Colombian protocol for the hospital management of non-critically ill patients with suspected or confirmed yellow fever

Yellow fever (YF) continues to cause high lethality in Colombia; timely, standardized care is critical. This guideline consolidates current evidence and frontline experience to support hospital management of non-critically ill patients with YF. It introduces an operational five-group classification (A, B1, B2, C1, C2) to guide level of care, monitoring, and escalation, complemented by NEWS2 and West Haven scores to help judgment. Recommendations cover initial assessment; laboratory tests and imaging; restriction of fluids; bleeding risk mitigation with transfusion thresholds; avoidance of hepatotoxic and nephrotoxic medications; measures to prevent mosquito exposure; and criteria for safe discharge (after 7 days from symptom onset and >72 h of fever-free status). The protocol emphasizes differential diagnosis with other etiologies of tropical/endemic fever and defines post-discharge surveillance to detect late-onset hepatitis and persistent progressive jaundice. Developed by a multidisciplinary team and endorsed by scientific societies, this context-adapted guidance aims to significantly reduce morbidity and mortality in endemic settings.