Time Zone: +3 hours. No daylight savings time in 2008.
Tel. Country Code: 256
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). United Kingdom Sytle Adaptor Plug. Grounding Adaptor Plugs C, F.
• Canadian Embassy
IPS Building, Parliament Road
Tel: 256-41-258-141 or 235-768
Canadian interests are also handled by the Canadian Embassy in Nairobi, Kenya Website: http://www.dfait-maeci.gc.ca/nairobi/menu-en.asp
Uganda requires travelers >1 year of age arriving from countries where yellow fever is present to show proof of yellow fever vaccination. Vaccination should be given 10 days before travel and at 10 year intervals if there is on-going risk.
HIV Test: Not required.
A passport valid for three months beyond the date of entry, visa and evidence of yellow fever vaccination are required. Visas are available at Entebbe Airport upon arrival or may be obtained from the Embassy of the Republic of Uganda. Airline companies may also require travelers to have a visa before boarding. Travelers should obtain the latest information and details from the Embassy of the Republic of Uganda at 5911 16th Street, N.W., Washington, D.C. 20011; telephone (202) 726-7100; Internet site: http://www.ugandaembassy.com; e-mail: firstname.lastname@example.org. Travelers may also contact the Ugandan Permanent Mission to the United Nations, telephone (212) 949-0110. Overseas, inquiries may be made at the nearest Ugandan embassy or consulate.
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; 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.
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,
• The new Tdap vaccine, ADACEL, which also boosts immunity against pertussis (whooping cough) should be considered when a tetanus-diphtheria booster is indicated.
Typhoid: Recommended for all travelers.
Yellow Fever: Travelers >1 year of age entering the country from an endemic area are required to present a certificate of immunization against yellow fever. the CDC recommends that all travelers >9 months of age be vaccinated.
Hospitals / Doctors
Medical care is substandard throughout this country, especially outside Kampala.
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; may be of dubious origin; may be counterfeit, or of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance medevac. In the event of a serious illness or injury that can't be treated locally, every effort should be made to arrange medical evacuation to Nairobi (the closest city with more advanced medical facilities), South Africa, or Europe.
• International Hospital, Kampala, is a 200-bed private hospital run by the International Medical Group, IMG (http://www.img.co.ug/)
Destination Health Info for Travelers
A Country Profile: Uganda is a nation of about 25 million people located in central Africa. In the 1990s it emerged as a relatively stable, well-governed nation with consistent economic growth. Average annual income is about $240 per capita, and exports include coffee, tea, tobacco, cotton and other agricultural products. A rebel group known as the Lords Resistance Army (LRA) has been active in northern Uganda and southern Sudan for 20 years and has been responsible for a large number of murders and abductions. More than 1.3 million people are currently living in camps for internally displaced people in northern Uganda. Talks between the Government of Uganda and the LRA have been ongoing in Southern Sudan since July 2006, and progress has been made. There have been no confirmed LRA attacks in Uganda since August 2006. However the situation remains fragile and we are keeping it under close review.
• Uganda was one of the first African countries where HIV/AIDS cases were identified in the early 1980s. Today it is one of the few sub-Saharan countries where significant success has been achieved in efforts to mitigate the spread and impact of the HIV epidemic. Current estimates from the Uganda AIDS Commission indicate that national HIV prevalence in the adult population (15-49) has fallen from about 18.5 percent in 1995 to about 8.3 percent in 2000 and recently to about 5 percent in 2002. In the capital city of Kampala, one of the hardest hit areas, HIV prevalence has dropped from 31 percent among antenatal clinic attendees in 1990/1 to 8 percent in 1998. In a higher risk group of STI clinic patients tested in Kampala, an overwhelming 42% of males and 62% of females tested HIV positive in 1989. By 1997, HIV prevalence in this group had declined to 37%. Much of this success has been attributed to the strong government leadership and a supportive political environment in fighting the epidemic.
While Uganda has had success in its fight against AIDS, it has had more difficulties in fighting malaria. Reported malaria cases increased from 2.3 million in 1997 to 12.3 million in 2003. One factor in the increase in malaria cases is the declining utility of chloroquine-fansidar as a treatment. The government is taking steps to counter the growing threat of malaria, including reintroducing DDT to combat mosquitoes, and switched its anti-malarial drug-treatment preference from chloroquine-fansidar to artemisinin. Source: researchafrica.rti.org
• Doctors Without Borders/Medecins Sans Frontieres (MSF) has been in Uganda since 1982.
AIDS/HIV: At the end of 2007, UNAIDS/WHO estimates that 8.3% of the population of Uganda aged 15-49 years old were living with HIV or AIDS. Heterosexual contact is the predominate mode of transmission. HIV-1 prevalence is estimated at up to 86% of the high-risk urban population. For further information, go to the Avert.org website:http://www.avert.org/aidsuganda.htm
• 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 fluid 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.
• MEDICAL INSURANCE: 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.
Health insurance is essential.
• East African Flying Doctor Services, based in Nairobi, have introduced special Tourist Membership which guarantees that any member injured or ill while on safari can call on a flying doctor for free air transport.
