Yellow Fever

  • Definition

    Yellow fever is a disease carried by female mosquitoes. The species of mosquito that carry yellow fever are native to sub-Saharan Africa and South America, but can also be found in other areas. Although it may be rare in developed countries, yellow fever is endemic in impoverished areas where people cannot afford to get vaccinated.
    There is no specific treatment for yellow fever, but vaccination can prevent it.
  • Causes

    Yellow fever is caused by specific viruses transmitted by bites from infected mosquitoes.
    Mosquito Bite
    Mosquito bite
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  • Risk Factors

    Factors that may increase your chances of getting yellow fever include:
    • Living, working, or traveling areas with yellow fever
    • Failure to take proper precautions, such as vaccination or using mosquito protection
  • Symptoms

    Yellow fever symptoms appear within a week after a person is bitten by an infected mosquito. Typically, acute phase symptoms will persist for 3-4 days, and then disappear. A small percentage of people progress into the toxic phase. The toxic phase symptoms begin within 24 hours of the end of the acute phase. Recovery from yellow fever provides lifetime immunity from the disease.
    Acute phase symptoms may include:
    • Fever
    • Headache
    • Muscle pain
    • Backache
    • Chills
    • Loss of appetite
    • Nausea and/or vomiting
    Toxic phase symptoms may include:
    • High fever
    • Abdominal pain
    • Bleeding from the gums, nose, eyes, and/or stomach
    • Vomit that appears black due to blood content
    • Low blood pressure
    • Liver failure, which may lead to jaundice
    • Kidney failure
    • Confusion
    • Seizure
    • Coma
  • Diagnosis

    Your doctor will ask you about your symptoms and medical and travel history. A physical exam will be done. Blood tests will be needed for diagnosis. Antibodies or the virus may be detected in the blood.
  • Treatment

    Currently, medications or treatments specifically for yellow fever are not available. However, there are treatments that that can be given at a hospital to ease some symptoms of yellow fever.
    Hydration
    It is important to keep the body hydrated. Fluids containing electrolytes may be given orally, or may be injected through a vein to prevent dehydration.
    Fever Reduction Methods
    Cool water or anti-fever medications may be given to reduce fever.
    Kidney Dialysis
    In toxic phases, dialysis may be needed to help the kidneys filter waste.
    Dialysis Mechanism
    Dialysis pump
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    Blood Transfusion
    In toxic phase cases, a transfusion may be needed to replace blood cells and clotting agents lost through bleeding.
    Antibiotics for Secondary Infections
    Fighting yellow fever may cause the immune system to become temporarily weak. A weak immune system cannot guard against bacterial infections as it normally would, so infections occur more easily. Antibiotics may be given to fight bacterial infections if they occur. Antibiotics cannot be given to treat yellow fever because yellow fever is a virus, and viruses do not respond to antibiotics.
  • Prevention

    Vaccination is the best way to prevent yellow fever. The yellow fever vaccine is recommended for those who are traveling to or living in areas where the disease is present. Your doctor will help decide if the vaccine is right for you.
    Other ways to reduce your chances of getting yellow fever include:
    • Staying in air-conditioned or well-screened areas.
    • Wearing long-sleeved clothing and long pants.
    • Using bed netting while sleeping.
    • Removing or destroying mosquito-breeding areas. Mosquitoes lay their eggs in standing pools of water, such as the inside of old tires, flower pots, and small puddles.
    • Using insect repellents containing DEET on exposed skin.
    • Using Permethrin or DEET on clothes and bed nets for extra protection.
  • RESOURCES

    US Centers for Disease Control and Prevention http://www.cdc.gov

    World Health Organization http://www.who.int

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    Arboviruses & encephalitis. PEMSoft at EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Accessed June 19, 2014.

    García-Rejón JE, Loroño-Pino MA, et al. Mosquito infestation and dengue virus infection in Aedes aegypti females in schools in Merida, Mexico. Am J Trop Med Hyg. 2011;84(3):489-496.

    Global map. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/yellowfever/maps/index.html. Updated December 31, 2011. Accessed June 19, 2014.

    Walker KR, Joy TK, et al. Human and environmental factors affecting Aedes aegypti distribution in an arid urban environment. J Am Mosq Control Assoc. 2011;27(2):135-141.

    Yellow fever. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/yellowfever/index.html. Updated December 13, 2011. Accessed June 19, 2014.

    Yellow fever. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 25, 2014. Accessed June 19, 2014.

    Yellow fever VIS. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/yf.html. Updated June 18, 2013. Accessed June 19, 2014.

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