Africa Medical and Health

This section is meant as a guideline only. It is very important to get the latest up-to-date information and advise for the countries you plan to visit from your physician or from a specialist in tropical illnesses and diseases.

As well as the information below the CDC Travel Information and the SAA Netcare Travel Clinics websites are very good sources for up to date information on Health Advice for travellers in Africa

There are numerous illness and diseases throughout Africa and many of them have similar symptoms. With most of the more serious diseases, vaccinations have been developed as a form of protection. Some vaccinations can have different side effects on different people, but if you are travelling to Africa you should always obtain specialist advice from your physician or travel clinic. Many countries have clinics that specialise in tropical diseases. The risk of contracting a number of the diseases can be greatly reduced if you are careful about where and what you eat and drink and who you come into direct contact with.

It is also worth bearing in mind that however careful you are, or whatever precautions you take, you will still be susceptible to some form of stomach upset which can be caused simply by the change in diet or climate, but these will usually clear in a few days.

On a personal note having lived in Africa for fifteen years I think you have to be careful whenever you can and take the prevention and protective medicines and vaccinations available and suitable for you as an individual. But I also think you should not be overly paranoid, as this will spoil your holiday. I think it would be shame if the risk of disease should put anyone off wanting to experience this great continent.

Below is a basic rundown on some of the more common diseases in Africa, but there are more...

Aids
HIV and other venereal diseases are widespread throughout Africa and it goes without saying that very strict precautions should always be taken. If there is a possibility the you will have sexual contact with an unknown individual you should take with you your own supplies of condoms.
Hospital workers deal with AIDS victims on a regular basis and, contrary to popular belief, they do realise the danger involved in using unsterilised needles and in a town hospital or clinic you are unlikely to be at risk. But it worth bearing in mind that in remote areas, needle supplies could be low and therefore it is advisable to carry a few with you.

Bilharzia (Schistosomiasis)
Many inland waters in Africa, especially the central region are infected with Bilharzia, which is caused by parasites that live and breed in specific freshwater snails. When these larvae are released into the water they are capable of penetrating unbroken skin of their human host. The disease is carried by humans and spread by people urinating in the water.
Bilharzia is now curable but it is obviously best to take precautions. Steering clear of still water pools, dams and some lower lying rivers, using an insect repellent like DEET before swimming or paddling and after swimming drying off thoroughly with a towel will give you some protection.

Cholera
A public health concern in most African countries and is a bacterial disease transmitted mainly through contamination of food and water. Person to person transmission is rare.
If you are in an area with poor sanitation and hygiene, you should only drink canned or bottled carbonated drinks, with no ice, and beverages made with boiling water. It is recommended that you avoid eating raw and inadequately cooked fish or seafood and uncooked vegetables and salads..
Severe cases of cholera start with the onset of frequent watery stools and vomiting may also occur. The disease will quickly dehydrate you and it is therefore essential to ensure rapid replacement of lost body fluids and salts using an oral rehydration solution. If a severe case is left untreated, the patient becomes dehydrated with abnormally low blood pressure, suffering from muscle cramps, subnormal temperature, decreased urine output and shock eventually leading to coma.

Diarrhoea and sickness
Even if you follow all the rules in the book, travellers diarrhea is unavoidable in most cases and nearly all travellers to Africa will experience some form of diarrhoea & sickness . Diarrhea can also occur along with abdominal cramps, nausea , vomiting and fever
Usually you will only be laid up for a couple of days at the most and the best advise is to rest, avoid heavy greasy foods and drink lots of non-alcoholic fluids. Popular belief of a quick remedy is a liquid diet for 24 hours. If you do not recover within 7 days and are feeling weak you should seek medical attention, some cases, such as Giardia and Amoeba can only be cured by taking a prescribed course of antibiotics.

Amoebic Dysentery
This can best be described as a form of travellers diarrhea and it is difficult to distinguish between the two. In most cases of dysentery white cells, mucus and occasional blood appear in the stool and a medical examination is necessary .

Hepatitis A
This is a viral infection of the liver transmitted through poor personal hygiene, poor sanitation and intimate contact. Many people get the disease by drinking contaminated water or eating contaminated food stuffs but it is possible to catch the disease from your own hands to mouth contact, by touching a contaminated object or from the hands of an infected individual with poor sanitation habits. Again, by avoiding raw vegetables and salad, uncooked or undercooked fish, and boiling or sterilising all drinking water will reduce the chances of contracting the disease.
The risk of infection is greater for older people and the symptoms include fever, lack of appetite, nausea, abdominal pains, dark urine and jaundice. Hepatitis A is very rarely fatal, even so you should consider being vaccinated before travelling to a high risk area, the vaccination has proved to be highly effective.

