What are the effects of yellow fever vaccination. How does the yellow fever vaccine work. Who should and should not receive the yellow fever vaccine. What are the potential reactions to the yellow fever vaccine. How long does yellow fever vaccine immunity last.

Understanding Yellow Fever: Causes, Symptoms, and Transmission

Yellow fever is a serious viral disease transmitted by mosquitoes, primarily found in parts of Africa and Central and South America. The World Health Organization (WHO) maintains updated lists of countries where yellow fever is widespread. The disease gets its name from the characteristic yellow skin and eyes (jaundice) that occur in severe cases due to liver infection.

The yellow fever virus typically incubates in the body for 3 to 6 days before symptoms appear. The disease progresses in two stages:

Stage 1 Symptoms (Acute Phase)

• Fever
• Nausea and vomiting
• Flushed face
• Constipation
• Stomach ache
• Headache
• Muscle pain
• Restlessness and irritability

These initial symptoms typically last for 3 to 4 days and then subside over 1 to 2 days. In mild cases, the infection may end after this first stage as the body clears the virus.

Stage 2 Symptoms (Toxic Phase)

In 15-25% of cases, severe symptoms develop, even after an initial remission period. This stage occurs when the virus infects vital organs such as the liver, heart, and kidneys. Approximately half of the people who reach this stage do not survive.

• High fever
• Upper abdominal pain
• Black, ‘coffee-ground’ vomit
• Bleeding
• Jaundice (yellow skin and eyes)
• Kidney failure
• Liver failure

Given the severity of yellow fever, vaccination is crucial for those traveling to or residing in affected areas.

Yellow Fever Vaccination: Importance and Requirements

Vaccination against yellow fever is generally safe and effective, significantly reducing the risk of infection. Some countries require travelers passing through infected areas to show proof of vaccination with an International Certificate of Vaccination or Prophylaxis.

Are there specific entry requirements for yellow fever vaccination? Many countries have implemented strict regulations regarding yellow fever vaccination for travelers. While some nations have no entry requirements, others mandate proof of vaccination for all visitors to satisfy entry criteria. It’s essential to check the specific requirements of your destination country well in advance of your trip.

How can you obtain yellow fever vaccination and certification? Vaccination and certification are available through travel clinics or health providers authorized by the WHO. It’s advisable to schedule an appointment with your GP or a travel clinic doctor 6 to 8 weeks before departure, as multiple vaccines may be necessary.

When should you receive the yellow fever vaccine before travel? The yellow fever vaccine should be administered at least 10 days before entering a country where immunization is a legal requirement. This timeline ensures you avoid potential quarantine procedures upon arrival.

Yellow Fever Vaccine: Dosage and Immunity Duration

How many doses of the yellow fever vaccine are required? Immunization against yellow fever typically requires only a single dose of the vaccine. This single dose usually provides most people with lifetime immunity against the disease.

How long is the yellow fever vaccination certificate valid? In most cases, once you have been vaccinated, the certificate is valid for life. This long-term validity eliminates the need for frequent revaccination for most travelers and residents of affected areas.

Does the vaccine provide immediate protection? While the vaccine is highly effective, it’s important to note that it takes about 10 days after vaccination for the body to develop immunity. Therefore, it’s crucial to plan your vaccination well in advance of your travel date.

Who Should Receive the Yellow Fever Vaccine?

The yellow fever vaccine is recommended for specific groups of people based on their risk of exposure to the virus. Who are the primary candidates for yellow fever vaccination?

• People over 9 months of age traveling to or living in areas with a high risk of yellow fever transmission
• Laboratory workers who routinely handle the yellow fever virus

Are there any age restrictions for yellow fever vaccination? The vaccine is generally not recommended for children under 9 months of age due to an increased risk of vaccine-associated neurologic disease in this age group.

Should pregnant women receive the yellow fever vaccine? Immunization against yellow fever is not typically recommended for pregnant women or those breastfeeding babies under 9 months of age. However, if travel to a high-risk area is unavoidable during pregnancy, it’s crucial to consult with a healthcare provider to weigh the risks and benefits of vaccination.

Contraindications: Who Should Not Receive the Yellow Fever Vaccine?

While the yellow fever vaccine is safe for most people, there are certain groups who should not receive it due to increased risk of adverse reactions. Who should avoid the yellow fever vaccine?

• Infants under 9 months of age
• Individuals who have had a severe allergic reaction (anaphylaxis) to a previous dose of the vaccine
• People with severe allergies to any component of the vaccine, including egg allergies
• Those with weakened immune systems due to illness or medical treatment
• Individuals with a history of thymic disorders, including myasthenia gravis, thymoma, thymectomy, or DiGeorge syndrome
• People who have experienced damage to the thymus from chemotherapy, radiotherapy, or complications after transplantation

Why are people with egg allergies advised against receiving the yellow fever vaccine? The yellow fever vaccine is produced using chicken embryos, which means it contains small amounts of egg protein. For individuals with severe egg allergies, this could potentially trigger an allergic reaction.

