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Keeping fit on the road is important if you want to get the most out of Africa. Our correspondent Andy has the run-down on looking after your health before you go and while you’re in Africa.
AFRICA is an amazing continent from which travellers will return with the memories of a lifetime. But the multitude of African bacterias and viruses play larger roles in African life than lions and gorillas. Hence, pre-departure preventative measures must be taken.
Although African pestilents can be life-threatening, the good news is that many are easily prevented by a painless(?) injection or two, or by a course of pills — better to walk around as a rattling pin cushion than to go down with malaria or typhoid.
But, it is not enough to be aware of necessary immunisations.
Travellers must plan a course of injections as many vaccines are “live” — that is, they cannot be given at the same time as others — while some require more than one shot to provide full immunisation. Travel health centres around London suggest a course of injections for overlanders should take four to six weeks.
The following is a list of recommended immunisations:
Diptheria — Bacterial throat infection transmitted from person to person. A highly effective vaccine which provides 10 years’ immunisation.
Hepatitis A — Virus transmitted from contaminated food or water, affecting the liver. The most effective vaccine is Havrix. Two shots provide 12 months’ protection (a third shot within 12 months gives 10 years' protection).
Hepatitis B — Potentially fatal virus affecting the liver. Transmitted through sexual intercourse, unsterilised needles or blood transfusions. Public shaving, tattoos or ear piercing are other risky situations. An effective vaccine is readily available, but requires two injections at least a month apart with a third after a further five months.
Meningitis — Person-to-person virus that attacks membranes covering the brain and spinal cord. A very effective vaccine is available, but, as the virus is seasonal and outbreaks tend to be localised, immunisation isn’t needed by all travellers.
Polio — Found worldwide and transmitted from contaminated food or water, or from person-to-person. An oral vaccine, taken in three doses, is very effective and lasts for 10 years.
Rabies — Usually fatal virus transmitted through bites from infected animals. A pre-exposure vaccine makes post-exposure treatment easier. However, post-bite treatment must still be sought.
Tetanus — Fatal bacterium found worldwide and transmitted when dirt or soil enters cuts. Wounds should still be washed thoroughly even after vaccination. The vaccination is valid for 10 years.
Typhoid — Bacteria transmitted from contaminated food and water. Two vaccinations a month apart provide three years’ immunisation.
Yellow fever — A virus endemic in many sub-Saharan African countries. Transmitted by mosquitoes, but immunisation provides effective protection for 10 years. Evidence of the vaccination is an entry-requirement for many African nations.
But it is malaria, a serious parasitic infection transmitted through mosquito bites, that is the big killer.
Anti-malarial tablets do not stop you catching the disease, but they substantially reduce your exposure to it. The only effective way to prevent catching malaria is to avoid being bitten by mosquitos. Myths surround anti-malarials and their purported side-effects, so seek professional advice about the different tablets available.
Travellers’ health centres will give you advice and treatment, but several vaccines are still available free on the National Health Service from your local GP. Shop around for your injections, prices vary from centre to centre.
Vaccines are not available for some diseases, including schistosomiasis and dengue fever. The former is an infection that develops after flatworm larvae have penetrated the skin and the risk rises with increasing contact with contaminated fresh water for bathing or swimming. It is dificult to determine whether water is contaminated water so swimming in rural-area fresh water should be avoided. Water for washing can be treated with chlorine or iodine. Dengue fever is an urban flu-like virus transmitted by mosquito bites. Bite prevention is the only prevention since no treatment exists.
As most diseases are transmitted via insect bites, contaminated food and water, or through blood and bodily fluids, common sense dictates you continue to take precautions once you’re overseas.
Avoiding insect bites altogether is the best so cover-up with long trousers and long-sleeved shirts at night. Liberal use of DEET-based insect repellents will also keep the little buggers at bay, while a treated mosquito net prevents sleeping beauties from becoming, potentially, the sleeping dead.
Always eat well and observe basic food and water hygiene. Eat thoroughly-cooked food that is still hot, or fresh food that can be peeled, while water should only be drunk from a bottle or after treatment if its purity is in doubt.
Observe the law of strict personal hygiene. Africa is a dirty, dusty place and many travellers inadvertently infect themselves eating fingerfood with unwashed mitts. Not only that, but keeping scrupulously clean will prevent infections such as tetanus. Finally, the likes of HIV and Hepatitis A are easily avoided by practising safe sex. That said, use of condoms merely reduces the risk of infection — it does not eliminate the risk.
When travelling in high-risk HIV areas, travellers should carry their own sterile needles and be aware that, in many African nations, blood isn’t always screened before transfusion. However, we’re now entering the realm of travel insurance and that is a separate topic.
Country H Mn Y Ty M P T
Albania R R R R
Algeria R R * R R
Angola R R R R R R
Benin (C) R * R R R R R
Botswana R R * R R
Burkino Faso R * R R R R R
Burundi R R R R R R
Cameroon R * R R R R R
Cen Africa Rep (C) R R R R R R R
Chad R R R R R R R
Congo R R R R R
Côte d’ Ivoire (C) R R R R R R
Egypt R * R * R R
Eritrea R R R R R R
Ethipoia R R R R R R
Guatemala R R R R R
Gabon (C) R R R R R R R
Gambia (C) R * R R R R R
Ghana (C) R R R R R R R
Guinea R R R R R R R
Guinea Bisseau R R R R R R
Kenya R * R R R R R
Lesotho R R R
Liberia (C) R R R R R R
Libya R R * R R
Madagascar R R R R R
Malawi R R R R R
Mali R R R R R
Mauritania R R R * R R
Mauritius R R * R R
Morocco R R R R
Mozambique R R R R R
Niger (C) R R R R R R
Nigeria (C) R R R R R R
Rwanda (C) R R R R R R R
São Tomé R R R R R
Senegal (C) R R R R R R
Sierra Leone R R R R R R R
Somalia R R R R R R R
South Africa R R * R R
Sudan R R R R R R R
Swaziland R R R R R
Tanzania (C) R R R R R R R
Togo (C) R R R R R R R
Uganda (C) R R R R R R R
Zaire (C) R R R R R R R
Zambia (C) R R R R R R
Zimbabwe R R R R R
Key to chart H=Hepatitis A, Mn=Meningitis, Y=Yellow Fever,
Ty=Typhoid, M=Malaria, P=Polio, T=Tetanus. R=Recommended,
*=Seasonal or geographic risk (C) = Yellow fever certificate may be required. | 