YELLOW FEVER

Yellow fever is an acute viral disease. It is an important cause of hemorrhagic illness in

many African and South American countries despite existence of an effective vaccine. The yellow in the

disease name refers to the jaundice that affects some patients .

Yellow fever has been a source of several devastating epidemics. During one of Napoleon's campaigns

to Haiti in 1802, the troops were attacked by yellow fever. More than half of the army perished due to the

disease. Outbreaks followed by thousands of fatalities occurred periodically in other Western Hemisphere

locations until research which included human volunteers (some of whom died) led to an understanding of

the method of transmission to humans (primarily by mosquitos) and development of a vaccine and other

preventative efforts in the early 20th century.

Despite the costly and sacrificial breakthrough research by Cuban physician Carlos Finlay, American

physician Walter Reed and many others, over 100 years later, unvaccinated populations in many developing

nations in Africa and Central and South America continue to be at risk. As of 2001, the World Health

Organization (WHO) estimates that yellow fever causes 200,000 illnesses and 30,000 deaths every year in

unvaccinated populations.

Yellow fever occurs only in Africa, South and Central America, and the Caribbean . Most outbreaks in South

America are to people who work within the tropical rain forests and have direct contact with the organisms

within the rainforest.

The disease can remain locally unknown in humans for long periods of time and then suddenly break out in

an epidemic fashion. In Central America and Trinidad, such epidemics have been due to a form of the
disease (jungle yellow fever) that is kept alive in Red Howler monkey populations and transmitted

by Haemagogus mosquito species which live only in the canopy of rain forests. The virus is passed to

humans when the tall rainforest trees are cut down. Infected woodcutters can then pass on the disease to
others via species of Aedesmosquitoes that typically live at low altitudes, thus triggering an epidemic.
Symptoms

After a 3 to 6 day incubation period, the typical symptoms that arise are fever, muscle aches, headache, and

backache. Other symptoms may include a red tongue, flushed face, and reddening of the eyes. In a portion

of cases there is also involvement of internal organs including the liver, kidneys, and heart. There may

be hemorrhage from the gastrointestinal tract, causing a bloody vomit with a black colour called coffee

ground vomiting (which explains the name "black vomit"). Later, the disease is sometimes complicated

by jaundice with liver failure (which causes yellow skin colour, hence the name "yellow fever") and/or kidney

insufficiency with proteinuria. If the disease progresses, delirium, seizures and coma ensue. Hypotension

and dehydration are also common.

Prevention
A vaccine for yellow fever was developed which gives a 10-year or more immunity from the disease and

effectively protects people traveling to the affected areas whilst being a means to control the disease at the

same time. Woodcutters working in jungle areas should be particularly targeted for vaccination. Insecticides,

protective clothing and screening of houses are helpful but not always enough. In affected areas mosquito

control methods have proved effective in decreasing the number of cases.

Recent studies have noted the increase in areas affected by mosquito-borne viral infections and have called

for further research and funding for vaccines.,

Treatment

There is no real specific cure for yellow fever; therefore vaccination is important. Treatment is symptomatic

and supportive only. Fluid replacement, fighting hypotension and transfusion of blood derivates is mostly

needed in severe cases. In severe cases resulting in acute renal failure, dialysis may be necessary. A fever

victim needs to get lots of rest, fresh air, and drink plenty of fluids.