Infectious Diseases More Infectious Diseases Yellow Fever Guide Yellow Fever Guide Symptoms Causes Symptoms of Yellow Fever By Adrienne Dellwo Adrienne Dellwo LinkedIn Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. Learn about our editorial process Updated on June 13, 2022 Medically reviewed by Ronald Lubelchek, MD Medically reviewed by Ronald Lubelchek, MD LinkedIn Ronald Lubelchek, MD, is a board-certified physician and medical director in Chicago, Illinois who specializes in infectious diseases. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Frequent Symptoms Rare Symptoms- Stage 3 Risk of Complications When to See a Healthcare Provider Frequently Asked Questions Next in Yellow Fever Guide Causes and Risk Factors of Yellow Fever Yellow fever is named for two of its main symptoms: Fever and the possibility of jaundice, which causes the skin and eyes to take on a yellowish tinge. This condition can also cause many other symptoms, including a headache, body aches, vomiting, and fatigue. Rarely, it can become severe and may cause multi-organ failure, which can be fatal. © Verywell, 2018 Frequent Symptoms Many people who contract a mild case of yellow fever will never even know it because they won't have any symptoms at all. Others with a mild case will get sick between three and six days after they're infected. Stage 1 Yellow fever either has two stages or progresses through three stages. Stage 1 is what starts after a three to six day incubation period. The initial symptoms of yellow fever come on quickly and can include any of the following: High fever Chills A severe headache Back pain Widespread body aches Nausea and vomiting Lack of appetite Dizziness Fatigue Weakness These symptoms generally last for two to four days and then go away. Most people get better and stay better—the disease doesn't progress any further. Stage 2 The next stage, remission, is when the symptoms go away. Most of the time, the recovery is permanent, without any recurrence of symptoms. Some people will have weakness and fatigue that continues for several months, but then they, too, will completely recover. But in rare cases, it progresses to stage 3, which has its own set of symptoms. Rare Symptoms- Stage 3 Only around 15% of people who get yellow fever develop severe illness, broadly described as the toxic stage of Infection. Before this stage, there will be a brief period of remission in which the person will feel well for about 24 to 48 hours. Stage 3 occurs between 6 and 11 days from the initial infection when symptoms suddenly come rushing back, and new symptoms begin. Toxic stage symptoms can include: Return of a high feverPossible jaundice (yellowing) due to damage to the liverFatigue and lethargyDark urineAbdominal pain with vomitingBleeding from the gums, nose, eyes, and/or stomachBloody stoolsBloody vomitEasily bruised skinConfusionShockKidney, liver, or other organ failureIrregular heartbeatsDeliriumSeizuresComa is possibleDeath is possible Between 20 and 50 percent of the people who go on to phase 3 of the disease die within the next week or two. Risk of Complications Babies and people over 50 years old are more likely than others to develop severe symptoms and to die from yellow fever, making prevention especially important for those age groups. Some people are also more susceptible to having a severe infection, and some strains of the disease are more serious than others. For people who survive yellow fever—which is the vast majority of those who are infected—the illness goes away and the organ damage heals. Once you've had yellow fever, you're generally immune to it and won't be infected again even if you're exposed. When to See a Healthcare Provider If you've been to a region where yellow fever is a risk and you begin developing stage 1 symptoms, call your healthcare provider for advice on how to take care of yourself. If you begin to experience symptoms of stage 3, get emergency medical attention right away. There's no specific treatment that can cure the illness but it's important to have proper monitoring and management of your symptoms. This may include fluid management, medication to stop seizures, and more. Yellow fever sounds scary, but the toxic stage is rare and most people survive it. If 100 people contract yellow fever during an outbreak in a city, that means about 15 would move on to stage 3. Depending on factors like age, susceptibility, the specific strain, and the quality of available medical care, at least three people and possibly as many as seven or eight would die. While those deaths are tragic, don't forget the big picture. Your odds of survival are high if you do contract the illness. Of course, it's better not to risk it at all, which means getting the vaccine before going into high-risk areas and doing what you can to prevent mosquito bites. Frequently Asked Questions What are the common symptoms of yellow fever? Not everyone who gets yellow fever will develop symptoms. Of those that do, the majority of cases are relatively mild.Signs and symptoms may include:HeadacheFever and chillsFatigueMuscle aches (particularly in the back or back of the knees)Nausea or vomitingLoss of appetite What are symptoms of the toxic stage of yellow fever? The second stage of yellow fever, called the toxic stage, occurs in around 15% of cases. This stage is characterized by a systemic infection involving the liver, kidneys, brain, and other organ systems.Signs and symptoms may include:Recurring high feverJaundice (yellowing of the skin and eyes)Ascites (abdominal swelling)Bleeding from the mouth, nose, or eyesBloody vomit (caused by gastrointestinal bleeding)Decreased urination and fluid retention (due to kidney failure)Abnormal heart rhythmDelirium and seizures (due to encephalopathy)Coma How soon do yellow fever symptoms appear? Symptoms of yellow fever usually develop within three to seven days of being bitten by an infected mosquito. For the 15% who experience toxic-stage infection, symptoms will develop one to two days after the initial symptoms have gone into apparent remission, only to rebound with more severe and potentially life-threatening symptoms. How long do yellow fever symptoms last? Mild cases of yellow fever often resolve within three to four days. Among those who enter the toxic stage, a longer duration of symptoms translates to a higher risk of death. Therefore, every effort is made to provide aggressive supportive care to help prevent or reduce the impact of liver or kidney failure. What is the risk of death from yellow fever? The overall risk of death from yellow fever is between 3% and 7.5%. If jaundice or kidney failure develop, the risk increases to between 20% and 50%. If the infection is severe and persists for more than seven days, the risk of death climbs to 50% or higher. Can you be reinfected with yellow fever? People who recover from yellow fever have long-lasting immunity and usually cannot be infected again. The same applies to anyone who has been vaccinated. Once recovered, people will usually experience no organ damage or significant aftermath. Causes and Risk Factors of Yellow Fever 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Simon LV, Hashmi MF, Torp KD. Yellow fever. In: StatPearls [Internet]. Centers for Disease Control and Prevention. Yellow fever: frequently asked questions. McGuinness I, Beckham JD, Tyler KL, Pastula DM. An overview of yellow fever virus disease. Neurohospitalist. 2017;7(4):157-8. doi:10.1177/1941874417708129 Lopes RL, Pinto JR, Silva Junior GB da, Santos AKT, Souza MTO, Daher EDF. Kidney involvement in yellow fever: a review. Rev Inst Med Trop S Paulo. 2019;61:e35. doi:10.1590/S1678-9946201961035 By Adrienne Dellwo Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. 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