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Yellow Fever- to have or not to have

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for Tanzania
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Yellow Fever- to have or not to have

Steve B 108, Agent M99, 4Sandi,

I visited 2 travel clinics and my own GP since Saturday 12th.

Some members of my family are travelling to Tz. via Dubai and Nairobi. On the trip over they will catch a private shuttle and will probably be in Kenya less than 6 hours.

On the return journey they "might" stay overnight ( 1 night )in Nairobi. So here is a summary.

Saturday 12th Jan. Doctor number 1 Travel clinic Melbourne

Doc 1 said she hadn't been notified about the new yellow fever regulations on the travel sites nor had read nor seen the WHO site which now excludes TZ. I had a printed copy of the page Steve had referred me to in a previous post. She said she hadn't been officially notified so ignored it.

She then referred to her 2012 Australian Government Travel Guide for Travel Clinics.

Vaccination required for those going to TZ via Kenya even if less than 6 hours would be amongst others yellow fever.She said this was required by the Australilan government- For anybody returning from a declared yellow fever zone and according to her book Kenya and TZ where such zones.. She didn't know what the TZ or Kenyan governments/border officials would say or do.

So those travelling had the yellow fever vaccination at this clinic They were also given Hepatitis A and Typhoid. I was asked by her if they needed the rabies vaccination and I said no- wouldn't be necessary. They were all given a prescrition for malaria meds.

Cost $380 per person.

Doc 1 had never been to East Africa.

Sunday 13th Doc 2 Travel Clinic Geelong

I met Doc 2 socially and as there were 8 people out of the 10 there travelling to TZ in the next year -the conversation got around to vaccinations.

I asked Doc 2 what was required for Tz. He said yellow fever, Hep A and Typhoid and a new one to me Meningitis A. Also to make sure tetanus and polio were up to date very important.

Then I said to him I had seen on the web that TZ was no longer on the list of countries that Australlia required, when returning, for you to have had the vaccination.

He then disappeared to his computer and came back and said he checked the WHO site and I was right. Nairobi, Mombassa and Tanzania were now okay and you didn't not need the yellow fever vaccination if visiting those areas when returning to Australia.

I asked him what he would've done I if hadn't told him to check- he said he would've used the same book Doc 1 used.

I then said what will you do now, his reply: Before I give anybody any more vaccinations for yellow fever I will read the updates on the WHO site and the Travel Sites (the one Steve referred me to.)

Then he told me Meningitis A is very dangerous and to have that before they go. He gave them a prescription for it.

Doc 2 has travelled to east Africa more than 10 times and Tanzania 6.

I then asked why do you need the vaccine and what would you recommend from now on.

His comments not mine-

-everybody going to TZ via Kenya should have the vaccination for yellow fever as the guy at the boder at Namanga or even Kia might not also have read the WH0 site and who knows any way what they might think and do. Not worth the risk.

- yellow fever is carried by mosquitoes and the Maasai Mara is not on the "cleared list" . The Serengeti is part of the Maasai Mara. What if a mosquito flys across the border and bites you in the Serengeti. He won't know where the border is and he doesn't know he shouldn't be there so for your own safety have the vaccine.

-What if you are travelling for a month or so and there is a fresh outbreak and you haven't had the vaccine then what will you do?

Doc 3 my own GP

I visited him for a new prescription for the meningitis vaccine for travel to East Africa.

He said hardly anybody worries about Meningitis A as it is seasonal he said Doc 2 was being extra cautious.

He gave me the script. Then I asked about yellow fever -His reply and I quote -without the vaccination "they won't let you back into Australia."

I didn't pursue it any more.

Doc 3 is a well travelled Malayasian doctor.

I hope this is of some interest.

My opinion have the vaccine for your own safety if nothing else.

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1. Re: Yellow Fever- to have or not to have

Tres, tres interesting. A good read and not at all surprising.

As I've always said - flying things do just that, fly... don't know nothin' 'bout borders.

No uniformity, so as the regulars advise... get the jabs as no one knows what/if the agent at airport or land border will ask, and this is not the person with whom you'd want to be arguing when looking forward to your holiday.

Washington DC...
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2. Re: Yellow Fever- to have or not to have

Noexpert, thanks for all the details. I guess it's hard to get everyone on the same page! Other than that, I couldn't say anything more than Sandi already has.

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3. Re: Yellow Fever- to have or not to have

I think there is another message here. It is common for people to answer queries about travel medicine with a pat "You shouldn't get your medical advice from an internet forum - go see your doctor." I've probably said that myself a number of times, in response to some know-it-all giving overly-specific medical advice without having the necessary background or training or relationship with the recipient.

