Kilimanjaro - Trekking to the Roof of Africa - Summer 2008

CDC RECOMMENDED VACCINATIONS
(http://www.cdc.gov/travel/eafrica.htm)
See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect.
(But if you want to come on this trip, we recommend to call your MD as soon as possible !)

HEPATITIS A or immune globulin (IG).
HEPATITIS B, if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay longer than 6 months, or be exposed through medical treatment.
MENINGOCOCCAL (MENINGITIS) VACCINE, if you plan to visit the western half of Ethiopia from December through June.
RABIES, if you might be exposed to wild or domestic animals through your work or recreation.
TYPHOID, particularly if you are visiting developing countries in this region.
YELLOW FEVER, if traveling to Burundi, Ethiopia, Kenya, Rwanda, or Tanzania.
As needed, booster doses for TETANUS-DIPTHERIA, MEASLES, and a one-time dose of POLIO vaccine for adults.

MALARIA
Malaria is a serious, but preventable infection that can be fatal. Your risk of malaria may be high in these countries, including cities. Prevent this deadly disease by seeing your health care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites .

Most travelers to East Africa, including infants, children, and former residents of East Africa, are at risk for malaria.

All travelers at risk for malaria should take one of the following drugs (listed alphabetically): atovaquone/proguanil, doxycycline, mefloquine, or primaquine (in special circumstances).

NOTE: Chloroquine is NOT an effective antimalarial drug in East Africa and should not be taken to prevent malaria in this region.

(http://www.cdc.gov/travel/regionalmalaria/eafrica.htm)

TO STAY HEALTHY:
Wash hands often with soap and water.
Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an “absolute 1-micron or less” filter AND adding iodine tablets to the filtered water. “Absolute 1-micron filter” are found in camping/outdoor supply stores.
Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
If you travel to an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
Protect Yourself from Mosquito Bites

Malaria is transmitted by the bite of an infected mosquito; these mosquitoes usually bite between dusk and dawn. If possible, remain indoors in a screened or air-conditioned area during the peak biting period. If out-of-doors, prevent mosquito bites by wearing long-sleeved shirts, long pants, and hats; apply insect repellent to exposed skin. Use insect repellents that contain DEET (diethylmethyltoluamide) for the best protection.

When using repellent with DEET, follow these precautions:
Read and follow the directions and precautions on the product label.
Use only when outdoors and wash skin with soap and water after coming indoors.
Do not breathe in, swallow, or get into the eyes. (DEET is toxic if swallowed.) If using a spray product, apply DEET to your face by spraying your hands and rubbing the product carefully over the face, avoiding eyes and mouth.
Do not put repellent on wounds or broken skin.
Higher concentrations of DEET may have a longer repellent effect; however, concentrations over 50% provide no added protection.
Timed-release DEET products may have a longer repellent effect than liquid products.
DEET may be used on adults, children, and infants older than 2 months of age. Protect infants by using a carrier draped with mosquito netting with an elastic edge for a tight fit.
Children under 10 years old should not apply insect repellent themselves. Do not apply to young children’s hands or around eyes and mouth.

If you are not staying in well-screened or air-conditioned rooms, you should take additional precautions, including sleeping under mosquito netting (bed nets). Bed nets sprayed with the insecticide permethrin are more effective; permethrin both repels and kills mosquitoes. In the United States, permethrin is available as a spray or liquid (e.g. Permanone) to treat clothes and bed nets. Bed nets may be purchased that have already been treated with permethrin. Permethrin or another insecticide, deltamethrin, may be purchased overseas to treat bed nets and clothes.
To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.

TO AVOID GETTING SICK:
Don’t eat food purchased from street vendors.
Don’t drink beverages with ice.
Don’t eat dairy products unless you know they have been pasteurized.
Don’t share needles with anyone.
Don’t handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague).
Don’t swim in fresh water, including Lake Malawi. Salt water is usually safer.

WHAT YOU NEED TO BRING WITH YOU
Long-sleeved shirt, long pants, and a hat to wear while outside whenever possible, to prevent illnesses carried by insects
Insect repellent containing DEET.
Bed nets impregnated with permethrin. (Can be purchased in camping or military supply stores. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.)
Flying-insect spray or mosquito coils to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
Over-the-counter antidiarrheal medicine to take if you have diarrhea.
Iodine tablets and water filters to purify water if bottled water is not available.
Sunblock, sunglasses, hat.
Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).

AFTER YOU RETURN HOME
If you have visited a malaria-risk area, continue taking your antimalarial drug for 4 weeks (mefloquine or doxycycline) or seven days (atovaquone/proguanil) after leaving the risk area.

Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to1 year), you should seek immediate medical attention and should tell your health care provider your travel history.

Other health topics
Altitude Sickness
On reaching heights above 3000m, heart pounding and shortness of breath are a normal response to the lack of oxygen in the air. However, for some visitors these symptoms can deteriorate into a conditions known as Soroche (or acute mountain sickness) when you can start to experience headaches, loss of appetite, extreme tiredness, sleeplessness and often nausea. Symptoms usually develop within the first day at altitude, but may be delayed by up to 2 weeks. To prevent Soroche, try to take things easy as soon as you arrive. Once settled in your hotel room have a lie down for a while and drink plenty of fluids. Don't plan any strenuous treks until you've acclimatized for a few days. Avoid alcohol, cigarettes and heavy food. Drinking mate de coca (an infusion of coca leaves - and perfectly legal in Peru ) may help.

Consider bringing DIAMOX for prophylaxis.

Traveler’s Diarrhea
Can be avoided by following the appropriate health precautions. Consider bringing ANTIBIOTICS (doxycycline, bactrim, or ciprofloxacin) and over the counter antidiarrheal medications (ie-Imodium) just in case

FOR MORE INFORMATION:
Ask your doctor or check the CDC web sites for more information about how to protect yourself against diseases that occur in East Africa: www.CDC.gov