Yellow fever

Last reviewed: 9 Nov 2022
Last updated: 02 Nov 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • constitutional symptoms
  • conjunctival injection
  • relative bradycardia (Faget's sign)
  • biphasic illness
  • haemorrhagic diathesis
  • signs of renal failure
  • signs of hepatic failure
  • jaundice
More key diagnostic factors

Other diagnostic factors

  • hypotension
  • abdominal pain, vomiting, and lethargy
Other diagnostic factors

Risk factors

  • residence in, or recent travel to, endemic area
  • lack of immunisation
  • mosquito bite
  • travel during rainy and early dry seasons
More risk factors

Diagnostic investigations

1st investigations to order

  • FBC
  • liver function tests
  • coagulation screen
  • reverse transcription polymerase chain reaction (RT-PCR)
  • serology
More 1st investigations to order

Investigations to consider

  • ECG
  • histopathology
More investigations to consider

Emerging tests

  • virus isolation
  • isothermal nucleic acid amplification assays

Treatment algorithm

INITIAL

unidentified viral haemorrhagic fever

ACUTE

confirmed yellow fever

Contributors

Authors

William A. Messer, MD, PhD

Associate Professor of Medicine

Department of Molecular Microbiology and Immunology

Division of Infectious Diseases

Oregon Health & Science University

Portland

PortlandOR

Disclosures

WAM declares that he has no competing interests.

Acknowledgements

Dr William A. Messer would like to gratefully acknowledge Dr Philip A. Yeon and Dr Helmut Albrecht, previous contributors to this topic.

Disclosures

PAY and HA declares that he has no competing interests.

Peer reviewers

Carlos Franco-Paredes, MD, MPH

Assistant Professor

Emory University

TravelWell Clinic

Emory University Hospital Midtown

Atlanta

GA

Disclosures

CFP declares that he has no competing interests.

Andrea K. Boggild, MSc, MD, DTMH, FRCPC

Clinical Assistant

Tropical Diseases Unit

Division of Infectious Diseases

Department of Medicine

Toronto General Hospital

University Health Network

Toronto

Canada

Disclosures

AKB declares that she has no competing interests.

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