African Sleeping Sickness (Trypanosomiasis): Sleeping sickness is prevalent in scattered areas countrywide. During November 2007, 12 people were diagnosed with sleeping sickness at one health centre in the Mayuge Region. Major risk of disease persists in the southeast (extending from the northern shore of Lake Victoria and Lake Kyoga), with foci of Gambiense disease primarily in north-western and north central areas (along the White Nile and the Sudanese border). Travelers at most risk are those on safari and game-viewing holiday. Travelers to urban areas are at very 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: Animal hazards include snakes (vipers, cobras), centipedes, scorpions, and black widow spiders. Crocodiles are known to attack boats and people on shore.
Cholera: Cholera outbreaks occur on a regular basis in Uganda. A small outbreak was reported from Kampala in January and February 2008. An outbreak was reported from the Arua and Nebbi districts in northwestern Uganda in late 2007, which was ongoing as of February 2008. Other areas are also affected. Although this disease is reported active, the threat to tourists is low. Cholera is an rare disease in travelers from developed countries. 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)
Crime/Security/Civil Unrest: We strongly advise you not to travel to northern Uganda (particularly the Nebbi, Arua, Moyo, Yumbe, Adjumani, Apac, Gulu, Kitgum, Lira and Pader districts) and areas bordering Sudan and the DRC (including Lake Albert and Murchison Falls National Park) because of the serious risk of attacks and abductions by rebel groups, including the Lords Resistance Army (LRA), and the risk of banditry in these areas.
• North-eastern Uganda: We strongly advise you not to travel to the Karamoja region of north-eastern Uganda (particularly the Kotido, Moroto, Nakapiripirit and Katakwi districts north of Kate Kyoga), because of the risk of banditry and inter-tribal clashes.
Far south-western borders with the DRC: We strongly advise you not to travel to the far south-western borders with the DRC, including Bwindi Impenetrable National Park and the Mgahinga Gorilla Park, due to the risk of banditry and cross-border attacks by rebel groups. We strongly advise you not to take gorilla trekking tours that cross into the DRC.
• Crime: Petty crime such as pickpocketing and bag snatching is common, especially on public transport. Theft from vehicles which are stationary in heavy traffic or stopped at traffic lights occurs frequently. You should ensure valuables are out of sight and that vehicle windows are up and doors are locked. There is a risk of armed robbery and carjacking when travelling outside the capital, Kampala, particularly to the east and in areas around Lake Victoria.
• Isolated incidents of violence have also occurred in urban centres, such as Kampala, Jinja and Kasese. Residential burglaries have turned violent. Security risks are heightened after dark. Do not accept food or drink from strangers as it may be drugged.
• Local Travel: The Ugandan Government periodically closes tourist areas considered to be at risk of rebel activity. You should seek local advice about the current situation prior to travel.
• Driving in Uganda can be hazardous due to poor road conditions, vehicle maintenance, bad driving habits, excessive speeds and poor lighting, especially at night. Traffic accidents are common and pose a significant risk to tourists. For further advice, see our bulletin on Overseas Road Safety.
• Long distance bus travel is also hazardous and accidents have resulted in fatalities.
Ebola/Marburg Hemorrhagic Fever: An outbreak of Ebola hemorrhagic fever, a highly contagious and often fatal viral infection, was reported in November 2007 from Bundibugyo District, western Uganda, resulting in 149 suspected cases and 37 deaths as of January 4, 2008. The Ministry of Health in Uganda is now investigating two suspected Ebola deaths in Bundibugyo, a week after the country was declared free of the disease. There are no confirmed cases in any other part of the country. Ebola virus is transmitted through close personal contact with severely ill patients and direct contact with infected blood, secretions, and organs. Travelers should take precautions against the virus, which include careful hand-washing, avoiding contact with potentially-infected patients and avoiding any contact with ill or dead animals. There is little, if any, direct threat to travelers to Uganda from this illness. For further information on the outbreak go to the WHO Global Outbreak Alert and Response Network pages at: http://www.who.int/csr/disease/ebola/en/
News from the CDC (July 2008):
The European Centre for Disease Prevention and Control (ECDC) has reported that a woman from The Netherlands recently died from Marburg hemorrhagic fever. She got sick after returning from a trip to Uganda. The traveler was most likely exposed to Marburg virus after entering a cave with large numbers of bats. The cave is in the Maramagambo Forest in western Uganda (at the southern edge of Queen Elizabeth Park). She had direct contact with a bat while in the cave.
Travelers should know that there are serious health risks associated with visiting caves in the Maramagambo Forest in Uganda and in other areas of Africa. These risks include diseases spread by bats, such as Marburg, rabies, and histoplasmosis. The Uganda Ministry of Health has advised people not to enter any caves or mines where bats may live.
Recommendations for U.S. travelers from the CDC:
• The main ways that travelers may get Marburg virus are through direct contact with a person very sick with Marburg or through direct contact with infected bats, monkeys, or other wild animals that may be infected.
• The risk of Marburg for travelers is very low. However, travelers should take the following steps to help protect themselves.
• Avoid direct contact with bats and other wild animals. Travelers should not enter caves where bats may live.
