Hi,

I've gotten to the point of talking an African trip over with my spouse. She has brought up the issue of diseases, parisitic problems, etc. I would like to hear: 1) personal experiences [trips with out catching anything is good news; catching something and getting it fixed is also good news; but anything that you've experienced]; 2) ways to avoid problems; 3) references (websites or other sources of info); 4) recommendations from PH's.

I greately appreciate this!


Dan

I am no expert, so here is my layman's approach:

1. I went to the local county health department TRAVEL CLINIC and purchased every shot that they offer, except rabies. Now I am having second thoughts and will go back for the rabies shot. I reall the list being MMR (measles mumps rubella), DPT (diptheria polio tetanus), typhoid, flu, pneumonia, Japanese encaphalitis, Hepatitis A, Hepatitis B, Lyme disease and others. Some, like Hep are a series.

2. For malaria prophylaxis I prefer doxycycline because it gives me the added benefit of having a broad spectrum antibiotic floating through my system during the entire trip just in case of a cut, tick bite, leopard scratch, car accident, etc.

3. Don't pet the dogs.

Dan

I personally believe that SOMe of us get a little paranoid when travelling to Africa nowadays ... having said that a lot really depends UPON where you go specifically and the Outfitter whom you book with

Essentially in the broad spectrum Southern Africa region being ... SA Bots Zim's Namibia Zambia Mozambique & Tanzania the MAIN things needed are

1) Anti Malaria - I also like and swear by Doxy

2) Tetanus - cuts and scratches can get infected

Generally speaking the water in most areas is either from borehole or (reasonably clean) so unless you are with an operator whom does not have good facilities you will be OK

All the fancy fandangled hep's typhoid and yellow fever worries IMHO are (blown out of proportion) in a lot of cases,

BUT you are master of your own destiny so I only give what I personally feel is good advice ...

If you take all the general reconised NO MEDICIANAL precuations you will most offen be OK

Some hunters might take a (small compact water purefying unit) with them which can be quite good if you are very worried

To keep up with worldwide outbreaks CDC & BA Travel Clinic are quite extensive websites

www.cdc.gov/travel/Safrica.htm

www.travelclinic.co.za

Peter

I've not used up all the fingers on my hands on trips to Africa yet... but will have by March of next year!

I don't think that disease is a great danger, but a very valid concern. I have done exactly as the prior posters, except that I take Larium with only mildly exotic dreams... I'll take my second pill tomorrow morning after my return, so I'll probably dream pretty vividly tomorrow night (no nightmares, just funky dreams)... and the Larium and lots of gin and tonics seem to work.

I get my doc to give me some Ambien for the airplane and give me some super antibiotic, but never have had to take it.

I do seem to get a pretty bad cold from flying a zillion hours with 300 some odd folks on the plane (combined with being worn out), always on the trip back, though.

I got a little crabapple two step this trip, but my P.H. had some "cholic" medicine in the safari car and one shot of that stuff got rid of the cramps immediately. Whatever it was tasted so bad, I was just glad to survive the stuff and completely forgot about intestinal problems.

I think it would be a great service to us all if a doctor would give us some suggestions of a little "med pac" to take with us... we could consult with our local physician, of course... and get him or her to prescribe the prescription stuff.

In other words, you can't be too prepared, and what space will a couple of bottles of pills take up?

Trust me on this suggestion. You'll often walk long distances and get sweaty. Then you'll partially dry out when in the safari car, then hot and sweaty again. Cortaid oil (it last longer than cream) is great to avoid chapped thighs. Baby wipes really help avoid a chapped nether part when you have to use the bush toilet. Just put a few into a sandwich baggy and tote them in your pocket. You'll not be sorry.

I did have a really interesting experience this trip. I got a pretty bad thorn in my trigger finger one morning and was picking at the thing with my knife. A Masai watched, somewhat bemused for a while, then in sign language told me to stop. He wandered off in the bush and came back with two plants. He produced a needle-like thorn from one and quite painlessly extracted the splinter and then crushed the second plant and dripped some juice on the small wound. It healed quite quickly. Pretty cool, huh?

