The Union health ministry’s move to set up three more yellow fever vaccination centres in the state, including one in Pune, has run into trouble. The centers are meant for the people travelling to some countries in Africa and South America which require people entering their land to carry a yellow fever vaccination certificate.

Health authorities at the state-run hospitals, where these centers are supposed to come up, are reluctant to assign additional work to their existing staff. They say their teams are overburdened to manage the centres’ functioning. The three state-run facilities identified are Sassoon Hospital, Pune, J J Hospital, Mumbai and Government Medical College in Nagpur.

“All the three hospitals want separate and independent staff to look after the functioning of the centres. Past two meetings to find a solution could not take place due to technical reasons. The matter will be sorted out soon,” said D D Malekar, senior regional director (regional office) of the Union ministry of health and family welfare.

“Besides the need for separate staff, there is the question of forming a supply chain to fulfill the vaccine requirement at the identified centres. The issue will be discussed in the next meeting,” Malekar added.

At present, there are two vaccination centres operational in Mumbai at Port Health Office, Colaba, and at the Chattrapati Shivaji International Airport.

Senior orthopaedic surgeon Ajay Chandanwale, dean, Sassoon Hospital and B J Medical College in Pune, said, “There are some technical issues vis-à-vis starting the yellow vaccination centre at our hospital which have not yet been resolved.”

The centre envisages a one-room set up at the government health facility which will be manned by a medical officer and a nurse. “It will offer vaccinations only on fixed days and during fixed hours. It will be open once or twice a week for those travelling to yellow fever endemic countries,” Malekar said.

Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. 'Yellow' in the name refers to jaundice that affects some patients. There is no cure for yellow fever. Treatment is symptomatic, aimed at reducing the symptoms for the comfort of the patient.

Certain countries in South Africa and South America require travellers to get the yellow fever vaccination certificate. People coming to India from endemic countries also need a certificate stating they are vaccinated, otherwise they are quarantined at airport hospitals and kept under observation for 10 days, Malekar said.

A yellow fever vaccination certificate is valid only if it conforms to the model certificate. The validity period of the international certificate against yellow fever is 10 years, beginning 10 days after vaccination.

Foreign nationals residing or who have passed through yellow fever endemic countries during the preceding six days, are granted visas only after producing the vaccination certificate. After checking the certificate, an entry that reads 'Valid Yellow fever Vaccination Certificate Checked', is made in the passenger's passport.

For many months now, India has been importing Yellow fever vaccines as Central Research Institute (CRI) Kasauli, the lone manufacturer of the vaccine in South-East Asia since 1960, has stopped production due to a fault in its machine. CRI Kasauli had a annual production of approximately 60,000 vaccines which were being supplied to all 17 international airports across the country.

• Yellow fever is endemic in 33 countries in Africa and 11 countries in South America
• There are two modes of transmission of the yellow fever virus - the sylvatic or forest cycle and the urban cycle
• Transmission begins when vector mosquitoes (Aedes africanus in Africa, and several species of the genus Haemagogus in South America) feed on non-human primates infected with the virus. The infected mosquitoes then feed on humans travelling through the forest
• Once contracted, the virus incubates in the body for three to six days, followed by infection that can occur in one or two phases. The first, 'acute' phase usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve and their symptoms disappear after 3 to 4 days
• However, 15% of patients enter a second, more toxic phase within 24 hours of the initial remission. High fever returns and several body systems are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates. Half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage