Vaccination and Travel Information for Sierra Leone

SIERRA LEONE

 Information current as at:  February 2009 by The D2 Medical centre No1 Fitzwilliam Street Upper Dublin 2 ph 6314500. Th experts in travel vaccines Dublin 2.


Climate: Tropical and humid throughout the year. Between November and April it is very hot and dry. The coastal areas are cooled by sea breezes. In December / January the dry dusty Harmattan wind blows from the Sahara desert. During the rainy season between May and November rainfall can be torrential.
Capital City: Freetown
Altitude: 50 metres above sea level
Main Cities: Bo, Kenema, Makeni
Population: 5,232,624
Land Area (sq km): 71,740
Currency: 1 leone (Le) = 100 cents
Languages: English (official, regular use limited to literate minority), Mende
Religions: Muslim 60%, indigenous beliefs 30%, Christian 10%
Economy: Diamonds, cocoa, coffee, fish



The D2 Medical advises all travellers to be 'up-to-date' for:

CHOLERA Immunisation is neither required nor recommended.
DIPHTHERIA We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

HEPATITIS 'A' This is the most vaccine preventable disease for travellers. Strongly recommended but not compulsory for travel to this area.


HEPATITIS 'B' Immunisation is strongly recommended for travellers who will be in the area for 1 month or more.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.

MENINGO-COCCAL MENINGITIS There is current significant risk of the disease. Immunisation is recommended.

POLIO Adults who are travelling to areas where poliomyelitis cases are occurring, or where the contracting the disease is possible, and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.



RABIES Immunisation is recommended for travellers who will be in rural or remote areas for 1 month or more at a time.


TUBERCULOSIS (TB) Immunisation is not compulsory, and is not recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt.


TETANUS We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.
TYPHOID FEVER Immunisation is recommended.


YELLOW FEVER A yellow fever vaccination certificate is required from travellers coming from endemic areas ( see * below ).

* World Health Organization:
The following countries and areas are regarded as Yellow Fever infected areas:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan (south of 15°N), Togo, Uganda, United Republic of Tanzania, Zambia.
America: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, Trinidad and Tobago, Venezuela.




Malaria risk, predominantly due to P. falciparum, exists throughout the year in the whole country, including urban areas. Increased risk occurs during and immediately after the rainy season (May through November). Falciparum malaria accounts for 80% of cases,

There are five common medications for malaria prevention available in Ireland. They are: chloroquine, doxycycline, malarone, mefloquine, paludrine. To determine the appropriate antimalarial, it is advised that the traveller discuss this with a Worldwise Travellers Health Specialist or other Travel Health Professional. None of the medicines are 100% effective against the disease at all times, and each has its own side effects. These need to be discussed with the intending traveller.

 

General Advice on Mosquito Prevention.
Malaria is transmitted by mosquito bite, so recommend all travellers to the country to:

  • cover exposed skin after dusk when they are at most risk for getting bitten
  • use insect repellent with DEET in it.
  • return before dusk from country areas where malarial mosquitoes are the most active
  • sleep in screened room or use a bed net, remembering to tuck in the edges & spray inside.
  • sleep in air conditioned rooms or rooms with fans. Vapour pads and smoke coils also help. Insect buzzers are useless.

Malaria map of Sierra Leone




GENERAL
Medical facilities fall critically short of the standards of Irish health care facilities. Persons with medical conditions that may require treatment, or medications, are discouraged from travelling to Sierra Leone. Medicines are in short supply, sterility of equipment is questionable, and treatment is unreliable. Many primary health care workers, especially in rural areas, lack professional training. Instances of misdiagnosis, improper treatment and administration of improper drugs have been reported.

Travellers should carry a supply of any needed prescription medicines, along with copies of the prescriptions, including the generic name for the drugs, and a supply of preferred over-the-counter medications. Diagnostic and treatment equipment is most often poorly maintained and many medicines are unavailable. Counterfeit pharmaceuticals are a common problem and may be difficult to distinguish from genuine medications. This is particularly true of generics purchased at local pharmacies or street markets.

HEALTH, ACCIDENTS AND INSURANCE
Accidents and injuries are the leading cause of death among travellers under the age of 55. Most are caused by motor vehicle and motorcycle crashes; and to a lesser degree, drowning, aircraft crashes, murders, and burns.

Heart attacks cause most fatalities in older travellers, but infections cause only 1% of fatalities in overseas travellers. Generally, infections are the most common cause of travel-related illness.

Travellers are advised to obtain, before departure, travel health insurance with specific overseas coverage. The policy should include a medical evacuation benefit. Check for any exclusions that are part of the policy, and keep in mind that many insurance policies have terrorism exclusion clauses. The D2 medical recommends that the policy also provide 24-hour access to an assistance centre that can help arrange and monitor delivery of medical care, and determine if air ambulance services are required.

Yellow Fever Map


                                                                                                                                                                              DR JOHN J RYAN MEDICAL DIRECTOR


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