Reporting & Investigation of Yellow Fever

Table of Contents

A. Purpose of Surveillance and Reporting

  • To identify imported cases of yellow fever to understand the global epidemiology of endemic and epidemic yellow fever.

  • To ensure that cases are appropriately contained to prevent the introduction of virus into native mosquito populations.
  • To identify locally acquired cases, if they occur, so appropriate active surveillance and mosquito control interventions can be taken.
  • To identify cases that may be part of a larger, worldwide outbreak.
  • To provide travelers with appropriate preventive health information.

B. Laboratory and Healthcare Provider Reporting Requirements

Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report immediately. The reporting phone number for IDPH Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698.

Laboratory Testing Services Available

Laboratory testing for yellow fever is not available at the University of Iowa State Hygienic Laboratory (SHL). However, the SHL serology laboratory will forward specimens to the Centers for Disease Control and Prevention (CDC) for yellow fever testing. CDC requests that physicians submit complete case history information with the specimens. For additional information on submitting samples, contact SHL Serology at 319-335-4500, or visit: www.shl.uiowa.edu/  

C. Local Public Health Agency Follow-Up Responsibilities

Case Investigation

Case investigation of yellow fever in Iowa residents will be directed by IDPH Center for Acute Disease Epidemiology (CADE).

Following notification of IDPH, the LPHA(s) may be asked to assist in an investigation of a case of yellow fever by interviewing the case and others who may be able to provide pertinent information. Most of the information required can be obtained from the medical provider or the medical record. Use the following guidelines to assist in conducting an investigation:

  • Confirm the diagnosis of Yellow Fever with the case’s healthcare provider and request a copy of all laboratory tests used to diagnose the illness.
  • Record the case’s demographic information.
  • Record the date of symptom onset, symptoms, date of diagnosis, hospitalization information (if applicable), and outcome of disease (e.g., recovered, died).
  • Exposure history: use the approximate incubation period range for yellow fever (3-6 days). Specifically, focus on the period beginning 3 days prior to the onset date back to approximately 6 days before onset for travel history: determine the date(s) and geographic area(s) traveled to by the case.
  • If there is NO history of travel outside of the United States within 6 days prior to illness onset notify IDPH immediately and begin active surveillance for additional cases where the individual may have traveled, their home and work.
  • Include information about the case’s yellow fever vaccination status, including the date most recently vaccinated.
  • If several attempts to obtain case information have been made, but have been unsuccessful (e.g., the case or healthcare provider does not return calls or respond to a letter, or the case refuses to divulge information or is too ill to be interviewed), please gather as much information as possible, notify CADE and enter as much information as is possible through the Iowa Disease Surveillance System (IDSS).