Everything You Need to Know About Yellow Fever in Africa

Mosquito biting a person

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Many first-time visitors to Africa worry about encountering dangerous animals like lions and crocodiles, but in reality, the continent’s deadliest creature is the mosquito. Mosquitoes are the source of several potentially fatal diseases, including malaria, West Nile virus, dengue fever, and yellow fever. Yellow fever is an acute viral hemorrhagic disease, which is transmitted by mosquitoes from one infected primate (either human or non-human) to another. It is endemic in many parts of tropical and subtropical Africa and gets its name from the yellow skin, or jaundice that some patients suffer from. Yellow fever can be deadly but is easy to avoid for informed travelers.

Yellow Fever Symptoms

After an infected mosquito bites a person, the virus takes three to six days to incubate. Some patients may not experience any symptoms at all, while others complain of fever, headaches, muscle pain, nausea, vomiting, and fatigue. In the majority of cases, these symptoms disappear on their own after approximately four days. However, one in seven patients experiences a brief remission before entering into a second phase of the illness, known as the toxic phase. The virus begins to attack major organs (usually the liver and kidneys). High fever, jaundice, abdominal pain, and bleeding from the mouth, nose, or eyes are all common symptoms of this phase. Around half of those who experience toxic symptoms will die from the disease within 10 days if it is left untreated. 

How to Avoid Yellow Fever

  • Choose your destination carefully. The easiest way to prevent yellow fever is to avoid traveling to a yellow fever country. The disease is nationally or regionally endemic in 34 African countries, including popular tourist destinations like Ethiopia, Ghana, Kenya, Senegal, and Uganda. This map from the Centers for Disease Control and Prevention (CDC) gives a complete list of affected countries. Generally, countries in North and Southern Africa are yellow fever-free. Plan a visit to Morocco, Egypt, Botswana, or South Africa, for example, and you shouldn’t have any problems. 
  • Get the yellow fever vaccination. If you plan on traveling to an affected country, the yellow fever vaccination is highly recommended. It’s affordable, extremely effective, and safe in most cases (see below for a list of people who are at a higher risk of adverse side effects). A single dose usually provides life-long protection without the need for a booster. The vaccine takes between 10 and 30 days to provide immunity. You’ll need to plan well in advance, especially in the United States, where a shortage of the yellow fever vaccine means that you may have to travel considerable distances to get it.
  • Prevent mosquito bites. Preventing mosquito bites in the first place is a smart idea, especially for those that can’t be vaccinated for medical reasons. When choosing an insect repellent, make sure that it is EPA-registered and contains active ingredients like DEET or Picaridin. Wear long-sleeved shirts and long pants, and opt for clothing and gear treated with permethrin (an insecticide proven to repel mosquitoes). Because mosquitos also bite at night, choose accommodation with air-conditioning, screened windows and doors, and mosquito nets over the beds. 

Compulsory Vaccinations

People infected with yellow fever have the potential to bring the disease with them over international borders. Consequently, many African countries require proof of yellow fever vaccination from any traveler who has recently spent time in a yellow fever endemic country, even if they do not have the disease themselves. If you cannot provide proof that you have been vaccinated, you will not be allowed to enter. Examples of countries with this rule include Rwanda, Tanzania, and South Africa, but there are many others, so make sure to check individual entry requirements carefully when planning your trip. 

Medical Reasons Not to Be Vaccinated

The yellow fever vaccine is considered safe for most people. However, the likelihood of serious side-effects increases for certain high-risk groups, including infants aged nine months or younger, pregnant or breastfeeding women, those with severe allergies to egg protein and people with HIV/AIDS or any other severe immunodeficiency disorder. Seniors 60 or older are also more vulnerable. If you fall into any of these categories, weigh up the pros and cons carefully with your doctor before deciding to get the yellow fever vaccination. 

Yellow Fever Treatment 

If you believe that you may have already contracted yellow fever, consult your doctor immediately, making sure to tell them that you have recently spent time in Africa. Yellow fever can be challenging to diagnose, especially in the early stages when it is easily confused with other diseases, including malaria, dengue fever, and viral hepatitis. Blood and urine tests help to give a definitive diagnosis. Yellow fever requires immediate hospitalization. Although there is currently no specific anti-viral drug for yellow fever, you will be closely monitored and treated for fever, dehydration, and organ failure as necessary. 

The earlier you receive treatment, the better your chances are of survival. Therefore, if you suspect that you have yellow fever, do not wait until toxic phase symptoms develop to seek medical help. If you recover, you should be immune to future infections. 

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