We are NOT authorized by Govt of India for Yellow Fever Vaccination

Friday, November 20, 2015

Everything You Need to Know About Visiting a Travel Clinic

Until recently I had never visited a travel clinic. But after going once, I'm a convert, and from now on will always go before I take far-flung trips.
After going to Thailand and meeting a handful of people with friends who had contracted malaria on their trips, I vowed to start making a visit to the travel clinic part of my pre-trip prep work before going to developing or at-risk countries. So, when I recently traveled to Colombia I decided to follow through on this promise. When I researched online and checked out the CDC website, I found mixed opinions on whether to get certain vaccines. I knew what to do next: get a professional opinion on what exactly I needed for the areas I was headed.
I contacted my primary care doctor, who referred me back to the CDC website, and after explaining that I'd already done the initial research, they decided to schedule me for a yellow fever vaccine. However, the yellow fever vaccine at the time was on a national back order, and my primary care doctor would not have it in enough time to administer it before my trip. The wild-goose chase to find a yellow fever vaccine led me to the Harvard Vanguard Travel Medicine Department.
I made an appointment a little over a week before my trip. When I arrived, I met with a nurse who asked which areas I was traveling to and went over my immunization chart they had from my primary care office. Shortly after, the doctor came in and handed me a thick folder with information I didn't even know I needed. She went over the Travax Traveler Health Report for Colombia, which included health concerns, requirements for entry (i.e. necessary visas, immunization requirements—some countries require proof of a yellow fever vaccine for reentry if you've been to Colombia), recommended immunizations, travel advisories, general information (i.e. entry and exit fees, currency, unusual laws, driving laws, civil unrest warnings), embassy contact information, basic preventative measures, and finally a pre-travel checklist. Access to Shoreland Travax reports are restricted to licensed professionals only, so you can only receive this information at a clinical visit.
We also went over a detailed map of the country with at-risk areas for yellow fever and malaria and determined I should take malaria pills and get the yellow fever vaccine since I was going to a national park. She also recommended I get the typhoid vaccine, since mine was outdated and gave me a prescription for traveler's diarrhea medicine, since most areas in the country are at high risk.
She also helped me register in STEP (Smart Traveler Enrollment Program) and verified my travel insurance coverage through work with GeoBlue. I also got a handy over-the-counter travel medicine/product list to keep for future travels.
Overall, I had a surprisingly pleasant experience and will make sure to visit the clinic before any travels to developing countries or destinations where I am unsure of what health and safety precautions I should take.

Things to Consider Before You Go

The CDC website is a good place to start; however, the amount of information can be overwhelming and sometimes vague or conflicting. If your primary care office has its own travel medicine department, call them first and see what they recommend. In some cases (like mine) you may end up needing additional vaccines or prescriptions, so having an appointment or consultation is best in person so the doctor can order everything you need at the time of your visit. If your primary care office does not have a travel medicine department, call around and find a clinic covered by insurance in your area, as consultations and vaccines can be pricey if not covered.
Keep in mind that some vaccines can take up to six weeks to be active, so you will need to make your visit well in advance (something I will make note of for my next trip). Also, some vaccines cannot be given at the same time, or need to be given in doses, so it's extra important to give yourself plenty of time in advance for the necessary vaccinations.

What to Bring With You

A copy of your itinerary or at least a list of places you are going to as well as an updated immunization list if you are visiting a clinic outside of your primary care office. Also make sure to notify the clinic of any allergies, especially to medications.

What to Expect

My visit was short and sweet. I got all of the information (and more) that I needed. My two shots were administered at the time of my visit and I filled out a card to keep with my passport verifying I had the yellow fever immunization.

Preparing for Your Trip

In addition to any prescriptions needed, this basic list for health and safety comes in handy for international travel:
  • Antihistamines: Benadryl, Zyrtec, or Claritin
  • Pain/Fever Relief: Asprin, Ibuprofen, or Tylenol
  • Insect Repellent: 30 percent DEET spray, and permethrin clothing spray
  • Anti-Diarrhea and Rehydration: Loperamide, Pepto Bismol, Pedialyte powder packets, Gatorade powder packets
  • Probiotics: Culturelle
  • Motion Sickness: Meclizine
  • Other Supplies: Hydrocortisone cream, flight compression socks, digital thermometer, bed net for mosquitos

After Your Trip

Make sure you take all of the recommended doses of your prescriptions, as oftentimes it's necessary to take them for a few weeks after travel. Watch for any signs of diseases, as symptoms can have delayed onset.

