Yellow fever seems to play a role in single, sudden breakouts of the disease. Three epidemiologically different infectious cycles occur, in which the virus is transmitted from mosquitoes to humans or other primates. In the "urban cycle", only the yellow fever mosquito "A. aegypti" is involved. It is well adapted to urban areas, and can also transmit other diseases, including Zika fever, dengue fever, and chikungunya. The urban cycle is responsible for the major outbreaks of yellow fever that occur in Africa. Except for an outbreak in Bolivia in 1999, this urban cycle no longer exists in South America. Besides the urban
Yellow fever vaccine of age. Those travelling to areas where the disease occurs should also be immunized. Additional doses after the first are generally not needed. Yellow fever vaccine is generally safe. This includes in those with HIV infection but without symptoms. Mild side effects may include headache, muscle pains, pain at the injection site, fever, and rash. Severe allergies occur in about eight per million doses, serious neurological problems occur in about four per million doses, and organ failure occurs in about three per million doses. It is likely safe in pregnancy and therefore recommended among those who will be potentially exposed.