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YELLOW FEVER OVERVIEW

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1. Yellow Fever, (n.d.), https://www.gov.mb.ca/health/publichealth/cdc/protocol/yellow.pdf. Accessed 20 November 2022.

2. Banluta, C. “Yellow Fever.” World Health Organization (WHO), (n.d.), https://www.who.int/health-topics/yellow-fever#tab=tab_1. Accessed 20 November 2022.

3. Centers for Disease Control and Prevention. “Yellow Fever Virus.” CDC, 2021, https://www.cdc.gov/yellowfever/index.html. Accessed 20 November 2022.

4. Legg, Timothy J., and Alana Biggers. “Yellow Fever: Symptoms, causes, and prevention.” Medical News Today, 2017, https://www.medicalnewstoday.com/articles/174372#symptoms. Accessed 20 November 2022.

5. National Library of Medicine. “Yellow Fever and Cardiovascular Disease: An Intersection of Epidemics.” NCBI, (n.d.), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898767/. Accessed 20 November 2022.

6. National Library of Medicine. “Yellow Fever Virus in Haemagogus leucocelaenus and Aedes serratus Mosquitoes, Southern Brazil, 2008.” NCBI, 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294583/. Accessed 20 November 2022.

7. National Organization for Rare Disorders. “Yellow Fever - NORD.” National Organization for Rare Disorders, (n.d.), https://rarediseases.org/rare-diseases/yellow-fever/. Accessed 20 November 2022.

8. Pan American Health Organization. “Yellow Fever.” PAHO, (n.d.), https://www.paho.org/en/topics/yellow-fever. Accessed 20 November 2022.

9. Research Occupational Health Program. “Yellow Fever Virus Agent Information Sheet | Research Support.” Boston University, (n.d.), https://www.bu.edu/researchsupport/safety/rohp/agent-information-sheets/yellow-fever-virus-agent-information-sheet/. Accessed 20 November 2022.

10. Ryabov, Eugene V. “Factors Involved in the Apoptotic Cell Death Mechanism in Yellow Fever Hepatitis.” NCBI, 1 June 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227230/. Accessed 20 November 2022.

11. Sethman, Nathan Storey, and Tyrrell Conway. “Yellow Fever virus - microbewiki.” microbewiki, 11 February 2016, https://microbewiki.kenyon.edu/index.php/Yellow_fever_virus. Accessed 20 November 2022.

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The yellow fever vaccine is THE MOST IMPORTANT THING TO DO TO PREVENT YELLOW FEVER. Other options (not as effective as the vaccine) that can help prevent you from getting yellow fever is to use mosquito/bug spray and wear clothing that covers your skin in areas where yellow fever is prominent.

There is currently no medicines to treat or cure yellow fever, however, the best way to prevent yourself from getting it is to get vaccinated.

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There is no cure or medicine for yellow fever.  However, there is specific care from hospitals to treat for dehydration, fever, and liver and kidney failure. Some supportive treatments can be: blood products to help with extreme bleeding, dialysis during kidney failure and IV fluids for dehydration.

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Most people recover, but it can take months or even years. In some cases, the damage to the liver and kidney could be reversed. Internal bleeding can occur and in some severe cases, death is a possible outcome. Yellow fever can cause severe complications and illness.

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DIAGNOSIS

Yellow fever is difficult to diagnose, especially during the early stages because they can be misdiagnosed with other diseases.

In the early stages of the disease, polymerase chain reaction (PCR) testing in the patient’s blood and urine can be used to detect the virus.

In later stages of the disease, testing to identify IgM antibodies is required.

Methods of detection: immunofluorescence, PCR, real-time PCR, compliment fixation, hemagglutinin inhibition, neutralization, and IgM capture ELISA.

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The yellow fever virus is an arbovirus of the Flavivirus genus and is transmitted to humans by the bites of infected Aedes and Haemagogus mosquitoes.

Haemagogus mosquitoes are the primary yellow fever virus vector in Southern Brazil and Aedes mosquitoes are a secondary vector.

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Sylvatic/Jungle yellow fever:

In tropical rainforests, monkeys (the primary reservoir of yellow fever) are bitten by Aedes and Haemogogus species mosquitoes and then acquires the virus. Sometimes humans in tropical rainforests can be infected, but the virus is mainly passed on to monkeys by infected mosquitoes.

Intermediate yellow fever:

Semi-domestic mosquitoes- mosquitoes that breed in the wild and households. Semi-domestic mosquitoes infect both monkeys and people. This is the most common type of outbreak in Africa.

Urban yellow fever:

Large epidemics occur when infected people carry the virus in areas with high population of Aedes mosquitoes and areas with high population of humans. They can also occur where most people have little/ no immunity (due to lack of vaccination). With these specific conditions, infected mosquitoes are able to transmit the virus from human to human.

