UBTH is committed to the health and safety of our clients and staff. To that end, please read the following information on transmission, prevention, treatment and protocols for yellow fever outbreaks. As we work together, we will keep our communities safe. KEY FACTS ABOUT YELLOW FEVER • Yellow fever (YF) is a potentially fatal viral haemorrhagic disease.  • The YF virus is endemic in tropical areas of Africa and Central and South America. Symptoms • The incubation period (interval from infection to onset of symptoms) is usually from 3 to 6 days. Acute phase • Fever, headache, muscle aches, backache, chills, nausea and vomiting Toxic phase • Fever, jaundice (yellowness of the eyes and skin), abdominal pain with vomiting, problems with kidney function and bleeding from the mouth, nose, eyes and/or stomach. Transmission  • Humans and monkeys are the main animals infected by the virus. • YF is transmitted to humans through the bite of infected mosquitoes (Aedes spp). • Aedes mosquitoes bite all day • Infected people can transmit the infection to mosquitoes for up to five days after the onset of symptoms. • The infection is not spread directly from person to person or from animal to person.  Prevention  • There is no specific treatment for YF; only good supportive treatment for symptoms.  • Vaccination is the most effective way to prevent yellow fever. Vaccination – A single dose of yellow fever vaccination provides life-long protection. (Booster dose after 10 years is not needed) Anti-mosquito measures:  • Remove potential mosquito breeding sites around the home– drain stagnant water, clear out drains, cover water containers, etc. • Clear bushes around dwellings. • Sleep under insecticide–treated bed nets. • Screen windows and doors with nets.   • Wear long sleeved shirt and long trousers when outside.  • Use of insecticides, mosquito repellent. • Take extra precautions when travelling to areas with a higher risk of mosquito-borne diseases.  • Health-care workers should have a high index of suspicion. • Isolate infected patients being managed in a mosquito-proof room. FOR FURTHER INFORMATION, CONTACT INFECTION CONTROL COMMITTEE @ 08023355029  ———————————————————————– CASE MANAGEMENT PROTOCOL FOR SUSPECTED CASE OF YELLOW FEVER   SCREEN – ASK ABOUT Symptoms – Fever, headache, muscle aches, backache, chills, nausea and vomiting, jaundice, abdominal pain, bleeding from the mouth, nose and eyes. Exposure – History of travel to an area where there was an outbreak or endemic for yellow fever within 6 days of becoming ill. YF Vaccination: History of YF vaccination.   Standard case definitions for yellow fever: Suspected case: Any person with acute onset of fever with jaundice appearing within 14 days of onset of the first symptoms. Probable case: A suspected case AND one (1) of the following – Epidemiological link to a confirmed case or an outbreak; Positive post-mortem liver histopathology. Confirmed case: Any suspected case with positive laboratory test for yellow fever. ISOLATION  • Isolate patient with suspected Yellow fever in a mosquito-proof room immediately. • Blood sample should be taken for: – Bedside clotting time: Use pre-labelled plain bottle (Not diagnostic but may be helpful especially for clients who present with bleeding problems). – PCR: Use two (2) pre-labelled EDTA bottles. Draw 5mls each for adults/3mls each for children and stored/transported in cold packs.  • Observe standard precautions always. • Inform contacts of suspected case immediately. TREATMENT Supportive care with specific attention to fluid and electrolyte management.  Appropriate antibiotics if there is superimposed infection. Avoid hepatotoxic drugs, Aspirin, NSAIDs. NOTIFICATION  • Notify the Infection Control Unit, Department of Community Health, UBTH. (08023355029) • Notify the Infectious Disease Unit, Department of Medicine, UBTH. (08063522265) • Notify the Infectious Disease Unit, Department of Child Health, UBTH. (08033435312)