Key facts

Transmission: vector-borne (mosquito)

Mosquito bite (mostly spread by daytime biting mosquitoes),
Other transmission modes exist but these rarely cause epidemics (for example vertical mother-child transmission is thought to be possible, but is uncommon)

Most vulnerable to severe consequences

Young children and older people are more likely to become very sick or have complications

Most vulnerable to contracting the disease

Every unvaccinated person in the community is vulnerable to yellow fever

General symptoms

(** People show symptoms with different levels of severity. Some people become very sick. Most people develop mild symptoms. Some people do not show any symptoms, but they can still transmit the disease. Prevention of transmission is very important. **)

Sudden fever
Chills
Severe headache
Back pain
General body aches
Nausea
Vomiting
Tiredness
Weakness

Symptoms of severe infection

(** Some people will develop severe yellow fever after a brief remission – a brief period when they feel better, before developing severe symptoms. **)

High fever
Yellow skin or eyes (jaundice)
Bleeding

What can you do to prevent and control an epidemic?

Vector control and prevention

Initiate elimination of mosquitos and breeding sites
- Remove standing water and apply larvicides
- Promote community clean-up campaigns to remove rubbish and cover water containers
Prevent mosquito bites by advocating the use of:
- Insecticide-treated curtains or screens on windows and doors
- Personal protection (application of repellents, wearing long sleeved clothes)
- Insecticide-treated bed nets for children and others who sleep during the day

Monitoring the community and identifying sick people

Identify community members who have suspected yellow fever disease based on the community case definition

Treatment and management

Rapidly detect and refer severe cases to health facilities
Provide psychosocial support to the sick person and their family members

Social mobilization and behaviour change

Find out the specific advice being given by health and other relevant authorities
Model following this advice and inform community members of current health practice advice
Offer support and encouragement to follow the advice
- Try to gain understanding about if and why health practice advice is not being followed
- With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices

Immunization

Support routine and mass vaccination campaigns (if available)

Mapping and community assessment

Make a map of the community.
Mark the following information on the map:
- How many people have fallen sick with yellow fever? Where?
- How many people have died? Where? When?
- Who and where are the vulnerable people?
- Where are the local health facilities and services? (include traditional healers)
Record the following information on the back of the map:
- When did people start to fall sick with yellow fever?
- How many people live in the affected community?
  - How many are children under five years?
- Are children and adults in the affected community vaccinated against yellow fever?
  - Is a vaccination campaign planned?
- What are the community’s habits, practices and beliefs regarding vaccination?
  - What prevents people from having their children vaccinated?
- Have the authorities established a vector control programme?
- Do people generally cover their water containers (inside and outside)? Who is responsible for the maintenance of containers for household drinking water and for vessels to do laundry; is it women or men?
- How does the community usually remove standing, stagnant water?
- What are the usual ways of disposing of rubbish and solid waste in the community?
- How common is it for people to live in houses with insect screens on windows and doors?
- How common is it for people to sleep under insecticide-treated bed nets?
  - How many children and pregnant women sleep under a bed net at night?
  - Are nets hung up and maintained properly?
  - If people are not using nets, why not?
- What are the community’s habits, practices and beliefs about repellents and sprays?
- What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between men and women.
  - When babies and infants are sick, do women continue to breastfeed them?
- Are children badly affected by yellow fever? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected?
- Is a social mobilization or health promotion programme in place?
- Which sources do people use/trust the most for information?
  - Are there rumours or misinformation about yellow fever? What are the rumours?
- Who spends more time in the household during the day (and is more exposed to the mosquito bite)? Women, or men, or both?

Volunteer actions

25. Mass vaccination campaigns 24. Routine vaccinations 01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 05. Volunteer protection and safety 12. Managing fever 19. Psychosocial support 36. Vector and reservoir control 37. Mosquito nets / bed nets 38. Waste disposal and clean-up campaigns 43. Social mobilization and behaviour change