Travel health advice for travelling to South Africa

Required Vaccinations

Yellow Fever

A yellow fever vaccination certificate is only required for travellers coming from, or in transit (for 12 or more hours) a country with risk of yellow fever transmission. The vaccination requirement is imposed by this country for protection against yellow fever since the principal mosquito vector Aëdes aegypti is present in its territory. 

The WHO World Health Assembly in May 2014 adopted an amendment to Annex 7 of the International Health Regulations (2005) (IHR), which stipulates that the period of protection afforded by yellow fever vaccination, and the term of validity of the certificate will change from 10 years to the duration of the life of the person vaccinated.

This change will enter into force legally in June 2016. Some countries may continue to request proof of vaccination or a booster within the last ten years from travellers.

http://www.who.int/ith/2016-ith-annex1.pdf?ua=1

Risk of Yellow Fever transmission exists in these countries:

AFRICA - Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Republic of the Congo, Democratic Republic of the Congo, Côte d'Ivoire, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Togo, Uganda.

AMERICAS - Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Suriname, Trinidad and Tobago, Venezuela.

Note: A vaccination certificate is required for children over one year of age.

If your medical practitioner has advised you against the yellow fever vaccine for medical reasons, a vaccination waiver should be issued. Be aware that problems may arise when crossing borders and your vaccination waiver may not be honoured.

South Africa no longer requires proof of vaccination from travellers coming from, or in transit through, the following countries: Eritrea, São Tomé and Principe, Somalia, Tanzania and Zambia.

Recommended Vaccinations

Routine Immunizations

A trip is an important opportunity to ensure routine immunizations are up to date; more than 80% of adults in developed countries have not maintained their immunization status. The following vaccinations are recommended for personal protection and to prevent the spread of infectious diseases.

Vaccinations for tetanus, diphtheria, pertussis, measles, mumps, rubella, poliomyelitis should be reviewed and updated if necessary. Note: Many of these vaccine- preventable diseases have resurged due to non-vaccination, incomplete vaccination, and waning immunity. It is important to ensure your routine immunization is up-to-date.

Seasonal influenza vaccination is strongly recommended for pregnant women, persons over 65, and those with chronic health conditions such as asthma, diabetes, lung disease, heart disease, immune-suppressive disorders and organ transplant recipients. Note: In the northern hemisphere the flu season typically runs from November to April and from May to September in the southern hemisphere and the vaccine formulation varies for the specific influenza season in each hemisphere. If the flu vaccine is not available at the time of departure, contact your doctor or travel health clinic regarding influenza anti-viral protection.

Pneumococcal vaccine is recommended for persons over the age of 65 and persons of any age suffering from cardiovascular disease, diabetes, renal disorders, liver diseases, sickle cell disease, asplenia, or immuno-suppressive disorders.

Hepatitis A

The hepatitis A virus (HAV) is primarily transmitted from person to person via the faecal-oral route and through contaminated water and food - such as shellfish and uncooked vegetables or fruit prepared by infected food handlers.

Risk: The virus is present worldwide, but the level of risk depends on local sanitary conditions. HAV circulates widely in populations living in areas with poor hygiene and sanitary infrastructure. In these areas, persons usually acquire the virus during childhood when the illness is asymptomatic (but still infective to others) or mild, and this leads to lifelong immunity. Large outbreaks in these countries are rare. In contrast, a large number of non-immune persons are found in highly industrialized countries where community wide outbreaks can occur when proper food handling or good sanitation practices are not maintained including in day care centres, prisons, or mass gatherings.

Symptoms: In many cases, the infection is asymptomatic (persons do not exhibit symptoms). Those with symptoms will usually get ill between 15 to 50 days after becoming infected. Symptoms include malaise, sudden onset of fever, nausea, abdominal pain and jaundice after a few days. The illness can range from mild to severe lasting from one to two weeks or for several months. Severe cases can be fatal especially in older persons. Most infections are asymptomatic in children under six years of age, but infants and children can continue to shed the virus for up to six months after being infected, spreading the infection to others. Many countries are now including vaccination against Hepatitis A in their childhood vaccination schedules.