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The "yellow" in the name refers to the jaundice that affects some patients.

The disease cannot spread from human contact, only infected mosquitoes can spread the disease to humans.

By 2026, over 1 billion people are expected to be protected against the disease.

People who are allergic to eggs should not get the yellow fever vaccine

There was a case of yellow fever vaccine virus being transmitted to an infant from its mother’s breast milk.

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JUST GOT DIAGNOSED WITH YELLOW FEVER? CHECK THIS OUT!

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JUST GOT DIAGNOSED WITH YELLOW FEVER? CHECK THIS OUT!

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Banluta, C. “Yellow Fever.” World Health Organization (WHO), (n.d.), https://www.who.int/health-topics/yellow-fever#tab=tab_1. Accessed 20 November 2022.

Centers for Disease Control and Prevention. “Yellow Fever Virus.” CDC, 2021, https://www.cdc.gov/yellowfever/index.html.

Legg, Timothy J., and Alana Biggers. “Yellow Fever: Symptoms, causes, and prevention.” Medical News Today, 2017, https://www.medicalnewstoday.com/articles/174372#symptoms.

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You got bitten by an infected mosquito. The virus enters your body.

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The virus then starts to replicate locally and is then transported to the rest of the body via the the lymphatic system

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The virus proceeds to dominate throughout multiple organ systems. Some of the organs affected are: the heart, kidneys, the adrenal glands, and liver. The body undergoes viremia- presence of virus in the blood. Necrotic masses begin to appear in hepatocytes (liver cells).

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The virus induces cell death of liver cells and other cells such as kidney cells. Cytokines cause hypotension and shock.

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This can lead to multiple organ failures in the body.

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YELLOW FEVER IS CHARACTERIZED BY 3 CLINICAL ILLNESS STAGES: INFECTION, REMISSION, AND INTOXICATION.

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YELLOW FEVER IS CHARACTERIZED BY 3 CLINICAL ILLNESS STAGES: INFECTION, REMISSION, AND INTOXICATION.

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Infection This stage lasts 3-4 days and is characterized with common signs/symptoms of: fever, chills, headache, lower back pain, knee pain, nausea, and dizziness (9).

Remission This stage is lasts around 48 hours. Fever and of the symptoms usually start to go away. Most people recover during this phase. The virus could still be present in the patient’s bloodstream, but typically starts to diminish (9)

Intoxication About 15-25 % of people enter a more toxic
stage within 24 hours of recovering from the infection stage. Usually can last for 3-8 days. Common signs/symptoms of this stage are: fever, bradycardia, vomiting, nausea, epigastric pain, jaundice- yellowing of the skin and eyes, oliguria and hemorrhaging, dark urine, abdominal pain and bleeding from the mouth, nose, eyes or stomach. Many patients will suffer from multi-organ failure which can be hepatic, renal, hematological and cardiovascular associated. Half of these patients usually die within 7-10 days (9).

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Most common symptoms are: fever, muscle pain & prominent backache, headache, loss of appetite, nausea, vomiting, and chills.  In most cases, the symptoms disappear after 3–4 days (9).

The main virulence factor is the surface macromolecules on yellow fever virus and it aids in the virus’s entry and cell interactions (11).

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The infectious agent is arthropods (mosquitoes) and yellow fever is caused by an arbovirus- virus transmitted by vectors such as mosquitoes, ticks or other arthropods.

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The specific arbovirus is the yellow fever virus (YFV)- member of the genus Flavivirus, and Flaviviridae family.

Yellow fever virus- is a spherical, enveloped virus with a single-stranded, positive- sense RNA genome.

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Yellow fever cases seem to be increasing in frequency because residents in Africa refuse to get the yellow fever vaccine. They also seem to be increasing because of global climate changes, the infected species of mosquitoes could have potentially shifted geographically.

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Yellow fever is characterized with multiple organ failure and cardiovascular shock. Several organ systems are affected some are: Hepatic system, Renal System, Digestive System, Cardiovascular system

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Yellow fever can cause cells to die in the liver and kidneys. Liver damage can be a result of too many liver cells dying which leads to jaundice (that’s where the name yellow fever came from). Kidney damage can be a result of hypotension. This can lead to nausea, vomiting, and oliguria- decrease in urine output and in turn renal failure.

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The virus is endemic in tropical areas of Africa and Central and South America. Haemagogus species mosquitoes primarily reside in Southern Brazil and Aedes species mosquitoes primarily reside in Africa. People living in semitropical or tropical climates and near marshes/swamps may be at risk unless vaccinated.

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Large epidemics of yellow fever occur when infected people introduce the virus into areas with high mosquito density and where most people have little/no immunity (due to lack of vaccination).

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The disease can only spread easily if the country has specific mosquito species able to transmit it, specific climatic conditions (summer months and rainy weather) and the animal reservoir needed to maintain them.