waterborne diseases are the number one cause of
illness in travelers. Travelers�
diarrhea can be caused by viruses, bacteria,
or parasites, which are found throughout the region
and can contaminate food or water. Infections may
cause diarrhea and vomiting (E. coli, Salmonella,
and parasites), fever (typhoid
fever and toxoplasmosis), or liver damage
(hepatitis). Make sure your food and drinking water
are safe. (See below.)
is a serious, but preventable infection that can be
fatal.Your risk of malaria may be high in these
countries, including cities. Prevent this deadly
disease by seeing your health care provider for a prescription
antimalarial drug and by protecting yourself
against mosquito bites (see below).
All travelers to West Africa, including infants,
children, and former residents of West Africa, are at
risk for malaria. All travelers should take one of the
following drugs (listed alphabetically): atovaquone/proguanil,
doxycycline, mefloquine, or primaquine (in special
circumstances). See Malaria
Information for Travelers to West Africa
for detailed information on malaria-risk areas and
antimalarial drugs. See also Preventing
Malaria in the Pregnant Woman (Information for the
Public) and Preventing
Malaria in Infants and Children (Information for the
fever vaccination is recommended and may be
required for entry into certain of these
countries. If you travel to West Africa, the easiest
and safest thing to do is get a yellow
fever vaccination and a signed certificate. For
detailed information, see Comprehensive
Yellow Fever Vaccination Requirements.
(sleeping sickness) are diseases carried by
insects that also occur in this region. Protecting
yourself against insect bites (see
below) will help to prevent these diseases.
a parasitic infection, is found in fresh water in the
region. Do not swim in fresh water (except in
well-chlorinated swimming pools) in these countries.
(For more information, please see the Swimming
Precautions on the Making
Travel Safe page.)
Because motor vehicle
crashes are a leading cause of injury among travelers,
walk and drive defensively. Avoid nighttime travel if
possible and always use seat belts.
CDC recommends the
following vaccines (as appropriate for age):
See your doctor at
least 4�6 weeks before your trip to allow time for
shots to take effect.
A or immune globulin (IG).
B, if you might be exposed to blood (for
example, health-care workers), have sexual contact
with the local population, stay longer than 6
months, or be exposed through medical treatment.
meningitis, for travel to most of these
meningitis map) from December through June.
if you might be exposed to wild or domestic
animals through your work or recreation.
particularly if you are visiting developing
countries in this region.
- As needed, booster
doses for tetanus-diphtheria,
and a one-time dose of polio vaccine for adults. Hepatitis
B vaccine is now recommended for all infants
and for children ages 11�12 years who did not
complete the series as infants.
To stay healthy, do...
- Wash hands often
with soap and water.
- Drink only bottled
or boiled water, or carbonated (bubbly) drinks in
cans or bottles. Avoid tap water, fountain drinks,
and ice cubes. If this is not possible, make water
safer by BOTH filtering through an �absolute
1-micron or less� filter AND adding iodine
tablets to the filtered water. �Absolute
1-micron filters� are found in camping/outdoor
- Eat only
thoroughly cooked food or fruits and vegetables
you have peeled yourself. Remember: boil it,
cook it, peel it, or forget it.
- Take your malaria
prevention medication before, during, and
after travel, as directed. (See your doctor for a
yourself from mosquito bites:
- Pay special
attention to mosquito protection between dusk
and dawn. This is when the type of mosquito
whose bite transmits malaria is active.
long-sleeved shirts, long pants, and hats.
- Use insect
repellents that contain DEET
- Read and
follow the directions and precautions on the
- Apply insect
repellent to exposed skin.
- Do not put
repellent on wounds or broken skin.
- Do not breathe
in, swallow, or get into the eyes (DEET is
toxic if swallowed). If using a spray product,
apply DEET to your face by spraying your hands
and rubbing the product carefully over the
face, avoiding eyes and mouth.
- Unless you are
staying in air-conditioned or well-screened
housing, purchase a bed net impregnated with
the insecticide permethrin or deltamethrin.
Or, spray the bed net with one of these
insecticides if you are unable to find a
pretreated bed net.
- DEET may be
used on adults, children, and infants older
than 2 months of age. Protect infants by using
a carrier draped with mosquito netting with an
elastic edge for a tight fit.
- Children under
10 years old should not apply insect repellent
themselves. Do not apply to young children�s
hands or around eyes and mouth.
- For details on
how to protect yourself from insects and how
to use repellents, see Protection
against Mosquitoes and Other Arthropods.
- To prevent fungal
and parasitic infections, keep feet clean and dry,
and do not go barefoot.
- Always use latex
condoms to reduce the risk of HIV and other
sexually transmitted diseases.
To avoid getting
- Don�t eat food
purchased from street vendors.
- Don�t drink
beverages with ice.
- Don�t eat dairy
products unless you know they have been
- Don�t share
needles with anyone.
- Don�t handle
animals (especially monkeys, dogs, and cats), to
avoid bites and serious diseases (including rabies
(For more information, please see the Animal-Associated
Hazards on the Making
Travel Safe page.)
- Don�t swim in
fresh water. Salt water is usually safer. (For
more information, please see the Swimming
Precautions on the Making
Travel Safe page.)
you need to bring with you:
shirt, long pants, and a hat to wear while outside
whenever possible, to prevent illnesses carried by
insects (e.g., malaria,
- Insect repellent
- Bed nets
impregnated with permethrin. (Can be purchased in
camping or military supply stores. Overseas,
permethrin or another insecticide, deltamethrin,
may be purchased to treat bed nets and clothes.)
spray or mosquito coils to help clear rooms of
mosquitoes. The product should contain a
pyrethroid insecticide; these insecticides quickly
kill flying insects, including mosquitoes.
antidiarrheal medicine to take if you have
- Iodine tablets and
water filters to purify water if bottled water is
not available. See Do�s
above for more details about water filters.
medications: make sure you have enough to last
during your trip, as well as a copy of the
After you return
If you have visited a
malaria-risk area, continue taking your antimalarial
drug for 4 weeks (mefloquine or doxycycline) or seven
days (atovaquone/proguanil) after leaving the risk
Malaria is always a
serious disease and may be a deadly illness. If you
become ill with a fever or flu-like illness either
while traveling in a malaria-risk area or after you
return home (for up to 1 year), you should seek immediate
medical attention and should tell your health care
provider your travel history.
Ask your doctor or
check the CDC web sites for more information about how
to protect yourself against diseases that occur in
West Africa, including the following:
For more information
about these and other diseases, please check the Diseases