Travel Tips: Safari Medical Advice.

All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure. Any side effects or unsuitable drugs, (some people do not respond well to Lariam for example), can be dealt with well before departure. The last thing one needs is to feel nauseous on the flight, especially if it’s not from alcohol.

Immunizations that should be considered prior to leaving on a hunt to Africa:

Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later. Hepatitis A is highly contagious and contracted by eating food or drinking beverages that have been handled by a person with hepatitis.

Typhoid vaccine is recommended for all travelers Typhoid is a life threatening illness caused by bacteria and much like Hepatitis A is spread by eating food or drinking beverage that have been handled by a person who is shedding typhoid bacteria, or if sewage contaminated with typhoid bacteria gets into the water used for drinking or washing clothes.

Yellow fever vaccine is a pre-requisite for hunters going to Tanzania and Cameroon. Travelers will be denied access unless they have a fully validated International Certificate of Vaccination.

Polio immunization is recommended, due to the persistence of polio in sub-Saharan Africa.

Hepatitis B vaccine is recommended for all travelers if not previously vaccinated. Vaccination consists of three intra muscular doses given at 0, 1 and 6 months. Engerix-B is also approved for administration at 0, 1, 2, and 12 months, which may be appropriate for travelers departing in less than 6 months.

Tetanus-diphtheria vaccine is recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years, especially hunters as one is continually being cut and scratched.

Rabies is a deadly disease, in spite of being 100% preventable. It is estimated that 55000 people die of rabies, annually, world wide. Most cases involve bites from dogs not vaccinated. Wild animals can also contract the disease; in Africa jackals, mongooses and bats are often infected. Any animal bite or scratch should be thoroughly cleaned with large amounts of soap and water and antibiotics and tetanus injections administered to protect against bacterial infections. Local health authorities should be contacted immediately for possible post-exposure treatment, whether or not the person has been immunized against rabies.

Cholera.

A major cholera outbreak was reported from Zimbabwe in August 2008, causing more than 30,000 cases and over 1500 deaths by early December. The outbreak began in the Northern provinces, and then spread to the southern and central provinces. The Limpopo River, which marks the border between Zimbabwe and South Africa, was found to be contaminated with cholera bacteria and cases are now being reported in South Africa.

The main symptoms of cholera are profuse watery diarrhea and vomiting, which in severe cases may lead to dehydration and death. Most outbreaks are related to contaminated drinking water, typically in situations of poverty, overcrowding, and poor sanitation. Most travelers are at extremely low risk for infection.

Cholera vaccine, where available, is recommended only for certain high-risk individuals, such as relief workers, health professionals, and those traveling to remote areas where cholera epidemics are occurring. All travelers should carefully observe food and water precautions.

Food and water precautions.

Travelers diarrhea is the most common travel-related ailment. The best prevention is food and water precautions.

Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink un-bottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous.

Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish. Most cases of travelers diarrhea are mild and do not require either antibiotics or anti-diarrhoeal drugs. Adequate fluid intake is essential. Antibiotics which have been shown to be effective for diarrhea include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.

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