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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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