https://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&feed=atom&action=historyYellow Fever Vaccine - Revision history2024-03-28T16:05:21ZRevision history for this page on the wikiMediaWiki 1.39.6https://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=119576&oldid=prevBarichD at 18:04, 9 February 20162016-02-09T18:04:33Z<p></p>
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</table>BarichDhttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=119575&oldid=prevBarichD at 18:03, 9 February 20162016-02-09T18:03:56Z<p></p>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Edited by Christopher Kei Helm of [mailto:slonczewski@kenyon.edu Joan Slonczewski] for [http://biology.kenyon.edu/courses/biol238/biol238syl14.html BIOL 238 Microbiology], 2014, [http://www.kenyon.edu/index.xml Kenyon College].</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Edited by Christopher Kei Helm of [mailto:slonczewski@kenyon.edu Joan Slonczewski] for [http://biology.kenyon.edu/courses/biol238/biol238syl14.html BIOL 238 Microbiology], 2014, [http://www.kenyon.edu/index.xml Kenyon College].</div></td></tr>
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</table>BarichDhttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103272&oldid=prevHelmc at 00:25, 9 May 20142014-05-09T00:25:54Z<p></p>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> As a result of the effectiveness of the yellow fever vaccine 17D, a critical avenue of research has been to use the YF-17D cells and chimeric variants to produce vaccines against other arbovirus diseases such as dengue fever (DENV), West Nile (WNV), and Japanese encephalitis (JEV). Each of these three diseases presents an urgent public health issue. Currently, there have yet to be any vaccines developed for DENV or WNV further reinforcing the need for these vaccines.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> As a result of the effectiveness of the yellow fever vaccine 17D, a critical avenue of research has been to use the YF-17D cells and chimeric variants to produce vaccines against other arbovirus diseases such as dengue fever (DENV), West Nile (WNV), and Japanese encephalitis (JEV). Each of these three diseases presents an urgent public health issue. Currently, there have yet to be any vaccines developed for DENV or WNV further reinforcing the need for these vaccines.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>A new technology, called ChimeriVax has been developed and fine tuned in the last decade and has began to show promising results for making available a vaccine for these viruses.<sup>52</sup> Specifically, with the ChimeriVax technology, scientists have been able to clone the YF-17D genome into cDNA and excise the specific genes that encode the E and prM proteins of the YFV and replace it with the gene for the E and prM protein of the target virus such as DENV (Fig. 8).<sup>53</sup> Then, by transcribing the modified cDNA into RNA and growing the new virus in a cell culture, scientists have been able to create a new, chimeric virus that is designed to develop immunity against a different disease. Fortunately, promising chimeric vaccines for all three have been developed and await clinical trials before moving to commercial availability.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>A new technology, called ChimeriVax has been developed and fine tuned in the last decade and has began to show promising results for making available a vaccine for these viruses.<sup>52</sup> Specifically, with the ChimeriVax technology, scientists have been able to clone the YF-17D genome into cDNA and excise the specific genes that encode the E and prM proteins of the YFV and replace it with the gene for the E and prM protein of the target virus such as DENV (Fig. 8).<sup>53</sup> Then, by transcribing the modified cDNA into RNA and growing the new virus in a cell culture, scientists have been able to create a new, chimeric virus that is designed to develop immunity against a different disease.<ins style="font-weight: bold; text-decoration: none;"><sup>54</sup> </ins>Fortunately, promising chimeric vaccines for all three have been developed and await clinical trials before moving to commercial availability.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> <u>Climate Change and Yellow Fever</u></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> <u>Climate Change and Yellow Fever</u></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br>Another current field of study is the effect of changing global climates on the susceptibility of the mosquitos (<i>A. aegypti </i>) to the yellow fever virus and consequently, the possibility of increasing transmission to humans. A greater portion of research into the yellow fever virus focuses on medical interests and how the virus interacts with humans. However, another portion of understanding YFV is the susceptibility of <i>A. aegypti </i> to the virus, considering if we can prevent the spread of the disease in mosquitos, it will be far easier to prevent it human transmission. With that in mind, some research has shown that to a certain degree, higher temperatures correlate with a higher infection rate of the virus. <sup><del style="font-weight: bold; text-decoration: none;">54</del></sup> A study showed that the extrinsic incubation period (EIP), or the time it takes between being infected by a blood meal and oral transmission, is inversely related to the temperature. Specifically, the study observed the EIP of the yellow fever virus in a certain species of mosquitos was 28 days when the temperature was 25 <sup>o</sup>C while only 12 days at 30 <sup>o</sup>C. <sup><del style="font-weight: bold; text-decoration: none;">55</del></sup> Therefore, if global climate change continues to progress at the current rate, it may mean a higher likelihood of yellow fever transmission as well as other arbovirus-based diseases.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br>Another current field of study is the effect of changing global climates on the susceptibility of the mosquitos (<i>A. aegypti </i>) to the yellow fever virus and consequently, the possibility of increasing transmission to humans. A greater portion of research into the yellow fever virus focuses on medical interests and how the virus interacts with humans. However, another portion of understanding YFV is the susceptibility of <i>A. aegypti </i> to the virus, considering if we can prevent the spread of the disease in mosquitos, it will be far easier to prevent it human transmission. With that in mind, some research has shown that to a certain degree, higher temperatures correlate with a higher infection rate of the virus.<sup><ins style="font-weight: bold; text-decoration: none;">55</ins></sup> A study showed that the extrinsic incubation period (EIP), or the time it takes between being infected by a blood meal and oral transmission, is inversely related to the temperature. Specifically, the study observed the EIP of the yellow fever virus in a certain species of mosquitos was 28 days when the temperature was 25 <sup>o</sup>C while only 12 days at 30 <sup>o</sup>C. <sup><ins style="font-weight: bold; text-decoration: none;">56</ins></sup> Therefore, if global climate change continues to progress at the current rate, it may mean a higher likelihood of yellow fever transmission as well as other arbovirus-based diseases.