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
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.
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.
- 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.
- Citronella: Coils, Wipes and Spray
- Tabard Spray or Roll-on
- Peaceful Sleep Spray or Roll-on
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.
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
- Sore throat
- High Fever
- Dramatic Perspiration
- Delirious actions resulting in falling into a coma
African Chapter Tours brings you an update brought by Tourism, Hospitality and Wildlife Risk Solutions , on the recent cholera outbreaks and the concerns there of. Herewith answers and further information provided to current questions and concerns.
How do people get it?
According to Dr. Simon King, Managing Director of TRM Contact Centre – a tourism specific emergency incident management centre, Cholera acts by releasing a toxin within the intestine. “It has to get into your gut via your mouth (not absorbed through skin by bathing or showering) and it has to survive the hostile acidic stomach on the way. If it makes it to the small bowel it is well adapted to survive there; each germ is capable of ‘swimming’ by wiggling its tail to counteract the intestine's propulsive movement, which would tend to push it down and out. It is resistant to bile salts and can adhere to the intestinal wall as well, says Dr. King. People get it by ingesting it either in water or contaminated food. The contamination comes from another individual who has cholera - faecal excretement contaminates hands or water supplies and passes the germs along. Washing food in contaminated water is a problem and swallowing water while bathing or showering or while brushing teeth can pass it along. Washing hands is very important in preventing it, as is very careful food handling, washing and preparation”.
Is your operation at risk?
There is a lot of concern being raised about South African sites being swept away in the Zimbabwean pandemic. “The important thing to understand is that nobody is at any more risk of contracting cholera than they are many other illnesses spread via the faecal-oral route. Even in the midst of a community suffering an epidemic you can avoid contracting it as an individual if you are very careful about what you touch and use and how you clean and wash your hands and disinfect and manage food and what you eat and drink. It is not like an airborne spread illness, which can strike no matter what you do to protect yourself.”
How do I know if someone has cholera?
“Perhaps this is one of the most important questions because there is a lot of minor viral based gastroenteritis going around right now which causes diarrhoea, vomiting and stomach cramps along with fever, aches and pains that may look like cholera. The bottom line in picking up potential cholera patients is symptom severity. MASSIVE diarrhoea is how it is typically described. Certainly patients look ill and dehydrate quickly and it is nothing more than the consequences of rapid and massive dehydration that kill patients. Dehydration leads to kidney failure because with too little fluid the blood flow through the kidneys is too low and they literally ‘shut down’. This worsens the electrolyte abnormalities caused by diarrhoea with its fluid and electrolyte loss. Both these result in acid-base problems where the body becomes more acidic and this state of acidosis is harmful to all organ systems - our pH body-wide has to remain within very tight limits or things just don't work and get damaged. Worsening this is that low potassium states (you lose a lot of potassium in diarrheal stool) are a big problem for the heart because the heart muscle relies on potassium flow across its cell membranes in order to pump properly. So low potassium states mean heart failure, rhythm disturbances and even cardiac arrest”.
How much time do I have to respond?
“With cholera patients can go from symptoms to dehydration to death in under 4 hours. That’s a bit extreme but not impossible. Certainly the patient gets very ill within a 12-24 hour period. The message is that if you are in a remote area and you suspect cholera, don't wait until the next day to make a decision on what to do. Phone for help immediately” advises Dr. King.
What can I do about it?
Cholera's mortality untreated is about 50-60% in places, says Dr. King. “Treated though, the mortality is easily dropped tenfold. The treatment is almost exclusively aimed at reversing the dehydration, providing the correct rehydration fluid and volumes, either intravenously or orally. At the TRM Contact Centre, clients contact us first if they suspect anyone of contracting cholera - we then risk stratify the patient for them right over the phone and walk them through correct management. If you do not have access to an emergency medical assistance centre or are stuck without communication for whatever reason remember that with cholera and extreme diarrhoea you can't give too much fluid, so give as much as someone can feasibly drink and keep down and remember not to give just water but salt and sugar or electrolyte solution powder mixed into the water in correct proportions”.
Source: SATIB Risk Solutions / Copyright: Dr. Simon King, Tourism Risk Managers Contact Centre – January 2009.
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
- Body Pains
- 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.
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:
- Body pains
- Loss of appetite
- 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.
- 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.
- 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.
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.
A disease contracted from contaminated food and water eventually leading to high fevers and septicaemia.Two vaccines are currently available:
- a single-dose injected vaccine
- 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.
Un-immunized adults and children visiting endemic areas for prolonged periods of time should consider immunization.
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.
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.