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Cameroon



Capital: Yaounde

Time Zone: +1 hour.
Tel. Country Code: 237
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.


Travel Advisory - Cameroon

Sub-Saharan Africa has the highest incidence of insect-transmitted diseases, such as malaria, and all travelers need products to prevent mosquito and tick bites. I recommend all travelers use a combination of DEET or Picaridin repellent on their skin and Permethrin fabric insecticide on their clothing for greater than 99% protection against mosquito and tick bites.

Dr. Rose Recommends for Travel to Cameroon


Resource Links

NaTHNaC
World Health Organization
CDC
Travel Health Services
Country Insights
Travel Warnings
Consular Information
Foreign Commonweatlh Office

Embassies


• U.S. Embassy
Avenue Rosa Parks
Mbankolo Quartier
Yaounde
Tel: [237] 220-1500
Fax: [237] 220-1572
Website: http://yaounde.usembassy.gov

• Canadian Embassy
Immeuble Stamatiades
Place de L'Hotel de Ville
Yaounde
Tel: [237] 23-23-11
Fax: [237] 22-10-90
E-mail: yunde@dfait-maeci.gc.ca
Website: http://www.dfait-maeci.gc.ca/world/embassies/menu-en.asp

• British High Commission
Avenue Winston Churchill
Yaounde
Tel: [237) 2222 05 45
Facsimile: [237] 2222 01 48
Email: BHC.yaounde@fco.gov.uk
Website: www.britishhighcommission.gov.uk/cameroon

Entry Requirements

HIV Test: Not required.

Required Vaccinations: Yellow fever vaccination is required for all travelers >1 year of age arriving from ALL COUNTRIES.

Passport Information

Passport/Visa: Cameroon is a developing country in central Africa. Although there are many natural and cultural attractions in Cameroon, facilities catering to western-style tourism are quite limited. The capital is Yaounde, though Douala, the country's largest city, is its main port and commercial center. Official languages are French and English, though French predominates in most of the country. English may be used in Cameroon's two Anglophone provinces and the larger cities. The staff of major hotels in Cameroon's large cities is usually bilingual.
A valid passport, visa, evidence of yellow-fever vaccination, and current immunization records are required. Travelers should obtain the latest information and details from the Embassy of the Republic of Cameroon, 2349 Massachusetts Avenue, NW, Washington D.C. 20008, tel: (202) 265-8790, fax: (202) 387-3826. Overseas, inquiries should be made at the nearest Cameroonian embassy or consulate. 
See the Foreign Entry Requirements brochure for more information on Cameroon and other countries. Visit the Embassy of Cameroon's web site at http://www.ambacam-usa.org/ for the most current visa information.

Vaccinations: Recommended and Routine

Hepatitis A: Recommended for all travelers >1 year of age not previously immunized against hepatitis A.

Hepatitis B: Recommended for all non-immune travelers at potential risk for acquiring this infection. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from acupuncture, tattooing or body piercing; when receiving non-sterile medical or dental injections, or unscreened blood transfusions; by direct contact with open skin sores on an infected person. Recommended for long-term travelers, expatriates, and any traveler requesting protection against hepatitis B infection.


Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.

Meningococcal (Meningitis): Quadrivalent conjugate meningitis vaccine is recommended for those travelers anticipating living or working closely with local people. The risk is greatest in the dry season, from November to May/June. Vaccination should be considered for all travelers venturing into epidemic regions at any time of year.
• Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at:
http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx#651

Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).

Rabies: Rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection.

Routine Immunizations: Immunizations against tetanus-diphtheria, measles, mumps, rubella (MMR vaccine) and varicella (chickenpox) should be updated, if necessary, before departure. MMR protection is especially important for any female of childbearing age who may become pregnant.
• In addition to tetanus, all travelers, including adults, should be fully immunized against diphtheria. A booster dose of a diphtheria-containing vaccine (Td or Tdap vaccine) should be given to those who have not received a dose within the previous 10 years.
Note: ADACEL and Boostrix are new tetanus-diphtheria-pertussis (Tdap) vaccines that not only boost immunity against diphtheria and tetanus, but have the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children. The Tdap vaccines can be administered in place of the Td vaccine when a booster is indicated.

Typhoid: Recommended for all travelers.

Yellow Fever: Yellow fever vaccination is required for all travelers >1 year of age arriving from ALL COUNTRIES. Vaccination is recommended for all travelers >9 months of age.

