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Destination
Health Precautions for
East Africa
Burundi,
Comoros, Djibouti, Eritrea, Ethiopia,
Kenya, Madagascar, Malawi, Mauritius,
Mayotte, Mozambique, Reunion, Rwanda,
Seychelles, Somalia, Tanzania, Uganda
Several cases of African trypanosomiasis
(African sleeping sickness) have been
reported from this region recently,
including cases among tourists visiting
game parks. For more information and
recommendations on trypanosomiasis,
see Travelers' Health Information
on African Trypanosomiasis.
Food and waterborne diseases are the
number one cause of illness in travelers.
Travelers’ diarrhea can be caused
by viruses, bacteria, or parasites,
which are found throughout the region
and can contaminate food or water.
Infections may cause diarrhea and
vomiting (E. coli, Salmonella, cholera,
and parasites), fever (typhoid fever
and toxoplasmosis), or liver damage
(hepatitis).
Malaria is a preventable infection
that can be fatal if left untreated.
Prevent infection by taking prescription
antimalarial drugs and protecting
yourself against mosquito bites. Travelers
to East Africa should take one of
the following antimalarial drugs:
mefloquine (Lariam®), doxycycline,
or Malarone™. Your risk of malaria
may be high in these countries, including
cities.
A certificate of yellow fever vaccine
may be required for entry into certain
of these countries.
Dengue, filariasis, leishmaniasis,
onchocerciasis, trypanosomiasis (sleeping
sickness), and Rift Valley fever are
diseases carried by insects that also
occur in this region. Protecting yourself
against insect bites will help to
prevent these diseases.
Schistosomiasis, a parasitic infection,
is found in fresh water in the region,
including Lake Malawi. Do not swim
in fresh water (except in well-chlorinated
swimming pools) in these countries.
Because motor vehicle crashes are
a leading cause of injury among travelers,
walk and drive defensively. Avoid
nighttime travel if possible and always
use seat belts.
CDC recommends the following vaccines
(as appropriate for age):
See your doctor at least 4–6 weeks
before your trip to allow time for
shots to take effect.
- Hepatitis
A or immune globulin (IG).
- Hepatitis
B, if you might be exposed to blood
(for example, health-care workers),
have sexual contact with the local
population, stay longer than 6 months,
or be exposed through medical treatment.
- Meningococcal
(meningitis) vaccine, if you plan
to visit the western half of Ethiopia
(see meningitis map) from December
through June.
- Rabies,
if you might be exposed to wild
or domestic animals through your
work or recreation.
- Typhoid,
particularly if you are visiting
developing countries in this region.
- Yellow
fever, if you travel anywhere outside
urban areas.
- As
needed, booster doses for tetanus-diphtheria,
measles, and a one-time dose of
polio vaccine for adults. Hepatitis
B vaccine is now recommended for
all infants and for children ages
11–12 years who did not receive
the series as infants.
All travelers should take the following
precautions, no matter the destination:
- Wash
hands often with soap and water.
- Because
motor vehicle crashes are a leading
cause of injury among travelers,
walk and drive defensively. Avoid
travel at night if possible and
always use seat belts.
- Always
use latex condoms to reduce the
risk of HIV and other sexually transmitted
diseases.
- Don’t
eat or drink dairy products unless
you know they have been pasteurized.
- Don’t
share needles with anyone.
- Eat
only thoroughly cooked food or fruits
and vegetables you have peeled yourself.
Remember: boil it, cook it, peel
it, or forget it. Never eat undercooked
ground beef and poultry, raw eggs,
and unpasteurized dairy products.
Raw shellfish is particularly dangerous
to persons who have liver disease
or compromised immune systems.
Travelers visiting undeveloped
areas should take the following precautions:
To stay healthy, do...
- Drink
only bottled or boiled water, or
carbonated (bubbly) drinks in cans
or bottles. Avoid tap water, fountain
drinks, and ice cubes. If this is
not possible, make water safer by
BOTH filtering through an “absolute
1-micron or less” filter AND adding
iodine tablets to the filtered water.
“Absolute 1-micron filters” are
found in camping/outdoor supply
stores.
- If
you visit an area where there is
risk for malaria, take your malaria
prevention medication before, during,
and after travel, as directed. (See
your doctor for a prescription.)
- Protect
yourself from insects by remaining
in well-screened areas, using repellents
(applied sparingly at 4-hour intervals),
and wearing long-sleeved shirts
and long pants from dusk through
dawn.
- To
prevent fungal and parasitic infections,
keep feet clean and dry, and do
not go barefoot. To avoid getting
sick...
- Don’t
eat food purchased from street vendors.
- Don’t
drink beverages with ice.
- Don’t
share needles with anyone.
- Don’t
handle animals (especially monkeys,
dogs, and cats), to avoid bites
and serious diseases (including
rabies and plague).
What you need to bring with you:
- Long-sleeved
shirt and long pants to wear while
outside whenever possible, to prevent
illnesses carried by insects.
- Insect
repellent containing DEET (diethylmethyltoluamide),
in 30%–35% strength for adults and
6%–10% for children, as well as
a bed net impregnated with the insecticide
permethrin. (Bed nets can be purchased
in camping or military supply stores.)
- Over-the-counter
antidiarrheal medicine to take if
you have diarrhea.
- Iodine
tablets and portable water filters
to purify water if bottled water
is not available.
- Sunblock,
sunglasses, hat.
- Prescription
medications: make sure you have
enough to last during your trip,
as well as a copy of the prescription(s).
After you return home:
If you have visited a malaria-risk
area, continue taking your antimalarial
drug for 4 weeks (Lariam®, doxycycline)
or seven days (Malarone™) after leaving
the risk area. Travelers who become
ill with a fever or flu-like illness
while traveling in a malaria-risk
area and up to one year after returning
home should seek prompt medical attention
and should tell the physician their
travel history.
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