And for goodness sake, get medevac insurance that covers you from the camp to home. It's cheap.
Any suggestions, you Safari doctors?

quote:

Originally posted by 500grains:
I am no expert, so here is my layman's approach:

1. I went to the local county health department TRAVEL CLINIC and purchased every shot that they offer, except rabies. Now I am having second thoughts and will go back for the rabies shot. I reall the list being MMR, DPT, Japanese encaphalitis, Hepatitis A, Hepatitis B, Lyme disease and others. Some, like Hep are a series.

2. For malaria prophylaxis I prefer doxycycline because it gives me the added benefit of having a broad spectrum antibiotic floating through my system during the entire trip just in case of a cut, tick bite, leopard scratch, car accident, etc.

3. Don't pet the dogs.

Yup and don't forget to get a tetanus shot..

I agree....go to a travel clinic. Most health insurance policies cover immunizations and many of these you should do whether or not you travel to Africa or other places.

I'd caution however that Hep A and B is a series of shots....three and two and if you do these over six months...and I think it takes that long you can get a damn sore arm.

I heartily recommend that all the immunizations one get in preparation for travel start a minimum of one year in advance of the trip. Or in other words....don't stuff ten pounds of immunization in a five pound time period.

Your doctor will give (if asked politely) a prescription for an antibiotic to take along just in case you get ill while there. It makes good sense. You will probably not need it but it's the old addage better safe than sorry.

Balla Balla is dead on....we way over do it....but I'd do it again...just over 12 months and not six.

I have Hep A & B already. Cannot say about DPT, MMR. My wife has had both, not to mention TB. My tetanus is up to date within the last year or so.

This is all very helpful -- particularly on preparations!

Thanks!

Dan

My MD told me there was a possibility that the polio vaccine I was given (40+ years ago) might not have been good and it was suggested that I get another.

In several trips now, I've never had an issue with disease and it's not much of a concern for me. I'm much more concerned about an injury of some sort that could lead to complications.

As JudgeG said, medivac insurance is a smart idea. I've paid out-of-pocket for an air ambulance and insurance is MUCH cheaper.

Oh I forgot to mention, lots of dark frothy fluids

Peter

I agree with 500 Grains, get vacinated and use doxi, I never got sick and neither did my wife.

It is a good idea to get a prescription of cipro in case you do get sick as it will knock what ails you away quick.

The only problem I ever had was my wife and I got "TICK BITE FEVER" in Zim. Not that bad , we realy did not get sick untill we were on our way back and we were over it in a few days.

I don't think travel to Southern Africa is any more dangerous that traveling to Mexico or any place in the tropics. I took doxy as a malarial prophylactis when I hunted in Zambia, which helped produce a bad sunburn, but I've hunted in RSA 3 times with no precautionary shots, although I'm up on tetanus. I did get a bad head cold in Morrocco once, but I think I caught that on the plane.

DanEP, I've never been sick in any way in Africa! However, I reccomend the travel clinic, and Hep A&B, I use Larium, and have had no ill effects from it at all! There are a couple things I try to avoid. #1 Is, I will not drink from a comunal water bottle. HIV is rampant in all Southern Africa. The medavac insurance is a must, in case you get scratched,gored, or squished under a hunting car! Carry lots of sunscreen, and leave what is left for your PH. I take three times what I'll need, so that I can leave the rest with him. Some of these things are hard to come by in the bush. I'm prone to skin cancer, so use long sleave shirts, and pants, or shorts with zip off legs. At the risk of looking like a Stuart Granger wana-be, I have to use the classic wide brimmed hat, though I've used baseball caps for years, before I developed a skin cancer. If your not alergic, take a large bottle of asperine, and quality pair of sunshades, if you don't wear perscription glasses, and if you do, take an old pair as a back up! Blister patches for your feet may not be used, but if needed they will be worth about $1,000,000.00 in the bush if you get a blister on a foot! Finally, be prepared to give injections to the Buffalo with a ten pound seringe of the proper caliber, you know "500GRs of prevention" beats recuperation every time!

The killer diseas's in Zim according to Ministry of Health are
1) Hep B complications
2) TB
3) Menigacocal (sp) Menigitis
4) Malaria

The first three are all accociated with HIV/AIDS (nobody dies of AIDS in Zim - officially). However, they are not exclusively caught by people with compromised immune systems. Both my Cook and Senior Tecnian at Parks cuaght TB, and nearly died. Neighter was HIV possitive and made complete recoveries and are going strong 8 and 10 years down the line. I got a good wake up call when I put another officer, who was a friend from university days into my landrover and drove him from Hwange to Harare - He was delerious and diagnosed as having ceribral malaria at the Hwange hospital. Stuart wasn't getting better, so I loaded him up, Left the quinine drip plugged in and drove the 9 hrs to Harare. He died the next day of meningitis- very infectious and I wasn't vaccinated.

