Epidemics of yellow fever struck the United States in the 18th and 19th centuries when it was carried in on ships arriving from the Caribbean. The disease attacked port cities as far north as Boston, including Philadelphia in 1793, but after 1822 it was restricted to the South. New Orleans, Mobile, Savannah and Charleston were hit hard; Memphis suffered terribly in 1878. Yellow fever epidemics caused terror, economic disruption and 100,000–150,000 deaths. Although yellow fever is no longer seen in the United States, travelers may be at risk in some areas of the world.
Yellow fever is an acute viral hemorrhagic disease caused by a virus related to the West Nile, St. Louis encephalitis and Japanese encephalitis viruses. It is endemic in tropical and subtropical areas of Sub-Saharan Africa and parts of Latin and South America. Yellow fever is spread through the bite of an infected female mosquito of the Aedes aegypti or Haemagogus species. Mosquitoes that feed on infected primates (human or non-human) carry the virus from one host to another, primarily between monkeys, from monkeys to humans, and from person to person. The mosquitoes breed in clean water, around houses (domestic), in the jungle (wild) or in both habitats (semi-domestic). Yellow fever cannot be transmitted by direct contact with an infected person.
Anyone can get yellow fever, but the elderly have a higher risk of severe infection. Each year there are an estimated 200,000 cases of yellow fever, causing 30,000 deaths worldwide. The number of cases increased over the past two decades due to declining population immunity, deforestation, urbanization, population movements and climate change.
Once a person is bitten by an infected mosquito, symptoms develop in three to six days. The disease progresses in three stages. Symptoms of Stage 1, or infection, include irregular heartbeat, headache, muscle and joint aches, fever, flushing, loss of appetite, dehydration, vomiting, possibly vomiting blood, and jaundice (which inspired the name “yellow fever”). Symptoms often go away after three or four days. In Stage 2, remission, fever and other symptoms go away. Most people recover at this stage, but others get worse within 24 hours. Stage 3, intoxication, involves the organs; people may experience shock; failure of the heart, liver or kidneys; bleeding disorders; gastrointestinal bleeding; secondary bacterial infections; seizures; delirium coma; and death. Up to 50 percent of those who develop severe illness die.
Inform your physician if you traveled to areas where the disease is known to thrive. Diagnosis is confirmed through a blood test for antibodies and a physical assessment. There is no specific treatment for yellow fever except supportive care in the hospital, which includes rest, pain management, intravenous fluids for hydration and blood transfusion for severe bleeding. In some cases, dialysis for kidney failure is needed.
Check with the Centers for Disease Control and Prevention for the status of the countries you are visiting; some require certificates of vaccination for entry. Yellow fever vaccine is available at designated vaccination centers, and it is considered safe and effective, although in rare cases serious side effects occur. A single dose provides protection for 10 years. The vaccine is not recommended for children under 9 months, pregnant women or people over 60. Those who are vaccinated receive a stamped and signed International Certificate of Vaccination or Prophylaxis (yellow card) which becomes valid 10 days after vaccination and is good for 10 years. Anyone at continued risk because of residence or travel should receive a booster dose every 10 years. Yellow fever vaccine can be administered at the same time as most other vaccines.
An outbreak of yellow fever began last September in the Darfur region of Sudan, placing 6 million people at risk. The World Health Organization is supporting the Ministry of Sudan to confront the outbreak.
Mosquito control is vital until vaccination takes effect. Yellow fever transmission in urban areas can be reduced by eliminating mosquito breeding sites and applying insecticides to water where they develop. Application of spray insecticides to kill adult mosquitoes during urban epidemics, combined with emergency vaccination campaigns, can reduce or halt disease transmission, buying time for vaccinated populations to build immunity. This kind of control is not possible in the jungle.
Tips for Travel to a Yellow Fever Zone
- Get vaccinated for yellow fever at least 10 days before travel.
- When outdoors, use an EPA-registered insect repellant containing DEET, picaridin, IR3535 or oil of lemon eucalyptus.
- To reduce mosquito bites, wear light-colored long sleeves, long pants and socks outdoors.
- Some mosquitoes bite through fabric. Spray clothing with EPA-registered repellant; clothing pretreated with permethrin is available.
- Stay in well-screened and air-conditioned areas. If you stay in camps or local hotels, use bed nets and mosquito coils.
- Beware of peak mosquito feeding hours, usually from dusk to dawn; however, the Aedes aegypti feeds during the day.
The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.
Attend one of the most acclaimed fall events, Autumn at the Arboretum, in Dallas. In its 14th year, the annual event is known as one of the best pumpkin festivals in the country, with its creative displays featuring more than 90,000 pumpkins, gourds and squash. The event takes place at Dallas Arboretum, Sept. 21 –Oct. 31. Alongside thousands of pumpkins, guests glimpse 150,000 autumn flowers across the 66-acre space.
United Airlines announces a number of new routes.
WalletHub compared the 100 largest U.S. cities across 24 key metrics to determine the best destinations for an upcoming Oktoberfest celebration. The brand’s study found the estimated cost for an American to attend Oktoberfest in Munich, Germany, is $5,000. Munich boasts a $1.43 billion annual economic impact on Munich. During Oktoberfest, nearly 2 million gallons of beer are consumed and more than 510,000 whole roast chickens eaten.
Welcome to Rhodes, a medieval treasure beautifully preserved throughout the centuries. Rhodes is the capital of the Dodecanese, an island ideal not only for those who want to relax, but also for those looking for an action-packed holiday! With its bright green hills, rich green valleys and uninterrupted line of golden beaches, Rhodes is truly a blessed place. “The sun island” has more sunshiny days and milder temperatures throughout the year than any other location in Greece. It is, after all, one of the country’s easternmost places and among the first to welcome summer on its impressive beaches. Add in the excellent facilities for tourism, the island’s special blend of cosmopolitan and traditional, and numerous cultural and archaeological sites, the most important being the Medieval (Old) Town, a UNESCO World Heritage site, and you’ve got the perfect holiday destination. While on Rhodes, don’t miss a daytrip to nearby Sými. An island of sponge divers and seamen, Sými used to have 30,000 inhabitants before the Second World War and was the richest island in the Dodecanese, despite its small size. Today, Sými attracts many visitors thanks to its beautifully preserved Neo-Classical buildings and the famous Archangel Michael monastery at Panormitis.
Qantas will start using a Boeing 787-9 Dreamliner on its Sydney–Santiago route starting in late June 2020.
TAP Air Portugal is adding 15 new weekly flights from the United States and Canada by summer 2020, a new record for the carrier of 71 weekly flights between North America and Portugal.