International Travel

Posted by Judy Arbique Feb 20, 2007

I will have been in Tanzania 2 days before this blog is posted. I have travelled to Tanzania to teach with the Clinical and Laboratory Standards Institute. We have been charged with helping implement quality management systems as part of the President's Emergency Response Plan for AIDS Relief (PEPFAR). I have to admit that prior to the planning for this trip, my knowledge of the geography of Africa was sketchy to say the least. Tanzania lies just below Kenya on the east coast of Africa, and is bordered by the Congo, Rwanda, Zambia and Mozambique.

So what are the infectious risks in visiting Tanzania? I have not worked in parsitology for close to 10 years now, but yellow fever, dengue fever and schistosomiasis were pulled from one of the floppy discs in my memory as exposures to avoid. I wasn't sure of the best route to determine which vaccines would be necessary for my trip, and what precautions I should take while in Tanzania. My doctor referred me to the International Travel Clinic Public Health Services for a consult. The consult itself cost $40 (Cdn) and was well worth it. The travel clinic consultants have access to information on public health risk factors in countries all over the world and are equipped to recommend and provide vaccine coverage (at an extra cost) for the particular country and time of year that you will be travelling. In addition, I received advice on precautionary measures to take while in the country to reduce my risk of infection.

Yellow fever, malaria and dengue fever are three risks associated with mosquito bites - yellow fever and dengue fever from daytime mosquitos, and malaria from night-time mosquitos. Although a vaccine is not currently available for protection against dengue fever, there is a vaccine for yellow fever, which I opted for. Areas of Tanzania also have malarial strains that are resistant to chloroquine. Although I will be staying and working in an air-conditioned hotel in Arusha, where the risk of mosquitos during the day or night will be small, I will be taking anti-malarial drugs to reduce the risk of mosquito bite while outside the hotel. In addition, DEET-containing mosquito repellants will be a must. I have decided not to purchase anti-malarial mosquito netting for sleeping as it is unlikely that malaria-containing mosquitos will enjoy an air-conditioned environment. However, if I planned on travelling around the country and wasn't sure of where I would be staying, the mosquito netting would be a good investment.

Schistosomiasis is caused by one of three different species of Schistosoma - S. haemotobium which infects the bladder, and S. japonicum and mansoni which infect the large intestine. Infective larva attach to and penetrate the skin of humans in contaminated waters. Although the parasite does not like sea water, it does like lake and pond waters where its intermediate host, the snail are found. So, no wading in fresh water for me!

There is also the risk of traveller's diarrhea that is a risk with travel to numerous countries. I will use the mantra "Boil it, cook it, peel it or forget it!" to help reduce my risk of infection. I'll also have to remember to drink only bottled water, even when brushing my teeth...and no ice cubes in my drinks! One of the microbiologists that is travelling with me suggested taking an oral vaccine, Dukoral, which protects against E. coli 0157 infection, and I am taking his advice.

I have already been vaccinated for Hepatitis B, but in preparation for my trip have also received Hepatitis A vaccine.

Related Content:

Travel-related Illness: Prevention.

Mosquito-Borne Disease Prevention.