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 | What is yellow fever? |
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Yellow fever is a serious viral infection, transmitted by mosquitoes in tropical regions. It has both an urban cycle and a jungle cycle that relies on monkeys as carriers ('sylvatic cycle'). In mild cases the symptoms are similar to influenza, but serious cases develop a high temperature and may have a series of after effects, such as internal bleeding, kidney failure and meningitis. A classic feature of yellow fever is hepatitis, which is the reason for the yellow colouring of the skin (jaundice) and the name of the disease.
Yellow fever can cause sudden epidemics, with a mortality rate of almost 50 per cent. Although a safe, efficient vaccine has been available for the last 60 years, epidemics still occur, constituting a health risk in tropical regions. The disease is covered by the International Quarantine Regulations, which are taken very seriously by authorities everywhere. Therefore, the vaccine has to be administered by a specially authorised doctor. In the UK you can only obtain the yellow fever vaccination from a designated Yellow Fever Clinic.
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| What causes yellow fever? |
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Yellow fever virus belongs to the Flaviviridae family, other members of which cause dengue fever and Japanese encephalitis. The virus is introduced into the bloodstream via the saliva of the mosquito as it bites. The virus can then be transported around the body and reproduce itself in a variety of the body's cells, usually the liver, kidneys and blood vessels. In serious cases, these cells may become damaged themselves.
In addition, the cells of the immune system are affected and release large quantities of signalling substances. These substances are the cause of the normal disease symptoms, such as muscular pain and fever, which are also observed in influenza.
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| What are the symptoms of the disease? |
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The incubation period from infection to developing yellow fever is 3 to 16 days.
Mortality ranges from 5 per cent to 40 per cent. Some people do not develop a serious form of the disease. They may have no symptoms at all or just a mild influenza-like illness.
In the actual full-blown disease there is:
 high fever
generalised symptoms like violent headache, muscular pain, upset stomach and loss of fluid.
The fever dies down after three to four days and the general condition improves. However, in about 15 per cent of cases the fever returns within 24 hours and a dangerous situation develops.
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| The Danger Signals |
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Various systems in the body are affected during this phase. Anaemia (lack of red blood cells) develops as well as liver inflammation, hepatitis and jaundice.
The kidneys are also affected and bleeding from the mouth, nose and stomach may occur, which leads to blood in vomit and faces.
The majority of patients who experience bleeding die in a short space of time.
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