Health Information for Travelers to Republic of South Sudan

Safety and Security Abroad

Preparing for Your Trip to South Sudan

Vaccination or Disease	Recommendations or Requirements for Vaccine-Preventable Diseases
Routine	Recommended if you are not up-to-date with routine shots, such as measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine, poliovirus vaccine, etc.
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 staying with friends or relatives or visiting smaller cities, villages, or rural areas where exposure might occur through food or water.
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.
Yellow Fever	Requirements: Undetermined. Recommendations: *Recommended* for all travelers ≥9 months of age. Vaccination should be given 10 days before travel and at 10-year intervals if there is on-going risk. Find an authorized U.S. yellow fever vaccination clinic.
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.

Malaria

Areas of South Sudan with Malaria: All (more information)

If you will be visiting an area of South Sudan with malaria, you will need to discuss with your doctor the best ways for you to avoid getting sick with malaria. Ways to prevent malaria include the following:

Taking a prescription antimalarial drug
Using insect repellent and wearing long pants and sleeves to prevent mosquito bites
Sleeping in air-conditioned or well-screened rooms or using bednets

All of the following antimalarial drugs are equal options for preventing malaria in South Sudan: Atovaquone-proguanil, doxycycline, or mefloquine. For detailed information about each of these drugs, see Table 3-11: Drugs used in the prophylaxis of malaria. For information that can help you and your doctor decide which of these drugs would be best for you, please see Choosing a Drug to Prevent Malaria.

Note: Chloroquine is NOT an effective antimalarial drug in South Sudan and should not be taken to prevent malaria in this region.

To find out more information on malaria throughout the world, you can use the interactive CDC malaria map. You can search or browse countries, cities, and place names for more specific malaria risk information and the recommended prevention medicines for that area.

Malaria Contact for Health-Care Providers
For assistance with the diagnosis or management of suspected cases of malaria, call the CDC Malaria Hotline: 770-488-7788 or toll-free 1-855-856-4713 (M-F, 9 am-5 pm, Eastern time). For clinicians needing emergency consultation after hours, call 770-488-7100 and ask to speak with a CDC Malaria Branch clinician.

Items to Bring With You

Medicines you may need:

The prescription medicines you take every day. Make sure you have enough to last during your trip. Keep them in their original prescription bottles and always in your carry-on luggage. Be sure to follow security guidelines, if the medicines are liquids.
Antimalarial drugs, if traveling to a malaria-risk area in South Sudan and prescribed by your doctor.
Medicine for diarrhea, usually over-the-counter.

Note: Some drugs available by prescription in the US are illegal in other countries. Check the US Department of State Consular Information Sheets for the country(s) you intend to visit or the embassy or consulate for that country(s). If your medication is not allowed in the country you will be visiting, ask your health-care provider to write a letter on office stationery stating the medication has been prescribed for you.

Other items you may need:

Iodine tablets and portable water filters to purify water if bottled water is not available. See A Guide to Water Filters, A Guide to Commercially-Bottled Water and Other Beverages, and Safe Food and Water for more detailed information.
Sunblock and sunglasses for protection from harmful effects of UV sun rays. See Basic Information about Skin Cancer for more information.
Antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60% alcohol.
To prevent insect/mosquito bites, bring:
- Lightweight long-sleeved shirts, long pants, and a hat to wear outside, whenever possible.
- Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
- Bed nets treated with permethrin, if you will not be sleeping in an air-conditioned or well-screened room and will be in malaria-risk areas. For use and purchasing information, see Insecticide Treated Bed Nets on the CDC malaria site. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.

See other suggested over-the-counter medications and first aid items for a travelers' health kit.

Note: Check the Air Travel section of the Transportation Security Administration website for the latest information about airport screening procedures and prohibited items.

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Other Diseases Found in Central Africa
Risk can vary between countries within this region and also within a country; the quality of in-country surveillance also varies.

Dengue, filariasis, leishmaniasis, and onchocerciasis (river blindness) are other diseases carried by insects that also occur in Central Africa. African trypanosomiasis (African sleeping sickness) has increased in Africa (it is epidemic in Angola, Democratic Republic of the Congo, and the Sudan; and highly endemic in Cameroon, Central African Republic, Chad, Congo, Cote d'Ivoire, Guinea, Mozambique, Uganda, and Tanzania; low levels are found in most of the other countries), and an increase in travelers has been noted since 2000. Most had exposures in Tanzania and Kenya, reflecting common tourist routes. Protecting yourself against insect bites will help to prevent these diseases.

Plague occurs sporadically or in outbreaks. Outbreaks have occurred since 2000 in Madagascar, Malawi, Mozambique, Uganda, and Tanzania. Ituri Distric (Oriental Province) in the Democratic Republic of the Congo reports about 1,000 caes per year and was the site of an outbreak in 2006.

Schistosomiasis, a parasitic infection, can be contracted in fresh water in this region. Do not swim in fresh water (except in well-chlorinated swimming pools) in these countries.

Polio outbreaks were reported in several previously polio-free countries in Central, Eastern, and Western Africa beginning in 2003. Polio is still endemic in Nigeria.

Travelers should be aware of the serious health risks associated with visiting caves in certain areas of Africa. These risks include infectious diseases spread by bats, such as Marburg hemorrhagic fever, rabies, and histoplasmosis. CDC advises people not to enter any caves or mines where bats may live.

Highly pathogenic avian influenza (H5N1) has been found in poultry populations in several countries in Africa. Avoid all direct contact with birds, including domestic poultry (such as chickens and ducks) and wild birds, and avoid places such as poultry farms and bird markets where live birds are raised or kept. For a current list of countries reporting outbreaks of H5N1 among poultry and/or wild birds, view updates from the World Organization for Animal Health (OIE), and for total numbers of confirmed human cases of H5N1 virus by country see the World Health Organization (WHO) Avian Influenza website.

Other risks to travelers to Central, East, and West African countries include typhoid (a large outbreak occurred in the Democratic Republic of the Congo in 2004-2005) and paratyphoid fever, amebiasis, and brucellosis.

Many countries in this region have high incidence rates of tuberculosis and high HIV prevalence rates.

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Staying Healthy During Your Trip

Prevent Insect Bites

Many diseases, like malaria and dengue, are spread through insect bites. One of the best protections is to prevent insect bites by:

Using insect repellent (bug spray) with 30%-50% DEET. Picaridin, available in 7% and 15% concentrations, needs more frequent application. There is less information available on how effective picaridin is at protecting against all of the types of mosquitoes that transmit malaria.
Wearing long-sleeved shirts, long pants, and a hat outdoors.
Remaining indoors in a screened or air-conditioned area during the peak biting period for malaria (dusk and dawn).
Sleeping in beds covered by nets treated with permethrin, if not sleeping in an air-conditioned or well-screened room.
Spraying rooms with products effective against flying insects, such as those containing pyrethroid.

For detailed information about insect repellent use, see Insect and Arthropod Protection.

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Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Centers for Disease Control and Prevention concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked.