Health information

Health information for travellers to Southern African region.
See also US Department of State tips for Travellers to Sub-Saharan Africa and A safe trip abroad.

Food and waterborne diseases are the number one cause of illness in travellers. Travellers' diarrhoea can be caused by viruses, bacteria, or parasites, which are found throughout Southern Africa and can contaminate food or water. Infections may cause diarrhoea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking water are safe.

Malaria is a preventable infection that can be fatal if left untreated. Prevent infection by taking prescription antimalaria drugs and protecting yourself against mosquito bites (see below). Most travellers to Southern Africa should take mefloquine to prevent malaria. Risk for malaria exists all year in the northern part of Botswana, rural areas of South Africa, all nonmountainous areas of Swaziland, and all areas of Zimbabwe except the cities of Harare and Bulawayo. There is no reported risk for travellers visiting Lesotho and St. Helena.

A certificate of yellow fever vaccination may be required for entry into certain of these countries if you are coming from a country in tropical South America or sub-Saharan Africa. (There is no risk for yellow fever in Southern Africa.)

Dengue, filariasis, leishmaniasis, onchocerciasis, and trypanosomiasis (sleeping sickness) are other diseases carried by insects that also occur in this region. Protecting yourself against insect bites  will help to prevent these diseases.

Schistosomiasis, a parasitic infection, is found in fresh water in this region. Do not swim in fresh water (except in well-chlorinated swimming pools) in Southern African countries. Because motor vehicle crashes are a leading cause of injury among travellers, walk and drive defensively. Avoid night-time travel if possible and always use seat belts.

CDC Recommends the Following Vaccines (as Appropriate for Age):

See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect.

• Hepatitis A or immune globulin (IG).
• Hepatitis B if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay longer than 6 months, or be exposed through medical treatment.
• Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
• Typhoid, particularly if you are visiting developing countries in this region.
• As needed, booster doses for tetanus-diphtheria, measles, and a one-time dose of polio vaccine for adults. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not complete the series as infants.

To Stay Healthy, Do:

• Wash hands often with soap and water.
• Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an "absolute 1-micron or less" filter AND adding iodine tablets to the filtered water. "Absolute 1-micron filters" are found in camping/outdoor supply stores.
• Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
• If you visit an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
• Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4-hour intervals) and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and long pants from dusk through dawn.
• To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
• Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.

To Avoid Getting Sick:

• Don’t eat food purchased from street vendors.
• Don’t drink beverages with ice.
• Don’t eat dairy products unless you know they have been pasteurised.
• Don’t share needles with anyone.
• Don’t handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague).
• Don’t swim in fresh water. Salt water is usually safer.

What You Need To Bring with You:

• Long-sleeved shirt and long pants to wear whenever possible while outside to prevent illnesses carried by insects (e.g., malaria, dengue, filariasis, leishmaniasis, and onchocerciasis).
• Insect repellent containing DEET (diethylmethyltoluamide), in 30%–35% strength for adults and 6%–10% for children. Unless you are staying in air-conditioned or well-screened housing, purchase a bed net impregnated with the insecticide permethrin. (Bed nets can be purchased in camping or military supply stores.)
• Over-the-counter antidiarrheal medicine to take if you have diarrhoea.
• Iodine tablets and water filters to purify water if bottled water is not available. See Do’s above for more detailed information about water filters.
• Sunblock, sunglasses, hat.
• Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription (s).

After You Return Home:

If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area.
If you become ill after your trip—even as long as a year after you return—tell your doctor where you have travelled.

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