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TEXTBOOK YELLOW FEVER arranged by Kel 7 (3B)

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 TEXTBOOKS
communicable disease epidemiology course
“Yellow Fever”

Arranged by:
Dr. dr. Wulan Pingkan Julia Kaunang GrndDip, M.Kes, DK
Maria Frya Paisa (211111010055)
Clarissa Evania S. Kusnaedi (211111010065)

FACULTY OF PUBLIC HEALTH

SAMRATULANGI UNIVERSITY MANADO
2022

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 FOREWORD
With the love of God Almighty who has given health and with the cooperation of our
group, so that we can compile a paper for the Epidemiology of Infectious Diseases course
with the title "Yellow Fever".

Werealize that this paper is far from perfect because of our shortcomings, both in
experience and knowledge. We hope that readers and supporting lecturers can provide
criticism and suggestions to build this paper even better.

Manado, 23 October 2022

Compiler

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 TABLE OF CONTENTS
FOREWORD .................................................................................................................. ii
TABLE OF CONTENTS .............................................................................................. iii
1.1 Background ............................................................................................................ 1
1.2 Formulation of the problem ................................................................................... 1
1.3 Authorship Purpose ............................................................................................... 1
CHAPTER II LITERATURE REVIEW ..................................................................... 3
2.1 What is yellow fever? ............................................................................................ 3
2.2 Who discovered the yellow fever? ........................................................................ 3
2.3 When was yellow fever discovered? ..................................................................... 4
2.4 In which countries have the most cases of yellow fever?...................................... 4
2.5 Why does someone get yellow fever? ................................................................... 4
2.6 How to handle and control the yellow fever disease? ........................................... 5
CHAPTER V CLOSING ............................................................................................... 8
3.1 Conclusion ............................................................................................................. 8
3.2 Suggestion ............................................................................................................. 8
BIBLIOGRAPHY ........................................................................................................... 9

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 CHAPTER I INTRODUCTION
1.1 Background
Yellow Fever or Yellow Fever is a disease caused by mosquito species that can
be found in various countries, especially in Africa and South America. For tourists
who want to go to certain areas with mosquito species that cause Yellow Fever,
vaccinations will be given. In mild cases of Yellow Fever, sufferers will experience
symptoms of fever, headache, nausea and vomiting. In serious cases, this disease can
attack or damage the heart, liver and kidneys of sufferers fatally.

This fever is included in the acute viral hemorrhagic fever disease which is
transmitted by using mosquitoes as disease vectors. The death rate for sufferers of
Yellow Fever is in the 20-50% but for the category of severe cases it can reach
50%.(MOH, 2017).

There is no specific cure for this disease yet. However, there are efforts to manage
symptoms, limit complications, and carry out prevention such as vaccination. A single
dose of vaccination can protect humans from this disease for life. In an outbreak
situation, vaccination for this disease will be given especially to residents in affected
areas who have not yet received the vaccine.(MOH, 2017)

1.2 Formulation of the problem

1. What is yellow fever?
2. Who discovered the yellow fever?
3. When was yellow fever discovered?
4. In which countries have the most cases of yellow fever?
5. Why does someone get yellow fever?
6. How to handle and control the yellow fever disease?

1.3 Authorship Purpose

1. Know and understand the definition of yellow fever
2. Knowing the discoverer of yellow fever
3. Know and understand when the discovery of yellow fever
4. Know and understand the places where yellow fever breeds
5. Know and understand how someone gets yellow fever

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6. Know and understand the handling and control of yellow fever

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 CHAPTER II LITERATURE REVIEW
2.1 What is yellow fever?
Yellow fever (Yellow Fever) or other name Black Vomit, is a disease caused by an
RNA virus, namely Flavivirus which belongs to the Arbovirus group of the Togaviridae
family. This disease is a quarantine disease that has received many reports in various
parts of the world(Soedarto, 2019).

This fever is included in the acute viral hemorrhagic fever disease which is
transmitted by using mosquitoes as disease vectors. The death rate for sufferers of
Yellow Fever is in the 20-50% but for the category of severe cases it can reach 50%
(KEMENKES, 2017).

According to the CDC, most people infected with this virus will not feel sick or only
experience mild symptoms. These people will feel sick when symptoms appear such as
fever, headache, back or muscle pain in the 3-6 days after infection. Nearly 12% of
sufferers have other symptoms that make the disease serious, namely jaundice, bleeding,
shock, organ failure and even death.(CDC, 2022).

