Its been said about South Africa that its "a world in one country." This epitome is almost apt as South Africa has a diverse geography, which includes lush subtropical regions, forests region, wide vistas, and the deep desert of the Kalahari, the wide varieties of animal species, reserves of game, the diverse origins of the population right from India, Africa, Europe, and Southeast Asia. South Africa represents a country with a variety of cultural, culinary and traditional values.
South Africa has witnessed an increase in tourism in the past 20-25 years. Tourists are attracted from the African subcontinent as well as from Europe and and North America. Business travelers mostly head to the commercial centers of Durban, Johannesburg, and Cape Town. Tourists mostly visit the game reserves, the largest of which is Kruger National Park, located near Mozambique . There are a number of game parks in Kwa-Zulu Natal, and the Eastern Cape has parks like the Addo Elephant Park and Shamwari park . Many smaller luxury package provider has emerged to cater to the high-spending traveler in the country. Outstanding drives and engrossing tours of the old wineries along the wine line in the Western Cape; or tourist visits to the southern regions of Africa at Cape Agulhas or Cape Point, where the Indian and Atlantic Oceans meet together.
South Africa is also a destination for people associated with the non-profit running humanitarian workers, missionaries, and for the students. Also a sizable percentage of South African population live abroad for various reasons like business, jobs or for higher education. These travelers when visiting the country are referred to as VFR(Visitors to friends and relatives). It is a developing country and the standard of living of the people of most visitors to the country is that of developed countries. A small section of visitors also travels to less developed areas, either the smaller townships and cities or to rural areas. Many hikers, adventure-sports seekers, and missionaries travel in and out of the country. There are expats from many countries in the country.
When we witness such a huge assortment of people traveling to and fro the country, there also is a risk of health condition . Many different types of diseases are already prevalent in the country itself and with travelers coming from outside the country risk of getting infected with the contagious disease is also high. The quality and accessibility of health care facilities are variable. The middle class and an upper-income group of South Africans live in low-risk health environments and have access to world-class healthcare facilities inside the country and also they travel abroad for the various health condition. The economically deprived class of people have lesser resource and have limited access to adequate health care facilities. They are exposed to different diseases and are often struck by various health condition.
The various health issues prevalent in South Africa are:
These diseases are preventable by vaccines and the tourists are advised to get vaccinated for the same before traveling to South Africa.
Other diseases like Malaria, STD and HIV infection are also common in the country.
Infectious diseases such as mumps and measles are native in the region. In addition, Hepatitis A and Hepatitis B vaccines are recommended to travelers in this country. Travelers who may be traveling for reasons like adventure sports or are staying in a less sanitary environment, are recommended to take typhoid vaccine.
Travelers are required to carry a valid vaccination certificate also known as International Certificate of Vaccination for yellow fever vaccination,10 days before arriving in South Africa for all the travelers aged more than 1 year and who are traveling or will be in transit for >12 hours through the airport of a country as there is a risk of yellow fever virus transmission.
HIV and Sexually Transmitted Diseases
Travelers should be aware of the risks of transmission of STD.
South Africa has the largest prevalence of HIV infection in its population of approximately 18-19%. Other sexually transmitted diseases (STDs) are also present at higher rates among the population.
Many tourists travels to visit the game reserves and national parks of the country particularly along the borders of Zimbabwe and Mozambique.
Tick-bite fever caused by a species of rickettsial is common in South Africa. The relative frequency rate for visitors from Europe is estimated to be 4%– 5%.
Also diarrhea is common as in most of the travel destinations.It is very important for tourists to chose water and food carefully while traveling. Fluoroquinolone, Ciprofloxacin, can be considered as an option for self-treatment of moderate to severe diarrhea.
James, a travel author and wildlife traveler from Ireland traveled to South Africa this time. He mostly traveled to the forests of different parts of the world. This time he was traveling in the Congo basin forest and during his travel he got infected with yellow fever due to a mosquito bite.
Yellow fever is a hemorrhagic condition and it leads to high fever, bleeding into the skin, and also the death of the cells in the liver and kidneys. If more damage is caused to the cells of the liver it may lead to jaundice, a condition in which the yellowish color develops on the skin.
It is an acute disease,it starts slowly and suddenly it starts affecting the whole body. Its a viral infection, the Flavivirus causes yellow fever.
The virus is transmitted through mosquitoes, mainly the Haemogogus, Aedes species.
Mostly it occurs in tropical and subtropical parts of the Caribbean, Africa, and South America.
According to (WHO) World Health Organization, it is estimated that there were more than 84,000 severe cases of yellow fever and 29,000 to 60,000 fatalities and about 90 percent of all cases occurrence was in Africa.
Transmission of Yellow fever is by mosquitoes. It can affect human being and monkeys as well.
In case a mosquito bites a monkey that has yellow fever, it can pass it to humans. And lead to an outbreak of the viral infection.
Yellow fever can occur in regions which are close to the jungle, where infected monkeys and mosquitoes live.
It can cause a high fever and in severe cases organ damage, and this can be fatal.
There is no specific treatment, so the person infected will need supportive care.
Travelers to affected areas should login to official portals and check if they need a vaccine before they travel to any country.
In some countries entry is restricted to a traveler to enter without an immunization certificate.
Diagnosis can be done by conducting a blood test by the doctor as other diseases like dengue, malaria, typhoid, viral hepatitis too has similar signs and symptoms.
A blood test may unveil the virus, or it may help detect the antibodies that the body produces when the virus enters the body. A blood test can also help to diagnose whether there is a drop in white blood cells, or leucopenia, another sign of infection.
The blood tests used is called ELISA- an enzyme-linked immunosorbent assay and polymerase chain reaction (PCR).
Test results take several days at times.
There is no effective antiviral medication to treat yellow fever, so treatment consists of supportive care in a hospital.
Supportive care includes providing oxygen, fluids, making sure blood pressure does not drop, kidney dialysis if there is kidney failure, and treating any other secondary infections.
Some patients may require plasma transfusion at times.
James developed the symptoms of the infection after 5-6 days. His companion, who was a regular traveler in the region could relate to the disease. They contacted a hospital in South Africa and consulted the doctor to transport James to his home country, so that he could get better treatment and care from his family members. The doctors conducted an initial diagnosis and also contacted the team of Hi-Flying for carrying out the repatriation in an Air Ambulance. As the patient required personal supportive care, Air Ambulance service seemed to be the best feasible option. The team of medical escort included a nurse and a doctor. All arrangements for oxygen, saline, blood pressure monitoring was arranged in the Air ambulance itself. The patient was transported from Pretoria International airport to Ireland and then to a healthcare center in a ground ambulance arranged by Hi-Flying.
James reached his country safely with care and hospitality of the medical escort team of Hi-Flying and he is undergoing further treatment and recovery.