More from SmarterTravel:

Ashley Rossi is always ready for her next trip. Follow her on Twitter and Instagram @ashley_stravel for more advice on travel hacks and destination ideas.
Find Related Stories: Ashley Rossihealth and safety

Monday, November 16, 2015

Current status of Polio in Nigeria - no longer on the endemic list - Nov 2015 (CDC)

Polio in Nigeria

Warning - Level 3, Avoid Nonessential Travel
Alert - Level 2, Practice Enhanced Precautions
Watch - Level 1, Practice Usual Precautions

What is the current situation?

The latest wild poliovirus case in Nigeria occurred on July 24, 2014. Because more than a year has passed since this case occurred, the World Health Organization has removed Nigeria from the list of polio-endemic countries; only Afghanistan and Pakistan remain. According to Global Polio Eradication Initiative, one vaccine-derived poliovirus case was identified in Nigeria in May 2015. Vaccine-derived poliovirus can circulate in areas with low coverage of oral polio vaccine (OPV).
CDC recommends that all travelers to Nigeria be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine. (Inactivated polio vaccine [IPV] is used in the United States instead of OPV. IPV does not contain live virus, so it cannot cause vaccine-derived polio.)

What is polio?

Polio is a disease caused by a virus that affects the nervous system, and is mainly spread by person-to-person contact. Polio can also be spread by drinking water or other drinks or eating raw or undercooked food that has been contaminated by the feces of an infected person.
Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. Most people recover completely. In rare cases, polio infection causes permanent loss of muscle function in the arms or legs (usually the legs); if there is loss of function of the muscles used for breathing or an infection of the brain, death can occur.

What can travelers do to prevent polio?

  • Get the polio vaccine:
    • Ask your doctor or nurse to find out if you are up-to-date with your polio vaccination and whether you need a booster dose before traveling. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster dose to make sure that you are protected. See individual destination pages for vaccine recommendation information.
    • Make sure children are vaccinated.
    • See Vaccine Information Statements (VIS) for more information.
  • Eat foods and drink beverages that are considered safe: Follow the Food and Water Safety tips to avoid eating or drinking things that could be contaminated with polio.
  • Practice hygiene and cleanliness:
    • Wash your hands often.
    • If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
    • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.

Traveler Information

Clinician Information

All travelers to any country should be up-to-date on routine vaccinations, including polio vaccine. CDC recommends a single lifetime IPV booster dose for travelers to certain countries. See the Vaccine section in Chapter 3, Poliomyelitis,CDC Health Information for International Travel, for specific vaccination details.

Additional Information

The world is running short of yellow fever vaccines—and millions are at risk

Until the early 20th century large epidemics of yellow fever erupted routinely in Africa, Europe and the Americas, killing hundreds of thousands. The viral disease, spread by a mosquito, is fatal in about 20% cases—making it a serious threat for about 900 million people living in the 45 countries where the virus is present. While yellow fever cannot be eliminated from the wild and there is no cure for it, immunizing at least 70% of the population in at-risk areas effectively eliminates the risk of outbreaks, a goal that had been reached in the decades following the introduction of the vaccine in the 1930s.

The immunization coverage, however, has not been maintained, and there are currently an estimated 200,000 cases of yellow fever ever year, with 30,000 deaths. Of 17 high-risk countries, 14 are in Africa, where 90% of the cases and deaths occur, while between 1933 and 1961 the high vaccination coverage had successfully wiped out the epidemic in West and Central Africa.

The resurgence of yellow fever in Africa is a classic tale of complacency: not only the routine immunizations aren’t kept up with the required levels, but the vaccine supply doesn’t match the world’s requirements.According to UNICEF (pdf, p.2), the world needs about 64 million yellow fever vaccine doses, but only 35 million are produced—42% under the required quantity.