According to WHO, this yellow fever refers to a fever that affects some patients.
This virus is endemic in the tropics of Africa, Central and South America. But large
epidemics of this disease occur because a patient brings this disease to areas with dense
populations, high numbers of mosquitoes and in areas where most people have low
immunity.(WHO, 2019).

2.2 Who discovered the yellow fever?

The discoverer of Yellow Fever or Yellow Fever is Carlos J. Finlay who is an
epidemiologist from Cuba. He succeeded in discovering the fact that Yellow Fever is
transmitted by mosquitoes from infected people to healthy humans.

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 In 1879, he was commissioned by the Cuban government to work with the North
American commission to study the causes of Yellow Fever and was elected to the Fifth
International Sanitary Conference in Washington, DC as Cuba's representative. It was
then, he stated that the vector of this Yellow Fever was Culex fasciatus or called Aedes
aegypti nowadays.(Britannica, 2022).

2.3 When was yellow fever discovered?

Yellow Fever is believed to have come from Africa and spread to South America via
the slave trade in the 16th century. In the 17th century, several cases of massive epidemics
were identified in America, Africa and Europe. Then in the 19th century, In 1879, a Cuban
scientist, Finlay, suggested that the cause of Yellow Fever was the vector of the Aedes
aegypti mosquito.

2.4 In which countries have the most cases of yellow fever?

In forest areas, naturally flaviviruses will develop and multiply by infecting the bodies
of primates such as monkeys and chimpanzees. This flavivirus can be transmitted to
humans by mosquitoes as the disease vector. The type of mosquito that is the vector for
Yellow Fever in African forest areas is Aedes Africanus and other Aedes species.
Meanwhile in South America, it is spread through the Haemagogus and Sabethes vectors.
In urban areas in Africa and South America, the transmission vector is Aedes Aegypti.

Yellow Fever is believed to have come from Africa and spread to South America via
the slave trade in the 16th century. In the 17th century, several cases of massive epidemics
were identified in America, Africa and Europe. Then in the 19th century, yellow fever
was believed to be one of the most dangerous infectious diseases for humans. This disease
is recorded as an endemic disease in 31 countries on the African continent and 13
countries in Latin America. WHO estimates that yellow fever causes 200,000 cases of
infection and 30,000 cases of patient death per year in areas where the population is not
vaccinated, and nearly 90% of infections of this disease occur in Africa (Wahyuni, 2021).

2.5 Why does someone get yellow fever?

Yellow fever is an acute systemic disease that occurs due to infection with a
flavivirus carried by infected mosquitoes. Mosquitoes that become flavivirus vectors are

4
usually A. aegypti mosquitoes. This mosquito will attack the host (humans and monkeys)
which can damage the liver, heart, kidney and digestive system.

This flavivirus from the Togaviridae family has a diameter of 40-50 nanometers with
a nonglycosylated protein capsid, small polypeptides and a glycoprotein coat. The virus
will develop by multiplying in the cytoplasm and its maturation occurs through the
intracytoplasmic membrane, especially in the endoplasmic reticulum. (Soedarto, 2019).

The risk factor for someone being infected with Yellow Fever could be because the
area where he lives or visited is a place for mosquito species that carry Flavivirus. In
addition, the act of being indifferent, or passing the Yellow Fever vaccination while
traveling can be a risk factor for someone being infected with Yellow Fever

This fever is also used as an acute viral infection that has a short duration and various
mortality rates. Someone who has been infected will suddenly get typical symptoms such
as fever, chills, headache, back and muscle pain in all parts of the body, fatigue, nausea
and vomiting.

The pulse will be weak and slow even though the body temperature rises. Moderate
jaundice is sometimes detected early in the disease and becomes more pronounced.
Sometimes albuminuri is also detected clearly and can cause anuria.

Lecopenia may also appear earlier and become more pronounced on the fifth day.
Generally the infection will improve at this stage. During a brief remission of hours to a
day, some cases of infection will progress to a more severe stage of intoxication.
Symptoms of this stage are hemorrhagic symptoms such as nosebleeds, gingival bleeding,
hematemesis, melena, kidney and liver failure and 20-50% of jaundice can be fatal. Total
case mortality among indigenous people in endemic areas is around 5% but can be as high
as 20-40% in certain outbreaks.(Endris, 2021).

2.6 How to handle and control the yellow fever disease?

Even though cases of yellow fever have not been found in Indonesia, this disease
should always be prevented, so that everyone travels to areas that are likely to cause
someone to be infected with yellow fever. Yellow fever vaccination is also recommended
by WHO and the Indonesian Ministry of Health for international travel.(Revelation,
2021).

