Yellow fever is a viral infection spread by mosquitoes.A.D.A.M.

Causes, incidence, and risk factors

Yellow fever is caused by a virus carried by mosquitoes. You can catch this disease if you are bitten by a mosquito infected with this virus. 

This disease is common in South America and in sub-Saharan Africa.

Anyone can get yellow fever, but the elderly have a higher risk of severe infection.

If a person is bitten by an infected mosquito, symptoms usually develop 3 - 6 days later.

Symptoms

Yellow fever has three stages:

• Stage 1 (infection): Headache, muscle and joint aches, fever, flushing, loss of appetite, vomiting, and jaundice are common. Symptoms often go away briefly after about 3-4 days. 
• Stage 2 (remission):  Fever and other symptoms go away. Most people will recover at this stage, but others may get worse within 24 hours.
• Stage 3 (intoxication): Problems with many organs occur. This may include heart, liver, and kidney failure, bleeding disorders, seizures, coma, and delirium.

Symptoms may include:

• Irregular heart beats(arrhythmias)
• Bleeding (may progress to hemorrhage)
• Coma
• Decreased urination
• Delirium
• Fever
• Headache
• Yellow skin and eyes (jaundice)
• Muscle aches 
• Red eyes, face, tongue
• Seizures
• Vomiting, possibly vomiting blood

Signs and tests

The health care provider will examine the person. This may show liver and kidney failure and shock.

It is important to tell your doctor if you have traveled to areas where the disease is known to thrive. Blood tests can confirm the diagnosis.

Treatment

There is no specific treatment for yellow fever. Treatment for symptoms can include:

• Blood products for severe bleeding
• Dialysis for kidney failure
• Fluids through a vein (intravenous fluids)

Expectations (prognosis)

Yellow fever can cause severe problems, including internal bleeding. Death is possible.

Complications

• Coma
• Death
• Disseminated intravascular coagulation (DIC)
• Kidney failure
• Liver failure
• Parotitis
• Secondary bacterial infections
• Shock

Calling your health care provider

Get medical attention at least 10 - 14 days before traveling to an endemic area for yellow fever to find out whether you should be vaccinated against the disease.

Tell your health care provider right away if you or your child develop fever, headache, muscle aches, vomiting, or jaundice, especially if you have traveled to an area where yellow fever is known to occur.

Prevention

If you will be traveling to an area where yellow fever is common:

• Sleep in screened housing
• Use mosquito repellents
• Wear clothing that fully covers your body

There is an effective vaccine against yellow fever. Ask your doctor at least 10 - 14 days before traveling if you should be vaccinated against yellow fever.

References

1.  
2. Bausch DG. Viral hemorrhagic fevers.In: Goldman L, Schafer AI, eds.Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 389.

Review Date: 12/6/2011.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.