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Unusually active outbreaks of yellow fever in rural areas of Brazil are stoking fears among experts that the deadly mosquito virus could go the way of Zika and spark a massive and devastating epidemic in the Americas.
In a commentary published Wednesday in the New England Journal of Medicine, infectious disease experts at the National Institutes of Health note that, so far, the outbreaks are mostly in rural areas and involve forest mosquitoes transmitting the virus to nonhuman primates as well as incidental humans.
Since February, there have been 234 confirmed human infections, with 80 deaths and hundreds more cases currently under investigation.

But those outbreaks are encroaching on densely packed urban areas.
“This proximity raises concern that, for the first time in decades, urban transmission of yellow fever will occur in Brazil,” experts Catharine Paules, of the NIH’s National Institute of Allergy and Infectious Diseases, and Anthony S.

Fauci, director of the NIAID, write.
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