How does a weakened immune system affect eligibility for yellow fever vaccination? People with compromised immune systems may not develop an adequate immune response to the vaccine, rendering it less effective. Additionally, as the yellow fever vaccine contains live, weakened virus, it could potentially cause illness in immunocompromised individuals.

Potential Side Effects and Reactions to Yellow Fever Vaccine

Like all vaccines, the yellow fever vaccine can cause side effects, although serious reactions are rare. What are the common side effects of the yellow fever vaccine?

• Low-grade fever
• Mild headache
• Muscle pain
• Fatigue
• Soreness at the injection site

These mild side effects typically occur within days after vaccination and resolve on their own within a week.

Are there any serious side effects associated with the yellow fever vaccine? While rare, more severe reactions can occur, including:

• Severe allergic reactions (anaphylaxis)
• Yellow fever vaccine-associated neurologic disease (YEL-AND)
• Yellow fever vaccine-associated viscerotropic disease (YEL-AVD)

YEL-AND and YEL-AVD are extremely rare but can be life-threatening. They occur more frequently in older adults and those with certain medical conditions.

How soon after vaccination might side effects appear? Mild side effects typically occur within days of vaccination. Serious reactions, if they occur, usually manifest within 30 days of receiving the vaccine.

Yellow Fever Prevention Beyond Vaccination

While vaccination is the most effective way to prevent yellow fever, it’s not the only measure travelers should take. What additional precautions can help reduce the risk of yellow fever and other mosquito-borne diseases?

• Use insect repellent containing DEET, picaridin, or other EPA-registered ingredients
• Wear long-sleeved shirts and long pants, especially during peak mosquito hours
• Stay in accommodations with air conditioning or window and door screens
• Use bed nets if sleeping areas are exposed to the outdoors
• Treat clothing and gear with permethrin or purchase permethrin-treated items

Why is mosquito bite prevention important even after vaccination? While the yellow fever vaccine is highly effective, it doesn’t provide 100% protection. Moreover, mosquitoes can transmit other diseases such as malaria, dengue, and Zika virus. Therefore, comprehensive mosquito bite prevention is crucial for overall health during travel.

How can travelers stay informed about yellow fever risk in their destination? The CDC and WHO regularly update their travel health notices and country-specific recommendations. Travelers should consult these resources and speak with a travel medicine specialist before their trip.

International Travel and Yellow Fever Vaccination Requirements

Yellow fever vaccination requirements can vary significantly between countries. How can travelers ensure they meet the necessary vaccination requirements for their destination?

1. Check the official government travel websites of both your home country and destination country
2. Consult with a travel medicine specialist or your healthcare provider
3. Review the WHO’s list of countries with yellow fever vaccination requirements
4. Obtain an International Certificate of Vaccination or Prophylaxis (ICVP) if required

What is an International Certificate of Vaccination or Prophylaxis (ICVP)? The ICVP, also known as the “yellow card,” is an official document that proves you’ve been vaccinated against yellow fever. It must be signed and stamped by an authorized vaccination center.

Can travelers be denied entry to a country without proper yellow fever vaccination documentation? Yes, some countries may deny entry or require quarantine for travelers who cannot provide proof of yellow fever vaccination when required.

Are there any exemptions to yellow fever vaccination requirements for international travel? Some countries may grant waivers for medical contraindications to the vaccine. However, this often requires advance planning and documentation from a healthcare provider.

The Future of Yellow Fever Prevention and Control

As global travel continues to increase and climate change affects mosquito habitats, the fight against yellow fever remains crucial. What advancements are being made in yellow fever prevention and control?

• Improved surveillance systems to detect outbreaks early
• Research into new vaccine technologies, including non-egg-based vaccines
• Enhanced vector control strategies to reduce mosquito populations
• Efforts to increase vaccine production capacity to meet global demand

How might climate change impact the spread of yellow fever? Climate change could potentially expand the geographic range of the Aedes aegypti mosquito, the primary vector for yellow fever. This could introduce the disease to new areas and populations, making ongoing vaccination efforts even more critical.

What role does global cooperation play in yellow fever control? International collaboration is essential for effective yellow fever control. This includes sharing epidemiological data, coordinating vaccine distribution, and implementing consistent travel policies.

As we continue to navigate the challenges of yellow fever prevention in a changing world, vaccination remains a cornerstone of protection. By staying informed about vaccination requirements, understanding the risks and benefits, and taking comprehensive preventive measures, travelers can significantly reduce their risk of contracting this serious disease. Always consult with healthcare professionals and stay updated on the latest travel health advisories to ensure a safe and healthy journey.

Travel health – yellow fever immunisation

About yellow fever

Yellow fever is a serious viral disease, transmitted by mosquitoes, found in parts of Africa and Central and South America. The World Health Organization (WHO) keeps updated lists of countries where yellow fever is widespread.

The name of this disease comes from the fact that people with serious infections have yellow skin and eyes (jaundice) caused by infection of the liver.

