South Africa
A high standard of care is available in the towns and cities
Supplies of international medications are generally available from both the hospitals and private pharmacies in South Africa
Blood supplies are considered safe and screened to international standards
Medical facilities are good in urban areas and in the vicinity of game parks and beaches, but may be limited elsewhere.
Recent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.
Take personal protective measures against insects. Swim only in well-maintained, chlorinated pools or ocean water known to be free from pollution; avoid freshwater lakes, streams and rivers. Drink only bottled beverages (including water) or beverages made with boiled water. Do not use ice cubes or eat raw seafood or rare meat. Eat well-cooked foods while they are still hot and fruits that can be peeled without contamination. Avoid roadside stands and street vendors. Only pasteurized dairy products should be consumed.
AIDS occurs. Blood supply may not be adequately screened and/or single-use, disposable needles and syringes may be unavailable. When possible, travelers should defer medical treatment until reaching a facility where safety can be assured. (A University of Natal survey indicates there has been a sharp increase in HIV/AIDS cases over the last 2 years in KwaZulu-Natal, the most populous province. Poverty and fighting that displaces people make this region particularly vulnerable to HIV infection. HIV-infected migrant workers who travel to other areas increase the risk of transmission.)
Some people are susceptible to allergies and respiratory problems associated with the dry, sometimes dusty climate of the uplands or the humid, changeable climate of the lowlands.
Snakes, including poisonous species are common in South Africa, especially in the bushveld. (The South African Institute for Medical Research is a major supplier of anti-venom for Southern Africa.)
Hepatitis A: Consider active immunization with hepatitis A vaccine or passive immunization with immune globulin (IG) for all susceptible travelers. Especially consider choosing active immunization for persons planning to reside for a long period or for persons who take frequent short-term trips to risk areas. The importance of protection against hepatitis A increases as length of stay increases. It is particularly important for persons who will be living in or visiting rural areas, eating or drinking in settings of poor or uncertain sanitation, or who will have close contact with local persons (especially young children) in settings with poor sanitary conditions.
Hepatitis B: Vaccination is advised for health care workers, persons anticipating direct contact with blood from or sexual contact with inhabitants, and persons planning extended stays of 6 months or greater (especially those who anticipate using local health care facilities, staying in rural areas, or having intimate contact with the local population).
Polio: A one-time booster dose is recommended for travelers who have previously completed a standard course of polio immunization. Refer to CDC guidelines for vaccinating unimmunized or incompletely immunized persons. Pregnancy is a relative contraindication to vaccination; however, if protection is needed, either IPV or OPV may be used, depending on preference and time available.
Rabies: Preexposure vaccination should be considered for persons staying longer than 30 days who are expected to be at risk to bites from domestic and/or wild animals (particularly dogs), or for persons engaged in high risk activities such as spelunking or animal handling. Need for vaccination is more important if potential exposure is in rural areas and if adequate postexposure care is not readily available.
Typhoid: Vaccination should be considered for persons staying longer than 3 weeks, adventurous eaters, and those who will venture off the usual tourist routes into small cities, villages and rural areas. Importance of vaccination increases as access to reasonable medical care becomes limited. Contraindications depend on vaccine type.
Note: All routine vaccines (such as DTP or Td, Hib, MMR, polio, varicella, influenza and pneumococcal) should be kept up-to-date as a matter of good health practice unrelated to travel.
General health standards are good in urban areas and epidemic or contagious diseases are rare among the European population.
Insect-borne illness: unlikely to be a major health problem for the traveler (with the exception of malaria as noted).
Crimean-Congo hemorrhagic fever - occurs
Plague - occurs
Relapsing fever - occurs
Rift Valley fever - occurs
Tick-bite fever - occurs
Typhus - occurs (mainly tick-borne)
Food-borne and water-borne illness: these diseases are common in some areas, particularly amoebiasis and the typhoid fevers.
Other hazards:
Diseases such as measles and diphtheria are commonly reported. Polio is still considered a possible risk, although no cases have been reported in recent years.
Influenza risk extends from May to October.
Yellow fever: A yellow fever vaccination certificate is required from travelers over 1 year of age coming from infected areas. A certificate is also required from travelers arriving from countries in the endemic zones.
