Yellow fever (patient information)

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

Overview

Yellow fever is a viral infection transmitted by mosquitoes. This disease is common in South America and in sub-Saharan Africa.

What are the symptoms of Yellow fever?

Yellow fever has three stages:

• Early stage: Headache, muscle and joint aches, fever, flushing, loss of appetite, vomiting, and jaundice are common. After approximately 3 - 4 days, often symptoms go away briefly (remission).
• Period of remission: After 3 - 4 days, fever and other symptoms go away. Most people will recover at this stage, but others may move onto the third, most dangerous stage (intoxication stage) within 24 hours.
• Period of intoxication: Multi-organ dysfunction occurs. This may include heart, liver, and kidney failure, bleeding disorders, hemorrhage, and brain dysfunction including delirium, seizures, coma, shock, and death.

Symptoms include:

• Arrhythmias, heart dysfunction
• Bleeding (may progress to hemorrhage)
• Coma
• Decreased urination
• Delirium
• Fever
• Headache
• Jaundice
• Muscle aches (myalgia)
• Red eyes, face, tongue
• Seizures
• Vomiting
• Vomiting blood

Who is at highest risk?

Anyone can get yellow fever, but the elderly have a higher risk of severe infection. It is common in South America and in sub-Saharan Africa. If a person is bitten by an infected mosquito, symptoms usually develop 3 - 6 days later.

When to seek urgent medical care?

A person with advanced yellow fever may show signs of liver failure, renal failure, and shock. Tell your health care provider right away if you or your child develop fever, headache, muscle aches, vomiting, or jaundice, especially if you have traveled to an area where yellow fever is known to occur. Blood tests can confirm the diagnosis.

Treatment options

There is no specific treatment for yellow fever. Treatment for symptoms can include:

• Blood products for severe bleeding
• Dialysis for kidney failure
• Fluids through a vein (intravenous fluids)

What to expect (Outlook/Prognosis)?

Yellow fever varies in severity. Severe infections with internal bleeding and fever (hemorrhagic fever) are deadly in up to half of cases. Possible Complications:

• Coma
• Death
• Disseminated intravascular coagulation (DIC)
• Kidney failure
• Liver failure
• Parotitis
• Secondary bacterial infections
• Shock

Prevention

There is an effective vaccine against yellow fever. Get medical attention at least 10 - 14 days before traveling to an endemic area for yellow fever to find out whether you should be vaccinated against the disease.

If you will be traveling to an area where yellow fever is common:

• Sleep in screened housing
• Use mosquito repellents
• Wear clothing that fully covers your body