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Yellow fever
- 1. PRESENTED BY PRAJNYA ELINARDIGAL M.Sc (N) TUTOR
- 2. INTRODUCTION • Yellow feveris a highly infectious disease,this is produced by Arbovirus (a big group of virus, which are transmitted by insect carriers). • In human beings, it occurs due to the bite of a special type of mosquitoes Culicine. • This disease affect liver and kidneys of the person.
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- 4. AGENT FACTOR Agent-flavivirus fibricusformely classified as a group b arbovirus,is a member of togavirus family. Reservoir of infection: • In forest area, in monkeys and forest mosquitoes, in urban area the reservoir is man . Period of communicability: • Man: blood of patient infective during the first 3-4 days of illness. • Mosquitoes: after an extrinsic incubation period of 8-12 days the mosquito becomes infective.
- 5. HOST FACTOR • Ageand sex-all ages and both sexes are susceptible to yellow fever. • Occupation-person whose occupation brings them in contact with forests(wood cutters, hunters) • Immunity-one attack of yellow fever gives life long immunity, second attacks are unknown. • Infants born of immune mother have antibodies up to 6 month of life.
- 6. ENVIRONMENTAL FACTOR • Climate-atemperature of 24 deg.C or over is required for the multiplication of the virus in the mosquito. • SOCIAL FACTOR-In African, urbanization is leading to the extension of yellow fever. • MODES OF TRANSMISSION: • There are two known cycles of transmission the jungle and the urban cycles.
- 7. a. The jungle(or sylvan)cycle: • The jungle cycle which was discovered in 1930 involves transmission of the disease between monkeys by various mosquitoes. • In the Americas, mosquitoes of the genus Haemagogus are the primary vectors. In Africa, the jungle cycle is maintained chiefly by Aedes mosquitoes, such as Aedes africanus and Aedes simpsoni, but mosquitoes of other genera may also be involved. • Transmission from monkey to man is accidental and is the result of human penetration into an infected focus.
- 8. b.The urban cycle: • The urban cycle involve person to person transmission by Aedes aegypti and is now virtually abolished in the Americans owing to efforts eradicate the vector. • The urban yellow fever is often traced to persons who had been infected in forested areas, and had brought the disease into the city, and less frequently by an infected monkey which has strayed into human settlements and is bitten by an Aedes mosquito.
- 9. RISK FACTORS Anybodywho travels to an area which is known to have the yellow fever virus is at risk of becoming infected - these areas include parts of Africa (especially sub-Saharan Africa), tropical South America, as well as some parts of the Caribbean.
- 10. Cause Yellow fever iscaused by a flavivirus; it is transmitted by the bite of mosquitoes, usually the Aedes aegypti mosquito, which had become infected by biting an infected human or animal (a monkey). An infected mosquito is a source of infection for the rest of its life.
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- 13. Cont….. • Acute Phase •Toxic Phase
- 14. Acute Phase: • Thisphase usually lasts for three to four days. Common symptoms include: • headaches • muscle aches • joint aches • Fever • loss of appetite • shivers • backaches
- 15. Toxic Phase • decreasedurination • abdominal pain • vomiting (sometimes with blood) • heart rhythm problems • seizures • delirium • bleeding from the nose, mouth, and eyes • This phase of the disease is often fatal, but only 15 percent of people with yellow fever enter this phase.
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- 17. DIAGNOSTIC FINDING Ablood test may also reveal drop in white blood cells (leucopenia). The blood tests are known as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). Test results may take several days.
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- 19. MANAGEMENT Jungle yellow fever •Control is difficult ,vaccination of humans with 17D vaccine is the only control measure.
- 20. Urban yellow fever 1.Vaccination:Rapidimmunization of the population at risk is the most effective control strategy for yellow fever. For international use the approved vaccine is the 17D vaccine.
- 21. 2.Vector control: Theobjective of vector control is to reduce rapidly the vector population to the lowest possible level and thereby stop or reduce transmission quickly. 3.Surveillance:Aprogramme of surveillance (clinical, serological, histological and entomological)should be instituted in countries where the disease is endemic, for the early detection of presence of the virus in human population or in animals that may contribute to its dissemination.
- 22. TREATMENT providing fluids oxygen making sure the patient's blood pressure is adequate replacing lost blood kidney dialysis if there is kidney failure treating any secondary infections. Some patients may be given plasma The patient should be kept away from mosquitoes • Prophylaxis: 0.5 mL SC ≥10 days before travel • A single, lifetime dose of yellow fever vaccine is sufficient . • Booster/additional dose for high-risk groups
- 23. Additional doses ofyellow fever vaccine recommended for – Women who were pregnant (regardless of trimester) – Persons who received a hematopoietic stem cell transplant
- 24. Histamine H2 antagonists Famotidine(Pepcid) Nizatidine (Axid) Ranitidine (Zantac)
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- 27. PREVENTION OF YELLOWFEVER: Vaccine A single vaccine dose provides at least 10 years' protection. Vaccine side effects may include: Headaches Low grade fevers Muscle pain Tiredness Soreness at the injection site Infants and elderly people may develop more serious reactions, such as encephalitis (very rare). The vaccine is deemed to be safe for patients aged over 9 months to 60 years.
- 28. The following groupsof people should not have the vaccination: • Children aged less than 9 months in the USA, 6 months in the UK (unless the risk of yellow fever is unavoidable) • Pregnant women (unless the risk of yellow fever is unavoidable) • Breastfeeding mothers • People with weakened immune systems • receiving chemotherapy and/or radiotherapy. • Patients who are allergic to eggs • If the patient is over 60 years of age he/she should discuss whether to have the vaccine with a doctor.
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