A Review of Yellow Fever: Epidemiology, Pathogenesis, Clinical Manifestations, Treatment, Prevention, and Prognosis

Yellow fever is a mosquito-borne viral illness caused by the yellow fever virus (YFV), a member of the Flaviviridae family. Despite the availability of an effective live-attenuated vaccine, the disease remains endemic in regions of Africa and South America. Transmission occurs primarily via an infected mosquito called Aedes aegypti, with distinct urban, sylvatic, and intermediate transmission cycles. Clinically, infection ranges from mild febrile illness to severe disease, which is characterized by jaundice, hemorrhage, and multiorgan failure. Pathogenesis involves viral replication in hepatocytes, immune-mediated injury, and dysregulated inflammatory responses, leading to characteristic hepatic mid-zone necrosis. Diagnosis relies on molecular detection of viral RNA, serological testing, and supporting laboratory findings. Management remains largely supportive, as no antiviral therapy is available. Preventive strategies focus on vaccination and vector control, and surveillance, which are limited during outbreaks, reduce mortality. Yellow fever continues to be a neglected disease despite the availability of an effective vaccine. Improved vaccination coverage and enhanced surveillance systems are essential to prevent its re-emergence in endemic areas.