Gambia Travel Health Information

Read below for travel health advice on Gambia from the MDtravelhealth channel on Red Planet Travel.

Page Sections

  1. Summary
  2. Medications
  3. Immunizations
  4. Recent outbreaks of diseases
  5. Other Infections
  6. Food and Water
  7. Insect Tick Protection
  8. Swimming and Bathing
  9. General Advice
  10. Medical Facilities
  11. Travel with children
  12. Travel and pregnancy
  13. Maps
  14. Embassy
  15. Safety Information
  16. Page Drop Box

Are you a doctor or medical professional with knowledge of the situation in Gambia  Why not apply to contribute to this page?

Would you like to Edit this page? Login or Sign up!
  • Summary You can't Edit

    1

    Summary of recommendations

    Most travelers to the Gambia will need vaccinations for hepatitis A, typhoid fever, polio, and yellow fever, as well as medications for malaria prophylaxis and travelers' diarrhea. Meningococcal vaccine is recommended for travel during the dry season (November through June). Other immunizations may be necessary depending upon the circumstances of the trip and the medical history of the traveler, as discussed below. Insect repellents are recommended, in conjunction with other measures to prevent mosquito bites. All travelers should visit either a travel health clinic or their personal physician 4-8 weeks before departure.

    Malaria:Prophylaxis with Lariam (mefloquine), Malarone (atovaquone/proguanil), or doxycycline is recommended for all areas.

    Vaccinations:

    Hepatitis A Recommended for all travelers
    Typhoid Recommended for all travelers
    Yellow fever Recommended for all travelers. Required for travelers arriving from a yellow-fever-infected area in Africa or the Americas.
    Meningococcus Recommended during the dry season (November through June)
    Polio One-time booster recommended for any adult traveler who completed the childhood series but never had polio vaccine as an adult
    Hepatitis B Recommended for all travelers
    Rabies For travelers spending a lot of time outdoors, or at high risk for animal bites, or involved in any activities that might bring them into direct contact with bats
    Measles, mumps, rubella (MMR) Two doses recommended for all travelers born after 1956, if not previously given
    Tetanus-diphtheria Revaccination recommended every 10 years
  • Medications You can't Edit

    2

    Medications

    Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.

    Most cases of travelers' diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.

    If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

    Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.

    Malaria in Gambia: prophylaxis is recommended for all travelers. Either mefloquine (Lariam), atovaquone/proguanil (Malarone)(PDF), or doxycycline may be given. Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia, and nightmares. Rarely, severe reactions occur, including depression, anxiety, psychosis, hallucinations, and seizures. Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine. Those taking mefloquine (Lariam) should read the Lariam Medication Guide (PDF). Atovaquone/proguanil (Malarone) is a combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Doxycycline is effective, but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics.

    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. See malaria for details. Symptoms of malaria sometimes do not occur for months or even years after exposure.

    Insect protection measures are essential.

    For further information about malaria in the Gambia, go to the World Health Organization.

  • Immunizations You can't Edit

    3

    Immunizations

    The following are the recommended vaccinations for Gambia:

    Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available in the United States: VAQTA (Merck and Co., Inc.) (PDF) and Havrix (GlaxoSmithKline) (PDF). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise.

    Older adults, immunocompromised persons, and those with chronic liver disease or other chronic medical conditions who have less than two weeks before departure should receive a single intramuscular dose of immune globulin (0.02 mL/kg) at a separate anatomic injection site in addition to the initial dose of vaccine. Travelers who are less than one year of age or allergic to a vaccine component should receive a single intramuscular dose of immune globulin (see hepatitis A for dosage) in the place of vaccine.

