Yellow fever

Abstract

Yellow fever, a mosquito-borne flavivirus disease occurs in tropical areas of South America and Africa. It is a disease of major historical importance, but remains a threat to travelers to and residents of endemic areas despite the availability of an effective vaccine for nearly 70 years. An important aspect is the receptivity of many non-endemic areas to introduction and spread of yellow fever. This paper reviews the clinical aspects, pathogenesis, and epidemiology of yellow fever, with an emphasis on recent changes in the distribution and incidence of the disease. Recent knowledge about yellow fever 17D vaccine mechanism of action and safety are discussed.

Global risk mapping for major diseases transmitted by Aedes aegypti and Aedes albopictus

“…The presence of an effective, safe, and economic vaccine for yellow fever is thought to have significantly limited the distribution and burden of this disease (Monath and Vasconcelos, 2015). The disease poses a significant hazard to unvaccinated travellers to Africa and Latin America and unprotected individuals in these areas.…”

“…The disease poses a significant hazard to unvaccinated travellers to Africa and Latin America and unprotected individuals in these areas. The recent expansion in the distribution of A. aegypti and A. albopictus and a rise in air travel, have increased the risk of the introduction and spread of yellow fever to North and Central America, the Caribbean, Southern Europe, and many Asian countries (Monath and Vasconcelos, 2015; Ortiz-Martínez et al, 2017). The USA has suitable conditions in areas such as the south of Florida and Texas, where A. albopictus is present and has been linked to the transmission of dengue, chikungunya, and Zika.…”

Serious adverse events associated with yellow fever vaccine

“…The clinical picture is similar to wild yellow fever. 9 Causal relationship to YFV 17D virus was established beyond doubt, and a search for possible explanations Keywords: disease, neurotropic disease, serious adverse events, vaccine safety, yellow fever vaccine followed, but until now without success. The limited number of genetic variations in the genome of the vaccine viruses and the lack of consistency of these changes when the genomes of case viruses are compared do not support single site reversion to wild type virus sequence, and therefore cannot explain the clinical picture.…”

Questions regarding the safety and duration of immunity following live yellow fever vaccination

“…Although disease may be mild in some instances, clinical presentation often involves severe acute onset with fever, nausea, vomiting, hepatitis, hemorrhage and renal failure. The case fatality rate (CFR) for severe cases of yellow fever ranges from 20–60% [2,3]. There are no licensed antiviral drugs to treat yellow fever and prevention or reduction of disease burden is mainly accomplished through vaccination as well as through vector control measures.…”