A vaccination certificate is not required for visitors arriving directly from Europe, for example with the KLM flights from Amsterdam to Kilimanjaro (JRO/HTKJ) and Dar es Salaam (DAR/HTDA), as yellow fever is not present in Europe.

A vaccination certificate is required for visitors arriving via for example Nairobi (NBO/HKJK) or Addis Abeba (ADD/HAAB), even if the stay there has been only a few hours in the airport.

Safari health in general
Many diseases that are exotic or unfamiliar to foreign visitors can be found in Kenya and Tanzania. Many of them should be taken seriously. They are not very common among safari-goers, though, partly because safari-goers are usually not exposed to the environments where the diseases are most common, and partly because many safari-goers make sure to be vaccinated against the most dangerous diseases.

Be observant after your trip
Be observant during the months following your trip. Don't hesitate to consult a doctor should you get ill or suspect you have caught something. Many of the tropical diseases, including malaria, can be diagnosed quickly by a clinic that has the proper training and equipment.

Health care and hospitals in East Africa
Good hospitals are available in Nairobi only. Otherwise, local hospitals and medical treatment is generally low standard, and should be avoided unless in emergencies.

African Medical & Research Foundation (see More web sites in the left column) offers a flying doctor service based in Nairobi. Membership isn't very expensive.

Food and drink
The health problem most common to safari-goers is problems with the stomach. Be careful to eat and drink wisely.

More about health

Necessary vaccinations
Consult a doctor or vaccination clinic in good time before travelling, to make sure you have appropriate vaccinations and malaria protection for East Africa.

Vaccinations often recommended include yellow fever, polio, tetanus, diphtheria, hepatitis A and B, cholera, typhoid fever, meningococcemia, tuberculosis and rabies, but fore normal safari holidays, all of these may not be needed. In addition to vaccinations, you will most likely be recommended a malaria prophylaxis.

Children who have not had, or been vaccinated against, measles, mumps and rubella may need vaccinations before travelling to East Africa.

Malaria
Malaria is a deadly and widespread disease in Africa, and is present in most of East Africa. Not very many safari-goers get infected, but it does happen, and you should do whatever you can to reduce risks. The standard protection is eating malaria prophylaxis pills, sleeping in an environment free from mosquitoes, and covering your skin (using clothes and mosquito repellent) when outdoors during dusk, dawn and night.

Malaria is a blood parasite, spread by biting mosquitoes that are active at night. The first symptoms of malaria may not be seen until after your trip. High fever or aching head or joints can be such signs. Should you have them in the weeks, or even months, after visiting East Africa, we recommend that you immediately contact an infection clinic. The malaria found in East Africa can be cured altogether, provided it's treated promptly.

Non-malaria zones
Some lodges market themselves as non-malaria lodges, usually because of being set at some altitude. This doesn't mean that you shouldn't protect yourself against malaria when staying there.

Altitude can result in winds and in low temperatures that malaria mosquitoes don't thrive in. A guideline for malaria free altitude is 2,500 m/8,200 ft, and most lodges are set well below that. Note that in spells of hot weather, malaria spreads to higher altitudes than otherwise. The water required for mosquitoes to hatch is rarely absent in mountains forests etc.

Irrespective of where you stay in East Africa, you will most likely spend time in or pass through areas where malaria is present. Because of that, and because malaria is such a dangerous disease, you should consider no place malaria safe.

Malaria prophylaxis
Some malaria prophylaxis products have been known to cause severe side effects, but there are now modern products with few or no such effects. Consult a doctor or vaccination clinic to have a good malaria prophylaxis prescribed.

The prophylaxis doesn't give you a 100 % protection against malaria. It reduces the risk of being infected.

Mosquito nets
Mosquito nets are meant to keep mosquitoes away from you when sleeping. Most hotels, lodges and tented camps have mosquito nets in your room or tent. If so, use them. If there are holes in your net, cover it using a towel, adhesive tape, band-aid etc. You may even bring a net of your own for a spare.

Some hotels and lodges don't have nets above the beds, but instead have nets covering the windows. If there is a chink below the door to your room, you may use a towel to cover it.

Covering your skin
Prevent mosquitoes from biting you by wearing trousers and long sleeves when outdoors (or wherever there may be mosquitos) during dusk, dawn and night. Use a mosquito repellent where your skin is not covered by fabric.

Other local diseases
Yellow fever and Rift Valley fever
Yellow fever and Rift Valley fever are viral diseases spread by mosquitoes, both occurring in East Africa, although few safari-goers are infected. There is a vaccine for yellow fever.

Rift Valley fever is less deadly (approximately 1 %), and mainly occurs during periods of heavy rainfall. An outbreak in Kenya and Tanzania during late 2006/early 2007 came during a period of such rainfall.

Sleeping sickness
Sleeping sickness is a parasite disease spread through bites by tsetse flies (active during the day), and is fatal if not treated. No good, modern treatments are available. The disease is uncommon among safari-goers.

Ebola
Ebola hemorrhagic fever is an often-fatal virus disease. Reports of outbreaks in Africa are sometimes seen in the news. It has never been reported in Kenya or Tanzania, but in neighbouring Uganda and Congo.

Years ago, western Kenya had a few cases of Marburg hemorrhagic fever, similar to ebola. Rare cases are also known from Uganda, Congo and Zimbabwe. The Mount Elgon area in western Kenya may be a natural reservoir for both ebola and Marburg.

Bilharzia
Bilharzia or schistosomiasis is a parasite disease that you may catch in fresh water lakes or slow rivers; avoid drinking, bathing, wading or washing in water from these. It causes liver and intestinal damage, and may be fatal, although the mortality rate is low.

There is no risk of bilharzia in chlorinated swimming pools, salt water or temporary water puddles.

HIV/AIDS
Although Kenya and Tanzania are not the worst affected countries in sub-saharan Africa, HIV is widespread.

General
Avoid walking barefooted outdoors. Apart from stepping on sharp acacia thorns, you may get in contact with parasites on the ground, for example in animal droppings. When walking through grass or vegetation, you may be exposed to ticks, which can infect you with tick bite fever.