Yellow fever, scourge from the 1800s, is coming back

“Yellow jack” is back.

The mosquito-borne disease known as yellow fever is primed for a resurgence, say medical experts, and the US is woefully unprepared.

Yellow fever joins other diseases — malaria, dengue, leishmaniasis — that were once confined to the tropics, but have now spread northwards into the US due to a warming climate.

There is no cure for yellow fever, and up to 60% of people who develop a severe form of the disease will die, according to the Centers for Disease Control and Prevention.

And although an effective vaccine is available, the US has a limited supply, and the vaccine can cause a reaction in some people.

“Currently, the US population is nearly entirely unvaccinated against yellow fever, and there are no vaccine doses in the US Strategic National Stockpile,” wrote the authors of a report in the New England Journal of Medicine.

“During a sizable epidemic, yellow fever could tear quickly through unimmunized populations across the American South, and it is unlikely that the US government would be prepared to acquire and distribute vaccines in a timely manner, even if there were public demand.”

Public health experts fear that population growth in the South — including boomtowns like Galveston, Corpus Christi and Houston, Texas; Mobile, Alabama; New Orleans; Miami and Tampa, Florida — could fuel an epidemic similar to those that terrorized the region in centuries past.

“During the 1800s, yellow fever caused highly lethal and economically devastating urban epidemics in southern U.S. coastal cities and those on the Mississippi River,” the authors wrote.

“It was sometimes known as ‘yellow jack,’ from the name of a nautical flag hoisted from ships arriving from the Caribbean that were quarantined because of suspected cases of the disease.”

In addition to climate change, economic factors can affect the spread of yellow fever and other mosquito-borne diseases.

“The reason why poverty is important is, for instance, here in Texas . . . in our low-income neighborhoods we have a lot of tire dumping, and tires with a little bit of water are great for breeding . . . mosquitoes,” Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine, said in an NEJM interview.

Yellow fever is caused by a virus spread by Aedes aegypti mosquitoes. The disease causes about 30,000 deaths worldwide per year, according to the Cleveland Clinic.

Symptoms can include fever, headache, body aches, nausea and vomiting. In severe cases, organ failure, hemorrhaging and jaundice — yellowing of the skin and eyes — can precede death.

Experts advise protection against mosquitoes such as wearing insect repellent and protective clothing, and getting the vaccine if traveling to an area where yellow fever is common.

“We believe yellow fever should be prioritized as part of our national pandemic-preparedness efforts, given that the conditions are now in place for yellow jack to return and sicken many people in southern U.S. cities,” the report authors wrote.