Yellow Fever

Definition

Definition

Yellow fever is a disease carried by female mosquitoes.

Causes

Causes

Yellow fever is caused by specific viruses transmitted by bites from infected mosquitoes.

Mosquito Bite

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Risk Factors

Risk Factors

Factors that may increase your chances of getting yellow fever include:

  • Living, working, or traveling to areas with yellow fever
  • Failure to take proper precautions, such as vaccination or using mosquito protection

Symptoms

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
  • Yellowing of the skin—jaundice
  • Confusion
  • Seizure
  • Coma

Diagnosis

Diagnosis

You will be asked about your symptoms and medical and travel history. A physical exam will be done. Blood tests will be needed for diagnosis. Antibodies for the virus may be detected in the blood.

Treatment

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

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

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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

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. Ask your doctor if the vaccine is right for you.

Other ways to reduce your chances of getting yellow fever include:

  • Stay in air-conditioned or well-screened areas.
  • Wear long-sleeved clothing and long pants.
  • Use bed netting while sleeping.
  • Remove or destroy mosquito-breeding areas. Mosquitoes lay their eggs in standing pools of water, such as the inside of old tires, flower pots, and small puddles.
  • Use insect repellents containing DEET on exposed skin.
  • Use 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 2, 2015.

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 13, 2011. Accessed June 2, 2015.

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 2, 2015.

Yellow fever. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated March 5, 2014. Accessed June 2, 2015.

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 2, 2015.

Last reviewed June 2015 by David L. Horn, MD, FACP
Last Updated: 6/19/2014

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