Volume 83, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Yellow fever virus is a global health threat due to its endemicity in parts of Africa and South America where human infections occur in residents and travelers. To understand yellow fever dynamics, it is critical to characterize the incubation periods of the virus in vector mosquitoes and humans. Here, we compare four statistical models of the yellow fever incubation periods fitted with historical data. The extrinsic incubation period in the urban vector was best characterized with a temperature-dependent Weibull model with a median of 10 days at 25°C (middle 95% = 2.0–37 days). The intrinsic incubation period, fitted with a log-normal model, had a median of 4.3 days (middle 95% = 2.3–8.6 days). These estimates and their associated statistical models provide a quantitative basis to assist in exposure assessments, model potential outbreaks, and evaluate the effectiveness of public health interventions.


Article metrics loading...

Loading full text...

Full text loading...



  1. Monath TP, , 2001. Yellow fever: an update. Lancet Infect Dis 1: 1120.[Crossref]
  2. Staples JE, Monath TP, , 2008. Yellow fever: 100 years of discovery. J Am Med Assoc 300: 960962.[Crossref]
  3. Vainio J, Cutts F, , 1998. Yellow Fever. Geneva: World Health Organization.
  4. Pan American Health Organization, 2008. Outbreak of yellow fever in Paraguay. Epidemiol Bull 27: 2.
  5. Theiler M, Smith H, , 1937. The use of yellow fever virus modified by in vitro cultivation for human immunization. J Exp Med 65: 787800.[Crossref]
  6. Robertson SE, Hull BP, Tomori O, Bele O, LeDuc JW, Esteves K, , 1996. Yellow fever: a decade of reemergence. J Am Med Assoc 276: 11571162.[Crossref]
  7. Lindsey NP, Schroeder BA, Miller ER, Braun MM, Hinckley AF, Marano N, Slade BA, Barnett ED, Brunette GW, Horan K, Staples JE, Kozarsky PE, Hayes EB, , 2008. Adverse event reports following yellow fever vaccination. Vaccine 26: 60776082.[Crossref]
  8. World Health Organization Department of Immunization Vaccines and Biologicals, 2009. Vaccine Preventable Diseases: Monitoring System. Available at: http://www.who.int/immunization_monitoring/en/globalsummary/timeseries/tsincidenceyfe.htm. Accessed November 4, 2009.
  9. World Health Organization Division of Epidemiological Surveillance and Health Situation Trend Assessment, 1992. Global Health Situation and Projections—Estimates. Geneva: World Health Organization.
  10. World Health Organization, 1996. The State of World Health: World Health Report. Geneva: World Health Organization.
  11. Barros ML, Boecken G, , 1996. Jungle yellow fever in the central Amazon. Lancet 348: 969970.[Crossref]
  12. McFarland JM, Baddour LM, Nelson JE, Elkins SK, Craven RB, Cropp BC, Chang GJ, Grindstaff AD, Craig AS, Smith RJ, , 1997. Imported yellow fever in a United States citizen. Clin Infect Dis 25: 11431147.[Crossref]
  13. Teichmann D, Grobusch MP, Wesselmann H, Temmesfeld-Wollbruck B, Breuer T, Dietel M, Emmerich P, Schmitz H, Suttorp N, , 1999. A haemorrhagic fever from the Cote d'Ivoire. Lancet 354: 1608.[Crossref]
  14. Centers for Disease Control and Prevention, 2000. Fatal yellow fever in a traveler returning from Venezuela, 1999. MMWR Morb Mortal Wkly Rep 49: 303305.
  15. Colebunders R, Mariage JL, Coche JC, Pirenne B, Kempinaire S, Hantson P, Van Gompel A, Niedrig M, Van Esbroeck M, Bailey R, Drosten C, Schmitz H, , 2002. A Belgian traveler who acquired yellow fever in The Gambia. Clin Infect Dis 35: e113e116.[Crossref]
  16. Centers for Disease Control and Prevention, 2002. Fatal yellow fever in a traveler returning from Amazonas, Brazil, 2002. MMWR Morb Mortal Wkly Rep 51: 324325.
  17. Struchiner CJ, Luz PM, Dourado I, Sato HK, Aguiar SG, Ribeiro JG, Soares RC, Codeco CT, , 2004. Risk of fatal adverse events associated with 17DD yellow fever vaccine. Epidemiol Infect 132: 939946.[Crossref]
  18. Barrett AD, Monath TP, Barban V, Niedrig M, Teuwen DE, , 2007. 17D yellow fever vaccines: new insights. A report of a workshop held during the World Congress on medicine and health in the tropics, Marseille, France, Monday 12 September 2005. Vaccine 25: 27582765.[Crossref]
  19. Hayes EB, , 2007. Acute viscerotropic disease following vaccination against yellow fever. Trans R Soc Trop Med Hyg 101: 967971.[Crossref]
  20. Whittembury A, Ramirez G, Hernandez H, Ropero AM, Waterman S, Ticona M, Brinton M, Uchuya J, Gershman M, Toledo W, Staples E, Campos C, Martinez M, Chang GJ, Cabezas C, Lanciotti R, Zaki S, Montgomery JM, Monath T, Hayes E, , 2009. Viscerotropic disease following yellow fever vaccination in Peru. Vaccine 27: 59745981.[Crossref]
  21. Hindle E, , 1930. The transmission of yellow fever. Lancet 219: 835842.[Crossref]
  22. Massad E, Coutinho FA, Burattini MN, Lopez LF, , 2001. The risk of yellow fever in a dengue-infested area. Trans R Soc Trop Med Hyg 95: 370374.[Crossref]
