Yellow Fever in Africa
Yellow fever is a viral disease that has caused large epidemics in Africa and the Americas. It can be recognized from historic texts stretching back 400 years. Infection causes a wide spectrum of disease, from mild symptoms to severe illness and death. The "yellow" in the name is explained by the jaundice that affects some patients. Although an effective vaccine has been available for 60 years, the number of people infected over the last two decades has increased and yellow fever is now a serious public health issue again.
Thirty-three countries, with a combined population of 508 million, are at risk in Africa. The disease is caused by the yellow fever virus, which belongs to the flavivirus group. In Africa there are two distinct genetic types associated with East and West Africa. Humans and monkeys are the principal animals to be infected. The virus is carried by a biting mosquito which can also pass the virus via infected eggs to its offspring.
The virus remains silent in the body during an incubation period of three to six days. There are then two disease phases. While some infections have no symptoms whatsoever, the first, "acute", phase is normally characterized by fever, muscle pain (with prominent backache), headache, shivers, loss of appetite, nausea and/or vomiting. Often, the high fever is paradoxically associated with a slow pulse. After three to four days most patients improve and their symptoms disappear.
However, 15% enter a "toxic phase" within 24 hours. Fever reappears and several body systems are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes and/or stomach. Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates; this can range from abnormal protein levels in the urine (albuminuria) to complete kidney failure with no urine production (anuria). Half of the patients in the "toxic phase" die within 10-14 days. The remainder recover without significant organ damage.
Yellow fever is difficult to recognize, especially during the early stages. It can easily be confused with malaria, typhoid, rickettsial diseases, haemorrhagic viral fevers (e.g. Lassa), arboviral infections (e.g. dengue), leptospirosis, viral hepatitis and poisoning (e.g. carbon tetrachloride). A laboratory analysis is required to confirm a suspect case. Blood tests (serology assays) can detect yellow fever antibodies that are produced in response to the infection. Several other techniques are used to identify the virus itself in blood specimens or liver tissue collected after death. These tests require highly trained laboratory staff using specialized equipment and materials.
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- Asanda Mcoyana12 Mar 2014
Dear Ally Thank you very much for your enquiry. You would only require a yellow fever vaccination for Zambia. You will have to get the vaccination 10 days before you enter the country and it is valid for 10 years. If you cannot get the vaccine for medical reasons, but require proof of yellow fever vaccination for travel, your doctor can give you a waiver letter if he considers the risk acceptably low. If you plan to use a waiver, you should also contact the embassy of the countries you plan to visit for more information. Should you wish to book a trip to any of the countries below, please let me know and we would be glad to assist. Have a great day! Kind regards
- Michael 11 Mar 2014
Traveling from US via London to Cape Town. Driving up coast with friends to Durban and then to Kruger. .... Return sane way back. No other countries visiting. Need yellow fever vaccine and/or proof?
- ally finch11 Feb 2014
Is it possible to enter Zimbabwe, Zambia and Botswana without a yellow fever immunisation ? Can you have an exempt certificate from your doctor and still be allowed entry ? What are the chances of being infected during a two week holiday on safari in these areas ?
- Minette - OverlandingAfrica.com23 Apr 2012
Hi Tori; yes as Zambia is on the list of endemic countries you will definitely need to get the yellow fever vaccination. I recommend you contact your GP or local travel clinic for up to date information. Cheers!
- Tori21 Apr 2012
Hello; I am travelling to Zambia on a school expedition; we are there for 2 weeks and are then going to Malawi for 2 weeks; will I require the yellow fever vaccine?
- Minette - OverlandingAfrica.com19 Mar 2012
Hello Katie; there seems to be a travel clinic in Haifa. Your alternative option is to contact a local GP or hospital for more information. Happy trails!
- katie 17 Mar 2012
Hello; I am trying to get vaccinated to go to Ghana and I am having trouble finding a clinic here in Jerusalem to get the Yellow Fever vaccine. Any suggestions where to go?
- Minette - OverlandingAfrica.com27 Feb 2012
Hello Cassandra; we only sell scheduled overland truck safaris and travel advice for these tours - cots depend from country to country; doctor to doctor and/or clinic to clinic. I recommend you contact your GP or local travel clinic for more information. Cheers!
- Cassandra 25 Feb 2012
I have a friend and his daughter leaving Accra; Ghana and they require to have the yellow fever vaccination before leaving. I want to know how much does it costs to have that vaccination?
