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PUBLIC HEALTH RESEARCH
Year : 2009  |  Volume : 1  |  Issue : 1  |  Page : 7-13

Assessing yellow fever risk in the Ecuadorian Amazon


1 Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, USA
2 Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
3 Department of Pathology, Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, USA
4 Ecuadorian Armed Forces Hospital HG-1, Quito, Ecuador, USA
5 Institute for Global Health, School of Medicine, Vanderbilt University, USA

Correspondence Address:
Ricardo O Izurieta
Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.49188

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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.


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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008