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
Southern Africa is currently experiencing the annual malaria season and as expected there has been an increase in transmission due to the rise in ambient temperature, rainfall and humidity as compared to the same period last year.
It is important for travellers visiting any of the malaria areas within Southern Africa and elsewhere to take appropriate precautions and maintain a high index of suspicion for symptoms of malaria on their return.
The areas of transmission of malaria in South Africa are the north -eastern parts of Limpopo (along the borders with Mozambique and Zimbabwe), the lowveld areas of Mpumalanga (including the Kruger National Park but excluding Mbombela and immediate surrounds) and the far northern parts of Kwa-Zulu Natal (see map). While the Kruger National Park does fall in the malaria risk area, the transmission risk would be considered low to moderate, depending on the specific camps visited for overnight stays. Personal protection against mosquito bites should be the focus of malaria prevention. The occurrence of an acute febrile/ flu-like illness in the month after return must prompt an urgent malaria blood test and follow up of results. According to the national guidelines, personal preventive measures against mosquito bites must always be applied, and chemoprophylaxis is recommended.
The Mopani district in Limpopo is an area of known high transmission and has recently experienced an upsurge of malaria cases but the number of cases is now decreasing as the temperatures come down. In Kwa-Zulu Natal, Richards Bay and St Lucia are not considered malaria transmissionareas. In Mpumalanga, the towns of White River, Nelspruit and Sabie are not considered malaria transmission areas.
With respect to the neighbouring countries, malaria is present in the following areas:
Mozambique and Zambia have high malaria transmission throughout the country. Mozambique would be especially considered a high transmission area for malaria at this time of the year. The majority of malaria cases treated in South Africa have a history of travel to Mozambique so preventative measures should include both prevention of mosquito bites and preventative medication.
Zimbabwe,including the Victoria Falls, is a high transmission area except for Bulawayo, Harare and Gweru and their immediate surrounds.
Malawi and the area around Lake Malawi are high transmission areas.
Botswana has transmission in the central and northwest districts including the Chobe National Park and the Okavango Delta but there is no malaria transmission in any of the major cities in Botswana.
In Namibia, malaria is present in the regions of Kavango (East and West), Kunene, Ohangwena, Omusati, Oshana, Oshikoto, Otjozondjupa, and Zambezi and there is no malaria transmission in Windhoek.
Malaria control in Swaziland has resulted in a major decrease in local cases and there are very limited foci of malaria transmission in the lowveld area in the east of the country bordering Mozambique.
Malaria is distinctly seasonal in Southern Africa and predominantly occurs during the rainy months between September and May, with January to April being periods of high transmission.
Unlike the mosquito responsible for transmitting Yellow Fever, the female Anopheles mosquitos that transmit malaria are only active and likely to bite between dusk and dawn and prevention of mosquito bites should be enforced during this period.
All travellers should be alert for flu-like symptoms and fever during and up to one month after their visit ends. These symptoms include:
Malaria is an emergency and treatment is required urgently. Anyone presenting with the above symptoms should visit their nearest doctor or health facility immediately for an urgent malaria test. A negative test should be treated with caution and tests should be repeated until positive or until symptoms resolve.
Malaria can be effectively treated with medication especially if it is diagnosed early.
Anti malaria medication is available directly through Travel Doc – Travel Clinic.
NB: Any person presenting with unexplained fever and progressive illness which may include jaundice (yellow discolouration of eyes) and/or a change in the level of consciousness should be investigated for malaria, even without a history of recent travel as there have been cases of odyssean (or taxi) malaria in South Africa.
Communicated by: National Institute for Communicable Diseases