Please note these are my personal suggestions, things that I consider before travelling to Senegal and/or The Gambia.  They are only suggestions, not recommendations - I am not a medical practitioner and am not qualified to give such advice - please consult with your doctor and/or travel clinic ahead of departing for the region.

Suggested Healthcare Precautions

It is possible, but not advisable, to visit the doctor/travel clinic for precautionary healthcare advice and the recommended inoculations in the last couple of weeks before travelling to Africa. 

Let's say that 6-8 weeks prior to travel represents the latest you should leave it before making an appointment to talk things over with your doctor. I know you're all busy, but please don't wait until the last minute to start thinking about it!!! 

A certain number of healthcare precautions are advisable before visiting West Africa.  None are obligatory, but just strongly recommended for your own well being.  

All I will do here is introduce some of the diseases and precautions -  I know what precautions I take and although I'm pretty much informed, I'm not a healthcare professional and so certainly can not tell you what to do -- your doctor or a specialist travel clinic are obviously valuable sources of up to date information and it would be helpful if you make a contact with one or other within the next month or two. 

The Center for Disease Control and Prevention in Atlanta is another excellent source of information - www.cdc.gov .

The first and most important of vaccinations - inoculation against Hepatitis A.   There are several different ways in which this can be done.   Hepatitis A is always a concern -- food hygiene standards, staff hand-washing or lack there of must always be guarded against.  It's always possible to get a little sick, diarrhoea, stomach ache, food poisoning if unlucky, but Hepatitis A is clearly a more serious matter. 

I've now spent a total of more than 3 months in The Gambia and Senegal and have been sick only once - I suffered from a bout of diarrhoea and vomiting for a little more than one day (before necessarily clearing things up quickly with a short course of antibiotics).  I blame this on myself rather than on the overall standards of restaurants in  West Africa - I believe the offending meal was a salad in a restaurant with a questionable standard of cleanliness (although in truth there could have been any number of sources - given the incubation time before sickness takes hold it's impossible to be sure).  If you're thinking that I was unwise or even stupid to eat a salad in a restaurant in West Africa you might be right - however, when you're in any part of the world for longer than a few days, I believe it's simply unwise as well as close to impossible to avoid fresh vegetables indefinitely - there is inevitably an element of risk to eating in any restaurant in West Africa, but that's also the case in just about any part of the world.   

The northern winter and spring is the dry season in West Africa and the number of mosquitoes will be at a minimum - but nevertheless malaria prophylactic tablets are highly recommended.    Again, there are several options including Lariam and Malarone. 

During my trips thus far I have seen very few or practically no mosquitoes in Dakar -- and accordingly suffered hardly any bites -- the same will not be true on the Gambia River, where the 'flying syringes' are sure to be present in somewhat greater numbers, though nothing like the numbers that can be found at times during the rainy season (June/July to October).

Vaccination against Yellow Fever (also mosquito-borne) is equally recommended.  (And in Senegal, is I believe actually a legal requirement, but one which is only ever enforced if you are arriving in Senegal from an infected country.  I have never been asked to show my certificate of inoculation against yellow fever in Senegal or The Gambia.  If you are arriving in Senegal from Europe or North America you will certainly  not be asked to show  proof of yellow fever inoculation.)

Tetanus, Diptheria and Polio (TdP) -  these aren't specific to West Africa, but should be updated prior to travelling to the region.  You will see plenty of victims of polio throughout the region - although thankfully almost no children, since the authorities have a stranglehold on vaccinating against the disease of late. 

Typhoid is another possible vaccination.

Meningitis is certainly one other vaccination worth considering.   We will be in well ventilated spaces at all times -- especially where sleeping is concerned -- outbreaks in the places we will be visiting are not common, and the likelihood that we will come up against this disease is extremely small.   My major concern about failure to be inoculated against meningitis, and the reason I got the vaccination some time ago, is the extremely rapid onset and severity of the disease.  

I wouldn't personally worry about Rabies - just stay from cats, dogs and other mammals during the trip.  Rabies vaccinations will be available in Dakar in case of an emergency.

Equally I don't think Hepatitis B vaccination is at all necessary for a short trip. 

A Broad Spectrum Antibiotic is something I typically carry with me when in Africa, good for any number of minor ailments.  Just in case I happen to pick up a gastrointestinal bug and do not have a doctor right at hand, I sometimes take a short course (5 days) of ciprofloxacin (Ciloxan, Cipro) to remedy the situation.  It can come in handy, and might be something you want to consider -- not for Dakar, since doctors and pharmacies are plentiful, but for use in rural Gambia or while on the road where the nearest doctor could well be a couple of hours away.  

Any questions about the information and suggestions given here - please email me at england@mangosee.com

LINKS TO SPRING 2006 MEETING PAGES:

Hepatitis 2006 Meeting Home Page is Here

Kinetoplastid Diseases 2006 Meeting Home Page is Here

Tuberculosis 2006 Meeting Home Page is Here

Bacterial Gastroenteritis 2006 Meeting Home Page is Here