What is yellow fever and how is it transmitted. What are the symptoms of yellow fever and how can it be prevented. Is yellow fever contagious between humans. How is yellow fever diagnosed and treated.

Understanding Yellow Fever: A Mosquito-Borne Viral Disease

Yellow fever is a potentially deadly viral infection transmitted primarily through the bite of infected Aedes aegypti mosquitoes. This disease, caused by the yellow fever virus (YFV) of the Flavivirus genus, has a long history of causing devastating outbreaks in Africa and the Americas. Despite significant progress in prevention and control, yellow fever remains a serious public health concern in many tropical and subtropical regions.

The Origins and Spread of Yellow Fever

Yellow fever originated in Africa, where it circulated between primates and mosquitoes in forest habitats. The virus and its primary vector, Aedes aegypti, were inadvertently introduced to the Americas during the transatlantic slave trade. This historical event led to the establishment of yellow fever in new ecosystems, creating additional challenges for public health authorities.

Transmission Cycle of Yellow Fever

How does yellow fever spread in different environments? The transmission of yellow fever occurs through three distinct cycles:

• Sylvatic (jungle) cycle: Involves transmission between non-human primates and mosquitoes in forest habitats
• Intermediate (savannah) cycle: Occurs in humid or semi-humid parts of Africa, involving transmission between humans and mosquitoes
• Urban cycle: Characterized by human-to-mosquito-to-human transmission in densely populated areas

Is yellow fever contagious between humans? No, yellow fever does not spread directly from person to person. The virus requires a mosquito vector to transmit the infection between individuals.

Recognizing Yellow Fever: Symptoms and Disease Progression

Yellow fever can manifest in various ways, ranging from asymptomatic infections to severe, life-threatening illness. Understanding the symptoms and progression of the disease is crucial for early detection and appropriate medical intervention.

Common Symptoms of Yellow Fever

What are the initial symptoms of yellow fever? The onset of yellow fever is typically sudden, with symptoms appearing 3-6 days after infection. Common initial symptoms include:

• Fever
• Chills
• Severe headache
• Back pain
• General body aches
• Nausea and vomiting
• Fatigue and weakness
• Loss of appetite

Stages of Yellow Fever Progression

How does yellow fever progress in infected individuals? Yellow fever typically progresses through three stages:

1. Infection: Characterized by the initial symptoms mentioned above, lasting 3-4 days
2. Remission: A brief period of symptom improvement, lasting up to 48 hours
3. Intoxication: In severe cases, a return of symptoms with the addition of jaundice, bleeding, and organ failure

It’s important to note that while many people recover after the initial phase, approximately 15-25% of patients enter the toxic phase, which can be fatal.

Diagnosing Yellow Fever: Challenges and Techniques

Accurate and timely diagnosis of yellow fever is essential for proper patient management and outbreak control. However, diagnosing yellow fever can be challenging due to its similarity to other tropical diseases.

Diagnostic Methods for Yellow Fever

How is yellow fever diagnosed? Yellow fever diagnosis typically involves a combination of clinical assessment, patient history, and laboratory tests. The main diagnostic methods include:

• Serological tests: Detection of yellow fever-specific IgM and IgG antibodies
• Molecular tests: RT-PCR to detect viral RNA
• Virus isolation: Culturing the virus from blood or tissue samples
• Histopathology: Examination of liver tissue samples in fatal cases

Why is early diagnosis of yellow fever important? Early diagnosis allows for prompt supportive care, implementation of vector control measures, and activation of surveillance systems to prevent further spread of the disease.

Treatment Approaches for Yellow Fever

Currently, there is no specific antiviral treatment for yellow fever. Management of the disease focuses on supportive care to alleviate symptoms and prevent complications.

Supportive Care Strategies

What does supportive care for yellow fever involve? The main components of supportive care include:

• Rest and hydration
• Pain relief and fever reduction
• Management of nausea and vomiting
• Oxygen therapy if needed
• Treatment of secondary bacterial infections
• Blood transfusions in cases of severe bleeding
• Dialysis for patients with kidney failure

Why is intensive care necessary for severe yellow fever cases? Severe cases of yellow fever can lead to multi-organ failure, requiring advanced supportive care in an intensive care unit to manage complications and improve survival chances.

