Yellow feverTropical hemorrhagic fever caused by yellow fever virus
Yellow fever is a viral infection spread by mosquitoes.
Yellow fever is caused by a virus carried by mosquitoes. You can develop this disease if you are bitten by a mosquito infected with this virus.
This disease is common in South America and in sub-Saharan Africa.
Anyone can get yellow fever, but older people have a higher risk of severe infection.
If a person is bitten by an infected mosquito, symptoms usually develop 3 to 6 days later.
Yellow fever has 3 stages:
- Stage 1 (infection): Headache, muscle and joint aches, fever, flushing, loss of appetite, vomiting, and jaundice are common. Symptoms often go away briefly after about 3 to 4 days.
- Stage 2 (remission): Fever and other symptoms go away. Most people will recover at this stage, but others may get worse within 24 hours.
- Stage 3 (intoxication): Problems with many organs may occur, including the heart, liver, and kidney. Bleeding disorders, seizures, coma, and delirium may also occur.
Symptoms may include:
- Fever, headache, muscle aches
- Nausea and vomiting, possibly vomiting blood
Vomiting blood is regurgitating (throwing up) contents of the stomach that contains blood. Vomited blood may appear bright red, dark red, or look lik...Read Article Now Book Mark Article
- Red eyes, face, tongue
Eye redness is most often due to swollen or dilated blood vessels. This makes the surface of the eye look red or bloodshot.Read Article Now Book Mark Article
- Yellow skin and eyes (jaundice)
- Decreased urination
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 mL of urine in 24 hours (a little over 2 cups)....Read Article Now Book Mark Article
- Irregular heartbeats (arrhythmias)
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...Read Article Now Book Mark Article
- Bleeding (may progress to hemorrhage)
Exams and Tests
The health care provider will perform a physical examination and order blood tests. These blood tests may show liver and kidney failure and evidence of shock.
It is important to tell your provider if you have traveled to areas where the disease is known to thrive. Blood tests can confirm the diagnosis.
There is no specific treatment for yellow fever. Treatment is supportive and focuses on:
- Blood products for severe bleeding
- Dialysis for kidney failure
- Fluids through a vein (intravenous fluids)
Yellow fever can cause severe problems, including internal bleeding. Death is possible.
Complications that may result include:
- Disseminated intravascular coagulation (DIC)
Disseminated intravascular coagulation ...
Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become overactive.Read Article Now Book Mark Article
- Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...Read Article Now Book Mark Article
- Liver failure
- Salivary gland infection (parotitis)
Salivary gland infections affect the glands that produce spit (saliva). The infection may be due to bacteria or viruses. There are 3 pairs of major ...Read Article Now Book Mark Article
- Secondary bacterial infections
Secondary bacterial infections
A secondary infection is an infection that occurs during or after treatment for another infection. It may be caused by the first treatment or by cha...Read Article Now Book Mark Article
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...Read Article Now Book Mark Article
When to Contact a Medical Professional
See a provider at least 10 to 14 days before traveling to an area where yellow fever is common to find out whether you should be vaccinated against the disease.
Tell your provider right away if you or your child develops fever, headache, muscle aches, vomiting, or jaundice, especially if you have traveled to an area where yellow fever is common.
There is an effective vaccine against yellow fever. Ask your provider at least 10 to 14 days before traveling if you should be vaccinated against yellow fever. Some countries require proof of vaccination to gain entry.
If you will be traveling to an area where yellow fever is common:
- Sleep in screened housing
- Use mosquito repellents
- Wear clothing that fully covers your body
Centers for Disease Control and Prevention website. Yellow fever. www.cdc.gov/yellowfever. Updated January 15, 2019. Accessed February 15, 2022.
Endy TP. Viral hemorrhagic fevers. In: Ryan ET, Hill DR, Solomon T, Aronson NE, Endy TP, eds. Hunter's Tropical Medicine and Infectious Disease. 10th ed. Philadelphia, PA: Elsevier; 2020:chap 37.
Thomas SJ, Endy TP, Rothman AL, Barrett AD. Flaviviruses (dengue, yellow fever, Japanese encephalitis, West Nile encephalitis, Usutu encephalitis, St. Louis encephalitis, tick-borne encephalitis, Kyasanur Forest disease, Alkhurma hemorrhagic fever, Zika). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 153.
Review Date: 11/23/2021
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.