Prevention: Practice good personal hygiene, including washing your hands frequently and thoroughly, drink boiled or bottled water, eat well cooked foods, and peel your own fruits.

All non-immune persons, especially travellers, should be vaccinated. Two vaccines are available for persons over one year of age. Two doses are needed for full protection (the second dose is given 6 to 12 months after the first dose (HAVRIX) or 6 to 18 months after the first dose (VAQTA). TWINRIX is a vaccine against hepatitis A and hepatitis B. It is available for persons over 18 years of age. Three doses are needed for full protection. The second dose is given 1 month after the first, and the third 6 months later. For an accelerated schedule four doses are needed at 0, 7, 21, 31 days and the last dose 12 months later.

Vaccination is highly recommended for persons going outside the areas usually visited by tourists such as travelling extensively in the interior of the country (trekkers, hikers) and for persons on long-term working assignments in remote areas.

Typhoid Fever

This intestinal infection, caused by Salmonella typhi bacteria, is transmitted from person to person primarily through ingestion of contaminated food and water in areas with poor sanitary and hygienic conditions. Prevention includes good personal hygiene such as washing your hands frequently, ensuring safe water supply, eating well cooked foods, and peeling your own fruits. Vaccination is also recommended for travellers' protection.

Vaccination is highly recommended for persons going outside the areas usually visited by tourists such as travelling extensively in the interior of the country (trekkers, hikers) and for persons on working assignments in remote areas.

Selective Vaccinations

Cholera

Cholera is an acute gastro-intestinal infection caused by vibrio cholerae bacteria. Risk of infection to travellers is low and vaccination is advised only for medical and rescue personnel working in endemic areas.

The best protection is to avoid potentially contaminated water and food. See IAMAT's 24 World Climate and Food Safety Charts describing the sanitary condition of water, dairy products and food in 1440 cities. Meticulous food and water hygiene are essential when travelling in endemic areas.

Persons living and working in inadequate sanitary conditions and those with impaired defence mechanisms (deficient production of gastric acid due to surgery for duodenal or gastric ulcers), persons on antacid therapy, and users of cannabis (smoking marijuana reduces acid secretion of the stomach) are more susceptible to cholera infection. The World Health Organization announced in 1991 that cholera vaccination certificates are no longer required by any country or territory.

Rabies

This viral infection is transmitted through the saliva of infected animal bites which affects the brain and the spinal cord, and may be fatal.

A series of three (3) pre-exposure rabies vaccination shots is advised for persons planning an extended stay or on working assignments in remote and rural areas, particularly in Africa, Asia, Central and South America. The pre-exposure series simplifies medical care if the person has been bitten by a rabid animal. Although this provides adequate initial protection, a person potentially exposed to rabies will require two (2) additional post-exposure innoculations.

Persons who have not received the pre-exposure shots need five (5) injections in addition to rabies immune globulin (RIG). RIG is in short supply around the world and may not be available in remote areas. If a traveller has had the three pre-exposure shots, they will only need additional two shots; they do not need RIG.

Children are especially vulnerable since they may not report scratches or bites. They should be cautioned not to pet dogs, cats, monkeys, or other mammals. Any animal bite or scratch must be washed repeatedly with copious amounts of soap and water. Seek medical attention immediately.

Updated 06 July 2016


The recommendations for vaccinations outlined above are intended as guidelines only. Your immunization needs depend on your health status, previous immunizations received, and your travel itinerary. Seek further advice from your doctor or travel health clinic.

 

Read 11509 times Last modified on Wednesday, 06 July 2016 13:55

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Important Notice

You are advised to visit your general practice surgery or a travel medicine clinic at least 6 weeks before you travel. However, it is never too late to seek advice.

If you have a medical condition, you are advised to discuss the suitability of the trip before you book.

 

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