It is prudent on theoretical grounds to avoid vaccinating pregnant women, and for non-immunized pregnant women to postpone travel to epidemic areas until after delivery. Pregnant women who must travel to HIGH RISK areas should consult their doctor to discuss their specific situation.
Persons, whose immune systems are suppressed due to HIV infection, or those travellers undergoing treatments for cancers (leukemia, lymphoma, etc.), or receiving corticosteroids, alkylating drugs, antimetabolites or radiation, in general, should not be vaccinated unless travelling to an area of known yellow fever transmission. Patients with suppressed immune systems have a theoretical risk of encephalitis due to the yellow fever vaccine virus. Consult your doctor.
If you have a medical reason not to receive the yellow fever vaccine you should obtain a written medical waiver from the respective consulate or embassy before leaving home.
TRAVELLERS' DIARRHOEA (& PROBIOTICS)
According to the World Health Organisation, over 50% of people travelling to developing countries will experience travellers' diarrhoea. Whilst Africa certainly qualifies as 'developing' I would not classify the safari camps and lodges in that third world category. However, diarrhoea is not unheard of on safari and if it is something that you know you are prone to, it may be worth considering taking along a suitable preventative medication. The most common cause of travellers’ diarrhoea is infection by the bacterium Enterotoxigenic E. coli. To negate this it is advisable to seek out a medication that contains a rich source of antibodies (what are commonly referred to as probiotics). Such antibodies, such as found in Bovine Colostrum Powder, bind to the E. coli in the gastrointestinal tract, preventing it from attaching to the intestinal wall and thereby neutralising its ability to cause fever, belly cramps and diarrhoea. Speak to your GP or pharmacist.
It's important to distinguish between travellers’ diarrhoea and food poisoning. The latter is the result of eating toxins that have already formed in the food, and while it may cause both vomiting and diarrhoea, it’s usually over within 12 hours. Beyond avoiding uncooked or poorly cooked food, the best advise I can offer is to wash your hands regularly with an alcohol based hand santizer (or soap if sanitizer is not available).
MOTION SICKNESS
If you suffer from motion sickness (whether car, air or boat) you might want to check your itinerary to see if there will be occasion for you to be concerned. In cars, including game-drive vehicles, and light aircraft it is best to sit up front or in the middle (to reduce the up-and-down movement or bumpiness). Be sure to get sufficient airflow and try to suck on something (or chew gum) – this will help to keep your ears unblocked. Ginger is reputed to be excellent for motion sickness too – pick up some ginger sweets before you leave home. You can also purchase pressure-point bands that fit around your wrist - or you can talk to your chemist about other options.
Vaccinations
It is important to check with your local health professional/physician/GP for information on recommended vaccinations or other precautions relating to travel in Africa.
A POINT OF DIFFERENCE: There is a subtle difference between a vaccine that is recommended and one that is required. A number of vaccinations (Hepatitis A and B, typhoid, polio, tetanus, cholera) are recommended. This does not mean that you must have them – only that they are recommended. On the other hand, if you are told that a yellow fever inoculation is required for example, then you stand the risk of not being allowed into that country should you not have the appropriate vaccination certificate.
Staying at a luxury safari camp or lodge does to some extent set you apart from everyday exposure to many of these diseases. Whilst it is always a possibility, it is fairly unlikely that you will be exposed to any of the infectious diseases on the recommended list while on safari. The kitchens are generally well schooled on hygiene and food preparation and all aspects of staff health are actively monitored. However, if you are planning to spend extended periods of time living in close contact with the local people, perhaps as an aid worker or volunteer, or you will be in known areas of infection, you should certainly have the inoculations. If you are in any doubt, or at all concerned about the possibility of contracting any of these diseases, then the vaccinations are the safe and sensible choice.
Please also keep in mind that a number of tropical diseases can remain dormant for some time, only making an appearance many months later. If you become ill after your safari - even up to a year later – be sure to mention your visit to Africa to your doctor so that he/she can take this into consideration and order the appropriate tests (if warranted).
IMPORTANT:
The Centre for Disease Control recommends the following vaccines – no matter where you are visiting in Africa:
Hepatitis A or immune globulin (IG)
Hepatitis B (a disease transmitted via blood)
Typhoid
Booster doses for tetanus-diphtheria, measles, and a one-time dose of polio vaccine.
Vaccination certificates
If you are required to have a vaccination be sure that you have the certificate on you (in your hand luggage with your passport and airline tickets) – do not pack this in your suitcase. Please note that Yellow Fever vaccines are often only available from designated clinics and may not be readily available at your GP.
Vaccine recommendations for children
Most of the following should already have been covered in your child’s standard immunization program from a very early age. Please treat the following as a guide only.
Review the following vaccines with a physician at least 10 weeks before departure to ensure the proper scheduling of the various appropriate vaccines and dosages.d
Infants and children up to two years of age should have received 3 doses of diphtheria, tetanus, and pertussis vaccine (DTP Vaccine). One dose of DTP affords little protection; two doses provide some protection and 3 doses 70-80% protection. Parents should note that less than the 3 recommended doses of DTP will put a child at greater risk of infection. You may wish your child to receive the remaining doses of the vaccine at the recommended intervals while abroad.
The measles, mumps, and rubella vaccine (MMR vaccine) should be administered to all children 15 months of age or older. For younger children going to areas of high risk, measles vaccine may be given earlier. Infants less than 6 months of age are protected by maternally derived antibodies.
Three doses of trivalent oral polio vaccine (OPV) are normally recommended for all infants and children by two years of age. Enhanced inactivated poliovirus vaccine (eIPV) is also available.
Hepatitis B vaccine is a routine vaccination for infants and children under 2 years of age. All infants and children should be vaccinated.
Haemophilus influenza type b (Hib) vaccine: By age 2 years, four doses of vaccine are normally recommended for infants and children.
Immune globulin for protection against Hepatitis A is recommended for infants and children under 2 years of age travelling to areas of the world with intermediate or high rates of Hepatitis A. The new hepatitis A vaccines are not licensed for use with children less than 2 years of age.
For typhoid fever, breast-feeding is likely to protect infants. Careful preparation of formula and food from boiled or chlorinated water can help protect non-breastfed infants and children up to two years of age. The old typhoid fever vaccine is licensed for use in children as young as 6 months of age. The new ViCPS typhoid vaccine is recommended for children between 2 and 6 years