US Medical Experts Issue Warning on Yellow Fever's Advance

Infectious disease experts in the United States suspect the ongoing yellow fever outbreak in Brazil could carve an epidemic path similar to Zika virus, according to The Washington Post.

Fauci said clinicians need to keep yellow fever on their radar in case they start seeing possible clusters of cases in areas where there are also Zika outbreaks, and also in possible travel-related cases.

Dr. Fauci and Dr. Paules also warned that US territories like Puerto Rico - where more than 37,000 people have contracted Zika since January 2015 - could be vulnerable to outbreaks of yellow fever.

In a Perspectives piece for the New England Journal of Medicine, Dr Fauci and his associate Dr Catharine Paules noted that the latest outbreak of yellow fever comes as Zika virus, which is spread by the same mosquito as yellow fever virus, continues to affect countries throughout the Americas.

Overall, since December Brazil has reported 1,500 suspected cases, 371 of them confirmed, 163 ruled out, and 966 still under investigation.

The number of yellow fever cases reported so far in 2017 is higher than what Brazil normally experiences this time of year, the report said. Now, though, the health ministry is rushing to vaccinate people, sending almost 15 million extra doses to the newly affected areas.

As of March 2, the virus has killed an estimated 220 people, according to an update from the Pan American Health Organization.

Although there is a highly effective vaccine for yellow fever, it is not routinely given in Brazil's major urban centers, they said. He also pointed out that many clinicians in the US have never actually seen a case of yellow fever, so it's important to be aware of and recognize the symptoms, especially in patients who may have recently traveled to areas where Zika is also present.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, acknowledged that while it was too early to panic, the prospect of "urbanized" yellow fever was one that strikes fear in the hearts of public health officials.

During the 2015 outbreak in Angola and Congo, health officials were constrained to administer to each infected person only a fifth of the normal dose. Officials also said that they are anxious about infected people coming from the jungles of Brazil.

"In light of the serious nature of this historically devastating disease, public health awareness and preparedness are critical", wrote Paules and Fauci. Early symptoms include a fever that can mimic flu, followed by a period of remission, and then a stage called "intoxication" - high fever, liver dysfunction and jaundice, and even kidney failure, heart and nervous system dysfunction, and shock. It's taking place primarily in jungle areas, where forest-dwelling mosquitoes are spreading the virus mainly to monkeys.

"The yellow fever outbreak in Brazil is yet another reminder of the dangers posed by mosquito-borne diseases around the world", said Erin Staples, a medical epidemiologist at the CDC.

  • Lila Blake