Discuss your travel plans and personal health with a healthcare provider to determine your necessary vaccines.

• Hepatitis A or immune globulin (IG). Transmission of hepatitis A virus can occur through direct person-to-person contact, through exposure to contaminated water, ice, or shellfish harvested in contaminated water, or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling.
• Hepatitis B, especially if you might be exposed to blood or body fluids (for example, healthcare workers), have sexual contact with the local population, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11-12 years who did not receive the series as infants.
• Malaria: your risk of malaria may be high in all countries in East Africa, including cities. See your healthcare provider for a prescription antimalarial drug.
• Meningococcal (meningitis) if you plan to visit countries in this region that experience epidemics of meningococcal disease during December through June.
• Rabies, pre-exposure vaccination, if you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities.
• Typhoid vaccine. Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages handled by an infected person. Large outbreaks are most often related to fecal contamination of water supplies or foods sold by street vendors.
• Yellow fever, a viral disease that occurs primarily in sub-Saharan Africa and tropical South America, is transmitted to humans through the bite of infected mosquitoes. The virus is also present in Panama and Trinidad and Tobago. Yellow fever vaccination is recommended for travelers to endemic areas and may be required to cross certain international borders (For country specific requirements, see Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country.). Vaccination should be given 10 days before travel and at 10 year intervals if there is on-going risk. · As needed, booster doses for tetanus-diphtheria, measles, and a one-time dose of polio vaccine for adults.

Malaria is always a serious disease and may be a deadly illness. Humans get malaria from the bite of a mosquito infected with the parasite. Your risk of malaria may be high in all countries in East Africa, including cities. All travellers to East Africa, including infants, children, and former residents of East Africa, may be at risk for malaria. Prevent this serious disease by seeing your health care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites.

All travellers should take one of the following drugs:

• Atovaquone/proguanil,
• Doxycycline,
• Mefloquine, or
• Primaquine (in special circumstances).

Arriving from countries where yellow fever is present, a certificate of yellow fever vaccination is required for entry into Tanzania.

Make sure your food and drinking water are safe. Food and waterborne diseases are the primary cause of illness in travellers. Travellers’ diarrhoea can be caused by viruses, bacteria, or parasites, which are found throughout East Africa and can contaminate food or water. Infections may cause diarrhoea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis).

• Wash your hands often with soap and water, or if they are not visibly soiled, use a waterless, alcohol-based hand rub to remove potentially infectious materials from your skin and help prevent disease transmission.
• In developing countries, 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, learn how to make drinking water safer.
• Take your malaria prevention medication before, during, and after travel, as directed. (See your health care provider for a prescription.)
• To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot, even on beaches.
• Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
• Protect yourself from mosquito insect bites:
• Wear long-sleeved shirts, long pants, and hats when outdoors.
• Use insect repellents that contain DEET (N, N-diethylmethyltoluamide).
• If no screening or air conditioning is available, use a pyrethroid-containing spray in living and sleeping areas during evening and nighttime hours. Sleep under bed nets, preferably insecticide-treated ones.

• Do not eat food purchased from street vendors or food that is not well cooked to reduce risk of infection (i.e., hepatitis A and typhoid fever).
• Do not drink beverages with ice.
• Avoid dairy products unless you know they have been pasteurized.
• Do not swim in fresh water to avoid exposure to certain water-borne diseases, such as schistosomiasis.
• Do not handle animals, especially monkeys, dogs, and cats, to avoid bites and serious diseases (including rabies and plague). Consider pre-exposure rabies vaccination if you might have extensive unprotected outdoor exposure in rural areas.
• Do not share needles for tattoos, body piercings or injections to prevent infections such as HIV and hepatitis B.
• Avoid poultry farms, bird markets, and other places where live poultry is raised or kept.