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> <u>Availability of Yellow Fever 17D Vaccine</u></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> <u>Availability of Yellow Fever 17D Vaccine</u></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br> An increasing concern regarding the YF-17D vaccine is the availability of the vaccine worldwide.<sup><del style="font-weight: bold; text-decoration: none;">56</del></sup> Luckily, in recent years there have not been overwhelmingly numerous outbreaks of yellow fever around world. However, because the vaccine still relies on the same 70+ year old, out of date method to create the vaccine using chicken embryos, there is a very real concern that if multiple large-scale outbreaks were to occur at once, stockpiles of the vaccine would be exhausted and production could not keep up with the demand with short notice.<sup><del style="font-weight: bold; text-decoration: none;">57</del></sup> Thus, the need for an improved method of creating the vaccine that is not only more efficient but also is able to keep the same effectiveness as the current YF-17D vaccine is necessary.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br> An increasing concern regarding the YF-17D vaccine is the availability of the vaccine worldwide.<sup><ins style="font-weight: bold; text-decoration: none;">57</ins></sup> Luckily, in recent years there have not been overwhelmingly numerous outbreaks of yellow fever around world. However, because the vaccine still relies on the same 70+ year old, out of date method to create the vaccine using chicken embryos, there is a very real concern that if multiple large-scale outbreaks were to occur at once, stockpiles of the vaccine would be exhausted and production could not keep up with the demand with short notice.<sup><ins style="font-weight: bold; text-decoration: none;">58</ins></sup> Thus, the need for an improved method of creating the vaccine that is not only more efficient but also is able to keep the same effectiveness as the current YF-17D vaccine is necessary.</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==References==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==References==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><sup>1, 5, 6, 9, 11, <del style="font-weight: bold; text-decoration: none;">53</del></sup> Barrett, A. D. T., & Higgs, S. (2007). Yellow fever: A disease that has yet to be conquered. Annual Review of Entomology, 52(1), 209-229. doi:10.1146/annurev.ento.52.110405.091454 </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><sup>1, 5, 6, 9, 11, <ins style="font-weight: bold; text-decoration: none;">57</ins></sup> Barrett, A. D. T., & Higgs, S. (2007). Yellow fever: A disease that has yet to be conquered. Annual Review of Entomology, 52(1), 209-229. doi:10.1146/annurev.ento.52.110405.091454 </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><sup>3, 7, 8, 10</sup> Michael A. Tolle, Mosquito-borne Diseases, Current Problems in Pediatric and Adolescent Health Care, Volume 39, Issue 4, April 2009, Pages 97-140, ISSN 1538-5442, http://dx.doi.org/10.1016/j.cppeds.2009.01.001. (http://www.sciencedirect.com/science/article/pii/S1538544209000145) </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><sup>3, 7, 8, 10</sup> Michael A. Tolle, Mosquito-borne Diseases, Current Problems in Pediatric and Adolescent Health Care, Volume 39, Issue 4, April 2009, Pages 97-140, ISSN 1538-5442, http://dx.doi.org/10.1016/j.cppeds.2009.01.001. (http://www.sciencedirect.com/science/article/pii/S1538544209000145) </div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><sup>29, 30, 31, 32</sup> Quaresma, J. A. S., Barros, Vera L R S, Pagliari, C., Fernandes, E. R., Guedes, F., Takakura, C. F. H., Duarte, M. I. S. (2006). Revisiting the liver in human yellow fever: Virus-induced apoptosis in hepatocytes associated with TGF-β, TNF-α and NK cells activity. Virology,345(1), 22-30. doi:10.1016/j.virol.2005.09.058 </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><sup>29, 30, 31, 32</sup> Quaresma, J. A. S., Barros, Vera L R S, Pagliari, C., Fernandes, E. R., Guedes, F., Takakura, C. F. H., Duarte, M. I. S. (2006). Revisiting the liver in human yellow fever: Virus-induced apoptosis in hepatocytes associated with TGF-β, TNF-α and NK cells activity. Virology,345(1), 22-30. doi:10.1016/j.virol.2005.09.058 </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><sup><del style="font-weight: bold; text-decoration: none;">51</del>, <del style="font-weight: bold; text-decoration: none;">52</del></sup> William C. Black IV, Kristine E. Bennett, Norma Gorrochótegui-Escalante, Carolina V. Barillas-Mury, Ildefonso Fernández-Salas, Marı́a de Lourdes Muñoz, José A. Farfán-Alé, Ken E. Olson, Barry J. Beaty, Flavivirus Susceptibility in <i>Aedes aegypti </i>, Archives of Medical Research, Volume 33, Issue 4, July–August 2002, Pages 379-388, ISSN 0188-4409, http://dx.doi.org/10.1016/S0188-4409(02)00373-9. (http://www.sciencedirect.com/science/article/pii/S0188440902003739)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><sup><ins style="font-weight: bold; text-decoration: none;">55</ins>, <ins style="font-weight: bold; text-decoration: none;">56</ins></sup> William C. Black IV, Kristine E. Bennett, Norma Gorrochótegui-Escalante, Carolina V. Barillas-Mury, Ildefonso Fernández-Salas, Marı́a de Lourdes Muñoz, José A. Farfán-Alé, Ken E. Olson, Barry J. Beaty, Flavivirus Susceptibility in <i>Aedes aegypti </i>, Archives of Medical Research, Volume 33, Issue 4, July–August 2002, Pages 379-388, ISSN 0188-4409, http://dx.doi.org/10.1016/S0188-4409(02)00373-9. (http://www.sciencedirect.com/science/article/pii/S0188440902003739)</div></td></tr>
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<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><sup>13, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, <del style="font-weight: bold; text-decoration: none;">54</del></sup> Querec, T. et al. Yellow fever vaccine YF-17D activates multiple dendritic cell subsets via TLR2, 7, 8, and 9 to stimulate polyvalent immunity. J. Exp. Med. 203, 413–424 (2006)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><sup>13, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, <ins style="font-weight: bold; text-decoration: none;">48, 49, 50, 51, 58</ins></sup> Querec, T. et al. Yellow fever vaccine YF-17D activates multiple dendritic cell subsets via TLR2, 7, 8, and 9 to stimulate polyvalent immunity. J. Exp. Med. 203, 413–424 (2006)</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><sup>25, <del style="font-weight: bold; text-decoration: none;">48</del>, <del style="font-weight: bold; text-decoration: none;">49</del>, <del style="font-weight: bold; text-decoration: none;">50</del></sup> Bruno Guy, Farshad Guirakhoo, Veronique Barban, Stephen Higgs, Thomas P. Monath, Jean Lang, Preclinical and clinical development of YFV 17D-based chimeric vaccines against dengue, West Nile and Japanese encephalitis viruses, Vaccine, Volume 28, Issue 3, 8 January 2010, Pages 632-649, ISSN 0264-410X, http://dx.doi.org/10.1016/j.vaccine.2009.09.098. (http://www.sciencedirect.com/science/article/pii/S0264410X09014455)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><sup>25, <ins style="font-weight: bold; text-decoration: none;">52</ins>, <ins style="font-weight: bold; text-decoration: none;">53</ins>, <ins style="font-weight: bold; text-decoration: none;">54</ins></sup> Bruno Guy, Farshad Guirakhoo, Veronique Barban, Stephen Higgs, Thomas P. Monath, Jean Lang, Preclinical and clinical development of YFV 17D-based chimeric vaccines against dengue, West Nile and Japanese encephalitis viruses, Vaccine, Volume 28, Issue 3, 8 January 2010, Pages 632-649, ISSN 0264-410X, http://dx.doi.org/10.1016/j.vaccine.2009.09.098. (http://www.sciencedirect.com/science/article/pii/S0264410X09014455)</div></td></tr>
