Writing in the New England Journal of Medicine, infectious disease experts from Baylor College of Medicine and Stanford University School of Medicine highlight the historic devastation caused by yellow fever between 1820 and 1905 and highlight the potential for a resurgence. As similar diseases increase in the American South, experts advocate increased surveillance, development of antiviral drugs, vaccines and innovative gene drive technology.
Experts are warning of a possible resurgence of yellow fever in the southern United States, advocating for increased disease surveillance, the development of antiviral drugs and innovative mosquito control measures.
Mosquito-borne viral infections are on the rise and are spreading at an accelerated rate in Texas, Florida and other parts of the southern United States. Infectious disease experts at Baylor College of Medicine and Stanford University School of Medicine are warning that yellow fever may be re-emerging in the southern United States as mosquito-borne diseases increase. Their opinion piece on the possible resurgence of the yellow fever virus was published in the October 19 issue of the New England Journal of Medicine. The article calls for prioritizing yellow fever in national pandemic preparedness planning.
Historical influence and current situation
Dr. Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor University and co-director of the Vaccine Development Center at Texas Children's Hospital, is a co-author of the paper. Yellow fever virus is a flavivirus and arboviral infection, like dengue or Zika, but with a much higher mortality rate. Yellow fever is spread by Aedes mosquitoes, which are common in the Caribbean and Latin America and in southern urban areas such as Texas and Florida.
"We've already seen an increase in mosquito-borne diseases in Texas and Florida, including malaria, dengue, chikungunya and Zika, but now we're also concerned about yellow fever, as it appears to be accelerating in tropical regions of Latin America, such as Brazil and Venezuela," Hotez said. "The re-emergence of high-mortality infectious diseases like yellow fever in the southern United States will be deeply destabilizing."
Recommended actions and expert opinion
Experts recommend expanding surveillance activities to combat mosquitoes and mosquito-borne diseases by strengthening local health departments, and developing antiviral drugs, vaccines and new gene drive technology (which permanently alters insect genes through genetic engineering) to control mosquitoes.
"The mosquitoes that transmit yellow fever are here in the United States, and as the world warms, conditions are becoming more favorable for them," said Dr. Desiree LaBeaud, professor of pediatric infectious diseases at Stanford School of Medicine and co-author of the publication. "We need a comprehensive plan to better protect at-risk communities in the southern United States from mosquito-borne diseases."
"One of the reasons we established the National School of Tropical Medicine at Baylor University is to recognize that tropical infectious diseases have become the new normal due to climate change, urbanization and poverty along the U.S. Gulf Coast and Texas," Hotez said.