    Typhoid vaccine is recommended for all travelers. It is generally given in an oral form (Vivotif Berna) consisting of four capsules taken on alternate days until completed. The capsules should be kept refrigerated and taken with cool liquid. Side-effects are uncommon and may include abdominal discomfort, nausea, rash or hives. The alternative is an injectable polysaccharide vaccine (Typhim Vi; Aventis Pasteur Inc.) (PDF), given as a single dose. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. The oral vaccine is approved for travelers at least six years old, whereas the injectable vaccine is approved for those over age two. There are no data concerning the safety of typhoid vaccine during pregnancy. The injectable vaccine (Typhim Vi) is probably preferable to the oral vaccine in pregnant and immunocompromised travelers.

    Yellow fever vaccine is recommended for all travelers greater than nine months of age. The vaccine is required for all travelers greater than one year of age arriving from a yellow-fever-infected country in Africa or the Americas or from a country in the endemic zones. In the Gambia, yellow fever is reported in Upper River Division, but may occur elsewhere. A case of yellow fever was recently reported in an unimmunized Belgian tourist. See Eurosurveillance for details.

    Yellow fever vaccine (YF-VAX; Aventis Pasteur Inc.) (PDF) must be administered at an approved yellow fever vaccination center, which will give each vaccinee a fully validated International Certificate of Vaccination. The vaccine should not in general be given to those who are younger than six months of age, immunocompromised, or allergic to eggs (since the vaccine is produced in chick embryos). It should also not be given to those with a malignant neoplasm and those with a history of thymus disease or thymectomy. Caution should be exercised before giving the vaccine to those who are between the ages of 6 and 8 months, age 60 years or older, pregnant, or breastfeeding. Reactions to the vaccine, which are generally mild, include headaches, muscle aches, and low-grade fevers. Serious allergic reactions, such as hives or asthma, are rare and generally occur in those with a history of egg allergy.

    Polio immunization is recommended, due to the persistence of polio in sub-Saharan Africa. Any adult who received the recommended childhood immunizations but never had a booster as an adult should be given a single dose of inactivated polio vaccine. All children should be up-to-date in their polio immunizations and any adult who never completed the initial series of immunizations should do so before departure. Side-effects are uncommon and may include pain at the injection site. Since inactivated polio vaccine includes trace amounts of streptomycin, neomycin and polymyxin B, individuals allergic to these antibiotics should not receive the vaccine.

    Meningococcal vaccine is recommended for travel during the dry season (November through June), especially if prolonged contact with the populace is likely. Meningococcal vaccine has few side-effects. Mild redness at the injection site may occur. Young children may develop transient fever.

    Hepatitis B vaccine is recommended for all travelers if not previously vaccinated. Two vaccines are currently licensed in the United States: Recombivax HB (Merck and Co., Inc.) (PDF) and Engerix-B (GlaxoSmithKline) (PDF). A full series consists of three intramuscular doses given at 0, 1 and 6 months. Engerix-B is also approved for administration at 0, 1, 2, and 12 months, which may be appropriate for travelers departing in less than 6 months. Side-effects are generally mild and may include discomfort at the injection site and low-grade fever. Severe allergic reactions (anaphylaxis) occur rarely.

    Rabies vaccine is recommended for travelers spending a lot of time outdoors, for travelers at high risk for animal bites, such as veterinarians and animal handlers, for long-term travelers and expatriates, and for travelers involved in any activities that might bring them into direct contact with bats. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. A complete preexposure series consists of three doses of vaccine injected into the deltoid muscle on days 0, 7, and 21 or 28. Side-effects may include pain at the injection site, headache, nausea, abdominal pain, muscle aches, dizziness, or allergic reactions.

    Any animal bite or scratch should be thoroughly cleaned with large amounts of soap and water and local health authorities should be contacted immediately for possible post-exposure treatment, whether or not the person has been immunized against rabies.

    Tetanus-diphtheria vaccine is recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.

    Measles-mumps-rubella vaccine: two doses are recommended (if not previously given) for all travelers born after 1956, unless blood tests show immunity. Many adults born after 1956 and before 1970 received only one vaccination against measles, mumps, and rubella as children and should be given a second dose before travel. MMR vaccine should not be given to pregnant or severely immunocompromised individuals.

    Cholera vaccine is not recommended. Cholera is not being reported from Gambia at this time.

