Assessing yellow Fever risk in the ecuadorian Amazon

• Published in: Journal of global infectious diseases Vol. 1; no. 1; pp. 7 - 13
• Main Authors: Izurieta, Ricardo O, Macaluso, Maurizio, Watts, Douglas M, Tesh, Robert B, Guerra, Bolivar, Cruz, Ligia M, Galwankar, Sagar, Vermund, Sten H
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.01.2009; Medknow Publications & Media Pvt. Ltd; Medknow Publications; Wolters Kluwer Medknow Publications
• Subjects: Armed forces; Coma; Diagnosis; Disease; Disease outbreak; Disease transmission; Ecuador; Family medical history; Fever; Human subjects; Immune response; Military personnel; Monkeys & apes; Mortality; Patients; Physiological aspects; Population; Public Health Research; Rainforests; Risk factors; Tropical diseases; Yellow fever; United States; South America; Brazil; Ecuador; Bolivia; Peru; Ecuador; Disease outbreak; Military personnel; Risk factors; Yellow fever
• ISSN: 0974-777X; 0974-8245
• DOI: 10.4103/0974-777X.49188

This study reports results of a cross-sectional study based on interviews and seroepidemiological methods to identify risk factors for yellow fever infection among personnel of a military garrison in the Amazonian rainforest. Clinical symptoms and signs observed among yellow fever cases are also described. Humoral immune response to yellow fever, Mayaro, Venezuelan equine encephalitis, Oropouche, and dengue 2 infection was assessed by evaluating IgM and IgG specific antibodies. A yellow fever attack rate of 13% (44/341, with 3 fatal cases) was observed among military personnel. Signs of digestive track bleeding (14.6%) and hematuria (4.9%) were observed among the yellow fever cases. In 32.2% of the cases, we measured high levels of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase with maximum levels of 6,830 and 3,500, respectively. Signs of bleeding or jaundice were observed in some cases, and high levels of transaminases were seen. The epidemiological and laboratory investigations demonstrated that the military personnel were affected by a yellow fever outbreak. The association between clearing the rainforest and also being at the detachments with yellow fever infection confirms that clearing is the main factor in the jungle model of transmission, which takes place deep in the Amazonian rainforest.