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</table>Helmchttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103271&oldid=prevHelmc at 00:21, 9 May 20142014-05-09T00:21:15Z<p></p>
<a href="https://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103271&oldid=103154">Show changes</a>Helmchttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103154&oldid=prevHelmc at 20:28, 8 May 20142014-05-08T20:28:35Z<p></p>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Mechanism of Infection==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Mechanism of Infection==</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> From examining tissue samples from those who died from the disease, studies have shown that the yellow fever virus appears to target hepatic cells, causing steatosis, apoptosis and necrosis in the hepatocytes. <sup>29</sup> More specifically, the virus tends to target hepatocytes in the midzonal area of the liver.<sup>30</sup> This targeting of a specific region of the liver has remained a puzzle for many years although studies are on going to better understand the cause of this targeting. Researchers are hopeful that by understanding what the virus are targeting, advancements can be made in treating patients already infected by the disease. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> From examining tissue samples from those who died from the disease, studies have shown that the yellow fever virus appears to target hepatic cells, causing steatosis, apoptosis and necrosis in the hepatocytes. <sup>29</sup> More specifically, the virus tends to target hepatocytes in the midzonal area of the liver.<sup>30</sup> This targeting of a specific region of the liver has remained a puzzle for many years although studies are on going to better understand the cause of this targeting. Researchers are hopeful that by understanding what the virus are targeting, advancements can be made in treating patients already infected by the disease. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> Interestingly, it has been observed in midzonal hepatocytes that the much of the cell death in the area is attributed to apoptosis rather than lytic necrosis of the tissue.<sup>31</sup> Furthermore in the same study, although significant lesions were observed in the hepatocytes, analysis of the tissue showed very mild levels of inflammation. This disparity between the degree of hepatocyte injury and little to lack of inflammatory response is highly irregular. <sup>32</sup> Thus, many aspects of the actual pathological mechanism of the yellow fever virus remain unknown.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> Interestingly, it has been observed in midzonal hepatocytes that the much of the cell death in the area is attributed to apoptosis rather than lytic necrosis of the tissue.<sup>31</sup> Furthermore in the same study, although significant lesions were observed in the hepatocytes, analysis of the tissue showed very mild levels of inflammation. This disparity between the degree of hepatocyte injury and <ins style="font-weight: bold; text-decoration: none;">the </ins>little to lack of inflammatory response is highly irregular. <sup>32</sup> Thus, many aspects of the actual pathological mechanism of the yellow fever virus remain unknown <ins style="font-weight: bold; text-decoration: none;">as well</ins>.</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Vaccine==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Vaccine==</div></td></tr>
</table>Helmchttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103151&oldid=prevHelmc at 20:28, 8 May 20142014-05-08T20:28:11Z<p></p>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Mechanism of Infection==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Mechanism of Infection==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br> From examining tissue samples from those who died from the disease, studies have shown that the yellow fever virus appears to target hepatic cells, causing steatosis, apoptosis and necrosis in the hepatocytes. <sup>29</sup> More specifically, the virus tends to target hepatocytes in the midzonal area of the liver. <sup>30</sup> This targeting of a specific region of the liver has remained a puzzle for many years although studies are on going to better understand the cause of this targeting. Researchers are hopeful that by understanding what the virus are targeting, advancements can be made in treating patients already infected by the disease. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br> From examining tissue samples from those who died from the disease, studies have shown that the yellow fever virus appears to target hepatic cells, causing steatosis, apoptosis and necrosis in the hepatocytes. <sup>29</sup> More specifically, the virus tends to target hepatocytes in the midzonal area of the liver.<sup>30</sup> This targeting of a specific region of the liver has remained a puzzle for many years although studies are on going to better understand the cause of this targeting. Researchers are hopeful that by understanding what the virus are targeting, advancements can be made in treating patients already infected by the disease. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> Interestingly<del style="font-weight: bold; text-decoration: none;">, in midzonal hepatocytes</del>, it has been observed that the much of the cell death in the area is attributed to apoptosis rather than lytic necrosis of the tissue.<sup>31</sup> Furthermore in the same study, although significant lesions were observed in the hepatocytes, analysis of the tissue showed very mild levels of inflammation. This disparity between the degree of hepatocyte injury and little to lack of inflammatory response is highly irregular. <sup>32</sup> Thus, many aspects of the actual pathological mechanism of the yellow fever virus remain unknown.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> Interestingly, it has been observed <ins style="font-weight: bold; text-decoration: none;">in midzonal hepatocytes </ins>that the much of the cell death in the area is attributed to apoptosis rather than lytic necrosis of the tissue.<sup>31</sup> Furthermore in the same study, although significant lesions were observed in the hepatocytes, analysis of the tissue showed very mild levels of inflammation. This disparity between the degree of hepatocyte injury and little to lack of inflammatory response is highly irregular. <sup>32</sup> Thus, many aspects of the actual pathological mechanism of the yellow fever virus remain unknown.</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Vaccine==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Vaccine==</div></td></tr>
</table>Helmchttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103149&oldid=prevHelmc at 20:27, 8 May 20142014-05-08T20:27:28Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 20:27, 8 May 2014</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The disease is usually only prevalent in tropical regions of the world, mostly South America and parts of Africa (Fig. 2). Even though a vaccine is available, yellow fever (YF) still causes 30,000 deaths annually with almost 200,000 cases occurring in Africa.<sup>2</sup> YF is an acute infection, and has high mortality rates ranging from 25~50%.<sup>3</sup> </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The disease is usually only prevalent in tropical regions of the world, mostly South America and parts of Africa (Fig. 2). Even though a vaccine is available, yellow fever (YF) still causes 30,000 deaths annually with almost 200,000 cases occurring in Africa.<sup>2</sup> YF is an acute infection, and has high mortality rates ranging from 25~50%.<sup>3</sup> </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Unfortunately, the number of cases of YF has increased in the past 20 years as a result of declining immunity among susceptible populations to infection, climate change, and urbanization.<sup>4</sup> Because of this, YF is a critical public health issue in South America and Africa. Thus, it has become even more important to truly understand how the most effective YF vaccine (YF-17D) functions so that a treatment can be developed for infected individuals. Furthermore, by understanding how YF-17D’s mechanism functions, researchers are better able to develop additional vaccines for other diseases caused Flavivirus (such as Dengue and Japanese Encephalitis).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Unfortunately, the number of cases of YF has increased in the past 20 years as a result of declining immunity among susceptible populations to infection, climate change, and urbanization.<sup>4</sup> Because of this, YF is a critical public health issue in South America and Africa. Thus, it has become even more important to truly understand how the most effective YF vaccine (YF-17D) functions so that a treatment can be developed for infected individuals. Furthermore, by understanding how YF-17D’s mechanism functions, researchers are better able to develop additional vaccines for other diseases caused Flavivirus (such as Dengue <ins style="font-weight: bold; text-decoration: none;">Fever </ins>and Japanese Encephalitis).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Image:YF_WHO_Map.jpg|thumb|300px|right|Figure 2. Map depicting geographic high-risk areas for Yellow Fever, published by the WHO, July 2013. (http://apps.who.int/immunization_monitoring/diseases/yellow_fever/en/index.html)]]</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Image:YF_WHO_Map.jpg|thumb|300px|right|Figure 2. Map depicting geographic high-risk areas for Yellow Fever, published by the WHO, July 2013. (http://apps.who.int/immunization_monitoring/diseases/yellow_fever/en/index.html)]]</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br> Spaniards documented the first major occurrence of YF in Yucatan, Mexico in 1648.<sup>5</sup> Local Mayans at the time referred to the disease as <i>xekik</i> (black-vomit), which was a common symptom of late stage YF.<sup>6</sup> <del style="font-weight: bold; text-decoration: none;">Previous to </del>arriving in Mexico however, it is hypothesized that the disease originated in Africa and spread as a result of slave ships travelling from Africa <del style="font-weight: bold; text-decoration: none;">and </del>transporting <del style="font-weight: bold; text-decoration: none;">with them </del>infected specimens of <i>A. aegypti </i> in their drinking water.<sup>7</sup></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br> Spaniards documented the first major occurrence of YF in Yucatan, Mexico in 1648.<sup>5</sup> Local Mayans at the time referred to the disease as <i>xekik</i> (black-vomit), which was a common symptom of late stage YF.<sup>6</sup> <ins style="font-weight: bold; text-decoration: none;">Before </ins>arriving in Mexico however, it is hypothesized that the disease originated in Africa and spread as a result of slave ships travelling from Africa <ins style="font-weight: bold; text-decoration: none;">unintentionally </ins>transporting infected specimens of <i>A. aegypti </i> in their drinking water.<sup>7</sup></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>After the Yucatan outbreak, YF spread even further around the world causing high death tolls <del style="font-weight: bold; text-decoration: none;">even </del>in Barcelona and in the Mississippi Valley.<sup>8</sup> While it is now seen as a foreign tropical disease, there were numerous outbreaks in North America <del style="font-weight: bold; text-decoration: none;">up </del>through most of the 19th century<del style="font-weight: bold; text-decoration: none;">, with epidemics </del>in New York, <del style="font-weight: bold; text-decoration: none;">4,000 deaths in </del>New Orleans, and even at one point <del style="font-weight: bold; text-decoration: none;">an outbreak </del>in Quebec.<sup>9</sup> </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>After the Yucatan outbreak, YF spread even further around the world causing high death tolls in Barcelona and <ins style="font-weight: bold; text-decoration: none;">even </ins>in the Mississippi Valley.<sup>8</sup> While it is now seen as a foreign tropical disease, there were numerous outbreaks in North America through <ins style="font-weight: bold; text-decoration: none;">out </ins>most of the 19th century <ins style="font-weight: bold; text-decoration: none;">including </ins>in New York, New Orleans, and even at one point in Quebec.<sup>9</sup> </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>It was not until 1881 when a Cuban scientist, Dr. Carlos Finlay, proposed that YF spread through <i>A. aegypti </i> (Fig. 1) that people began exterminating the mosquito and <del style="font-weight: bold; text-decoration: none;">subsequently </del>almost completely eradicated YF outside of South America and Africa. <sup>10</sup> The control of the disease was best exemplified by Cuba’s Major William C. Gorgas led and implemented specific mosquito-eradication procedures <del style="font-weight: bold; text-decoration: none;">which </del>effectively eradicated YF in the area <del style="font-weight: bold; text-decoration: none;">within the year </del>in 1901.<sup>11</sup> It was thanks to extermination efforts like Gorgas’ that Panama Canal could even be built considering many workers would have otherwise succumbed to YF <del style="font-weight: bold; text-decoration: none;">as </del>they worked on the canal.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>It was not until 1881 when a Cuban scientist, Dr. Carlos Finlay, proposed that YF spread through <i>A. aegypti </i> (Fig. 1) that people began exterminating the mosquito and almost completely eradicated YF outside of South America and Africa.