Yellow fever

Written by Dr Charlie Easmon, specialist adviser in travel medicine

Requirement for yellow fever vaccination
In some countries where there are mosquitoes that could transmit the virus, actual documentation is required, stating that you have been vaccinated against yellow fever before you can obtain permission to enter the country. This can be provided by a stamp in the yellow international vaccination card issued by a WHO recognised vaccination centre.

To be on the safe side, it has been agreed internationally that the vaccination provides protection for 10 years. After that you have to be vaccinated again, even though the first vaccination may still be effective for a little while longer.

Preventing mosquito bites
Apart from vaccination, prevention of mosquito bites is the best way of avoiding yellow fever. However, because the disease is so dangerous, taking a chance and going without vaccination is absolutely not recommended.

In many poor countries where for one reason or another vaccination is not available, bite avoidance may be the only method of protecting the local population.

How is the disease diagnosed?
The disease may be difficult to distinguish from other illnesses, especially in the early stages. To confirm any suspicions from the case history and information on the patient's journeys abroad, the doctor has to take a blood sample.

In the laboratory, specific yellow fever virus antibodies can be detected in the blood.

What treatment is there for yellow fever?
There are no medicines that are effective against this virus.

Serious cases of yellow fever always need hospital treatment. As there are no products that combat the virus itself, the doctor can only treat the symptoms.

If there is a lack of fluid in the body, leading to disturbances in the electrolyte balance, this can be remedied by administration of fluids by intravenous drip.

In mild cases, the pain may be relieved with simple painkillers. High temperatures can be treated by cooling the patient and giving them appropriate medicines to lower the temperature, such as aspirin or ibuprofen.

Paracetamol is probably best avoided if there is already evidence of liver damage.

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