Persons severely allergic to eggs should not be given the vaccine. Generally, persons able to eat eggs or egg products can safely receive the vaccine.
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.
Ebola & Covid-19
Ebola is a highly infectious viral disease with a high fatality rate and very contagious. The virus spreads through contact with the bodily fluids of someone who is infected. The good news is that the latest Ebola outbreak in the Democratic Republic of Congo (DRC) was declared over on 25 June 2020 thanks to diligent work by local heath authorities, the World Health Organisation and a highly effective vaccine. It is important to understand that the disease remains largely confined to the DRC and a few West African countries, and that no cases have occurred in any of the major safari-going countries of East and Southern Africa.
The latest worldwide outbreak of Covid-19 continues to unfold with dire consequences for communities everywhere, including Africa. Until a vaccine is found, I can only suggest that you avail yourself of the latest recommendations in terms of when and where you can travel.
HIV/AIDS (and Hep B.)
The HIV virus and AIDS (and Hepatitis B to a lesser extent) are serious health issues in many African countries. However, the risk to travellers is negligible assuming proper precautions are taken. HIV (and Hep B.) are largely transmitted through exposure to bodily fluids containing the virus. Use the same precautions while in Africa as at home.
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.
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.
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.
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).
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, measles) 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.