In 2003, an emergency stockpile had been created by the World Health Organization (WHO) and the Global Alliance for Vaccine and Immunization (GAVI) to provide six million emergency doses per year. The quantity, however, is not enough to make up for the shortage of doses—nor is the role of an emergency stockpile to routinely make up for the lack of production.

While highly effective—a single dose protects 99% immunized patients for 35 years or more—the yellow fever vaccine is relatively complex to produce, and there are currently only four facilities—in Brazil, Senegal, Russia, and France—equipped with the required technology.

Orin Levine, who directs the vaccine team of the Gates Foundation points out the situation is rather telling of the general attitude towards diseases that are being kept under control through, albeit in need of continued immunization efforts. “Nobody was looking after it until we didn’t have as many doses as we needed,” he told Quartz.

The good news, however, is we’re still in time to fix this—and with a relatively small investment. Just recently, Levine said, the Gates Foundation has invested to both ensure the lifeline of the Institut Pasteur de Dakar, the manufacturer of vaccine in Senegal, and to increase the dosage: “$1.6 million—that’s all it took to help maintain the supply,” Levine told Quartz.

It’s a good first step, but not enough to successfully solve the shortage—until the supply exceeds the world demand of vaccines, and the system is equipped to produce enough doses even in extreme cases (for instance, if one factory closed), the alert needs to stay high.

Sign up for the Quartz Africa Weekly Brief — the most important and interesting news from across the continent, in your inbox.

Mosquitos Are best repelled by DEET

A recent study concluded that while DEET is the best way to repel mosquitos, an Eau de Parfum from Victoria’s Secret was also an effective option.
Published in the October edition of Journal of Insect Science, the work was done by researchers from New Mexico State University’s College of Arts and Sciences, who were looking to proof the efficacy of mosquito repellents.
The research team took 10 commercially available products and put them to the test against the yellow fever mosquito (Aedes aegypti) and the tiger mosquito (Aedes albopictus), both known to transmit diseases.
“People need to protect themselves, especially if they travel to the tropics,” said Immo Hansen, an NMSU associate professor of biology when discussing the study with the New Mexico State University’s website, “Insect repellents can be highly efficient, but you need to find out which work.”
The testing included three sprays that use diethyltoluamide: Repel 100 Insect Repellent, OFF Deep Woods Insect Repellent VIII and Cutter Skinsations Insect Repellent — as well as four DEET-free options: Cutter Natural Insect Repellent, EcoSmart Organic Insect Repellent, Cutter Lemon Eucalyptus Insect Repellent, and Avon Skin So Soft Bug Guard. According to the study, while “DEET is considered a very safe repellent… fear of possible side effects of DEET and general chemophobia has resulted in the development of a multitude of “DEET-free” mosquito repellents.”
To test the products, a volunteer placed a hand at one angled end of a Y-shaped tube — at the far end of the same tube was a chamber holding 20 mosquitos — with the other Y branch a free space.
Once the helper’s scent was fanned toward the chamber (as mosquitos are attracted to lactic acid and octanol, components of human sweat), the target hand was anointed with each of the repellents in question. Once the test began, the mosquitos were watched to see if there was immediate and eventual biting over a four-hour period, with observation points at zero minutes, 30 minutes, 120, and 240 minutes.
A repellent-free hand was used at first — which drew 61 percent of the 20 yellow fever mosquitos, 41 percent of the tigers.
Of the applications that followed, the DEET-containing sprays OFF Deep Woods Insect Repellent VIII, Repel 100 Insect Repellent, and Cutter Skinsations Insect Repellent were the most successful. All three kept both the yellow fever and tiger mosquito biting under 20 percent as late as 120 minutes into their tests, and Repel 100 took the prize by scoring a bite percentage of 14 at the 240-minute mark.
On the other hand, the four DEET-free options tested (Cutter Natural Insect Repellent, Cutter Lemon Eucalyptus Insect Repellent, Avon Skin So Soft Bug Guard, EcoSmart Organic Insect Repellent) were all subject to an over-50 percent yellow fever mosquito biting by the 120 minute post—save the Cutter Lemon Eucalyptus, at only 13 percent. Additionally, all four non-DEET options were subject to tiger mosquitos biting under 25 percent at two hours — except for Cutter Natural, which was recorded to have a 120-minute mark biting percentage of 37.
As for the final three test subjects, an AgraCo Technologies vitamin B1-based Mosquito Skin Patch, Avon brand Skin So Soft Bath Oil, and Victoria’s Secret Bombshell perfume — it was the patch that was recorded as least effective, with 48 percent of the yellow fever and 34 percent of the tiger mosquitos recorded biting at 120 minutes. Skin So Soft saw 43 yellow fever/ 36 tiger at that same mark — but as for the “Bombshell” perfume, only 18 percent of the yellows and 17 percent of the tigers were biting at that point, making it (in this study) statistically effective.
The Victoria’s Secret website describes the fragrance as “Sexy today, sexy tomorrow, sexy forever.”
To a mosquito? Maybe not so much.

