What's the Best Medicine?
Infectious Disease Experts Are Concerned About A Potential Reemergence Of Yellow Fever In The U.S. Do I Need To Worry?
Experts are warning that yellow fever — which hasn't had a major outbreak in the U.S. Since 1905 — could make a comeback. (Photo illustration: Yahoo News; photo: Getty Image)
When you think of yellow fever and other mosquito-borne illnesses, which are diseases that spread to people when they're bitten by an infected mosquito, you probably assume they don't happen often in the U.S. — and you would be right.
While these diseases are more common in other places of the world, particularly Africa and South America, they are starting to rise in the U.S. In June, for example, malaria was detected in the U.S. For the first time in 20 years. More recently, the first locally acquired case of dengue virus was detected in California.
Experts are now concerned that yellow fever — which hasn't had a major outbreak in the U.S. Since 1905, when it killed 900 people in New Orleans — could make a comeback as well.
What's happeningBaylor College of Medicine recently issued a release stating that cases of mosquito-transmitted virus infections are increasing, especially in the Southern states — which could cause a reemergence of yellow fever.
Infectious disease experts at both Baylor and Stanford School of Medicine published a piece in the New England Journal of Medicine warning about yellow fever and urging that it be prioritized in national pandemic preparedness planning.
Experts say that climate change is playing a role in the uptick of these mosquito-borne diseases in the U.S. "The threat of yellow fever developing in America is closely linked to rising temperatures and climate change," Dr. Sarah Park, medical director at Karius, tells Yahoo Life. "Mosquitos love warm, wet weather."
Do I need to worry?As with many diseases, the seriousness of yellow fever depends on the individual case. However, there's less need to worry now than there was during the last U.S. Outbreak more than a hundred years ago.
Yellow fever can be deadly, but most people have no symptoms or mild symptoms and completely recover, according to the Centers for Disease Control and Prevention. "The mortality rate in modern times is low, thanks to modern medicine and a vaccine that reduces the risk of serious disease," Dr. Linda Yancey, infectious disease specialist at Memorial Hermann Health System in Houston, tells Yahoo Life.
The yellow fever vaccine, which has been available for 80 years, isn't part of standard immunizations in the U.S. And is mainly administered when people are traveling to a place that has active cases, such as Africa or South America, explains Yancey.
That doesn't necessarily mean the U.S. Is or will be 100 percent safe, however. "We are seeing an uptick in several mosquito-borne diseases in the U.S., including malaria and dengue fever," Yancey says. "If those can come back, then there is no reason that yellow fever could not come back as well."
Outbreaks are historically most likely to hit the South, according to Park, along ports such as New Orleans; Galveston, Texas; and along the Mississippi River.
However, as Park points out, "The spread of mosquito-borne diseases in the U.S. Is very limited because we all tend to sleep indoors with air conditioning and there are no native nonhuman primate populations," meaning mosquitos have less opportunity to bite people or animals that can act as hosts.
What can I do about it?First and foremost, get the vaccine, if you're traveling to an area where there's yellow fever. (The CDC has yellow fever maps that can help pinpoint the specifics, too.) "The yellow fever vaccine is safe and offers lifelong immunity against the disease," Park says. "Currently, the vaccine is recommended for people who are age 9 months or older and traveling to or living in areas at risk for yellow fever virus in Africa and South America." She adds that getting the vaccine may be a requirement to enter certain countries.
According to Yancey, your best bet otherwise is to avoid or fend off mosquitos whenever possible. If you'll be outside in an area with mosquitos, she says, you can use repellents such as Deet, picaridin or permethrin, the latter of which is applied to clothing.
Treating clothes with permethrin is "a great strategy," says Yancey, because it can last through several wash cycles, "and for little kids because they don't tend to like the feel of repellents on their skin."
Park also recommends wearing loose-fitting, long-sleeved shirts and pants; sleeping under a mosquito net if screened rooms aren't available; staying in air-conditioned spaces when you can; and staying informed. "Before traveling, check the CDC or WHO websites for updates on yellow fever risk in the intended destination," she says.
Knowing the symptoms of yellow fever also can't hurt. The telltale sign is yellow eyes and skin, Yancey says, which is the result of the virus attacking the liver.
The signs may look different at first, however. Park says the initial symptoms include fever, chills, a severe headache, back pain, body aches, fatigue, nausea and vomiting.
"Most people improve after this initial phase," she says. "However, roughly 15 percent of patients can enter a more toxic phase within 24 hours." At that point, she says, you may notice a high fever, jaundice, bleeding, abdominal pain, shock and even organ dysfunction.
If you notice these signs, both Yancey and Park urge you to seek medical attention immediately. "Early detection and supportive care can make a significant difference in outcomes," Park says, advising patients to let their doctor know if they've traveled (and to where) in the two weeks prior to the symptoms starting.
The main takeawayExperts say awareness, protecting yourself from being bitten by mosquitoes and getting the vaccine if traveling to countries at risk of yellow fever virus is key.
