Planning on Visiting South Africa in 2010?

Here’s some travel-health advice that will serve you well

Are you planning on visiting South Africa during the 2010 Soccer World Cup? That is great news as you are going to love our country and its people! While in South Africa we want you to feel secure in the knowledge that we have a highly sophisticated, world renowned private healthcare infrastructure that can cater for your every healthcare need and emergency.

To ensure that you enjoy your visit to our beautiful country we wish to provide you with some pertinent healthcare information that will assist you in preparing for your 2010 World Cup sojourn.

From the outset it is important to highlight that anyone planning a trip to a foreign country without having the appropriate immunisation would be unwise. “Even in ‘disease free’ countries, you are taking a considerable risk by travelling without the proper immunisations,” cautions Glenda Seeger, Operations Manager of Netcare Travel Clinics.

“Netcare Travel Clinics are kept up to date with information on potential health hazards in more than 250 countries around the world. We keep a comprehensive range of vaccines and our countrywide team of healthcare professionals are always on hand to ensure that travellers are well informed and prepared for any medical eventuality,” says Ms Seeger.

When planning your trip to South Africa you need to be aware of the following important information:

Yellow fever

What exactly is it, and is it endemic in South Africa?

Yellow Fever is a viral disease transmitted to humans by the bite of a mosquito. The mosquito, known as Aedes aegypti, is a daytime biter and is found widespread throughout the world. Monkeys and humans act as carriers for the virus. The disease itself is characterised by fever, muscular pain, headaches, nausea and vomiting, a slow pulse, followed in 15% of cases by jaundice, abdominal pain and bleeding tendencies. By the time patients develop the jaundice, half of them will die.

While South Africa has the mosquito and the carrier, the disease is not prevalent here.

However, prospective travellers to South Africa are warned that it is essential to be inoculated against yellow fever when travelling to the country from or via countries where the disease is endemic.

The law requires you to have proof of yellow fever vaccination should you be coming from an endemic country. This is to make certain that you do not bring the disease into the country, as it can very easily spread.

Countries like Tanzania, Kenya, Nigeria, Brazil and Venezuela are all yellow fever endemic countries. This means that they have the disease, the mosquito and the carrier. For your own protection, a yellow fever vaccine is needed when visiting these countries.

According to Seeger, travellers attempting to enter South Africa from a yellow fever endemic country without a valid yellow fever vaccination certificate could be refused entry to the country. “Officials have the authority to decide either to keep such travellers under observation for approximately ten days at their own cost, or to vaccinate them against yellow fever, again at their own cost. Foreigners from countries where yellow fever is endemic, and who are not in possession of a valid vaccination certificate, will be returned to their port of embarkation at the airline’s expense. Alternatively, they could also be subject to the ten days’ observation requirement or vaccination, at their own cost,” she says.

The World Health Organisation (WHO), which closely monitors reports of yellow fever infection, publishes an updated, bi-annual book on yellow fever cases, where it occurs and which countries require vaccination when travelling from endemic areas.

Malaria infections - on the up-and-up in Africa

There are certain parts of South Africa where Malaria poses a considerable risk. The carrier of the malaria parasite is the smallest Anopheles mosquito. Although there are times when malaria is very much less active, it is important to remember that you are at risk at any time of year when entering a malarial area.

“Because nobody is truly immune from malaria it is imperative that leisure and business travelers are at all times made aware of the risks associated with malaria and how to prevent possible infection,” says Seeger.

There are three critical lines of defence that can safeguard you against Malaria:

The first line of defence is: “Don’t get bitten!”

Personal protective measures against mosquito bites are the cornerstone of malaria prevention, whether in a high or a low risk area
* Know the risks of the area that you are travelling to/deployed in
* Wear long sleeved clothing and long pants from dusk until dawn when you are outside
* Sleep under mosquito nets
* Use lotions, sprays, and coils to kill or repel mosquitoes
* Stay in rooms with screening in front of the doors and windows
* Use fans or air conditioners where possible.

The second line of defence, and a critical one, is: “Be sure to take malaria chemoprophylaxis measures as advised by your doctor or travel clinic.”

