Health and Vaccinations

East Africa is a safe and healthy destination for well-prepared travellers. The health considerations are manageable and well-understood. The key is to see a qualified travel medicine specialist or travel clinic 6 to 8 weeks before departure, not 48 hours before. Many vaccinations require time to take effect, and some malaria prophylactics need to be started in advance.

None of the health considerations in this guide should deter you from travelling to East Africa. Millions of people visit every year without health incidents. Preparation is the differentiator.

The following vaccinations are recommended for most travellers to East Africa. Your travel clinic will advise based on your personal health history and destination-specific risk.

Required

• —Yellow Fever: Legally required for entry into Uganda and strongly recommended for all East Africa travel. A live vaccine given as a single dose, valid for life. You receive an International Certificate of Vaccination (yellow card) upon vaccination. Must be given at least 10 days before arrival.

Strongly Recommended

• —Hepatitis A: Transmitted through contaminated food and water. High recommendation for all travellers.
• —Typhoid: Transmitted through contaminated food and water. Recommended for all travellers, particularly those visiting rural areas or eating at local restaurants.
• —Hepatitis B: Transmitted through blood and sexual contact. Recommended if not previously vaccinated.

Consider Based on Your Itinerary

• —Rabies: Recommended for those spending extended time in rural areas, working with animals or likely to be away from prompt medical care. The pre-exposure vaccine does not eliminate the need for post-exposure treatment, but it does extend the window before treatment is critical.
• —Meningococcal meningitis: Higher risk in parts of the meningitis belt. Discuss with your travel clinic.
• —Cholera: Low risk for most tourists but discuss with your travel clinic if visiting during outbreaks or staying in very basic conditions.

Routine Vaccinations

Ensure you are up to date on routine vaccinations including measles-mumps-rubella (MMR), tetanus-diphtheria-pertussis, varicella (chickenpox) and influenza.

Malaria is present across most of East Africa and is the most significant health risk for travellers. However, it is very effectively prevented with the right combination of prophylactic medication and bite prevention.

Prophylactic Medications

There are three main prophylactic options. Your travel medicine doctor will recommend the most appropriate one based on your destination, medical history and tolerance.

Bite Prevention

Malaria prevention requires both medication and bite prevention. Mosquitoes that carry malaria (Anopheles) bite primarily between dusk and dawn.

• —Apply DEET-based repellent (minimum 30%, ideally 50% or higher) to all exposed skin at dusk and after
• —Wear long-sleeved clothing and long trousers in the evenings
• —Sleep under insecticide-treated mosquito nets (provided by all reputable lodges)
• —Use permethrin-treated clothing for additional protection

Several key safari destinations in East Africa are at significant altitude. Bwindi Impenetrable Forest sits at 1,600 to 2,400 metres above sea level. Rwanda's Volcanoes National Park, where gorilla trekking takes place, is at 2,400 to 3,000 metres. Kilimanjaro climbers reach 5,895 metres.

At Bwindi and Volcanoes NP altitudes, altitude sickness is uncommon but possible, particularly in those who arrive directly from sea level and trek immediately. Headaches and mild breathlessness are the most common symptoms and usually resolve quickly. Stay well hydrated, do not rush the trek and inform your guide if you feel unwell.

All reputable safari lodges provide filtered, safe drinking water. Bottled water is widely available. We recommend the following precautions:

• —Drink only bottled or filtered water and avoid ice in drinks unless you are confident of the source
• —Eat at reputable establishments, lodge restaurants are universally safe
• —Wash hands regularly, especially before meals
• —Peel fruit yourself where possible and avoid uncooked vegetables in basic restaurants
• —Carry oral rehydration sachets in your medical kit for any stomach upset

• —Prescribed malaria prophylactics
• —DEET insect repellent (50%+)
• —Oral rehydration sachets
• —Anti-diarrhoeal medication (loperamide)
• —Pain and fever relief (paracetamol / ibuprofen)
• —Antihistamine tablets
• —Antiseptic wipes and cream
• —Adhesive plasters and blister plasters
• —Tweezers (for thorns and splinters on gorilla treks)
• —Any prescription medications you take regularly, plus extra supply

Kampala, Nairobi, Kigali and Dar es Salaam all have good private hospitals capable of handling most medical emergencies. International insurance networks operate in all four capitals. In rural safari areas, facilities are limited and medical evacuation to the nearest capital is standard procedure for serious incidents. This is why comprehensive travel insurance including emergency medical evacuation cover is essential.