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Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The "yellow" in the name refers to the jaundice that affects some patients. Up to 50% of severely affected persons without treatment will die from yellow fever. There are an estimated 200 000 cases of yellow fever, causing 30 000 deaths, worldwide each year, with 90% occurring in Africa. The virus is endemic in tropical areas of Africa and Latin America, with a combined population of over 900 million people. The number of yellow fever cases has increased over the past two decades due to declining population immunity to infection, deforestation, urbanization, population movements and climate change. There is no specific treatment for yellow fever. Treatment is symptomatic, aimed at reducing the symptoms for the comfort of the patient. Vaccination is the most important preventive measure against yellow fever. The vaccine is safe, affordable and highly effective, and a single dose of yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against yellow fever disease and a booster dose of yellow fever vaccine is not needed. The vaccine provides effective immunity within 30 days for 99% of persons vaccinated.

WHO response WHO is the Secretariat for the International Coordinating Group for Yellow Fever Vaccine Provision (ICG). The ICG maintains an emergency stockpile of yellow fever vaccines to ensure rapid response to outbreaks in high risk countries. The Yellow Fever Initiative is a preventive control strategy of vaccination led by WHO and supported by UNICEF and National Governments, with a particular focus on most high endemic countries in Africa where the disease is most prominent. The Initiative recommends including yellow fever vaccines in routine infant immunizations (starting at age 9 months), implementing mass vaccination campaigns in high-risk areas for people in all age groups aged 9 months and older, and maintaining surveillance and outbreak response capacity. Between 2007 and 2012, 12 countries have completed preventive yellow fever vaccination campaigns: Benin, Burkina Faso, Cameroon, Central African Republic, Côte d’Ivoire, Ghana, Guinea, Liberia, Mali, Senegal, Sierra Leone and Togo. The Yellow Fever Initiative is financially supported by the GAVI Alliance, the European Community Humanitarian Office (ECHO), the Central Emergency Response Fund (CERF), the Ministries of Health, and the country-level partners.

Yellow fever is diagnosed clinically, with laboratory confirmatory testing available.

Yellow fever is diagnosed clinically, with laboratory confirmatory testing available.

Ring around the rosy, A pocket full of posies, Ashes … ashes, We all fall down.

A familiar nursery rhyme that children have recited as a harmless play song for generations

ironically refers to one of Europe's most devastating diseases. The bubonic plague, better known as the “The Black Death,” has existed for thousands of years. The first recorded case of the plague was in China in 224 B.C.E. But the most significant outbreak was in Europe in the mid-fourteenth century. Over a five-year period from 1347 to 1352, 25 million people died. One-third to one-half of the European population was wiped out!

Fever Headache Muscle pain Backache Chills Loss of appetite Nausea and/or vomiting

High fever Abdominal pain Bleeding from the gums, nose, eyes, and/or stomach Vomit that appears black due to blood content Low blood pressure Liver failure, which may lead to jaundice Kidney failure Confusion Seizure Coma

SymptomsYellow fever symptoms appear within a week after a person is bitten by an infected mosquito. Typically, acute phase symptoms will persist for 3 to 4 days, and then disappear. A small percentage of people progress into the toxic phase. The toxic phase symptoms begin within 24 hours of the end of the acute phase. Recovery from yellow fever provides lifetime immunity from the disease.

Western Africa has long been regarded as the home of yellow fever, although the first recorded outbreaks of the disease were in central and coastal South America after the Spanish conquest in the 16th century. For the next 300 years, yellow fever, given various names such as Yellow Jack and “the saffron scourge,” was one of the great plagues of the New World. The tropical and subtropical regions of the Americas were subjected to devastating epidemics, and serious outbreaks occurred as far north as Philadelphia, New York, and Boston but also as far away from the endemic centres as Spain, France, England, and Italy.