Vaccination for yellow fever is generally safe and effective, and reduces the risk of yellow fever infection. Some countries require that people travelling through infected areas show proof of vaccination against yellow fever with an International Certificate of Vaccination or Prophylaxis. Vaccination and certification is available through travel clinics or health providers authorised by WHO.

You should always avoid mosquito bites to reduce the risk of all mosquito-borne diseases.

Fatal cases of yellow fever in unvaccinated travellers to Africa and South America continue to be reported.

Symptoms of yellow fever

The first symptoms of yellow fever appear 3 to 6 days after exposure to the virus. These symptoms are known as stage one of the disease and include:

• fever
• nausea
• vomiting
• flushed face
• constipation
• stomach ache
• headache
• muscle pain
• restlessness and irritability.

These symptoms last for 3 to 4 days and then settle over one to 2 days. In mild cases, the infection ends after stage one as the virus is cleared. But in severe cases of yellow fever, this remission period is followed by serious symptoms and complications known as stage 2.

Complications of yellow fever

In 15 to 25% of cases of yellow fever, severe symptoms develop, even if there has been a remission period. This is known as stage 2 and occurs because the yellow fever virus has the ability to infect organs such as the liver, heart and kidneys. This is also known as the ‘toxic’ stage of the infection and about half of the people who reach this stage will die.

The severe complications include:

• high fever
• pain in the upper part of the abdomen
• vomiting – black, ‘coffee-ground’ vomit
• bleeding
• jaundice (yellow skin and eyes)
• kidney failure
• liver failure
• death.

Immunisation against yellow fever

If you are travelling or passing through areas infected with yellow fever, some countries require you to be vaccinated. A record of your immunisation must be entered and validated in your International Certificate of Vaccination or Prophylaxis by a healthcare provider that is authorised by the WHO to vaccinate against yellow fever.

Although some countries have no entry requirements, others may require proof of vaccination for all travellers in order to satisfy entry requirements. You can find out if the countries you intend to visit have requirements for yellow fever vaccination by checking the Australian Government Department of Foreign Affairs and Trade’s Smartraveller website,External Link or asking your GP (doctor) when you have your appointment.

It is best to arrange an appointment with your GP or a travel clinic doctor 6 to 8 weeks prior to departure in case a series of vaccines are needed. Yellow fever vaccine should be given at least 10 days before entering a country where immunisation is a legal requirement in order to avoid quarantine procedures.

Immunisation against yellow fever only requires a single dose of vaccine, which usually gives most people lifetime immunity. Also, in most cases, once you have been vaccinated, the certificate is valid for life.

People who should receive yellow fever vaccination

People who should be vaccinated for yellow fever include:

• people over 9 months of age travelling to or living in areas with a high risk of yellow fever transmission
• people who work in laboratories and routinely work with yellow fever virus.

People who should not receive yellow fever vaccination

The vaccine is not suitable for everyone and should not be given to people who:

• are under 9 months of age
• have had a severe allergic reaction (anaphylaxis) to an earlier dose of the vaccine
• have had severe allergic reaction (anaphylaxis) to any component of the vaccine
• have allergies to eggs
• have a weakened immune system due to illness or medical treatment
• have a history of a thymic disorder – including myasthenia gravis, thymoma, thymectomy, DiGeorge syndrome, or cases of damage to the thymus from chemotherapy, radiotherapy or as a result of complications after transplantation.

Pregnancy and yellow fever immunisation

Immunisation against yellow fever is not usually recommended for women who are pregnant or breastfeeding babies under 9 months of age. Speak with your doctor if you are pregnant and unable to avoid travel to an area where yellow fever is widespread.

Pre-immunisation checklist

Before receiving the vaccine, tell your doctor or nurse if you or someone in your care:

• is under 9 months of age
• is pregnant or intends to become pregnant
• is unwell (temperature over 38.5 ˚C)
• has allergies to any other medications or substances
• has had a serious reaction to any vaccine
• has had a serious reaction to any component of the vaccine
• has had a severe allergy to anything
• has a disease or is having treatment that causes low immunity
• is taking any prescription or over-the-counter medications.

Side effects of the vaccine against yellow fever

Immunisations against yellow fever are generally effective and safe, although all medications can have unwanted side effects.

Side effects from the vaccine are uncommon and usually mild, but for up to 5 to 10 days after vaccination may include:

• low-grade temperature (fever)
• mild headache
• muscle aches.

Many vaccine injections may result in soreness, redness, itching, swelling or a burning sensation at the injection site for one to 2 days. Paracetamol might be required to ease the discomfort.

There are a number of treatment options that can reduce the side effects of the vaccine, including:

• having extra fluids to drink and not overdressing if there is a fever
• although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given – check the label for the correct dose or speak with your pharmacist, (especially when giving paracetamol to children).

Concerns about side effects

If a reaction following immunisation is unexpected, persistent or severe, or if you are worried, see your GP (doctor) or immunisation provider as soon as possible ,or go directly to a hospital.

In Victoria, immunisation side effects may be reported to SAEFVIC – the central reporting service for any significant adverse events following immunisationsExternal Link.