<sup>10</sup> The control of the disease was best exemplified by Cuba’s Major William C. Gorgas <ins style="font-weight: bold; text-decoration: none;">who </ins>led and implemented specific mosquito-eradication procedures <ins style="font-weight: bold; text-decoration: none;">that </ins>effectively eradicated YF in the area in 1901.<sup>11</sup> It was thanks to extermination efforts like Gorgas’ that <ins style="font-weight: bold; text-decoration: none;">the </ins>Panama Canal could even be built considering many workers would have otherwise succumbed to YF <ins style="font-weight: bold; text-decoration: none;">while </ins>they worked on <ins style="font-weight: bold; text-decoration: none;">building </ins>the canal.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>In 1937, Max Theiler created a live-attenuated vaccine for yellow fever by serial-passaging the YF virus through chicken embryotic tissue.<sup>12</sup> This vaccine, known as the 17D vaccine has <del style="font-weight: bold; text-decoration: none;">impressively </del>been highly effective in preventing the disease, with an unusually long antibody persistence upwards of 35 years in some individuals.<sup>13</sup> Since its production, over 500 million individuals have been vaccinated with the 17D vaccine further controlling the spread of yellow fever.<sup>14</sup> Appropriately, Max Thelier was rewarded with a Nobel Prize in 1951 for his contributions.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>In 1937, Max Theiler created a live-attenuated vaccine for yellow fever by serial-passaging the YF virus through chicken embryotic tissue.<sup>12</sup> This vaccine, known as the 17D vaccine<ins style="font-weight: bold; text-decoration: none;">, </ins>has been highly effective in preventing the disease, with an unusually long antibody persistence upwards of 35 years in some individuals.<sup>13</sup> Since its production, over 500 million individuals have been vaccinated with the 17D vaccine further controlling the spread of yellow fever.<sup>14</sup> Appropriately, Max Thelier was rewarded with a Nobel Prize in 1951 for his contributions<ins style="font-weight: bold; text-decoration: none;">. And yet, little is still known about how the vaccine works</ins>.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br> The yellow fever virus (YFV) is a single, positive strand RNA virus with an icosahedral envelope as is characteristic of Flaviviruses and has a diameter of <del style="font-weight: bold; text-decoration: none;">around </del>50nm. It has a genome of around 10kb. It is further characterized by the mature virions having three major types of structural proteins Capsid (C), Envelope (E), and Membrane (M)<del style="font-weight: bold; text-decoration: none;">, which </del>make up the virion envelope (Fig. 3). <sup>17</sup> Premature virions on the other hand have M precursor proteins (prM) that form heterodimers with E proteins, making the surface appear spiky.<sup>18</sup> Mature cells maintain a smooth surface as a result of the E proteins forming homodimers in “herringbone-like arrangements.” <sup>19</sup> </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br> The yellow fever virus (YFV) is a single, positive strand RNA virus with an icosahedral envelope<ins style="font-weight: bold; text-decoration: none;">, </ins>as is characteristic of Flaviviruses<ins style="font-weight: bold; text-decoration: none;">, </ins>and has a diameter of <ins style="font-weight: bold; text-decoration: none;">about </ins>50nm. It has a genome of around 10kb. It is further characterized by the mature virions having three major types of structural proteins Capsid (C), Envelope (E), and Membrane (M) <ins style="font-weight: bold; text-decoration: none;">that </ins>make up the virion envelope (Fig. 3). <sup>17</sup> Premature virions on the other hand have M precursor proteins (prM) that form heterodimers with E proteins, making the surface appear spiky.<sup>18</sup> Mature cells maintain a smooth surface as a result of the E proteins forming homodimers in “herringbone-like arrangements.” <sup>19</sup> </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> <u> Replication </u></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> <u> Replication </u></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Image:Flavivirus_Life_Cycle.jpg|thumb|300px|right|Figure 4. Diagram of the Flavivirus' life cycle. Notice the initial binding to the host cell and the clathrin mediated endocytosis that follows the initial binding. Then the viral membrane fuses with the host's endosome to expose the viral ssRNA to the endoplasmic reticulum (ER). There, the ssRNA is transcribed and copied to make new viral proteins and new ssRNA. The viral particles are assembled and form a immature virion by budding off of the ER. After budding off, the immature virion moves to the Golgi. Moving from the Golgi to the host's membrane, the cell undergoes cleavages that cleave the prM protein into M proteins, maturing the virion before being secreted out of the host cell. Additionally, notice how the immature virion has a rough, spiked surface in contrast to the smooth surface of the mature virion. Diagram by Ted C. Pierson, NIH National Institute of Allergy and Infectious Diseases (http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/lvd/viralpathogenesissection/Pages/default.aspx)]]</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Image:Flavivirus_Life_Cycle.jpg|thumb|300px|right|Figure 4. Diagram of the Flavivirus' life cycle. Notice the initial binding to the host cell and the clathrin mediated endocytosis that follows the initial binding. Then the viral membrane fuses with the host's endosome to expose the viral ssRNA to the endoplasmic reticulum (ER). There, the ssRNA is transcribed and copied to make new viral proteins and new ssRNA. The viral particles are assembled and form a immature virion by budding off of the ER. After budding off, the immature virion moves to the Golgi. Moving from the Golgi to the host's membrane, the cell undergoes cleavages that cleave the prM protein into M proteins, maturing the virion before being secreted out of the host cell. Additionally, notice how the immature virion has a rough, spiked surface in contrast to the smooth surface of the mature virion. Diagram by Ted C. Pierson, NIH National Institute of Allergy and Infectious Diseases (http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/lvd/viralpathogenesissection/Pages/default.aspx)]]</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br>To replicate, the yellow fever virus first uses its E proteins to bind to receptors on the host cell to promote clatharin-mediated endocytosis. (Fig. 4) Then once the virion reaches the endosome in the eukaryotic cell, the YFV fuses its membrane with the host endosomal membrane and releases the RNA genome into the host’s cytoplasm. (Fig. 4) Once the single-stranded viral RNA (ssRNA) is released, it is translated and the translated proteins are brought to the endoplasmic reticulum (ER) to be assembled into immature virions. (Fig. 4) Specifically, the proteins are assembled in certain invaginations in the membrane of the ER called spherules. <sup>20</sup> <del style="font-weight: bold; text-decoration: none;"> </del>At these spherules, the ssRNA is also replicated to create new positive sense ssRNA genomes for the new virions (Fig. 4).