Yellow fever history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Patients infected may have no symptoms; if they develop the disease, they can develop symptoms such as fever, muscle pain (with prominent backache), headache, shivers, loss of appetite, and nausea or vomiting. After three or four days most patients improve and their symptoms disappear. Fifteen percent of patients, however, enter a toxic phase within 24 hours. Fever reappears, the patient rapidly develops jaundice and abdominal pain with vomiting. Bleeding occurs and kidney function deteriorates.

History and Symptoms

• The majority of persons infected with yellow fever virus have no illness or only mild illness. Patients with yellow fever can present in three forms: subclinical infection, nonspecific abortive febrile disease and fatal hemorrhagic fever.
• In persons who develop symptoms, the incubation period (time from infection until illness) is typically 3–6 days, with an average of 4 days.
• The initial symptoms include:

• Sudden onset of fever
• Chills
• Severe headache
• Back pain
• General body aches
• Nausea
• Vomiting
• Fatigue
• Weakness
• Irritability
• Photophobia
• Dizziness

• Most persons improve after the initial presentation.
• The high fever is often paradoxically associated with a slow pulse (known as Faget's sign).
• After a brief remission of hours to a day, roughly 15% of cases progress to develop a more severe form of the disease.
• The severe form is characterized by high fever, jaundice, bleeding, and eventually shock and failure of multiple organs.

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