Prevention Strategies: Vaccination and Vector Control

Prevention is the cornerstone of yellow fever control. A combination of vaccination and vector control measures has proven effective in reducing the burden of this disease.

Yellow Fever Vaccination

How effective is the yellow fever vaccine? The yellow fever vaccine is highly effective, providing lifelong immunity in up to 99% of vaccinated individuals after a single dose. Vaccination is recommended for:

• Residents of yellow fever endemic areas
• Travelers to countries where yellow fever is present
• Laboratory personnel working with yellow fever virus

Are there any contraindications to yellow fever vaccination? The vaccine is contraindicated in certain groups, including infants under 6 months, individuals with severe egg allergies, and those with compromised immune systems.

Vector Control Measures

What vector control strategies are effective against yellow fever? Key vector control measures include:

• Environmental management to reduce mosquito breeding sites
• Use of insecticides and larvicides
• Personal protection methods (e.g., insect repellents, bed nets)
• Community education and engagement

Why is integrated vector management important for yellow fever control? An integrated approach combining multiple vector control strategies is more effective in reducing mosquito populations and interrupting disease transmission.

Global Impact and Ongoing Challenges

Yellow fever continues to pose significant public health challenges, particularly in resource-limited settings. Understanding the global impact and ongoing challenges is crucial for developing effective control strategies.

Epidemiological Trends

How has the epidemiology of yellow fever changed over time? Recent trends include:

• Resurgence of urban yellow fever outbreaks in Africa
• Expansion of yellow fever into previously unaffected areas
• Increased risk of international spread due to global travel and trade

Why is yellow fever surveillance important? Effective surveillance systems are essential for early detection of outbreaks, monitoring disease trends, and guiding public health interventions.

Challenges in Yellow Fever Control

What are the main obstacles to yellow fever control? Key challenges include:

• Limited vaccine production capacity
• Incomplete vaccination coverage in endemic areas
• Emergence of sylvatic transmission in new geographic areas
• Climate change impacts on vector distribution
• Urbanization and population movements

How can these challenges be addressed? Addressing yellow fever control challenges requires a multifaceted approach, including:

1. Strengthening global vaccine supply and distribution systems
2. Enhancing surveillance and laboratory capacities
3. Improving vector control strategies
4. Promoting research and development of new tools and interventions
5. Fostering international collaboration and knowledge sharing

Future Perspectives: Research and Innovation

Ongoing research and innovation are crucial for improving our understanding of yellow fever and developing more effective prevention and control strategies.

Emerging Research Areas

What are some promising areas of yellow fever research? Current research focuses on:

• Development of new vaccine technologies
• Identification of antiviral treatments
• Improved diagnostic tools for rapid and accurate detection
• Novel vector control approaches, including genetic modification of mosquitoes
• Understanding the impact of climate change on yellow fever transmission

How might advances in genomics and bioinformatics contribute to yellow fever research? These technologies can help in:

1. Tracking the evolution and spread of yellow fever virus strains
2. Identifying genetic factors influencing disease severity
3. Developing more targeted interventions based on molecular insights

Innovative Control Strategies

What innovative approaches are being explored for yellow fever control? Some promising strategies include:

• Development of thermostable vaccines for use in remote areas
• Implementation of mobile health technologies for disease surveillance
• Use of drones for targeted insecticide application in hard-to-reach areas
• Exploration of plant-based vaccines and therapeutics

How can community engagement be leveraged for more effective yellow fever control? Engaging local communities in vector control efforts, vaccination campaigns, and health education can significantly improve the effectiveness and sustainability of yellow fever prevention programs.

In conclusion, yellow fever remains a significant public health concern, particularly in tropical and subtropical regions of Africa and South America. While great strides have been made in understanding the disease and developing effective prevention strategies, ongoing challenges necessitate continued research, innovation, and global cooperation. By combining vaccination efforts, vector control measures, improved surveillance, and community engagement, we can work towards reducing the burden of yellow fever and protecting vulnerable populations from this potentially deadly disease.

