Background
Yellow fever (YF) is a mosquito-borne infection that is caused by the YF virus and is endemic to Africa and South America. It is characterized by variable symptoms ranging from a minimal flulike illness to one that may be complicated by a toxic phase characterized by hemorrhage, hepatic failure, proteinuria, renal failure, and death.
Overall, YF reemergence has occurred since 1985, as reflected in the number of cases per year officially reported to the World Health Organization (WHO). Approximately 200,000 cases occur annually; 80-90% of those reported are from sub-Saharan Africa, primarily West Africa. YF is reemerging in South America. In addition, Aedes aegypti has repopulated large swaths of Central America, as well as the Caribbean coastal areas of the United States and most of Florida, allowing the potential reemergence of yellow fever in these areas.
Supportive care is the only treatment. Mortality is 20-50%. Prevention using the live-attenuated 17D vaccine is highly efficacious.
Immediately report all suspected or confirmed cases of YF to local and state health departments, which then report immediately to the Division of Global Migration and Quarantine (1-404-498-1600) or Division of Vector-Borne Infectious Diseases (1-970-221-6400), Centers for Disease Control and Prevention (CDC). If local or state health departments cannot be reached, contact the CDC directly.