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Yellow fever is an arthropod-borne disease with symptoms ranging from mild fever to acute hepatonephritis, hemorrhages and shock often fatal. The pathophysiology of severe yellow fever in humans and in monkeys susceptible to the virus is largely unknown. Yellow fever virus replicates in Küpffer cells and in hepatocytes in the liver. The degree of severity in yellow fever disease is linked to different factors related to virus virulence and to host susceptibility. A better knowledge of the complex interactions between the virus and the host is requested before initiating new actions in prophylaxy and therapy against yellow fever.

Although the causative agent has long been identified and a safe, effective vaccine is available, yellow fever still poses a threat in South America and tropical areas of Africa where it mainly affects young people. The presentation of yellow fever has changed relatively little since description of the first outbreaks, but study has entered a new age thanks to development of more accurate techniques for characterization of viral strains. Comparison of the RNA sequences of virus from different geographical regions has demonstrated the existence of several stable genotypes which have been designated as topotypes. These topotypes have yet to be correlated with different viral activity but their recognition has allowed better epidemiologic surveillance of the disease. Study of the viral genome has also allowed improvement of diagnostic techniques, identification of factors influencing virulence, and enhancement of understanding of viral mutations. Ultimately knowledge of the processes underlying viral evolution could assist development of effective preventive strategies.

Yellow fever and dengue are two current viral diseases induced by flaviviruses and usually transmitted by the same mosquito vector, Aedes aegypti. From 1987 to 1991, 18,753 cases of yellow fever, mainly from Africa, have been notified to WHO, leading to 4,522 deaths. On the other hand, WHO estimates that 2.5 billions individuals living in tropical areas are at risk to contract dengue fevers. In fact, 500,000 patients are hospitalized each year for dengue hemorrhagic fever/dengue shock syndrome and 90% of them are children. Nevertheless, the control of these two viral diseases would be reached easily in destroying mechanically the mosquito larval resting places. Although superficially similar, the two entities are in fact quite different. Relatively few is known about the pathogenesis of yellow fever whereas, for dengue fevers, it is difficult to integrate so many results accumulated to explain the occurrence of haemorrhagic phenomena according to the two main theories so far proposed which are not exclusive. The immunological one (S.B. Halstead) tries to explain the pathological events by the effect of anti-dengue enhancing antibodies acquired during a previous exposure to one of the dengue viruses, whereas that of increased virus virulence (L. Rosen) refers to fast passages between individuals during explosive epidemics.

The yellow fever virus has been isolated from a pool of Aedes africanus caught on men in a region situated between forest and savannah near Touba, in the Ivory Coast. This isolation, occurring at an interepidemic period, proves for the first time in West Africa, the part played by this mosquito in the transmission of the yellow fever virus.