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Frequently Asked Question's


1. How do we diagnose Yellow fever?
  • In order to make a yellow fever diagnosis, your doctor will ask questions about a number of things (including recent medical and travel history), perform a physical exam, and recommend certain tests. As part of diagnosing a yellow fever virus infection, the doctor will also rule out other more common causes of possible yellow fever symptoms, such as the flu or the common cold. If the doctor thinks a person is at risk for yellow fever, he or she can order certain tests. These tests can include Blood tests, Cerebrospinal fluid tests (CSF), Electrocardiograms (EKGs). These individual tests will not definitely diagnose yellow fever, but they can be helpful. To make a definitive diagnosis of yellow fever, the doctor will draw a blood sample and send it to a commercial or public health laboratory for confirmation.[ Click to see source ]

  • The diagnosis of yellow fever is made through examining the blood using various techniques in order to demonstrate the presence of either yellow fever viral antigens (the part of the virus that initiates the patient's immune response) or specific antibodies (the cells produced by the patient's immune system that are specifically directed against the yellow fever virus). [ Click to see source ]

  • Specific diagnosis depends on isolation of virus from blood, demonstration of viral antigen in serum by enzime-linked immunosorbent assay ( ELISA ) or of viral RNA by polimerase chain reaction ( PCR ) during the period of infection. Serologic diagnosis include IgM antibody-capture ELISA, hemagglutination inhibition (HI), complement fixation (CF) or neutralization (N) tests. It's important to consider that IgM, HI and N antibodies appear within 5 - 7 days and CF antibodies within 7 - 14 days after onset. Thus, paired acute and convalescent sera should be tested (interval of 14 days ). [ Click to see source ]


2. What are the other conditions that can mimic/ look like Yellow fever?
Leptospirosis:
Increased erythrocyte sedimentation rate, total WBC elevated with neutrophilia and trans aminases levels slightly elevated . Dengue fever: Indistinguishable from yellow fever in the initial stages; jaundice is, however, a rare sign.

Malaria:
It must be always excluded by serial blood examination, even when the diagnosis of yellow fever is confirmed, due to the possible concomitant of both diseases. Anemia without hemorrhagic manifestations, splenomegaly and low levels of transaminases take account of malaria.

Hepatitis:
The insidious onset, usually without renal disease ( suggestive ) + presence of viral markers of hepatitis in sera confirm the diagnosis.


3. Can you provide a list of Government Vaccination Centers in India?
The Government of India has designated certain Government Hospitals and Agencies as Centers for Yellow Fever Vaccination.

Here is a list of these Government Centers Vaccination centres For Yellow Fever For International Travellers

Delhi:
Health Organization, Palam Airport. (Tue. and Thursday 1400 - 1600 hrs) Tel. 3295507.

Public Health Laboratory, Municipal Corporation, Town Hall, Alipur Road, Mon & Fri 1000 - 1200 hrs. Tel. 252 2058Dr. Ram Manohar Lolia Hospital (Wed & Sat 1100 to 1300 hrs) Tel: 3365525 / 3735337

International Inoculation Centre, Mandir Marg, New Delhi - 110001

Mumbai:
Health Office, Mumbai Airport.

Port Health Organisation, Seamens Medical Examination Organization, Nav Bhawan

Calcutta:
All India Institute of Hygiene and Public Health.

Health Organization, Dum Dum Airport.

Port Health Organization.

Cochin:
Port Health Organization

Goa:
Urban Health Organization, Panaji.

Hyderabad:
Institute of Preventive Medicine

Jamnagar:
Irwin Hospital

Kandla:
Port Health Organization.

Kasauli:
Central Research Institute

Lucknow:
Balrampur Hospital

Chennai:
King Institute of Preventive Medicine, Guindy.

Port Health Officer / Assistant Port Health Officer / Assistant Airport Health Officer, Port Health Organization.

Marmugao:
Port Health Organization

Porbandar:
Office of the Civil Surgeon

Pune:
Department of Preventive & Social Medicine, BJ Medical College

Vishakhapatamam:
Port Heath Organization.