  23. Monath TP, Barrett AD, , 2003. Pathogenesis and pathophysiology of yellow fever. Adv Virus Res 60: 343395.[Crossref]
  24. Codeco CT, Luz PM, Coelho F, Galvani AP, Struchiner C, , 2007. Vaccinating in disease-free regions: a vaccine model with application to yellow fever. J R Soc Interface 4: 11191125.[Crossref]
  25. Davis N, , 1932. The effect of various temperatures in modifying the extrinsic incubation period of the yellow fever virus in Aedes aegypti . Am J Epidemiol 16: 163176.[Crossref]
  26. Watts DM, Burke DS, Harrison BA, Whitmire RE, Nisalak A, , 1987. Effect of temperature on the vector efficiency of Aedes aegypti for dengue 2 virus. Am J Trop Med Hyg 36: 143152.
  27. New M, Lister D, Hulme M, Makin I, , 2002. A high-resolution data set of surface climate over global land areas. Clim Res 21: 125.[Crossref]
  28. Bates M, Roca-Garcia M, , 1946. The development of the virus of yellow fever in Haemagogus mosquitoes. Am J Trop Med Hyg 26: 585605.
  29. Lunn DJ, Thomas A, Best N, Spiegelhalter D, , 2000. WinBUGS—a Bayesian modelling framework: concepts, structure, and extensibility. Stat Comput 10: 325337.[Crossref]
  30. Spiegelhalter DJ, Best NG, Carlin BR, van der Linde A, , 2002. Bayesian measures of model complexity and fit. J R Stat Soc Series B Stat Methodol 64: 583616.[Crossref]
  31. Reed W, Carroll J, Agramonte A, Lazear JW, , 1900. The etiology of yellow fever—a preliminary note. Public Health Pap Rep 26: 3753.
  32. Reed W, Carroll J, Agramonte A, , 1901. The etiology of yellow fever-an additional note. J Am Med Assoc 36: 431440.[Crossref]
  33. Reed W, Carroll J, Carroll J, Gorgas W, Owen R, McCaw W, , 1911. The etiology of yellow fever-a supplemental note. , eds. Yellow Fever: A Compilation of Various Publications. Washington, DC: Government Printing Office, 149160.
  34. Guiteras J, , 1901. Experimental yellow fever at the inoculation station of the sanitary department of Havana with a view to producing immunization. American Medicine 21: 809817.
  35. Marchoux E, Salimbeni A, Simond P, , 1903. La fièvre jaune: rapport de la mission française. Ann Inst Pasteur (Paris) 17: 665731.
  36. Rosenau M, Parker H, Francis E, Beyer G, , 1904. Experimental Studies in Yellow Fever and Malaria at Vera Cruz, Mexico. Washington, DC: Government Printing Office.
  37. Parker H, Beyer G, Pothier O, , 1903. A Study of the Etiology of Yellow Fever. Washington, DC: Government Printing Office.
  38. Bauer J, Hudson N, , 1928. The incubation period of yellow fever in the mosquito. J Exp Med 48: 147153.[Crossref]
  39. Stokes A, Bauer J, Hudson N, , 1928. Experimental transmission of yellow fever to laboratory animals. Am J Trop Med Hyg 8: 103164.
  40. Hindle E, , 1929. An experimental study of yellow fever. Trans R Soc Trop Med Hyg 22: 405430.[Crossref]
  41. Carter H, , 1900. A note on the interval between infecting and secondary cases of yellow fever from the records of the yellow fever at Orwood and Taylor, Mississippi in 1898. New Orleans Med Surg J 52: 617636.
  42. Carter H, , 1901. The period of incubation of yellow fever: a study from unpublished observations. Med Rec 59: 361367.
  43. Carter H, , 1901. A note on the spread of yellow fever in houses: extrinsic incubation. Med Rec 59: 933937.
  44. Beeuwkes H, , 1936. Clinical manifestations of yellow fever in the West African native as observed during four extensive epidemics of the disease in the Gold Coast and Nigeria. Trans R Soc Trop Med Hyg 30: 6186.[Crossref]
  45. Reisen WK, Fang Y, Martinez VM, , 2006. Effects of temperature on the transmission of West Nile virus by Culex tarsalis (Diptera: Culicidae). J Med Entomol 43: 309317.
  46. Richards SL, Lord CC, Pesko K, Tabachnick WJ, , 2009. Environmental and biological factors influencing Culex pipiens quinquefasciatus say (Diptera: Culicidae). Am J Trop Med Hyg 81: 264272.
  47. Styer LM, Minnick SL, Sun AK, Scott TW, , 2007. Mortality and reproductive dynamics of Aedes aegypti (Diptera: Culicidae) fed human blood. Vector Borne Zoonotic Dis 7: 8698.[Crossref]
  48. Christophers SR, , 1960. Aedes aegypti (L.): The Yellow Fever Mosquito. Cambridge, England: The University Press.
  49. Monath TP, Nasidi A, , 1993. Should yellow fever vaccine be included in the expanded program of immunization in Africa? A cost-effectiveness analysis for Nigeria. Am J Trop Med Hyg 48: 274299.
  50. Massad E, Coutinho FA, Burattini MN, Lopez LF, Struchiner CJ, , 2005. Yellow fever vaccination: how much is enough? Vaccine 23: 39083914.
  51. Wearing HJ, Rohani P, Keeling MJ, , 2005. Appropriate models for the management of infectious diseases. PLoS Med 2: 621627.
  52. American Academy of Pediatrics Pickering L, Baker C, Kimberlin D, Long S, , 2009. Hepatitis A, B, C, and D. , eds. Red Book: 2009 Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics.

Data & Media loading...

  • Received : 23 Dec 2009
  • Accepted : 08 Apr 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error