Yellow Fever: No Cure, but Prevention Works

There is no specific antiviral cure for yellow fever. Treatment is entirely supportive:

• IV fluids, electrolyte correction
• Transfusion for hemorrhage/coagulopathy
• Renal replacement therapy if acute kidney injury
• Vasopressors for shock
• Mechanical ventilation for respiratory failure
• ICU monitoring for multi-organ dysfunction

Case fatality rate: 20–50% in severe (toxic) phase.

Prevention Is Highly Effective

• YF-17D live-attenuated vaccine: Single dose confers lifelong immunity in ≥99% (WHO). Administered ≥10 days before travel to endemic zones.
• Mosquito bite avoidance: DEET/Picaridin repellents, permethrin-treated clothing, screened/air-conditioned lodging, eliminate standing water.
• International Certificate of Vaccination (Yellow Card): Required for entry to many countries in Africa/South America.

Contraindications to Vaccine

• Age <6 months (or <9 months if travel unavoidable)
• Severe immunodeficiency (HIV CD4 <200, transplant, chemo)
• Thymus disorder/thymectomy
• Anaphylaxis to egg/chicken/gelatin (vaccine grown in chicken embryos)

Travelers to endemic areas: consult a travel medicine clinic 4–6 weeks pre-departure.