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Why we Should Always go for Yellow Fever Check-ups

Yellow fever: Apart from that time when travellers are compelled to present certificates before going to certain countries, vaccination against yellow fever has for long received limited attention from the public.

A person suspected of yellow fever, is always with yellowish eyes.

Even following fresh outbreaks in Angola and Uganda this year, regional governments only reinforced measures at main exit and entry points.

According to the Ministry of Health, both citizens and non-citizens present certificates upon arrival or departure pay $40 or its equivalent in Rwandan francs for vaccination at Kanombe International Airport. Exceptions are only made for infants.

While there are vaccines to immunize people against several diseases, research continues to show that involuntary yellow fever testing and treatment is rare within African communities, which even makes the disease much harder to wipe out. But how is the disease spread?

Yellow fever signs. palms appear yellowish.

Yellow fever is a serious, potentially deadly flu-like viral infection spread by a mosquito - Aedes Aegyptii. It is characterised by a high fever and jaundice.

This jaundice or yellowing of the skin and eyes is the source for the name ‘yellow fever.’ While the disease is most prevalent in certain parts of Africa and South America, transmission from infected people is common around the world.

Dr Raymond Awazi, a pediatrician at a polyclinic at St Famillie in Kigali, explains that the symptoms of the disease are similar to those of a person infected with malaria.

“Most times people will have high fever, temperature, severe headache joint pains and vomiting,” he says.

Dr Awazi adds that without appropriate attention on contracting yellow fever, individuals risk damaging their internal organs.

“When one has yellow fever, organs such as the intestines, stomach, liver and kidneys may be damaged due to delayed treatment of the vector borne disease,” he adds.

The growth of the disease.

After three to five days of growth within the body, mortality is expected to occur in 50 per cent of cases.

Early yellow fever check-ups can help one from over spending especially in covering hospital bills, "prevention is better than cure."

“Being haemorrhagic, death due to yellow fever often results from bleeding that occurs from the different sites in the body,” says Dr Rachna Pande, a specialist in internal health at Ruhengeri Hospital.

From between 84,000 and 170,000 annually, the World Health Organisation estimates that 60,000 die every year from yellow fever.

Within the three to six days of incubation, the infection occurs in one or two phases.

The first - “acute” phase - regularly causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting.

Although most patients improve and their symptoms disappear after three to four days, 15 per cent of these enter a second, more toxic phase within 24 hours of the initial remission.

This is characterized by high fever, which affects several body systems. The patient rapidly develops jaundice with abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach.

Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates. And sadly, half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage.

How can we prevent yellow fever?

Like most viral infections, yellow fever has no cure, but treatment relies on vaccination approaches.

Dr Achille Manirakiza, a resident clinical oncologist at Mubimbili University in Tanzania, explains that the disease can be transmitted from an infected person to another.

“Yellow fever is as worrisome as Zika and Ebola. Through bites of infected mosquitoes, the disease can be spread from an infected person to another but we can prevent yellow fever the same way we can prevent diseases spread through mosquito bites,” says Dr Manirakiza.

A person to be tested for yellow, will require him/her to make a blood sample.

He adds that vaccines against yellow fever are effective and individuals do not have to wait for emergency shots.

“Luckily enough, vaccination exists and does not need a travel emergency to work on it as if it is a formality. The vaccine is useful for at least 10 years,” he adds.

Dr Pande also points out that controlling the growth of mosquitoes can put the spread of yellow fever in check.

“Aedes mosquitoes also breed in closed water containers and stagnant cesspools. Individuals should ensure that no stagnant water remains in flower vases, coolers and jugs. Where possible, water containers such as tanks should be covered with larvicide.

Bushes around the house should be kept trimmed,” adds Dr Pande.

On contracting the infection, Dr Awazi suggests that patients receive supportive care from their relatives.

“Much as there is no absolute cure, supportive care is needed to rehabilitate those affected,” he adds.

Situation on regional incidences.

At least 151 suspected cases were reported from the Democratic Republic of Congo and two cases in Kenya.

Maps of Yellow fever endemic areas in Africa and South America.

Some cases have also been confirmed in Uganda. Luckily no incidences have been detected in Rwanda.

Despite cases of yellow fever in the neighbouring countries, Nathan Mugume, the head of communications at Rwanda Biomedical Centre, maintains that such cases were imported from other countries outside East Africa.

“You realise most people who had the disease travelled from other countries, but the cases appeared after reaching their destination,” says Mugume.

Yellow fever may have no cure but the biggest challenge is that several communities have overlooked it.

A study published by the University of California in the journal PLOS Neglected Tropical Diseases concluded that yellow fever is just another neglected tropical disease for which at least 900 million are at risk.

By Robert Muriisa.

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