Characterization of an Unusual Severe Yellow Fever Outbreak in the Colombian Andean Region.
11 affiliations
- 1Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chía, Colombia.
- 2Clinical and Translational Medicine Research Group, Critical Physiology Subdivision, Intensive Care Department, Hospital Federico Lleras Acosta, Ibagué, Colombia.
- 3School of Medicine, Faculty of Health Sciences, Universidad del Tolima, Ibagué, Colombia.
- 4Biosciences PhD Program, School of Engineering, Universidad de La Sabana, Chía, Colombia.
- 5Department of Critical Care Medicine, Clínica Keralty, Ibagué, Colombia.
- 6Doctorado en Ciencias Clínicas, Facultad de Medicina, Universidad de La Sabana, Chía, Colombia.
- 7School of Medicine, Universidad Salud Colombia, Ibagué, Colombia.
- 8Department of Critical Care Medicine, Clínica Universidad de La Sabana, Chía, Colombia.
- 9Department of Critical Care Medicine, Extracorporeal Life Support Unit, Fundación Clínica Shaio, Bogotá, DC, Colombia.
- 10Department of Pediatric Nephrology, Fundación Valle del Lili, Cali, Colombia.
- 11ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, UK.
Abstract
Background
Yellow fever (YF) reemerged in Colombia's Andean region during 2024-2025, outside the country's historically recognized endemic areas. We characterized critically ill adults admitted during this outbreak and described clinical features, organ dysfunction, supportive care, and in-hospital outcomes.Methods
We conducted a prospective observational cohort study of consecutive adults with reverse transcription polymerase chain reaction (RT-PCR)-confirmed YF admitted to the national referral intensive care unit in Ibagué, Tolima, Colombia, from March through September 2025. Clinical, laboratory, complication, intervention, and outcome data were prospectively captured using a standardized case report form.Results
Sixty-one patients were analyzed; 22 died (36.1%). Non-survivors had lower platelet counts and fibrinogen and higher INR, aminotransferases, lactate dehydrogenase, and creatinine at ICU admission. Shock, acute kidney injury, acute respiratory distress syndrome, disseminated intravascular coagulation, and severe bleeding were more frequent among non-survivors. Prior YF vaccination was self-reported by 10 patients (16.4%).Conclusions
Severe YF in this Andean outbreak was characterized by hepatic-coagulation abnormalities and multisystem organ dysfunction. The occurrence of critical illness outside historically recognized endemic areas supports surveillance and vaccination strategies that can adapt to changing epidemiological risk.
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BibTeX
@article{forerodelgadillo2026characterization,
title = {{Characterization of an Unusual Severe Yellow Fever Outbreak in the Colombian Andean Region.}},
author = {Alex Julián Forero-Delgadillo and Jeison Andrés Morales-Olivera and Paula O Narvaez-Ramirez and Natalia Sanabria-Herrera and Valeria Aguirre Gutierrez and Lina F Martinez-Lemus and Cristian C Serrano-Mayorga and Diana Catalina Ramírez-Reyes and Juan Diego Melo-Pedraza and Julián Celis-Guzmán and Gustavo González-Varona and Henry Robayo-Amortegui and Jessica María Forero and Erwin Hernandez and Ingrid G Bustos and Sara Duque and Esteban Garcia-Gallo and Luis F Reyes},
journal = {Open forum infectious diseases},
year = {2026},
month = oct,
doi = {10.1093/ofid/ofag636},
url = {https://europepmc.org/article/MED/42909258},
note = {CC BY},
}
RIS
TY - JOUR
TI - Characterization of an Unusual Severe Yellow Fever Outbreak in the Colombian Andean Region.
AU - Alex Julián Forero-Delgadillo
AU - Jeison Andrés Morales-Olivera
AU - Paula O Narvaez-Ramirez
AU - Natalia Sanabria-Herrera
AU - Valeria Aguirre Gutierrez
AU - Lina F Martinez-Lemus
AU - Cristian C Serrano-Mayorga
AU - Diana Catalina Ramírez-Reyes
AU - Juan Diego Melo-Pedraza
AU - Julián Celis-Guzmán
AU - Gustavo González-Varona
AU - Henry Robayo-Amortegui
AU - Jessica María Forero
AU - Erwin Hernandez
AU - Ingrid G Bustos
AU - Sara Duque
AU - Esteban Garcia-Gallo
AU - Luis F Reyes
PY - 2026
DA - 2026/10/21
JO - Open forum infectious diseases
DO - 10.1093/ofid/ofag636
UR - https://europepmc.org/article/MED/42909258
AB - Background Yellow fever (YF) reemerged in Colombia's Andean region during 2024-2025, outside the country's historically recognized endemic areas. We characterized critically ill adults admitted during this outbreak and described clinical features, organ dysfunction, supportive care, and in-hospital outcomes.Methods We conducted a prospective observational cohort study of consecutive adults with reverse transcription polymerase chain reaction (RT-PCR)-confirmed YF admitted to the national referral intensive care unit in Ibagué, Tolima, Colombia, from March through September 2025. Clinical, laboratory, complication, intervention, and outcome data were prospectively captured using a standardized case report form.Results Sixty-one patients were analyzed; 22 died (36.1%). Non-survivors had lower platelet counts and fibrinogen and higher INR, aminotransferases, lactate dehydrogenase, and creatinine at ICU admission. Shock, acute kidney injury, acute respiratory distress syndrome, disseminated intravascular coagulation, and severe bleeding were more frequent among non-survivors. Prior YF vaccination was self-reported by 10 patients (16.4%).Conclusions Severe YF in this Andean outbreak was characterized by hepatic-coagulation abnormalities and multisystem organ dysfunction. The occurrence of critical illness outside historically recognized endemic areas supports surveillance and vaccination strategies that can adapt to changing epidemiological risk.
SN - 2328-8957
ER -