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
(** 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
- Severe headache
- Back pain
- General body aches
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)
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
- 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?