  • Recent outbreaks of diseases You can't Edit

    4

    Recent outbreaks

    A single case of yellow fever was reported in September 2010 in a man who lived in Senegal and had been fishing in the Tanji locality, on Gambia's Atlantic coast (see the World Health Organization). Yellow fever vaccine is recommended for all travelers to the Gambia.

    A series of malaria cases, two of them fatal, was recently reported among European travelers to the Gambia (see TropNetEurop). None of the travelers had taken appropriate malaria medication. Malaria prophylaxis is strongly urged for all travelers to the Gambia.

    An outbreak of meningococcal infections, resulting in 50 cases and 3 deaths, was reported in the first three months of 2002. In the previous year, an outbreak occurred in Upper River Division, resulting in 137 cases and 21 deaths. Meningococcal vaccine is recommended for travel during the dry season (November through June), especially if prolonged contact with the populace is likely.

  • Other Infections You can't Edit

    5

    Other infections

    Schistosomiasis may be acquired by swimming, wading, rafting, or bathing in contaminated fresh water. Swimming and bathing precautions are advised (see below).

    A case of melioidosis was reported in October 2009 in a young male diabetic immigrant from Gambia living in Spain (see ProMED-mail, October 24, 2009).

    Louse-borne relapsing fever has been reported in travelers.

    HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.

  • Food and Water You can't Edit

    6

    Food and water precautions

    Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, and sea bass.

    All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if accompanied by nausea, vomiting, cramps, fever or blood in the stool. Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.

    If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

  • Insect Tick Protection You can't Edit

    7

    Insect and Tick Protection

    Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accommodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.

  • Swimming and Bathing You can't Edit

    8

    Swimming and bathing precautions

    Avoid swimming, wading, or rafting in bodies of fresh water, such as lakes, ponds, streams, or rivers. Do not use fresh water for bathing or showering unless it has been heated to 150 degrees F for at least five minutes or held in a storage tank for at least three days. Toweling oneself dry after unavoidable or accidental exposure to contaminated water may reduce the likelihood of schistosomiasis, but does not reliably prevent the disease and is no substitute for the precautions above. Chlorinated swimming pools are considered safe.

  • General Advice You can't Edit

    9

    General advice

    According to the U.S. State Department, "Travelers in possession of prescription drugs should carry proof of their prescriptions, such as labeled containers. Police have been known to arrest foreigners carrying unlabeled pills. For a complete list of prohibited items, please contact the nearest Gambian embassy or consulate." If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity.Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.

    Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.

    Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.

    Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.

  • Medical Facilities You can't Edit

    10

    Medical facilities

    Medical facilities are extremely limited. There are frequent shortages of medications and essential supplies. Most doctors and hospitals will expect payment in cash, regardless of whether you have travel health insurance. Serious medical problems will require air evacuation to a country with state-of-the-art medical facilities.

  • Travel with children You can't Edit

    11

    Traveling with children

    Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed.

    All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).

    Because yellow fever vaccine is not approved for use in children less than nine months of age, children in this age group should not in general be brought to the Gambia.

    The recommendations for malaria prophylaxis are the same for young children as for adults, except that (1) dosages are lower; and (2) doxycycline should be avoided. DEET-containing insect repellents are not advised for children under age two, so it's especially important to keep children in this age group well-covered to protect them from mosquito bites.

    When traveling with young children, be particularly careful about what you allow them to eat and drink (see food and water precautions), because diarrhea can be especially dangerous in this age group and because the vaccines for hepatitis A and typhoid fever, which are transmitted by contaminated food and water, are not approved for children under age two. Baby foods and cows' milk may not be available in developing nations. Only commercially bottled milk with a printed expiration date should be used. Young children should be kept well-hydrated and protected from the sun at all times.

    Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, oral replacement salts, and appropriate antibiotics for common childhood infections, such as middle ear infections.

