Yellow fever

Last reviewed: 7 Jan 2023
Last updated: 02 Nov 2022

Summary

Definition

History and exam

Key diagnostic factors

  • history of residence in, or recent travel to, endemic area
  • lack of yellow fever immunization
  • history of mosquito bite
  • fever
  • constitutional symptoms
  • conjunctival injection
  • relative bradycardia (Faget sign)
  • biphasic illness
  • hemorrhagic 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 immunization
  • mosquito bite
  • travel during rainy and early dry seasons
More risk factors

Diagnostic investigations

1st investigations to order

  • CBC
  • 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 hemorrhagic 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

OR

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.

  • Yellow fever images
  • Differentials

    • Dengue fever
    • Malaria
    • Zika virus infection
    More Differentials
  • Guidelines

    • CDC health information for international travel (Yellow Book) - yellow fever
    • Laboratory diagnosis of yellow fever virus infection
    More Guidelines
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer