

What is yellow fever?
Yellow fever is a serious viral infection, transmitted by mosquitoes in tropical regions. It has both an urban cycle and a jungle cycle that relies on monkeys as carriers ('sylvatic cycle').In mild cases the symptoms are similar to influenza, but serious cases develop a high temperature and may have a series of after effects, such as internal bleeding, kidney failure and meningitis.A classic feature of yellow fever is hepatitis, which is the reason for the yellow colouring of the skin (jaundice) and the name of the disease.Yellow fever can cause sudden epidemics, with a mortality rate of almost 50 per cent. Although a safe, efficient vaccine has been available for the last 60 years, epidemics still occur, constituting a health risk in tropical regions. The disease is covered by the International Quarantine Regulations, which are taken very seriously by authorities everywhere. Therefore, the vaccine has to be administered by a specially authorised doctor. In the UK you can only obtain the yellow fever vaccination from a designated Yellow Fever Clinic.
What causes yellow fever?
Yellow fever virus belongs to the Flaviviridae family, other members of which cause dengue fever and Japanese encephalitis. The virus is introduced into the bloodstream via the saliva of the mosquito as it bites. The virus can then be transported around the body and reproduce itself in a variety of the body's cells, usually the liver, kidneys and blood vessels. In serious cases, these cells may become damaged themselves.In addition, the cells of the immune system are affected and release large quantities of signalling substances. These substances are the cause of the normal disease symptoms, such as muscular pain and fever, which are also observed in influenza.
How is yellow fever passed on?
The virus is transmitted among humans by a couple of species of mosquito, including Aedes egyptii, which can also transmit dengue fever. It is an unexplained fact that despite the presence of the Aedes mosquito in Asia, yellow fever is limited to Africa and South America. In its original jungle cycle, the mosquito sucks the blood of an infected monkey. The mosquito develops a permanent infection, in which the virus accumulates in its salivary glands. Then the mosquito bites another monkey, which then also becomes infected with the virus. A person travelling through the jungle may also become infected by an infected mosquito. When this person returns to urban areas, a new cycle begins. Urban cycles start when an infected traveller returns from the jungle. A mosquito bites the traveller, who then becomes infected and passes the virus on to other people, and either an epidemic breaks out, or an endemic situation is perpetuated.
