Yellow Fever (cont.)
Steven Doerr, MD
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- Yellow fever facts
- What is yellow fever? What is the history of yellow fever?
- What causes yellow fever?
- How is yellow fever transmitted?
- What areas are high risk for contracting yellow fever?
- What is the incubation period for yellow fever?
- Is yellow fever contagious? How long is the contagious period for yellow fever?
- What are yellow fever symptoms and signs?
- How is yellow fever diagnosed?
- What is the treatment for yellow fever?
- How long does yellow fever last?
- What is the prognosis for people with yellow fever?
- Is it possible to prevent yellow fever?
- What are the side effects of the yellow fever vaccine?
- Where can people get more information on yellow fever?
- Find a local Doctor in your town
How is yellow fever diagnosed?
Because the symptoms during the initial phase of yellow fever are nonspecific and similar to a flu-like illness, diagnosis during this stage can be difficult. Therefore, the preliminary diagnosis is often made clinically based on the patient's signs and symptoms, the travel history (when and where), and the related travel activities.
Various blood test abnormalities may be present in individuals with yellow fever, particularly those who go on to develop the second toxic phase of the disease. Blood test abnormalities may include a low white blood cell count (leukopenia), a low platelet count (thrombocytopenia), elevations in liver function tests, abnormally prolonged blood clotting times, and abnormal electrolyte and kidney function tests. Urine tests may demonstrate elevated levels of urinary protein and urobilinogen. An electrocardiogram (ECG) may reveal heart conduction or rhythm disturbances if cardiac involvement has occurred.
The laboratory diagnosis of yellow fever requires specialized testing. Blood tests may demonstrate the presence of virus-specific antibodies produced in response to the infection, though cross-reactivity with antibodies from other flaviviruses may occur, sometimes necessitating additional testing. A variety of other specialized laboratory techniques and tests may be used to identify and confirm the presence of the virus using blood, body fluids, or body-tissue samples.
What is the treatment for yellow fever?
There is no specific curative treatment for yellow fever. Treatment is supportive and aimed at relieving the symptoms of the disease, including the pain and fever. As previously mentioned, the majority of patients who do develop symptoms from yellow fever will experience a mild course of illness which will resolve on its own.
Supportive measures implemented depend on the severity of the disease, and may include
- oxygen administration,
- intravenous fluid administration for dehydration,
- medications to increase blood pressure in cases of circulatory collapse,
- transfusion of blood products in cases of severe bleeding,
- antibiotics for secondary bacterial infections,
- dialysis for kidney failure,
- endotracheal intubation (placement of a breathing tube) and mechanical ventilation in cases of respiratory failure.
Acetylsalicylic acid (Aspirin) and nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided because of the increased risk of bleeding.
For the first few days of illness, infected individuals should also be isolated indoors and/or under mosquito netting in order to prevent further mosquito exposure, thus eliminating the potential for further transmission of the disease.
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