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 Transmission of yellow fever can be through mosquito bites, flavivirus carriers with
an incubation period of between 3-6 days. The flavivirus will enter the human's blood and
he will have a fever on the third or fourth day after being infected. This disease will spread
quickly if in one family or group there are members whose bodies are susceptible to
disease.

For transmission of this disease, it is divided into 3 types, namely:

- Sylvatic type
 Mosquitoes will attack primates to be infected with flavivirus and cause these
primates to be exposed to Yellow Fever
 Mosquitoes will generally bite primates or other humans who are in the forest
 This type can occur in tropical rain forest areas
- Intermediate Type
 The yellow fever virus can be transmitted from primates to humans and fellow
humans with the same vector, namely the A. aegypti mosquito
 This type of transmission is common in Africa
- Urban Type
 Transmission of the virus to humans is via the Aeges Aegypti mosquito vector
 This transmission would be so vulnerable that it would give rise to epidemics
of yellow fever in many areas

Although there is no specific treatment or treatment to cure this disease, there are
several methods of treatment such as:

a) Administration of supplemental oxygen

b) Blood pressure is kept stable by administering intravenous fluids
c) Blood transfusion procedure as a precaution if the patient has anemia due to bleeding
d) Dialysis procedure for patients with kidney failure
e) Administration of fever and pain relievers and antibiotics(Pittara, 2022)

Yellow fever can be prevented by carrying out vaccination campaigns for people who
want to go to areas that have the potential to spread yellow fever. A person can be
vaccinated against Yellow Fever at least ten days before the scheduled departure. The age

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level that can receive this disease vaccination is 9 months to 60 years so that a person
does not experience the risk of brain inflammation until death(Revelation, 2021).

To control this disease, there are things that must be considered, namely during the
extrinsic incubation period, where the time needed for the virus in the mosquito's body to
cause humans to become infected with the disease starts when the virus enters the
mosquito's body. The incubation period is usually around 9-12 days in tropical
temperatures. If someone is infected, the virus that is in the mosquito's body will remain
there until the animal dies.

The Eliminate Yellow fever Epidemics or EYE strategy issued in 2017 is a new
breakthrough that has never been sparked before. With more than 50 active partners,
EYE's partners support 40 countries in Africa and America who are at risk of exposure to
Yellow Fever to prevent, detect and take this outbreak seriously. EYE was created to
protect at-risk populations, prevent this disease from spreading internationally and
contain it quickly. It is estimated that around 2026 there will be 1 billion people who will
be protected from exposure to this disease.

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 CHAPTER V CLOSING
3.1 Conclusion
Yellow Fever is believed to have come from Africa and spread to South America via
the slave trade in the 16th century. In the 17th century, several cases of massive epidemics
were identified in America, Africa and Europe. Even though cases of yellow fever have
not been found in Indonesia, this disease should always be prevented, so that everyone
travels to areas that are likely to cause someone to be infected with yellow fever. Yellow
fever vaccination is also recommended by WHO and the Indonesian Ministry of Health
for international travel.

3.2 Suggestion
It is hoped that we can carry out the Yellow Fever vaccination when traveling abroad.

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 BIBLIOGRAPHY
Britannica, E., 2022. Carlos J. Finlay. [Online] Available at:
https://www.britannica.com/biography/Carlos-J-Finlay[Accessed 26 November
2022].
CDC, 2022. Yellow Fever Virus. [Online] Available at:
https://www.cdc.gov/yellowfever/index.html[Accessed 26 November 2022].
Endris, A., 2021. Encyclopedia of Various Diseases: Chicken Pox to Epilepsy. Indonesia:
Hikam Pustaka.
KEMENKES, 2017. Guidelines for Prevention and Control of Yellow Fever. Indonesian:
sn
Pittara, 2022. Yellow Fever. [Online] Available at: https://www.alodokter.com/demam-
kuning[Accessed 25 October 2022].
Soedarto, 2019. Synopsis of Tropical Medicine. Indonesia: Airlangga University Press.
Wahyuni, D., 2021. Advanced Basic Biomedical Textbook. Indonesia: Deepublish.
WHO, 2019. Yellow Fever. [Online] Available at: https://www-who-
int.translate.goog/news-room/fact-sheets/detail/yellow-
fever?_x_tr_sl=en&_x_tr_tl=id&_x_tr_hl=id&_x_tr_pto=wapp[Accessed 30
November 2022].

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