- Minette - OverlandingAfrica.com23 Jan 2012
Hi Mohammad; you will only need to get the Yellow Fever vaccination if you are going to or coming from a Yellow Fever infected area. Egypt is not on the list of endemic countries; however Kenya is. I would advise in getting the yellow fever jab. Contact your GP or local travel clinic for up to date information on what you will need. Happy trails!
- Mohammad ELOraby21 Jan 2012
We're planning to travel to Kenya and we're from Egypt. As mentioned in many views we read that having yellow fever certificate is mandatory to enter Kenya if our country is infected. is Egypt one of the infected areas?
- Esther23 Nov 2011
That was helpful
- Minette - OverlandingAfrica.com31 Oct 2011
Hi Rhiannon; as Zambia is on the list of infected countries; yes you will most certainly need the yellow fever jab as you will not be allowed back into Johannesburg for your onward flight. I recommend you contact your GP or local travel clinic for more information. Happy trails!
- Rhiannon29 Oct 2011
Hello. My friend and i are travelling from Australia to south africa; botswana and zambia for 9 days. We are making our way from johannesburg to botswana; then flying from livingstone zamiba; back to johannesburg. We are only in Zambia for two nights. Do we require a yellow fever vaccine even if we are from australia and are only staying in Zambia for 2 nights. any info would be great. many thanks
- Minette - OverlandingAfrica.com14 Oct 2011
Hi Jan. As Tanzania and Kenya are on the list of countries infected with Yellow Fever - your friend will most certainly need the jab. I would recommend that he contacts his GP or local travel clinic for more information. Good luck!
- Jan Mitchell14 Oct 2011
Have received a panic email this morning from someone in the office currently in Harare. He leaves on MOnday for Tanzania and Zanzibar. Having checked with everyone before leaving Yellow Fever jab was not compulsory now some doubt has been raised by friends there. Also; he transits in Nairobi on return to the UK and; again; it would appear that he does not require one unless he transits for more than 12 hours. I cannot find out definitively on website on by other means. Can you help rather quickly please with a yes or no. Trying; also; to contact the Tanzanian High Commission in London but with difficulty!! Many thanks
- Minette - OverlandingAfrica.com26 Sep 2011
Hi B Virdee; Yes you will most certainly need the yellow fever jab as Zambia is on the list of countries for yellow fever. We recommend that you contact your GP or local travel clinic for a list of vaccinations you will require in the area that you will be traveling. Cheers
- B Virdee23 Sep 2011
i am visiting livingstone; botswana and cape town in oct. Do i need the yellow fever jab?
- Minette - OverlandingAfrica.com11 Aug 2011
Hi J Davis; you will only need the yellow fever vaccination if you are coming from or going to a yellow fever infected area before heading back to your home country. As Kenya is on the list for Yellow Fever; it is best that you get the jab! I would also recommend you see your GP or local travel clinic for an up to date list of vaccinations that you will need before you travel. Malaria will most certainly be one that you will need prophylactics for! Good luck and safe travels :)
- Minette - OverlandingAfrica.com11 Aug 2011
Hi Tara; you only need the yellow fever jab if you are going to be entering a yellow fever zone before heading back to your home country. Best would be to contact your GP or your local travel clinic for the best up to date information regarding vaccinations and what you will need for your trip! Happy trails :)
- J Davis10 Aug 2011
I am traveling with my two children 7 and 10yrs to Kenya in Oct.... We will be in Nairobi; but will also take a quick Safari trip and maybe make it to the ocean coast too for a few days... we will be in Kenya for 3wks... Should we get the Yellow Fever Vaccination? we are coming from Vancouver Canada (hardly a Yellow Fever Zone)
- Tara10 Aug 2011
I will be going to South Africa on an escorted tour with a group in a few weeks( tourist attractions; hotels...not remote areas). The CDC says coming from the United States I will NOT need the yellow fever vaccine; but I have heard by two different people at one of those travel health clinics that I will have a problem getting back into the US without the vaccine...have you ever heard of this??? I don't want any issues at the airport; please advise.
- Minette - OverlandingAfrica.com23 May 2011
Hi Craig! Basically your girlfriend will not be able to receive the vaccination if she has an infection or is running a fever as this is a live virus. According to our travel clinic in Cape Town; the vaccination is only valid from a minimum of 7 to 10 days after she has received the jab and is valid for 10 years there after. Happy trails!
