The World Health Organization has revised countries requiring Yellow Fever Vaccinations. Travelers going to or coming from Zambia, Tanzania, Eritrea, Somalia, Sao Tome and Principe as well as Rwanda will no longer be required to produce a yellow fever vaccination certificate when in South Africa as these countries have been included on the World Health Organization (WHO) list of countries with low potential for exposure to yellow fever.
During the 136th session of the WHO Executive Board meeting, a review of countries with risk of yellow fever transmission and countries requiring yellow fever vaccination was conducted and based on the recommendations of the meeting; all travelers arriving into South Africa from these countries will NOT be required to produce proof of vaccination against Yellow Fever. This provision is with immediate effect.
In line with the International Health Regulations, 2005 South Africa requires a valid yellow fever certificate from all citizens and non citizens over one year of age (citizens over 60 years of age require a waiver certificate) if they are:
· Travelling from a yellow fever risk country; or
· Have been in transit exceeding 12 hours, through the airport of a country with risk of yellow fever transmission.
Vaccine should be approved by the WHO and administered at least 10 days before departure to South Africa at a Yellow Fever approved vaccination centre. The vaccine offers protection 10 days after administration and provides lifetime immunity.
CENTRAL AND SOUTH AMERICA
|Central African Republic||Mauritania||French Guyana|
|Democratic Republic of the Congo||Sierra Leone||Peru|
|Equatorial Guinea||Southern Sudan||Suriname|
|Ethiopia||Sudan||Trinidad and Tobago|
For a PDF of Countries with risk of yellow fever transmission and countries requiring yellow fever vaccination click HERE
Yellow fever virus is found in tropical and subtropical areas in South America and Africa. The virus is transmitted to people by the bite of an infected mosquito. The mosquito responsible for spreading Yellow Fever is from the Aedes and Haemogogus species.
Once contracted, the yellow fever virus incubates in the body for 3 to 6 days. Many people do not experience symptoms, but when these do occur, the most common are fever, muscle pain with prominent backache, headache, loss of appetite, and nausea or vomiting. In most cases, symptoms disappear after 3 to 4 days.
A small percentage of patients, however, enter a second, more toxic phase within 24 hours of recovering from initial symptoms. High fever returns and several body systems are affected, usually the liver and the kidneys. In this phase people are likely to develop jaundice (yellowing of the skin and eyes, hence the name ‘yellow fever’), dark urine and abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Half of the patients who enter the toxic phase die within 7 – 10 days.
Yellow fever is difficult to diagnose, especially during the early stages. More severe disease can be confused with severe malaria, leptospirosis, viral hepatitis (especially fulminant forms), other haemorrhagic fevers, infection with other flaviviruses (e.g. dengue haemorrhagic fever), and poisoning. It is imperative to visit Travel doc – Travel Clinic should you experience any of these symptoms when returning from a yellow fever area.
Updated 26 June 2017
With thanks to The South African National Travel Health Network
The death toll continues to rise in Yemen, where a cholera outbreak has been spreading for months, according to the WHO. There have been 275 987 suspected cholera cases and 1634 deaths from the illness between 27 Apr and 5 Jul 2017, the WHO said in a statement on Wed 5 Jul 2017.
“If you get caught early in the morning with this and you don’t get treated by the end of the day, then you really have a problem,” WHO spokesman Christian Lindmeier said. “A weak elderly person could really be dead by the end of the day.” The WHO said in a statement last week, “we are now facing the worst cholera outbreak in the world.”
The following countries have areas with cholera. However, it’s important to remember that most cholera is spread in limited outbreaks, and travelers are rarely at risk.
Cholera is caused by ingestion of _Vibrio cholera_ bacteria, which are spread through water or food that is contaminated with faeces. Up to 80 percent of people with cholera don’t have symptoms, but they are still capable of spreading it. Those who do show symptoms have a sudden onset of watery diarrhoea, which can lead to death by severe dehydration. About 14.5 million people in Yemen don’t have access to clean water and sanitation, according to the WHO. All but 2 of the nation’s governorates have been hit by the outbreak.
The WHO has partnered with the United Nations Children’s Fund and local health authorities to deliver medication and aid to combat the ongoing outbreak, including the establishment of 45 diarrhoea treatment centers and 236 oral rehydration therapy corners. Lindmeier said it is essential for people who are infected to rehydrate immediately. “The biggest challenge is reaching people,” he said. “This is great. This is a major effort and a huge logistical effort, but people need to know that they can get there. People need to know that they can find these places.”
Efforts have been complicated by Yemen’s civil war, which has left more than 18.8 million people in need of humanitarian assistance, according to the WHO. Many of the country’s trained medical personnel have fled or been killed as the conflict intensified over the past 2 years, said Juliette Touma, UNICEF’s regional chief of communications for the Middle East and North Africa.
Touma travelled to Yemen in early June 2017 to see what work was being done and said she was impressed by the dedication of health workers however, she couldn’t help but think about all the people who still needed relief. “What I kept thinking about was all of these children who couldn’t actually make it to medical care because they live in the remote parts of Yemen and the rural areas where there are no facilities, or those who couldn’t afford to pay,” Touma said.
Since the outbreak began, campaigns and community volunteers across the country have been trying to spread the message of how to prevent cholera, she said, including how to clean water, to wash food before eating it and to take general hygienic measures. But Touma said there is a lot more to be done. “As long as we have more reports and suspected cases of cholera, and as long as the number of suspected cases increases — and it has been increasing by the day — we can’t unfortunately say there has been progress,” Touma said. “There is a cure for cholera, we can cure it, and that is very much dependent on getting in essential supplies, but we need to get more. We need to get more dedicated personnel.”
The Advisory Committee on Immunization Practices (ACIP) recommends CVD 103-HgR vaccine for adult travelers (age 18–64 years) to an area of active cholera transmission. An area of active cholera transmission is defined as a province, state, or other administrative subdivision within a country with endemic or epidemic cholera caused by toxigenic V. cholerae O1 and includes areas with cholera activity within the last year that are prone to recurrence of cholera epidemics; it does not include areas where rare sporadic cases have been reported.
The risk for cholera is very low for people visiting areas with epidemic cholera when simple precautions are observed.
All people (visitors or residents) in areas where cholera is occurring or has occurred should observe the following recommendations:
Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to be mixed with water and drunk in large amounts. This solution is used throughout the world to treat diarrhea. Severe cases also require intravenous fluid replacement. With prompt rehydration, fewer than 1% of cholera patients die.
Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as receiving rehydration. Persons who develop severe diarrhea and vomiting in countries where cholera occurs should seek medical attention promptly.
Oral rehydration solution (ORS) is available in health centres, pharmacies, markets and shops.
If ORS is unavailable give the child a drink made with 6 level teaspoons of sugar and 1/2 level teaspoon of salt dissolved in 1 litre of clean water.
Be very careful to mix the correct amounts. Too much sugar can make the diarrhoea worse. Too much salt can be extremely harmful to the child.
Making the mixture a little too diluted (with more than 1 litre of clean water) is not harmful.
Encourage the child to drink as much as possible.
A child under the age of 2 years needs at least 1/4 to 1/2 of a large (250-millilitre) cup of the ORS drink after each watery stool.
A child aged 2 years or older needs at least 1/2 to 1 whole large (250-millilitre) cup of the ORS drink after each watery stool.
Communicated by: ProMED-mail