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Yellow fever
Other Resources UpToDate PubMed

Yellow fever

Contributors: Edith Lederman MD, Noah Craft MD, PhD, Paritosh Prasad MD, Susan Burgin MD
Other Resources UpToDate PubMed


Yellow fever is a mosquito-borne viral infection of the Flaviviridae family. The disease is endemic to equatorial regions of Africa, South America, and Central America. The mortality rate of yellow fever in general is 8%; however, patients that develop severe disease have a mortality rate of 20%-50%.

The incubation period of yellow fever is 3-6 days, and many cases are mild or asymptomatic. Symptomatic patients experience a sudden onset of fever, chills, myalgia, headache, facial flushing, prominent low back pain, conjunctival redness, loss of appetite, and nausea / vomiting, which lasts for 3-4 days. This is followed by a period of remission with resolution of symptoms for 48 hours, and approximately 85% of patients will clear the infection at this stage.

The remaining 15% of patients will develop a hemorrhagic disease (malignant yellow fever) consisting of hepatitis, jaundice, abdominal pain, hematemesis, melena, petechiae, and hemorrhaging from the mouth, nose, and eyes. Fever recurs with relative bradycardia. Renal dysfunction often occurs, resulting in anuria. Disseminated intravascular coagulopathy, myocarditis, seizures, and coma may occur. Mortality varies according to level of supportive care received: up to 50% of patients in this phase will die within 2 weeks.

Person-to-person transmission is not possible. Aedes, Haemagogus, and Sabethes mosquitoes are the vectors, and forest monkeys are reservoirs of the disease.


A95.9 – Yellow fever, unspecified

16541001 – Yellow fever

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Differential Diagnosis & Pitfalls

  • Malaria
  • Leptospirosis
  • Crimean-Congo hemorrhagic fever
  • Dengue fever
  • Rift Valley fever
  • Zika virus infection
  • Oropouche fever
  • Influenza
  • Hepatitis (eg, Hepatitis A virus infection, Hepatitis B virus infection, or Hepatitis C virus infection)
  • Ricin poisoning, inhaled
  • Aflatoxicosis
  • Enteric fever
  • Rickettsial diseases
  • Other viral hemorrhagic fevers
  • Hantavirus Hemorrhagic fever with renal syndrome
  • Carbon tetrachloride poisoning

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Last Reviewed:03/20/2017
Last Updated:02/12/2024
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Yellow fever
A medical illustration showing key findings of Yellow fever (Period of Infection) : Chills, Fever, Headache, Vomiting, Leukopenia, Anorexia, Myalgia
Copyright © 2024 VisualDx®. All rights reserved.