You can discuss with your immunisation provider how to report adverse events in other states or territories. It is also important to seek medical advice if you (or your child) are unwell, as this may be due to other illness rather than because of the vaccination.

Rare side effects

There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.

Two very rare side effects associated with the yellow fever vaccine are inflammation of the brain (meningoencephalitis) and organ failure (viscerotropic disease). People over 60 years of age are at a small risk of these rare side effects, and people with thymus disorders are at increased risk of viscerotropic disease.

Immunisation and HALO

The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.

Talk to your GP (doctor) or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary. You can check your immunisation HALO using the Immunisation for Life infographic.

Avoid mosquito bites

Another way to help reduce the risk of yellow fever and other mosquito-borne diseases is to avoid mosquito bites. Whether or not you need to be vaccinated, it is always a good idea when travelling to protect yourself and those in your care against mosquito bites.

There are a few simple ways to avoid getting bitten by mosquitoes including:

• Use an effective mosquito repellent on exposed skin that contains at least 30% DEET (N,N-Diethyl-meta-toluamide or diethyltoluamide) or 20% picaridin.
• Wear loose, light coloured clothing that covers your skin, such as socks, long pants and long-sleeved shirts when outdoors.
• Use a bed net.
• Stay in air-conditioned, screened accommodation.
• Clothing, bedding, mosquito nets and tents can be soaked in a safe repellent (such as permethrin) prior to travel.

Where to get help

• Your GP (doctor)
• In an emergency, always call triple zero (000)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Immunisation Unit, Department of HealthExternal Link, Victorian Government Tel. 1300 882 008 Email: [email protected]
• Smartraveller.gov.auExternal Link, Australian Government
• Travel Clinics AustraliaExternal Link Tel. 1300 369 359
• SAEFVICExternal Link Tel. 1300 882 924 (select option one)
• Australian Government Consular Emergency CentreExternal Link Tel. +61 2 6261 3305 (from overseas) or 1300 555 135 (from within Australia) – for urgent assistance while overseas (24 hours, 7 days)
• Australian embassy or consulateExternal Link in the country you are in – most will have a list of local doctors or hospitals. If you do not speak the language, ask for someone who speaks English

Travel health – yellow fever immunisation

About yellow fever

Yellow fever is a serious viral disease, transmitted by mosquitoes, found in parts of Africa and Central and South America. The World Health Organization (WHO) keeps updated lists of countries where yellow fever is widespread.

The name of this disease comes from the fact that people with serious infections have yellow skin and eyes (jaundice) caused by infection of the liver.

Vaccination for yellow fever is generally safe and effective, and reduces the risk of yellow fever infection. Some countries require that people travelling through infected areas show proof of vaccination against yellow fever with an International Certificate of Vaccination or Prophylaxis. Vaccination and certification is available through travel clinics or health providers authorised by WHO.

You should always avoid mosquito bites to reduce the risk of all mosquito-borne diseases.

Fatal cases of yellow fever in unvaccinated travellers to Africa and South America continue to be reported.

Symptoms of yellow fever

The first symptoms of yellow fever appear 3 to 6 days after exposure to the virus. These symptoms are known as stage one of the disease and include:

• fever
• nausea
• vomiting
• flushed face
• constipation
• stomach ache
• headache
• muscle pain
• restlessness and irritability.

These symptoms last for 3 to 4 days and then settle over one to 2 days. In mild cases, the infection ends after stage one as the virus is cleared. But in severe cases of yellow fever, this remission period is followed by serious symptoms and complications known as stage 2.

Complications of yellow fever

In 15 to 25% of cases of yellow fever, severe symptoms develop, even if there has been a remission period. This is known as stage 2 and occurs because the yellow fever virus has the ability to infect organs such as the liver, heart and kidneys. This is also known as the ‘toxic’ stage of the infection and about half of the people who reach this stage will die.

The severe complications include:

• high fever
• pain in the upper part of the abdomen
• vomiting – black, ‘coffee-ground’ vomit
• bleeding
• jaundice (yellow skin and eyes)
• kidney failure
• liver failure
• death.

Immunisation against yellow fever

If you are travelling or passing through areas infected with yellow fever, some countries require you to be vaccinated. A record of your immunisation must be entered and validated in your International Certificate of Vaccination or Prophylaxis by a healthcare provider that is authorised by the WHO to vaccinate against yellow fever.

Although some countries have no entry requirements, others may require proof of vaccination for all travellers in order to satisfy entry requirements. You can find out if the countries you intend to visit have requirements for yellow fever vaccination by checking the Australian Government Department of Foreign Affairs and Trade’s Smartraveller website,External Link or asking your GP (doctor) when you have your appointment.

It is best to arrange an appointment with your GP or a travel clinic doctor 6 to 8 weeks prior to departure in case a series of vaccines are needed. Yellow fever vaccine should be given at least 10 days before entering a country where immunisation is a legal requirement in order to avoid quarantine procedures.

Immunisation against yellow fever only requires a single dose of vaccine, which usually gives most people lifetime immunity. Also, in most cases, once you have been vaccinated, the certificate is valid for life.

