Family doctor

OSG

Medication

YELLOW FEVER - a patient's guide

Abstract

Yellow Fever is increasing in developing countries, largely due to urbanisation and a lack of mosquito control. This article describes the vaccination process for travellers.

yellow fever

Introduction

Yellow Fever - so called because one of the early symptoms of infection is jaundice - is now being classified as a 're-emerging disease'. This unfortunate situation means that disease control is deteriorating and that the incidence of the illness is increasing in affected areas of the world.

A 1960's copy of Manson's Tropical Diseases textbook states ' formerly Yellow Fever was the most dreaded disease in the world, but so effective have been the prophylactic measures perfected by medical science, that it is no longer such an important factor.'

Statistics from the World Health Organisation show that the last 5 years have seen the highest rates of Yellow Fever since 1948. Most recently there have been outbreaks in many parts of South America, including the large city of Santa Cruz in Bolivia. In general, this has been a result of urbanisation and a lack of mosquito control in the rapidly growing cities of these countries.

What is it?

Yellow Fever is a mosquito borne disease that is limited to certain areas of South America and Africa.

It is the only disease that still requires official proof of vaccination when entering or leaving infected areas. The purpose behind this is not only to protect individuals against contracting this appalling illness but also to limit its spread to uninfected areas of the world. In particular, Australia and many countries in Asia have the mosquito which is capable of carrying this disease and hence are strict about travellers showing their 'yellow card'.

Vaccination

Yellow Fever vaccination can only be administered at World Health Organisation and NZ Ministry of Health approved clinics.

There are certain individuals who should not receive this vaccine and so it is important that you consult with a doctor who specialises in travel medicine to ensure that there is no medical reason for you to avoid the vaccine and that your itinerary does require it. There should always be a doctor on site at the clinic when this vaccine is administered.

There have been a number of recent case reports of travellers who have managed to enter infected areas without vaccination and have subsequently caught the disease and died - this is not an illness to be taken lightly.

After the bite of an infected mosquito, the illness has a short incubation period of around 3-6 days - unfortunately there is no specific treatment and around 20-50% of those infected will die. Vaccination however offers excellent protection for at least 10 years with just a single shot.

We find that around 5% of people will experience mild side effects such as fever, headache, backache and muscle pains which typically occur between 4 and 7 days after the vaccination. A recent study has shown that travellers over the age of 65 are more likely to have side effects from the vaccine and so we recommend older travellers should try to get their vaccination done as soon as possible.

We also ask people to stay in the clinic for half an hour after their vaccine in case of an allergic reaction (which is very rare). Whilst it is always important to take personal anti-mosquito measures, this is one disease where prevention via vaccination really is the only way to go.


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