Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/yellow-fever

  The incubation period for yellow fever is 3 to 6 days. Many people do not experience symptoms. Common symptoms include fever, muscle pain, headache, loss of appetite, nausea or vomiting. In most cases, symptoms disappear after 3 to 4 days. […] A small percentage of patients enter a second, more toxic phase within 24 hours of recovering from initial symptoms. High fever returns and several body systems are affected, usually the liver and the kidneys. In this phase, people are likely to develop jaundice (yellowing of the skin and eyes, hence the name yellow fever), dark urine, and abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes, or stomach. Half of the patients who enter the toxic phase die within 7 to 10 days.

• #1 Yellow fever Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/yellow-fever

  Yellow fever has 3 stages: […] Stage 1 (infection): Headache, muscle and joint aches, fever, flushing, loss of appetite, vomiting, and jaundice are common. Symptoms often go away within a week. […] Stage 2 (remission): Fever and other symptoms go away. Most people will recover at this stage, but others may get worse within 24 hours. […] Stage 3 (intoxication): Problems with many organs may occur, including the heart, liver, and kidney. Bleeding disorders, seizures, coma, and delirium may also occur. […] Symptoms may include: Fever, headache, muscle aches […] Nausea and vomiting, possibly vomiting blood […] Red eyes, face, tongue […] Yellow skin and eyes (jaundice) […] Decreased urination […] Delirium […] Irregular heartbeats (arrhythmias) […] Bleeding (may progress to hemorrhage) […] Seizures […] Coma.

• #1 Yellow Fever: What Is It, Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/23162-yellow-fever

  Symptoms range from mild symptoms like body aches and fever to serious symptoms like organ failure. […] The yellow fever virus can have a range of symptoms. Some people may have no symptoms. It can present with mild flu-like symptoms but can also be deadly in its most severe form. You could have flu-like symptoms with aches, pains and fever or you could begin bleeding and develop liver disease. Symptoms take about three to six days to develop. […] If you do have signs and symptoms of yellow fever, they might be less severe or more severe. Less severe symptoms may include: Fever. Headache. Body ache. Tiredness (fatigue). Nausea and vomiting. […] More severe symptoms include: Very high fever. Jaundice (your skin and the whites of your eyes turn yellow). Hemorrhage (bleeding). Shock. Liver failure. Kidney failure. Death.

• #1 Yellow Fever: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/232244-overview

  Yellow fever usually is a mild, self-limited illness consisting of fever, headache, myalgia, and malaise. It typically is divided into three stages: the period of infection, period of remission, and period of intoxication. […] More serious illness presents with the abrupt onset of the following during the period of infection: General malaise, Fever, Chills, Headache, Lower back pain, Nausea, Dizziness. […] In 15-25% of individuals with yellow fever, symptoms recur during the period of intoxication and can progress to fatal illness. This period is marked by the following: Fever, Vomiting, Abdominal pain, Renal failure, Hemorrhage. […] As the disease progresses, additional physical findings include the following: Scleral icterus, Jaundice, Epigastric tenderness, Hepatomegaly. […] The following is also often apparent in severe disease: Petechiae, Purpura, Mucosal bleeding, Gastrointestinal bleeding (gross or occult).

• #1 Yellow Fever – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/arboviruses-arenaviridae-and-filoviridae/yellow-fever

  Symptoms may include sudden onset of fever, relative bradycardia, headache, and, if severe, jaundice, hemorrhage, and multiple organ failure. […] Infection ranges from asymptomatic or mild symptoms in most people to a hemorrhagic fever with a case fatality rate of 30 to 60%. […] Onset is sudden, with fever of 39 to 40 C, chills, headache, dizziness, and myalgias. […] The pulse is usually rapid initially but, by the 2nd day, becomes slow for the degree of fever (Faget sign). […] Nausea, vomiting, constipation, severe prostration, restlessness, and irritability are common. […] Mild disease may resolve after 1 to 3 days. However, in moderate or severe cases, the fever falls suddenly 2 to 5 days after onset, and a remission of several hours or days ensues. […] Jaundice, extreme albuminuria, and epigastric tenderness with hematemesis often occur together after 5 days of illness.