For simple peace of mind, I would get MMR and DPT (all the locals do except in the most remote areas - It is officially compusory and the vaccines are provided free) + Hep B , TB and Meningitis. I would take doxy as protection against both malaria and tick borne diseases.

That said, you are highly unlikely to be exposed to any of these diseases in the hunting camp or even in the cities. The only time you run any risk of exposure is if you are hunting in tribal concessions and stop to talk to the locals.

Don't pet the dogs, and don't pick up dead cats (lion, leopard serval, wild, feral) without gloves on.

Why are you taking Hep A and B? Are you planing on getting a blood transfusion while your there or does your camp provide how do you say, "Ladies of the Nile". I would think you should only need Hep-A, besides "Woman weaken legs, Rock"

Steve

My only trip was to Namibia last September which in the southern hemisphere is onset of spring. It was considered a malaria free area so I and my hunting partner did not take any meds for malaria at all. Did take meds for Hep-A, rabies and Yellow fever. And the sleep aid Ambien was a blessing in that cattle-car Airbus. We only drank bottled water or well water, and did not partake of raw fruits. All meats was fully cooked except for the raw kudu appetizer one night. Apparently it had no parasites as both of us came home with no sickness whatsoever.

Just follow the precautions of the doctor in the travel clinic for those areas of Africa you plan to visit.

Began Hep shots -- all that were available -- partly as prep to visit my inlaws in Asia. Only later did I realize I didn't likely need Hep B.

Dan

quote:

Originally posted by A-TEAM:
Why are you taking Hep A and B? Are you planing on getting a blood transfusion while your there or does your camp provide how do you say, "Ladies of the Nile". I would think you should only need Hep-A, besides "Woman weaken legs, Rock"

Steve

I don't think anyone plans on a blood transfusion, but should something sharp catch up with you it might be needed, and Hep-B shouldn't be something you have to worry about at that point.

Peter,

I agree that getting ever shot known to man is overkill. However, it costs very little compared to hospitalization. So why not? And all the needle pricks get me prepped for tse tse flies anyway.

Just go to cdc.gov. They're the experts. Get what you need. No more, no less.

Dave

Having had a bad case of malaria that I picked up in zim last year, I am very cautious in how I behave in a malaria area. Long pants and long sleeved shirts that are sprayed with Deep Woods Off in the evenings, use of a mosquito net that has also been sprayed with DWO. Follow your PH's warnings on drinking water etc. Take along some Imodium as you'll surely need it sometime.
All of the above suggestions are worth considering.

465H&H

First of all everything in our Tanzania camp is bottled water, even the ice is made with bottled water..Wash and shower water is boiled for days at a high rate in 5 to 10 55 gal drums and then a disinfectant is added to it....

Tanz. requires a Yellow Fever shot, one of the hep shots is a good one, the other only if you intend to cavort with the locals sexually..Lariam is the preferred Malaria drug, I also take Doxycycline, as a broad spectrum medicine (mostly for tic fever), I suggest Hydroco/APAps 50 mg. Acetaninophen w/hydrocodo for pain and Lonox and Cipro for food poisoning.
A dental kit for emergency tooth disorders..bug spray or cream, I like Skintastic for tetsi flys, it works for me better than deet, but repelent is a personal thing I think, none of it works on everybody so you have to find one that works for you...

Take a good supply of chewing gum, it keeps you from getting thirsty...Wear long sleeve Khaki colored upper clothing, not the popular dark green..and Levi type pants that a Tetsi can't bite through. Always take light weight unlined gators to keep the grass seeds out of your socks and skin, they are a festerous thing and love infection...Sun glasses and extra glasses are a good thing...Good idea to take two of most things and put them in your carry on and in your luggage in case of loss, especially needed prescription medicines...Tell the PH and booking agent all allergies and malodys you have, don't like surprises..tell him your food and drink preferences also.

That should cover it for now, you booking agent should send you a list of needs for your consideration...

