Why travelers must carry YELLOW FEVER VACCINATION CARD in India?

Yellow fever is a disease caused by a virus that is spread through mosquito bites. Although there is no risk of yellow fever in India, the Government of India requires proof of yellow fever vaccination if you are arriving from a country with risk of yellow fever.


Yellow Fever

1. Introduction

Yellow fever is a serious, potentially deadly flu-like disease transmitted by infected mosquitoes. The "yellow" in the name refers to jaundice that affects some patients. In about 15% of people, within a day of improving the fever comes back, abdominal pain occurs, and liver damage begins causing yellow skin. If this occurs, the risk of bleeding and kidney problems is also increased.

There are three main types of the disease: Sylvatic yellow fever (Jungle yellow fever), Intermediate yellow fever, Urban yellow fever.


2. Symptoms

The yellow fever virus incubates in the body for 3 to 6 days. The most common are fever (at a high temperature), muscle pain with prominent backache, headache, loss of appetite and feeling generally unwell, and nausea or vomiting. In most cases, people make a full recovery after 3 to 4 days.

However, there are some people develop a more serious stage of this fever, more toxic phase within 24 hours of recovering from initial symptoms. High fever returns and several body systems are affected, usually the liver and the kidneys. In this phase, people are likely to develop jaundice (yellowing of the skin and eyes), heart rhythm problems, dark urine and abdominal pain with vomiting (sometimes with blood). Bleeding can occur from the mouth, nose, eyes or stomach. Half of the patients who enter the serious stage die within 7 - 10 days.


Yellow Fever


3. Transmission

  • Yellow fever is a virus spread by mosquito bites. You can't get it from close contact with someone who has it (It cannot be transmitted directly from person to person).
  • The mosquitoes that spread the infection are found in towns and rural areas. They mainly bite during the day. Mosquitoes can also spread other serious illnesses, such as malaria and dengue.


Yellow Fever


There are three forms of yellow fever:

  • Sylvatic yellow fever (also known as “jungle yellow fever”) occurs when the disease is passed from monkeys infected by wild mosquitoes to humans. This can occur when humans enter jungle areas.
  • Intermediate yellow fever—the most common type of outbreak in modern Africa—results when semi-domestic mosquitoes (which can infect both monkeys and humans) are present in an area where they commonly come into contact with humans.
  • Urban yellow fever occurs when the Aedes aegypti species of domestic mosquito transmits the virus between humans, without transmission via other primates.


4. Diagnosis

Yellow fever is difficult to diagnose, especially during the first stages. A more severe case can be confused with severe malaria, leptospirosis, viral hepatitis (especially fulminant forms), other haemorrhagic fevers, infection with other flaviviruses (such as dengue haemorrhagic fever), and poisoning.

See your doctor right away if you’ve been traveling recently and you experience flu-like symptoms. Your doctor will ask you about the symptoms you’ve been experiencing and if you've traveled recently. If your doctor suspects that you have yellow fever, they’ll order a blood test.

  • Polymerase chain reaction (PCR) testing in blood and urine can sometimes detect the virus in the early stages of the disease. In later stages, testing to identify antibodies is needed (ELISA and PRNT).


5. Treatment

There's no cure for yellow fever, but the symptoms can be treated while your body fights off the infection. That’s why most people make a full recovery after 3 or 4 days. Here are some suggests:


  • Drink plenty of water to avoid dehydration.
  • Go into the hospital for close monitoring and treatment of your symptoms until you're feeling better.
  • Supportive care may be provided, including efforts to reduce pain and to lower the fever associated with the disease. Medications used for pain relief must be carefully selected, as some nonsteroidal anti-inflammatory drugs (including aspirin) may increase bleeding risk. Painkillers such as paracetamol or ibuprofen can help lower your temperature and relieve aches or pains in the meantime. 


6. Areas with Risk of Yellow Fever

The following are regarded as countries and areas with risk of Yellow Fever virus transmission:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Togo, and Uganda.

Americas: Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago (Trinidad only), and Venezuela.


Note: When a case of yellow fever is reported from any country, that country is regarded by the government of India as a country with risk of Yellow Fever virus transmission and is added to the above list.


7. Prevention

  • Stay Healthy and Safe
  • Yellow fever vaccine is the best protection against yellow fever disease. Travelers to areas with risk of yellow fever should also prevent by using mosquito nets, wearing clothes that cover your arms and legs: wearing long-sleeved shirts and pants when outdoors, and sleeping in an air-conditioned or well-screened room.
  • Get rid of water containers around dwellings and ensure that you’re sleeping in an air-conditioned or door and window screens work properly.
  • Use an insect repellent containing 20%-30% DEET or 20% Picaridin on exposed skin. Re-apply according to manufacturer’s directions.
  • Vaccination is the only way to prevent yellow fever. The vaccine for yellow fever is given as a single shot. It contains a live, weakened version of the virus that helps your body create immunity. However, you should try to avoid being bitten, even if you have been vaccinated.


8. Vaccination

The yellow fever vaccines are readily available at 27 government vaccination centers approved by the Ministry of Health and Family Welfare (MOHFW).

The vaccination against yellow fever should be given at least 10 days before traveling to the endemic area.


Groups of people who shouldn’t get the vaccine include:

  • People who have severe allergies to eggs, chicken proteins, or gelatin
  • Children are younger than 9 months of age.
  • People who have HIV, AIDS, or other conditions that compromise the immune system
  • Pregnant females


The vaccine is considered extremely safe. A single dose provides protection for at least 10 years. The side effects may include 

  • A low-grade fever.
  • Soreness
  • Redness or swelling where the shot was given.


9. Conclusion

India requirement while repairing an Indian eVisa: anyone (except infants up to the age of 6 months) arriving by air or sea without a yellow fever vaccination certificate is detained in isolation for up to 6 days if that person:

  • Arrives within 6 days of departure from an area with risk of yellow fever transmission
  • Or has been in such an area in transit (except those passengers and members of the crew who, while in transit through an airport situated in an area with risk of yellow fever transmission, remained within the airport premises during the period of their entire stay and the Health Officer agrees to such exemption) 
  • Or arrives on a ship that started from or touched at any port in an area with risk of yellow fever transmission up to 30 days before its arrival in India, unless such a ship has been disinsected in accordance with the procedure laid down by WHO, 
  • Or arrives on an aircraft that has been in an area with risk of yellow fever transmission and has not been disinsected in accordance with the Indian Aircraft Public Health Rules, 1954 
  • Or as recommended by WHO







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