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br>To replicate, the yellow fever virus first uses its E proteins to bind to receptors on the host cell to promote clatharin-mediated endocytosis. (Fig. 4) Then once the virion reaches the endosome in the eukaryotic cell, the YFV fuses its membrane with the host endosomal membrane and releases the RNA genome into the host’s cytoplasm. (Fig. 4) Once the single-stranded viral RNA (ssRNA) is released, it is translated and the translated proteins are brought to the endoplasmic reticulum (ER) to be assembled into immature virions. (Fig. 4) Specifically, the proteins are assembled in certain invaginations in the membrane of the ER called spherules. <sup>20</sup> At these spherules, the ssRNA is also replicated to create new positive sense ssRNA genomes for the new virions (Fig. 4).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Once the premature virions are formed<del style="font-weight: bold; text-decoration: none;">, </del>budding off of the ER, they move down the trans-Glogi network and are proteolytically cleaved, breaking down the prM and E heterodimers into M and E proteins to form mature virions (Fig. 4).<sup>21</sup> Once mature, the virion particles leave the host cells through secretion.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Once the premature virions are formed <ins style="font-weight: bold; text-decoration: none;">by </ins>budding off of the ER, they move down the trans-Glogi network and are proteolytically cleaved, breaking down the prM and E heterodimers into M and E proteins to form mature virions (Fig. 4).<sup>21</sup> Once mature, the virion particles leave the host cells through secretion.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>A large portion of the virion’s ability to replicate relies on the E proteins on its cell surface, which bind to the host cell’s receptor proteins to enter the host cell.<sup>22</sup> This protein is also responsible for inducing fusion of the viral membrane with the host cell.<sup>23</sup> Thus, a significant aspect of neutralizing the virus by the host’s immune system is to produce antibodies that target and disrupt the E protein’s ability to function.<sup>24</sup> That is why much of the research into vaccines against Flavivirus is focused on disrupting or knocking-out proper E protein function.<sup>25</sup></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>A large portion of the virion’s ability to replicate relies on the E proteins on its cell surface, which bind to the host cell’s receptor proteins to enter the host cell.<sup>22</sup> This protein is also responsible for inducing fusion of the viral membrane with the host cell.<sup>23</sup> Thus, a significant aspect of neutralizing the virus by the host’s immune system is to produce antibodies that target and disrupt the E protein’s ability to function.<sup>24</sup> That is why much of the research into vaccines against Flavivirus is focused on disrupting or knocking-out proper E protein function.<sup>25</sup></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br>Yellow fever owes its name to its historically common symptom of causing jaundice in those who are afflicted. Jaundice is characterized by a yellow hue in an individual’s skin and eyes, as a result of excess bilirubin in the blood as the disease targets the liver (Fig. 5). </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br>Yellow fever owes its name to its historically common symptom of causing jaundice in those who are afflicted. Jaundice is characterized by a yellow hue in an individual’s skin and eyes, as a result of excess bilirubin in the blood as the disease targets the liver (Fig. 5). </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Female mosquitos carry the disease and individuals are only infected through <del style="font-weight: bold; text-decoration: none;">their </del>bite. For a mosquito to be able to pass on the disease however, it must first feed off of already infected individuals. Only after reaching a certain number of the yellow fever virus in its body, will the mosquito have their salivary glands infected and then begin transmitting the disease to its future blood feed hosts.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Female mosquitos carry the disease and individuals are only infected through <ins style="font-weight: bold; text-decoration: none;">the female’s </ins>bite<ins style="font-weight: bold; text-decoration: none;">, not males</ins>. For a mosquito to be able to pass on the disease however, it must first feed off of already infected individuals. Only after reaching a certain number of the yellow fever virus in its body, will the mosquito have their salivary glands infected and then begin transmitting the disease to its future blood feed hosts.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The incubation period for disease is short and usually within 3~6 days after being bitten. <sup>26</sup> For most individuals, the extent of the illness is having a fever and flu-like symptoms such as nausea, back pain, and loss of appetite for upwards of a week. After these initial symptoms, the disease often passes and the survivors make a complete recovery and additionally develop a life-long immunity after infection. <sup>27</sup> </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The incubation period for disease is short and usually within 3~6 days after being bitten. <sup>26</sup> For most individuals, the extent of the illness is having a fever and flu-like symptoms such as nausea, back pain, and loss of appetite for upwards of a week. After these initial symptoms, the disease often passes and the survivors make a complete recovery and additionally develop a life-long immunity after infection. <sup>27</sup> </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>However, for others, around 15% of those infected, the illness can enter a far more severe, secondary phase after the initial symptoms. <sup>28</sup> Once the infection reaches this stage, there is a greater than 20% likelihood of death. At this point, symptoms such as jaundice (Fig. 5), bleeding, and organ failure <del style="font-weight: bold; text-decoration: none;">are </del>common. Thus, understanding how the YF vaccine works so that a post-infection treatment can be developed is crucial to avoid this stage of the disease.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>However, for others, around 15% of those infected, the illness can enter a far more severe, secondary phase after the initial symptoms.<sup>28</sup> Once the infection reaches this stage, there is a greater than 20% likelihood of death. At this point, symptoms such as jaundice (Fig. 5), bleeding, and organ failure <ins style="font-weight: bold; text-decoration: none;">become </ins>common. Thus, understanding how the YF vaccine works so that a post-infection treatment can be developed is crucial to avoid this stage of the disease.