4. Can you provide a list of Private centers performing Yellow Fever Vaccination in India?
Unfortunately, no resource is available that provides a comprehensive list of Private Centers giving the Yellow Fever Vaccination.

5. In what countries is there a risk for getting Yellow Fever disease? Or for traveling to what countries is Yellow Fever Vaccine
    recommended?
See our Population at risk page.

6. Is Yellow Fever vaccination a legal obligation?
If you are travelling or transiting through areas that are infected with yellow fever, many countries including India require you to be vaccinated. A record of your vaccination must be entered and validated in your International Certificate of Vaccination. It is best to get the vaccination to make sure that you meet the varying entry requirements. For the latest information on the list of countries that are infected with yellow fever, look here. Talk to your travel agent and also consult with your doctor (preferably at least two months before traveling) to arrange for this and other travel vaccinations. You must have the yellow fever vaccine at least 10 days before to a yellow fever endemic country, otherwise you may be quarantined compulsorily (kept forcibly in a hospital for a week to make sure that you do not have Yellow Fever).

Reference http://www.indiaatbest.com/india_welcome.htm

7. Can you guarantee that your certificate would be acceptable to all Embassies?
We cannot & do not guarantee this. While this is a Universally Acceptable WHO Certificate of Vaccination, different embassies & officials in the same may have different views regarding the same. We provide the WHO approved vaccination, the WHO International certification and all the necessary details regarding the same, on a best effort basis only. While we have been providing this vaccination since 2005 without any complaints whatsoever, but cannot guarantee the same in an individual case.

8. Which Yellow Fever Vaccines are approved by WHO?
Here is the list of the only 3 WHO approved yellow fever vaccine producers in the world.Charak Clinics, in Chandigarh, India, uses the ONLY WHO pre-approved vaccination that is licensed in India, namely STAMARIL from Aventis Pasteur, France.

9. Where should I get myself vaccinated, a private center or the government recognized center?
While the government vaccination is cheaper, a private center has the following important advantages.

a) Convenience - Most government centers provide vaccinations either once or twice a week. Also the time for the vaccination is restricted to a couple of hours. Prior appointment is generally needed too. We are open not only daily, but also work on most holidays too. We are only closed on Sundays.

b) Better vaccine, possibly less side-effect - Private centers like ours use STAMARIL - a WHO Pre-approved french vaccination, in a single dose form. Government uses multi-dose vials of Indian origin (each vaccine is used for 5-10 recipients), thus possibly increasing the chances of side-effects like fever, pain etc. while private centers use single dose injections.

10. What are other travel vaccine that are recommended (in addition to Yellow fever vaccine)?
There is no "legal" requirement for any vaccine other than Yellow Fever (for most countries). However you MUST confirm the same by checking the CDC website here or by contacting the local embassy of the specific country.

As far as our Charak Clinics is concerned, we are recommending the following Optional vaccines for Personal Protection to travelers to African and South American countries
  • Typhoid Vaccine (repeat every 3 years)
  • Hepatitis A (2 doses at 6 months interval for life-long protection)
  • Cholera Vaccine (new drops available - 2 doses at a gap of 15 days)
  • Swine Flu + Influenza vaccination (combination - single dose above 9 years, 2 doses at a gap of 1 month below 9 years)
  • Hepatitis B vaccine - 3 doses (0, 1 & 6 months preferably, otherwise accelerated schedule may be given with 0,1 & 2 months and a booster after a gap of 1 year)
These would help prevent common serious water-borne diseases prevalent in these regions. For the latest tips about vaccination required for personal protection, see this excellent website (http://www.mdtravelhealth.com/)

11. What are the BEST resources for Travel related information / vaccination?
I would recommend the following resources as authoritative and comprehensive, if you are looking for genuine and rapid access to vast amounts of constantly update travel information.

While there are a large number of websites offering travel medicine related information, these are three websites that are regularly updated and have huge amounts of unbiased up to date information about almost any travel related health concerns that need to be addressed.

12. Are you a member of any Travel health related organization / website?
We are proud members of the International Association of Medical Assistance to Travelers (IAMAT). Visit them at http://www.iamat.org/. This is an excellent resource for travelers since they provide (on free registration) a list of medical clinics providing assistance to travelers too.