yellow fever in the developing world
Despite increased understanding of the mosquito-transmitted disease since it presented in the 15th century, yellow fever in the developing world continues to have a widespread effect. The World Health Organize  estimates that there are 200,000 cases of yellow fever every year, with 30,000 deaths, 90 percent of which occur in Africa. In Africa and Latin America, 900 million people are at risk of infection as the disease spreads without a cure.

When a mosquito bites a person and transmits yellow fever, there are two paths the disease can take. It will either present as flu like symptoms with fever, aching and nausea, before going away in three to four days. However, 15 percent of patients take the second path. Symptoms worsen rapidly, as the patient develops jaundice, bleeding and increased vomiting. Half of these patients die within 14 days, and those who survive suffer from severe organ damage.

The fight against yellow fever is challenging for a few reasons. For starters, in the early stages, it is difficult to diagnose the disease, as its symptoms are similar to diseases like malaria, viral hepatitis and poisoning. Once the disease can be identified, it is often too far along to effectively control.

Additionally, yellow fever has no treatment. Though it can be prevented, there is no vaccine to cure it. Patients are often treated for secondary conditions that result from yellow fever, which can be effective in helping the patient survive the disease.

Despite the lack of treatment, there are myriad methods to prevent yellow fever. The GAVI Alliance, which has brought together the efforts of the WHO, UNICEF, the World Bank, the Bill and Melinda Gates Foundation and various other governmental agencies, has been successful in administering preventative vaccines worldwide. Since GAVI got involved, an estimated 64 million children have had the vaccine, and 17 of the 33 countries at risk have received routine vaccinations.

In addition to vaccination, protection from mosquitoes can be effective in preventing yellow fever, whether it be insecticide treated nets, clothing that covers as much skin as possible or remaining indoors at night when the mosquitoes are in abundance.

The WHO has been involved beyond its participation in the GAVI Alliance, acting as Secretariat for the International Coordinating Group for Yellow Fever Vaccine Provision. The ICG is adamant about maintaining a stockpile of yellow fever vaccinations in case of a sudden outbreak. Additionally, the WHO along with UNICEF and national governments has led the Yellow Fever Initiative which focuses its vaccination efforts in Africa, targets infants younger than nine months and works to monitor outbreaks to minimize damage.

Preventing yellow fever is very much dependent on efficient healthcare and sanitation, things that are difficult to achieve in impoverished areas. The efforts of GAVI, as well as the individual organizations, are crucial to control the number of yellow fever cases every year.

– Maggie Wagner

Sources: Gavi Alliance, NCBI, WHO
Photo: Gavi Alliance