Hospitals / Doctors

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.
All travelers should be up-to-date on their immunizations and are advised to carry a medical kit as well as antibiotics to treat travelers diarrhea or other infections; they should bring drugs for malaria prophylaxis, if needed according to their itinerary. Travelers who are taking regular medications should carry them properly labeled and in sufficient quantity to last for the duration of their trip; they should not expect to obtain prescription or over-the-counter drugs in local stores or pharmacies in this country - the equivalent drugs may not be available or may be of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage. Policies should cover: ground and air ambulance transport, including evacuation to home country; payment of hospital bills; 24-hour telephone assistance. In the event of a serious illness or injury that can't be treated locally, you should arrange medical evacuation to South Africa or Europe.

The U.S. Embassy maintains a list of physicians and clinics at: http://yaounde.usembassy.gov/physicians_list.html

• Polyclinic Bonanjo
Avenue Charles de Gaulle
Douala
Tel: [237] 342 7936, 342 7983
Emergency Tel; [237] 342 1780
Website: http://www.clibo.com
In-patient hospital care, ambulatory care clinic, 24-hour ER; can also stabilize patients prior to medical evacuation.

• Polyclinic Bonanjo
OUT PATIENT SERVICE & SPECIALISTS
Rue Mairie Douala
Bonanjo
Douala
Tel: [237] 342.79.36 / 342.79.83 / 342.99.10
EMERGENCY: [237] 342.17.80

• Clinique Bel-Air
Rue Toyota
Bonapriso
Douala
Tel: [237] 342 82 84

• Clinique la Citadelle
Dla Bld de la Republique
Douala
Tel: [237] 342 4708 / 347 2505

• Hopital Laquintinie
(Laquintinie Hospital)
Douala
General medical services; ICU.

• Yaounde Central Hospital
Yaounde
General medical services; blood bank.

Destination Health Info for Travelers

A Summary of Risk: Cameroon is a West African nation of about 16 million people. Its economy, largely dependent on petroleum and cocoa exports, is strong in comparison with many other sub-Saharan countries.
• The HIV-burden in Cameroon is estimated at almost 12 percent of the 15-49 age population (see below). Important HIV-related research is being conducted in Cameroon; almost every known strain of HIV, including the rare O clade HIV-1, can be found in the country (Source: CRISP database).
• Malaria is endemic and is the leading cause sickness and mortality in Cameroon. It accounts for as many as half of all medical consultations, 30 percent of hospitalizations, and more than a quarter of work-days lost. Two-thirds of malaria cases in some locations are chloroquine resistant.
• The WHO has estimated a tuberculosis death rate of 61 per 100,000 for the country in 2000. Nine of ten provinces are covered by the Cameroon National Tuberculosis Control Program (NTCP).

AIDS/HIV: Heterosexual contact is the predominate means of HIV transmission. A recent study (http://gateway.nlm.nih.gov/MeetingAbstracts/102238076.html) found that HIV seroprevalence was significantly higher among women (12.1%) compared to men (5.8%). HIV seroprevalence was significantly higher among subjects co-habitating (17%) compared to those unmarried (7%) and married (6.9%). HIV prevalence in Cameroon is estimated at 9% of the urban population and 45%, or higher, among commercial sex workers.
• Transmission of HIV can be prevented by avoiding: sexual contact with a high-risk partner; injecting drug use with shared needles; non-sterile medical injections; unscreened blood transfusions.
• The threat of HIV/AIDS should not be a primary concern for the traveler. However, there may be a concern for a subset of travelers who may be exposed to HIV, the virus that causes AIDS, through contact with the body fluids of another person or their blood. Although travel has contributed in a general way to the global spread of AIDS, fear of traveling because of this disease is not warranted.

Accidents & Medical Insurance: Accidents and injuries are the leading cause of death among travelers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drownings, aircraft crashes, homicides, and burns are lesser causes.
• Heart attacks cause most fatalities in older travelers.
• Infections cause only 1% of fatalities in overseas travelers, but, overall, infections are the most common cause of travel-related illness.
• Travelers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance center that can help arrange and monitor delivery of medical care and determine if medevac or air ambulance services are required.

