Yellow Fever

Yellow fever is an acute, infectious, hemorrhagic viral

disease transmitted by the bite of a female mosquito native to tropical and
subtropical regions of South America and Africa.

Those that survival get immunity from

future infections.

Image from
http://www.cdc.gov/mmwr/preview/mmwrh
tml/mm5144a1.htm
Symptoms
After being infection from the
bite of a female mosquito, there is
three to six days of incubation. After
which, the virus begins its destruction
of its host. The symptoms of the virus
is characterized by sudden onset of
fever, bradycardia (slow heart beat),
and headache. In severe cases,
jaundice from liver damage (hince
“yellow” fever) and hemorrhaging in
the mouth, the eyes and in the
gastrointestinal tract can occur. Once
liver cells and other organ cells are
affected, multi-organ failure can take
place. Fatality of the severe cases is
approximately 20%. Fatality can
increase to 50% during epidemics.
Transmission
Yellow-fever, a flaviviridae
family member, is an enveloped,
positive sensed RNA virus of about
11,000 nucleotides in length. It is
transmitted mainly by Aedes aegypti
and other mosquitoes of the genus
Aedes. These are frequently found in
tropical and subtropical regions on
most continents. Members of this
genus serve as the primary vector of
many infectious diseases of humans
including Dengue fever, West Nile
Virus, Chikungunya, Filariasis, and
Yellow fever. Yellow fever, though
endemic to Africa, was brought to the
Americas by tradeships and slaveships
resulting in severe epidemics. It is
believed that infected mosquitos laid
their eggs in water casks and barrels
in ships that voyaged to the New
World.
Imagefrom http://www.s-
union.com.tw/Download/Insect/ima
ge/Aedes.jpg
Image from http://www.gg.rhul.ac.uk/ict4d/yellowfever/yellowfever.htm

Transmission originates in the monkeys of the rainforest regions of

Africa which serve as an animal reservoir for replication and the survival on
Yellow fever. Slyvatic (or Jungle) Yellow fever transfers to mosquitoes when
mosquitoes bite an infected monkey. Next, the infected mosquitoes transfer
the virus to humans in the humid and semi-humid savannahs in Africa.
Yellow Fever can then be transmitted from human to human via Aedes
aegypti mosquitoes. This can lead to epidemics in urban areas if the
conditions are suitable and if people are not vaccinated. Larger outbreaks of
Yellow Fever can occur in population dense areas.

Mechanisms of Replication
There are several steps to the infection and replication of the Yellow
fever virus. First, the RNA virus binds to monocytes, macrophages, or
dendritic cells via specific receptors and are internalized in an endosomal
vesicle (See Figure Below). Next, the envelope and the vesicle fuse together
due to a pH decrease resulting in the protein shell of the virus (capsid) to
release its genome into the cytoplasm of the cell. The proteins encoded by
the virus genome are then replicated by using the host cell transcription
processes to make the necessary proteins for the new yellow virus. The new
viral genome is replicated in the endoplasmic reticulum (ER) and then
packed into vesicles in the Golgi apparatus via the host protein furin. Lastly,
the vesicle is release from the host cell as a mature virus.
Image from http://bilbo.bio.purdue.edu/~viruswww/Kuhn_home/flaviprojtxt.html

Treatment & Prevention

Treatment includes rehydration and pain relief, but there is no cure.
Therefore, prevention remains to be the primary means of management.
There are three major ways to prevent infection of Yellow Fever. First,
vaccination is highly recommended to non-native people to endemic regions
as they are more susceptible to severe symptoms. In addition, the WHO
(World Health Organziation) recommends vaccination of children from 9 to
12 months of age who lived in high risk areas. Several countries in Asia at
risk for Yellow Fever outbreaks require compulsory vaccination to avoid the
spread of the virus. Secondly, insecticides can be used to kill larvae and
adult Aedes aegypti mosquitoes help to reduce their numbers and control
the pest. Lastly, prevention of Yellow Fever can be achieved by the
avoidance of mosquitoes in endemic areas by using with mosquito nets, bug
spray, and avoiding being out during early morning and early evening when
mosquitoes feed the most.

Conclusion
Yellow fever has long been a major concern for regions of Africa and
South America due to the severity of the symptoms and mosquito
infestations. However, spread to non-endemic regions remains a constant
threat. The replication of Yellow Fever in its host causes a variety of
unpleasant symptoms which can lead to death. However, the spread of the
virus human to human by mosquito vectors in dry, humid regions can be
limited by vaccination, pest control, and mosquito avoidance.