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Is India Prepared to Face the Epidemics?

The reappearance of chikungunya after 32 years and India's inability to prevent recurrent outbreaks of dengue year after year have raised //the million dollar question: can India cope up with yellow fever (YF) if it ever strikes?

This is one of the questions likely to come up at the eighth international symposium on vector-borne diseases sponsored by the Indian Council of Medical Research (ICMR) at Madurai in Tamil Nadu that started Friday.

After all, YF is also spread by the same aedes aegypti mosquito that transmits dengue and chikungunya. Moreover, India has a lot of monkeys that can act as a reservoir for the YF virus once introduced. And Africa, only a few hours by flight, is endemic for this virus and there is good chance of passengers with YF arriving in India.

"Despite these favourable factors, YF is absent in India and it is a mystery," said Kalyan Banerjee, former director of the National Institute of Virology in Pune. He, however, cautioned that YF would come "some day" if India failed to shore up its crumbling vector control programme.

According to Banerjee, recurring dengue outbreaks are due to unplanned urbanisation and crumbling mosquito control programme. Environmental management to prevent mosquito breeding is key to protecting the country from yellow fever - occurring naturally or introduced deliberately.

Sriram Prasad Tripathy, former chief of ICMR, echoed him. "No one has excluded the possibility of YF coming to India," Tripathy told IANS from Pune. "An effective vaccine against YF is there, but the cost of vaccinating the entire population would be prohibitive."

Some public health experts believe that the absence of YF in India has to do with the genetic makeup of Indians or the Indian strain of aedes aegypti mosquitoes are incapable of transmitting the virus.

But virologist Pradeep Seth, formerly with the All India Institute of Medical Sciences (AIIMS) in New De
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