Travel Reference
In-Depth Information
any fever or flu-like symptoms to a doctor as soon as possible. Some people advocate
homeopathic preparations against malaria, such as Demal200, but there is no evidence
that this is effective, and many homeopaths do not recommend their use.
Malaria in pregnancy frequently results in miscarriage or premature labour, and the
risks to both mother and foetus during pregnancy are considerable. Travel throughout the
region when pregnant should be carefully considered. Adults who have survived child-
hood malaria have developed immunity and usually only develop mild cases of malaria;
most Western travellers have no immunity at all. Immunity wanes after 18 months of non-
exposure, so even if you have had malaria in the past and used to live in a malaria-prone
area, you may no longer be immune.
ANTIMALARIAL A TO D
A - Awareness of the Risk No medication is totally effective, but protection of up to 95% is achievable with
most drugs, as long as other measures have been taken.
B - Bites To be avoided at all costs. Sleep in a screened room, use a mosquito spray or coils, sleep under a
permethrin-impregnated net at night. Cover up at night with long trousers and long sleeves, preferably with
permethrin-treated clothing. Apply appropriate repellent to all areas of exposed skin in the evenings.
C - Chemical prevention (ie antimalarial drugs) Usually needed in malarial areas. Expert advice is needed as
resistance patterns can change, and new drugs are in development. Not all antimalarial drugs are suitable for
everyone. Most antimalarial drugs need to be started at least a week before and continued for four weeks after the
last possible exposure to malaria.
D - Diagnosis If you have a fever or an illness similar to flu within a year of travel to a malarial area, malaria is a
possibility, and immediate medical attention is necessary.
Rabies
Rabies is spread by receiving bites or licks from an infected animal on broken skin. Few
human cases are reported in Botswana and Namibia, with the risks highest in rural areas.
It is always fatal once the clinical symptoms start (which might be up to several months
after an infected bite), so postbite vaccination should be given as soon as possible. Post-
bite vaccination (whether or not you've been vaccinated before the bite) prevents the virus
from spreading to the central nervous system. Animal handlers should be vaccinated, as
should those travelling to remote areas where a reliable source of postbite vaccine is not
available within 24 hours. Three preventive injections are needed over a month. If you
have not been vaccinated, you'll need a course of five injections starting 24 hours or as
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