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Malaria and other health information

Malaria: Please note, no malaria is transmitted at White Elephant.

While malaria is not transmitted in any of the host cities where matches will take place, visitors may travel to other areas within South Africa where there is a risk. Travellers visiting the north-eastern parts of South Africa, the Kruger National Park and surrounds, and the far northern parts of Kwazulu-Natal Province should take precautions to prevent malaria. Such precautions include personal protection against mosquito bites (which is the mainstay of prevention), as well as appropriate chemoprophylaxis (mefloquine, atovaquone + proguanil (Malanil®) or doxycycline). Chloroquine resistance is prevalent in all malaria areas in sub-Saharan Africa and with Plasmodium falciparum being the predominant species, artemisinin combination therapy (notably artemether + lumefantrine (Coartem®)) is effective treatment for uncomplicated disease. Persons who plan on visiting a malaria area must be advised to seek healthcare immediately should they develop flu-like symptoms, even if they are taking chemoprphylaxis.

African tick bite fever is common, occurs throughout the year and poses a risk for any persons going on hikes in the bush. Tick bites may be prevented by wearing long pants, application of DEET-containing insect repellents to exposed areas, and checking for ticks after walks and carefully removing them if found. While most disease is mild, complications do occur – especially with delayed treatment. Tick bite fever should be included in the differential diagnosis of persons with febrile illness with compatible exposure history. The finding of a classical eschar and, if present, a maculopapular rash, must prompt early empiric treatment with doxycycline. Chemoprophylaxis is not effective.

The risks of African haemorrhagic fever viruses would be expected to be low given the unlikely exposure risk. There have been no human cases of Rift Valley Fever since June 2011, and no cases of Crimean-Congo haemorrhagic fever this year to date.

Rabies is endemic in South Africa, with most human cases related to dog exposure. Risks would be considered low. However, it is always prudent to emphasise animal avoidance practice. Post-exposure prophylaxis with cell-derived vaccine and human rabies immunoglobulin is widely available in the event of exposure. 

Bilharzia (schistosomiasis) is endemic in the north and east part of South Africa, and may be present elsewhere. Avoid swimming and paddling in stationary water. Swimming pools which are well-chlorinated and maintained are safe. 

TB/STI/HIV: South Africa is classified by the WHO as a country wit high TB and high MDR-TB burdens. There is an increased risk of acquiring a sexually transmitted infection (STI) during mass gatherings – this bears particular revelance for visitors to South Africa given the high prevalence of HIV and other STI’s.

Visitors who travel from or through yellow fever endemic areas, even if in transit, must present proof of vaccination on entry to South Africa. Although there is no risk of yellow fever in South Africa, International Health Regulations requires travellers aged >9 months arriving from countries where yellow fever is a risk to show proof of yellow fever vaccination, or a waiver certificate. A yellow fever inoculation certificate only becomes valid 10 days after inoculation – after which it remains valid for 10 years.

Hepatitis A is transmitted through contaminated food and water. The risk of infection varies within the country. Travellers should practice strict food, water and personal hygiene precautions. Hepatitis A vaccine may be considered for travellers over one year age. It should be given at least two weeks (preferably four weeks or more) prior to departure.

Hepatitis B is transmitted via infected blood or bodily fluids. Travellers may be exposed when receiving medical or dental treatment, via direct contact between open skin lesions, or if participating in risk behaviour such as needle sharing, unprotected sex or contact sports. Hepatitis B vaccine is recommended for all travellers if not previously vaccinated, especially those who might be exposed to blood or body fluids, or have sexual contact with local population. 

Sporadic cases of meningococcal disease are reported, with a seasonal increase typically during the period May to October. Routine vaccination for travellers is not recommended.

Behaviour modification plays an important role in limiting exposure to many potential pathogens. Hand hygiene and cough etiquette must be encouraged; avoiding close contact with people who have respiratory illnesses is also advised. Practising safe sex is extremely important. Taking appropriate precautions when travelling to malaria areas or the bush must be emphasised. We wish you a happy stay in South Africa, enjoy White Elephant!

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