Sunday, November 15, 2015

WHO says: Sierra Leone stops transmission of Ebola virus

World Health Organization: Media centre: News release by WHO African Region, November 7, 2015, Freetown
The World Health Organization declares that Ebola virus transmission has been stopped in Sierra Leone. Forty-two days, that is two Ebola virus incubation cycles, have now passed since the last person confirmed to have Ebola virus disease had a second negative blood test.
"Since Sierra Leone recorded the first Ebola case in May 2014, a total number of 8,704 people were infected and 3,589 have died, 221 of them healthcare workers, all of whom we remember on this day” said Dr Anders Nordström, WHO Representative in Sierra Leone.
The country now enters a 90-day period of enhanced surveillance which will run until 5 February 2016 and WHO will continue to support Sierra Leone during this period. This new phase is critical for ensuring early detection of any possible new cases of Ebola virus disease.
The World Health Organization commends the Government of Sierra Leone and her people on achieving this significant milestone in the country’s fight against Ebola. Sierra Leone achieved this milestone through tremendous hard work and commitment while battling the most unprecedented Ebola virus disease outbreak in human history.

Quarantine Station Commissioned at CIAL, Kochi Airport

KOCHI: The third health and quarantine station in the country was commissioned at the Cochin International Airport in wake of the outbreak of yellow fever in various parts of the world. With the commissioning of the quarantine station in Kochi, the practice of redirecting passengers arriving from the affected countries who are suspected to be suffering from the disease to Mumbai and New Delhi, the two airports that have quarantine station, has stopped, said authorities.
The quarantine station set up at CIAL at a cost of one crore rupees has facilities to keep the passengers, suspected to be harbouring the virus, under observation. At present, the passengers, suspected to be harbouring the virus reaching here were being redirected to Mumbai and New Delhi. The passengers from the affected countries have been told to carry vaccination certificates, issued by the authorities concerned from the host areas, along with them during the time of their travel. Those who reach here without the mandatory vaccination certificate will be sent to the quarantine station.
According to V J Kurien, managing director, CIAL, it is estimated that yellow fever infects two million people and claim thirty thousand lives every year. As the number of passengers coming from places affected by yellow fever such as South America and Africa is increasing, the airport operation becomes a hazardous job. Since January this year, 33 cases of passengers travelling without vaccination cards for yellow fever were reported and the airport was compelled to send 27 passengers to Delhi for quarantine, he said.
“Considering the urgency, we had approached the Directorate of Health Services, and we then received permission from the DHS to start the station. CIAL will also follow all the international health related circulars and procedures regarding the health and quarantine station, he added. According to Dr Jagdish Prasad, director general of health services, who commissioned the station, setting up of more such stations at Thiruvananthapuram, Chennai and Thiruchirappally airports is also in the pipeline.
Published: 11th November 2015

Wednesday, November 4, 2015

CDC Travelers' Health: Ebola in Sierra Leone travel notice downgrade

What is the current situation?