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment and Cure==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment and Cure==</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Image:Jaundice.jpg|thumb|200px|right|Figure 5. Example of a patient suffering from jaundice. Notice the distinct yellow pigmentation of the skin. Retrieved from wikimedia. Author:James Heilman, MD (http://en.wikipedia.org/wiki/File:Jaundice08.jpg)]]</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Image:Jaundice.jpg|thumb|200px|right|Figure 5. Example of a patient suffering from jaundice. Notice the distinct yellow pigmentation of the skin. Retrieved from wikimedia. Author:James Heilman, MD (http://en.wikipedia.org/wiki/File:Jaundice08.jpg)]]</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br> Unfortunately, there is no specific treatment that has been developed to cure yellow fever. Afflicted individuals are advised to be hospitalized and simply rest as much as possible. Some suggest using pain relievers to reduce the fever but outside of that, few medications are <del style="font-weight: bold; text-decoration: none;">recommended</del>. <del style="font-weight: bold; text-decoration: none;">Specifically, anti</del>-inflammatory drugs such as aspirin are to be avoided as they <del style="font-weight: bold; text-decoration: none;">may </del>worsen the symptoms and further promote bleeding.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br> Unfortunately, there is no specific treatment that has been developed to cure yellow fever. Afflicted individuals are advised to be hospitalized and simply rest as much as possible. Some suggest using pain relievers to reduce the fever but outside of that, few medications are <ins style="font-weight: bold; text-decoration: none;">prescribed</ins>. <ins style="font-weight: bold; text-decoration: none;">Anti</ins>-inflammatory drugs such as aspirin are <ins style="font-weight: bold; text-decoration: none;">especially </ins>to be avoided as they <ins style="font-weight: bold; text-decoration: none;">can </ins>worsen the symptoms and further promote bleeding.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Besides care, health organizations strongly advise keeping the infected individuals away from any more contact with mosquitos. Since mosquitos must receive the yellow fever virus from feeding off of infected individuals to be contagious, <del style="font-weight: bold; text-decoration: none;">by </del>keeping an infected patient from being bitten by other mosquitos<del style="font-weight: bold; text-decoration: none;">, it </del>reduces the spread of the disease.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Besides <ins style="font-weight: bold; text-decoration: none;">simply taking </ins>care <ins style="font-weight: bold; text-decoration: none;">of the infected</ins>, health organizations strongly advise keeping the infected individuals away from any more contact with mosquitos. Since mosquitos must receive the yellow fever virus from feeding off of infected individuals to be contagious, keeping an infected patient from being bitten by other mosquitos reduces the spread of the disease.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Mechanism of Infection==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Mechanism of Infection==</div></td></tr>
</table>Helmchttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103130&oldid=prevHelmc at 20:16, 8 May 20142014-05-08T20:16:00Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 20:16, 8 May 2014</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l8">Line 8:</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br>Yellow fever (YF) is a human disease caused by the yellow fever virus, prevalent mostly in tropical climates. The yellow fever virus is a part of a family of viruses known as the Flavivirdae and the genus Flavivirus that fall under a broader category of arboviruses, or “arthropod-borne” viruses.<sup>1</sup> In this case, most common arthropod vector of YF is the <i>Aedes aegypti </i> mosquito (Fig. 1).</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br>Yellow fever (YF) is a human disease caused by the yellow fever virus, prevalent mostly in tropical climates. The yellow fever virus is a part of a family of viruses known as the Flavivirdae and the genus Flavivirus that fall under a broader category of arboviruses, or “arthropod-borne” viruses.<sup>1</sup> In this case, most common arthropod vector of YF is the <i>Aedes aegypti </i> mosquito (Fig. 1).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"> </del>The disease is usually only prevalent in tropical regions of the world, mostly South America and parts of Africa (Fig. 2). Even <del style="font-weight: bold; text-decoration: none;">with vaccines </del>available, yellow fever (YF) still causes 30,000 deaths annually with almost 200,000 cases occurring in Africa.<sup>2</sup> <del style="font-weight: bold; text-decoration: none;">Moreover, </del>YF is an acute infection, <del style="font-weight: bold; text-decoration: none;">with </del>mortality rates ranging from 25~50%.<sup>3</sup> <del style="font-weight: bold; text-decoration: none;">Even worse</del>, the number of cases of YF has increased in the past 20 years as a result of declining immunity among susceptible populations to infection, climate change, and urbanization.<sup>4</sup> Because of this, YF is a critical public health issue in South America and Africa.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>The disease is usually only prevalent in tropical regions of the world, mostly South America and parts of Africa (Fig. 2). Even <ins style="font-weight: bold; text-decoration: none;">though a vaccine is </ins>available, yellow fever (YF) still causes 30,000 deaths annually with almost 200,000 cases occurring in Africa.<sup>2</sup> YF is an acute infection, <ins style="font-weight: bold; text-decoration: none;">and has high </ins>mortality rates ranging from 25~50%.<sup>3</sup> </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Unfortunately</ins>, the number of cases of YF has increased in the past 20 years as a result of declining immunity among susceptible populations to infection, climate change, and urbanization.<sup>4</sup> Because of this, YF is a critical public health issue in South America and Africa. <ins style="font-weight: bold; text-decoration: none;">Thus, it has become even more important to truly understand how the most effective YF vaccine (YF-17D) functions so that a treatment can be developed for infected individuals. Furthermore, by understanding how YF-17D’s mechanism functions, researchers are better able to develop additional vaccines for other diseases caused Flavivirus (such as Dengue and Japanese Encephalitis).</ins></div></td></tr>
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</table>Helmchttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103127&oldid=prevHelmc at 20:08, 8 May 20142014-05-08T20:08:48Z<p></p>
