Litvoc Marcelo Nóbrega, Novaes Christina Terra Gallafrio, Lopes Max Igor Banks Ferreira
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2018 Feb;64(2):106-113. doi: 10.1590/1806-9282.64.02.106.
The yellow fever (YF) virus is a Flavivirus, transmitted by Haemagogus, Sabethes or Aedes aegypti mosquitoes. The disease is endemic in forest areas in Africa and Latin America leading to epizootics in monkeys that constitute the reservoir of the disease. There are two forms of YF: sylvatic, transmitted accidentally when approaching the forests, and urban, which can be perpetuated by Aedes aegypti. In Brazil, the last case of urban YF occurred in 1942. Since then, there has been an expansion of transmission areas from the North and Midwest regions to the South and Southeast. In 2017, the country faced an important outbreak of the disease mainly in the states of Minas Gerais, Espírito Santo and Rio de Janeiro. In 2018, its reach extended from Minas Gerais toward São Paulo. Yellow fever has an incubation period of 3 to 6 days and sudden onset of symptoms with high fever, myalgia, headache, nausea/vomiting and increased transaminases. The disease ranges from asymptomatic to severe forms. The most serious forms occur in around 15% of those infected, with high lethality rates. These forms lead to renal, hepatic and neurological impairment, and bleeding episodes. Treatment of mild and moderate forms is symptomatic, while severe and malignant forms depend on intensive care. Prevention is achieved by administering the vaccine, which is an effective (immunogenicity at 90-98%) and safe (0.4 severe events per 100,000 doses) measure. In 2018, the first transplants in the world due to YF were performed. There is also an attempt to evaluate the use of active drugs against the virus in order to reduce disease severity.
黄热病（YF）病毒是一种黄病毒，通过趋血蚊属、萨氏蚊属或埃及伊蚊传播。该疾病在非洲和拉丁美洲的森林地区流行，导致作为疾病宿主的猴子发生动物流行病。黄热病有两种形式：丛林型，在靠近森林时意外传播；城市型，可由埃及伊蚊持续传播。在巴西，上一例城市型黄热病病例发生在1942年。自那时以来，传播区域已从北部和中西部地区扩展到南部和东南部。2017年，该国主要在米纳斯吉拉斯州、圣埃斯皮里图州和里约热内卢州面临该疾病的一次重大疫情。2018年，疫情范围从米纳斯吉拉斯州蔓延至圣保罗州。黄热病的潜伏期为3至6天，症状突然发作，伴有高烧、肌痛、头痛、恶心/呕吐和转氨酶升高。该疾病症状从无症状到严重不等。最严重的形式发生在约15%的感染者中，致死率很高。这些形式会导致肾、肝和神经功能损害以及出血症状。轻度和中度形式的治疗为对症治疗，而重度和恶性形式则依赖重症监护。通过接种疫苗进行预防，这是一种有效（免疫原性为90 - 98%）且安全（每10万剂有0.4例严重事件）的措施。2018年，世界上首次进行了因黄热病导致的移植手术。此外，人们还在尝试评估使用抗该病毒的活性药物以降低疾病严重程度。
