South Africa and Victoria Falls South Africa is a diverse country both in terms of living conditions and geography. Australian travellers usually visit the game reserves in the northeast, particularly Kruger National Park , however there a number of others scattered around the country. Other popular destinations include a trip from Capetown along the south coast and wine tours in the Western Cape. Most travellers experience a standard of living comparable to Australia, however in the townships and some rural areas there is extreme poverty. Victoria Falls (on the border of Zimbabwe and Zambia) is a popular side trip. Yellow fever vaccination is required by the South African authorities for travellers returning from the Zambian side of the falls. The following information provides some broad and general guidelines about health risks and recommendations for these destinations.This should not be taken as a substitute for personal consultation with a doctor with experienced in travel health.
Most Common Health Issues Malaria This mosquito borne parasite is present in north eastern KwaZulu-Natal Province as far south as the Tugela River, Limpopo (Northern) Province, and Mpumalanga Province. It is present in Kruger National Park and Victoria Falls. Risk is higher during the rainy season (October through to May), and the mosquitoes usually bite at dusk and dawn. Mosquito bites should be avoided by covering up exposed skin and with DEET containing repellents. Sleeping accommodation should be mosquito proof. Preventive medication options should be discussed with a doctor experienced in travel health. Doxycycline is often chosen as it provides additional protection against tick-bite fever, which is a fairly common disease in rural South Africa. Even if all precautions are taken, any fever even up to a month or two after leaving the area should be presumed to be malaria until proven otherwise, which usually means a prompt visit to a reputable medical clinic.
Yellow Fever Vaccination Requirements and Recommendations Yellow fever vaccination is required by the South African authorities for travellers returning from the Zambian side of Victoria Falls or from other yellow fever affected countries in Africa. This is strictly policed at the airport and failure to provide a certificate or exemption (see below) may lead to refusal of entry or quarantine for 6 days. Some people should not have the vaccine because of medical contraindications, such as the elderly, pregnant women, those with immune suppression from illness or medication and those allergic to eggs. In these cases a medical exemption may be issued by a registered yellow fever clinic, such as Travel Health Fremantle. This vaccine has common mild side effects and very rarely more serious reactions. This is a complex topic and advice should be sought from one of our experience travel doctors.
STD's According to CDC, 18% of the population between 15-49 years old is HIV positive in South Africa, and the rates are higher in sex workers. Do not put yourself at risk. If you do, see a doctor ASAP and abstain until you are given the all clear.
Travellers’ Diarrhoea Risk depends on itinerary and is much higher if visiting and eating in townships or poorer rural areas. Careful food and drink choices (no tap water in these areas), as well as hand hygiene, help in prevention. It is treated with rehydration if mild but if inconvenient, with a ‘bowel stopper’ such as loperamide (Gastrostop or Imodium) and if more severe or persistent with an antibiotic or giardia treatment. These are best obtained prior to travel. We stock gastro kits containing all of these medications.
Animal Bites Rabies occurs in dogs and other mammals throughout the country. Most travellers keep well away from larger animals in game reserves! Immediate and thorough irrigation and cleaning of animal wounds, followed by a course of shots for rabies is essential. A tetanus booster may also be necessary. Animal bites are prone to becoming infected and early treatment with antibiotics may be necessary.
Security and Safety Avoid putting yourself at risk of becoming a victim of street crime as robbery, muggings and carjacking are a major problem in some urban centres. Take advice from locals as to which areas to avoid. Keep an eye on the Australian government’s Smart Traveller website.
TB (Tuberculosis) This is an issue for those working in hospital environments or those visiting friends and relatives in poor areas. Vaccination is generally not given to adults as it is ineffective. Sometimes testing for the disease is performed upon return home. The vaccine is occasionally given to children under 5 years of age, travelling long-term
Seeking Medical Help and Travel Insurance Insurance is essential. Seek medical help if ill/injured in a major centre used to dealing with tourists. Fortunately good quality medical care is available in South Africa. If you return to Australia and develop a fever, rash or are patricianly unwell, isolate yourself and phone ahead for advice.
Vaccinations Required Vaccination (for some) Yellow Fever – only if arriving in South Africa from yellow fever affected countries –this is a complex topic - see comments under yellow fever above
Routine Vaccinations for all travellers All international travellers should be up to date or immune to the following as these are transmissable diseases which may have serious complications:
Measles Chickenpox Influenza - especially for the elderly or those with underlying medical conditions
In addition a tetanus booster if more than 5- 10 years since last vaccinated is advisable to avoid having to get a booster shot in remote areas in the event of a tetanus prone wound.
Recommended Vaccinations for most travellers to South Africa Hepatitis A is a food and water borne virus that infects the liver and causes jaundice. Many people in the developing world have natural immunity, but travellers generally do not. The vaccine is very safe and effective, a single injection providing immediate protection for 6-12 months, after which a booster shot provides long-term immunity.
Other vaccinations to consider Hepatitis B is a blood borne virus, but may also be sexually transmitted. Accidents, injuries and sexual activity can expose travellers to this disease in South Africa. Hepatitis B is highly infectious and can lead to chronic liver disease and liver cancer. All children and young adults born since 1990 in Australia have generally been vaccinated. Rabies is a virus spread from infected animals to humans through bites, scratches and exposure to saliva. If not properly treated and rabies develops, the disease if fatal. Travellers should avoid close contact with either wild, stray or domestic animals; in particular dogs, cats, monkeys and bats. For travel to South and East Africa, pre-vaccination against rabies is often recommended for those at particularly high risk, for example working with animals and those travelling for longer periods. Typhoid fever is a bacterial infection which is caught through ingesting contaminated food and water. Risk is higher in townships and poor rural areas. Mortality is in the order of 1 in 10 in some settings. Resistance to common antibiotics is also widespread so treatment has become more difficult.