Africa, as the second-largest continent, can only be described as a melting pot of mystery and diversity. With its complexities and idiosyncrasies, there is no doubt that Africa can be a challenging experience for any traveller. Language and cultural differences aside, it is health issues surrounding the prevalence of various diseases that travellers worry about most.
And while Africa’s reputation of being the ‘Dark Continent’ has been dispelled to a certain extent, travellers are concerned with the availability and access to professional medical services while visiting this continent. For most of the common illnesses found in Africa, prevention is better than cure. Being aware of health risks associated with travel in Africa and taking the necessary precautions to prevent infection are important parts of planning your trip. Here are some of the most common travel ailments in Africa:
Traveller’s diarrhoea
Perhaps one of the most common travel ailments, traveller’s diarrhoea, is caused by contaminated food or water. Other diseases transmitted by contaminated food or water include cholera and dysentery. Precautions include the following: Boil it, peel it or don’t eat it. Avoid salads and fresh fruits. Eat only well-cooked, hot foods. Avoid dairy products in tropical climates where pasteurisation and refrigeration are questionable. Treat all water with iodine tablets or a water purifi er. Alternatively purchase bottled water. Do not consume drinks with ice. Brush your teeth and wash vegetables with treated water as well.
Malaria
Malaria, one of Africa’s most well-known illnesses, is transmitted by infected mosquitoes. Malaria kills more than a million people worldwide every year and is caused by a parasite, which the female mosquito transmits to humans. The symptoms of malaria include nausea, fever, headaches, sweating, cold shivers and bodily aches and pains.
Prevention: Preventive medication can to be taken before, during and after your trip. See your doctor for more information. Cover up exposed areas of your body by wearing long-sleeved shirts and pants. Use insect repellent on exposed skin. Use mosquito nets at night.
Cholera
Cholera is caused by bacteria, Vibrio cholerae, which make their way into the small intestine where they release a toxin. The most prevalent symptom is severe diarrhoea, and death is caused by severe dehydration. The disease is spread through contact with contaminated food and water, and other symptoms include abdominal cramps and nausea. In some cases there may be vomiting and high fever. Prevention: Avoid eating raw food or undercooked food. Drink only bottled or sterilised water.
Hepatitis
Hepatitis, a viral infection of the liver, is immune to most antibiotics, and many people, who are infected, have to live with the virus for the rest of their lives. Travellers into Africa need to be aware of both hepatitis A and hepatitis B, which have the same general symptoms including fever, abdominal pains, nausea and jaundice. Hepatitis A is most often contracted through contaminated food and water. It is not usually fatal, but it is a debilitating disease. Hepatitis B is contracted through body fl uids and intimate contact. If left untreated, hepatitis B is often fatal. Prevention: Vaccinate against both strains
Poliomyelitis
More commonly known as polio, this disease, which is a viral infection, has a debilitating and paralysing effect on those who contract it. The virus is spread through contaminated food and water and close contact with infected individuals. Prevention: Highly effective, readily available vaccines that ensure immunity to the virus.
Rabies
The rabies virus can infect any mammal, and even if an animal shows no signs of the disease, it may still be a carrier. Contrary to popular belief, rabies is not only passed on through a bite from an infected animal. Touching or being licked by an infected animal could also cause the disease to spread if the saliva comes in to contact with broken skin, eyes or mouth. The virus attacks the central nervous system and once it has taken hold, there is very little that can be done. Symptoms include muscle spasms, headaches and delirium. Prevention: Vaccines are available. Get your immunisation updated before you go. If bitten by an animal while on your trip, or you suspect you may have come into contact with the virus, go to a clinic for a post-infection vaccination.
Tuberculosis
Africa has a high incidence of tuberculosis (TB). This debilitating respiratory disease can also affect the central nervous system, the lymphatic system and other parts of the human body. Because the disease is spread through the air when infected people cough, sneeze or spit, travellers spending a large amount of time in a country where the disease is a problem are at higher risk of contracting TB. The symptoms of TB include coughing, bloody sputum after coughing, night sweats, fever and weight loss. If detected early, TB is easily treated with antibiotics. Prevention: Vaccines against TB are usually only administered in countries where the disease is a serious problem. Many of the vaccinations are not effective against the adult version of the disease and since the rise of drug-resistant. TB, vaccinations are considered to be a deterrent, but not a guarantee that vaccinated people wont contract the disease.
Typhoid
In countries where adequate waste disposal is not available, typhoid is caused by bacteria that are spread through people via the faecal-oral route and through the ingestion of contaminated food and water. Symptoms start with fever, headaches and tiredness. Typhoid is not fatal if treated with a combination of antibiotics and rehydration therapy. Prevention: An effective vaccine is available. Even with a vaccination, travellers should watch what they eat and stay away from raw food and untreated water.
Access to professional medical facilities and assistance
While travellers are urged to research their destination, which should include medical facilities in the area of travel, they are also advised to elect travel insurance, as poor medical care and lack of medical facilities are a concern throughout Africa. Travel insurance usually provides cover for medical expenses and emergency evacuation which could cost up to R500 000, among other benefi ts. Banks, travel agents and insurance companies, as well as some medical aid schemes, offer travel insurance as a part of their service offering. However, these benefi ts are usually limited, and more comprehensive cover is often available for an additional fee. Travellers should always read the fi ne print of these insurance policies as they may require authorisation for treatment, or limit the traveller to certain medical service providers or facilities. Travellers should always have the 24-hour emergency number of the insurance provider on hand. As the old adage says, prevention is better than cure. Be sure to pack a fi rst aid kit and ensure that you are vaccinated in accordance with those inoculations recommended for your area of travel.
Yellow fever
A viral disease that that remains a problem in many sub-Saharan African countries, yellow fever, like malaria, is transmitted through mosquito bites. But instead of a parasite like malaria, yellow fever is a virus that the mosquito spreads from one infected individual to another. The disease typically reveals itself about six days after a patient has been bitten by a mosquito. The symptoms have a rapid onset and include fever, headache, body pains, jaundice and nausea. The disease progresses quickly, and patients may enter a coma that is swiftly followed by death, if not treated. Treatment is symptomatic along with the replacement of lost fluids and blood. If treated early, most patient survive with few lasting side-effects. Prevention: Vaccines against yellow fever are readily available. Travellers should receive a certificate of vaccination, called a Yellow Card, after the vaccination. It is important that this certificate is taken along when travelling in Africa, as immigration officials will ask for this certificate when entering and leaving a country where yellow fever is a problem. People without this certificate may be detained, or even quarantined, for their own safety and the safety of the people around them.
**Finding out what vaccinations you need before you travel to Africa is an important part of planning your trip. See our table on the next page for more detail.
Michelle Swart