Please wait a minute...
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    0, Vol. Issue () : 527-530    https://doi.org/10.1007/s11684-016-0487-2
COMMENTARY
Yellow fever and Hajj: with all eyes on Zika, a familiar flavivirus remains a threat
Qanta A. Ahmed1,Ziad A. Memish2,3()
1. Division of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Winthrop University Hospital; State University of New York (SUNY) at Stony Brook, NY 11790, USA
2. Ministry of Health, Riyadh 11514, Kingdom of Saudi Arabia
3. College of Medicine, Alfaisal University, Riyadh 11533, Kingdom of Saudi Arabia
 Download: PDF(142 KB)   HTML
 Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
Abstract

Hajj is among the world’s largest mass gatherings, drawing between 2 and 3.5 million Muslims from 183 nations annually to perform pilgrimage in Mecca, Saudi Arabia. Infectious disease outbreaks can be imported both into the Hajj population and exported internationally by returning pilgrims. The domestic Saudi population can also be at risk of outbreaks traveling amid this mass migration. With yellow fever reported for the first time in China following the infection of expatriate Chinese workers in Angola and a full blown outbreak underway in wider West Africa, the prospect of yellow fever outbreaks in Asia threatens to impact Saudi Arabia, both during and beyond the Hajj season. With global focus trained on Zika, the rising threat of yellow fever cannot be overlooked. Strategies to mitigate risk to Saudi Arabia and the global population are thereby suggested.

Keywords yellow fever      mass gathering      Saudi Arabia      Hajj      Zika virus     
Corresponding Author(s): Ziad A. Memish   
Just Accepted Date: 15 September 2016   Online First Date: 17 October 2016    Issue Date: 01 December 2016
 Cite this article:   
Qanta A. Ahmed,Ziad A. Memish. Yellow fever and Hajj: with all eyes on Zika, a familiar flavivirus remains a threat[J]. Front. Med., 0, (): 527-530.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0487-2
https://academic.hep.com.cn/fmd/EN/Y0/V/I/527
Yellow fever virus Zika virus
Causative virus YF virus
(Flavivirus)
Zika virus
(Flavivirus)
Single stranded RNA Single stranded RNA
Non-human host Forest-dwelling non-human primate Non-human primate (Rhesus monkey)
Vector Aedes mosquitos Aedes mosquitos
Incubation period 3?6 days 3?12 days
Geographic distribution Tropical rain forests of Africa and South America Africa, the Pacific Islands, South-east Asia, large part of South/Central America, a number of islands in the Caribbean, including Puerto Rico, the Virgin Islands, and Mexico
Human-to-human transmission Breast feeding
Exposure to infected blood/organs
Mosquito bites
From a pregnant woman to her fetus
Sexual contact
Blood transfusion
Clinical features Asymptomatic
Mild febrile illness Severe disease with jaundice and hemorrhage
Contact with tears
Asymptomatic (80%)
Mild febrile illness: headache; arthralgia; myalgia; conjunctivitis; fever; vomiting; maculopapular rash; prostration; edema of extremities
Complications Liver failure, renal failure, DIC Congenital microcephaly, Guillain Barrie syndrome, meningoencephalitis, acute myelitis
Mortality (%) 20?50 0
Diagnostic test Virus isolation, viral antigen in tissue, viral RNA in blood and tissue (RT-PCR), serology Viral RNA in blood (RT-PCR), serology
Prevention Vaccine
Mosquito prevention measure
No vaccine
Mosquito prevention measure
Tab.1  Comparison between yellow fever and Zika virus
Fig.1  Map of Saudi Arabia indicating all (sea, air, and land) ports of entry for Hajj.
1 Wasserman S, Tambyah PA, Lim PL. Yellow fever cases in Asia: primed for an epidemic. Int J Infect Dis 2016; 48: 98–103
https://doi.org/10.1016/j.ijid.2016.04.025 pmid: 27156836
2 Elachola H, Ditekemena J, Zhuo J, Gozzer E, Marchesini P, Rahman M, Sow S, Kattan RF, Memish ZA. Yellow fever outbreaks, vaccine shortages and the Hajj and Olympics: call for global vigilance. Lancet 2016 Sep 5. [Epub ahead of print]
https://doi.org/10.1016/S0140-6736(16)31546-X
3 Wang L, Zhou P, Fu X, Zheng Y, Huang S, Fang B, Zhang G, Jia K, Li S. Yellow fever virus: increasing imported cases in China. J Infect 2016; 73(4):377–380
https://doi.org/DOI: 10.1016/j.jinf.2016.07.003 pmid: 27422700
4 Gulland A.Vigilance still needed to contain Africa’s yellow fever outbreak, says WHO. BMJ 2016; 354:i4756
https://doi.org/10.1136/bmj.i4756
5 Beasley DW, McAuley AJ, Bente DA. Yellow fever virus: genetic and phenotypic diversity and implications for detection, prevention and therapy. Antiviral Res 2015; 115: 48–70 PMID:25545072
https://doi.org/10.1016/j.antiviral.2014.12.010
6 Monath TP, Vasconcelos PF. Yellow fever. J Clin Virol 2015; 64: 160–173
https://doi.org/10.1016/j.jcv.2014.08.030 pmid: 25453327
7 Burki T. Yellow fever in Africa: a disaster waiting to happen. Lancet Infect Dis 2016; 16(8): 896–897 PMID:27477983
https://doi.org/10.1016/S1473-3099(16)30224-9
8 Maguire HC, Heymann DL. Yellow fever in Africa. BMJ 2016; 354: i3764
https://doi.org/10.1136/bmj.i3764 pmid: 27422309
9 WHO. Yellow fever global vaccine stockpile in emergencies. <Date>(Accessed September 10, 2016)</Date>
10 Jamie A. Yellow fever spreads rapidly in Africa, vaccine supply running low. <Date>(Accessed September 10, 2016)</Date>
11 Barrett AD. Yellow fever in Angola and beyond—the problem of vaccine supply and demand. N Engl J Med 2016; 375(4): 301–303
https://doi.org/10.1056/NEJMp1606997 pmid: 27276108
12 Kupferschmidt K. Yellow fever outbreak triggers vaccine alarm. Science 2016; 352(6282): 128–129
https://doi.org/10.1126/science.352.6282.128 pmid: 27124428
13 No authors listed. Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj), 2016. Wkly Epidemiol Rec 2016; 91(26-27): 331–335 PMID:27372990
14 Mo Y, Alferez Salada BM, Tambyah PA. Zika virus—a review for clinicians. Br Med Bull 2016; 119(1): 25–36
https://doi.org/10.1093/bmb/ldw023 pmid: 27283145
[1] Weibao Song, Hongjuan Zhang, Yu Zhang, Rui Li, Yanxing Han, Yuan Lin, Jiandong Jiang. Repurposing clinical drugs is a promising strategy to discover drugs against Zika virus infection[J]. Front. Med., 2021, 15(3): 404-415.
[2] Xiaohuan Wang, Peng Zou, Fan Wu, Lu Lu, Shibo Jiang. Development of small-molecule viral inhibitors targeting various stages of the life cycle of emerging and re-emerging viruses[J]. Front. Med., 2017, 11(4): 449-461.
[3] Ali A. Rabaan, Ali M. Bazzi, Shamsah H. Al-Ahmed, Jaffar A. Al-Tawfiq. Molecular aspects of MERS-CoV[J]. Front. Med., 2017, 11(3): 365-377.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed