Yellow fever causes panic in Paraguay

by Tara Smith     Department: Science & Society

Yellow fever. "Yellow jack." "The American plague." "Black vomit." The disease has many names, but they all trace back to one common strand: infection with a type of arbovirus (a virus transmitted by an arthropod; in the case of yellow fever, the arthropod in question is the mosquito Aedes aegypti). The disease starts out similar to influenza: causing fever, muscle aches, headache. The majority of individuals improve and recover following this phase.

However, a minority of patients feel fine for a bit--and then the fever returns. The skin and whites of the eyes begin to yellow as the liver fails and jaundice sets in (giving the disease its name). Abdominal cramps can be excruciating. The patient may hemorrhage and bleed from the eyes, gums, in the stool or urine. The kidneys fail. Some recover; others die within a week or two.

The virus causes occasional outbreaks in humans. In the wild, it can be maintained in a jungle environment via a cycle between mosquitoes and non-human primates. Humans can be infected via a mosquito bite in the jungle, and may bring the virus into the urban environment, sparking an outbreak there.

In the United States, yellow fever is largely a historical footnote. Though it was a scourge in our early history, the last large outbreak in this country occurred in 1905 in New Orleans. However, while it's been rare in the U.S. for the last hundred years, yellow fever still causes around 200,000 illnesses and 30,000 deaths each year--and outbreaks are currently percolating in Brazil and Paraguay:

Paraguayan authorities have confirmed 13 cases of yellow fever, including three deaths, though other suspected cases remain under investigation, Dr. Antonio Barros, vice minister of Public Health, told reporters Saturday. Health officials say the numbers do not constitute an epidemic, though that is the word often used in the media here.

This is the first outbreak there in over 30 years, and people are scared:

Frustrated Paraguayans have blocked roads, burned tires and lined up in front of health centers chanting, "Vaccinations! Vaccinations!"

"People are desperate: The government should have had the vaccines ready," said Teresa Ocampos, 37, a domestic worker who was recently inoculated against the disease. "That would have avoided all the chaos that we see now."

A highly effective vaccine for yellow fever was developed over 60 years ago, but it's only helpful if it's available when it's sorely needed.

Tags: disease, outbreak, virus, Yellow fever

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