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Yellow fever - Chem-Bio-Rad Suspicion
See also in: Overview
Other Resources UpToDate PubMed

Yellow fever - Chem-Bio-Rad Suspicion

See also in: Overview
Contributors: David R. Lane MD, Paritosh Prasad 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%.

Although the use of yellow fever as an agent of bioterrorism is unlikely, in a bioterrorist attack it would most likely be dispersed as an aerosol; the release of infected mosquitoes is also feasible. Mosquitoes serve as the natural reservoir and vector: Aedes spp. in Africa and Haemagogus and Sabethes spp. in South America.

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 consisting of hepatitis, jaundice, abdominal pain, vomiting, petechiae, and hemorrhaging from the mouth, nose, eyes, and gastrointestinal tract. Renal dysfunction often occurs resulting in anuria. 50% of patients in the toxic phase will die within 2 weeks. Those who recover experience months of fatigue and have lasting immunity to reinfection.

Person-to-person transmission is not possible.

A vaccine for yellow fever is available. Refer to Management Pearls.


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 - Chem-Bio-Rad Suspicion
See also in: Overview
A medical illustration showing key findings of Yellow fever (Period of Infection) : Chills, Fever, Headache, Vomiting, Leukopenia, Anorexia, Myalgia
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