{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T10:38:50Z","timestamp":1792579130850,"version":"4.5.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010628","name":"Universidad de La Sabana","doi-asserted-by":"publisher","award":["MED-122-2025"],"award-info":[{"award-number":["MED-122-2025"]}],"id":[{"id":"10.13039\/501100010628","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["303666\/Z\/23\/Z"],"award-info":[{"award-number":["303666\/Z\/23\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UK International Development","award":["301542-403"],"award-info":[{"award-number":["301542-403"]}]},{"DOI":"10.13039\/100021281","name":"Gates Foundation","doi-asserted-by":"publisher","award":["INV-063472"],"award-info":[{"award-number":["INV-063472"]}],"id":[{"id":"10.13039\/100021281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Yellow fever (YF) reemerged in Colombia\u2019s Andean region during 2024\u20132025, outside the country\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational cohort study of consecutive adults with reverse transcription polymerase chain reaction (RT-PCR)\u2013confirmed YF admitted to the national referral intensive care unit in Ibagu\u00e9, Tolima, Colombia, from March through September 2025. Clinical, laboratory, complication, intervention, and outcome data were prospectively captured using a standardized case report form.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag636","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T09:46:56Z","timestamp":1792576016000},"source":"Crossref","is-referenced-by-count":0,"title":["Characterization of an Unusual Severe Yellow Fever Outbreak in the Colombian Andean Region"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2924-5151","authenticated-orcid":false,"given":"Alex Juli\u00e1n","family":"Forero-Delgadillo","sequence":"first","affiliation":[{"name":"Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana , Ch\u00eda ,","place":["Colombia"]},{"name":"Clinical and Translational Medicine Research Group, Critical Physiology Subdivision, Intensive Care Department, Hospital Federico Lleras Acosta , Ibagu\u00e9 ,","place":["Colombia"]},{"name":"School of Medicine, Faculty of Health Sciences, Universidad del Tolima , Ibagu\u00e9 ,","place":["Colombia"]},{"name":"Biosciences PhD Program, School of Engineering, Universidad de La Sabana , Ch\u00eda ,","place":["Colombia"]},{"name":"Department of Critical Care Medicine, Cl\u00ednica Keralty , Ibagu\u00e9 ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4076-9127","authenticated-orcid":false,"given":"Jeison Andr\u00e9s","family":"Morales-Olivera","sequence":"additional","affiliation":[{"name":"Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana , Ch\u00eda ,","place":["Colombia"]},{"name":"Clinical and Translational Medicine Research Group, Critical Physiology Subdivision, Intensive Care Department, Hospital Federico Lleras Acosta , Ibagu\u00e9 ,","place":["Colombia"]},{"name":"School of Medicine, Faculty of Health Sciences, Universidad del Tolima , Ibagu\u00e9 ,","place":["Colombia"]},{"name":"Department of Critical Care Medicine, Cl\u00ednica Keralty , Ibagu\u00e9 ,","place":["Colombia"]},{"name":"Doctorado en Ciencias Cl\u00ednicas, Facultad de Medicina, Universidad de La Sabana , Ch\u00eda ,","place":["Colombia"]},{"name":"School of Medicine, Universidad Salud Colombia , Ibagu\u00e9 ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9099-646X","authenticated-orcid":false,"given":"Paula O","family":"Narvaez-Ramirez","sequence":"additional","affiliation":[{"name":"Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana , Ch\u00eda ,","place":["Colombia"]},{"name":"Cl\u00ednica Universidad de La Sabana Department of Critical Care Medicine, , Ch\u00eda 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