(101 things to know when you go) ON SAFARI IN AFRICA. Patrick Brakspear
where you are going. Be sure to start taking your malarial prophylactics well before you leave home. A small percentage of people can have adverse reactions to certain brands – it is best to find out before you leave and not while on safari! And don’t forget that you need to continue to take the prescribed dosage for at least 4 weeks after returning home (check the instructions).
Just as important as preventative prophylactics is to take active measures to protect yourself from being bitten at all. This is definitely the most effective means of avoiding malaria – if they don’t bite you then you can’t get malaria! Generally mosquitoes start feeding at dusk – so, from just before dusk, clothing should be worn that covers the arms and legs. In addition, a mosquito repellent should be applied on exposed areas. It is a good practice to spray inside your tent before you zip up on the way to dinner – by the time you return the smell would have dissipated and all the mosquitoes that were lurking inside will be dead.
Pregnant women (and children) are especially vulnerable to malarial infection. In fact, pregnant women are twice as attractive to malaria-carrying mosquitoes as non-pregnant women. This is mostly due to a warmer skin surface and the fact that pregnant women exhale a greater volume of air. Be more cautious.
Malaria protection for younger children
Safer, more effective malaria protection for families travelling to Africa is now available.
Malarone is available in a children's formulation and is the first ever malaria tablet designed just for kids. The key benefits include:
Small, easy to swallow tablets that are film coated and therefore don't taste bitter.
Tablets can be crushed for small children.
Simple, once daily dosage starting just the day before travel.
Tablets can be discontinued just 7 days after leaving the malaria area.
98% efficacy against Plasmodium falciparum, the most serious form of malaria.
Extremely low risk of side effects.
Despite the growth of travel to Africa generally, many families have held back from going there on account of the fear of malaria and a reluctance to expose their children to possible side-effects of medication. The launch of a children’s formulation of Malarone has opened up new opportunities for families wishing to travel to Africa, enabling them to do so with much greater safety and peace of mind - great news for families. Speak to your doctor or pharmacist before you leave home.
Zika virus
The Zika virus, which came to prominence in an outbreak across South America in 2016, is transmitted by daytime-active Aedes mosquitoes (the risk of infection from other modes of transmission, beyond mosquito bites, remains unclear). Its name comes from the Zika Forest of Uganda, where the virus was first isolated in 1947, and is related to dengue, yellow fever, Japanese encephalitis, and West Nile viruses. The infection, known as Zika fever, often causes no symptoms or only mild symptoms (mild headaches, fever, malaise, conjunctivitis, and joint pains) and if detected, is treated by rest. However, there is the possibility, but currently no scientific evidence, that Zika fever in pregnant women may cause abnormal brain development in their foetuses by mother-to-child transmission, which may result in miscarriage or microcephaly (reduced head size).
Since its original discovery there have only been a handful of confirmed cases of Zika fever across Africa, and as such, the Zika virus is not considered a concern for visitors going on safari.
Bilharzia (schistosomiasis)
Bilharzia is common in the tropics where lakes, streams and dams (still water) harbour bilharzia-transmitting snails. Parasite larvae develop in snails from which they infect humans, their definitive host, in which they mature and reproduce. There is no prophylactic available against bilharzia but treatment is now readily available in pill or injection form (a drug called praziquantel). The condition can be unpleasant so it is better not to swim in rivers, streams or dams, particularly where the water is stagnant or used by local villagers as a laundry or bathing area.
African sleeping sickness (Nagana)
Sleeping sickness or African trypanosomiasis is a parasitic disease which affects people and domestic animals. The disease is transmitted by the tsetse fly which is endemic to many parts of Africa. Although a serious threat to local populations, the incidence amongst visitors is extremely low. Symptoms include severe headaches, irritability, extreme fatigue and malaise.
Tsetse flies are relatively resistant to standard insect repellents and can bite through light clothing. They are attracted to bright and also very dark colours and to clouds of dust such as that kicked up by a herd of buffalo – and moving vehicles! Their bite can cause severe discomfort (itching and swelling) and they are extremely difficult to kill (you can squash them between two fingers and they just get up and fly away!). My advice is, when travelling through a tsetse area (generally a woodland), to remain vigilant and use your hat to brush them out of the vehicle (and keep an eye out on the necks and exposed skin of others in your vehicle). In my experience, the more you try to kill them, the more replacements fill the void – spend the energy keeping them away from you and only kill those trapped inside (if you are in an enclosed safari vehicle).
The Tsetse Fly
The name "tsetse" was coined from the Setswana name for the fly. This fly is a drab brown colour, is similar to a horse fly, with a long proboscis. The tsetse fly is a major scourge of Africa, for it feeds on blood and transmits diseases to man (sleeping sickness) and domestic animals (‘nagana'). Game animals are carriers but are otherwise unaffected – this is an important point and the reason why some conservationists believe it to be the saviour of many of Africa’s wild places. It is the female tsetse fly that bites, leaving behind microscopic parasites (tripanasomes) which invade your bloodstream, multiply rapidly and then attack your nervous system and brain. The good news is that it is easily treated and has been eliminated from, or is controlled within most, although not all, safari areas. With assistance from the World Health Organisation (WHO) many African countries are eradicating the tsetse fly from many areas. The bad news is that they seem able to land on your skin so softly that you do not realise they are there until you feel their stinging bite!
Rabies
Rabies is a serious viral disease affecting animals and humans, prevalent in most countries throughout the world. The rabies virus is transmitted to humans through the saliva of an infected mammal. The most common animals involved are dogs or other canines and bats, but any mammal including cats, monkeys, bats are capable of transmitting the virus. Although an animal bite is the usual way in which the virus gets into the body, because the virus is present in saliva even a scratch which breaks the skin is dangerous. The general rule is that in a country where rabies is present any bite or scratch from any mammal which breaks the skin, however small, needs immediate medical attention.
Modern vaccines are safe, effective and relatively pain-free with little in the way of side-effects. Three injections over a period of four weeks are required. Because the vaccination course is expensive and the risk of infection is very small for most tourists, immunisation is frequently declined. In such a case, should there be an animal bite, the injury must be thoroughly cleansed (with antiseptic if available) and medical attention sought as soon as possible- preferably within 24 hours. The course of treatment then involves the use of anti-rabies immunoglobulin to provide some degree of protection through passive immunity while full immunity is induced by a series of 5 injections.
Discuss this with your doctor, but it is highly unlikely that you will come into direct contact with any animals whilst on safari and so the risk of contracting rabies is extremely low.
WARNING: DO NOT BE TEMPTED TO FEED ANY ANIMAL ON SAFARI – EVER!