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Yellow fever 

Yellow fever
Chapter:
Yellow fever
DOI:
10.1093/med/9780198729228.003.0124
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date: 19 November 2019

Yellow fever is a viral haemorrhagic disease endemic in tropical areas of Africa and South America. Monkeys are the primary host; humans become infected when bitten by an infected mosquito. Most human cases occur in Africa in areas that border the jungle and forests. In South America, humans working in, or visiting, forested areas of the Amazon basin are at risk. Large urban outbreaks can occur if the virus is introduced by humans; Aedes species mosquitoes are responsible for transmission in urban areas. Following an incubation period of 3–6 days, yellow fever can range from a mild febrile illness to severe haemorrhagic disease with multi-organ failure and a case fatality rate of 20–50%. Prevention of infection includes environmental control measures in urban areas, and insect bite avoidance and vaccination for individuals. Proof of vaccination may be required as a condition of entry by some countries. Yellow fever vaccination is highly effective and historically safe. However, severe adverse events, including death, following vaccination have been rarely reported. In order to ensure that yellow fever vaccine is given appropriately, vaccine safety, risk of disease, and requirements for vaccination under international health regulations must be considered.

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