Global & Disaster Medicine

One of the largest emergency vaccination campaigns ever attempted in Africa will start in Angola and the Democratic Republic of Congo this week as WHO and partners work to curb a yellow fever outbreak that has killed more than 400 people and sickened thousands more.

WHO

CDC

Symptoms

  • The majority of persons infected with yellow fever virus have no illness or only mild illness.
  • In persons who develop symptoms, the incubation period (time from infection until illness) is typically 3–6 days.
  • The initial symptoms include sudden onset of fever, chills, severe headache, back pain, general body aches, nausea, and vomiting, fatigue, and weakness. Most persons improve after the initial presentation.
  • 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.

Treatment

  • No specific treatments have been found to benefit patients with yellow fever. Whenever possible, yellow fever patients should be hospitalized for supportive care and close observation.
  • Treatment is symptomatic. Rest, fluids, and use of pain relievers and medication to reduce fever may relieve symptoms of aching and fever.
  • Care should be taken to avoid certain medications, such as aspirin or other nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen), which may increase the risk of bleeding.
  • Yellow fever patients should be protected from further mosquito exposure (staying indoors and/or under a mosquito net) for up to 5 days after the onset of fever. This way, yellow fever virus in their bloodstream will be unavailable to uninfected mosquitoes, thus breaking the transmission cycle and reducing risk to the persons around them.

Outcome

  • The majority of infected persons will be asymptomatic or have mild disease with complete recovery.
  • In persons who become symptomatic but recover, weakness and fatigue may last several months.
  • Among those who develop severe disease, 20–50% may die.
  • Those who recover from yellow fever generally have lasting immunity against subsequent infection.

 

 


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