Yellow Fever Fact Sheet

Last Reviewed: July 2017

What is yellow fever?

Yellow fever is a disease caused the bite of a mosquito infected with the yellow fever virus. The Aedes aegypti mosquito is most commonly associated with spreading yellow fever. Aedes aegypti mosquitoes are not found naturally in New York State.

Who gets yellow fever?

Yellow fever can affect people of any age especially people travelling to areas where mosquitoes infected with yellow fever virus are found.

How is yellow fever spread?

Yellow fever is spread by the bite of infected Aedes aegypti mosquitoes. A mosquito becomes infected when it bites a person who has yellow fever in his or her blood. Direct spread of yellow fever from one person to another does not occur. Aedes aegypti mosquitoes are not found naturally in New York State.

What are the symptoms of yellow fever and when do they appear?

Most people infected with yellow fever virus have no illness or mild illness. People who get symptoms usually have a sudden onset of fever, chills, severe headache, backache, weakness, nausea (a sick feeling in the stomach) and vomiting. Most people feel better after these initial symptoms. However, some people will develop more severe symptoms. As the disease progresses, yellowing of the whites of the eyes and skin, slowing and weakening of the heart rate, bleeding of the gums, and bloody urine may occur. Symptoms typically occur within 3 to 6 days after the bite of an infected mosquito.

How is yellow fever diagnosed?

Symptoms, travel history, and a physical exam can cause a health care provider to suspect yellow fever. Laboratory tests confirm diagnosis by seeing if the virus or antibodies against the virus are present in the person.

What is the treatment for yellow fever?

There is no specific treatment for yellow fever. People traveling to areas where yellow fever exists should speak with their health care provider about receiving the yellow fever vaccine.

Does past infection with yellow fever make a person immune?

Yes. People who have had yellow fever generally develop lifelong immunity.

How can yellow fever be prevented?

It is important for travelers to be vaccinated before visiting areas where yellow fever exists such as Africa or South America. In addition, travelers should take action to prevent mosquito bites including using EPA-registered insect repellent and wearing long sleeve shirts, long pants, and socks outdoors. More information on repellents: Environmental Protection Agency – insect-repellents.

In addition:

• Be sure to follow label directions.
• Try to reduce the use of repellents by dressing in long sleeves and pants tucked into socks or boots.
• Children should only handle repellents with adult supervision. Adults should apply repellents to their own hands first and then gently spread on the child’s exposed skin. Avoid applying directly to children’s hands. After returning indoors, wash your child’s treated skin and clothing with soap and water or give the child a bath.
• Do not apply near eyes, nose or mouth and use sparingly around ears.
• After returning indoors, wash treated skin with soap and water.

Facts about yellow fever

1. Name and nature of infecting organism

Yellow fever (YF) is an African mosquito-borne infection of primates. It is caused by a virus of the Flavivirus genus of the Flaviviridae family. In its natural habitat, it is transmitted between monkeys by forest-dwelling primatophilic Aedes mosquitoes. The virus and its vector (Ae. aegypti) were introduced to the Americas, where it is also enzootic in forest habitat, with the slave trade.

Sylvatic infection of humans occurs when they enter the forest to hunt, gather food, harvest timber and so on. Forest-infected persons can initiate human-to-human transmission if suitable peridomestic vectors are present in towns and villages. In the urban environment, Ae. (Stegomyia) aegypti (Linn.), a forest species that has adopted the human domestic environment, is a highly effective vector for yellow fever virus (YFV). This mosquito is also the principal urban vector of dengue and chikungunya viruses.

Yellow fever is distributed in west, central and east Africa and in South America, from Panama to the northern part of Argentina. It has never been detected in Asia. Catastrophic epidemics, with tens of thousands of deaths, have been recorded in rural Africa.

The vector Aedes aegypti was once endemic in Europe, and responsible for large epidemics of YF and dengue. The reason for its disappearance after World War II has never been explained. It is still present in the United States and has been recorded in 21 states. It is conceivable that the vector could become re-established and widespread in Europe, as has happened in recent years with another putative vector, Ae. albopictus.

