Yellow fever Symptoms And Causes

A variety of specialists may become involved in the care of patients who develop symptoms of yellow fever. Initially, primary care physicians, including family physicians, internists, emergency physicians, and pediatricians, may encounter patients with yellow fever. Infectious-disease specialists care for individuals diagnosed with yellow fever, as well.

Patients with yellow fever may see other specialists depending on the severity of their illness and the development of complications (for example, a nephrologist in cases of kidney failure).

After infection with the yellow fever virus, many individuals will experience no clinically apparent manifestations of the mosquito-borne disease (asymptomatic), while others will go on to develop a mild, self-limiting flu-like illness characterized by the following symptoms and signs:

• Fever
• Chills
• Generalized muscle pain
• Back pain
• Headache
• Malaise
• Weakness
• Lack of appetite
• Nausea
• Vomiting

Most patients with this initial acute phase of the disease improve spontaneously after approximately three to four days. However, approximately 15% of patients may enter a second phase of the disease that typically appears after a short remission of symptoms (about 24 hours) from the initial phase of the illness.

This next toxic phase of the disease is more severe, at which time the high fever returns and more organ systems become involved. In addition to the above symptoms, the following symptoms and signs may also develop:

• Abdominal pain
• Jaundice
• Bleeding from the gums, nose, eyes, and/or stomach
• Blood in the stool and blood in the vomit
• Easy bruising of the skin
• Kidney failure
• Confusion
• Seizures
• Coma

Prevention

Vaccine

A highly effective vaccine exists to prevent yellow fever. Yellow fever is known to be present in sub-Saharan Africa and parts of South America. If you live in one of these areas, talk to your doctor about whether you need the yellow fever vaccine.

If you plan to travel in these areas, talk with your doctor at least 10 days, but preferably three to four weeks, before your trip begins. Some countries require travelers to present a valid certificate of immunization upon entry.

A single dose of the yellow fever vaccine provides protection for at least 10 years. Side effects are usually mild, lasting five to 10 days, and may include headaches, low-grade fevers, muscle pain, fatigue and soreness at the site of injection.

More significant reactions such as developing a syndrome similar to actual yellow fever, inflammation of the brain or death can occur, most often in infants and older adults. The vaccine is considered safest for those between the ages of 9 months and 60 years.

Talk to your doctor about whether the yellow fever vaccine is appropriate if your child is younger than 9 months, if you have a weakened immune system, are pregnant or if you’re older than 60 years.

Mosquito protection

In addition to getting the vaccine, you can help protect yourself against yellow fever by protecting yourself against mosquitoes.

To reduce your exposure to mosquitoes:

• Avoid unnecessary outdoor activity when mosquitoes are most active.
• Wear long-sleeved shirts and long pants when you go into mosquito-infested areas.
• Stay in air-conditioned or well-screened housing.
• If your accommodations don’t have good window screens or air-conditioning, use bed nets. Nets that have been pre-treated with insecticide offer additional protection.

To ward off mosquitoes with repellent, use both of the following:

• Nonskin repellent. Apply permethrin-containing mosquito repellent to your clothing, shoes, camping gear and bed netting. You can buy some articles of clothing and gear pre-treated with permethrin. Permethrin is not intended for use on your skin.
• Skin repellent. Products with the active ingredients DEET, IR3535 or picaridin provide long-lasting skin protection. Choose the concentration based on the hours of protection you need. In general, higher concentrations last longer.Keep in mind that chemical repellents can be toxic, and use only the amount needed for the time you’ll be outdoors. Don’t use DEET on the hands of young children or on infants under 2 months of age. Instead, cover your infant’s stroller or playpen with mosquito netting when outside.