QUIZ: Which country does NOT have endemic yellow fever circu | Figure 1
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QUIZ: Which country does NOT have endemic yellow fever circulation?
A. Brazil
B. Chile
C. Ghana
D. Nigeria
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CASE STUDY: A 35-year-old man presents to the emergency department with fever, malaise, abdominal pain, nausea, and diarrhea. He reports being in good health until a few days ago, at which time he suddenly began experiencing these symptoms. Being the astute clinician you are, you inquire about recent international travel as part of his social history and find that he returned from a trip to India three weeks ago. He did not have a pre-travel consultation, nor did he receive any pre-travel vaccines. While in India, he stayed in a rural area and ate food prepared by locals. He does not report any contact with freshwater. During the examination, you notice the yellowing of the patient’s sclera. Due to the scleral icterus, you order LFTs which show a total bilirubin of 2.1mg/dL, AST 9,000 U/L, and ALT 10,500 U/L. Which travel-related illness is at the top of your differential diagnosis?
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