"The disease is something that should be on the radar of public health so that we are ready to act if there is an outbreak, but it is going to be fairly easy to contain if there is," Yancey says. "Yellow fever is very uncommon in the U.S., but there are other vaccine-preventable viruses that are."
Yellow Fever Risk Analysis Findings Dissemination Workshop Held In Ethiopia
The Yellow Fever sub-national risk analysis findings dissemination workshop, and consultative and advocacy meeting was held in Addis Ababa Ethiopia on 4th October 2023. The workshop was organized by World Health Organization (WHO) Ethiopia in collaboration with Ministry of Health (MoH) and global and in-country partners.
"Today's meeting will hopefully result in a concrete consensus for the advancement and for the scaling up of the national yellow fever control strategy in Ethiopia. WHO is committed to continue its support for the implementation of the Yellow Fever programme in Ethiopia." said Dr Sarai Malumo, RMNCAH Cluster Lead speaking on behalf of Dr. Nonhlanhla Dlamini, WHO Representative to Ethiopia a.I.
The Yellow Fever (YF) risk analysis was led by the National Risk Analysis Working Group (RAWG) with members from MOH, Ethiopian Public Health Institute (EPHI), WHO and US-CDC. The findings from the risk analysis were presented during the workshop conveying the relative risks of regions in Ethiopia, and the updated Ending Yellow Fever Elimination (EYE) Strategy and the global, regional and national yellow fever epidemiological situation.
The rational for the risk analysis was prioritization of regions for a risk-based and phased Preventive Mass Vaccination Campaign (PMVC) and to support country applications to Gavi for YF vaccine allocation through transparent & equitable process.
The current subnational YF risk assessment has shown all regions have risks of Yellow Fever but the relative risk of regions varies with some degrees of risk scores. The recent outbreaks in Ethiopia reported in 2013, 2018, and 2020 and the most recent one occurred in the Gurage Zone of Southern Nations, and Nationalities and Peoples' Region (SNNPR), an area that had not been affected earlier.
WHO estimates from the early 1990s, annually 2,200,000 yellow fever cases, with 30,000 deaths occurring globally, and above 90% occurring in Africa. Ethiopia is one of the 27 high-risk countries in Africa.
The gathering of all stakeholders in the YF Sub-national risk analysis dissemination workshop was used as an opportunity to discuss and resolve potential concerns with the yellow fever vaccine introduction and to decide on the next actions to better fight yellow fever in Ethiopia.
The large Ethiopian population has very low yellow fever immunity and yet the yellow fever virus is endemic in the country. The risk of a yellow fever outbreak is real but can be minimized. With support from EYE partners, Ethiopia is well positioned to contribute to the success of the EYE Strategy in its endeavor to protect its population from a high-impact vaccine-preventable disease.
The Ending Yellow fever Elimination (EYE) Strategy was developed in 2017 by a coalition of partners (Gavi, UNICEF and WHO) following the major outbreak of yellow fever in Angola in 2016. It is a comprehensive and long-term strategy built on lessons learned from the Angola outbreak that spread worldwide resulting in tremendous economic, social and political impacts. The strategy aims at ending yellow fever epidemics by 2026 and consists of three strategic objectives: protect at-risk populations; prevent international spread; and contain outbreaks rapidly. The yellow fever virus itself cannot be eradicated, but we can stop the epidemics using Yellow Fever vaccine.All Member States of the African region endorsed the EYE Strategy in 2017. The Strategy is being implemented in 40 countries and with more than 50 partners involved.
The EYE strategy offers a continuum from prevention to outbreak, which have helped to prevent and respond to yellow fever emergencies in the last six years. Without the work of EYE partners, yellow fever has the potential to trigger large epidemics with international spread. But through the efforts led by countries, this can be avoided.
(With Inputs from APO)
South Faces Growing Threat Of Yellow Fever Resurgence, Experts Say
The spread of mosquito-transmitted viruses is accelerating in the Southern U.S., stirring concerns about the potential return of yellow fever, two infectious disease experts wrote in an Oct. 14 article for The New England Journal of Medicine.
The two experts are:
Yellow fever outbreaks decimated many Southern cities between 1820 to 1905. The virus, spread by aedes mosquitoes, has a higher mortality rate than other mosquito-transmitted diseases such as dengue or Zika.
Drs. Hotez and LaBeaud noted that outbreaks of human infections caused aedes mosquitos have already occurred in Florida and Texas. They predict that factors such as climate change and urbanization could create conditions in which future epidemics become more common.
A vaccine for yellow fever exists, though it is expensive and not currently stored in the Strategic National Stockpile, according to Drs. Hotez and LaBeaud.
"During a sizable epidemic, yellow fever could tear quickly through unimmunized populations across the American South, and it is unlikely that the U.S. Government would be prepared to acquire and distribute vaccines in a timely manner, even if there were public demand," they wrote. "We believe yellow fever should be prioritized as part of our national pandemic-preparedness efforts, given that the conditions are now in place for yellow jack to return and sicken many people in southern U.S. Cities."
Comments
Post a Comment