People who should receive yellow fever vaccination

People who should be vaccinated for yellow fever include:

• people over 9 months of age travelling to or living in areas with a high risk of yellow fever transmission
• people who work in laboratories and routinely work with yellow fever virus.

People who should not receive yellow fever vaccination

The vaccine is not suitable for everyone and should not be given to people who:

• are under 9 months of age
• have had a severe allergic reaction (anaphylaxis) to an earlier dose of the vaccine
• have had severe allergic reaction (anaphylaxis) to any component of the vaccine
• have allergies to eggs
• have a weakened immune system due to illness or medical treatment
• have a history of a thymic disorder – including myasthenia gravis, thymoma, thymectomy, DiGeorge syndrome, or cases of damage to the thymus from chemotherapy, radiotherapy or as a result of complications after transplantation.

Pregnancy and yellow fever immunisation

Immunisation against yellow fever is not usually recommended for women who are pregnant or breastfeeding babies under 9 months of age. Speak with your doctor if you are pregnant and unable to avoid travel to an area where yellow fever is widespread.

Pre-immunisation checklist

Before receiving the vaccine, tell your doctor or nurse if you or someone in your care:

• is under 9 months of age
• is pregnant or intends to become pregnant
• is unwell (temperature over 38.5 ˚C)
• has allergies to any other medications or substances
• has had a serious reaction to any vaccine
• has had a serious reaction to any component of the vaccine
• has had a severe allergy to anything
• has a disease or is having treatment that causes low immunity
• is taking any prescription or over-the-counter medications.

Side effects of the vaccine against yellow fever

Immunisations against yellow fever are generally effective and safe, although all medications can have unwanted side effects.

Side effects from the vaccine are uncommon and usually mild, but for up to 5 to 10 days after vaccination may include:

• low-grade temperature (fever)
• mild headache
• muscle aches.

Many vaccine injections may result in soreness, redness, itching, swelling or a burning sensation at the injection site for one to 2 days. Paracetamol might be required to ease the discomfort.

There are a number of treatment options that can reduce the side effects of the vaccine, including:

• having extra fluids to drink and not overdressing if there is a fever
• although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given – check the label for the correct dose or speak with your pharmacist, (especially when giving paracetamol to children).

Concerns about side effects

If a reaction following immunisation is unexpected, persistent or severe, or if you are worried, see your GP (doctor) or immunisation provider as soon as possible ,or go directly to a hospital.

In Victoria, immunisation side effects may be reported to SAEFVIC – the central reporting service for any significant adverse events following immunisationsExternal Link.

You can discuss with your immunisation provider how to report adverse events in other states or territories. It is also important to seek medical advice if you (or your child) are unwell, as this may be due to other illness rather than because of the vaccination.

Rare side effects

There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.

Two very rare side effects associated with the yellow fever vaccine are inflammation of the brain (meningoencephalitis) and organ failure (viscerotropic disease). People over 60 years of age are at a small risk of these rare side effects, and people with thymus disorders are at increased risk of viscerotropic disease.

Immunisation and HALO

The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.

Talk to your GP (doctor) or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary. You can check your immunisation HALO using the Immunisation for Life infographic.

Avoid mosquito bites

Another way to help reduce the risk of yellow fever and other mosquito-borne diseases is to avoid mosquito bites. Whether or not you need to be vaccinated, it is always a good idea when travelling to protect yourself and those in your care against mosquito bites.

There are a few simple ways to avoid getting bitten by mosquitoes including:

• Use an effective mosquito repellent on exposed skin that contains at least 30% DEET (N,N-Diethyl-meta-toluamide or diethyltoluamide) or 20% picaridin.
• Wear loose, light coloured clothing that covers your skin, such as socks, long pants and long-sleeved shirts when outdoors.
• Use a bed net.
• Stay in air-conditioned, screened accommodation.
• Clothing, bedding, mosquito nets and tents can be soaked in a safe repellent (such as permethrin) prior to travel.

Where to get help

• Your GP (doctor)
• In an emergency, always call triple zero (000)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Immunisation Unit, Department of HealthExternal Link, Victorian Government Tel. 1300 882 008 Email: [email protected]
• Smartraveller.gov.auExternal Link, Australian Government
• Travel Clinics AustraliaExternal Link Tel. 1300 369 359
• SAEFVICExternal Link Tel. 1300 882 924 (select option one)
• Australian Government Consular Emergency CentreExternal Link Tel. +61 2 6261 3305 (from overseas) or 1300 555 135 (from within Australia) – for urgent assistance while overseas (24 hours, 7 days)
• Australian embassy or consulateExternal Link in the country you are in – most will have a list of local doctors or hospitals. If you do not speak the language, ask for someone who speaks English

Yellow fever – Features of the disease

07/08/2022

“By the way, why is it called yellow?” asked another traveler who was going to Togo. He was faced with the need to be vaccinated against the yellow fever virus, because when entering the country it is necessary to provide proof of vaccination – a vaccination certificate.

