Medical Information

Visiting Africa can be a very daunting thought, but not if you're prepared for your visit. African Chapter has put together a document that should provide efficient information for your special trip to our beautiful continent.

Diseases Commonly Found In Africa

MalariaCholeraYellow FeverHepatitisPolioTyphoidTuberculosisTetanusRabies

Malaria

A potentially fatal illness of tropical and subtropical regions, this disease is caused by a parasite which is transmitted to human beings through bites of the infected Anopheles arabiensis mosquito. These mosquitoes are widespread through Africa, causing more than 1 million deaths per year on the African continent. Fortunately, the number of mosquito species that transmit malaria is small.

Malaria Distribution

The disease is encountered mainly in Northern and Eastern Mpumulanga, northern Kwa-Zulu Natal and the border areas of the Northern and West provinces. Malaria is also considered a threat to travelers visiting lower lying areas of Swaziland. Mozambique, Zimbabwe and much of Botswana are also malarious along with Northern Namibia and Malawi. Malaria transmission in South Africa is at its peak during the wetter months of November to April, while the threat of acquiring malaria is reduced during the months of May to October.

Malaria Prevention

• Use insect repellent containing di-ethyl toluamide or DEET
• conceal as much of the body as practical during daylight hours
• avoid being outdoors at night
• sleep under mosquito nets
• burn an insecticide / citronella laden coil before bed time.

Products

• Citronella: Coils, Wipes and Spray
• Tabard Spray or Roll-on
• Peaceful Sleep Spray or Roll-on

Tablets

A wide range of Prophylaxis is available for all regions and different circumstances. Deciding on the right one for you depends largely on the area you will be visiting, the activities you prefer to partake in and your own personal history. SAA Netcare Travel clinics recommend the following;

• Mefloquine:1 tablet per week, taken at least 1 week prior to arrival. Continue for 4 weeks after departing the malarious area. Principal contra-indications are a history of psychiatric problems as well as epilepsy.
• Doxycycline: Taken a day or two before arrival and 4 weeks after departure from the malarious area. It is best to avoid this drug during pregnancy and administration to children.
• Atovaquone - proguanil: Taken daily, the drug should be started a day or two before arrival and taken for another 7 days after leaving the malarious area.

All of the above medicinal precautions are available with a prescription. No method of malaria prevention is one hundred percent effective and there is still a small chance that you might contract the disease even with the use of the above products. We encourage travelers to malarious areas to consult their general practitioners for specific requirements.

Malaria Symptoms

Symptoms may develop in the period of 7 days or as long as 6 months after leaving the malaria area. These symptoms are mild in the initial stages, often misdiagnosed as influenza. The symptoms listed below can be experienced very mildly and does not necessarily have to be dramatically life threatening in the initial stages. However, serious deterioration could occur quite suddenly with a rapid increase of parasites in the victims' blood stream.

We encourage you to visit a physician if you experience any of the symptoms listed below:

• Body ache
• Tiredness
• Headache
• Sore throat
• Diarrhoea
• High Fever
• Shivering
• Dramatic Perspiration
• Delirious actions resulting in falling into a coma

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Cholera

The risk of contracting Cholera is negligible, and the average tourist will not be exposed to the bacterium at all. Make sure to observe good food and water hygiene while traveling in the affected areas.

Cholera is a disease of the under-privileged who have been denied clean water and proper sewerage. It typically affects communities residing in squatter camps or rural areas. Cholera is not transmitted from person to person. The infection only occurs with the ingestion of contaminated food and water.

Rivers, lakes and dams in affected areas should be regarded as potentially contaminated by bacteria. However, they pose no threat to visitors unless direct contact is made with the water. Therefore it is advisable to swim only in chlorinated swimming pool water or clear seawater. Oysters and Shellfish harvested along the Kwa-Zulu Natal coast should also not be consumed unless cooked.

Travelers likely to be exposed to cholera infected areas should consider immunization against the disease. This immunization can be taken orally by high risk travelers. It also helps prevent other travel diarrhoea related infections.