• Go to a doctor right away if you have a fever AND you have visited bat-infested caves in Africa during the past three weeks. Tell the doctor that you have been around bats.
• If you are bitten or scratched by an animal or if body fluid (such as saliva) from the animal gets into your eyes, nose, mouth, or a wound, take these steps:
1. Wash the area thoroughly with soap and water.
2. Go to a doctor or hospital right away.
3. Consider buying medical evacuation insurance if you are visiting a country where there may not be good access to medical care.
Filariasis: Sporadic cases are reported. Travelers to this country are advised to take protective measures against blackfly bites.
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 and sporadic cases and outbreaks occur. In Kitgum District, 7,727 cases of hepatitis E including 121 deaths have recntly been reported. (Source: ProMED September 2008) The Health Ministry in Uganda also confirmed an outbreak of hepatitis E in Madi Opei Sub-county in Lamwo County, Kitgum District of Northern Uganda neighbouring Sudan. A total of 314 cases with 11 deaths have been registered since the epidemic began to spread in November 2007. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. 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 >10%. 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 endemic with a prevalence of 1.2% 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 >6 months of age.
Leishmaniasis: Visceral leishmaniasis occurs in the northeast province of Karamoja. Sporadic cases of cutaneous leishmaniasis are reported from the Mt. Elgon vicinity. 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.
Loiasis: Sporadic cases are reported. Travelers to this country are advised to take protective measures against blackfly bites.
Malaria: Risk is present year-round throughout this country, including urban areas. Falciparum malaria accounts for approximately 80% of cases. Other cases of malaria are due to the P. malariae species, followed by P. ovale and (rarely) P. vivax. Chloroquine-resistant falciparum malaria is reported.
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), or doxycycline 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). Get to the Uganda page from the Destinations section or the A-Z Index and select Malaria Map.
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: Picaridin 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: In early 2009, outbreaks were reported in Masindi, Hoima, Arua, Adjumani, and Moyo districts. Some of these areas are just outside the “meningitis belt,” however such transmission activity is not unusual at this time of year.
• Quadrivalent conjugate meningitis vaccine is recommended for those travelers anticipating living or working closely with local people, especially in the north. 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. Uganda lies partially within the sub-Saharan meningitis belt.
• Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at:
Onchocerciasis: Sporadic cases are reported. Travelers to this country are advised to take protective measures against blackfly bites.
Other Diseases/Hazards: African tick typhus (contracted from dog ticks and from bush ticks)
• Chikungunya fever (mosquito-transmitted)
• Crimean-Congo hemorrhagic fever (tick-borne; cases reported from Entebbe)
Plague: Outbreaks of plague occur regularly in this country. One hundred and twenty cases, including 10 deaths, have been recently reported from the Arua and Masindi Regions. Plague most commonly occurs when plague-infected fleas bite humans, who then develop bubonic plague. Some patients will also develop a bloodstream infection (septicemic plague). A small minority of persons with either bubonic or septicemic plague will develop secondary pneumonic plague, and they can then spread the plague bacterium by coughing out respiratory droplets. Persons who inhale these droplets can develop so-called primary pneumonic plague.
There is no vaccine against plague. Intravenous gentamicin or oral doxycycline are effective treatments. Doxycycline, tetracycline or ciprofloxacin are effective for post-exposure prophylaxis.
Poliomyelitis (Polio): Uganda has reported a recent case of polio. According to the UN, one confirmed case of paralytic poliomyelitis has been reported from Amuru, a northwestern district of Uganda bordering Sudan, in February 2009. This is the first case reported since 1998.
• 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: Increased incidence of rabies is reported in Kampala and Karamoja Provinces. 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.
• All animal bite wounds, especially from a dog, should be thoroughly cleansed with soap and water and then medically evaluated for possible post-exposure treatment, regardless of your vaccination status. Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Even if rabies vaccine was administered before travel, a 2-dose booster series of vaccine is needed after the bite of a rabid animal.
Schistosomiasis: Intestinal schistosomiasis occurs primarily in the northwest and along the northern shore of Lake Victoria. Urinary schistosomiasis is confined to northern central Uganda, north of Lake Kyoga.
• 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. Supplies of potable water are inadequate to meet the needs of the population. Piped water supplies may be grossly contaminated. 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 vegetable. 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 Uganda with an annual occurrence was greater than or equal to 40 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 unvaccinated 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: According to Uganda's Ministry of Health, more than 100 cases of yellow fever have been reported in the northern districts of Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong, and Lira since December 2010. This is the first large outbreak since 1970. Travelers over 9 months of age should be vaccinated before travel to this country.
• A yellow fever vaccination certificate is required for all travelers >1 year of age arriving from any infected area in the yellow fever endemic zone country in Africa or the Americas.
• Yellow fever is transmitted via the bite of an infected Aedes mosquito (mainly Aedes aegypti). Aedes mosquitoes feed predominantly during daylight hours. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin and applying permethrin spray or solution to clothing and gear. Sleeping under a permethrin-treated bednet at night gives you extra protection.
• There is risk of yellow fever in all areas of this country. A map of yellow fever endemic countries in Africa is here:http://www.nathnac.org/includes/contents/documents/yf_africa.gif