Yellow Fever: Understanding Symptoms, Causes, Nursing Care and Prevention Strategies

What is Yellow Fever

Yellow fever is an acute hemorrhagic fever caused by arbovirus. It has an incubation period of three to six days. There are two types of yellow fever. They are jungle yellow fever and urban yellow fever.

Types of Yellow Fever

Sylvatic or jungle yellow fever

This disease is primarily one that affects monkeys. In tropical rain forests, yellow fever occurs in monkeys that are infected by wild mosquitoes. The infected monkeys pass the virus unto other mosquitoes that feed on them. These infected wild mosquitoes bite humans entering the forest resulting in sporadic cases of yellow fever. The majority of cases are young men working in the forest such as those involved in logging etc. Occasionally, the virus spreads beyond the affected individual.

Urban yellow fever

Large epidemics can occur when migrants introduce the virus into areas with high human population density. Domestic mosquitoes (of one species, Aedes aegypti) carry the virus from person to person. No monkeys are involved in this transmission. These outbreaks tend to spread outwards from one source to cover a wide area.

Pathophysiology of Yellow Fever

The Aedes africanus mosquito lives in the forest and is primarily responsible for jungle yellow fever. Rarely, the hemagogus species also causes the jungle yellow fever. It bites an infected monkey and transmits the virus to another monkey, and the cycle continues like that in the jungle. When the infected monkey finds itself on the edges of the forest, the Aedes simpsoni mosquito then bites it, picks the virus and transmits it to man when he happens to be around the edges of the forest. The infected man now becomes a carrier of the virus and does not exhibit any sign or symptom of being infected. When the carrier man is bitten by the Aedes aegypti mosquito, the mosquito picks the virus and transmits it to another man by biting him. The newly infected man will now exhibit signs and symptoms of urban yellow fever.

Signs & Symptoms of Yellow Fever

• Fever
• Headache
• Muscular ache
• Prostration (a state of extreme physical weakness)
• Nausea and vomiting
• Haemorrhage from all the orifices. E.g. epistasis, haematemesis, melaena
• Oliguria
• Jaundice

Treatment of Yellow Fever

• The disease runs its cause in a little more than a week. Those who survive (and the great majority do) suffer no permanent damage.
• There is no specific treatment.
• Management is supportive or symptomatic.
• Analgesics for pain.
• Antipyretics for fever
• Immunization

Nursing Management of Yellow Fever

The following are the measures to put in place in the care of patient's with Yellow Fever

• Assess the level of pain.
• Explain the need for isolation to the patient and family members.
• Monitor vital signs 4 hourly.
• Monitor intake and output.
• Ensure complete bed rest.
• Tepid sponging should be cartied out to reduce the temperature.
• Analgesics should be given to reduce the pain and promote the comfort of the patient.
• During the first 4 days of the disease, the patient should be isolated in a well screened room to prevent the bite of mosquitoes.
• Prevent infection by concurrent and terminal disinfection.
• Easily digestible food and highly nourishing foods should be served.
• Serve patient's food in bits and at frequent intervals.
• Encourage patient to take more fluids.
• Milk is given in moderate quantities.
• Give full diet if vomiting and fever subsides.
• Assist the patient to take care of his/her personal hygiene.
• Mouth wash after each vomiting as well as before and after feeding. Care must be taken not to injure the gums.
• Urine testing for albumin.
• Assess the extent of jaundice.
• Educate them on the mode of transmission of the disease.
• Clearing of breeding places of mosquitoes.
• Explain the need of vaccination of travellers.

Prevention and Control Measures

• Nursing of infected persons in insecticide-treated bed nets to prevent others from being infected (isolation).
• All houses in the vicinity of the client should be sprayed with insecticides to kill mosquitoes.
• Destruction of breeding places of mosquitoes.
• Investigation of contacts and source of infection for early diagnosis.
• Active immunization with yellow fever vaccine, and repeated every ten years.
• Health education on prevention of mosquito bites.
• International travelers to have a valid international certificate of yellow fever vaccine, or to be quarantined for about six days after arrival.