October 19, 2023 – Medical experts fear that yellow fever and its dreaded “black vomit” could reemerge within the American South within the near future.
The viral disease is spread by mosquitoes and raged within the South and the Mississippi Valley for nearly 100 years, from 1820 to 1905. In 1853, a yellow fever epidemic in New Orleans killed 11,000 people, which on the time was about 10% of town's population.
“We have seen an increase in mosquito-borne diseases in Texas and Florida, including malaria, dengue fever, chikungunya fever and the Zika virus, but now we are also concerned about yellow fever, as it appears to be prevalent in tropical regions of Latin America “like Brazil and Venezuela,” said Peter J. Hotez, MD, PhD, dean of the National School of Tropical Medicine at Baylor College of Medicine, in an announcement opinion. “The consequences of a reemergence of a high-mortality infection like yellow fever in the southern United States would be deeply destabilizing.”
Hotez and his research colleague Angelle Desiree LaBeaud of Stanford University reported predicting a resurgence of yellow fever in Thursday's issue TheNew England Journal of Medicine.
The combination of worldwide warming, urbanization and “changing patterns of human migration” are driving predictions that show mosquito-borne infections and viruses will increase dramatically in the approaching years, Hotez and LaBeaud wrote. The threat is best within the southeastern parts of the U.S., emanating from “extreme poverty throughout Texas and the Gulf Coast states, where inadequate or substandard housing, missing or broken window screens, and widespread tire dumping in poor neighborhoods” make for prime breeding grounds for mosquitoes, they explained.
After the virus is transmitted through a mosquito bite, symptoms may appear inside 3 to six days, although not everyone has symptoms. Common symptoms include fever, muscle pain, headache, lack of appetite and vomiting, which often resolve inside 3 to 4 days, in accordance with the WHO World Health Organization. But “a small percentage” of individuals then go right into a toxic second phase inside a day of apparent recovery and might experience high fever and attack on the liver and kidney systems. In the ultimate stages, black vomit may occur resulting from bleeding within the intestines.
“During this phase, people are likely to develop jaundice (yellowing of the skin and eyes, hence the name yellow fever), dark urine and abdominal pain with vomiting,” explains the WHO. “Bleeding can occur from the mouth, nose, eyes or stomach. Half of patients who enter the toxic phase die within 7-10 days.”
According to WHO, yellow fever may be prevented with a protected and inexpensive vaccine. A single dose provides lifelong protection. Yellow fever is currently spreading in 13 Central and South American countries and 34 African countries, where the disease is taken into account endemic.
“The mosquitoes that spread yellow fever are here in the United States, and conditions are becoming more favorable for them as our world warms,” LaBeaud, a professor of pediatric infectious diseases at Stanford Medicine, said within the statement. “We need a comprehensive plan to better protect vulnerable communities in the southern United States from mosquito-borne diseases.”