African Sleeping Sickness (Trypanosomiasis): Most risk is found in the vicinities of Bafia (Mbam Division, Centre Province) and Fontem/Mamfe (Manyu/Fontem Division, Sud-Ouest Province). Mbam Division reports the most cases of sleeping sickness. Potential areas for recurrence include Extreme-Nord Province bordering Chad, and Est Province, bordering the Nola vicinity of the Central African Republic. Travelers at most risk are those on safari and game-viewing holiday. Travelers to urban areas are at low risk. The tsetse fly comes out in the early morning and the late afternoon. Insect repellent applied to the skin does not prevent tsetse fly bites, so travelers should wear protective clothing and sleep under a bed net.
• Initial symptoms: The bite of tsetse fly can be painful and may develop into a raised red sore, called a chancre. The initial sore may subside or develop into an expanding red, tender, swollen area, followed by a generalized illness with fever, myalgia, abdominal discomfort, diarrhea, vomiting, headache, rigors, and sweats.
Read more: http://www.phac-aspc.gc.ca/tmp-pmv/info/af_trypan-eng.php


Animal Hazards: Common animal hazards include snakes (vipers, mambas, cobras), centipedes, scorpions, and black widow spiders.

Avian Influenza A (Bird Flu): In March 2006, the Pasteur Institute identified the H5NI (Avian Influenza) virus in a domestic duck that came from a small poultry farm near to the northern town of Maroua.
• Avian influenza A (H5N1) is predominantly a disease of birds. The virus does not pass easily from birds to people and does not to pass from person to person (except in very rare cases of close contact with an infected blood relative).
• The risk to humans from avian influenza is believed to be very low and no travel restrictions are advised, except travelers should avoid visiting animal markets, poultry farms and other places where they may come into close contact with live or dead poultry, or domestic, caged or wild birds and their excretions. In addition, travelers are advised to:
1. Cook poultry and egg dishes thoroughly. (Well-cooked poultry is safe to eat.)
2. Wash hands frequently with soap and water if around poultry.
• The World Health Organization (WHO) does not recommend travel restrictions to countries experiencing outbreaks of influenza A (H5N1) in birds, including those countries which have reported associated cases of human infection. To date, no cases of avian influenza A (H5N1) illness have been identified among short-term travelers visiting countries affected by outbreaks among poultry or wild birds.

The usual vaccines against influenza are not protective against bird flu. Oseltamivir (Tamiflu) is somewhat effective in the treatment of avian influenza A (H5N1). It seems to be effective in some cases, but may fail in others. Recently, resistant strains have been reported. In addition, the dosage and duration of treatment appear to be different in severe cases.

Cholera: This disease is active in this country and cholera outbreaks occur regularly. In April 2006, an outbreak was reported from Bafoussam, northwest of the capital city of Yaounde. The risk to travelers is low. Cholera vaccine is recommended only for relief workers or health care personnel who are working in a high-risk endemic area under less than adequate sanitary conditions, or travelers who work or live in remote, endemic or epidemic areas and who do not have ready access to medical care. Canada, Australia, and countries in the European Union license an oral cholera vaccine. The cholera vaccine is not available in the United States.
• The main symptom of more severe cholera is copious watery diarrhea.
• Antibiotic therapy is a useful adjunct to fluid replacement in the treatment of cholera by substantially reducing the duration and volume of diarrhea and thereby lessening fluid requirements and shortening the duration of hospitalization.
• A single 1-gm oral dose of azithromycin is effective treatment for severe cholera in adults. This drug is also effective for treating cholera in children. (NEJM:http://content.nejm.org/cgi/content/short/354/23/2452)

Hepatitis: All travelers not previously immunized against hepatitis A should be vaccinated against this disease. Travelers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Travelers who will have access to safe food and water are at lower risk. Those at higher risk include travelers visiting friends and relatives, long-term travelers, and those visiting areas of poor sanitation.
• Hepatitis E is endemic but levels are unclear. Sporadic cases and outbreaks occur. Transmission of the hepatitis E virus (HEV) occurs primarily through contaminated drinking water. In developing countries, prevention of hepatitis E relies primarily on the provision of clean water supplies and overall improved sanitation and hygiene. There is no vaccine.
• Hepatitis B is hyperendemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 8% to 10%, or higher. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from non-sterile medical or dental injections, and acupuncture; from unscreened blood transfusions; by direct contact with open skin lesions of an infected person. The average traveler is at low risk for acquiring this infection. Vaccination against hepatitis B is recommended for: persons having casual/unprotected sex with new partners; sexual tourists; injecting drug users; long-term visitors; expatriates, and anybody wanting increased protection against the hepatitis B virus.
• Hepatitis C is hyperendemic with a prevalence of 12.5% in the general population. Most hepatitis C virus (HCV) is spread either through intravenous drug use or, in lesser-developed countries, through blood contamination during medical procedures. Over 200 million people around the world are infected with hepatitis C — an overall incidence of around 3.3% of the population of the world. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.

