Options
Yellow Fever vaccine
Hi, My wife Gail and I will be on the September 28, 2014 trip. Can't wait. Want to know if Yellow Fever Vaccine is advised for this trip. The problem is we are both over 65 and we were told not to have vaccine if over 60. However I beleive vaccine is advised if going to South Africa from Zambia. Also instead of vaccine one could have a doctor's waiver but not sure if South Africa accepts the doctor's waiver. Please advise. 2thdoc
0
Comments
We checked with the CDC first and then ran their suggested inoculation list past our Primary Care Physician. She said all were in order so we took the entire series including Yellow Fever and even a Polio booster. The only shot we passed on was rabies but we were also very careful not to pet the Maasai village guard dogs. They bite and they do carry rabies. In fact, the rabies contracted from domesticated dogs is a primary reason for the decline of the African wild dog.
One more quick note about medication. There are different anti-malaria formulations used for different parts of Africa. You might ask your doctor to check with the CDC for a recommendation on your destination. Take the discussion one step further and ask about dosage. Even though I weigh 240 and my wife 115, we were both given the same anti-malarial dosage. Once we were in the African bush, Beth became dizzy and disoriented. There was no one to ask for advice. I decided to cut her malaria pill in half and the symptoms disappeared. We were lucky. On subsequent safaris, we asked about dosage before we left.
We love Africa and know you will too....Leo M
Thank you for all the information on medications. I will definitely ask the doctor. I am planing the Botswava, Zambia and South Africa Safari on September 18, 2014. I am so excited. Did you visit Kalahara on your trip to see the Meerkets?
It seems there is no reason not to take as a prophylaxis; a lot of reasons to take it...one of them being a very high death rate (~20%) for those who visit a high risk area. According to the information, only one of the countries you are going to (Zambia is on the "recommended list") have the vaccination on their "required" or "recommended" list. However, any interest that Botswana and South Africa have in tourists getting the vaccination is to help prevent bringing it in from one of the countries on those lists. It seems your immunization falls into a gray area.
I am leaving in about a month for Tanzania ("recommended") and Kenya ("required") and both my PCP and travel doctor said I need the Yellow Fever vaccination. There are some contraindications for the vaccination such as: allergies to chicken products, eggs, and gelatin, among other reasons. There are ways to get the shot even with those issues and your travel physician can explain them to you. There are other issues for specific categories of people to either alter how they get the medication or to not take it at all.
Here is some information I found about people who contracted Yellow Fever:
"From 1970 through 2011, a total of 9 cases of yellow fever were reported in unvaccinated travelers from the United States and Europe who traveled to West Africa (5 cases) or South America (4 cases). Eight (89%) of these 9 travelers died. There has been only 1 documented case of yellow fever in a vaccinated traveler. This nonfatal case occurred in a traveler from Spain who visited several West African countries in 1988.
The risk of acquiring yellow fever is difficult to predict because of variations in ecologic determinants of virus transmission. For a 2-week stay, the risks for illness and death due to yellow fever for an unvaccinated traveler visiting an endemic area in:
West Africa are 50 per 100,000 and 10 per 100,000, respectively
South America are 5 per 100,000 and 1 per 100,000, respectively."
So, make your choice. For my trip I was given Yellow Fever, Hepatitis A, and Mefloquine (Lariam) 250 mg tablets in addition to my annual flu shot and a tetanus booster. Again, Yellow Fever Vaccination is required for Kenya. The Mefloquine is a seven pill Rx taken once a week, I am not sure if that regimen is universal or varies for specific demographics or length of visits. It is starts one week before you arrive in-country and continues for seven weeks. There are a variety of anti-malarial medications and your physician can give you more information on them. Should you contract malaria, although extremely uncomfortable (temps of 104 or more), it is treatable for the most part. I can tell you from experience (and I contracted it even though I took medication) that it is not something I wish to deal with again.
Treatment and prognosis are sketchy for Yellow Fever and it seems that symptom relief is the focus of that treatment. The death rate seems high (re-read above). It isn't worth the chance to me, but given where you are going it may be to you. We seem to have become pretty comfortable ignoring communicable diseases in the United States (i.e. the current mumps and chicken pox epidemics).
That's what I have for you...take it for what it is worth and have a wonderful and safe trip. I'm sure you'll love it.
I'm with Nick and Leo, you should check the CDC website for that "waiver." I didn't see that discussed there but it may have something to do with the countries you are headed to.