month, averaging over the years of the study period. Each was fit using hierarchical negative-binomial regression in an exhaustive model fitting process. Within each set, the best performing models, as measured by the Akaike Information Criterion (AIC), were combined to create ensemble models to describe interannual and seasonal variation in YF. The models reproduced the spatiotemporal heterogeneities in YF transmission with coefficient of determination (R²) values of 0.43 (95% CI 0.41–0.45) for the interannual model and 0.66 (95% CI 0.64–0.67) for the seasonal model. For the interannual model, EVI, land-cover and vegetation heterogeneity were the primary contributors to the variance explained by the model, and for the seasonal model, EVI, day temperature and rainfall amplitude. Our models explain much of the spatiotemporal variation in YF in South America, both seasonally and across the period 2003–2016. Vegetation type (EVI), heterogeneity in vegetation (perhaps a proxy for habitat fragmentation) and land cover explain much of the trends in YF transmission seen. These findings may help understand the recent expansions of the YF endemic zone, as well as to the highly seasonal nature of YF.