Yellow Jack Found Alive and Well!

If this disease was a newspaper headline, it would read: "Danger! Once banished from America, Yellow Jack is alive and well in South America and in sub-Saharan Africa."

Yellow Jack is a nickname for the disease, yellow fever. The name stems from a not-so-funny cartoon figure, depicting a violent skeletal bandit who stole human lives. Once one of the horrendous curses of the world, yellow fever is still a serious and sometimes fatal illness caused by a flavivirus.

In yellow fever history, people believed this malady was spread by unhealthy air. The rich would flee to cooler country homes, while the poor would often board up their houses and keep fireplaces burning to ward off the summer air.

Past generations were so fearful of this disease, that when people died, their clothing, personal possessions, beds, and sometimes homes were torched. All sorts of cures and remedies were tried, many of them proving more fatal than the yellow fever.

Today, we know that the yellow fever virus is spread by the bite of an infected mosquito. The yellow fever mosquito is the "Aedes aegypti." It can also spread dengue fever, Chikungunva, and other diseases. Once bitten, anyone can get yellow fever, but the elderly have a higher risk of complications and death

If you are planning to travel to countries still battling this disease, here are yellow fever's symptoms:

EARLY SYMPTOMS OF YELLOW FEVER

• Arrhythmias (heart dysfunction)
• Chills
• Constipation
• Decreased urination
• Fever
• Headache
• Jaundice
• Loss of Appetite
• Muscle aches
• Red eyes, face, and tongue
• Vomiting

Yellow fever begins suddenly after an incubation of only three to five days. In most cases, the symptoms are mild and patients make a full recovery within a week. Once contracted, if you recover, you will have a lifelong immunity against re-infection.

In it's earliest stage, yellow fever can be mistaken for other diseases, such as dengue fever, malaria, hemorrhagic viral fevers, etc. It is important to get a proper and early diagnosis, by both a blood test and physician. This illness is life threatening, it is not a time to self-diagnose.

After 3-4 days of early stage illness, the fever and other symptoms will go away briefly. Most people will recover, however, others will shift into a third, most perilous stage of the disease within twenty-four hours. So, don't be fooled into thinking that someone has recovered at this stage, danger still exists.

Period of Intoxication:

• Bleeding (may progress to hemorrhage)
• Coma
• Death
• Delirium
• Disseminated intravascular coagulation (DIC)
• Parotitis
• Secondary bacterial infections
• Seizures
• Shock
• Vomiting Blood
• Liver and kidney failure

There is no specific treatment for yellow fever. Once you have the disease, all that can be done is symptomatic treatments for fever and aching (rest, fluids, ibuprofen, naproxen, acetaminophen, or paracetamol).

Without a cure for yellow fever, the only real "cure" is prevention - get a yellow fever vaccination! These vaccinations may be required before visiting parts of Africa and South American. Before traveling, be aware that the yellow fever vaccine is not available through family doctors or clinics.

You must go to a government approved physician or medical center. Yellow fever vaccines are expensive and aren't covered by health insurance (military and veterans are the exceptions).

Additionally, if you are over the age of sixty, you have an increased risk of adverse reactions to the yellow fever vaccine.

These reactions can result in organ failure and death.

Outside of yellow fever vaccination, travelers should avoid mosquito bites in tropical areas.

Mosquitoes usually bite during the day, especially in the early morning and evening. When indoors, stay in well-screened areas, spray living and sleeping areas with insecticide, and use mosquito netting.

When outside, always wear long-sleeved clothing and long pants that are treated with insecticides containing permethrin. Additionally, use mosquito insect repellent on exposed skin.

Finally, international regulations command proof of yellow fever vaccinations for travelers into certain countries. Make sure you carry your international Certificate of Vaccination as you travel outside of the U.S.

This vaccination can be expensive to obtain. University based medical centers are often the nearest place to get vaccinated. However, if you are within the VA medical system, these vaccines are free and easily obtainable.

Just when you thought it was safe to go outside, along comes a new mosquito borne illness. Mosquito borne illnesses like yellow fever, continue to increase even today. Now, in addition to yellow fever, dengue fever, etc. there is a new threat.

There is a new mosquito borne illness -- Chikungunva (pronounced "chicken - GUN- ya). Like yellow fever, it is carried by the Asian tiger mosquito (yellow fever mosquito).

This illness is not fatal for most people, but like yellow fever, and other fever illnesses -- young children, those with weak immune systems, and the elderly could be at risk for death from Chikungunva. Some of the symptoms are:

Painful joint inflammation (stooped posture) that can last for months or years after infection). The ankles and wrists are vulnerable, and often the intense pain is felt when pressure is applied to a person's wrist. This is the first clue that this is Chikungunva.

Additionally, there are the following symptoms:

• Fever
• Headache
• Vomiting and nausea
• Rash (lasting three to five days) that starts on the face and chest
• Hemorrhaging in children and the elderly

Recently, nearly 250,000 people contracted this disease in Madagascar, leaving 2500 dead. What's interesting about this illness is that people infected, can pass the disease to mosquitoes who in turn spread the disease. The mosquitoes don't get it from animals, but from humans.

There is no vaccine and no cure at this time. The virus can only be detected in the first 48 hours in most people. In a few individuals, it can still be detected for about four days. So, this complicates verification of the disease. The human to mosquito factor, with international travel to popular destinations make this an epidemic waiting to happen, even here in the U.S.

Generally, three different types of mosquitoes are vectors for spreading disease in the U.S. They are:

• House Mosquito (Culex Pipiens)
• Tree-hole Mosquito (Aedes triceratops)
• Asian Tiger Mosquito (Aedes albopictus)

These three kinds of mosquitoes are also responsible for spreading:

• Encephalitis-- An inflammation of the brain that in severe cases can cause both death and permanent loss of mobility, mental retardation, and emotional problems. Encephalitis symptoms include: Severe headache with rapid onset; vomiting and nausea; high fever, mental confusion, irritability, shakes, and coma.
• St. Louis Encephalitis (SLE) -- This is the most common mosquito borne illness currently being spread in the U.S. Five to fifteen percent of those who contract this form of encephalitis die. Symptoms of St. Louis encephalitis are: Headaches, fever, stiff neck, lethargic, confusion, shakes, convulsions, paralysis and even death. However, you can also have this form of encephalitis and have no symptoms.
• La Crosse Encephalitis (LAC)-- This mosquito borne illness primarily affects children under the age of sixteen. One percent of those getting this kind of encephalitis will die. More rare than the other types of encephalitis, La Crosse it also causes inflammation of the brain and attacks the central nervous system. Symptoms are: fever, headache, nausea, vomiting and listlessness. It can progress to more serious symptoms such as, seizures, coma, and paralysis. Sometimes this illness is misdiagnosed as aseptic meningitis or as an unknown variety of encephalitis.
• West Nile Virus -- This mosquito borne illness affects both humans and birds, such as the American Blue Jay and the American crows. While it has a low mortality rate, three to fifteen percent of those contracting this illness will die. West Nile virus symptoms include: A low fever within three to fifteen days of being bitten; followed by a headache, rash, swollen lymph nodes and eye irritation. From there the illness rapidly includes: a severe headache, high fever, stiff neck, confusion, weakness, and can in some cases lead to coma or death.