Obviously, yellow fever is called yellow fever because jaundice can develop, but believe me, this is not the worst thing that can happen.

Today we will analyze it in detail, but first we will complain that if there were no requirement in Togo and in a number of other countries to confirm the need for confirmation of vaccination, the traveler would simply not come without knowing what other vaccines need to be done before the trip, what to collect in a first aid kit and how to protect yourself from tropical malaria, another potentially deadly disease.

Virus encounter

The tropical regions of Central and South America, as well as the countries of Africa, are endemic for yellow fever, that is, it is quite possible to get sick.

Transmission of the virus to humans occurs through the bite of a mosquito, which about 2 weeks ago became infected from a sick person. Transmission is also possible through the bite of forest mosquitoes, which carry the virus from wild primates. Infection rates peak during the heavy rainy season in South America and during the late rainy seasons in Africa.

The incubation period (the period from infection to the development of symptoms) can be 3 to 6 days. During this period, high viremia is usually observed – a large amount of virus in the blood. It is during this period that a mosquito can become infected from a sick person when bitten.

Symptoms of yellow fever

The disease begins suddenly, with an increase in body temperature up to 39-40C, headache / dizziness and muscle pain. Then nausea, vomiting appear, weakness, anxiety, irritability increase.

Another characteristic symptom is bradycardia against the background of fever, which develops at the second stage of the disease (Fage’s symptom). After a few days, remission sets in – the symptoms disappear. At this time, some patients can recover. But in 15–25% of patients, symptoms recur and can progress to death.

In the stage of relapse are noted:

• heat;
• stomach ache;
• kidney failure;
• vomit;
• enlargement of the liver and spleen;
• development of jaundice;
• bleeding from mucous membranes;
• hemorrhagic rash.

As the disease progresses, multiple organ failure develops. If the kidneys and liver are involved, the risk of death reaches 50%. Death occurs 7–10 days after the onset of symptoms.

Disease diagnosis

Mild forms of infectious disease are often not diagnosed. But the diagnosis of yellow fever should be ruled out if the patient develops jaundice, fever, and bradycardia.

Characteristic deviations can be detected in general clinical and biochemical blood tests, in a coagulogram and in a general urinalysis. Specific diagnostics is based on PCR diagnostics – the search for the genetic material of the virus in biological material. It is very important to test specimens within the first 10 days of disease onset, when the sensitivity of the tests is higher.

Serological diagnostics is also used, that is, ELISA (determination of antibodies), but there may be cross-over, and therefore false-positive, results with other flaviviruses, which makes interpretation difficult. After 7-10 days, the sensitivity of class M antibodies is 95%. A confirmed case is considered to be a clinically similar case + a four-fold increase in antibody titer in paired sera with the exclusion of cross-reactivity with other flaviviruses.

Yellow fever treatment

There is currently no specific antiviral treatment for yellow fever. Supportive therapy is of great importance, which consists in stopping bleeding, maintaining pressure, replenishing fluid, if necessary, performing hemodialysis, and antibiotic therapy for secondary complications.

But the disease can be prevented with an extremely effective vaccination. The vaccine is affordable and safe.

As with any other vaccine, within 2-3 days after vaccination against yellow fever, a post-vaccination reaction may develop: slight redness and swelling at the injection site, slight malaise. In 5-10% of those who received the vaccine, 4-10 days after vaccination, chills, fever up to 38.5 C, malaise, headache, which can last a couple of days and are well stopped by taking NSAIDs – non-steroidal anti-inflammatory drugs, may occur.

One dose of the vaccine is sufficient to form lifelong immunity against yellow fever virus in more than 80% as early as 10 days after vaccination, and in more than 99% within 30 days after vaccination. Therefore, it is necessary to be vaccinated at least 10 days before entering the endemic territory, not to mention the fact that the date of commencement of the validity of the international certificate with vaccination against yellow fever is + 10 days from the day of the vaccine.

10 days is a minimum, but it is still better to prepare in advance and consistently. At H-clinic, we help patients create an individual travel vaccination schedule based on the time available, the area the patient is traveling to, and the risks that may be there. In addition, we give recommendations on collecting a first-aid kit and non-specific prevention of other diseases (for example, parasitic diseases that can be contracted when swimming in water bodies).

and most importantly, many areas endemic for yellow fever are also endemic for malaria. Depending on the length of stay in the dangerous territory, concomitant diseases, the predominance of certain types of Plasmodium and their possible resistance to drugs, we select the most adequate and convenient malaria chemoprevention regimen. Even in the last hours before departure, you can always find out what you can do if you did not prepare for the trip in advance, or the need to fly arose suddenly. And we are always ready to help!

Author:
Infectious disease doctor, parasitologist,
Anastasia Konovalova

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St. Petersburg, Ivana Chernykh st., 25A

Mon.-Sat. from 9:00 – 20:00, sun. from 10:00 – 18:00

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• Yellow fever vaccination

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• herpes viruses
• human papillomavirus
• viral hepatitis
• mycobacteriosis
• HIV infection
• intrauterine, parasitic and other infectious diseases

Yellow fever is an acute infectious disease transmitted by a mosquito bite, manifested by fever, severe muscle pain, nausea, vomiting, bleeding of mucous membranes, damage to the liver and kidneys. The causative agent of infection is the yellow fever virus (arbovirus of the Flavivirus genus), mortality is from 5 to 20% (60% during epidemics).

