Introduction
Yellow fever is caused by a virus transmitted to man by a species of mosquitoes (Aedes aegypti) from infected monkeys.
The disease is not spread from person to person. Classical yellow fever is usually fatal.
After the onset of symptoms, there is a brief remission of 2-24 hours, following which the symptoms may recur with the development of epigastric pain, jaundice, renal insufficiency, cardiovascular instability and bleeding from various sites (e.g. gums and needle-puncture sites).
Yellow fever vaccination is protective against the disease and needs to be repeated every ten years.
Causes of yellow fever
- Yellow fever virus
Symptoms of yellow fever
- Fever
- Muscle pain, particularly backache
- Headache
- Shivering
- Loss of appetite
- Nausea or vomiting
- Diarrhoea
Signs of yellow fever
- Congestion of the conjunctivae
- Jaundice
- Bleeding from various sites (petechiae, ecchymosis, etc.)
- Right upper abdominal quadrant tenderness
- Signs of renal failure
Investigations
- Urinalysis – proteinuria and raised urobilinogen levels
- Liver function test
- Blood urea, electrolytes and creatinine
- Blood sample for yellow fever virus serology
Treatment for yellow fever
Objectives
- To provide supportive care for hepatic, renal and circulatory failure
- To manage bleeding disorder
Non-pharmacological treatment
- If yellow fever is suspected in a patient, admit immediately to an isolation ward
- Full supportive treatment for hepatic failure and acute renal failure
Pharmacological treatment
A. Antiviral therapy
- There is no specific treatment
For bleeding patients
- Fresh frozen plasma
Referral Criteria
Refer to a hospital, preferably one with an isolation unit