Hepatitis B
Risk of Hepatitis B virus infection occurs through Africa, but it is only normally transmitted through blood, body fluid or sexual contact. As a general rule the vaccination will protect you but it is only necessary if you are likely to have medical treatment, including dental treatment using local facilities, or intend having sexual contact with residents. It is also recommended that healthcare workers are vaccinated.
The symptoms usually are loss of appetite, extreme tiredness, nausea, vomiting and stomach pain. The disease is an infection of the liver and can last from a few weeks to several months. In some instances the disease is not curable and some people remain infected for the rest of their lives.

Lassa Fever
Found particularly in West Africa. Epidemics have broken out in Nigeria, Zaire and Sierra Leone. This disease is highly contagious and can cause severe or fatal illness. The infection will start with increasingly high fever, vomiting, cough and general weakness which lasts for several days. Its' incubation period is 7 to 21 days. The exact cause and transmission of Lassa Fever is unknown and patients are isolated.

Malaria

 

Map showing Malaria Risk Regions

Meningococcal Meningitis
Epidemics occur frequently in the sub-Saharan belt across the middle of Africa particularly during the dry season from December to June. Burundi, Kenya, and Tanzania are also risk areas. You are particularly at risk if your spleen has been removed or you have a certain deficiency in your bloods immune system.
Meningitis is caused when bacteria invades the membranes lining the brain and spinal cord. Symptoms include painful movement of the head, severe headaches, nausea, vomiting, dilated pupils . The disease progresses rapidly so if suspected treatment should be found immediately.
It is advisable to have the vaccination if you plan to travel in Africa.

Polio
Many people in Africa suffer from polio which is transmitted through close contact with infected persons or by contaminated food and water. The best protection is the vaccination (polio drops) and precautions in where and what you eat and drink.
Once polio has been contracted there is no special treatments for a cure and victims are unlikely to completely recover, some people will have weakness in an arm or leg for the remainder of their lives and in more serious cases a polio can leave a person paralyzed and it can also be fatal.

Rabies
A viral infection of the central nervous system and can be carried by almost any mammal. Once the symptoms show, rabies is incurable. If you are working with animals or are likely to come in regular contact with them it is highly recommended that you get the pre-exposure immunisation.
The obvious precaution is to avoid all close contact with all animals, even domestic pets, but if you do get bitten by any animal, scrub the wound with soap under running water for five minutes, then apply povidone iodine or 40% alcohol and seek immediate medical treatment for possible rabies and tetanus. Even if you have had the pre-exposure vaccine you will still need the post-exposure vaccine

Rift Valley Fever
Transmitted to humans from sheep, cattle, monkeys and rodents, via mosquito bites. The illness is usually brief and not life threatening, with symptoms of headache, weakness, fever and occasionally nausea and vomiting.

Sleeping sickness (African Trypanosomiasis)
There are two form of this disease in Africa - "The Rhodesian" or acute which is founds in the eastern third of Central Africa and "the Gambian" or chronic, which occurs in the western half of Central Africa.. The disease is transmitted through the bite of a tsetse fly , the Rhodesian form being common in low lying game reserves, and sparsely populated areas, and the Gambian organism found in humid areas and along forested river banks. The Tsetse fly looks like an oversized house-fly, they bite during daytime and are attracted to blue.
Symptoms include inflammation of the skin at the site of the bite, development of fever, skin rashes, painful skin surface, enlarge lymph noes and anemia. Later stage cause a person to become depressed, have a lack of appetite, disturbance of speech and the feeling of being extremely tired. Symptoms for the Rhodesian form take about 2 weeks to appears whereas the Gambian form can take from 6 months to several years to develop.
If left untreated the disease can cause irreversible brain damage and in some cases death.

Tuberculosis (TB)
TB is a contagious illness that is spread when infected people cough or sneeze and spread tiny droplets into the air which are then inhaled by uninfected people. People with low immune systems and poor hygiene and sanitation facilities are the most likely to be effected. The symptoms are tiredness, fever, weight loss, cough, chest pains, shortness of breath, night sweats and blood in saliva.
TB is treated with several drugs that need to be taken continuously for months.

