Infectious disease experts from Baylor College of Medicine and Stanford School of Medicine have issued a warning about the possible re-emergence of yellow fever in the American South. In a publication in the New England Journal of Medicine, they highlight the historical devastation caused by yellow fever between 1820 and 1905 and stress the need for enhanced disease surveillance, antiviral development, and innovative mosquito control measures.

The spread of mosquito-transmitted virus infections is on the rise, particularly in states like Texas and Florida. This has raised concerns among the experts about the resurgence of yellow fever in the southern region of the United States. Their perspective piece on the potential return of the virus was published on October 19 in the New England Journal of Medicine, urging national pandemic preparedness planning to prioritize yellow fever.

Yellow fever, a mosquito-borne viral illness, wreaked havoc on southern U.S. cities from 1820 to 1905. Dr. Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor, explains that yellow fever is a flavivirus and arbovirus infection, similar to dengue or Zika virus but with a higher mortality rate. It is transmitted by Aedes mosquitoes, which are prevalent in the Caribbean and Latin America, as well as urban areas in Texas and Florida.

"We've witnessed a surge in mosquito-transmitted illnesses such as malaria, dengue, chikungunya, and Zika virus in Texas and Florida. However, our concern has now shifted to yellow fever, as its prevalence seems to be increasing in tropical regions of Latin America," warns Dr. Hotez. He further emphasizes that the consequences of a high mortality infection like yellow fever re-emerging in the southern U.S. would be exceptionally destabilizing.

To address this potential threat, experts propose expanding surveillance activities by strengthening local health departments' capabilities in combating mosquitoes and mosquito-borne illnesses. They also emphasize the urgent need for the development of antiviral drugs, vaccines, and new gene drive technology, which permanently alter insect genes through genetic engineering, for effective mosquito control efforts.

Dr. Desiree LaBeaud, professor of pediatrics-infectious disease at Stanford Medicine and co-author of the publication, highlights the importance of a comprehensive plan to protect at-risk communities in the southern U.S. from mosquito-borne diseases. With climate change, urbanization, and poverty contributing to the increased prevalence of tropical infections, the National School of Tropical Medicine at Baylor was established to address these emerging challenges on the U.S. Gulf Coast and Texas.

The warning issued by the infectious disease experts serves as a wake-up call for the American South to bolster preventive measures and invest in research and infrastructure to combat mosquito-borne diseases. With the threat of yellow fever looming, it is crucial to prioritize the protection of vulnerable communities and mitigate the potential devastation caused by the virus.

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.