But on the other hand - my doc is a good internist... but I've traveled a lot more than he has and I have more time to prepare for my trips and read responsible literature.

So I think we are a lot better off going into our doctor setting with questions of "why not?" rather than relying on them to be omniscient God-like professionals. I like it that my doc will make me come in if the situation is ambivalent and requires discussion - but for malaria meds I just leave him a message with what drugs we want for what time span and he faxes the scrip to our mailorder pharmacy. He knows that we are informed medical consumers.

Nashville, Tennessee
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4. Re: Yellow Fever- to have or not to have

I agree with most of the above. I don't necessarily think people are ok just because they go to their doctor and ask and they say that some website says they do or don't need something. Most doctors have no clue and many website and government personnel have NO IDEA what they are supposed to know and what is right and up to date.

By the way, as I quoted before, the chance of a serious adverse reaction, in a person under the age of 65, to the yellow fever vaccine is around 1 in 400,000.

Get the jab....

Thanks for sharing noexpert.

Ottawa, Canada
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5. Re: Yellow Fever- to have or not to have

As seen, even 'travel docs' don't know everything. When I knew I would be travelling and living in Tanz for five weeks I went to a specialist at the hospital who travels somewhat frequently to Africa, and is on health boards with WHO. She also advises and trains students going overseas. She recommends everything and provides little care packages for all her patients travelling. So as well asconfirming I had all of the above, I got the rabies shot given my volunteering. Got the sex talk she gives to everyone from twelve to older than dirt, and then checked out my little brown bag - alcohol wipes, tylenol, Cipro,bandaids, a PEP kit (antiHIV meds) in case I worked in the villages, and condoms. Some would consider this overkill...others a good conversation piece.

Edited: 22 January 2013, 00:49
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6. Re: Yellow Fever- to have or not to have

I agree that you can't always assume your doctor is up on the latest. Heck, when I went to get my vaccinations the doctor said, "So where exactly is Tanzania?. *crickets* Thinking he just needed a reminder to create a visual in his mind I said, "East Africa". *crickets*. I then said, "South of Kenya". *crickets* At that point I just gave up.

So with that said, if a person doesn't know WHERE a place is, don't assume they know what you need vaccine wise. To this doctor's credit, he admitted he had no clue and went and looked it up. He said I didn't need Yellow Fever since I'm coming from the States; however, after reading the threads here I decided it was in my best interest to get one.

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7. Re: Yellow Fever- to have or not to have

Just for info, I just flew back into Tanzania via Joburg (well about a month ago) and they asked for my Yellow Fever card, which I have, it is just that my yellow fever was expired by 2 months. I had to get another jab right there and then, no questions asked and pay $50. It was all properly done with sterile equipment and a nurse in the back and the new jab was recorded in my book but I was caught out :-/

At least it is done for the next 10 years :)

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8. Re: Yellow Fever- to have or not to have

I also agree that there's no harm in people doing research and informing themselves about the requirements and recommendations. Doctors don't know everything. I once had to stop a doctor writing me a prescription for a ludicrous amount of malarone because she'd misread the dosage (or confused it with othe anti-malarials) and thought you needed to take it for 4 weeks after travel, at one tablet per day.

Stockholm, Sweden
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9. Re: Yellow Fever- to have or not to have

The way I see it: the people who can afford vaccine should get it. A lot of people want to do some good for the country they visit and getting all the shots you can is a very good thing. The least we can do is making sure we don't spread any diseases. Combine it with giving money to UNICEF:s vaccine program and you will do a lot more good than a few weeks of volunteering! Be sure to check your measles and rubella vaccines if you didn't have them as a child. Diseases that seem harmless to us well nourished westerners kill a lot of malnourished African children.

That said, the risk of getting or spreading yellow fever when you go to Tanzania is very low. There haven't been outbreaks in either Kenya or Tanzania for many years (according to WHO) so the chance of that one mosquito flying over the border is minuscule but still: it could change and if you want to travel in the future it will be good to have that certificate. It is valid for ten years after all. Hepatitis A shots make you immune for 30 years and hepatitis B probably for ever.

To me it is worth the trouble and money and I see it as a future gift to my children. They are not all that grateful at the moment...

Sydney, Australia
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10. Re: Yellow Fever- to have or not to have

I just checked the print outs my Dr gave me and it says for Tz yellow fever is only needed for Dar, Zanzibar and Pemba.