For more than a year, Sierra Leone, Liberia, and Guinea have been experiencing the largest and most complex outbreak of Ebola in history. Cases continue to be reported in Guinea. Currently, there are no known cases of Ebola in Liberia or Sierra Leone. The health system in Sierra Leone continues to monitor for new cases and to take precautions to prevent transmission in the country. CDC is also closely monitoring the situation and will update information and advice for travelers as needed.
CDC is no longer recommending that US residents avoid nonessential travel to Sierra Leone. However, CDC recommends that US residents practice enhanced precautions when traveling to Sierra Leone.Although the risk is extremely low, there is the possibility of reintroduction of Ebola into the country. Travelers should follow CDC’s advice for avoiding contact with blood and body fluids. Travelers should also be aware that getting medical care in Sierra Leone may be difficult because the health infrastructure has been severely strained by the Ebola outbreak. Certain travelers, such as senior citizens, people with underlying illnesses, and people with weakened immune systems, should consider postponing travel.
For more information, visit 2014 Ebola Outbreak in West Africa on the CDC Ebola website.

What is Ebola?

Ebola is a rare and deadly disease. The disease is caused by infection with one of the Ebola virus species (Zaire ebolavirus, Sudan ebolavirus, Bundibugyo ebolavirus, or Tai Forest ebolavirus). Ebola is spread by direct contact (through broken skin or mucous membranes in, for example, the eyes)
  • with the blood or body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with or has died from Ebola;
  • with objects (like needles and syringes) contaminated with body fluids of a person sick with Ebola or who has died of Ebola;
  • with infected fruit bats and primates (apes and monkeys); and
  • possibly with semen from a man who has recovered from Ebola (for example, contact during oral, vaginal, or anal sex).
Signs of Ebola include fever and symptoms such as severe headache, fatigue (feeling very tired), muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.

Who is at risk?

Travelers could be infected if they come into contact with blood or body fluids from someone who is sick with Ebola or has died from Ebola. Healthcare workers and the family and friends in close contact with patients with Ebola are most at risk of getting sick because they may come in contact with infected blood or body fluids.
People also can become sick with Ebola if they come into contact with infected wildlife or raw or undercooked bushmeat (wild animals hunted for food) from an infected animal.
Ebola virus has been found in the semen of some men who have recovered from Ebola. It is possible that Ebola could be spread through sex or other contact with semen. It is not known how long Ebola might be found in the semen of male Ebola survivors. Based on the results from limited studies conducted to date, it appears that the amount of virus decreases over time and eventually leaves the semen. CDC and other public health partners are continuing to study how Ebola is spread and will share what is known as it becomes available.

How can I be exposed to Ebola?

You can be exposed to Ebola if you have direct contact with blood or body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person sick with Ebola without wearing the right protective clothing and equipment. For healthcare workers, this includes wearing a face shield or goggles, a medical mask, double gloves, a waterproof gown or coveralls, an apron, and waterproof boots.

Exposure can happen if you —

  • Are stuck with a needle or splashed in the eye, nose, or mouth with blood or body fluids of someone sick with Ebola.
  • Handle blood or body fluids of a person who is sick with Ebola.
  • Touch a person who is sick with Ebola.
  • Touch the body of someone who died from Ebola.
  • Care for or live with a person who is sick with Ebola.
  • Spend a long amount of time within 3 feet (1 meter) of a person who is sick with Ebola.

What can travelers do to prevent Ebola?

There is no approved vaccine or specific treatment for Ebola, and many people who get the disease die. If you are traveling to Sierra Leone, please take the following steps to prevent Ebola.
  • Practice careful hygiene. For example, wash your hands frequently with soap and water or use an alcohol-based hand sanitizer.
  • Avoid contact with blood and body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen).
  • Avoid contact with dead bodies.
  • Until more information is known about sexual transmission, avoid contact with the semen of a man who has recovered from Ebola (for example, during oral, vaginal, or anal sex). If you do have sex, use a condom the right way every time. Consider bringing your own supply of condoms.
  • Avoid contact with animals (such as bats or monkeys) or with raw or undercooked meat.
  • Do not eat or handle bushmeat (wild animals hunted for food).
  • Seek medical care immediately if you develop fever (100.4°F / 38°C or above) or other symptoms such as severe headache, fatigue (feeling very tired), muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.
    • Limit your contact with other people when you travel to the doctor. Do not travel anywhere else.
    • The US Embassy or consulate is often able to provide advice on facilities that are suitable for your medical needs. The US Embassy in Sierra Leone can be reached at (232) (99) 105 500.