Influenza: Influenza is transmitted year-round in the tropics. The flu vaccine is recommended for all travelers over age 6 months.

Leishmaniasis: Cutaneous leishmaniasis is endemic in northern Cameroon, but risk may exist focally countrywide. Foci of cutaneous leishmaniasis occur in the north in the vicinity of Mokolo (50 kilometers west of Maroua) and also may occur in areas bordering Chad (including the N’Djamena vicinity); other foci historically have been reported from the eastern areas. A recently identified focus of visceral leishmaniasis has been reported from Kousseri in Extreme-Nord Province.

The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite in the evening and at night and are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• All travelers should take measures to prevent sandfly bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, permethrin (spray or solution) to clothing and gear, and sleeping under a permethrin-treated bednet.

Loiasis: Highly endemic foci presumably persist in southern rain forest and swamp forest
areas. All travelers should take measures to prevent insect (deer fly) bites.

Malaria: Malaria is prevalent year-round throughout this country, including urban areas, with increased risk in the Bénoué River Valley, the basin of Lake Chad, the coastal region, and the forests of southern Cameroon. Risk is elevated during and immediately following the rainy seasons (March through June and September through November in the south; June through September in the north), particularly in the more arid north. Falciparum malaria accounts for approximately 90% of malaria in this country. Chloroquine-resistant falciparum malaria is prevalent.
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine (requires G6-PD test) is recommended.

A malaria map is located on the Fit for Travel website (www.fitfortravel.nhs.uk), which is compiled and maintained by experts from the Travel Health division at Health Protection Scotland (HPS). Go to www.fitfortravel.nhs.uk and select Malaria Map from the Cameroon page on the Destinations menu or A-Z Index.

Malaria is transmitted via the bite of an infected female Anopheles mosquito. Anopheles mosquitoes feed predominantly during the hours from dusk to dawn. All travelers should take measures to prevent evening and nighttime mosquito bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, applying permethrin spray or solution to clothing and gear, and sleeping under a permethrin-treated bednet. DEET-based repellents have been the gold standard of protection under circumstances in which it is crucial to be protected against insect bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
NOTE: Picardin repellents (20% formulation, such as Sawyer GoReady or Natrapel 8-hour) are now recommended by the CDC and the World Health Organization as acceptable non-DEET alternatives to protect against malaria-transmitting mosquito bites. Picaridin is also effective and ticks and biting flies.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.
• Long-term travelers who may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours.

Meningitis: An outbreak of meningococcal infections was reported in 2007 from Extreme North (Nord) province, causing almost 100 cases and resulting in at least 10 deaths. Northern Cameroon lies within the sub-Saharan meningitis belt. Quadrivalent meningitis vaccine is recommended for travelers during the dry season, December to June, and should be considered consider for shorter stays if close contact with the local populace is anticipated or if traveling to an epidemic area.
• Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at: http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx#651

Onchocerciasis: Also called river blindness. Highly endemic foci presumably persist along fast-flowing rivers in the south and the southwest, and in the savanna area of northern Cameroon. All travelers should take measures to prevent insect (blackfly) bites, especially in the vicinity of rivers.

Other Diseases/Hazards: African tick-bite fever
• African tick typhus, (a similar rickettsial infection)
• Brucellosis (from consumption of raw dairy products or occupational exposure)
• Bancroftian filariasis (mosquito-borne)
• Chikungunya fever (reported in Spanish tourists in 2006)
• Cutaneous larva migrans, dengue (serologic evidence has been reported in Cameroon)
• Lassa fever (current endemic status unclear)
• Mansonellosis
• Rift Valley fever (chiefly among persons in close contact with livestock)
• Toxoplasmosis
• Typhus (murine- and louse-borne)
• Relapsing fever (louse-borne)


Paragonimiasis (lung fluke disease): Oriental lung fluke disease is endemic; travelers should avoid eating uncooked freshwater crustaceans, such as crabs.