There are regions in the world where outbreaks occur (about 47 countries in Africa, Central and South America), for this reason it is recommended to vaccinate at least 10 days before entering these regions. In countries with a high risk of contracting yellow fever, proof of vaccination is required.

Indications for vaccination

The main indications for vaccination are:
● prophylaxis of yellow fever in patients from 9 months of age and adults who travel abroad to endemic areas of yellow fever
● prevention of yellow fever in people who work directly with live cultures of yellow fever

Preparation before vaccination

Before vaccination, it is recommended to consult a doctor who will assess the state of health, determine the indications and contraindications. Of the general recommendations, it is important that the vaccinated person does not have a fever for two weeks before the procedure.

Contraindications include:
● allergic reactions to chicken protein
● the presence of congenital immunodeficiency states;
● pregnancy
● acquired immunodeficiency states: therapy with immunosuppressants, antimetabolites, X-ray therapy – vaccination is carried out at least 12 months after the end of treatment

Vaccination schedule

According to WHO recommendations, immunization with yellow fever vaccine is carried out at least ten days before departure to endemic regions of the infection. The vaccine is administered once subcutaneously into the outer corner of the scapula or into the region of the deltoid muscle of the shoulder. The immune response will form after 10 days, revaccination is carried out if necessary 10 years after the first dose.

After the procedure, the medical worker makes a note in the vaccination certificate about the name of the drug, the date of vaccination, the dose administered, the series, the reaction to the vaccine.

What vaccines are usually given with the yellow fever vaccine?

Vaccines against other infections endemic to the country of travel

For Africa, Asia and South America these are vaccines against meningococcal disease, hepatitis A, typhoid fever and dysentery0003

Most commonly diphtheria-tetanus, measles, hepatitis B

Vaccines against seasonal infections

Seasonal infections include influenza, Covid-19 and pneumococcal disease

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St. Petersburg, Ivana Chernykh st., 25A

Mon-Sat 09.00-20.00, Sun 10.00-18.00

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The immune response of the body causes ” live virus vaccine. The antibody titer against yellow fever reaches the required level by the 10th day after vaccination. After that, the body is reliably protected from the virus throughout life. In some cases, but usually not earlier than 10 years later, revaccination may be required.

An insufficient immune response can be expected: in children under 2 years of age with simultaneous vaccination against yellow fever, mumps, rubella and measles; in women vaccinated during pregnancy.

Recommendations before and after vaccination

For seven days after vaccination, it is not recommended to stay in the sun for a long time, perform heavy physical exertion, go to the bathhouse and sauna, and drink alcoholic beverages. Blood donation is prohibited for four weeks after vaccination.

When planning a pregnancy, it is recommended to vaccinate against yellow fever 1-3 months before the intended conception.

Vaccination at the ID-clinic

At the ID-clinic you can get the yellow fever vaccination. Our specialists will conduct a consultation in order to identify contraindications. The procedure is carried out in compliance with the standards of the Ministry of Health of Russia and the requirements of the sanitary and epidemic regime. Information about vaccination will be included in the vaccination certificate. It is recommended not to leave the clinic for about 30 minutes to assess the body’s response to the drug.

Vaccination fee

Examination before vaccination and 30 minutes of observation after vaccination are included in the price of the service. We use for immunization only products approved for use with a high safety and efficacy profile. Our employees comply with all requirements for the introduction of the vaccine.

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B04.014.004.016	Yellow fever vaccination (live culture vaccine)	2500 ₽
B04. 014.004.016	Vaccination against yellow fever (live culture vaccine) with the issuance and execution of an international vaccination certificate	3500 ₽

Other clinic services

Flu shot

Hepatitis B vaccine

Typhoid vaccine

Meningococcal vaccine

Diphtheria, whooping cough and tetanus vaccine Adasel and ADS-M

Pneumococcus vaccine

9 0002 Hepatitis A vaccine

Sonne dysentery vaccine

Vaccination against COVID-19

Vaccination against measles

• SavchenkoMikhail Andreevich

  Infectionist,
  Hepatologist,
  Doctor of the first category,
  Candidate of Medical Sciences

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• Efimov Georgy Alexandrovich

  Infectionist,
  Parasitologist

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• Korneeva Tatyana Sergeevna

  Infectionist,
  Hepatologist,
  Ultrasound doctor,
  PhD

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• Sizova Natalia Vladimirovna

  Infectionist,
  Doctor of the highest category,
  Doctor of Medical Sciences,
  Professor

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• Mayorova

  Svetlana Olegovna

  Infectionist,
  Doctor of the highest category,
  Candidate of Medical Sciences

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• Zvontsova Svetlana Alexandrovna

