Travel Reference
In-Depth Information
paddling or swimming and then migrate to the bladder or bowel. They are passed out via stools or urine and can contam-
inate fresh water, where the cycle starts again. Avoid paddling or swimming in suspect freshwater lakes or slow-running
rivers. There may be no symptoms or there may be a transient fever and rash, and advanced cases can have blood in the
stool or in the urine. A blood test can detect antibodies if you have been exposed, and treatment is then possible in
travel- or infectious-disease clinics. If not treated, the infection can cause kidney failure or permanent bowel damage. It
isn't possible for you to infect others.
Tuberculosis (TB)
TB is spread through close respiratory contact and occasionally through infected milk or milk products. BCG (Bacille
Calmette-Guérin) vaccination is recommended for those likely to be mixing closely with the local population, although
it gives only moderate protection against TB. It is more important for long stays than for short-term stays. Inoculation
with the BCG vaccine is not available in all countries. It is given routinely to many children in developing countries.
The vaccination causes a small, permanent scar at the injection site and is usually given in a specialised chest clinic. It is
a live vaccine and should not be given to pregnant women or immunocompromised individuals.
TB can be asymptomatic, only being picked up on a routine chest X-ray. Alternatively, it can cause a cough, weight
loss or fever, sometimes months or even years after exposure.
Typhoid
This is spread through food or water contaminated by infected human faeces. The first symptom is usually a fever or a
pink rash on the abdomen. Sometimes septicaemia (blood poisoning) can occur. A typhoid vaccine (typhim Vi, typherix)
will give protection for three years. In some countries, the oral vaccine Vivotif is also available. Antibiotics are usually
given as treatment and death is rare unless septicaemia occurs.
Trypanosomiasis
Spread via the bite of the tsetse fly, trypanosomiasis, also called 'sleeping sickness', causes a headache, fever and even-
tually coma. There is an effective treatment.
Yellow Fever
Travellers should carry a certificate as evidence of vaccination if they have recently been in an infected country, to avoid
any possible difficulties with immigration. For a full list of these countries visit the WHO website ( www.who.int/en ) or
the Centers for Disease Control and Prevention website ( www.cdc.gov/travel ) . There is always the possibility that a
traveller without a legally required, up-to-date certificate will be vaccinated and detained in isolation at the port of ar-
rival for up to 10 days, or possibly repatriated.
Yellow fever is spread by infected mosquitoes. Symptoms range from a flulike illness to severe hepatitis (liver inflam-
mation), jaundice and death. The yellow-fever vaccination must be given at a designated clinic and is valid for 10 years.
It is a live vaccine and must not be given to immunocompromised or pregnant travellers.
Traveller's Diarrhoea
It's not inevitable that you will get diarrhoea while travelling in Africa, but it's certainly likely. Diarrhoea is the most
common travel-related illness - figures suggest that at least half of all travellers to Africa will get diarrhoea at some
stage. Sometimes dietary changes, such as increased spices or oils, are the cause. To help prevent diarrhoea, avoid tap
water unless you're sure it's safe to drink. You should only eat cooked or peeled fresh fruits or vegetables, and be wary
of dairy products that might contain unpasteurised milk. Although freshly cooked food can often be a safe option, plates
or serving utensils might be dirty, so you should be very selective when eating food from street vendors (make sure that
 
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