Health Information for Visitors to KwaZulu-Natal

Be Safe, Secure and Healthy in KZN!

Malaria

Prescription Medication

1. Any person entering or departing from the Republic of South Africa may be in possession, for personal medicinal use, of a quantity of a prescription medicine, which shall not exceed a quantity required for use for a period of one month.



2. A person referred to above must have –


• a valid prescription for such prescription medicine; or


• a certificate by an authorised prescriber or a person dispensing such prescription medicine to the effect that the prescription medicine concerned including its quantity was prescribed for the person including the name and address of such authorised prescriber; and,
• his or her particulars of residence in the Republic, in the case of the person entering the Republic, recorded at the port of entry.

Rabies

Rabies is an acute viral disease, and once symptoms develop it is invariably fatal. It is transmitted to humans through the bite, scratch or lick of a rabid animal. Dogs are the main source of human infection, although the epidemiology of animal rabies infection varies from country to country.

Rabies is endemic in South Africa, particularly in rural areas. KwaZulu-Natal and the Eastern Cape are particular risk areas for dog rabies. Travellers to these areas must ensure they are well informed concerning their risk of rabies exposure and the local reservoir species so that they can avoid contact with potentially rabid animals.

Vaccination against rabies is available to protect people who are likely to be exposed to infected animals (e.g. animal handlers, wildlife officers, travellers to endemic areas where access to post-exposure treatment is limited) and those that have been exposed to rabies. Pre-exposure immunisation consists of three intramuscular doses administered on specific days.

The risk to travellers is proportional to their contact with potentially rabid animals in endemic areas. In areas of endemic rabies, dogs and cats should not be petted and contact with wild animals, especially bats, jackals, foxes, skunks, racoons and mongooses, and meerkats should be avoided. In South Africa the major host species include: dogs (Eastern Cape, Mpumalanga and KwaZulu-Natal), black backed jackal (Limpopo), bat-eared fox (Northern Cape, Free State and Eastern Cape) and yellow mongoose.

No animal bite, scratch, or lick should be ignored and after thoroughly cleaning the wound with anti-septic or soap under copious running water, a competent opinion should be sought as to whether the contact may pose a rabies risk. Post-exposure vaccination, preferably within 24 hours of the suspected exposure, together with the simultaneous administration of rabies-specific immunoglobulin,is 100% effective in preventing rabies provided it is administered in accordance with accepted protocols.

Tick Bite Fever

Tick-bite fever commonly occurs throughout South Africa but infection is most common in the rural bushveld of Limpopo, Mpumalanga, KwaZulu-Natal and Eastern Cape coast. In urban areas, the infection is associated with tick ectoparasites of dogs.

Within 3 to 4 days of a bite from an infected tick, the site of the bite becomes darkly discoloured, almost black ("eschar"), with an inflamed area of skin around it. There may be more than one eschar and these may not be highly visible e.g. behind knees, between toes and on head.

Swelling of glands may occur on day 7.Five to seven days after infection the patient may develop a severe headache, fever, chills and tiredness;- the typical spotty rash appearing 3 days from onset of symptoms, characteristically on the palms and soles of feet. Diagnosis cannot always be confirmed by blood tests but appropriate antibiotic treatment should be initiated without delay.

Preventing Tick Bite Fever:

• Hiking and camping should preferably be limited to safer areas and particularly during theinter months when adult ticks are least active. Hiking on designated trails in mountain or coastal resorts is likely to be safer than camping in the bush-veld in summer
• Ticks attached to people should be removed with tweezers with a firm steady pull
• Ticks should not be removed from dogs bypulling them off and squashing them between the fingers. This can result in infection
• Ticks, once removed, can be killed by placing them in oil or paraffin•
• When hiking in a tick-infested area, the skin should be searched every few hours for ticks.

Yellow Fever

Yellow fever is a virus carried by the Aedes mosquito that leads to death in about 25% of patients. There is no specific treatment, but vaccination is very effective. International law requires travellers crossing the borders of countries where yellow fever is endemic to have yellow fever vaccinations. After you have been vaccinated you will be issued with a Yellow Fever Certificate.

The certificate only becomes valid ten days after vaccination, and stays valid for ten years.If you have travelled in a Yellow Fever region in the six days before you wish to visit South Africa, you will have to show your Yellow Fever Certificate when you enter the country.

Is anyone exempt for the vaccination?

Pregnant women, babies under one year old and people who are allergic to the vaccine and to eggs do not have to have the vaccination. You will still have to get a certificate from the vaccination centre saying that you have been exempted.

What happens if you do not have the certificate?

If you arrive in South Africa without a valid Yellow Fever Certificate, you will be:

• kept under observation for six days at your own cost, or
• vaccinated against yellow fever at your own cost.

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Copyright © KwaZulu-Natal Department of Health, 2001

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