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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 arriving from infected areas; those countries formerly classified as endemic zones are considered to be still infected by the Kenyan authorities. Travellers arriving from non-endemic zones should note that vaccination is strongly recommended for travel outside the urban areas, even if an outbreak of the disease has not been reported and they would normally not require a vaccination certificate to enter the country.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is no longer a condition of entry to Kenya. However, cholera is a serious risk in this country and precautions are essential. There was an outbreak of cholera in the Eastleigh area of Nairobi in June 2005. 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 further information.

3
Immunisation against typhoid and poliomyelitis is recommended.

4
Malaria risk exists throughout the year in the whole country. There is usually less risk in Nairobi and in the highlands (above 2500m/8200ft) of the Central, Eastern Nyanza, Rift Valley and Western Provinces. The predominant falciparum strain has been reported as highly resistant to chloroquine and resistant to sulfadoxine/pyrimethamine. Mefloquine, doxycycline or malarone are the recommended prophylaxis.

Food & drink
Mains water is normally chlorinated and relatively safe. Bottled water is available and is advised for the first few weeks of the stay. Drinking water outside main cities and towns is likely to be contaminated and sterilisation is considered essential. Milk is pasteurised and dairy products are safe for consumption. Local meat, poultry, seafood, fruit and vegetables are generally considered safe to eat. Food prepared by unlicensed vendors should be avoided at all times.

Other risks
Dysenteries and diarrhoeal diseases are common. Hepatitis B is hyperendemic; hepatitis A and E are widespread. Meningococcal meningitis is a risk, particularly in the savannah in the dry season; long-staying visitors and backpackers should consider vaccination. Bilharzia (schistosomiasis) is present. Avoid swimming and paddling in fresh water; bathing in rivers and lakes is forbidden in national parks and is best avoided elsewhere due to dangers from wildlife and water borne diseases; swimming pools which are well chlorinated and maintained are safe. Dengue fever is present, as are leishmaniasis, trypanosomiasis (sleeping sickness) and filariasis. Avoid sandfly, mosquito and tsetse fly bites, and wear shoes to protect against hookworm. Relapsing fever and typhus are present. In June 2004, there were 141 suspected cases, including six deaths, of leptospirosis in a high school in the Bungoma district. A nearby primary school also reported two deaths. Travellers should be aware of these developments when within the Bungoma district.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. See the Health appendix for further information.

Note
There is a risk of contracting AIDS if the necessary precautions are not taken. It is advisable to take a kit of sterilised syringe needles for any possible injections needed, as well as drip needles for emergencies.
Health insurance is essential. East African Flying Doctor Services have introduced a special Tourist Membership which guarantees that any member injured or ill while on safari can call on a flying doctor for free air transport. There are good medical facilities in Mombasa and Nairobi. The Kenya Tourism Federation (KTF) safety communication centre (24-hour) help tourists in difficulty (tel: (20) 604 767 in emergencies or 604729 or 601343 or 604730; e-mail: safetour@wananchi.com).




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