2. Clinical features

Onset of symptoms is sudden, usually 3–5 days after infection. The disease can cause a wide spectrum of symptoms, from mild to fatal. In clinical cases there is a sudden onset of fever with severe headache, arthralgias and muscle pains. Jaundice may appear on the third day and indicates a poor prognosis. Transaminase elevations are also prognostic. In severe cases there may be spontaneous haemorrhage (‘coffee ground’ vomit), renal failure, delirium, coma and death. Mortality of these clinical cases can be as high as 80%, on a par with Ebola, Marburg and other haemorrhagic viral infections. Convalescence is long, often with serious sequelae.

3. Transmission

3.1 Reservoir

The virus circulates between monkeys in the forest and between humans in village and urban areas. The principal sylvatic vectors breed in tree-holes and similar small collections of water. Infection in African monkeys is asymptomatic or mild; epizootics are signalled when humans acquire the disease. By contrast, the virus is lethal to western hemisphere primates; epizootics are evident ‘when the jungle goes silent’ because of the high mortality of howler monkeys.

3.2 Transmission mode

Bites by infected mosquitoes are the only mode of transmission.

Mosquitoes acquire the virus when they feed on a viraemic host, after which (in a susceptible species) the virus infects many tissues, including the salivary glands. While it can take a matter of weeks (and many blood meals) to become infective, the mosquitoes are infected for life.

New infections in humans can occur when saliva that contains the virus is injected into a non-immune host during subsequent blood meals. The ‘extrinsic incubation period’, the time required for the mosquito to become infective, is about ten days, depending on the temperature. There is also evidence of vertical transmission (transmission directly from the adult female mosquitoes via eggs to adults of the next generation).

Viraemia reaches high titres on the day before onset of symptoms, and is generally high enough to infect mosquitoes for the next four days. Immunity is probably lifelong.

3.3 Risk groups

All unvaccinated persons are at risk in areas of active transmission. In recent years, a number of unvaccinated tourists from Europe and North America have died of the disease after visiting enzootic areas.

Aedes aegypti is ubiquitous and common throughout the tropics, so there is a real and present danger of a major epidemic in many tropical cities.

4. Prevention measures

A safe, effective and inexpensive yellow fever attenuated vaccine, known as YF 17D, has been used for more than half a century. The vaccine is highly effective but routine vaccination is implemented by very few countries.

A YF vaccination certificate is the only vaccination certificate that should be required in international travel. The certificate of vaccination against yellow fever is valid for the life of the person vaccinated, beginning 10 days after the date of vaccination. An individual risk benefit analysis particularly in patients with auto-immune diseases, immune-deficiencies or other related underlying conditions, and also among the elderly should be conducted prior to vaccination taking into account the destination and duration of travel, and the likelihood of exposure to mosquitoes.

At the beginning of the 20th century, urban YF was eliminated from many countries by energetic campaigns to eliminate Ae. aegypti breeding sites. After World War II, targeted application of DDT to infested containers and their surroundings was an outstanding success. According to the Pan American Health Organization, the species was eradicated from 22 countries of the Americas. No substitute for DDT is currently available. Many health authorities resort to insecticidal aerosols delivered from hand-held machines, road vehicles or aircraft. The technique is expensive and ineffective. Moreover, even if a high kill rate were attainable, the impact on adult populations would probably be too short to make an effective impact on transmission. The World Health Organization has recommended ‘community based source reduction’ for several years, but there is no evidence that this has been successful anywhere in the world.

Prevention is also based on protection against mosquito bites. Aedes mosquitoes have diurnal biting activities in both indoor and outdoor environments. Therefore, personal protection measures should be applied all day, especially during the hours of the highest mosquito activity (mid-morning, late afternoon to twilight). Personal protective measures against mosquito bites include the use of mosquito bed nets (preferably insecticide-treated nets), sleeping or resting in screened or air-conditioned rooms, the wearing of clothes that cover most of the body, and the use of mosquito repellent in accordance with the instructions indicated on the product label.

5. Diagnosis

The virus can be detected in blood specimens by RT-PCR, antigen-capture and/or viral isolation. A serological diagnosis can be made by detection of specific IgM antibodies one week after infection. Exposure to YF virus confers lifelong immunity.