* It is important to remember that there are only three types of medication that are effective in Africa. This medication, which is only 95% safe, is also suitable for long-term use.
* It is essential that each person be individually evaluated in order to determine which medication is the most appropriate for him/her.
* Medication must be taken according to instructions and continued for the prescribed time after leaving the malarial area.

The third line of defence is: “Be alert to any signs of illness after visiting a malarial area, no matter what time of year it is!”

You should have a high index of suspicion of malaria if you fall ill after returning from a visit to a malarial area, whether it’s ‘low risk’ geographically, or your visit took place at a ‘low risk’ period. Please bear the following important points in mind:
* Malaria can develop as early as seven days after entering a malarial area and for up to six months after leaving a malarial area.
* Early symptoms include fever, flu-like symptoms (chills, headache, body aches, joint pains, coughing etc.) and gastro-intestinal symptoms (nausea, diarrhoea and vomiting, abdominal pains). If you have any of these symptoms, have yourself tested for malaria immediately
* Severe malaria including cerebral malaria, severe anaemia, kidney failure etc. can develop within hours, so immediate action is needed.
* Please note that a negative test does not necessarily exclude malaria.

“Strict adherence and compliance to ALL three of the above lines of defence are needed to ensure maximum protection against malaria,” cautions Seeger. “Do remember that prevention is better than cure, as severe malaria is often fatal, even with the best possible care. We therefore strongly suggest that expert medical advice be sought prior to departure to a risk area.”

“Be well versed in personal protective measures, take malaria prophylaxis if indicated and know the early symptoms of malaria. Urgent medical treatment is critical if you suspect that you may have malaria, and always think malaria first if you are not well.”

Immunisations that are not essential but well worth having

Hepatitis A and B

Hepatitis B (serum hepatitis) is a serious viral infection of the liver, which can lead to chronic liver disease, liver cancer and even death. The virus, which is worse when it occurs in conjunction with the hepatitis D (delta hepatitis) virus, can be present and passed on in semen, vaginal secretions, saliva and especially blood in the follow ways:

• unprotected sex
• the sharing of needles, syringes and drug injecting equipment
• childbirth (from an infected woman to her child during birth)
• sharing tooth brushes, razors or personal items that may lead to the exchange of bodily secretions
• any form of blood – contaminated sharp injury

Symptoms generally develop within three months and can range from no symptoms through to a mild flu – like illness that may not be noticed, to nausea, vomiting, abdominal pain and jaundice. Hepatitis symptoms are noticeable in yellowing of the eyes and skin.

Hepatitis B is one of the only STI’s that has a preventative vaccine which consists of three injections. It takes between three to six months to complete the course.

Hepatitis A, or infectious hepatitis, is a less serious viral infection of the liver than Hepatitis B. Although patients appear to be seriously ill, the disease causes few deaths or long-term problems.

The symptoms, which are similar to those of hepatitis B, are less severe and recovery is much quicker.

Hepatitis A is contracted through the drinking of contaminated water or the eating of contaminated foods, especially shellfish. Poor personal hygiene, poor sanitation and intimate contact with an infected person can also put patients at risk of contracting Hepatitis A.

It is well worthwhile being immunised against Hepatitis A as the vaccination has proved to be highly effective.

Tetanus

Commonly known as Lockjaw, Tetanus is caused by toxins secreted by certain soil-dwelling bacteria that are capable of severely disrupting nerve function. This can result in muscle spasms, breathing failure and death.

Tetanus affects mainly people who have not been vaccinated or who have been in adequately immunised. A complete set of tetanus injections provides security for about ten years. Boosters are required approximately every 10 years thereafter.

Your travel-health lifeline
Please do not hesitate to contact your nearest Netcare Travel Clinic should you have any queries or questions regarding travel-health related topics. You may also visit our website on www.travelclinic.co.za.

For more information on any of the diseases mentioned in this article, please visit www.cdc.gov or www.who.int

Issued on behalf of Netcare Travel Clinics by Martina Nicholson Associates (MNA). For further information please contact
Martina Nicholson on (011) 469-3016.
email – martina@mnapr.co.za