Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 32-04: Viral Hemorrhagic Fevers + Key Features Download Section PDF Listen +++ ++ Zoonotic viral infection transmitted by the bite of the Aedes mosquito Found in tropical and subtropical South America and Africa Incubation period is typically 3–6 days Adults and children equally susceptible + Clinical Findings Download Section PDF Listen +++ ++ Mild form (85%) Fevers Malaise Retro-orbital pain Nausea Photophobia Bradycardia Severe form (15%) Begins with the same symptoms as the mild form of the disease Then, after initial remission of symptoms, a toxic phase ensues with fever, bradycardia, hypotension, jaundice, delirium, hemorrhage + Diagnosis Download Section PDF Listen +++ ++ Leukopenia, elevated liver enzymes, and bilirubin can occur Proteinuria is present and usually disappears completely with recovery Bleeding dyscrasias with elevated prothrombin and partial thromboplastin times, decreased platelet count, and presence of fibrin-split products, can also occur In the early stages of the disease (up to 10 days), diagnosis is confirmed if yellow fever virus RNA is detected by (RT-PCR) in blood from a person with no history of recent yellow fever vaccination Presence of yellow fever virus-specific IgM antibody and negative ELISA panel for other relevant flaviviruses confirm the diagnosis If ELISA is positive for other flaviviruses, plaque reduction neutralization assay, which measures the titer of the neutralizing antibodies in the serum towards the infecting virus, should be done + Treatment Download Section PDF Listen +++ ++ Supportive measures, including analgesia and hydration No specific antiviral therapy Prevention: a highly effective and safe vaccine is available and should be used when living or traveling to endemic areas Prevention: mosquito control measures