Mwanza is a bit away from home and many things are different; e. g. water-, food- and weather conditions. But your health as visitor depends often on the preparation before leaving your hometown - and your family doctor. Discuss the requirements with her/him not later than six weeks before leaving. There are few requirements for proof of vaccinations for entry into Tanzania, but some protections/vaccinations are strongly recommended anyway; e.g. against hepatitis A + B, typhoid, diphtheria, tetanus and yellow fever.

Acute health problems when in Mwanza: CF Hospital, Station Road, phone: +255 28 250 0260.
If you need a dentist: HOPE Dental Clinic, Balewa Road, Isamilo Hills. Phone +255 28 2500732 (landline), +255 754 887254 and +255 784 887254.

Yellow fever is a viral disease transmitted between humans by a mosquito. General precautions to avoid mosquito bites should be followed. These include the use of insect repellent (e.g. Citronella oil or DEET), protective clothing, and mosquito netting. Yellow fever is a very rare cause of illness in travellers, but some countries in Africa still have regulations and requirements for yellow fever vaccination. And among them - Tanzania.

Yellow fever vaccine entry requirements are necessary for travellers to comply with in order to enter Tanzania. In general, these are in place to prevent importation and transmission of yellow fever virus. Countries requiring yellow fever vaccination for entry adhere to the regulations put forth by WHO - as stated in the International Health Regulations.
Some countries require vaccination for travellers coming from an endemic zone. "Travelling from an endemic zone" is defined as transit through an endemic zone in the previous 6 (six) days. E.g. if you are travelling via Zambia, Kenya or Uganda - you are coming from an endemic zone.

Recently the authorities have established a 'Yellow Fever Check Point' at the door step to Dar es Salaam International Airport for passages' coming direct from Europe or US via Europe.

There's no need for that - it's only a money milking machine. To get an ejection 'at the door step' will have no effect for many travellers on a short holiday/safari - as it has to be injected at least 10 days before arrival for giving protection.
The vaccination is however a relatively cheap and it is valid for 10 years. And don't forget, that yellow fever is a deadly disease without any known cure.

Ebola virus causes an acute, very serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in two simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

NOTE: There have never been any cases of Ebola virus (EVD) in Tanzania.

Travellers' diarrhoea is a clinical syndrome resulting from microbial contamination of ingested food and water; it occurs during or shortly after travel, most commonly affecting persons travelling from an area of more highly developed hygiene and sanitation infrastructure to a less developed one like Tanzania. Diarrhoea is the most common travel-related illness. Avoid tap water, un-pasteurised milk, ice-cubes in drinks, fresh vegetables and fruits (of not cooked or peeled). Be selective when taking food from street vendors - it has to be cooked seriously all the way through.
Seek medical attention if the diarrhoea last for more than two - three days, are extreme painful and self treatment isn't working. A good self treatment is mashed bananas with plenty of fluids - e.g. Coca Cola.

Malaria is a serious disease that is transmitted to humans by the bite of an infected female Anopheles mosquito. Symptoms may include fever and flu-like illness, including chills, headache, muscle aches and fatigue. Malaria can often be prevented by using anti-malarial drugs and by using personal protection measures to prevent mosquito bites. However, in spite of all protective measures, travellers may still develop malaria. Malaria symptoms will occur at least seven to nine days after being bitten by an infected mosquito. Fever in the first week of travel in a malaria-risk area is unlikely to be malaria; however, any fever should be promptly evaluated. Travellers who become ill with a fever or flu-like illness while travelling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and should tell the physician their travel. There are several types of anti-malarial drugs. Discuss the best one for you with your doctor before leaving home.

The two most prescribed malaria-preventions today are: Doxycyklin(Vibradox) and Malarone. None are without small physical as well as some economical side effects. Malarone is effective, but somewhat expensive - why many travellers choose Doxycyklin(Vibradox) in the end - as their favourite protection against malaria. Always bring the anti-malarial drugs with you from home.

Latest news: An injecting against malaria has been on its way for almost 30 years, but it's now ready for distribution in the 2nd half of 2015).

Dengue fever is transmitted by the bite of a mosquito*) infected with one of the four dengue virus serotypes. It is a febrile illness that affects infants, young children and adults with symptoms appearing 3 - 14 days after the infective bite.

Dengue is not transmitted directly from person-to-person and symptoms range from mild fever, to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain and rash. There is no vaccine or any specific medicine to treat dengue. People who have dengue fever should rest, drink plenty of fluids to reduce the fever - and see a doctor ASAP.

Severe dengue (also known as dengue hemorrhagic fever) is characterized by fever, abdominal pain, persistent vomiting, bleeding and breathing difficulty and is a potentially lethal complication, affecting mainly children. Early clinical diagnosis and careful clinical management by trained physicians and nurses increase survival of patients. *) It's the Day-biting Aedes mosquito which spreads the disease.

NOTE: Dengue fever is quite uncommon in Tanzania, but there are known cases as late as in 2014.

Typhoid fever is an acute, life-threatening febrile illness caused by the bacterium Salmonella typhi. The disease is characterized by fever, headache, malaise, anorexia, splenomegaly, and a relative bradycardia. Many mild and atypical infections occur. Typhoid vaccination is not required for international travel, but it is recommended for travellers to areas where there is a recognized risk of exposure to Salmonella typhi. Vaccination is particularly recommended for those who will be travelling in smaller cities, villages, and rural areas off the usual tourist itineraries. Travellers should be cautioned that typhoid vaccination is not 100% effective and is not a substitute for careful selection of food and drink. There is more than one type of protection against typhoid fever. Discuss the best one for you with your doctor before leaving home. It is recommended to be protected before entering Tanzania.

Hepatitis A, B and C: "Hepatitis" means inflammation of the liver. It can have many causes, including viruses, medications and alcohol. Most commonly, however, we think of the viruses, called A, B and C.

Hepatitis A causes an acute hepatitis that almost always gets better on its own. It is easily spread from person to person, in food and water, and can infect many people at once.
Hepatitis B can be both acute (short-term illness) and chronic (ongoing illness), and is spread through blood or other body fluids in various ways. Hepatitis C is almost always chronic and spreads only by blood. Hepatitis A and B can be prevented by vaccination, but not Hepatitis C. There are now many good medications available to treat chronic Hepatitis B and C.

The symptoms of acute hepatitis include yellowing of the skin and eyes, nausea, fever and fatigue. Chronic hepatitis may have no symptoms, and can last many years and lead to cirrhosis of the liver, which means the liver becomes heavily scarred and less functional. Cirrhosis can sometimes lead to cancer of the liver or liver failure, both of which may require a liver transplant.
Prevention is very important. Other than vaccination, people should be very careful about hygiene (such as hand-washing after using the restroom) to prevent Hepatitis A. Hepatitis B and C can be transmitted by sex or sharing needles, razors, or toothbrushes with someone who has the disease. All three forms of viral hepatitis are very common around the world.

Cholera is an acute intestinal infection caused by toxigenic Vibrio cholerae. The infection is often mild and self-limited or sub clinical. People with severe cases respond dramatically to simple fluid- and electrolyte-replacement therapy. Infection is acquired primarily by ingesting contaminated water or food; person-to-person transmission is rare. The vaccine against cholera gives poor protection, many side effects, so it's not recommended for travellers. People who follow usual tourist itineraries and who observe food safety recommendations while in countries reporting cholera have virtually no risk. Risk increases for those who drink untreated water or ingest poorly cooked or raw seafood in endemic areas.

Other (not especially travel related) deceases:

Diphtheria is an acute infectious disease caused by the toxin-producing bacteria Corynebacterium diphtheriae. It usually affects the respiratory tract (primarily the larynx, tonsils, and throat). But it can also affect the skin, and the toxin produced by this bacterium can damage the nerves and heart.
Diphtheria is found only in humans and is usually transmitted by respiratory droplets from infected persons or a symptomatic carrier, but can be transmitted by contaminated objects or foods (such as contaminated milk). The incubation period is 2 to 5 days.

Tetanus is an acute disease caused by the toxin of the bacterium Clostridium tetani that affects the central nervous system, sometimes resulting in death. Spores of the bacterium Clostridium tetani live in the soil and are distributed worldwide. In the spore form, Clostridium tetani may remain dormant in the soil, but can be infectious for periods longer than 40 years. The disease is characterized by painful muscular contractions. Vaccination for diphtheria and tetanus are usually combined and are recommended for everyone, and boosters are necessary very ten years. Consult your family doctor before leaving home.

AIDS is a serious disease, first recognized as a distinct syndrome in 1981. This syndrome represents the late clinical state of infection with the human immunodeficiency virus (HIV), resulting in progressive damage to the immune system and in life-threatening infectious and non-infectious complications.
HIV infection occurs worldwide. Comprehensive surveillance systems are lacking in many countries, so the true number of cases is likely to be far greater than the numbers officially reported, particularly from developing nations. No vaccine is available to prevent infection with HIV.

Travellers should be advised that HIV infection is preventable. HIV is not transmitted through casual contact; air, food, or water routes, contact with inanimate objects, mosquitoes or other arthropod vectors.
Prevention of HIV equires foresight and self-discipline. The requirements often seem personally restrictive, but they are effective and can save your life. "Safe sex" practices, such as latex condoms, are highly effective in preventing HIV transmission. HOWEVER, there remains a risk of acquiring the infection even with the use of condoms. Abstinence is the only 100% sure way to prevent sexual transmission of HIV.

Bilharzia: Note that Lake Victoria is riddled with Bilharzia, so avoid swimming or walking barefoot through the grass along its shores, as this is where the parasite-hosting snails lurk. Some few km out in the lake there will be no problems, but still on your own risk.

Useful links:
www.cdc.gov - Centers for Disease Control and Prevention.Hospital/clinic in Mwanza:
CF Hospital - Care and Treatment, Station Road, Mwanza. Phone: +255 28 250 0260.

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Health Guide
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