Hepatitis A
Hepatitis A, also called 'infectious hepatitis', is generally contracted from contaminated food and water. The infection causes an inflammation of the liver and presents as nausea, fever, aches and pains (usually beginning 3 to 6 weeks after coming in contact with the virus). Most people recover completely but it can put adults off work for about a month. Obtain your immunization before you travel. Vaccination against Hepatitis A (or immune globulin), together with Hepatitis B (and typhoid) is recommended.
Typhoid
Typhoid or 'enteric fever' is a common life-threatening illness prevalent in developing countries, including parts of Africa. It is contracted by consuming food or drink handled by an infected person shedding Salmonella typhi bacteria (found in human faeces). It is also found in sewage contaminated with the bacteria, which can get into the water used for drinking or washing food. Symptoms are a rapidly fluctuating temperature, drowsiness, diarrhea, abdominal rash, delirium and coma. Immunization is effective and the disease is treatable with antibiotics. Being careful with your personal, food and water hygiene on safari is therefore paramount.
Meningitis
Meningitis is an inflammation of the membranes that cover the brain and the spinal cord. It is caused by viral or bacterial infection. It is most prevalent along the “meningitis belt” that stretches from Senegal to Ethiopia in the Sahel region of Africa.
Cholera
Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. Epidemics of cholera have occurred over the centuries but have been largely eliminated from countries with safe water supplies & proper sanitation although infrequent local outbreaks do occur in Africa from time to time.
Cholera is spread by water and food contaminated with the germ by unhygienic handling, or by flies. Sudden, large outbreaks are usually caused by a contaminated water supply. The germ can survive in fresh water for days or even a few weeks. Unless conditions are particularly unhygienic direct person-to-person transmission is rare.
Most infected people do not become ill although the bacterium can be detected in the faeces for 1 to 2 weeks. When illness does occur more than 90% of cases have mild to moderate diarrhoea indistinguishable from other causes such as simple traveller's diarrhoea. Less than 10% develop the dramatic & frightening disease with copious, painless diarrhoea quickly leading to severe dehydration & death within hours or days, if treatment is not promptly given.
Prevention - boiling water will kill the cholera organism as will filtered water treated with iodine or chlorine. Sealed bottled water with an identifiable label is safe. Do not trust any ice. Food that is thoroughly cooked & comes to you piping hot is safe. It is best to avoid shellfish. Avoid raw fruits & vegetables unless you can peel them or you are certain that they have been adequately washed. Avoid food that is likely to have been standing around & contaminated by flies. These are simple & time-tested precautions that will prevent cholera (and other water-borne diseases).
An effective 2 dose oral vaccine is now available, and this can provide good protection, up to 80%, for 2-3 years. Currently, no country requires proof of cholera vaccination as a condition for entry.
Tuberculosis (TB)
Tuberculosis, dramatically described in Victorian times as 'consumption', is proving to be just as serious a public health problem today. TB results from invasion of the body by a specific germ called Mycobacterium tuberculosis. Illness will occur from repeated or overwhelming invasions of the germ, or when the body's immune defenses are lowered by other diseases or malnutrition. Prolonged contact with an infectious person is generally needed for the germ to be transmitted and even then only about 10% of people infected will go on to develop the disease, depending on their state of health and living conditions. A short-term visit to an area with a high incidence of Tuberculosis should pose no problem, but people with low immunity either from disease (HIV infection; poorly controlled diabetes; chronic liver disease; leukemia, lymphoma) or having treatment (chemotherapy for cancer) should exercise care.
Polio
Poliomyelitis (polio) is an acute infection caused by a virus which attacks the nervous system and can lead to paralysis. Transmission is by fecal contamination of food, usually by unhygienic food handlers or flies, or directly from infected nasal secretions. Polio is a serious disease which attacks the central nervous system causing muscle paralysis. It is however preventable with a vaccine that is very safe & effective.
Although most countries have immunization programs in childhood it is important that travellers be aware that the efficacy wanes after ten years & a booster dose is advisable prior to travel especially if visiting a country where the disease is still found.
Polio continues to occur (endemic) in four countries: India, Pakistan, Afghanistan and Nigeria. In 2011, in addition to the 4 endemic countries there were cases reported in Angola, Burkina Faso, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Gabon, Guinea, Mali, Niger (all countries in Africa). All travellers need to get vaccinated if they are going to polio endemic countries, neighboring countries, or those countries where recent cases of polio have been reported.
Tetanus
Tetanus (also known as lockjaw) is a disease caused by infection with 'clostridium tetani' which is present in soil and in the intestines of humans and animals. Infection can enter the body via cuts after which bacteria produce a toxin affecting the motor nerve cells in the spinal cord. This is followed by convulsions and muscle spasms. The vaccine is effective and the disease can also be treated by an antitoxin and penicillin. It is advisable that EVERYONE be vaccinated irrespective of their travel plans - check with your family physician as to whether you should have a tetanus-diphtheria booster shot.
Yellow Fever
This infection is caused by a virus carried by monkeys and then transmitted by mosquitoes to humans. The symptoms are a short, mild fever often leading to jaundice, failure of the liver and kidneys and eventually death. The yellow fever vaccine is effective and is valid for life (the WHO recently amended this from being valid for 10 years). The vaccination is generally only available in specialist clinics or hospitals and children, people over 65 years, and auto-immune sufferers should discuss the potential side-effects with their doctor.
Yellow Fever is the one immunization that is required when travelling to most West African countries as well as Uganda, Rwanda, Tanzania (and Zanzibar).
Following advice by the World Health Organisation (WHO) South Africa has become especially vigilant, and if you travel from any of the countries above they will request to see your Yellow Fever Certificate and refuse entry should you not be able to supply it (or insist you have the inoculation then and there!).
It is therefore advisable to have a valid yellow fever certificate if arriving at your destination from or via ANY of the following countries in Africa and South America:
Yellow Fever Endemic Zone in Africa includes Senegal, Gambia, Guinea Bissau, Sierra Leone, Liberia, Cote D'Ivoire, Burkina Faso, Ghana, Nigeria, Mali, Niger, Chad, Central African Republic, Togo, Benin, Sao Tome and Principe, Cameroon, Gabon, Congo, Democratic Republic of Congo, Republic of Tanzania, Angola, Uganda, Kenya, Rwanda, Burundi, Ethiopia, Somali, Sudan and Equatorial Guinea.
The Yellow Fever Endemic Zone in America includes Panama, Venezuela, Colombia, Ecuador, Peru, Brazil, Guyana, Suriname, French Guiana and Bolivia.
Medical reasons not to receive the vaccine:
Infants under 9 months must not get immunized without consulting a doctor.
Adults over 65 years of age should not get immunized without consulting a doctor.
Persons severely allergic