Kenya is bush camps, safaris, vast lakes brimming with birds, snow-capped peaks, and ancient craters.
It’s not only home to some of East Africa’s most stunning scenery, but the landscape is dotted with the so-called Big 5 – the lion, leopard, elephant, buffalo, and rhino – without barriers or bars. In fact, it’s is one long Kodak moment.
However, like much of Africa, Kenya demands more thorough preparation than most destinations.
Australians visiting Kenya need to consider taking anti-malaria tablets and having a series of travel vaccinations: one that’s required, some that are recommended, and a few that would be advisable even if you were seeing Africa’s wildlife at Nairobi Zoo.
Let’s look at the microscopic ‘wildlife’ travellers need to be armed against when visiting Kenya.
VACCINATIONS FOR KENYA
It’s best to start vaccinations at least 6 weeks before departure. Here’s the list you should consider:
Yellow fever (YF) is a virus spread by mosquitoes. It occurs in both urban and rural areas of Kenya, except in North Eastern Province, the states of Kilifi, Kwale, Lamu, Malindi, and Tanariver in Coastal Province, or the cities of Mombasa and Nairobi. Yellow fever is not common in travellers but has a 50% death rate in those unlucky enough to get infected. However, many countries with populations of the ‘vector’ mosquitoes – including Australia – are concerned about the risk of YF being ‘imported’ by infected travellers returning home. So, YF vaccination is the only ‘required’ immunisation for Kenya and comes with an International Certificate of Vaccination or Prophylaxis that travellers may be asked to produce when travelling on to another country or returning directly to Australia. It’s also a requirement for visiting many other parts of Africa and for much of South America (see CDC map).
Hepatitis A – As with the rest of the developing world, Kenya is regarded as a high-risk destination for this viral liver infection – regardless of where you are staying or plan to eat. It is spread by contaminated food or water, but can also be passed from person to person by touching or handling everyday objects. The Hep A vaccine is highly effective, as is the Hep A-B combination vaccine.
Hepatitis B – Hep B vaccination is routine for kids these days and worth considering for older travellers who’ve never been immunised – particularly those getting off the beaten track in Kenya or anywhere where this blood-borne virus is common. (And, that’s most of the world.) It can be transmitted by unprotected sex, getting a tattoo or piercing, or having an unplanned medical or dental procedure – even in a hospital.
Typhoid – Typhoid fever is a bacterial disease found in contaminated food and water. It’s common in many parts of Kenya, especially among children in urban areas, where sanitation and personal hygiene is often poor. Visitors going on safari or venturing off the beaten track into rural areas are at higher risk of infection.
The following are childhood vaccinations should be up-to-date before any overseas trip: measles-mumps-rubella(MMR), diphtheria-tetanus-pertussis, chickenpox, polio*. Influenza vaccination has also become a routine recommendation for travel: flu is the most common vaccine-preventable illness among international travellers and it can seriously impact your holiday plans. (*More recently, Kenya has recorded cases of polio, mainly among Somali refugees. A single booster provides lifetime immunity for adults, ‘topping up’ the primary course they received as children.)
Others disease risks
The following vaccine-preventable diseases occur in Kenya, but generally present a low risk for the average visitor staying less than 2 weeks. However, they may be recommended for certain travellers, including those working, visiting family and friends, or spending more than a month ‘off the beaten track’.
Meningococcal meningitis – Kenya’s far north forms part of sub-Saharan Africa’s ‘meningitis belt’ (see map) and large-scale epidemics occur during the dry season (Dec-June), especially in rural areas. Men. meningitis is a vaccine-preventable disease: Discuss your itinerary with your travel doctor or GP.
Rabies – Rabies is a deadly viral infection transmitted by bites from infected animals – mainly dogs. It is also uncommon among travellers and generally vaccination is recommended for longer stays (over a month). The risk of infection is also higher for people planning holidays involving camping, hiking, riding bikes/motor cycles etc. because they are at greater risk of bites and medical assistance may also be difficult to access quickly. Studies show that kids are more susceptible to animal bites, too. Once symptoms appear, rabies is always fatal. For travellers, the golden rules of rabies are: Avoid physical contact with all animals of any species or age; wash any bite wound thoroughly with soap and running water; and, seek expert medical attention urgently.
Cholera – Cholera is a bacterial disease usually caused by drinking contaminated water and results in severe diarrhoea and rapid dehydration. Most travellers are at low risk – especially those that follow the guidelines for safe food and beverages. But, outbreaks can occur suddenly and without warning, while your travel plans may put you at particular risk. If vaccination is being considered, ask your doctor about the oral cholera vaccine: It has the added advantage of providing limited protection against some forms of traveller’s diarrhoea.
MALARIA IN KENYA
It’s been often said that the most dangerous animals in Africa is the mosquito. Mosquito-borne malaria is widespread in Kenya, with the potentially severe P. falciparum strain the cause of 85% of cases there. (It’s also the strain responsible for most of the estimated 600,000-plus annual malaria deaths worldwide - the majority in Africa.) America’s respected CDC rates the risk of malaria infection in Kenya as ‘moderate’ and it occurs in all areas below 2500m – including game parks. Only central Nairobi is risk-free. Discuss your itinerary with a travel medicine specialist, who will outline factors such as the relative risks in the areas you’ll be visiting, and the potential side-effects of various anti-malaria drugs. It is also important avoid bites from mosquitoes and other insects. Read more about malaria.
OTHER DISEASES/HEALTH RISKS
Traveller’s diarrhoea: Traveller’s diarrhea (TD) is the most common travel-related illness and Africa is one of the world’s high-risk regions. TD often clears up without specific treatment, however oral rehydration fluids should be on hand to replace lost fluids and electrolytes. Travellers who pass three or more loose bowel motions in an eight-hour period, especially if there are other symptoms like nausea, vomiting, abdominal cramps, fever, or blood in stools should consider taking a course of antibiotics. Ask about the appropriate medication and dosages during your pre-travel medical consultation. If diarrhoea persists despite therapy, see a doctor – the cause may be a parasitic infection. Learn more about traveller’s diarrhoea. RISK FACTOR: Medium-High
Dengue and Chikungunya: Experts believe that these mosquito-borne viruses are under-reported in Kenya and much of Africa due to a lack of surveillance and monitoring. Outbreaks of dengue have been documented in recent years in the country’s north. Chikungunya certainly occurs there – a major, 6 year-long epidemic that affected most of the Indian Ocean island nations and India originated in Kenya in 2004. RISK FACTOR: Medium
Schistosomiasis: Schistosomiasis or ‘bilharzia’ is a parasitic disease caused by a parasite released by snails into fresh water. It burrows into the skin of people who swim or wade in infected rivers, streams and lakes. Globally, the rate of infection among travellers exposed to infected water is around 10%, but with the rise in eco-tourism and adventure travel, increasing numbers of tourists are contracting schistosomiasis, according to the WHO. Lake Victoria, which Kenya shares with Uganda and Tanzania, is known to be infected. No vaccine or prevention medication is available, but schistosomiasis is treatable, especially if diagnosed promptly. Read more on schistosomiasis and how to avoid infection. RISK FACTOR: Low-Medium
There are other diseases you can get from biting bugs: most of them are a remote risk. These include sleeping sickness(transmitted by the tsetse fly), myiasis (Tumbu flies), and tungiasis or ‘jiggers’ (fleas). In all, they provide travellers with plenty of reasons to prevent insect bites.
WHAT TO PACK
A travel first-aid kit – The standard of medical equipment and facilities may vary, especially outside Kenya’s metro areas; Insect repellent – Apply repellent at all times when outdoors and cover up with a long sleeved shirt/top, long pants, and shoes and socks when mosquitoes are most active; Sunscreen – Apply it to exposed skin as required to protect yourself from the equatorial sun.
For more expert advice on staying healthy overseas, or to book your pre-travel medical consultation at a Travelvax Australia clinic, please call 1300 360 164 (toll-free for landlines).