- Craig21 May 2011
Hi; My girlfriend is due to fly to Kenya on June 13th and is yet to have a yellow fever injection. Unfortunately she has now got a tooth infection; the department of health in the UK have put guidance in place stating that they recommend against a yellow fever injection if an acute infection is in-situ. What is the absolute latest she can have the injection. I have read numerous articles and non state a timeframe just that you need to have the injection; does one assume from that information that you can have the injection a couple of days before flying and still be ok to pass immigration in Kenya? Many thanks; Craig.
- Tania - OverlandingAfrica.com07 Feb 2011
Hi Heidi; As long as she is not coming from a Yellow Fever area she will not need the vaccination. Cheers.
- Heidi07 Feb 2011
My Daughter is going on a schools worldwide trip to Namibia in July. Should she have the yellow fever vaccination? they will be working on biulding projects for orphans.
- Tania - OverlandingAfrica.com13 Jan 2011
HI Michelle; You have to speak to your GP before you book anything. As far as I am aware it is necessary to have a Yellow Fever shot and certificate for travel to Kenya and I would recommend Malaria treatment as well. The biggest catch other than the risk of catching Yellow Fever and not being immunized for it; is that your travel can be restricted if you meet a Immigration officer who asks for your certificate and you don't have one. It would pay for you to check it out with a tropical diseases clinic as well for your own safety. Happy Trails!
- Michelle Reid12 Jan 2011
I have anorexia...I am 6 stones in weight. Luckily; I seem to have a very hardy immune system. I am going to bamburi beach in Kenya in May. Although I`m booked to see a nurse next week; I`d like some information on this Yellow fever vaccination; please. lots of folk have said it is not an utter neccessary thing; but I`m not so sure!!! Please advise me!!! Thank you for your time....Michelle.
- Dayne - OverlandingAfrica.com31 Dec 2010
Hi Gary; As far as I am aware you require a yellow fever certificate to enter Kenya.These rules change all the time and sometimes they enforce it and other times not. I rather suggest getting the yellow fever certificate as it last for 10 years. Whether it will affect Arthritis you would have to consult a medical professional. Cheers
- GARY30 Dec 2010
WE ARE GOING TO KENYA. THE ABOVE SAYS YOU NEED YELLOW FEVER CERTIFICATE IF YOU ARE ARRIVING FROM A COUNTRY THAT HAS YELLOW FEVER. HOWEVER WE ARE ARRIVING FROM ENGLAND WHICH DOES NOT HAVE YELLOW FEVER. HOWEVER WE HAVE BEEN TOLD WE HAVE TO HAVE IT? ALSO CAN YOU HAVE THIS VACCINE IF YOU HAVE RHUMATOID ARTHRITIS? I HAVE BEEN TOLD IT COULD BE A PROBLEM
- Tania - OverlandingAfrica.com12 Oct 2010
Hi Jan, Yes a Yellow Fever vaccination is recommended and in certain locations you will need to produce documentation to prove you have had it. Hepatitis A and C immunisations are also recommended and you may need some anti-malaria drugs but we strongly recommend you consult your GP or tropical health expert BEFORE you travel. Some Malaria treatment must be started before you leave home. Cheers.
- jan morgan11 Oct 2010
Hi; We are travelling from Australia to South Africa / Sambia / Botswana; then to Tanzania / Zanzibar; returning to Aus via South Africa. Can you advise whether we need a yellow fever vaccination; and which other vacs we will require? Thanks.
- Margaret10 Sep 2010
Please tell me what the weather is like in Congo in January February. What is the temperature there and will there be rain etc
- Dayne - Overlanding Africa.com02 Dec 2009
Hi there; We have an array of overland tours to suit your requirements. I have sent you an email with more detailed options.The tour prices does not include flights but i can arrange them for you if you require flights. Cheers Dayne
- Dutch girl01 Dec 2009
Hi there; I'm a Dutch girl planning a tour to Southern Africa. Since many of the Dutch tour operators can't help me connect a few countries together in one tour; I'm looking for it overseas. Your tour Johannesburg-Livingstone is what I'm looking for. While ending in Livingstone I would like to extend the tour with 1 week in Zambia. I see the programs including Zambia is what I'm looking for in Zambia. Want to see the most popular parks and cities. All together I would like to travel approx 5 weeks; so when time available the option of hopping into Congo to see the gorillas; it would be great! I've no interest in seeing more of South Africa then JNB. No interest in seeing Mozambique either and Namibia is so-so... When possible I would like to camp - it must be a budget holiday. I'm traveling alone and want to leave end of November; beginning of December. Hope you can help me out by connection some tours. I'm possible to leave from Amsterdam or Dusseldorf international airport. When tour is excl flight tickets; I can arrange them myself too. Kind regards from the Netherlands
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