The Department for Health has highlighted an outbreak of a disease hitting some holiday hotspots - which is potentially fatal. Travel Health Pro, an official government advice site used by the Foreign Office highlighted the rise of Yellow fever.

It said that people going to the Caribbean, parts of Africa, Central and South America should watch out for the virus in a new update. It became well known in the 18th century when it was frequently called ‘Yellow Jack’ and caused huge fatalities among soldiers and sailors serving overseas, especially in the tropics.

It is spread by mosquitos and can cause a serious haemorrhagic illness that can be fatal for humans, and it can be prevented by vaccination. A cruel feature of the virus is the patient appears to recover - then 24 hours later gets much worse with up to 50 per cent of people reaching this stage dying.

The World Health Organisation advises yellow fever vaccine for all travellers aged nine months and older visiting areas with a risk of yellow fever. Countries which have suffered recent outbreaks of yellow fever include Trinidad in the Caribbean, Burkina Faso, Cameroon, Central African Republic, Chad, Republic of the Congo, Côte d’Ivoire, Democratic Republic of the Congo, Guinea, Niger, Nigeria, South Sudan, Togo and Uganda.

In South America, seven confirmed Yellow fever cases, including four fatal cases, have been reported between 1 January and 19 March 2024 in Colombia (three fatal cases), Guyana (two cases) and Peru (two cases, including one death). Brazil has reported confirmed Yellow fever in monkeys which indicates it is circulating in the country.

Travel Health Pro said as well as getting vaccinated people might need an International Certificate of Vaccination or Prophylaxis (ICVP) for yellow fever when they arrive in the country.

Symptoms

The infection has an incubation period from being bitten by a mosquito of three to six days. Initial symptoms include myalgia (muscle pain), pyrexia (high temperature), headache, anorexia (lack of appetite), nausea, and vomiting. In many patients, there will be improvement in symptoms and gradual recovery three to four days after the onset of symptoms.

Within 24 hours of an apparent recovery, 15 to 25 per cent of patients progress to a more serious illness. This takes the form of an acute haemorrhagic fever, in which there may be bleeding from the mouth, eyes, ears, and stomach, pronounced jaundice (yellowing of the skin, from which the disease gets its name), and renal (kidney) damage. The patient develops shock and there is deterioration of major organ function; 20 to 50 percent of patients who develop this form of the disease do not survive. Infection results in lifelong immunity in those who recover.

Treatment

An urgent referral to an infectious disease/tropical disease clinical team is required. UK Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory is a specialist centre for health professionals providing advice and diagnosis of a wide range of unusual viral and bacterial infections including yellow fever.