Notifiable condition that is endemic in South America, the Caribbean, and Africa. An ongoing outbreak in Brazil has raised the concern of local transmission in other countries, spread by infected returning travelers.
Infection may be asymptomatic or cause a biphasic, highly variable illness ranging from a nonspecific mild febrile illness to a potentially fatal hemorrhagic fever.
Molecular or serologic testing confirms diagnosis in the context of clinical presentation, epidemiologic context, and vaccination history.
As no specific antiviral therapy is available, treatment is supportive. A safe and effective vaccine is available.
A viral hemorrhagic fever caused by a flavivirus transmitted by the Aedes or Haemagogus mosquito. It is endemic in South America, the Caribbean, and Africa, and has been resurging in the last 2 decades. The clinical disease is variable, ranging from a nonspecific viral illness to hemorrhagic fever and death.
History and exam
- hx of residence in, or recent travel to, endemic area
- lack of yellow fever immunization
- hx of mosquito bite
- constitutional symptoms
- conjunctival injection
- relative bradycardia (Faget sign)
- biphasic illness
- hemorrhagic diathesis
- signs of renal failure
- signs of hepatic failure
Helmut Albrecht, MD, DTMH
Heyward Gibbes Distinguished Professor of Internal Medicine
Department of Internal Medicine
University of South Carolina
HA declares that he has no competing interests.
Dr Albrecht would like to gratefully acknowledge Dr Philip A. Yeon, a previous contributor to this monograph. PAY declares that he has no competing interests.
Carlos Franco-Paredes, MD, MPH
Emory University Hospital Midtown
CFP declares that he has no competing interests.
Andrea K. Boggild, MSc, MD, DTMH, FRCPC
Tropical Diseases Unit
Division of Infectious Diseases
Department of Medicine
Toronto General Hospital
University Health Network
AKB declares that she has no competing interests.
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