Infectious Disease Experts Warn: Brace for Yellow Fever Resurgence in U.S.

Experts warn of a potential resurgence of yellow fever in the American South, advocating for enhanced disease surveillance, antiviral development, and innovative mosquito control measures.

Mosquito-transmitted virusA virus is a tiny infectious agent that is not considered a living organism. It consists of genetic material, either DNA or RNA, that is surrounded by a protein coat called a capsid. Some viruses also have an outer envelope made up of lipids that surrounds the capsid. Viruses can infect a wide range of organisms, including humans, animals, plants, and even bacteria. They rely on host cells to replicate and multiply, hijacking the cell's machinery to make copies of themselves. This process can cause damage to the host cell and lead to various diseases, ranging from mild to severe. Common viral infections include the flu, colds, HIV, and COVID-19. Vaccines and antiviral medications can help prevent and treat viral infections.” data-gt-translate-attributes=”[{“attribute”:”data-cmtooltip”, “format”:”html”}]”>virus infections are on the rise and their spread is accelerating in Texas, Florida, and elsewhere in the American South. With the rise of mosquito-borne illnesses, infectious disease experts at Baylor College of Medicine and Stanford School of Medicine are warning of the possible re-emergence of yellow fever in the southern portion of the U.S. Their perspective piece on the virus’ potential return was published on October 19 in the New England Journal of Medicine. It calls for yellow fever to be prioritized in national pandemic preparedness planning.

Historical Impact and Current Situation

Yellow fever is a mosquito-borne viral illness that decimated southern U.S. cities in regular epidemics in New Orleans, Galveston, Memphis, and Charleston from 1820 to 1905, according to Dr. Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor and co-director of the Texas Children’s Hospital Center for Vaccine Development and co-author of the paper. The virus is a flavivirus and arbovirus infection like dengue or Zika virus, but with much higher mortality. Yellow fever is transmitted by Aedes mosquitoes, which are common in the Caribbean and Latin America, as well as southern urban areas like those in Texas and Florida.

“We’ve seen a rise in mosquito-transmitted illnesses in Texas and Florida, including malaria, dengue, chikungunya, and Zika virus, but now we’re also worried about yellow fever since it seems to be accelerating in tropical regions of Latin America such as Brazil and Venezuela,” Hotez said. “The consequences of a high mortality infection like yellow fever re-emerging in the southern U.S. would be profoundly destabilizing.”

Proposed Measures and Expert Insights

Experts propose expanding surveillance activities by enhancing local health departments to combat mosquitoes and mosquito-borne illnesses as well as developing antiviral drugs, vaccines, and new gene drive technology (permanently altering insect genes through genetic engineering) for mosquito control efforts.

“The mosquitoes that spread yellow fever are here in the U.S. and conditions are increasingly favorable for them as our world warms,” said Dr. Desiree LaBeaud, professor of pediatrics-infectious disease at Stanford Medicine and co-author of the publication. “We need a comprehensive plan to better protect at-risk communities in the southern U.S. from mosquito-borne diseases.”

“One of the reasons we established National School of Tropical Medicine at Baylor was in recognition that tropical infections have become a new normal due to a confluence of climate change, urbanization, and poverty on the U.S. Gulf Coast and Texas,” Hotez said.

Reference: “Yellow Jack’s Potential Return to the American South” by Peter J. Hotez and Angelle Desiree LaBeaud, 13 October 2023, New England Journal of Medicine.
DOI: 10.1056/NEJMp2308420