Central African Republic: First Confirmed Yellow Fever Case Since 2013 According to press sources, Central African Republic’s Ministry of Health reported 1 laboratory-confirmed human case of yellow fever (YF) on October 23, 2018, in Bocaranga, Ouham-Pende Prefecture. The last human YF case was reported in 2013. Shoreland continues to recommend vaccination for travelers aged ≥ 9 months going to Central African Republic. See Central African Republic Yellow Fever Map. Peru: Measles in 7 Regions According to Peru’s Ministry of Health, more than 4 confirmed cases of measles per week (a significant increase over average incidence) are being reported in Callao, Cusco, and Lima regions (including the city of Lima). Twenty-six confirmed cases of measles have occurred since late February 2018 in Amazonas, Callao, Cusco, Ica, La Libertad, Lima, and Puno regions. Many additional suspected cases are being reported. Most confirmed cases are of the Venezuelan genotype. Shoreland continues to make the following recommendations for travelers: All individuals ≥ 12 months of age born in 1957 or later (1970 or later in Canada and the U.K.; 1966 or later in Australia) without history of disease or of 2 countable doses of live vaccine at any time during their lives should complete a lifetime total of 2 doses of MMR vaccine (spaced by at least 28 days). All infants aged 6-11 months should receive 1 dose of MMR vaccine. All those born before 1970 (in Canada) without evidence of immunity or previous

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