Open AccessAssessing yellow fever risk in the Ecuadorian Amazon
Author(s) -
Ricardo Izurieta,
Maurizio Macaluso,
Douglas M. Watts,
Robert B. Tesh,
Bolivar Guerra,
Ligia M Cruz,
Sagar Galwankar,
Sten H. Vermund
Publication year - 2009
Publication title -
journal of global infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.437
H-Index - 25
eISSN - 0974-8245
pISSN - 0974-777X
DOI - 10.4103/0974-777x.49188
Subject(s) - yellow fever , dengue fever , outbreak , jaundice , medicine , virology , transaminase , transmission (telecommunications) , immunology , biology , virus , biochemistry , electrical engineering , enzyme , engineering
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.