South Africa >> General - Fast facts - Practical Information - Health - Safety - South Africa IQ

 

Before you are going to South Africa it is important to know something about the things you can be facing with in the area of health. Below there is some information about the condition of the water, the infectious diseases that occur in South Africa, travellers diarrhoea and a medical checklist. 

 

Water

In South Africa high-quality water is widely available and, in general, drinking from taps is fine, except in rural areas. When you are in Lesotho and Swaziland, stick to bottled water and only drink stream water after purifying it. Dirty water should first be strained through a filter bag and then boiled or treated. 

Infectious diseases:

Cholera

Cholera is caused by bacteria, and spread via contaminated drinking water. In South Africa, the risk to travellers is very low. You’re only likely to encounter cholera in eastern rural areas, where you should avoid tap water and unpeeled or uncooked fruits and vegetables. The main symptom is profuse watery diarrhoea, which causes debilitation if fluids are not replaced quickly.

 

Dengue Fever

This disease is present in south-eastern coastal areas of South Africa, in Lesotho and Swaziland. Dengue fever, spread through the bite of mosquitos, causes a feverish illness with headache ad muscle pains similar to those experienced with a bad, prolonged attack of influenza. There might be a rash. Mosquito bites should be avoided whenever possible. Self-treatment: paracetamol and rest.

 

Filariasis

Filariasis is caused by tiny worms migrating in the lymphatic system. It is spread by a bite from an infected mosquito. Symptoms include localised itching and swelling of the legs and/or genitalia. Treatment is available. 

 

Hepatitis A

Hepatitis A is spread through contaminated food and water. It causes jaundice and, although it is rarely fatal, it can cause prolonged lethargy and delayed recovery. The first symptoms include dark urine and a yellow colour to the whites of the eyes. Sometimes a fever and abdominal pain might be present. If you’ve had hepatitis A, you shouldn’t drink alcohol for up to six months afterwards, but once you’ve recovered, there won’t be any long term problems. The hepatitis A vaccine is given as an injection, for more information about the vaccination look at www.ggd.nl.  

 

Hepatitis B

Hepatitis B is spread through infected blood, contaminated needles and sexual intercourse. It affects the liver, causing jaundice and occasionally liver failure. Most people might be chronic carriers of the virus, which could lead eventually to cirrhosis or liver cancer. Those visiting high-risk areas for long periods or those with increased social or occupational risk should be immunised. The hepatitis B vaccination is given singly or can be given ate the same time as hepatitis A, for more information about the vaccination look at www.ggd.nl.

 

HIV

HIV is the virus that causes AIDS. The virus is spread through infected blood and blood products, by sexual intercourse with an infected partner, and from an infected mother to her baby during childbirth and breastfeeding. It can be spread through ‘blood to blood’ contacts, such as with contaminated instruments during medical procedures, and through sharing used intravenous needles. At present there is no cure. There is medication available that might keep the disease under control. If you think you might have been infected with HIV, a blood test is necessary; a three-month gap after exposure and before testing is required to allow antibodies to appear in the blood.

 

Malaria

Malaria is mainly confined to the eastern half of South Africa and to Swaziland. The disease is caused by a parasite in the bloodstream spread via the bite of a female Anopheles mosquito. There are several types of malaria; falciparum malaria is the most dangerous type and the predominant form in South Africa. Infection rates vary with season and climate.

The early stages of malaria include headaches, fevers, generalised aches and pains, and malaise (which could be mistaken for flu). Other symptoms can include abdominal pain, diarrhoea and a cough. Anyone who develops a fever in a malarial area should assume malarial infection until a blood test proves negative, even if you have been taking antimalarial medication. If not treated, the next stage could develop within 24 hours: jaundice, then reduced consciousness and coma followed by death, so treatment in a hospital is essential.

Many travellers think that malaria is a mild illness and that taking antimalarial drugs causes more illness through side effects than actually getting malaria. This is unfortunately not true. If you decide against antimalarial drugs, you must understand the risks and be obsessive about avoiding mosquito bites. Take precautions like a good insect repellent (particularly in the evening), long-sleeved shirts and nets. And report any fever or flulike symptoms to a doctor as soon as possible.

 

Rabies

Rabies is spread by receiving bites or licks from an infected animal on broken skin, with the risks highest in rural areas. It is always fatal once the clinical symptoms start (which mite be up to several months after an infected bite), so postbite vaccination should be given as soon as possible. Postbite vaccination (whether or not you’ve been vaccinated before the bite) prevents the virus from spreading to the central nervous system. Those travelling to remote areas should be vaccinated where a reliable source of postbite vaccine is not available within 24 hours.

 

Schistosomiasis (Bilharzia)

This disease is a risk in eastern parts of South Africa and in Swaziland. It’s spread by minute worms (flukes) that are carried by a species of freshwater snail, which then sheds them into slow moving or still water. During swimming the parasites penetrate human skin and then migrate to the bladder or bowel. To prevent getting bilharzias swimming in suspect freshwater lakes or slow-running rivers should be avoided. Symptoms range from none, to transient fever and rash, and advanced cases might have blood in the stool or in the urine. A blood test can detect antibodies if you might have been exposed, and treatment is readily available. If not treated, the infection can cause kidney failure or permanent bowel damage.

 

Tuberculosis

Tuberculosis (TB) is spread through close respiratory contact and occasionally through infected milk or milk products. BCG vaccination is recommended if you’ll be mixing closely with the local population, especially on long-term stays, although it gives only moderate protection. TB can be asymptomatic, only being picked up on a routine chest X-ray. Alternatively, it can cause a cough, weight loss or fever, sometimes months or even years after exposure.

 

Typhoid

This is spread through food or water contaminated by infected human feaces. The first symptom is usually a fever or a pink rash on the abdomen. Sometimes blood poisoning can occur. A typhoid vaccine will give protection for three years. Antibiotics are usually given as treatment, and death is rare unless blood poisoning occurs.

Travellers’ diarrhoea
This is a common travel-related illness, sometimes simply due to dietary changes. To avoid diarrhoea, only eat fresh fruits or vegetables that have been cooked or peeled, and be wary of dairy products that might contain unpasteurised milk. Although freshly cooked food can often be a safe option, plates or serving utensils might be dirty, so be selective when eating food from street vendors.

If you develop diarrhoea, be sure to drink plenty of fluids, preferably an oral rehydration solution containing lots of water and some salt and sugar. A few loose stools don’t require treatment but, if you start having more than four or five stools a day, you should start taking an antibiotic. If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking chills or severe abdominal pain, you should seek medical attention.

 

Medical checklist

When visiting South Africa it’s a good idea to carry a medical and first-aid kit with you. Following is a list of items to consider packing:

• Antibiotics (prescription only), eg ciprofloxacin (Ciproxin) or norfloxacin (Utinor)
• Antidiarrhoeal drugs
• Paracetamol or aspirin
• Anti-inflammatory drugs (eg ibuprofen)
• Antihistamines (for hay fever and allergic reactions)
• Antibacterial ointment for cuts and abrasions (prescription only)
• Anitmalaria pills
• Bandages, gauze
• Scissors, safety pins, tweezers, pocket knife
• DEET-containing insect repellent for the skin
• Permethrin-containing insect spray for clothing, tents and bed nets
• Sun block
• Oral rehydration salts
• Iodine Tablets (for water purification)
• Sterile needles, syringes and fluids (if travelling to remote areas)

<sup>Based on:
- Lonely Planet: South Africa, Lesotho & Swaziland (2006)
- Footprint: South Africa (2006)</sup>