Typhoid
A bacterial infection spread by contaminated food and water. It is transmitted by humans who are infected usually by person-to-person contact, particularly by food handlers.
Symptoms include tiredness, dull headaches, fever, stomach pain particularly in the lower right side and sometime constipation. After a few days dark red spots appears on the lower chest and outer portion of the upper abdomen.
The disease can progress to a serious condition where the victim experiences dis-orientation, delirium, diarrhea and coma, coupled with intestinal bleeding. Generally recovery can be expected after a period of 4 weeks.
All travellers to Africa should consider having the vaccination.

West Nile Fever
Transmitted to humans via mosquitoes bites. The disease is similar to Rift Valley fever with the same symptoms but you may have skin rashes. The illness is brief and you should make a full recovery

Yellow Fever
Transmitted to humans by mosquitoes and if you are travelling to Africa it is advisable to have the vaccination. The symptoms, which appears with 5 days of exposure include fever, nausea, flushed face, stomach pains and constipation, headaches, muscle pains particularly in the neck, back and legs, irritability and restlessness. In some cases the disease recurs and the patient develops jaundice (yellowed skin and eyes).
You can lower the chances of contracting the disease by covering up, using mosquito repellent and sleeping under nets. Mosquitoes are most prevalent at dawn and dusk.
If you have been to a country which is infected with Yellow Fever most other countries in the world will require you to show an International Certificate of Vaccination as proof that you have had the vaccination.

You should start planning your vaccinations & immunisation well in advance of starting your trip. There are two vaccinations that are compulsory in some African countries and for which you will need to have an International Certificate to gain entry, These are Cholera and Yellow Fever. You should also consider having certain vaccinations as a matter of course and also being vaccinated against specific diseases.

If you are not keen on being vaccinated, many countries nowadays recognised Homeopathic Medicines as an alternative protection for some of the diseases, including Malaria. Every country in the world has different recommendations on this subject and it is best to check with your physician.

Cholera
The World Health Organisation (WHO) has discourage countries from upholding policies requiring cholera vaccination for entry, although many local officials in African countries may still require travellers to show proof of vaccination at your port of entry. You should check with your local physician or travel clinic.
The current vaccine only provides protection for six months and is only about 50% effective.

Yellow fever
Many countries in Africa will require you to show proof of vaccination particularly if you are arriving from an area that is currently infected or arriving from an infected country. Even if it is not required it is recommended for travellers in countries where yellow fever is a risk. (contact your physician or travel clinic for latest advice)
The current Yellow Fever vaccine lasts for 10 years.

Hepatitis A
Africa is a high risk area for Hepatitis A therefore it is recommended all travellers to any country in Africa are vaccinated.
There are two forms of protection:

1. Gammaglobulin which provide short term protection against hepatitis A.
2. Hepatitis A Vaccine: A relatively new vaccine which gives long term protection ideal for regular and long term travellers.

Tetanus
all travellers should considers immunisation. Protection lasts for up to 10 years

Typhoid
Prevalent throughout Africa and all travellers should consider the vaccine.
Two different immunisations are available:

1. Injectable Vi (single dose) which lasts up to 3 years and new to the market.
2. Oral typhoid capsules which require boosting yearly.

Meningococcal Meningitis
This disease occurs in many African countries and usually strikes in epidemics, it is therefore recommended that you are vaccinated. The vaccine offer protection for up to 3 years depending on exposure to risk.

Polio
It is recommended that you take a vaccine against polio, of which there are two types. Oral Polio Vaccine, also called OPV given as drops in the mouth and usually used for children up to the age of 18 years. The other vaccine is Inactivated Polio Vaccine (IPV) and is usually recommended for people over the age of 18 and for those who have no previously been vaccinated and well and those people who cannot, for health reasons, take the Oral form.

Diphtheria
It is recommended that all travellers should consider immunisation. Protection last for up to 10 years

T.B.
Tuberculosis is a major risk in sub-Saharan Africa . A skin test (Heaf) is available to establish TB exposure. Those who are proved to be at risk should have the test performed again on they're return home. There is a vaccine available used usually to protect young children but it is rarely recommended and it can severe side effects (please obtain advice from your physician or travel clinic.

Rabies
Rabies is prevalent throughout Africa but unless you are working in close contact with animals the risk on contracting the disease is fairly low. Pre-exposure vaccinations do not eliminate the need for post-exposure vaccinations. Please obtain advice from your physician or travel clinic.

Hepatitis B
Transmission of Hepatitis B is only through sex or contact with contaminated blood, needles and syringes. It is therefore only recommended is you plans to receive medical care abroad or anticipate having sexual contact with local inhabitants.