6. Management and treatment

Supportive therapy is the only option, although the use of antivirals is an active field of research. Strict avoidance of aspirin and other anticoagulants is important.

7. Key areas of uncertainty

In spite of the wealth of information on the ecology, epidemiology and pathology of the disease, a high probability of large urban outbreaks in unvaccinated populations remains in areas where the Aedes aegypti vector is present.

Adverse (viscerotropic or neurotropic) events following immunisation after YF vaccination have been reported mostly in older age groups and in immunocompromised individuals. These cases would need to be investigated further to gather and verify evidence of the association between vaccine and clinical disease in order to support decision-making regarding YF vaccination.

8. References

Crosby M. The American plague: the untold story of yellow fever, the epidemic that shaped our history. Berkley, California: Berkley Publishing Group; 2007.
Monath TP. Yellow fever: Victor, Victoria? Conqueror, conquest? Epidemics and research in the last forty years and prospects for the future. Am J Trop Med Hyg 1991;45(1):1-43.
Monath TP. Treatment of yellow fever. Antiviral Res 2008;78(1):116-24.
Reiter P. Climate change and mosquito-borne disease. Environ Health Perspect 2001;109 Suppl 1:141-61.
Reiter P, Nathan M. Guidelines for assessing the efficacy of insecticidal space sprays for control of the dengue vector, Aedes aegypti. Geneva: World Health Organization; 2001.

Page last updated

31 May 2021

Yellow fever: symptoms, causes, treatment

Contents

• 1 Yellow fever: symptoms, treatment and prevention
  • 1.1 Discover exciting games in the exotic tropics!
    • 1.1.1 What do we offer?
    • 1. 1.2 Our advantages:
  • 1.2 Yellow fever is a dangerous disease
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    • 1.4.1 Exciting outdoor quests – fun and interesting pastime
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    • 1. 9 Yellow fever: a possible threat to our health
      • 1.9.1 19th century costumes and make-up to protect against disease
    • 1.10 Safety and comfort at events: YellowFever Protection guarantee
      • 1.10.1 When it comes to health, you can’t compromise.
    • 1.11 Journey into the past: Yellow Rush
      • 1.11.1 Organize an incredible trip to the era of the Gold Rush with us!
    • 1.12 Q&A:
      • • 1.12.0.1 What is Yellow Fever?
        • 1.12.0.2 What are the symptoms of Yellow Fever?
        • 1.12.0.3 How does the infection with “Yellow Fever” occur?
        • 1.12.0.4 How to protect yourself from “Yellow Fever”?
        • 1.12.0.5 How to treat “Yellow Fever”?
        • 1.12.0.6 What is the prognosis for recovery from “Yellow Fever”?

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  Q&A:

  What is Yellow Fever?

  Yellow fever is a contagious viral disease transmitted by mosquito bites.

  What are the symptoms of Yellow Fever?

  A patient with “Yellow fever” develops fever, headache, muscle pain, nausea, vomiting, icteric coloration of the skin and sclera. In severe cases, bleeding and organ failure may occur.

  How does the infection with “Yellow Fever” occur?

  Infection with “Yellow fever” occurs through the bites of mosquitoes that carry the virus from infected areas. You can get infected only in those places where this type of mosquito is common and there are sick people.

  How to protect yourself from “Yellow Fever”?

  To protect against “Yellow fever” it is necessary to use mosquito repellents, wear protective clothing, and disinfect premises. It is recommended to get vaccinated to reduce the chance of getting sick.

  How to treat “Yellow Fever”?

  Treatment for “Yellow Fever” is aimed at reducing symptoms, strengthening the immune system, and supporting the respiratory and cardiovascular systems. In addition, complications are treated, for example, bleeding syndromes, liver failure and other complications.

  What is the prognosis for recovery from “Yellow fever”?

  The prognosis for recovery depends on the severity of the disease. In mild cases, patients are completely cured, but in severe cases, survival is reduced to 50%. Therefore, it is important to consult a doctor in a timely manner.

