Yellow fever is an acute haemorrhagic fever caused by the yellow fever virus, an RNA virus in the Flaviviridae family. It infects humans, other primates, and Aedes aegypti and other mosquito species, which act as the vector. After transmission by the bite of a female mosquito, the virus replicates in lymph nodes, infecting dendritic cells, and can then spread to liver hepatocytes. Symptoms generally last 3–4 days, and include fever, nausea and muscle pain. In around 15% of people, a toxic phase follows with recurring fever, liver damage and jaundice, sometimes accompanied by bleeding and kidney failure; death occurs in 20–50% of those who develop jaundice. Infection otherwise leads to lifelong immunity.
The first definitive outbreak of yellow fever was in Barbados in 1647, and major epidemics have occurred in the Americas and southern Europe since that date. Yellow fever is endemic in tropical and subtropical areas of South America and Africa; its incidence has been increasing since the 1980s. An estimated 200,000 cases and 30,000 deaths occur each year, with almost 90% of cases being in Africa. Antiviral therapy is not effective. A vaccine is available, and vaccination, mosquito control and bite prevention are the main preventive measures.