and all the mosquitoes that were lurking inside will be dead.
Pregnant women (and children) are especially vulnerable to malarial infection. In fact, pregnant women are twice as attractive to malaria-carrying mosquitoes as non-pregnant women. This is mostly due to a warmer skin surface and the fact that pregnant women exhale a greater volume of air. Be more cautious.
Bilharzia (schistosomiasis)
Bilharzia is common in the tropics where lakes, streams and dams (still water) harbour bilharzia-transmitting snails. Parasite larvae develop in snails from which they infect humans, their definitive host, in which they mature and reproduce. There is no prophylactic available against bilharzia but treatment is now readily available in pill or injection form (a drug called praziquantel). The condition can be unpleasant so it is better not to swim in rivers, streams or dams, particularly where the water is stagnant or used by local villagers as a laundry or bathing area.
African sleeping sickness (Nagana)
Sleeping sickness or African trypanosomiasis is a parasitic disease which affects people and domestic animals. The disease is transmitted by the tsetse fly which is endemic to many parts of Africa. Although a serious threat to local populations, the incidence amongst visitors is extremely low. Symptoms include severe headaches, irritability, extreme fatigue and malaise.
Tsetse flies are relatively resistant to standard insect repellents and can bite through light clothing. They are attracted to bright and also very dark colours and to clouds of dust such as that kicked up by a herd of buffalo – and moving vehicles! Their bite can cause severe discomfort (itching and swelling) and they are extremely difficult to kill (you can squash them between two fingers and they just get up and fly away!). My advice is, when travelling through a tsetse area (generally a woodland), to remain vigilant and use your hat to brush them out of the vehicle (and keep an eye out on the necks and exposed skin of others in your vehicle). In my experience, the more you try to kill them, the more replacements fill the void – spend the energy keeping them away from you and only kill those trapped inside (if you are in an enclosed safari vehicle).
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 and Rwanda (and is still listed by the WHO as occurring in Kenya).
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:
The 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, Angola, Uganda, Kenya, Rwanda, Burundi, Ethiopia, Somali, Sudan and Equatorial Guinea.
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 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