  Infectionist,
  Parasitologist

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• Lavrenchuk Dmitry Vadimovich

  Infectionist,
  Hepatologist,
  Therapist,
  PhD

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• Fadeev Kirill Aleksandrovich

  Infectionist,
  Hepatologist,
  Parasitologist,
  Doctor of the highest category,
  Candidate of Medical Sciences

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• Bortulev Sergey Alexandrovich

  Head doctor of the clinic,
  Therapist,
  Cardiologist,
  Functional diagnostics doctor,
  Doctor of the highest category,
  Candidate of Medical Sciences

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• Kiseleva Lyudmila Ivanovna

  Therapist,
  Pulmonologist,
  Ultrasound Doctor,
  Somnologist

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• VeliherMarina Georgievna

  Therapist,
  Ultrasound doctor,
  Somnologist,
  Psychologist,
  Rabiologist

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• Balandina Anna Borisovna

  Infectionist,
  Hepatologist,
  Parasitologist,
  Rabiologist

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• Selivanova Marina Andreevna

  Infectionist,
  Hepatologist,
  Parasitologist,
  Rabiologist

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• KononchukOlga Nikolaevna

  Infectionist,
  Hepatologist,
  Therapist,
  Phthisiatrician,
  Functional Diagnostics Doctor,
  Doctor of the highest category,
  Candidate of Medical Sciences

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• Kuznetsov Alexey Romanovich

  Infectionist,
  Hepatologist

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All specialists

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Stories and testimonials from our patients

Tatyana Ivanova

I would like to thank Kirill Yurievich Krotov, an oncologist-urologist, for the operation performed in the 5th department of the cancer center. He is a very attentive, friendly, not indifferent doctor, a professional in his field. He has a long experience as an operating doctor. I wish him good health. I recommend contacting him for honey. help.

Specialist:
Krotov Kirill Yurievich

Prodoctorov

Attentive and polite, experienced doctor. The conclusion can be handed over, or sent by e-mail, which is convenient.
No one has done an ultrasound for me so carefully. He explained everything that he looks at and sees, what sizes of organs I have and which are normal, did not sit with a detached look, but commented on everything during the examination and immediately explained whether it was normal or not. From now on, I will do an ultrasound only with him. It turns out that he worked as a surgeon for many years, which makes itself felt in his detailed explanations and recommendations.

Specialist:
Baranov Alexey Vasilievich

Natalia (NaPopravku)

I liked the appointment very much, the doctor listened attentively about all my sores and gave advice. Conducted a therapeutic consultation before being vaccinated against coronavirus. I went to the reception with my daughter, who also vaccinated herself and her son-in-law. After vaccination, the temperature rose in the evening, but this is all expected and I was familiar with all the consequences. The service at the clinic is just wonderful, everything is clean, polite medical staff. Everything is excellent.

Specialist:
Veliher Marina Georgievna

Anonymous

Korneeva Tatyana Sergeevna I am very grateful for the professional and warm welcome during the examination before vaccination. The doctor was attentive and friendly. Removed all fears and instilled confidence and safety in my vaccination. Many thanks to the ladies at the front desk! Lovely attentive caring!!! Thanks everybody! I highly recommend this clinic. Tatiana

Specialist:
Korneeva Tatyana Sergeevna

Marina (NaPopravku)

I liked everything! The therapist was a little busy, at my appointed time, I had to wait for him. But if you compare the waiting time with the clinic, it’s not scary. In the treatment room, the doctor brought up to date what kind of vaccination he would carry out, about the expected consequences. After the introduction I felt good. Already signed up for a consultation with another specialist, as I liked the clinic.

Specialist:
Bortulev Sergey Alexandrovich

Correction User

Very professional and attentive Reception

Specialist:
Korneeva Tatyana Sergeevna

User (NaPopravku)

I am extremely glad that I got an appointment with Tatyana Sergeevna at ID clinics. Wonderful woman, professional doctor. Did a good initial inspection and scheduled the examination.
I would like to thank all the staff of ID clinics for their excellent work, sensitivity and caring. Now only to you!

Specialist:
Yuzefovich Tatyana Sergeevna

I express my gratitude to the neurourologist Natalia Olegovna Krotova for her attentive and individual approach to treatment, for her competence and desire to help. Based on the results of several visits, the highest ratings and impressions! Excellent doctor. Thank you.

Specialist:
Krotova Natalya Olegovna

Prodoctors

I have never met a better diagnostician. Olga Vladimirovna fulfills her duties with all responsibility. When I came to her for examination, there was excitement and distrust, but in the course of communication and diagnostics, it dissipated. I saw in front of me a professional who cares about his patients. She comprehensively studies the problem and gives clear explanations and decoding. I rate her work with the highest score, I want such doctors to meet as often as possible. Then it will not be scary to go to hospitals.

Specialist:
Teslya Olga Vladimirovna

Prodoctors

My mother was in the oncological dispensary at the 5th department, Krotov was her attending physician. I would like to express my gratitude to the doctor for the competent medical care of my mother and the moral support he gave her during her long stay in the hospital.