Inoculation regulations can change at short notice. Please take medical advice in the case of doubt.

1
A yellow fever vaccination certificate is required from travellers over one year of age.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not a condition of entry to the Central African Republic. However, cholera is a serious risk in this country and precautions are essential. Up-to-date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness. See the Health appendix for more information.

3
Immunisation against typhoid is usually recommended.

4
Risk of malaria (and of other insect-borne diseases) exists all year throughout the country. The malignant falciparum form is prevalent. Resistance to chloroquine and sulfadoxine-pyrimethamine has been reported. The recommended prophylaxis is mefloquine.

Food & drink
All water should be regarded as being potentially contaminated. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks

Hepatitis A and E are present and hepatitis B is hyperendemic. Diarrhoeal illnesses are common. Cutaneous and visceral leishmaniasis occur during the dry season. Bilharzia (schistosomiasis) is present. Avoid swimming and paddling in fresh water; swimming pools which are well-chlorinated and maintained are safe. Onchocerciasis (river blindness) and African trypanosomiasis (sleeping sickness) are also prevalent. Meningococcal meningitis is particularly prevalent during the dry season in December, especially in the north of the country. In March 2004, two districts (Nana Bongila with 39 cases/five deaths and Zere with four cases/two deaths) had attack rates above the epidemic threshold. Vaccination is strongly recommended. There is also a high incidence of HIV/AIDS; sensible precautions should be taken.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Full health insurance is essential, and should include air evacuation to Europe in case of serious accident or illness. Medical facilities are severely limited outside the major centres and visitors should travel with their own supply of remedies for simple ailments such as stomach upsets: pharmaceutical supplies are usually very difficult to obtain.