• #1 Yellow Fever Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/232244-clinical

  In approximately 15-25% of cases, remission is followed by the return of symptoms. Viremia is reduced, and humoral-mediated reactions are responsible for marked physical illness. This stage is marked by fever, vomiting, abdominal pain, renal failure, and hemorrhage. Petechiae, ecchymoses, epistaxis, and bleeding from gums and venipuncture sites can progress to melena, hematemesis, and metrorrhagia. […] Jaundice worsens as the levels of transaminases increase, with serum aspartate aminotransferase (AST) levels typically higher than those of alanine aminotransferase (ALT) owing to direct viral injury to skeletal muscle tissue and myocardium. Progressive liver involvement and humoral-mediated responses can lead to consumption coagulopathy. Prolonged clotting and prothrombin times and reduced levels of fibrinogen and clotting factors II, V, VII, VIII, IX, X occur; also, fibrin split products appear.

• #1 Yellow Fever: What Is It, Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/23162-yellow-fever

  About 30% to 60% of the people who have the severe form of yellow fever will die. […] If you have a less severe form of yellow fever, you’ll probably recover from your symptoms in about seven days. You may feel tired and weak for much longer than a week. After you recover, you’ll have immunity to yellow fever.

• #1

  https://journals.lww.com/international-journal-of-surgery/fulltext/2023/10000/the_emergence_of_yellow_fever__outbreak,_symptoms,.46.aspx

  Yellow fever has no known cure, which is one of the reasons vaccinations and other preventative measures are so crucial. Supportive treatment, which includes rest, water, and the use of medications to assist decrease fever and discomfort, aims to control the symptoms. […] After 3 or 4 days, the majority of patients recover fully. However, up to 50% of people who have the most severe yellow fever symptoms will pass away. […] Shock, disseminated intravascular coagulation, coma, death, kidney failure, parotitis, secondary bacterial infections, liver infection are complications that could happen.

• #1 Yellow Fever Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/yellow-fever

  In 15-25% of patients, a fatal infection occurs, resulting in complications like Liver failure, Renal failure, Pulmonary edema, Myocarditis, Secondary bacterial infections, Hemorrhage, disseminated intravascular coagulation, Encephalitis (rare), Shock, or death. […] The mortality risk is 50% for people suffering from a fatal infection. Death usually occurs after 7-10 days of the onset of the toxic phase of yellow fever.

• #1 Yellow Fever – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/yellow-fever

  Confirmation of yellow fever requires laboratory testing is difficult to diagnose (especially during the early stages) because its symptoms can be confused with other common diseases such as malaria, dengue, leptospirosis and Zika virus, as well as with poisoning. Molecular (RT-PCR) testing performed on blood samples can confirm or rule out a suspected diagnosis of yellow fever in the first 10 days of illness. Other blood tests (serology) can detect antibodies produced in response to yellow fever, suggesting that the person has been recently infected or vaccinated. In fatal cases, the virus can also be detected in the liver and other tissues.

• #1 History of Yellow Fever in the U.S.

  https://asm.org/articles/2021/may/history-of-yellow-fever-in-the-u-s

  Yellow fever is caused by a virus in the family Flaviviridae, and it is transmitted by the Aedes aegypti mosquito. […] While many who are infected do not experience any symptoms or have mild symptoms, others have fever, muscle pain, headache, nausea and vomiting. A small percentage of people infected with the virus develop a life-threatening form of the disease that involves high fevers, internal bleeding, vomiting of blood and jaundice which is where the yellow in yellow fever comes from. […] Yellow fever can be difficult to diagnose because it mimics other severe diseases like malaria, leptospirosis and other hemorrhagic fevers. […] Today, the most commonly used yellow fever diagnostics include enzyme-linked immunosorbent assay (ELISA), which tests for antibodies, and reverse transcription polymerase chain reaction (RT-PCR), which tests for viral genetic material. […] RT-PCR testing of the blood can detect the virus within the first few days of infection, but may be unreliable after that point when the patient may become symptomatic. […] All of these components must be taken into account when interpreting a yellow fever test result.

• #1 Yellow Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470425/

  The diagnosis requires a thorough travel history and record of immunization. Patients may present with headache, malaise, jaundice, and myalgias with severe back pain commonly reported. The incubation period is 3-7 days, with most individuals having mild flu like illness. About 15% of cases have severe symptoms including chills, low back pain, headache, and fever. There is a period of remission which may last 24-48 hours. This may be followed by a return of symptoms and marked intoxication. During this stage, the hepatorenal disease is common and carries a high mortality. […] Most cases are subclinical or mildly symptomatic with an excellent prognosis. About 15% of symptomatic patients will develop severe disease. Most will recover, but after a bout of yellow fever, full recovery may take weeks or months. In most cases, there is a reversal of the liver and renal dysfunction. Death occurs in 30% to 50% of patients with severe disease. […] Death often occurs within 2 weeks during the toxic phase of the infection. Unvaccinated travelers to endemic areas are at high risk for developing symptomatic disease compared to the natives, who have acquired immunity.

• #1 Yellow Fever Vaccine – Fit for Travel

  https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/yellow-fever-vaccine

  Yellow fever is a dangerous disease caused by a virus that is transmitted by infected mosquitoes. […] The yellow fever vaccine protects against yellow fever. It is helpful in two ways it protects you as an individual against catching the disease for the whole of your life, and also helps to prevent the disease from spreading further around the world. […] In most people one dose of yellow fever vaccine provides lifelong protection. […] Rarely, serious complications can occur after receiving the yellow fever vaccine. These are more common in those over 60 years of age. […] If you are 60 years of age or older, it is possible for you to receive yellow fever vaccine, but only if you are fit and well, fully understand the risks of vaccination, and have a real risk of getting yellow fever infection at your destination (rather than requiring the vaccine just for certificate purposes).

• #1 Facts about yellow fever

  https://www.ecdc.europa.eu/en/yellow-fever/facts

  Onset of symptoms is sudden, usually 35 days after infection. The disease can cause a wide spectrum of symptoms, from mild to fatal. In clinical cases there is a sudden onset of fever with severe headache, arthralgias and muscle pains. Jaundice may appear on the third day and indicates a poor prognosis. Transaminase elevations are also prognostic. In severe cases there may be spontaneous haemorrhage (coffee ground vomit), renal failure, delirium, coma and death. Mortality of these clinical cases can be as high as 80%, on a par with Ebola, Marburg and other haemorrhagic viral infections. Convalescence is long, often with serious sequelae. […] Viraemia reaches high titres on the day before onset of symptoms, and is generally high enough to infect mosquitoes for the next four days. Immunity is probably lifelong.

• #1 Yellow Fever Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/232244-clinical

  After an incubation period of 3-6 days, most individuals with yellow fever have a mild, self-limited illness consisting of fever, headache, myalgia, and malaise. […] More serious illness develops in 15% of cases and presents with the abrupt onset of general malaise, fever, chills, headache, lower back pain, nausea, and dizziness. Physical findings include pulse-fever dissociation (Faget sign), conjunctival injection, and facial flushing. Significant laboratory findings usually include leukopenia with relative neutropenia. Transaminase levels may rise 48-72 hours after initial symptoms appear. […] Following the period of infection, symptoms and temperature normalize for up to 24 hours. During this time, virus is cleared by antibodies and cellular immune response. The patient may then either recover, as is seen in self-limited illness, or progress to fatal illness during the next stage.

• #1 Yellow fever – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/yellow+fever/yellow+fever+-+including+symptoms+treatment+and+prevention

  Yellow fever can be diagnosed with a blood test, although this is not routinely performed in Australia. […] From 3 to 6 days. […] Yellow fever cannot be spread from person to person. […] There is no specific treatment for yellow fever. Supportive care to treat dehydration and symptomatic relief of pain may be required. […] Vaccination is the single most important measure for preventing yellow fever. Vaccination is recommended for all travellers to countries where yellow fever transmission occurs.

• #1 Yellow Fever Virus (YFV) | Florida Department of Health

  https://www.floridahealth.gov/diseases-and-conditions/yellow-fever/index.html

  After becoming infected, the incubation period of yellow fever is usually three to six days. Illness ranges in severity from a self-limited febrile illness to severe hepatitis and hemorrhagic fever. Symptoms of severe infection are high fever, chills, headache, muscle aches, vomiting, and backache. After a brief recovery period, the infection can lead to shock, bleeding, and kidney and liver failure. Liver failure causes jaundice, the yellowing of the skin and the whites of the eyes. Severe infections can be fatal. […] There is no specific treatment, only supportive care and treatment of symptoms. Aspirin and other non-steroidal anti-inflammatory drugs (such as ibuprofen and naproxen) should be avoided because these may increase the risk for bleeding.

• #2 Yellow fever – Wikipedia

  https://en.wikipedia.org/wiki/Yellow_fever

  Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains particularly in the back and headaches. Symptoms typically improve within five days. In about 15% of people, within a day of improving the fever comes back, abdominal pain occurs, and liver damage begins causing yellow skin. If this occurs, the risk of bleeding and kidney problems is increased. […] Yellow fever begins after an incubation period of three to six days. Most cases cause only mild infection with fever, headache, chills, back pain, fatigue, loss of appetite, muscle pain, nausea, and vomiting. In these cases, the infection lasts only three to six days. But in 15% of cases, people enter a second, toxic phase of the disease characterized by recurring fever, this time accompanied by jaundice due to liver damage, as well as abdominal pain. Bleeding in the mouth, nose, eyes, and the gastrointestinal tract cause vomit containing blood, hence one of the names in Spanish for yellow fever, vomito negro („black vomit”). There may also be kidney failure, hiccups, and delirium.

• #2

  https://www.who.int/health-topics/yellow-fever

  Yellow fever can present with a wide range of symptoms and severity. Once contracted, the yellow fever virus incubates in the body for 36 days. Many people do not experience symptoms, but when these do occur, the most common are fever, muscle pain with prominent backache, headache, loss of appetite, and nausea or vomiting. In most cases, symptoms disappear after 34 days. […] A small percentage of patients enter a second, more toxic phase within 24 hours of recovering from initial symptoms. High fever returns and several body systems are affected, usually the liver and kidneys. […] In this phase, people are likely to develop jaundice (yellowing of the skin and eyes, hence the name yellow fever), dark urine, and abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes, or stomach. Half of these patients die within 710 days.

• #2 Yellow Fever: Symptoms and Treatment

  https://www.webmd.com/a-to-z-guides/yellow-fever-symptoms-treatment

  Yellow fever gets its name from two of its most obvious symptoms: fever and yellowing of the skin. The yellowing occurs because the disease causes liver damage and hepatitis. For some people, yellow fever has no initial symptoms, while for others, the first symptoms appear from three to six days after exposure to the virus from a mosquito bite. […] An infection with yellow fever typically has three phases. The first phase of symptoms can last for three to four days and then, for most people, disappears. The first phase is generally non-specific and cannot be distinguished from other viral infections. […] The initial symptoms of yellow fever are: Fever and chills, Flu-like symptoms such as muscle aches, headache, and vomiting. […] The next phase is remission, which lasts for 48 hours. Patients improve. The majority recover.

• #2

  https://www.nhs.uk/conditions/yellow-fever/

  Yellow fever symptoms usually start 3 to 6 days after being bitten by an infected mosquito, but sometimes they can take longer to appear. […] Some yellow fever symptoms are similar to flu, such as: high temperature, headache, feeling or being sick, aches and pains, loss of appetite, feeling generally unwell. […] These symptoms often last 3 or 4 days. But a small number of people get more serious symptoms within 24 hours of feeling better. […] More serious symptoms include: yellowing of your skin and eyes (jaundice), dark pee, stomach pain, bleeding from your eyes, nose, mouth or stomach you may have blood in your vomit or poo. […] These more serious symptoms can be fatal.

• #2 Yellow Fever Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/232244-clinical

  After an incubation period of 3-6 days, most individuals with yellow fever have a mild, self-limited illness consisting of fever, headache, myalgia, and malaise. […] More serious illness develops in 15% of cases and presents with the abrupt onset of general malaise, fever, chills, headache, lower back pain, nausea, and dizziness. Physical findings include pulse-fever dissociation (Faget sign), conjunctival injection, and facial flushing. Significant laboratory findings usually include leukopenia with relative neutropenia. Transaminase levels may rise 48-72 hours after initial symptoms appear. […] Following the period of infection, symptoms and temperature normalize for up to 24 hours. During this time, virus is cleared by antibodies and cellular immune response. The patient may then either recover, as is seen in self-limited illness, or progress to fatal illness during the next stage.

• #2 Yellow Fever – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/yellow-fever

  Once contracted, the yellow fever virus incubates in the body for 3 to 6 days. Many people do not experience symptoms, but when these do occur, the most common are fever, muscle pain with prominent backache, headache, loss of appetite, and nausea or vomiting. In most cases, symptoms disappear after 3 to 4 days. A small percentage of patients, however, enter a second, more toxic phase within 24 hours of recovering from initial symptoms. High fever returns and several body systems are affected, usually the liver and the kidneys. In this phase people are likely to develop jaundice (yellowing of the skin and eyes, hence the name yellow fever), dark urine and abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Half of the patients who enter the toxic phase die within 7 – 10 days.

• #2 Yellow Fever: Symptoms and Treatment

  https://www.webmd.com/a-to-z-guides/yellow-fever-symptoms-treatment

  Unfortunately, a third, more toxic phase of infection occurs for 15% to 25% of patients. Ultimately, a condition called viral hemorrhagic fever can develop, with internal bleeding (hemorrhaging), high fever, and damage to the liver, kidneys, and circulatory system. The World Health Organization estimates that up to 50% of people worldwide who reach this severe phase of infection die, while half recover. […] The third-phase symptoms of yellow fever can include: Jaundice (liver damage), which causes yellowing of the skin and eyes, Hepatitis (inflammation of the liver), Internal bleeding (hemorrhaging), Vomiting blood, Shock, Multisystem organ failure leading to death.

• #2 Yellow Fever Transmission, Symptoms, Treatment, Vaccine

  https://www.medicinenet.com/yellow_fever/article.htm

  In addition to the above symptoms, the following symptoms and signs may also develop: Abdominal pain, Jaundice, Bleeding from the gums, nose, eyes, and/or stomach, Blood in the stool and blood in the vomit, Easy bruising of the skin, Kidney failure, Confusion, Seizures, Coma. […] The period from contracting the infection to the development of symptoms (incubation period) is generally between three to six days.

• #2 Yellow Fever Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/232244-clinical

  Hepatorenal disease carries a mortality rate of 20-50%; with death occurring 7-10 days after onset of symptoms. The terminal phase is marked by delirium, stupor, and coma due to cerebral edema and microscopic perivascular hemorrhage. […] Physical examination findings during early yellow fever include fever, relative bradycardia for the degree of fever (Faget sign), conjunctival injection, and skin flushing. […] Other physical findings, such as scleral icterus, jaundice, epigastric tenderness, and hepatomegaly, develop as disease progresses. Early appearance of jaundice indicates a poor prognosis. […] In late stages of disease, shock and multiorgan dysfunction syndrome (MODS) dominate the clinical picture. These septic patients present with tachycardia, hypothermia or hyperthermia, and hypotension. Individuals who are severely hypoperfused appear mottled and cyanotic. They are also often obtunded. […] Tachypnea and hypoxia with impending respiratory failure may develop as a consequence of sepsis and acute respiratory distress syndrome (ARDS).

• #2 Yellow fever : symptoms, treatment, prevention – Institut Pasteur

  https://www.pasteur.fr/en/medical-center/disease-sheets/yellow-fever

  Many people infected with yellow fever virus remain asymptomatic. For those who do experience symptoms, after an incubation period of three to six days the illness typically begins with a fever, chills, muscle pain and headaches. At this point, it could be confused with flu, dengue or malaria. In severe forms, there is a temporary remission after three days, followed by the onset of a hemorrhagic syndrome with black vomit, jaundice (which causes yellowish skin, hence the „yellow” in the disease name) and renal problems (albuminuria). Death then occurs in 20 to 60% of cases, after delirium, seizures and coma. […] All curable forms convey lifelong immunity.

• #2 Yellow fever – Wikipedia

  https://en.wikipedia.org/wiki/Yellow_fever

  Among those who develop jaundice, the fatality rate is 20 to 50%, while the overall fatality rate is about 3 to 7.5%. Severe cases may have a mortality rate greater than 50%. […] Yellow fever can lead to death for 20% to 50% of those who develop severe disease. Jaundice, fatigue, heart rhythm problems, seizures and internal bleeding may also appear as complications of yellow fever during recovery time.

• #2 Yellow Fever – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/arboviruses-arenaviridae-and-filoviridae/yellow-fever

  There may be oliguria, petechiae, mucosal hemorrhages, confusion, and apathy. […] Disease may last 1 week with rapid recovery and no sequelae. In the most severe form (called malignant yellow fever), delirium, intractable hiccups, seizures, coma, and multiple organ failure may occur terminally. […] During recovery, bacterial superinfections, particularly pneumonia, can occur. […] Severe cases result in jaundice, delirium, and sometimes often fatal hemorrhagic fever with seizures, coma, multiple organ failure, and death (in 30 to 60%).

• #2 Yellow fever – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/906

  Yellow fever is a notifiable condition that is endemic in South America, the Caribbean, and Africa. Infection may be asymptomatic or cause a biphasic, highly variable illness ranging from a nonspecific mild febrile illness to a potentially fatal hemorrhagic fever. […] The clinical disease is variable, ranging from a nonspecific viral illness to hemorrhagic fever and death. […] Key diagnostic factors include fever, constitutional symptoms, conjunctival injection, relative bradycardia (Faget sign), biphasic illness, hemorrhagic diathesis, signs of renal failure, signs of hepatic failure, and jaundice.

• #2

  https://www.who.int/health-topics/yellow-fever

  Yellow fever is difficult to diagnose, especially during the early stages. More severe cases can be confused with severe malaria, leptospirosis, viral hepatitis (especially fulminant forms), other haemorrhagic fevers, infection with other flaviviruses (such as dengue haemorrhagic fever) and poisoning. Polymerase chain reaction (PCR) testing in blood and urine can sometimes detect the virus in early stages of the disease. In later stages, testing to identify antibodies is needed (IgM).

• #2 Yellow Fever Vaccine – Fit for Travel

  https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/yellow-fever-vaccine

  Yellow fever is a dangerous disease caused by a virus that is transmitted by infected mosquitoes. […] The yellow fever vaccine protects against yellow fever. It is helpful in two ways it protects you as an individual against catching the disease for the whole of your life, and also helps to prevent the disease from spreading further around the world. […] In most people one dose of yellow fever vaccine provides lifelong protection. […] Rarely, serious complications can occur after receiving the yellow fever vaccine. These are more common in those over 60 years of age. […] If you are 60 years of age or older, it is possible for you to receive yellow fever vaccine, but only if you are fit and well, fully understand the risks of vaccination, and have a real risk of getting yellow fever infection at your destination (rather than requiring the vaccine just for certificate purposes).

• #2 Yellow Fever Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/232244-clinical

  In approximately 15-25% of cases, remission is followed by the return of symptoms. Viremia is reduced, and humoral-mediated reactions are responsible for marked physical illness. This stage is marked by fever, vomiting, abdominal pain, renal failure, and hemorrhage. Petechiae, ecchymoses, epistaxis, and bleeding from gums and venipuncture sites can progress to melena, hematemesis, and metrorrhagia. […] Jaundice worsens as the levels of transaminases increase, with serum aspartate aminotransferase (AST) levels typically higher than those of alanine aminotransferase (ALT) owing to direct viral injury to skeletal muscle tissue and myocardium. Progressive liver involvement and humoral-mediated responses can lead to consumption coagulopathy. Prolonged clotting and prothrombin times and reduced levels of fibrinogen and clotting factors II, V, VII, VIII, IX, X occur; also, fibrin split products appear.

• #2

  https://journals.lww.com/international-journal-of-surgery/fulltext/2023/10000/the_emergence_of_yellow_fever__outbreak,_symptoms,.46.aspx

  Yellow fever has no known cure, which is one of the reasons vaccinations and other preventative measures are so crucial. Supportive treatment, which includes rest, water, and the use of medications to assist decrease fever and discomfort, aims to control the symptoms. […] After 3 or 4 days, the majority of patients recover fully. However, up to 50% of people who have the most severe yellow fever symptoms will pass away. […] Shock, disseminated intravascular coagulation, coma, death, kidney failure, parotitis, secondary bacterial infections, liver infection are complications that could happen.

• #2

  https://www.health.nsw.gov.au/Infectious/factsheets/Pages/yellow-fever.aspx

  Symptoms include fever, headache, muscle pain, nausea and vomiting. […] Symptoms of yellow fever include: sudden onset of fever, chills, muscle pain, backache, headache, nausea and vomiting. […] Symptoms usually develop 3-6 days after the virus enters the body. Most patients with symptoms recover after 3-4 days. A small proportion of patients with yellow fever develop severe symptoms and approximately half of those die within 10-14 days. […] If you have the below severe symptoms, speak to your doctor immediately or in an emergency, call 000: bleeding (from the mouth, nose and/or gut), jaundice (yellowing of the skin and eyes), abdominal pain with vomiting, problems with kidney function. […] There is no specific treatment for yellow fever. People can be treated in hospital for dehydration and fever. […] If you have severe symptoms, you may need additional intensive care in the hospital.

• #2 Yellow Fever | Vaccine Information

  http://www.vaccineinformation.org/diseases/yellow-fever/

  Yellow fever is caused by a virus that is transmitted by the bite of an infected mosquito. The word yellow in the name refers to the jaundice from liver damage that affects some patients, causing a yellowing of their skin and eyes. […] There is no cure for yellow fever. Fortunately, the majority of infected patients improve and their symptoms disappear after 3 to 4 days. However, 15% of patients enter a second, more toxic, phase of the disease. About half of the patients who enter the second phase die within 10 to 14 days, the rest recover.

• #3 Yellow Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470425/

  Yellow fever is a mosquito-borne viral illness found in tropical and subtropical areas in South America and Africa. It can present with varying clinical features ranging from a self-limited, mild febrile illness to severe hemorrhage and liver disease. […] The incubation period is 3 to 6 days. Once acquired, the virus quickly spreads to multiple organs in the body. The liver is the most important organ affected by yellow fever. It produces profound jaundice due to liver damage. The kidneys also undergo similar pathological alterations and can lead to acute renal failure. When the upper gastrointestinal (GI) tract is involved, the gastric acid mixed with blood produces what is known as black vomit. Central nervous system (CNS) features include cerebral edema and hemorrhage. Encephalopathy is also a common feature of yellow fever.

• #3 Yellow Fever Transmission, Symptoms, Treatment, Vaccine

  https://www.medicinenet.com/yellow_fever/article.htm

  After infection with the yellow fever virus, many individuals will experience no clinically apparent manifestations of the mosquito-borne disease (asymptomatic), while others will go on to develop a mild, self-limiting flu-like illness characterized by the following symptoms and signs: Fever, Chills, Generalized muscle pain, Back pain, Headache, Malaise, Weakness, Lack of appetite, Nausea, Vomiting. […] Most patients with this initial acute phase of the disease improve spontaneously after approximately three to four days. However, approximately 15% of patients may enter a second phase of the disease that typically appears after a short remission of symptoms (about 24 hours) from the initial phase of the illness. This next toxic phase of the disease is more severe, at which time the high fever returns, and more organ systems become involved.

• #3 Yellow Fever – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/arboviruses-arenaviruses-filoviruses/yellow-fever

  Some people with yellow fever have no or mild symptoms, but others have more severe symptoms such as yellow skin (jaundice), fever, headache, muscle aches, and bleeding. […] Symptoms of yellow fever usually appear about 3 to 6 days after being bitten by an infected mosquito. The first symptoms are headache, dizziness, muscle aches, chills, and mild fever, which begin suddenly. Nausea, vomiting, constipation, extreme fatigue, irritability, and restlessness are common. The face is flushed. […] All of these symptoms subside after a few days. Some people then recover, but others develop a high fever, nausea, vomiting, and severe generalized pain a few hours or days after the initial symptoms subside. The skin turns yellow (jaundice) because the liver is infected. Often, there is bleeding from the nose, mouth, and gastrointestinal tract. People may vomit blood. They may become confused and apathetic. […] Some people become delirious. They have very low blood pressure (shock). Severe infection can cause seizures, malfunction of several organs, and coma may occur; 30 to 60% of people with severe bleeding and fever die.

• #3 Yellow Fever – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470425/

  The diagnosis requires a thorough travel history and record of immunization. Patients may present with headache, malaise, jaundice, and myalgias with severe back pain commonly reported. The incubation period is 3-7 days, with most individuals having mild flu like illness. About 15% of cases have severe symptoms including chills, low back pain, headache, and fever. There is a period of remission which may last 24-48 hours. This may be followed by a return of symptoms and marked intoxication. During this stage, the hepatorenal disease is common and carries a high mortality. […] Most cases are subclinical or mildly symptomatic with an excellent prognosis. About 15% of symptomatic patients will develop severe disease. Most will recover, but after a bout of yellow fever, full recovery may take weeks or months. In most cases, there is a reversal of the liver and renal dysfunction. Death occurs in 30% to 50% of patients with severe disease. […] Death often occurs within 2 weeks during the toxic phase of the infection. Unvaccinated travelers to endemic areas are at high risk for developing symptomatic disease compared to the natives, who have acquired immunity.

