eMedicine Specialties > Infectious Diseases > Gastrointestinal Tract and Intra-abdominal Infections

Yellow Fever: Follow-up

Author: Mary T Busowski, MD, Fellow, Infectious Diseases, Orlando Health
Coauthor(s): Mark Raymond Wallace, MD, Infectious Disease Fellowship Director, Orlando Regional Healthcare; Clinical Professor of Medicine, Florida State University; Janelle L Robertson, MD, Staff Physician, Department of Infectious Diseases, Wilford Hall Medical Center
Contributor Information and Disclosures

Updated: Apr 17, 2009

Follow-up

Deterrence/Prevention

  • Prevention remains the cornerstone to minimizing the risk of yellow fever. Travelers to endemic areas and local populations should be vaccinated.
  • International Health Regulations allow countries to require proof of vaccination before allowing travelers to enter or leave.
  • Travelers should have a completed International Certificate of Vaccination or Prophylaxis (ICVP). Only the most recent ICVP form CDC 731 complies with the International Health Regulations.
  • For specific information regarding vaccination, contact the CDC's Traveler's Health Web site.7
  • Stay in air-conditioned or properly screened sleeping quarters.
  • Protective clothing, long sleeves and long pants, and insect repellent containing DEET or Picaridin are advised.

Complications

  • Liver failure
  • Renal failure
  • Pulmonary edema
  • Myocarditis
  • Secondary bacterial infections
  • Hemorrhage or disseminated intravascular coagulation
  • Encephalitis (rare)
  • Shock or death

Prognosis

  • The mortality risk in patients who present in the toxic stage of yellow fever is up to 50%.

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose specific treatable conditions that resemble yellow fever may prove fatal.
  • Failure to recommend yellow fever vaccination for international travelers going to endemic regions may be a source of liability.
 


More on Yellow Fever

Overview: Yellow Fever
Differential Diagnoses & Workup: Yellow Fever
Treatment & Medication: Yellow Fever
Follow-up: Yellow Fever
Multimedia: Yellow Fever
References
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References

  1. Bob Arnebeck. A Short History of Yellow Fever in the US. Available at http://www.geocities.com/bobarnebeck/history.html. Accessed November 11, 2008.

  2. Kean BH, Dahlby T. Coming of age in Panama. In: One Doctor's Adventures Among the Famous and Infamous from the Jungles of Panama to a Park Avenue Practice. New York, NY: Ballantine Books; 1990:Ch 2.

  3. Tsai TF, Vaughn DW, Solomon T. Flaviviruses. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, Pennsylvania: Elsevier, Inc.; 2005:Ch 149; 1926-9.

  4. Centers for Disease ControlMMR WeeklyApril 14, 2000/49(14);303-5. Fatal Yellow Fever in a Traveler Returning from Venezula, 1999. CDC. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm491a3.htm. Accessed November 11, 2008.

  5. World Health Organization 2008. Yellow Fever. Pub Med. Available at http://www.who.int/mediacentre/factsheets/fs100/en/print.html. Accessed November 2008.

  6. Barnett ED. Yellow fever: epidemiology and prevention. Clin Infect Dis. Mar 15 2007;44(6):850-6. [Medline].

  7. CDC Health Information for International Travel 2008. Center for Disesae Control; 2008.

  8. Roukens, AH, Visser LG. Yellow fever vaccine: past, present and future. Expert Opinion Biol Ther. November 2008;8(11):1787-95. [Medline].

  9. McFarland JM, Baddour LM, Nelson JE, et al. Imported yellow fever in a United States citizen. Clin Infect Dis. Nov 1997;25(5):1143-7. [Medline].

  10. Peters CJ. Infections caused by arthropod- and rodent-borne viruses. In: Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, eds. Harrison's Principles of Internal Medicine. 16th ed. United States: McGraw Hill; 2005:Ch 180; 1172-3.

  11. Robertson SE, Hull BP, Tomori O, et al. Yellow fever: a decade of reemergence. JAMA. Oct 9 1996;276(14):1157-62. [Medline].

  12. Thompson C, O'Leary JP. Yellow fever in New Orleans. Am Surg. May 1996;62(5):424-6. [Medline].

  13. Tsai TF. Yellow fever virus. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. Infectious Diseases. 2nd ed. Philadelphia, Pa: WB Saunders and Co; 1998:2234-37.

  14. Van der Stuyft P, Gianella A, Pirard M, et al. Urbanisation of yellow fever in Santa Cruz, Bolivia. Lancet. May 8 1999;353(9164):1558-62. [Medline].

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Further Reading

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Keywords

yellow fever, sylvatic fever, jungle yellow fever, viral hemorrhagic fever, VHF, epidemic yellow fever, urban yellow fever, Flavivirus, Aedes aegypti, A aegypti, Haemagogus mosquito, yellow fever virus

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Contributor Information and Disclosures

Author

Mary T Busowski, MD, Fellow, Infectious Diseases, Orlando Health
Mary T Busowski, MD is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American College of Physicians, American Medical Association, Florida Medical Association, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Coauthor(s)

Mark Raymond Wallace, MD, Infectious Disease Fellowship Director, Orlando Regional Healthcare; Clinical Professor of Medicine, Florida State University
Mark Raymond Wallace, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Janelle L Robertson, MD, Staff Physician, Department of Infectious Diseases, Wilford Hall Medical Center
Janelle L Robertson, MD is a member of the following medical societies: American College of Physicians
Disclosure: Nothing to disclose.

Medical Editor

Thomas Herchline, MD, Professor of Medicine, Wright State University Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio
Thomas Herchline, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Richard B Brown, MD, FACP, Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine
Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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