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Eco Travel Guide to South Africa and Southern Africa
  
Health Guide for Eco Travel in South Africa
Information on immunisations & vaccines recomended for Eco Travel in South Africa and Africa.

Although Travel to South Africa is in most cases very first world, any adventure to more rural or tribal areas does come with a measure of a health risk. Some of the commonly recomended vaccines are "standard issue" whether you like it or not in most developed countries! Cholera (occurs in South Africa) and Yellow Fever (does not occur in South Africa) are not standard immunisations for South African citizens. Hepatitis A & B and TB infections are rather common within the poorer local communities of South Africa and infrequent outbursts of rabies (within animals) also occur. Travellers to infected areas should consider immunisation. Many of the immunisations below are thus recommended for hardcore Eco Travellers venturing deeper into rural areas or Africa!

Commonly recomended Immunisations:
The following immunisations are commonly recomended to travellers depending on where they are travelling to.
Cholera
Hepatitis A (immunoglobulin)
Polio
Tetanus
Typhoid
Yellow Fever (for travel further into Africa)

Immunisations for special situations:
The following vaccines may be appropriate for certain travellers, depending upon the nature of the journey planned, and the activities contemplated.
Hepatitis A (vaccine)
Hepatitis B
Rabies
TB

Commonly recomended Immunisations

Cholera: Cholera is an uncommon disease in travellers and the old injectable available vaccine is of poor efficacy. Immunisation with the old injected vaccine against cholera is not considered appropriate for most travellers, although, where it is known that border officials may demand a cholera certificate, it is wiser to be in possession of such a certificate prior to departure. The newer oral cholera vaccine does provide significant protection against cholera, and is well tolerated. It may be wise for travellers with the potential to be exposed to uncertain water and food hygiene to consider immunisation with the oral vaccine. Immunisation does not absolve the traveller from following the recommended food and water hygiene practices.

Hepatitis A: Short term protection agains this water-borne viral disease is offered by a single injection of immunoglobulin. A vaccine is now available which provides protection for ten years and is suitable for the frequent traveller.

Polio: This vaccine is given orally, usually on a lump of sugar, and is a simple and safe protection against poliomyelitis which is still prevalent in some tropical and developing countries.

Tetanus: All travellers should be in date for tetanus immunisation as the disease is spread thoughout the world and is potentially a hazard to life. A booster dose is given as a single injection.

Typhoid: Typhoid is a disease contracted from contaminated food and water which leads to high fever and septicaemia. There are now three vaccines available for protection against typhoid, these are; the older monovalent vaccine (which is presently unavailable), a new injected single-dose vaccine, and a live oral vaccine. Immunisation is usually advised for those going to areas where the standards of food and water hygiene are lower than South Africa.

Yellow Fever: Yellow fever kills up to sixty per cent of those it attacks. It is a viral illness for which there is no cure, but there is an effective vaccine which will prevent it. The yellow fever virus continuously lurks in the background in the forests and jungles of Africa, Central and South America. Wild monkey populations act as a natural reservoir of virus in these tropical regions. The intermediary between man and monkey is a mosquito. Mosquitoes acquire the virus through feeding on the blood of infected monkeys. Should such an infected mosquito's next feed come from biting a human, that unfortunate person will most likely become a yellow fever victim. The illness develops within six days of being bitten by an infected mosquito, and the onset is usually sudden. A fever develops, with headache, body pains, and often nausea. The fever may then remit briefly, only to return as the sufferer's condition deteriorates. As the liver begins to reel under the virus' onslaught, a form of jaundice develops, with the victim turning yellow. Internal bleeding, followed by coma and death may then be expected. It is from the jaundice, or yellowing of the skin, that the disease has earnt its name. Fortunately there is a safe and very effective vaccine against yellow fever. The vaccine, if properly administered, provides solid immunity against the disease for ten years. Travellers immunized against yellow fever are issued with an internationally recognized vaccination certificate, for inspection by immigration officials. The international health regulations concerning yellow fever control are unequivocal, and unvaccinated travellers may face denial of entry, or even quarantine. This strict control is maintained because yellow fever vaccination serves two purposes, protecting both the individual traveller and the broader community. Travellers to yellow fever areas should be vaccinated for their own personal protection. Travellers from yellow fever areas should have been vaccinated to prevent the spread of the infection into the community at large. Many countries currently free of yellow fever have mosquitoes potentially capable of transmitting the disease. Health authorities are concerned to avoid the inadvertent introduction of the yellow fever virus to these mosquitoes, as this might cause a repeat of the epidemics of seen in previous years. South Africa is home to such mosquito species, but remains free of yellow fever.

Immunisations for special situations

Hepatitis: Hepatitis is an infection of the liver. Such infections are generally serious because of the central role the liver plays in the detoxification of the body's waste products. Most of the commonly seen forms of hepatitis are caused by the very smallest micro-organisms, known as viruses. Viruses do not respond to antibiotics, and there is generally no effective treatment for most viral infections. Prevention is therefore of paramount importance. Most forms of hepatitis start with influenza like symptoms: lethargy, body pains, headache and fever. Loss of appetite, nausea and diarrhoea can lead to significant weight loss. The cardinal symptom is jaundice, where the skin turns yellow. This occurs because the liver becomes unable to eliminate the toxins released by red blood cells reaching the end of their normal 120 day lifespan. Although there are many different types of hepatitis, the two commonest forms are hepatitis A, and hepatitis B. Both are relatively common in less developed parts of the world.

Hepatitis A: is acquired from contaminated food. It is released in the stools of those infected, who subsequently contaminate food with faeces on their hands or under their fingernails. Inadequate hygiene compliance by food handlers is a major source of infection, especially in countries with sub-optimal public health enforcement. People with the virus may not always appear ill, especially during the early stages. The incubation period is 2 to 6 weeks, and recovery can be protracted in adults, taking many months. Although the disease is not usually fatal, it can cause a prolonged, debilitating and very unpleasant illness. Persons of higher socio-economic status are often more susceptible, as they will not have been exposed to the virus in childhood and acquired any natural immunity. A safe and effective vaccine giving at least ten years protection is available against hepatitis A. Additionally, an injection offering short term protection for a number of months is also available.

Hepatitis B: is a potentially fatal disease. It is acquired by contact with contaminated body fluids, especially blood. Contaminated or unsterile medical equipment is a common source of infection amongst travellers, usually in lesser developed countries where disposable medical equipment may be reused. It may also be sexually transmitted, and this represents another area of risk to travellers. In general, hepatitis B is acquired in much the same way as the human immunodeficiency virus. The incubation period is 2 to 6 months. The disease causes severe symptoms, similar to, but often worse than hepatitis A. Liver destruction and death can occur. Of those who seem to recover, about 15% will become persistent carriers of the virus. Carriers suffer ongoing liver damage, leading to liver cirrhosis (hardening) or, in a percentage of cases, cancer. An effective vaccine is available against hepatitis B.

Rabies: Pre-immunisation against rabies should be considered by travellers going to areas where rabies is endemic, who are staying for considerable periods of time or are at particular risk. The immunisation can be life saving, but any traveller who is bitten or licked by a potentially rabid animal must seek medical advice, as the vaccine will then definitely require boosting.

TB: Unimmunised adults and children going to endemic areas for prolonged periods of time should consider immunisation.

   
 

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