Preparing to Travel to Sierra Leone

CDC recommends you take steps to protect yourself from other health risks in Sierra Leone. See Health Information for Travelers to Sierra Leone to learn more about ways to stay healthy and safe on your trip.
  • Visit a travel medicine provider, ideally 4 to 6 weeks before you leave, to discuss health recommendations based on your medical history and travel plans.
    • Because it may be difficult to get medical care in Sierra Leone, certain travelers, such as senior citizens, people with underlying illnesses, and people with weak immune systems, should talk to their doctor about whether they should consider postponing travel.
  • Check your health insurance plan to learn what is covered in the event that you become sick. CDC recommends that anyone traveling to Sierra Leone have full coverage, including coverage for emergency medical evacuation.
    • Information about medical evacuation services can be found on the US Department of State’s website on the Air Ambulance/MedEvac/Medical Escort Providers page.
    • Be sure to check the coverage limits for evacuation insurance. Also check to see if the policy covers evacuation to the United States or to the nearest location where adequate medical care is offered.
    • Some insurance providers are excluding medical evacuation coverage for people who have Ebola. Check with providers to ensure you have the coverage you need.

Returning to the United States

See CDC’s Screening and Monitoring Travelers to Prevent the Spread of Ebola fact sheet for information about exit screening in West African countries with Ebola outbreaks and entry screening in other countries, including the United States.
You can also learn more about how you will be connected with a health department after you arrive in the United States to monitor your health for Ebola symptoms.

Traveling to Other Countries or on Cruises

Let your health department know about your travel plans, especially if you are going to another state, leaving the country, or taking a cruise. If you are allowed to travel, there may be special steps you need to follow.
  • If you plan to travel to another country, let your health department know and call the country’s embassy to find out if they have any travel bans or quarantines for people who have recently been in a country with an Ebola outbreak.
  • If you plan to take a cruise, call the cruise line to learn about restrictions that may apply to you. Some cruise lines may not allow passengers to board ships if they have recently been in or traveled through certain countries.

More Information

Traveler Information

Information for Humanitarian Aid Organizations

Clinician Information

Information for Airline Personnel

Tuesday, November 3, 2015

New Yellow Fever Vaccination Center in JJ Hospital Mumbai - some Traveler tips about immunization for Polio & Yellow Fever

There is a new center in mumbai at JJ Hospital. However not enough information is available about the same.
Here are some Traveler tips about immunization for Polio & Yellow Fever at JJ Hospital Mumbai.

"The OPV is available at J J Hospital, Byculla. Following is the process...
Visit the OPD Department of the Hospital (Entry through Gate No. 6 of the Hospital)From the Central Counter (It is right in the middle with many Windows. Even though it is not a room, it is Numbered as Room Nos. 11) take a Slip for OPV by showing your passport and Pay Rs. 10.
After Taking the Slip Go to Room Nos 13 and Visit the 1st Room on the Right which is marked for OPV and other Immunization. (Do not worry for the Line outside Room 13. It is for something else).
Show your slip to the Guys at Computer and follow as directed from thereon.
Please note timings are from 9.30 to 12.30 only. You need to reach hospital before 12.00 to complete the process within the time.
Comments by another traveler:1. Rs. 10 is the fee for 1st time registration as an OPB patient. This has to be done on Window No. 11 of Room No. 11.2. The immunization is now done in Room No. 50.3. You can get both Yellow Fever and Polio in Room No. 50"

We would love to have the feedback from more travelers about the new center in Mumbai. Please do remember that the easiest and most conveneient way to take the Yellow Fever vaccination in Mumbai is probably the TravelSafe Clinic Center in Chembur. You can get more information by calling Malini at +919867694813 or visiting our website at www.travelsafeclinic.com  

Traveling to South Africa from India, do I need a Yellow fever vaccination?

Q: I am travelling to South Africa, do I need to get yellow fever vaccination?

A: It depends on your transit station. If you transit via Ethiopia / Kenya, then it is mandatory to have the Yellow Fever Vaccination.
However, if you are traveling directly to South Africa, or transiting via a middle east country, then Yellow Fever vaccination is not needed. South Africa itself does not have Yellow Fever, BUT they are very strict in enforcing Yellow Fever vaccination requirements even if you are just transiting from any African country where Yellow Fever Vaccination is mandatory.