• #3 Yellow Fever: Symptoms, Treatment, and Prevention

  https://www.health.com/yellow-fever-8727950

  Symptoms of yellow fever develop about 3-6 days after exposure to the virus. Most people have either mild symptoms or no symptoms at all, but some people will become severely ill from the virus. […] For most people with yellow fever, the illness will feel flu-like with symptoms such as: Fever, Chills, Headache, Muscle pain, Loss of appetite, Fatigue or weakness, Nausea and vomiting. […] These symptoms usually last 3-6 days before improving, though some people report feeling fatigued and weak for months after infection. […] About 15% of people with yellow fever will experience severe illness. They may initially have milder symptoms, but after a brief recovery period (24-48 hours), symptoms return and worsen as the virus affects the body’s organs particularly the liver and kidneys. […] Symptoms of severe infection with yellow fever include: High fever, Jaundice, or yellowing of the skin and whites of the eyes, Nausea and vomiting, Abdominal pain or bleeding, Bleeding from the mouth, nose, and eyes, Dark urine.

• #3 Clinical Features and Diagnosis of Yellow Fever | Yellow Fever Virus | CDC

  https://www.cdc.gov/yellow-fever/hcp/clinical-diagnosis/index.html

  Yellow fever can be a mild febrile illness to severe, sometimes fatal disease, with hepatitis and hemorrhagic manifestations. […] Although most infections are asymptomatic, clinical disease ranges from a mild febrile illness to severe disease with hepatitis and hemorrhagic manifestations. […] In its mildest form, yellow fever is a self-limited infection characterized by sudden onset of fever and headache without other symptoms. […] Other patients experience an abrupt onset of a high fever (up to 104F [40C]), chills, severe headache, generalized myalgias, lumbosacral pain, anorexia, nausea, vomiting, and dizziness. […] Many patients recover uneventfully, but in approximately 15% of infected persons, the illness recurs in more severe form within 48 hours following the viremic period. Symptoms include fever, nausea, vomiting, epigastric pain, jaundice, renal insufficiency, and cardiovascular instability.

• #3 Yellow fever: Symptoms, causes, and prevention

  https://www.medicalnewstoday.com/articles/174372

  These symptoms usually improve after a few days, but around 15 percent of people enter a second stage, or toxic stage. The symptoms are more severe, and they may be life-threatening. […] These include: recurring fever, abdominal pain, vomiting, sometimes with blood, tiredness, sluggishness, lethargy, jaundice, which gives the skin and whites of the eyes a yellow tinge, kidney failure, liver failure, hemorrhage, delirium, seizures, and sometimes coma, arrhythmias, or irregular heartbeats, bleeding from the nose, mouth, and eyes. […] Between 20 percent and 50 percent of people who develop toxic stage symptoms die within two weeks. […] Within 7 to 10 days, yellow fever is fatal in around half of all people who enter the toxic phase.

• #3 Yellow fever | Cause, Symptoms, & Treatment | Britannica

  https://www.britannica.com/science/yellow-fever

  yellow fever appears with a sudden onset of fever, chills, headache, backache, nausea, and vomiting. […] The course of yellow fever is rapid. After the bite of the infecting mosquito, there is an incubation period of several days while the virus multiplies within the body. The onset of symptoms is then abrupt, with headache, backache, rapidly rising fever, nausea, and vomiting. This acute stage lasts two or three days, after which the patient either begins to recover or proceeds to a deeper toxic state marked by high fever, slow pulse rate, and the vomiting of dark blood. Death may occur six or seven days after the onset of symptoms. Because the virus destroys liver cells, jaundice (yellowing of the skin and eyes by deposition of bile pigment) is a common sign in persons with yellow fever. […] The yellow fever patients convalescence is prolonged, but, when recovery does occur, it is complete and is accompanied by a lifelong immunity. For reasons not yet understood, the mortality rate of yellow fever varies greatly. Many persons may experience only a mild infection that lasts a few days.

• #4 Clinical Features and Diagnosis of Yellow Fever | Yellow Fever Virus | CDC

  https://www.cdc.gov/yellow-fever/hcp/clinical-diagnosis/index.html

  A bleeding diathesis can occur, with hematemesis, melena, metrorrhagia, hematuria, petechiae, ecchymoses, epistaxis, and oozing blood from the gingiva and needle-puncture sites. […] Physical findings include scleral and dermal icterus, hemorrhages (e.g., hematemesis, melena, petechiae, ecchymoses), and epigastric tenderness without hepatic enlargement. […] Hyperbilirubinemia might be present as early as the third day but usually peaks toward the end of the first week of illness. […] Elevations of serum transaminase levels occur in severe hepatorenal disease and might remain elevated for up to 2 months after onset.

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