Poliomyelitis (Polio): Cases of poliomyelitis continue to occur in Cameroon and neighboring countries in sub-Saharan Africa. A single case of polio was reported from Cameroon in November 2006, near the Nigerian border.
• All travelers should be fully immunized. A one-time dose of IPV (Inactivated Polio Vaccine) is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult.

Rabies: Rabies is a public health problem in many rural and urban areas, including Yaounde. Although rabies is rare among tourists—there is risk. Pre-exposure rabies vaccine is recommended for: Travel longer than 3 months, for shorter stays in rural when travelers plan to venture off the usual tourist routes and where they may be more exposed to the stray dog population; when travelers desire extra protection; or when they will not be able to get immediate medical care. Children are considered at higher risk because they tend to play with animals and may not report bites.
• All animal bites or scratches, especially from a dog, should be thouroghly cleansed with soap and water and examined as soon as possible by a qualified health care provider, regardless of your vaccination status.
In the case of possible rabies exposure, pre-exposure vaccination only eliminates the need for rabies immune globulin; it does not eliminate the need for two additional booster doses of vaccine.

Schistosomiasis: Urinary and intestinal schistosomiasis are highly endemic in the north and in the southwest. Intestinal schistosomiasis is endemic in Nord Province and in Center-Sud Province. Areas also infested include Yaounde, Edea, and Douala.
• Schistosomiasis is transmitted through exposure to contaminated water while wading, swimming, and bathing. Schistosoma larvae, released from infected freshwater snails, penetrate intact skin to establish infection. All travelers should avoid swimming, wading, or bathing in freshwater lakes, ponds, streams, cisterns, aqueducts, or irrigated areas. There is no risk in chlorinated swimming pools or in seawater.

Travelers' Diarrhea: High risk. Several urban areas in the south, including Douala, Yaounde, and Mbalmayo, have treatment plants and piped water systems, but improper operation and poor maintenance of the plants allow bacterial recontamination. Water-borne and food-borne diseases are prevalent with more serious outbreaks occurring from time to time. Outbreaks of diarrheal diseases are common during the rainy season.
Outside of hotels and resorts, we recommend that you boil, filter or purify all drinking water or drink only bottled water or other bottled beverages and do not use ice cubes. Avoid unpasteurized milk and dairy products. Do not eat raw or undercooked food (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). Peel all fruits.
• Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
• A quinolone antibiotic, or azithromycin, combined with loperamide (Imodium), is recommended for the treatment of diarrhea. Diarrhea not responding to antibiotic treatment may be due to a parasitic disease such as giardiasis, amebiasis, or cryptosporidiosis.
• Seek qualified medical care if you have bloody diarrhea and fever, severe abdominal pain, uncontrolled vomiting, or dehydration.

Tuberculosis: Tuberculosis is highly endemic in Cameroon with an annual occurrence was greater than or equal to 100 cases per 100,000 population. Tuberculosis (TB) is transmitted following inhalation of infectious respiratory droplets. Most travelers are at low risk. Travelers at higher risk include those who are visiting friends and relatives (particularly young children), long-term travelers, and those who have close contact, prolonged contact with the local population. There is no prophylactic drug to prevent TB. Travelers with significant exposure should have PPD skin testing done to evaluate their risk of infection.

Typhoid Fever: Typhoid fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people traveling to or working in sub-Saharan Africa, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water. Current vaccines against Salmonella typhi are only 50-80% protective and do not protect against Salmonella paratyphi, the cause of paratyphoid fever. (Paratyphoid fever bears similarities with typhoid fever, but the course is generally more benign.) Travelers should continue to practice strict food, water and personal hygiene precautions, even if vaccinated.

Yellow Fever: This disease is reported currently active. On 25 January 2010, the Ministry of Health of Cameroon reported one case of yellow fever in Kumba district in the south-western region, close to the border with Nigeria (Cross River State). Between 2003 and 2007, 9 cases of yellow fever have ben reported in this country.
• Yellow fever vaccination is required for all travelers >1 year of age arriving from ALL COUNTRIES. Vaccination should be administered at least 10 days prior to arrival in order for the certificate of vaccination to be valid.
Vaccination is recommended for all travelers >9 months of age.