High Prevalence Diseases:
Major Infectious Diseases include:
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever vectorborne diseases: malaria and yellow fever water contact disease: schistosomiasis respiratory disease: meningococcal meningitis animal contact disease: rabies (2008)
(CIA World Factbook)
There are periodic outbreaks of cholera in Cameroon.
(travel.state.gov/travel/cis_pa_tw/cis/cis_1081.html)
Environmental Factors:
Waterborne diseases are prevalent (CIA World Factbook)
Cameroon Water & Sanitation
Indicator Value (year)
Population with sustainable access to improved drinking water sources (%) rural: 47 (2006)
Population with sustainable access to improved drinking water sources (%) urban: 88 (2006)
Population with sustainable access to improved sanitation (%) rural: 42 (2006)
Population with sustainable access to improved sanitation (%) urban: 58 (2006)
(WHO)
Water Related Diseases:
Schistosomiasis (CIA World Factbook)
Immunizations Necessary:
Malaria is a serious and sometimes fatal disease. Plasmodium falciparum malaria, the type that predominates in Cameroon, is resistant to the antimalarial drug chloroquine. Because travelers to Cameroon are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™) as prophylaxis to reduce this risk. Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area, and up to one year after returning home, should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease.
(travel.state.gov/travel/cis_pa_tw/cis/cis_1081.html)
Yellow Fever
Yellow fever vaccination requirement for travelers to Cameroon: Vaccination should be given 10 days before travel and at 10 year intervals if there is on-going risk.
Hepatitis A or immune globulin (IG)
Recommended for all unvaccinated people traveling to or working in countries with an intermediate or high level of hepatitis A virus infection (see map) where exposure might occur through food or water. Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors.
Hepatitis B
Recommended for all unvaccinated persons traveling to or working in countries with intermediate to high levels of endemic HBV transmission (see map), especially those who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment (e.g., for an accident).
Typhoid
Recommended for all unvaccinated people traveling to or working in Central Africa, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water.
Meningococcal (meningitis)
Recommended if you plan to visit countries that experience epidemics of meningococcal disease during December through June (see map).
Rabies
Recommended for travelers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking. Also recommended for travelers with significant occupational risks (such as veterinarians), for long-term travelers and expatriates living in areas with a significant risk of exposure, and for travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. Note: Rabies vaccine is temporarily in limited supply.
Polio
Recommended for adult travelers who have received a primary series with either inactivated poliovirus vaccine (IPV) or oral polio vaccine (OPV). They 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.
(wwwn.cdc.gov/travel/destinationCameroon.aspx)
Health Care Structure:
Medical facilities in Cameroon are extremely limited. Even in large cities, emergency care and hospitalization for major illnesses and surgery are hampered by the lack of trained specialists, outdated diagnostic equipment, and poor sanitation. Medical services in outlying areas may be completely nonexistent. Doctors and hospitals often require immediate payment for health services in cash. Pharmacies in larger towns are well stocked, but in other areas many medicines are unavailable. Travelers are advised to carry their own supply of needed prescription and anticipated over-the-counter medicines.
(travel.state.gov/travel/cis_pa_tw/cis/cis_1081.html)
Safety:
During the week of February 25, 2008, Cameroon experienced significant civil unrest in half of its ten provinces, most notably in the port city of Douala. Demonstrators clashed violently with police and then military personnel, resulting in the reported deaths of forty persons and arrest of over 1,600 individuals. The unrest was marked by widespread road blockages, attacks on public and private vehicles, looting, burning of government and other buildings, and roaming crowds of malcontents. This disturbance created shortages of fuel, food and other supplies throughout the country, and was ended through the deployment of military units and the use of significant force.
Embassy employees have been instructed to refrain from travel outside of city limits after dusk, and to monitor their movements in centrally located areas within cities and towns. Private American citizens are urged to follow the same guidelines and are strongly advised against nighttime travel. Armed highway bandits (most notably in border areas); poorly lit roads; hazardous, poorly maintained vehicles; and unskilled, aggressive and/or intoxicated drivers pose a threat to motorists. Attacks and accidents are most common outside major towns, especially in the provinces bordering Chad and the Central African Republic but occur in all areas of the country.
Due to the frequency of criminal incidents involving public transportation, American citizens are advised that use of public taxis can be dangerous. In April 2007, two American women were assaulted and robbed in a taxi. Public taxis in Cameroon function more like the U.S. bus system with drivers stopping to pick up additional passengers as long as there is space left in the vehicle. There have been numerous reports of assaults and robberies committed by "passengers" in shared taxis since crimes – rape and robbery being among the most common – are often a collaborative effort between the driver and "passengers." If a traveler must use a taxi, the use of a private taxi – or a taxi hired for exclusive use by the individual for that particular trip – where the driver is known to the passenger is a better alternative to the use of shared taxis. Taxi passengers should be particularly vigilant at night.
The risk of street and residential crime is high, and incidents of violent crime are on the rise throughout the country. During the last year, the number of carjacking and armed burglary incidents in residences and restaurants, particularly in Yaoundé and Douala, continued to increase. Carjacking and robbery has also been reported on rural highways, especially in the Northern provinces and regions near Cameroon's border with the Central African Republic.
Cameroon's road networks, both paved and unpaved, are poorly maintained and unsafe at all times of the year. Vehicles are poorly maintained and there is no mechanism or requirement to inspect for roadworthiness. During the rainy season, many roads are barely passable with four-wheel-drive vehicles. Livestock and pedestrians create constant road hazards (especially at night) and road safety rules are frequently ignored. There are few road and traffic signs; speed limits are neither posted nor enforced. Buses and logging trucks travel at excessive speed and are a constant threat to other road traffic.
Travelers on roads near the borders with CAR and Chad should ensure that their vehicles are fully fueled, and that they have adequate cooking fuel, food, and water for several days as well as a reliable means of communication, such as a satellite or cell phone, or radio.
(travel.state.gov/travel/cis_pa_tw/cis/cis_1081.html)
Thursday, February 19, 2009
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Country Specific Interventions
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