UNAIDS Report on Quarantine of PLWHAs for Yellow Fever

[Guest guest]

Dear Moderator,

attached is the report from Dr. Wind Andersen, Country Coordinator of

UNAIDS, India on the Quarantine for Yellow Fever at Mumbai airport. This is an

official report prepared by the UNAIDS office after consultations with the

Health Ministry officials, NACO, SACS etc. This may be put up on your forum as

soon as possible.

With regards,

Dr. Misra

E-maill:<misranaco@...>

________________________________

Report on Quarantine for Yellow Fever

Dear all,

This is in regard to the issue of Quarantine of 6 PLWAs for Yellow

fever at Mumbai. A group of 15 PLWAs were returning to India after

attending the International Conference at Kampala, Uganda on the 1st

October, early morning. They had participated in the conference on

scholarships provide by the organizers of the conference. Six of

them were quarantined at Mumbai as they did not have any certificate

for vaccination against Yellow fever. Certificates for waiver of

vaccination had been issued to only two PLWAs by their respective

State AIDS Control Societies. On the basis of these certificates they

had traveled to Uganda, since their visas were granted on arrival in

Uganda. Also quarantined were a couple of other people, without any

evidence of HIV/AIDS on the same ground. International and national

guidelines suggest mandatory quarantine for 6 days, if due to any

circumstances, vaccination against yellow fever is not possible.

Mr. Anand Tiwari, Advocacy Advisor, UNAIDS India, made a visit on 2nd

November to the PLWAs at the quarantine hospital after a call from

Mr. Rajeev Sadanandan, Consultant, NACO.

Mr. Anand, visited the hospital and also had telephonic conversation

with the Minister of health, Government of Maharashtra, Shri.

Digvijay Khanvilkar, the Director of Health Services, Maharashtra,

Dr. Subhash Salunke and the doctor at the airport, Dr. Prakash

Gaekwad.

This was closely monitored and meetings were held in the Ministry of

Health, Governemt of India and NACO, where the Country Coordinator,

UNAIDS, India, Dr. Wind Andersen and his team met with

Secretary of Health, Mr. Prasada Rao and the Project Director, NACO,

Mrs. Meenakshi Datta Ghosh. Dr. Alka Gogate, Project Director,

Mumbai AIDS Control Society was also contacted for details of steps

initiated.

Findings:

Following are the observations and steps taken.

„« The Health Ministry, NACO and the concerned State Health department

and SACS have taken steps to ensure adherence to international and

national guidelines on Yellow fever.

„« The Guidelines state that vaccinations against Yellow Fever is

contraindicated in cases of immunosupression due to AIDS, (CD4 counts

< 200 cells), leukaemia, lymphomas etc. besides, pregnancy and

lactation. Hence it is not AIDS but immunosuppression that

contraindicates Yellow fever vaccination. Yellow fever vaccination

certificates in India are issued under the authority of the

Directorate of Health services in the Central government and state

governments.

„« National Guidelines suggest quarantine for 6 days, in cases where

vaccination has not been possible due to any circumstances. This was

discussed with officials in the Ministry for health and these

guidelines are the ¡¥Law of the Land¡¦ and needs to be strictly

followed. The letters from respective State AIDS Control Societies

suggested waiving of vaccination and not of quarantine.

„« The hospital for quarantine in Mumbai does not provide food etc

free of cost to the inmates. However, medical help is provided and a

doctor visits the hospital on a daily basis to provide assistance as

and when required. However, both the Maharashtra AIDS Control Society

and the Mumbai district AIDS Control Society had initiated steps to

provide food and other necessities for the comfortable stay of the

PLWAs free of charge. UNAIDS had intimated to them of all possible

help in this regard.

„« As observed by Anand Tiwari of UNAIDS, the condition of the

hospital premises appear satisfactory, as is the case in any other

hospital premises in India.

„« The PLWAs appeared to be in good health. Doctors had visited the

hospital and provided all medical help to the PLWAs. They also

ensured separate rooms for the males and females in the group. The

hospital has been asked to provide all necessary help (food, stay and

medical help) to all PLWAs in the future and the State AIDS Societies

will be intimated and all expenses will be borne by the AIDS Control

Societies. The airport authorities have also been appraised on steps

to be taken in future.

A meeting was held on the 6th of November with the PLWAs by Dr. S. N.

Misra, Consultant UNAIDS after their release to discuss the technical

issues regarding Yellow fever vaccination and quarantine.

Conclusion:

The quarantine does not suggest any direct discrimination on grounds

of HIV/AIDS and necessary steps have been taken to ensure compliance

of the guidelines of the government and also for a comfortable stay

at the quarantine hospital.

It is however suggested, that steps are necessary to have better

information and communication on guidelines. Any updating of existing

guidelines, keeping the HIV/AIDS epidemic in context, may be

disseminated to all concerned authorities and PLWA networks. It was

also mentioned that UNAIDS would be rendering all possible help to

them in disseminating all necessary guidelines to them and be in

close cooperation with them and the government in future. Dr. S. N.

Misra, Public health expert in UNAIDS may be contacted for further

information in this regard.

Dr. Wind Andersen

Country Coordinator

UNAIDS, India

Dated: 8th November 2003.