Yellow fever

Symptoms can include sudden onset of fever, chills, muscle aches, headache, nausea and vomiting. Symptoms usually appear between 3 to 6 days after the person is bitten by an infected mosquito and generally last for 3 to 4 days.

Approximately 15 to 25 percent of people with yellow fever may go on to develop bleeding (from the mouth, nose and eyes and or stomach), jaundice (yellowing of the skin or whites of the eyes), abdominal pain and kidney and liver failure. While half of these patients recover the remaining half die within 10–14 days of developing these symptoms.

There is no specific treatment for yellow fever however, encouraging fluids to prevent dehydration and medications such as paracetamol or ibuprofen for the management of fever may be required. Seriously ill patients may require care in an intensive care unit.

Yellow fever is endemic in several African and Central and South American countries and is spread to humans when a person is bitten by an infected mosquito. Humans become infected when entering rainforest and jungle environments and rural and urban areas where mosquitos breed around households. Infected persons can transmit the infection to mosquitos, via a blood meal, up to 5 days after they develop symptoms. The infection is not transmitted from person to person or from animal to person.

The Aedes aegypti mosquito, the main transmitter of the virus, is widely found in urban areas in north and central Queensland and some parts of southern Queensland. While yellow fever does not occur in Australia, quarantine precautions are in place to prevent the introduction of yellow fever virus into Australian mosquitoes. Unimmunised travellers to, and people living in parts of America and South Africa are at risk of infection particularly if visiting jungle and forest areas and rural environments.

Vaccination

Vaccination is the most effective way to prevent yellow fever and is a legal requirement for people travelling through infected areas. If you are vaccinated, you will receive an International Certificate of Vaccination which you must take with you when you travel to countries with yellow fever. A yellow fever vaccination certificate is valid for the duration of the life of the person vaccinated.

Yellow fever immunisation is recommended for:

• people aged 9 months or older travelling to, or living in, areas with a risk of yellow fever virus transmission. Information about risk for specific destinations should be sought from a reputable source, such as the World Health Organization (WHO), prior to travel.
• laboratory staff who regularly work with yellow fever virus.

Yellow fever vaccinations can only be given by approved Yellow Fever Vaccination Centres. Certain groups of people should not receive yellow fever vaccination, including people who are allergic to eggs.

Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems. Possible side effects after receiving the vaccine may include fever, mild headache and tiredness. More serious side effects are extremely rare and may include severe allergic reactions. Contact your immunisation provider if you or your child has a reaction following vaccination which you consider serious or unexpected.

Avoiding mosquitos

While vaccination is considered the most effective way to prevent yellow fever all travellers to parts of Africa and America should avoid being bitten by mosquitos.

Make sure you:

• wear loose-fitting light-coloured clothing with long sleeves, long trousers and socks especially at dusk and in the first few hours after sunset
• use insect repellent containing diethyltoluamide (DEET) or picaridin when outdoors (lotions and gels are more effective and longer lasting than sprays)
• use mosquito-proof tents when camping
• use mosquito nets when sleeping unless accommodation is air conditioned or has mosquito screens on doors and windows.

Border protection measures are in place to prevent yellow fever being introduced into Australian mosquitoes. Disease surveillance, mosquito control and education on mosquito avoidance measures are all required to prevent community outbreaks.

A person who is diagnosed with yellow fever should avoid being bitten by mosquitoes by remaining indoors in mosquito-proof surroundings (e.g. air-conditioned, enclosed buildings or in a room with well-maintained fly screens) for at least 5 days from the onset of fever or until the fever has resolved whichever is later. The person should also be advised to avoid travelling to areas in north or central Queensland during their illness.

The use of personal mosquito repellent and interior spraying with an insect repellent is recommended in affected households.

• 13 HEALTH (call 13 43 25 84)
• Queensland Health immunisation
• https://www.health.gov.au/health-topics/immunisation/about-immunisation (call 1800 671 811)
• Dengue Management Plan 2015 - 2020

For further assistance, contact your local GP, community health centre or nearest public health unit. There are registered Yellow fever immunisation providers throughout Australia. To find your closest provider, click on the following link for a list of Yellow Fever Vaccination Centres

References

Heymann, D.L. (2015). Control of Communicable Diseases Manual, 20th edition. Washington, DC: American Public Health Association.

Australian Government Department of Health. (2022) Australian Immunisation Handbook.(2022). https://immunisationhandbook.health.gov.au/

Australian Government Department of Health. (2019). Yellow fever-general fact sheet. https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-communic-fact...