A dog with rabies loses territorial instincts and may wander long distances and so shows up unexpectedly and is called “Stray”.
However, studies have shown there is no significant stray dog population in KZN. Therefore, almost all rabid dogs were owned but unvaccinated and so contracted the disease.
Dogs are transported by people all over the country, and with a longish incubation normally 2 weeks or longer, can appear anywhere at any time. Rabies has been found in Johannesburg having come from KZN before. This means that although we consider some areas more dangerous than others it could pitch up anywhere.
Therefore, a message of caution especially to children must be spread abroad to avoid contact with any unknown dog or animal that is acting strangely.
Rabies is the most fatal disease known to man, once the virus attaches to a nerve cell (which they like) it is 100% fatal with no treatment available once symptoms start.
It is however 100% preventable with the correct treatment is given when the bite happens (Therefore timing is everything).
The incubation period can be from 10 days to two years.
It is one of the most horrific ways to die. It can appear as demon possession and brings fear to the whole community. All victims will die in a few days following the start of symptoms, fully aware of what is happening.
A dog bite in KZN is seen as an emergency and an ambulance can be called if transport is problem.
Treatment consists of four injections on day 0;3;7;14 which MUST BE COMPLETED!!!!
If a bad bite, additional injections will be done into the wound.
Travel Doc offers a Rabies Vaccination. In South Africa this vaccination is recommended for people with potential for occupational exposure eg. veterinary staff, wild life handlers, lab personal working with rabies virus and animal welfare staff. The vaccination is also recommended for long term travelers to high risk areas in South Africa especially for young children living close to the local population and their dogs.
For overseas travel: rabies vaccinations is not advised for routine overseas travel however it should be considered for travelers visiting regions in the world where canine rabies regularly affects animals and where contact with animals is probable and immediate access to appropriate treatment is limited – such as travel in the backpacking or adventure category (adventure travel to Asia, Indian sub-continent, South America or trans-Africa overland trips).
Call Travel Doc 011 440 5325 or 011 440 5326 or 082 457 0176
or Contact Us for more info
Communicated By: Mr Kevin Le Roux (Provincial Government of Kwa-Zulu Natal)
SA National Parks’ annual National Parks week will start on September 17.
From September 17-22, entrance to national parks such as the Golden Gate Highlands National Park (GGHNP), Mapungubwe, Marakele and the Kruger National Park is free for South African residents. GGHNP, Marakele, and Mapungubwe will extend the free entrance until September 24.
South Africans only have to produce their green bar-coded ID book at the entrance.
“Our theme for this year is still ‘Know your national parks’ and we encourage one and all to visit these parks that are full of rich history and heritage,” Lombard Shirindzi, gm of the northern region parks, said in a statement. Lombard hopes that they will see an influx of people as September 24 is Heritage Day.
A detailed programme of activities that are lined up for the week will soon be posted on the SANParks website.
Communicated by: Daily Travel and Meetings Buyer
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
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
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. Illness ranges in severity from a self-limited febrile illness to severe liver disease with bleeding.
1) Use insect repellent.
2) Wear proper clothing to reduce mosquito bites.
3) Be aware of peak mosquito hours: peak biting times for many mosquito species is dusk to dawn. However, one of the mosquitoes that transmits yellow fever virus, feeds during the daytime.
4) Yellow fever vaccine is recommended for people aged ≥9 months who are traveling to or living in areas with risk for YFV transmission in South America and Africa. In addition, some countries require proof of yellow fever vaccination for entry.
Do you need a Yellow Fever vaccination? Call Travel Doc 011 440 5325 or 011 440 5326 or 0824570176
Info and pictures are taken from the Centres for Disease Control and Prevention Website