Yellow fever
Tropical hemorrhagic fever caused by yellow fever virus
Yellow fever is a viral infection spread by mosquitoes.
Causes
Yellow fever is caused by a virus carried by mosquitoes. You can develop this disease if you are bitten by a mosquito infected with this virus.
This disease is common in South America and in sub-Saharan Africa.
Anyone can get yellow fever, but older people have a higher risk of severe infection.
If a person is bitten by an infected mosquito, symptoms usually develop 3 to 6 days later.
Symptoms
Yellow fever has 3 stages:
- Stage 1 (infection): Headache, muscle and joint aches, fever, flushing, loss of appetite, vomiting, and jaundice are common. Symptoms often go away briefly after about 3 to 4 days.
- Stage 2 (remission): Fever and other symptoms go away. Most people will recover at this stage, but others may get worse within 24 hours.
- Stage 3 (intoxication): Problems with many organs may occur, including the heart, liver, and kidney. Bleeding disorders, seizures, coma, and delirium may also occur.
Symptoms may include:
- Fever, headache, muscle aches
-
Nausea and vomiting, possibly
vomiting blood
Vomiting blood
Vomiting blood is regurgitating (throwing up) contents of the stomach that contains blood. Vomited blood may appear either a bright red or dark red c...
-
Red eyes
, face, tongue
Red eyes
Eye redness is most often due to swollen or dilated blood vessels. This makes the surface of the eye look red or bloodshot.
- Yellow skin and eyes (jaundice)
-
Decreased urination
Decreased urination
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 ml of urine in 24 hours (a little over 2 cups)....
- Delirium
-
Irregular heartbeats
(arrhythmias)
(arrhythmias)
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
- Bleeding (may progress to hemorrhage)
- Seizures
- Coma
Exams and Tests
The health care provider will perform a physical examination and order blood tests. These blood tests may show liver and kidney failure and shock.
It is important to tell your provider if you have traveled to areas where the disease is known to thrive. Blood tests can confirm the diagnosis.
Treatment
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)
Outlook (Prognosis)
Yellow fever can cause severe problems, including internal bleeding. Death is possible.
Possible Complications
Complications that may result include:
- Coma
- Death
-
Disseminated intravascular coagulation (DIC)
Disseminated intravascular coagulation ...
Disseminated intravascular coagulation is a serious disorder in which the proteins that control blood clotting become overactive.
-
Kidney failure
Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
- Liver failure
-
Salivary gland infection (
parotitis
)
Parotitis
Salivary gland infections affect the glands that produce spit (saliva). The infection may be due to bacteria or viruses. There are 3 pairs of major ...
-
Secondary bacterial infections
Secondary bacterial infections
A secondary infection is an infection that occurs during or after treatment for another infection. It may be caused by the first treatment or by cha...
-
Shock
Shock
Sepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.
When to Contact a Medical Professional
See a provider at least 10 to 14 days before traveling to an area where yellow fever is common to find out whether you should be vaccinated against the disease.
Tell your provider right away if you or your child develops fever, headache, muscle aches, vomiting, or jaundice, especially if you have traveled to an area where yellow fever is common.
Prevention
There is an effective vaccine against yellow fever. Ask your provider at least 10 to 14 days before traveling if you should be vaccinated against yellow fever. Some countries require proof of vaccination to gain entry.
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
References
Centers for Disease Control and Prevention. Yellow fever. www.cdc.gov/yellowfever . Accessed January 22, 2016.
Kanzaria HK, Hsia RY. Mosquitoes and mosquito-borne diseases. In: Auerbach PS, ed. Wilderness Medicine . 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 48.
Thomas SJ, Endy TP, Rothman AL, Barrett AD. Flaviviruses (dengue, yellow fever, Japanese encephalitis, West Nile encephalitis, St. Louis encephalitis, tick-borne encephalitis, Kyasanur Forest disease, Alkhurma hemorrhagic fever, Zika). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 155.
Review Date: 12/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.