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health advise


Immunisation and Malaria Advice

You must discuss your own particular needs and contraindications to vaccines or tablets with your doctor or practice nurse.

Ensure you are fully insured for medical emergencies including repatriation.

Immunisations
Courses or boosters usually advised: hepatitis A; typhoid; diphtheria; tetanus; poliomyelitis; yellow fever.
Vaccines sometimes advised: tuberculosis; hepatitis B; meningococcal meningitis; rabies; cholera.

Yellow fever certificate required if over 1 year old and entering from an endemic or an infected area.

It may sound a scary list of immunisations to be taken, but in fact they are all given in one go and present no side effects for the vast majority of people.
Make sure to have the immunisation done about 2 weeks before departure.

Notes on the above deseases
Tetanus is contracted through dirty cuts and scratches and poliomyelitis spread through contaminated food and water. They are serious infections of the nervous system.

Typhoid and hepatitis A are spread through contaminated food and water. Typhoid causes septicaemia and hepatitis A causes liver inflammation and jaundice. In risk areas you should be immunised if good hygiene is impossible.

Cholera is spread through contaminated water and food. More common during floods and rainy seasons. Those unable to take effective precautions, for example, during wars and when working in refugee camps or slums may consider vaccination when outbreaks are anticipated or being reported.
Tuberculosis is most commonly transmitted via droplet infection. Those going to countries where it is common, especially those mixing closely with the local population and those at occupational risk, e.g. health care workers, should ensure that they have previously been immunised. Check with your doctor or nurse.

Meningococcal meningitis and diphtheria are also spread by droplet infection through close personal contact. Vaccination is advised if close contact with locals in risk areas is likely.

Yellow fever is spread by mosquito bites. It is uncommon in tourist areas but can cause serious, often fatal illness so most people visiting risk areas are immunised.

Hepatitis B is spread through infected blood, contaminated needles and sexual intercourse, It affects the liver, causes jaundice and occasionally liver failure. Those visiting high risk areas for long periods or at social or occupational risk should be immunised.

Rabies is spread through bites or licks on broken skin from an infected animal. It is always fatal. Vaccination is advised for those going to risk areas that will be remote from a reliable source of vaccine. Even when pre-exposure vaccines have been received urgent medical advice should be sought after any animal bite.

Malaria
Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria.

Malaria Precautions
Malaria precautions are essential in all areas, all year round. Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net. Check with your doctor or nurse about suitable antimalarial tablets.(Mefloquine OR doxycycline OR Malarone is usually recommended).

Prompt investigation of fever is essential. If travelling to remote areas, a course of emergency 'standby' treatment should be carried.

Common Medical Problems


Diarrhoea
This is a very common disease in tropical countries, mostly because travellers are not used to local food and bacteria. It should never last more than a few days, otherwise you should consult a doctor. The best advice is to avoid anything uncooked and washed with unclean water, but sometimes, especially when safarying it might be quite difficult. Have tables with you at all time and this should be enough to reduce the symptoms.

Water
Avoid drinking water as much as you can. Mineral water is inexpensive and much safer.

Insect bites
Use insect repellent, if possible at all time, the best are the ones containing 50% diethyl-meta-toluanide (DEET). But be careful: it is an acid, clean your hands before touching anything (in particular your expensive digital camera!).
Coils, fans, nets, air conditioning (rare!) all help reducing bites.

HIV
HIV is largely spread in Africa. Don't forget the obvious prevention!


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