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Algeria,
Canary Islands (Spain), Egypt,
Libyan Arab Jamahiriya, Morocco
(including Western Sahara),
Tunisia
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).
Make sure your food and drinking
water are safe.
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 (see
below). Travelers to North
Africa should take chloroquine
as their antimalarial drug.
A limited risk of malaria
exists in parts of Algeria,
Egypt, and Morocco. For detailed
information on malaria-risk
areas and antimalarial drugs,
see Malaria Information for
Travelers to North Africa.
Dengue, filariasis, leishmaniasis,
and onchocerciasis 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
the Nile River. 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.
There is no risk for yellow
fever in North Africa. A certificate
of yellow fever vaccination
may be required for entry
into certain of these countries
if you are coming from countries
in South America or sub-Saharan
Africa.
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
in the region, or be exposed
through medical treatment.
- 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.
- 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 complete 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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