Clínica y laboratorio de la Fiebre Amarilla en Costa Rica

Abstract

A brief chronological account is given of the epidemic of yellow fever 10 Costa Rica, showing its course in the country. The cases observed are discussed, and analysis :ue made of the relation between morbidity and mortality and the vaccination employed; of the general symptomatology observed in the patients entering the adult infecto-contagious case ward of Hospital San Juan de Dios, San Jose; and of all the clinical tests made in the same Hospital. Some prognostic and diagnostic considerations are presented, with diso cussions of the therapy used. The following conclusions are reached: a. The recent yellow fever epidemic in Costa Rica was a fairly serious one, having reached a mortality of 37% aman nan-vaccinated cases. b. Vaccination proved beneficial even in those cases In which it did not prevent infection. c. Early diagnosis and treatment, before the 5th. day of illness, improves the prognosis of the case. d. In any epidemic of jungle yeIlow fever Plasmodium infection should be checked for, as regions where Haemagogus is found are, in general, malarial. e. Urine examination, blood urea, hemogram, and especially prothrombin percent tests are not only useful for diagnosis, but have great value in prognosis. f. Prothrombin time tests are valuable in the conduct of treatment. g. As deduced from the clinical observations and laboratory data at hand, the most adequate treatment consists of preventing dehydration, ancl supplying vitamins, especially high closes of vitamin K as early as possible.