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The Fight Against Yellow Fever Must Go On

As health systems around the world get stronger and more vaccines are available to more communities, it can be easy to grow complacent and forget that this absence of disease is the result of ongoing efforts that must be sustained. The most destructive Ebola outbreak in history provides a valuable reminder of the terrible toll of epidemic infectious diseases.

Earlier this year, Germany and the United States experienced their first measles deaths in years and just last month, polio crept back into Ukraine. Now, as governments and heroic health workers continue working to treat ill patients while increasing efforts to reach more communities with…

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 Yellow fever, the story of a re-emerging virus

With outbreaks in Angola in 2015 and Brazil in 2016, and cases detected in French Guiana in 2017 and even recently in Asia, where the virus had never previously been witnessed, yellow fever – a sometimes fatal mosquito-borne disease – has once again become a global public health problem. After major outbreaks between the 17th and 19th centuries, it never disappeared and has continued to be rife in some world regions. WHO even believes that the impact of yellow fever is underestimated, suggesting that the real number of cases is 10 to 250 times higher than those currently notified.

Articles of Interest

The Great Fever

This AMERICAN EXPERIENCE production documents the heroic efforts of Reed's medical team, some of whom put their own lives on the line to verify Finlay's theory. Eventually, their discovery enabled the United States to successfully eradicate the disease among workers constructing the Panama Canal, making possible the completion of one of the most strategic waterways in the world. When yellow fever struck New Orleans in 1905, an aggressive mosquito eradication campaign successfully ended the epidemic. It was the last yellow fever outbreak in the United States, and the first major public health triumph of the 20th century.

Yellow Fever

A mosquito-borne infection that continues to threaten the lives of people living in tropical areas.

Yellow fever and Ebola: similar scourges, centuries apart

The disease is terrifying. Many of the stricken are left in the streets to die horrible deaths, their bodies unclaimed. Thousands flee. The government appears helpless to stop the scourge from spreading. Physicians and nurses offer care, but have no effective methods of treatment or means to prevent the disease. Ebola in West Africa? No, yellow fever in the United States. Both are hemorrhagic fevers.

Yellow Jack

In the fever-stricken areas of Cuba a brave band of scientists, doctors and U. S. Marines fight a losing battle against the deadly plague of 'Yello Jack,' until the great heroic risk taken by an Irish sergeant brings victory.

Could Yellow Fever Return to the United States?

Peter Hotez and Kristy Murray from Baylor College of Medicine highlight the potential for yellow fever to return to the southern cities of the United States.

Dr Jesse William Lazear (1866 – 1900)

Jesse Lazear contributed to the work that established Yellow Fever as a mosquito-borne infection and ultimately led to the development of an effective vaccine. But he paid a high price for the discovery.

How Yellow Fever decimated the USA’s first capital

In 1793, with the United States of America less than 20 years old, a yellow fever epidemic decimates the capital city, Philadelphia, and shines a spotlight on stark racial and social inequalities.

Politics of Participation: Walter Reed's Yellow-Fever Experiments

At the termination of the Spanish-American War in 1900, American military forces occupied the island of Cuba. Tropical diseases were a major concern of the government, and the American Surgeon General dispatched Major Walter Reed and a team of young doctors to investigate the diseases, particularly the pathogenic mechanism of yellow fever. Reed’s team pursued a program of human experimentation by intentionally exposing human subjects, team members included, to potentially deadly virulent material. Despite several prominent fatalities during the experiment’s run, Reed’s experiments were a scientific success and instrumental in establishing that yellow fever was a mosquito-borne illness.

Yellow Fever in the 20th Century and Today

In the 20th century, a vaccine for yellow fever was developed to protect people in regions where the disease still flourishes. Epidemics continued, however, during every decade of the century, and cases still surface to the present time.

Yellow fever outbreak triggers vaccine alarm

The vaccine is the only bulwark against yellow fever, a formidable killer without a cure that is transmitted primarily through the bite of Aedes aegypti, also known as the yellow fever mosquito. Most infected people have no symptoms at all; some experience fever, joint pains, and headaches. But roughly 15% progress to a more severe stage in which their eyes and skin turn yellow; they may also bleed from the eyes, nose, and mouth. Up to half of these serious cases are fatal. Although yellow fever is endemic in much of Latin America, Africa bears by far the highest burden. Exact numbers are hard to come by, but a study published in 2014 in PLOS Medicine estimated that the disease kills 78,000 Africans every year—although many experts felt that number was too high.

Resources

Yellow Fever Casebook

Descriptions of historic yellow fever cases, especially in Philadelphia and New York in the 1790s.

YellowFever.com.au

Yellow fever is a serious disease, which occurs in tropical Africa and Latin America. 900 million persons live in areas at risk of this disease. There is no cure for Yellow Fever, and up to 50% of severely affected persons without treatment will die.

Timelines

Yellow fever killed about 10% of Philadelphia’s population in 1793, when it was the capital and largest city in the United States. Local and federal government officials fled, including President George Washington.

CDC

Yellow fever virus is found in tropical and subtropical areas in South America and Africa. The virus is transmitted to people by the bite of an infected mosquito. Yellow fever is a very rare cause of illness in U.S. travelers. Illness ranges in severity from a self-limited febrile illness to severe liver disease with bleeding. Yellow fever disease is diagnosed based on symptoms, physical findings, laboratory testing, and travel history, including the possibility of exposure to infected mosquitoes.

Department of Health - Australia

If you are travelling to Africa, the Caribbean, Central or South America, you should be aware of the risk of yellow fever virus transmission and take the necessary precautions to protect yourself from infection.

MayoClinic

There's no specific treatment for yellow fever. But getting a yellow fever vaccine before traveling to an area in which the virus is known to exist can protect you from the disease.

MedicineNet

The symptoms of yellow fever include fever, headache, and muscle aches, with some patients going on to develop life-threatening complications.

NHS

Yellow fever is a serious viral infection that's spread by certain types of mosquito. It’s mainly found in sub-Saharan Africa, South America and parts of the Caribbean. The condition can be prevented with a vaccination and is a very rare cause of illness in travellers.

Patient

Yellow fever is a viral illness transmitted between primates by several species of mosquito. It is not transmitted directly from person to person. The pathogen is an RNA virus belonging to the genus flavivirus and it affects only primates (including humans) and certain mosquito species of which the main vector is the yellow fever mosquito (Aedes aegyptii).

Public Health Agency of Canada

Immunisation is required legally for travelers visiting areas of endemicity or traveling from areas of endemicity into counties that are free of YF.

WHO

The number of yellow fever cases has increased over the past two decades due to declining population immunity to infection, deforestation, urbanization, population movements and climate change. There is no specific treatment for yellow fever. Treatment is symptomatic, aimed at reducing the symptoms for the comfort of the patient. Vaccination is the most important preventive measure against yellow fever.