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I had a very confusing situation with a case at work. While protecting identities here, most people don't know my new workplace. I will also keep the age of this patient hidden, but knowing their sex/gender is very important, so I'll add that here.

About a week ago, our team saw a patient who had different readings regarding her genotype. She had been wrongly told by one lab that she was an AA genotype, and another lab told her she was SS. In places where things like this matter, the first lab would have been taken to court for such a poor assessment, but this is Nigeria, and we don't even have data on the level of malpractice in the health sector. Hopefully, we can address that together in the future.

This patient came in with yellow eyes (icterus) and a fever, which is a warning sign for yellow fever, and she was admitted.

During my rounds, I had to ask questions about Yellow Fever and Lassa Fever because, in addition to having icterus and fever, she also had a urine dipstick that was positive for blood.

I was already about to dial the WHO representative, especially after asking her if she was constantly being exposed to rats, and she said she did and was getting bitten by mosquitoes in the daytime, meaning she was being exposed to a different type of mosquito aside from the female anopheles, possibly Egypti.

On the other hand, after days in the ward, her eyes began to turn clear white, and on further questioning, the urine analysis was done while she was menstruating...phew!!

Source

We, as health care professionals, can make those calls. My confusion was partly due to my wild imagination and a few key details that were not added to her medical notes (her last menstrual period, for example). After a little clarification...call it due diligence, we didn't have to send someone into isolation and possibly raise a state of emergency.

What is Yellow Fever and why should you care? Well, not all of you have to care, especially if you don't live in a country where the can be any resurgence. For some of you reading this, think of it as a tour into the health of the underdeveloped world.

Yellow fever is a cause of viral hemorrhagic fever. Was the name implies, it's a group of viral infections that cause haemorrhage and fever. Yellow fever happens to be a very rare one.

This condition is yet another condition caused by mosquitoes and adds to the number of deaths caused by malaria. This is not caused by the female anophales but by Aedes aegypti.

Unlike its cousin that bites at night, this one attacks during the day.

I already outlined some of the features that are suggestive of this dreaded disease. But here are the most important features:

• A recent fever followed by
• Yellow eyes
  All these typically happen within 2 weeks.

If you notice these symptoms, it is important that you see a medical facility as soon as possible so you can be evaluated and tested.

The test done depends on how long the symptoms have lasted:

• Serology – IgM Antibody Detection: Done 3-5 days of the illness.
• Test: RT-PCR for Yellow Fever virus RNA: Done 1 week of the illness
• Plaque Reduction Neutralisation Test (PRNT): Done for confirmation

Other tests are also done, including a liver function test and a Clotting profile.

In the case of suspicion of Yellow Fever, the suspected patient will need to be isolated. The reason for this is that the mosquitoes in the area do not get infected and spread the infection to others.

Treatment is usually done in an Isolation ward, preferably in the intensive care unit.

If you notice these changes in yourself or those around you, it is important to seek help. Also, if you are yet to get immunised. Here is a link to locate a vaccination centre

Call 0809 955 5577

References

• https://ncdc.gov.ng/diseases/info/Y
• https://www.who.int/emergencies/disease-outbreak-news/item/2021-DON336
• https://tripguide.com.ng/list-of-vaccination-centres-yellow-card-issuance-and-points-of-entry-locations/