Yellow fever
Background
- A Flavi virus transmitted by Aedes and Haemagogus mosquitos
- 200,000 cases per year with 30,000 deaths mostly in Africa
- Endemic in tropical areas of sub-Sahara Africa and South America
Clinical Features
Stage 1: Infection
3-4 days of:
- Fever
- Faget sign (low pulse compared to high fever)
- Myalgias
- Knee pain
- Nausea
- Vomiting
Stage 2: Remission
Either recovers or progresses to next stage in 48 hours
Stage 3: Intoxication
15% of patients Return of symptoms plus:
- Hepatic dysfunction
- Renal failure
- Myocardial injury
- CNS dysfunction
- Bleeding complications
Differential Diagnosis
Evaluation
- CBC
- Chem
- LFTs
- Coags
- Viral PCR
- ELISA for IgM
Management
- Symptomatic
- Vaccination in endemic areas
Disposition
- Admit
References
- Lupi O. Mosquito-Borne Hemorrhagic Fevers. Dermatologic Clinics, 2011-01-01, Volume 29, Issue 1, Pages 33-38
- WHO Yellow fever: http://www.who.int/mediacentre/factsheets/fs100/en/
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