Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Yellow fever
1. Presented By:
Krishna Bharat Patil
M.Pharmacy 1st year [Pharmacology]
SNJB's SSDJ College of Pharmacy,
Chandwad.
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Objectives:
At the end of the seminar, we are able to :
Define yellow fever
Know the Disease background
Know the transmission
Know the epidemiology
Relate the clinical features
Know the diagnosis and treatment
Understand the control
Of yellow fever
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Introduction:
Yellow fever is an acute viral haemorrhagic disease transmitted by infected
female mosquitoes
Caused by :
Yellow fever virus which is an arbovirus of the flavivirus gene
Also named yellow as it causes jaundice at later stage
Yellow fever is the disease that currently re-emerging and poses serious harm in
Africa, south America, and central America, with and annual estimate of series
84,000 to 170,000 and about 29,000 to 60,000 deaths.
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Disease Background:
Carlos Finlay was Cuban epidemiologist
recognized as pioneer in research of yellow fever.
First account of
sickness diagnosed as
YF occurred in 1648.
Causative agent:
genus Flavivirus.
Vector: Aedes aegypti
(mosquito).
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TRANSMISSION:
Transmitted by female mosquitoes,
belonging to the Aedes and
Haemogogus species.
3 types of transmission cycle :
1. Sylvatic ( jungle) yellow fever
2. Intermediate yellow fever
3. Urban yellow fever
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The jungle (sylvatic) cycle involves :
Reservoir : non-human primates (monkeys)
Vector : forest mosquito
(Haemogogus spegazzinni in South America,
Aedes africanus and A.simpsoni in Africa )
Probably when humans are visiting or working in the jungle.
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In Africa, an intermediate (savannah) cycle:
Reservoir : human working in forest
Vector : forest mosquito
(Aedes africanus and A.simpsoni in Africa)
virus can be transmitted from monkey to human or
from human to human via mosquitoes.
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The urban cycle involves :
Reservoir : human
Vector : urban mosquito (Aedes aegypti)
Virus brought to the urban setting by a viremic
human who was infected in the jungle or savannah.
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Incubation period – 3-6 days
Period of communicability - Blood of patients is infective during the first 3-4days.
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Stage1 (infection): Headache, muscle and joint aches,
fever, flushing, loss of appetite, vomiting, jaundice are
common
Stage2 (remission): fever and other symptoms go
away. Most people will recover at this stage, but other
may get worse within 24 hours
Stage3 (intoxication): Problems with many organs
occur. This may include heart, liver and kidney
failure, bleeding disorders, seizures, coma, and
delirium.
Yellow fever is caused in 3 stages:
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Clinical Features:
Acute Phase
Acute phase may disappear for up to 24 hours.
Headaches
Muscle aches
Joint aches
Fever
Loss of appetite
Shivers
Backaches
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Toxic Phase:
Acute phase may disappear for up to 24 hours.
Decreased urination
Abdominal pain
Vomiting (sometimes with blood)
Heart rhythm problems
Seizures
Delirium
Bleeding from the nose, mouth, and eyes
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TREATMENT:
1) Symptomatic.
2) Rest, fluids, and use of pain relievers
3) Medication to reduce fever may relieve symptoms of aching and fever.
4) Avoid certain medications, which may increase the risk of bleeding.
(e.g. ibuprofen, naproxen)
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Vaccination:
17D VACCINE
Thermo labile and subcutaneous inoculation
Routine infant immunization
Mass vaccination campaigns
Vaccination of travellers going to yellow fever endemic areas.
Single vaccine dose provide at least 10 years protection
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References:
1) Frederick AM. Emerging infectious diseases. CDC. 1998;4.
2) Quan L, et al. Major emerging and re-emerging zoonoses in China: A matter of
global health and socioeconomic development for 1.3 billion. Int J Infect Dis.
2014;25:65-72.
3) http://www.who.int/zoonoses/emerging_zoonoses/en/
4) http://www.who.int/en/news-room/fact-sheets/detail/yellow-fever
5) Elizabeth DB. Yellow Fever: Epidemiology and Prevention. Clin Infect Dis.
2007;44:850-856
6) Luciano ZG. Yellow fever outbreak in Brazil. Braz J Infect Dis. 2017;21:123-124. 7.
Sean W, et al. Yellow fever cases in Asia: Primed for an epidemic. Int J Infect Dis.
2016;48:98-103.
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10)Christina LG, et al. Yellow Fever: A Reemerging Threat. Clin Lab Med.
2010;30:237-260.
11) Emile F, et al. Advances and controversies in yellow fever vaccination. Ther
Adv Vacc. 2013;1:144-152.
12)Catharine IP, et al. Yellow Fever: Once Again on the Radar Screen in the
Americas. N Engl J Med. 2018;376:1397-1399.
13)Moritz UGK, et al. Spread of yellow fever virus outbreak in Angola and the
Democratic Republic of the Congo 2015-16: A modelling study. Lancet Infect
Dis. 2017;17:330-338.
14)James MN, et al. Fenner's Veterinary Virology. Elsevier Inc. 2011;4.
15)Brain RS, et al. Deadly Diseases and Epidemics: Yellow fever. 2010.
16)Kotar SL, et al. Yellow Fever: A World Wide History. 2017.