  • Travel and pregnancy You can't Edit

    12

    Travel and pregnancy

    Because of the risk of malaria and yellow fever, pregnant women should not in general travel to the Gambia. Yellow fever vaccine is not approved for use during pregnancy, because it contains live virus. Malaria may cause life-threatening illness in both the mother and the unborn child. None of the currently available prophylactic medications is 100% effective. Mefloquine (Lariam) is the drug of choice for malaria prophylaxis during pregnancy, but should not be given if possible in the first trimester. If travel to areas with malaria and yellow fever is unavoidable, insect protection measures must be strictly followed at all times. The recommendations for DEET-containing insect repellents are the same for pregnant women as for other adults.

  • Maps You can't Edit

    13

    Maps

    Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.

  • Embassy You can't Edit

    14

    Embassy/Consulate Location

    >(reproduced from the U.S. State Dept. Consular Information Sheet)

    U.S. citizens living in or visiting The Gambia are encouraged to register at the U.S. Embassy in The Gambia upon arrival and to obtain updated information on travel and security in The Gambia. The U.S. Embassy is located on Kairaba Avenue in Fajara, a suburb of the capital city of Banjul. The mailing address is P.M.B. no. 19, Banjul, Gambia. The telephone numbers are (220) 392856, 392858 or 391971, fax (220) 392475.

  • Safety Information You can't Edit

    15

    Safety information

    For information on safety and security, go to the U.S. Department of State, United Kingdom Foreign and Commonwealth Office, Foreign Affairs Canada, and the Australian Department of Foreign Affairs and Trade.

Back to Page Index

Page drop box for MDth Gambia

Been to Gambia recently? What is the current health situation there? Do you have any information on the place. Is the information on this page as you found it?

You can earn Reputation score by joining our community and also enrol on the TravelTip$ program and get paid for good advice by other travellers.

If you are not logged in, or choose to make the drop box anonymously you can tell the community honestly what you seen without any concern. Please send images or other evidence to support your claims.

Drop image here or click to upload

     

     

    The MDtravelhealth channel is a source of travel health information for travellers, written by medical professionals.

    MDth Navigation

    Page is maintained by

    The MDtravelhealth channel relies on medical professionals from all over the world to maintain the Travel Health Information on these pages.

    Nobody :(
    Are you a Doctor, nurse or other Medical professional that feels they can update this page? Please login or sign up and select MDtravelhealth Channel in the Account Area.

    Topic Tags for Gambia

    Topic Tags are what bind the Red Planet Travel site together, and are very important.

    This place has been tagged:

    If you think those tags are not perfect, then please let the person responsible for this page know by dropping a note in the anonymous drop box below, or better yet sign up or login and join our community, once you've got enough reputation score you can edit them yourself!

    Got a Question?

    ?

    Ask any travel related question or help others with your experience and earn Reputation Score and become a valued member of our community.

    MDtravelhealth Medical Contributions

    Before you apply read about the Medical Professionals Roles on Red Planet Travel

    You need to be logged in and have applied to MDth channel to contribute to this page.

    Have something to Contribute?

    We are looking to grow the information on this site, if you have something to contribute to any page then we'd like to hear from you.

    What's more you can now earn money (paid direct via Paypal) for writing descriptions about places you know.

    You will need to tell other members about yourself and your relevant knowledge and experience about what you want to contribute about.

    Look below for some example page types, and types of people whose views on a place might be useful to know.

    Page Type: Hotel

    Are there any special benefits or adaptations that this Hotel or it's location has that you can comment on in your capacity as a Doctor

    Tell us your job, knowledge, experience..

    My Experience: Doctor

    This hotel has great CPR equipment and I can see the team are all trained

    If you are the owner/manager of any place, then you can, of course, take control of your page and add relevant information other visitors might want to know

    Related Pages

    Check out our page on Gambia for information on how to get there, accommodation, video and reviews.

    Medical Clinics

    Do you have any recent experiences of clinics here? Please search for them, use the drop box at the bottom of their page to send us comments - good and bad.

    Hotels near Gambia

    More hotels from our Partner Booking.com