<a href="https://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103127&oldid=103111">Show changes</a>Helmchttps://microbewiki.kenyon.edu/index.php?title=Yellow_Fever_Vaccine&diff=103111&oldid=prevHelmc at 19:51, 8 May 20142014-05-08T19:51:25Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 19:51, 8 May 2014</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>After the Yucatan outbreak, YF spread even further around the world causing high death tolls even in Barcelona and in the Mississippi Valley.<sup>8</sup> While it is now seen as a foreign tropical disease, there were numerous outbreaks in North America up through most of the 19th century, with epidemics in New York, 4,000 deaths in New Orleans, and even at one point an outbreak in Quebec.<sup>9</sup> </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>After the Yucatan outbreak, YF spread even further around the world causing high death tolls even in Barcelona and in the Mississippi Valley.<sup>8</sup> While it is now seen as a foreign tropical disease, there were numerous outbreaks in North America up through most of the 19th century, with epidemics in New York, 4,000 deaths in New Orleans, and even at one point an outbreak in Quebec.<sup>9</sup> </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>It was not until 1881 when a Cuban scientist, Dr. Carlos Finlay, proposed that YF spread through <i>A. aegypti </i> that people began exterminating the mosquito and subsequently almost completely eradicated YF outside of South America and Africa. <sup>10</sup> The control of the disease was best exemplified by Cuba’s Major William C. Gorgas led and implemented specific mosquito-eradication procedures which effectively eradicated YF in the area within the year in 1901.<sup>11</sup> It was thanks to extermination efforts like Gorgas’ that Panama Canal could even be built considering many workers would have otherwise succumbed to YF as they worked on the canal.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>It was not until 1881 when a Cuban scientist, Dr. Carlos Finlay, proposed that YF spread through <i>A. aegypti </i> <ins style="font-weight: bold; text-decoration: none;">(Fig. 1) </ins>that people began exterminating the mosquito and subsequently almost completely eradicated YF outside of South America and Africa. <sup>10</sup> The control of the disease was best exemplified by Cuba’s Major William C. Gorgas led and implemented specific mosquito-eradication procedures which effectively eradicated YF in the area within the year in 1901.<sup>11</sup> It was thanks to extermination efforts like Gorgas’ that Panama Canal could even be built considering many workers would have otherwise succumbed to YF as they worked on the canal.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In 1937, Max Theiler created a live-attenuated vaccine for yellow fever by serial-passaging the YF virus through chicken embryotic tissue.<sup>12</sup> This vaccine, known as the 17D vaccine has impressively been highly effective in preventing the disease, with an unusually long antibody persistence upwards of 35 years in some individuals.<sup>13</sup> Since its production, over 500 million individuals have been vaccinated with the 17D vaccine further controlling the spread of yellow fever.<sup>14</sup> Appropriately, Max Thelier was rewarded with a Nobel Prize in 1951 for his contributions.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In 1937, Max Theiler created a live-attenuated vaccine for yellow fever by serial-passaging the YF virus through chicken embryotic tissue.<sup>12</sup> This vaccine, known as the 17D vaccine has impressively been highly effective in preventing the disease, with an unusually long antibody persistence upwards of 35 years in some individuals.<sup>13</sup> Since its production, over 500 million individuals have been vaccinated with the 17D vaccine further controlling the spread of yellow fever.<sup>14</sup> Appropriately, Max Thelier was rewarded with a Nobel Prize in 1951 for his contributions.</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Symptoms==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Symptoms==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">[[Image:Jaundice.jpg|thumb|200px|right|Figure 5. Example of a patient suffering from jaundice. Notice the distinct yellow pigmentation of the skin. Retrieved from wikimedia. Author:James Heilman, MD (http://en.wikipedia.org/wiki/File:Jaundice08.jpg)]]</del></div></td><td colspan="2" class="diff-side-added"></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><br>Yellow fever owes its name to its historically common symptom of causing jaundice in those who are afflicted. Jaundice is characterized by a yellow hue in an individual’s skin and eyes, as a result of excess bilirubin in the blood as the disease targets the liver. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><br>Yellow fever owes its name to its historically common symptom of causing jaundice in those who are afflicted. Jaundice is characterized by a yellow hue in an individual’s skin and eyes, as a result of excess bilirubin in the blood as the disease targets the liver <ins style="font-weight: bold; text-decoration: none;">(Fig. 5)</ins>. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Female mosquitos carry the disease and individuals are only infected through their bite. For a mosquito to be able to pass on the disease however, it must first feed off of already infected individuals. Only after reaching a certain number of the yellow fever virus in its body, will the mosquito have their salivary glands infected and then begin transmitting the disease to its future blood feed hosts.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Female mosquitos carry the disease and individuals are only infected through their bite. For a mosquito to be able to pass on the disease however, it must first feed off of already infected individuals. Only after reaching a certain number of the yellow fever virus in its body, will the mosquito have their salivary glands infected and then begin transmitting the disease to its future blood feed hosts.</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment and Cure==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment and Cure==</div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Image:Jaundice.jpg|thumb|200px|right|Figure 5. Example of a patient suffering from jaundice. Notice the distinct yellow pigmentation of the skin. Retrieved from wikimedia. Author:James Heilman, MD (http://en.wikipedia.org/wiki/File:Jaundice08.jpg)]]</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> Unfortunately, there are no treatments yet to cure yellow fever. Afflicted individuals are advised to be hospitalized and simply rest as much as possible. Some suggest using pain relievers to reduce the fever but outside of that, few medications are recommended. Specifically, anti-inflammatory drugs such as aspirin are to be avoided as they may worsen the symptoms and further promote bleeding.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><br> Unfortunately, there are no treatments yet to cure yellow fever. Afflicted individuals are advised to be hospitalized and simply rest as much as possible. Some suggest using pain relievers to reduce the fever but outside of that, few medications are recommended. Specifically, anti-inflammatory drugs such as aspirin are to be avoided as they may worsen the symptoms and further promote bleeding.</div></td></tr>
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</table>Helmc