Certain developing countries may require the traveler to be in possession of a cholera vaccination certificate in order to pass through immigration formalities without hindrance.

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Yellow Fever

This is another mosquito borne illness, transferred by the bite of an infected mosquito. It can create an immense health deterioration and may result in a serious case of jaundice or even death.

Yellow fever may kill up to 60% of those it attacks. It is found in the forests and jungles of Africa, Central and South America. Wild monkey populations act as a natural reservoir of the virus in tropical regions, while the mosquito acts as the intermediary vector in the transmittance of the disease.

The illness develops within 6 days of being bitten and occurs suddenly with the following symptoms:

• Fever, may remit briefly and return as the sufferer's condition deteriorates
• Headache
• Body Pains
• Nausea
• Jaundice, the victim turns yellow as the illness attacks the liver.
• Internal Bleeding followed by a coma and death may be expected.

International health regulations concerning Yellow Fever control are unequivocal and unvaccinated travelers may face denial of entry, or even quarantine in certain circumstances. This serves to avoid the introduction of the yellow fever virus and repeat future epidemics.

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Hepatitis

A disease that involves an infection of the liver. These infections are generally serious as it plays an important role in the proper functioning of the liver and in turn the detoxifying of the body's waste products.

Prevention is enormously important, as Hepatitis is a viral infection that does not respond to antibiotics.

Most forms of hepatitis start with influenza-like symptoms:

• Lethargy
• Body pains
• Headaches
• Fever
• Loss of appetite
• Nausea
• Diarrhoea
• Jaundice, where the skin turns yellow

The skin turns yellow due to the liver's inability to eliminate the toxins released by the red blood cells. Many types of Jaundice are present today, although two; Hepatitis A and Hepatitis B are the most common - especially in less developed parts of the world.

Hepatitis A

- is acquired by contaminated food and drink. The virus is released in the stools of those infected. They subsequently contaminate food with remnants on their hands or under their fingernails. Inadequate hygiene compliance by food handlers is a major source of infection.

People with the virus may not always appear ill during the initial stages, although after an incubation period of 2 to 6 weeks the recovery could take months. The disease is not usually fatal, but it can be prolonged, debilitating and unpleasant.

There is an effective vaccine available against Hepatitis A.

Hepatitis B

- is acquired by contact of contaminated body fluids, especially blood. This could be a potentially fatal disease. The transmittance is usually due to un-sterile medical equipment. It is a common source of infection among travelers, usually occurring in less developed areas.

Generally, Hepatitis B is contracted similarly to HIV. The incubation period is 2 to 6 months, and has the same symptoms but often worse than Hepatitis A. The liver destruction in Hepatitis B can often cause death. Of those that recover, 15% of them will become persistent carriers of the virus, thereby able to transmit the disease to another by blood contamination.

Carriers also suffer from ongoing liver damage, which may lead to cirrhosis or hardening of the liver and could result in cancer. There is an effective vaccine available against Hepatitis B.

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Polio

Poliomyelitis is a disease prevalent in some tropical and developing countries. It can be prevented through a simple vaccination, which is administered orally or intramuscularly.

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Typhoid

A disease contracted from contaminated food and water eventually leading to high fevers and septicaemia.Two vaccines are currently available:

1. a single-dose injected vaccine
2. a live oral vaccine

These immunizations are advised for travelers visiting areas where the food and water standards are at an undesirable standard and hygiene quality.

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Tuberculosis

Un-immunized adults and children visiting endemic areas for prolonged periods of time should consider immunization.

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Tetanus

All travelers should be up to date with their tetanus immunizations, as the disease is spread throughout the world and could be potentially hazardous to life. The booster injection is given singularly, and could last up to 5 years.

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Rabies

Pre-immunization against Rabies should be considered by travelers visiting areas where Rabies is endemic. The immunization can be life saving, but a traveler that is bitten or licked by a potentially rabid animal should seek urgent medical attention as the vaccine will then definitely require a booster treatment.

Please don't hesitate to contact us directly if you want more information.

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