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Yellow fever
A female ofÆdes ægypti on human skin.
Information
Region (s)	Sahel ; West Africa ; central Africa ; East Africa ; north of theSouthern Africa ; South America
Cause	Virus (Flavivirus)
Vector	Mosquito female Ædes
Contagiousness	no
CIM-10	A95
CIM-9	060
Prophylaxis:
* vaccine	Yes
* medication	no
Therapy:	no
Location
Geographical areas of yellow fever.      Endemic areas      Possible presence zones
Medical warning
edit

The yellow fever, also called amarile fever, is a viral disease transmitted by the bite of a female mosquito of the genus Ædes. It is mainly present in Africa and in South America. As this disease can be fatal, it is advisable to protect oneself not only against the mosquito but also against the virus by means of prior vaccination.

Understand

The yellow fever virus (fromSpanishamarillo "Yellow") responsible for yellow fever is an arbovirus of the genus Flavivirus, also responsible for other viral diseases, and only transmitted by the bite of a female mosquito.

Previously, the virus was confined to the rainforests ofcentral America and the disease was transmitted from monkey to monkey. As humans passed through these forests, the disease first spread from monkeys to humans and then from human to human. The first known epidemic dates from 1648 and affected the Yucatán. Thanks to the movement of infected humans, the virus was able to travel toNorth America and theEurope first and towardsAfrica then. It is mainly thanks to the eradication of vector mosquito species and the appearance of increasingly effective vaccines that the transmission of the disease has been stopped in North and Central America as well as in Europe.

Vector protection

Avoiding yellow fever means first of all avoiding mosquito bites by taking a few precautions. Mosquito females Ædes are activated between dawn and dusk.

• wear loose, long, light-colored clothing;
• as soon as you get up, coat your clothes with Permethrin or the skin of a repellent consisting of a solution containing 30% of DEET for adults or 10% of the same product for children between 2 and 12 years old;
• use an insecticide inside homes;
• mosquitoes being sensitive to air movement, the action of a fan, even if the room has an air conditioning system, will also be part of the means of protection;
• if you take rest during the day, do so under a mosquito net with a mesh size of less than 1,5 mm and, if possible, impregnated with insecticide which will protect the parts of the body that come into contact with the mosquito net. It is also imperative to check, before each rest, whether the mosquito net is in perfect condition.

Be careful that if the females ofÆdes, propagators of yellow fever, chikungunya and dengue fever, are active between dawn and dusk, females of other mosquito species, propagators of other viral diseases, such as Japanese encephalitis and the o ' nyong-nyong, or parasitoses such as malaria, are active during the night. The same precautions therefore remain desirable during the night.

Virus protection

Detail of a "international certificate of vaccination or prophylaxis Showing a vaccination against yellow fever.

Protection against the flavivirus is vaccination yellow fever which can be done from the age of six months and is valid for ten years. The following reminders can be carried out between, in theory, the day of departure and, effectively, ten days before departure to a risk area.

Please note, only approved centers can inject you with this vaccine, check with the health authorities in your country. It should also be noted that some countries will prohibit you from entering their territory, depending on your geographical origin, if you are not vaccinated. So take your international certificate of vaccination or prophylaxis bearing an anti-yellow fever vaccination certificate.

• Institute of Tropical Medicine  – Addresses of vaccination centers in Belgium and the Grand Duchy of Luxembourg. (last updated Nov 2019)
• Doctissimo  – Addresses of vaccination centers in France. (last update March 2018)
• Public Health Agency of Canada  – Addresses of vaccination centers in Quebec. (last update March 2018)
• Safe Travel  – Addresses of vaccination centers in Switzerland. (last update March 2018)

Access to the territory of a country may be dependent on prior vaccination, either in all cases or depending on your previous stay.

• 49.44091.110431 Rouen University Hospital  – List of countries where vaccination is compulsory, recommended or subject to conditions. (last update March 2018)
• WHO  – (in) List of territories where vaccination against yellow fever is required and prophylaxis against malaria recommended. (last update March 2018)

Diagnostic

The diagnosis is made on the appearance of the temperature curve specific to viral hemorrhagic fevers, the signs of a clinical examination and a blood test to rule out any other cause (malaria, emerging or recurring fever due to bacteria).

Symptoms

Sudden onset of discomfort, severe headaches, a feeling of back "pushing the bar" and feverish thrust. 39 ° C. During the next three days, hyperthermia sometimes exceeding 39 ° C with pulse-temperature dissociation (i.e. without pulse acceleration). After a drop in body temperature for 24 h , recrudescence of this temperature for three new days with the appearance of jaundice and vomiting of black color, hence the name of vomito negro given to yellow fever in Latin American countries, due to digestive bleeding.

Clinical signs

The clinical examination consists of the study of the temperature curve which should tend towards normality after the state period of seven to eight days. This favorable development must be accompanied by a resumption of urinary secretion.

Therapy

There is no specific treatment for yellow fever, which is a viral disease, and that is why preventive vaccination is so important. The only thing to do is to isolate the patient, under a mosquito net in the areas at risk, for at least five to six days, to hydrate him regularly and, possibly, to administer him medicines to fight against the disease.hyperthermia. The most serious cases may require heavy actions such as blood transfusions or liver dialysis.

Remarks

• In Belgium, in France, at Quebec and in Swiss, yellow fever is on the list of notifiable infectious diseases.
• At the start of a pregnancy, the doctor will assess the risk to the fetus of a vaccination.
• Vaccination is contraindicated for people with a severe egg allergy or severe immune deficiency as well as for infants under six months of age.
• The carriers of HIV can only be vaccinated if their CD4 antigen titer is at least 200 cells / mm³.

Further information

• Health topics, Yellow fever  – The yellow fever page on the WHO website. (last update March 2018)

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