South faces growing threat of yellow fever resurgence, experts say

The spread of mosquito-transmitted viruses is accelerating in the Southern U.S., stirring concerns about the potential return of yellow fever, two infectious disease experts wrote in an Oct. 14 article for The New England Journal of Medicine.

The two experts are:

  • Peter Hotez, MD, PhD, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children's Hospital Center for Vaccine Development in Houston 
  • Desiree LaBeaud, MD, professor of pediatrics-infectious disease at Stanford (Calif.) Medicine 

Yellow fever outbreaks decimated many Southern cities between 1820 to 1905. The virus, spread by aedes mosquitoes, has a higher mortality rate than other mosquito-transmitted diseases such as dengue or Zika. 

Drs. Hotez and LaBeaud noted that outbreaks of human infections caused aedes mosquitos have already occurred in Florida and Texas. They predict that factors such as climate change and urbanization could create conditions in which future epidemics become more common. 

A vaccine for yellow fever exists, though it is expensive and not currently stored in the Strategic National Stockpile, according to Drs. Hotez and LaBeaud.

"During a sizable epidemic, yellow fever could tear quickly through unimmunized populations across the American South, and it is unlikely that the U.S. government would be prepared to acquire and distribute vaccines in a timely manner, even if there were public demand," they wrote. "We believe yellow fever should be prioritized as part of our national pandemic-preparedness efforts, given that the conditions are now in place for yellow jack to return and sicken many people in southern U.S. cities."

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