Beruflich Dokumente
Kultur Dokumente
YELLOW FEVER:
1. CLINICAL SYNDROME:
a virus, immunologically related to Dengue, Uganda S, Zika and Ilheus and bas
been classified by Casal in the Group B viruses~/) Yellow fever derives its
name from the jaundiced or yellow color of the akin, mucous membrane and aclerae
which coaaonly develops about the 3rd or 4th day of illne11. (!!/) The textbook
version of yellow fever appear• to be aillple, but often times is very complex.
fulminating, fatal one. The diaeue bas been clusified according to severity
into 4 varieties: :'(1) very mild, ;.'(2) mild, ~(3) 110derately severe, :'(4) malignant.
u a hyperacute form. which reaults in death on the 3rd or 4th day. However, in
-ny cues, diagnosis can only be eatabliahed by aerologic teata}'QaJ JJ;/' 1]./,
In a study of yellow fever accidentally contacted in laboratoriea, it was
found that mild caaea •how many of the ch&racteriatic signa and ayaptOIIIS of the
severe cases?]/) The aaclclle-back type of temperature curvu and typical pulae
b. Prodromal aymptoma are uaually abaent, but if present are very vague
The onaet 1a usually very audclan ancl patients frequently r....a,er the aact
~ ~1 ,r,9 .. s-260 l
//
hour when they were taken ill ;'C.!.U' ~/' E/' 1]./) In general the symptoms
vomiting, hiccoughs, chilliness, pain in back and weakness; while the signs
.!!!/, 11:./, 1].I, ~/) During the period of infection which lasts about 3 days,
the virus is present in the circulating blood. The patient feels extreaely ill
fluahed face, awollen lips, conjunctival injection, bright red tongue and a
The patient suddenly feels better since his ache and pains are less severe.
Due to venous stasis, the face is no longer swollen and a •usky pallor replacu
('(23/)
the bright red of the active infection or congestion stage. --
this period free virua is not uaually preaent in the circulating bloocl. Berry
antibodies in the blood of patients during this period.:'Q/) Bowever, the tasllllia
2
and its affects resulting from the vi:us are manifestedi@/) The classical
symptoms of yellow fever become fully developed and the temperature ri1e1 again
but seldom reaches its previous maximum.:·~/) The pulse remain slow, leukopenia
troublesome and vomitus usually contains alter blood described as black vomit.
:'QI, ]]_/, ]1/, J:1./, 25/, Jl/) The gums become swollen, spongey and bleed
spontaneously or on light pressure. The tendency to hemorrhage is marked,
ecchymoses may develop while melena, albuminura, anuria or oligunia are common.
The toxemia of yellow fever affects the liver, heart, the kidney and the blood
recovery from the infection is usually rapid and complete. Deaths usually occur
on the 6th or 7th day, seldom later than 10 days after onset.
2. INCUBATI-ON PERIOD:
~culation of the virus and the onaet of 1yrapt0111 is C0111110nly accepted &a 3
tho 10 days/(];]:/, }Jl,/) The most enct information concerning the incubation
period of yellow fever has resulted from infection of hUJl&n volunteers by Reed.
were 2 hours leu than 3 days and 2 hours more than 6 days. Carter observed an
of urban yellow fever, the incubation period ii aeltlom more than 6 days; _/)
··c2s
3
:QI, !:.I, 2!, 2.I, J..I, §.I, 2./, J-.2.I, .!..V, 1:J:.l, 111, lf!./, ,!11, 11./, J.1./, ~/, 1Q/) .
3. },()RTALITY:
shown that for every case diagnosed, there are great numbers of mild cases
never detected. Mortality rates of yellow fever vary according to the clinical
severity of the disease while clinical severity of the disease depends upon the
Africa the fatality rate in the native population is between 5 and 10 percent
including clinical cases.:(]/' J:1/) However, the mortality rate in Aedes aegypti
transmitted urban epidemics elating from 1646 to 1954, varied from 4 to 100 percent
died of yellow fever in Malaya, SJMLin. During the period of 1793 to 1900, there
were over 100 epideai.ca with 500,000 cases and 100,000 deaths :'(20 percent) in
the United States. When the French were building the Panama Canal in 1879, 22,189
,~ ' .....
concerning yellow fever since 1900 shows 45 epicleadca.:'(~!/) Twenty of tb.ue
been vaccinated with French neurotropic vaccine juat prior to or during the
;'~/) :'(!!/)
epideaic and had. received good hoapitalization. lloaaro and Trejo•
made a special study of 157 caa•• and found that 37 percent of the deatba were
among the unvaccinat ... lo ••aae mortality rate for....._ ucr,t;t tranaittM
4
yellow fever epidemics is valid, since every individual epidemic is dependent' on
each locality.
4.
- - -- -
LENGI'H AND DEGREE OF INCAPACITATION OF HUMAN CASES NOT TERMINATING IN
.....
DEATH
a. Most deaths resulting from the yellow fever virus occur on the 6th
or 7th day and seldom later than 10 days after onset.'°~!) Complications are
infrequent while recovery from the infection is usually rapid and complete in
nonlethal cases. It is the concensua of the ablest clinicians that there are
no late sequelae of yellow fever. No clinical relapse of yellow fever has ever
neutralising antibodies appear so early in disease and remain over a long period
been developed. Autopsies have proven the cauae of death to be other than yellow
fever in a great number of caa .. in which an apparent relapse had been observed
r't28/)
after the 10th day of illneH; \ :
cation.''C.!!l) It is probably asaociated with the dry mouth and fauces that
clev·elop in some patients, -peci&lly if the fluicl intake baa been low. !neuaouia,
sometimes very marked, . .Y last a week or longer after the temperature returns
of yellow fever.r(J/' ]./) Myocardial failure after apparent full recovery baa
been a definite huard.1'Q/' .!Q/) Several dutha occurred frca ayocar4ial failure
5
in African patients who left the hoapital in the early convalescence period.
ever, long convaleacent period, have been recorded in cases infected accidentally
ranging from 15 to 60 days and one case required 80 days before the patient was
able to go back to work. All of these patients were apparently recovered, but
6
• I
REFERENCES
1. Reed, W., Carroll, J., Agramonte, A., and Lazear, J. W.: "Yellow Fever: A
Compilation of Various Publications." U.S. 61st Congr., 3rd sess. Senate
Doc. no. 822, Washington, 1911. Cited from "Viral and Rickettaial Diaeases11 ,
Rivers, T. M. and Horsfall, Frank L., J.B. Lippincott Company, Philadelphia,
3rd Edition, 343-360, 1959.
5. Jungmann, P.: Zur Klinik des Gelbfiebers. Ein Beitrag zur Pathologie der
Leber." Klin. Wchnschr., 8:14-17, 1929.
6. Hindle, E.: "Experimental Study of Yellow Fever." Tr. Roy. Soc. Trop. Med.
and Hyg., 22:405-434, 1929.
10. Burke, A~ W. and Davia, N.' c.': "Note, on Laboratory Infections with Yellow
Fever." Am. Jour. Trop. Macl., 10:419-426, 1930.
11. Annual Report, Rockefeller Foundation, 1928.
12. Obituary, Brit. Med. Jour., 2:615-618, 1927.
13. Theiler, M.: "Studies on Action of Yellow Fever Virus in Mice." Ann. Trop.
Mad., 24:249-272, 1930.
15. Boorman, J.P. T. and Porterfield, J. s.: "A S111.ll Outbreak of Yellow Fever
on the Gold Coast." Trana. Roy. Soc. Trop. MIMI. and Hyg., 51'(4):439-449,1957.
16. llollllro, A. and Trejos, A.: "Clinical and Laboratory FincU.nga of Yellow r...-
in Costa 'lica." l.ev. Biol. Trop. ((Coata lica), 2/2:113-168, 1954.
7
17. Kerr, J. Austin: "The Clinical Aspects and Diagnosis of Yellow Fever."
Yellow Fever, edited by George K. Strode, 2nd Edition, McGraw-Hill Book
Company, Inc., New York, pp. 389-425, 1951.
18. Bauer, J. H.: "Yellow Fever." Public Health Reports, 55'(9):362-371, 1940.
19. Wattley, G, H.: "Clinical Aspects of Four Fatal Cases of Yellow Fever in
Trinidad in 1954." Caribbean Med. Jour., 11'(1-2) :15-23, 1955.
21. BWL Technical Study 7, Part B, Table II. Short Title: XYA-8121, July
1958, pp. 225-229.
22. Klotz, 0. and Belt, T. H.: "Identity of Yellow Fever Lesions in Africa
and America." Amer. Jour. Trop. Med., 10:299-304, 1930.
23. Theiler, Max: "Yellow Fever." Virus and Rickettsial Diseases of Man.
T. M. Rivers and Frank L. Horsfall, J.B. Lippincott Company, Philadelphia,
3rd Edition, pp. 343-360, 1959.
24. Casals, J'ordi and R-eeves, William C.: "Arthropod-Borne Animal Viruaea."
T. M. Rivers and Frank L. Horsfall, J.B. Lippincott Company, Philadelphia,
3rd Edition, pp. 269-285, 1959.
26. Elton, Norman W., Romero, Arturo, and Trejos, ilfronao: "Clinical Pathology
of Yellow Fever." Am. J'our. Clin. Path., 25:135-146, 1955.
27. Dowu, Wilbur G., Thomas, H. G., and Anderson, Charles R..: "Activities
of the Triniclu ltegional Virus Laboratory in 1953 ani.1954 with Special
Reference to the Yellow Fever Outbreak in Trinidad, B.w."I., .Aa. Jour. Trop.
MIid. and Byg., 4:837-843, 1955.
28. Soper, Fred L.: "Yellow Fever." Clinical Trop. Mu., ?aul B. Roeber,
Inc., Mad. Book Dept. of Harper and 'Brothers, . _ York, Nev York, pp.
391-420, 1938.
29. Theiler, Max: ''Yellow Fever, The Virua," Yellow Fever, edited by George
IC.. Strode, 2nd Edition, McGr.,..Bill Book O Jany, Inc., New York, pp.
50-54, 1951.
30. Sulkin, s. Edvard and Pike, Robert M.: "Viral Infections Contracted in
the Laboratory." Nev Eng. Jour. Med., 241:20S-213, 1945.