Oh yes, as to the rest of your question, I have had two cases of tick fever and several bouts with Montezumas revenge in several countries, but the medicines above will knock both in a hurry...Tick fever is symtomatic of a flu like infection, so take the doxy for that...All that in about 25 years, so its not a problem as I see it...but one can contact about any sickness anywhere even here in the good old USA, the only place I have ever contacted Giordia was in Buhl, Idaho for petes sake.....

I deploy all over the world and provide medical care to the guys I bring with me.

Here is a good list.

Update all your shots are you might not make it through customs.
Meds
Mefloquine Malaria 1 per week
Cipro 500mg take 10 pills will handle most infections
Imodium 2mg take a box stops you up from peeing out your ass. Makes the long plane ride back much better.
Tylenol 500mg Fever.
Bacitracin Ointment 1 tube skin infections
You can also forget the ointment and take Doxycycline 100mg tabs one per day with the Mefloquine doxy can be used to treat tons of infections so it helps to have some on board.
Flagyl for parasites.

Is it over kill hell yes will a tiny bug ruin a few thousand dollar hunt hell yes.

I do over do it on my medical kit. I also get many things that are not commonly available to those not in the profession. The bad things that can happen could kill you. The rest of the stuff will be an inconvience. 10 lbs. of a medical kit can save a hunt and a life. We take Larium, mallarone, and carry enough doxicycline to treat our group if necessary. I include most things you can get OTC at wal mart; cortisone cream, neosporen, sun block, antifungal cream, cortisone cream. These things you may and should have at home. I also bring 2)Z-packs, 2) rounds of cipro and flagyl,and the doxicycline for two. I bring scopalamine patches, Imodium, benedryl, Aleve, tylenol, and ASA. No pharmacies in the bush. Most PH.s keep some remadies they find useful. I also keep some injectables for diarrhea, nausea, inflamation,non-steroidals,and IV antibiotics. At the end of the trip I leave the Iv's and the injectables with the local doctor or the PH. The kit I left in Namibia saved a doctors life three years ago when he was bitten by a cobra. They started an IV and gave some atropine that kept him going until while they took him to get further treatment. OVERKILL????? of course, but I also take 15lbs of candy and crayons for the kids as well as a huge bag of pens that the various detail people give out. It is a token of friendship rather than a snub! Your health is your responsibility. Take it serriously.

May I add...

My one and only trip to RSA for hunting earlier this year...I felt a sharp pain on my left hand, under my glove...thought nothing of it...two days later, hunt called off and the drive into Jo-Burg to a clinic, where I had 3 days of infra-red (?) teatment and various medications for my poisiones spider bite. My hand swelled up major nasty, flat where the bite was, then really gross around it for about a six inch circle. At the clinic they happened to have posters with photos of bites, I just got nicked, but it definitely was venomous and did some damage....

Some things one cannot control, but the spider was probably in my glove when I put it on, or dropped on me then sought refuge in the glove...

Some of those vaccinations are recommended for all adults, and I'd bet a lot of us don't keep up with them like we should. Also the CDC recommendations lump all of "Southern Africa" together. My PH recommended against malaria prophlaxis in Namibia unless going into the northern portion or Caprivi.

I needed a dT, and MMR anyway, got the hepA (already had hepB as a medical professional), and typhoid.

Was given bactrim in case travelers diarrhea came up (but I think flagyl would be better). Took Larium for malaria prophlaxis, but the idea of doxycyline because of it's broader coverage of other diseases makes a lot of sense.

Almost all the other meds I took with me were OTC's. Benadryl, immodium, sudafed, neosporin ointment.

A couple of other things I took: hand sanitizer in my pocket, and melatonin. Used the hand sanitizer each time we got in the truck to keep the scratches from getting infected. Melatonin helped me sleep on the plane.

Another good site to visit is: http://www.mdtravelhealth.com

John

Can anybody tell me if Doxy or Cipro would be good for treating a tooth abcess?

With regards the rest, i really think it depends on where in Africa your going..RSA probably needs the minimum precautions where as the further into Central and East Africa the list grows..

Regards,

Peter

quote:

Originally posted by Pete E:
Can anybody tell me if Doxy or Cipro would be good for treating a tooth abcess?
.......

Regards,

Peter

Actually, good ol penicillin is still pretty good for dental infections. Augmentin as well as clindamycin are my choices. Cipro and doxy will miss too much IMO.