  Yellow fever – Udmurt AIDS Center

  Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. “Yellow” it is called because of the jaundice that develops in some patients. Up to 50% of people who develop severe illness die from yellow fever. An estimated 200,000 cases of yellow fever occur worldwide every year, 30,000 of which are fatal, 90% of them in Africa. This virus is endemic in tropical regions of Africa and Latin America with a total population of more than 900 million people. Over the past two decades, the number of cases of yellow fever has increased as a result of declining population immunity to infection, deforestation, urbanization, population migration and climate change.

  There is no cure for yellow fever. Only symptomatic treatment is possible, aimed at alleviating symptoms for a more comfortable condition of patients. Vaccination is the most important measure to prevent yellow fever. The vaccine is safe, affordable and highly effective. It provides protection for 30-35 years or more. For 9In 5% of vaccinated people, the vaccine provides effective immunity one week after immunization. Yellow fever vaccination is highly recommended for those traveling outside urban areas in endemic countries (Africa and South America) that do not officially report cases and do not usually require a certificate to enter the country.

  Vaccination against yellow fever is nearly 100% effective, while mortality from the disease reaches 60% in non-immune adults. The tolerability of modern vaccines is excellent. The only contraindication, in addition to a true allergy to the protein of chicken eggs, is the insufficiency of cellular immunity (congenital or acquired, the latter can only be temporary). A vaccination certificate can only be valid if it meets the requirements for its issuance and if the vaccine used is approved by WHO and the vaccination was given at a certified yellow fever vaccination center.

  The validity of the vaccination certificate is 10 years, starting from the 10th day after the day of vaccination. If a person is revaccinated before the expiration of this period, the validity is extended for a further 10 years, starting from the date of immunization. If the revaccination is recorded on a new certificate form, it is recommended to keep the previous vaccination certificate for 10 days from the date of the revaccination, until the expiration date of the new certificate begins.

  List of countries requiring an international yellow fever vaccination certificate97 No. 2510/4106-97-32 “On changing the requirements for vaccination against yellow fever when Russian citizens travel to foreign countries”)

  • Benin
  • Burkina Faso
  • Gabon
  • Ghana
  • Zaire
  • Cameroon
  • Congo
  • Ivory Coast
  • Liberia
  • Mauritania
  • Mali
  • Niger
  • Rwanda
  • Sao Tome and Principe
  • Togo
  • French Guiana
  • Central African Republic

  List of countries endemic for yellow fever or with areas endemic for this infection, when entering (or transiting with a stopover) it is recommended to carry an international yellow fever vaccination certificate:

  Start of trip	Duration	Price
  Golden adventure	2 days	15000 rub
  Unique impressions of the Yellow Fever	5 days	30000 RUB
  The most memorable trip to Golden Lake	7 days	45000 RUB

  South America	Africa
  Venezuela	Angola
  Bolivia	Burundi
  Brazil	Gambia
  Guyana	Guinea
  Colombia	Guinea-Bissau
  Panama	Zambia
  Suriname	Kenya
  Ecuador	Nigeria
  	Senegal
  	Somalia
  	Sudan
  	Sierra Leone
  	Tanzania
  	Uganda
  	Chad
  	Equatorial Guinea
  	Ethiopia

  Tourists are advised to get vaccinated against yellow fever

  Russian epidemiologists urge citizens leaving for some countries of South America and Africa to get vaccinated against yellow fever. According to the World Health Organization, the number of people infected with this disease has increased significantly in recent years.

  The Federal Service for Supervision of Consumer Rights Protection and Human Welfare told MK that deadly mosquito bites have become more frequent in Guinea, Brazil and the Gambia, and in Mali yellow fever has been reported for the first time in 10 years. At the same time, only 16 countries require tourists to have an international certificate of vaccination. Another 27 countries where there are outbreaks of the epidemic are limited to recommendations to get vaccinated before entering the country. These are Angola, Burundi, Gambia, Guinea, Guinea-Bissau, Kenya, Mauritania, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Uganda, Tanzania, Chad, Equatorial Guinea, Bolivia, Brazil, Venezuela, Guyana, Guiana, Colombia, Panama, Peru, Suriname, Trinidad and Ecuador. In a word, tourists going there should take care of their own safety. And the only way of salvation that medicine can offer people today is a vaccine that is valid for 10 years.