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Health Information for Visitors to KwaZulu-Natal

Be Safe, Secure and Healthy in KZN!



Malaria risk is predominantly due to P. falciparum, and exists throughout the year in low altitude areas of Mpumalanga Province (including the Kruger National Park); Northern Province and north eastern KwaZulu-Natal as far south as the Tugela River. The risk is highest from October to May. Resistance to chloroquine and sulfadoxine- pyrimethamine reported.

Malaria Prevention:
Recommended prevention in risk areas is:
Mosquito bite prevention plus mefloquine, doxycycline or atovaquone + proguanil chemo prophylaxis.

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 –

Any visitor needing more medicine would have to consult an authorised prescriber, get a prescription and have the medicine dispensed at a pharmacy. Or attend a PHC clinic if appropriate. There would be no guarantee though that either the particular medicine or brand of medicine would be available in this country or from a state institution.


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:

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:

Yellow fever regions
The following countries are Yellow Fever regions:
Angola Guinea
Benin Guyana
Bolivia Kenya
Brazil Liberia
Burkina Faso Mali
Burundi Panama
Cameroon Peru
Central Africa Republic Rwanda
Chad Sao Tome & Principe
Colombia Senegal
Congo Sierra Leone
Cote d'Ivoire Somalia
Democratic Republic of Congo Sudan
Ecuador Suriname
Equatorial Guinea Tanzania
Ethiopia Togo
French Guinea Uganda
Gabon Venezuela


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