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U.S. health experts are keeping an eye on an outbreak of yellow fever in rural areas in Brazil since December. They warn that the virus may spread to warmer regions of the U.S. because of the same mosquito that carries Zika.

An uncommon spike in the number of yellow fever cases in the country has raised concerns that it could also increase travel-related cases. Dr. Catharine I. Paules and Dr. Anthony S. Fauci wrote the essay "Yellow Fever- Once Again on the Radar in the Americas" for The New England Journal of Medicine published on March 8. They were concerned that local yellow fever outbreaks could occur similar to the spread of Zika in the U.S. and other countries.

Figures from a health agency show that 220 people have died as of March 2. The Pan American Health Organization listed a 33% fatality rate for confirmed cases. according to the CNN. There are 326 confirmed cases of yellow fever and 916 are suspected to have this disease. Its symptoms include high fever and jaundice.

The majority of these are found in São Paulo, Minas Gerais, and Espírito Santo.

Zika, dengue and chikungunya viruses are transmitted by the Aedes or Haemagogus species and they move at a faster pace through mainly unvaccinated communities. Poor sanitation and abundance of trash where Aedes aegypti mosquito could breed are also to blame. An effective vaccination campaign and mosquito control are some of the suggested measures for preventing the spread of the yellow fever virus.

Vaccine for yellow fever was developed in 1937 but the stockpile was so low that only 20 percent of the standard dose per person was administered in Angola and Congo when outbreaks occurred two years ago.

Fauci clarified that it has not reached a critical level but they would be alarmed if residents in urban areas started showing symptoms of yellow fever, the Los Angeles Times reported.

Awareness and preparedness may just be what it takes to prevent the next outbreak of yellow fever.