Due to non-specific acute febrile illness in its early stage including substantial number of asymptomatic cases, there are limitations to define the true incidence and case fatality rate of YF.
- WHO suggests case definitions to survey YF with suspected case as Any person with acute onset of fever, with jaundice appearing within 14 days of onset of the first symptoms.
- A mathematical estimation using Bayesian model showed probability of asymptomatic infection, mild disease and severe disease as 55%, 33% and 12%, respectively, as well as case fatality rate among severe disease as 47%, but the 11 studies authors collected for the study were highly heterogeneous.
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Johansson, M. A., Vasconcelos, P. F. C., & Staples, J. E. (2014). The whole iceberg: Estimating the incidence of yellow fever virus infection from the number of severe cases. Transactions of the Royal Society of Tropical Medicine and Hygiene, 108(8), 482–487. https://doi.org/10.1093/trstmh/tru092
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- A systematic review and meta-analysis concluded from 14 articles that case fatality rate of YF among severe disease is 39% (95%CI 31-47).
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Servadio, J. L., Muñoz-Zanzi, C., & Convertino, M. (2021). Estimating case fatality risk of severe Yellow Fever cases: systematic literature review and meta-analysis. BMC Infectious Diseases, 21(1), 1–12. https://doi.org/10.1186/s12879-021-06535-4
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