Immunizations
Required Vaccinations
Yellow Fever
This viral infection is transmitted by the day-time biting Aëdes aegypti mosquito typically found in urban, suburban, and rural areas.
A Yellow Fever vaccination certificate is required only for travellers coming from, or in transit through, infected countries. The vaccination requirement is imposed by this country for protection against the introduction of Yellow Fever since the vector Aëdes aegypti is present in its territory.
The following countries are considered infected:
AFRICA - Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Republic of the Congo, Democratic Republic of the Congo, Côte d'Ivoire, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, São Tomé and Príncipe, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda.
AMERICAS - Argentina, Bolivia, Brazil, Colombia, Ecuador, Guyana, French Guiana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago, Venezuela.
Note: A vaccination certificate is required for travellers coming from, or in transit through, an infected Yellow Fever area within six days prior to arrival. A certificate is also required for children over one year of age.
Recommended Vaccinations
Routine Immunizations
Your trip is a good occasion for a reminder to keep your routine immunizations updated; more than 80% of adults in developed countries have not maintained their immunization status. The following vaccinations are recommended for your protection and to prevent the spread of infectious diseases.
Tetanus-Diphtheria, Poliomyelitis, Measles, Mumps, Rubella should be reviewed and updated if necessary.
Seasonal influenza vaccine is recommended for children, persons over the age of 50, and those of any age suffering from chronic heart disease, emphysema, asthma, renal disorders, immuno-suppressive disorders, and organ transplant recipients. Note: Flu seasonal patterns are opposite in the southern and northern hemispheres. If the flu vaccine is not available at the time of departure, contact your doctor or travel health clinic regarding influenza anti-viral protection.
Pneumococcal vaccine is recommended for persons over the age of 65 and persons of any age suffering from cardiovascular disease, diabetes, renal disorders, liver diseases, sickle cell disease, asplenia, or immuno-suppressive disorders.
Hepatitis A
The Hepatitis A virus is primarily transmitted through contaminated water and food or by the fecal-oral route, and may cause severe liver damage. Prevention includes good personal hygiene, ensuring safe water supply, eating well cooked foods, and peeling your own fruits.
Vaccination is recommended for all travellers over one year of age. The vaccine is often combined with Hepatitis B and affords excellent long-term protection for both viral diseases.
Typhoid Fever
This intestinal infection, caused by Salmonella typhi bacteria, is transmitted from person to person primarily through ingestion of contaminated food and water in areas with poor sanitary and hygienic conditions. Prevention includes good personal hygiene such as washing your hands frequently, ensuring safe water supply, eating well cooked foods, and peeling your own fruits. Vaccination is also recommended for travellers' protection.
Selective Vaccinations
There are no selective vaccinations for this country.
The recommendations for vaccinations outlined above are intended as guidelines only. Your immunization needs depend on your health status, previous immunizations received, and your travel itinerary. Seek further advice from your doctor or travel health clinic.
Disease Risks
Chikungunya Virus
Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes (Aëdes aegypti). Aëdes aegypti mosquitoes feed predominantly in the daytime. Symptoms include fever, headache, fatigue nausea, vomiting, muscle pain, rash and joint pain.
Travellers should take measures to prevent 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 at night.
A massive outbreak of chikungunya fever affected the island countries in the southwest Indian Ocean (Réunion, Mayotte, Mauritius, and Seychelles). An outbreak, with over 5000 cases, was reported from the Seychelles in 2005 and 2006. Travellers to the Seychelles returning to France and other European countries have also reported this illness. This mosquito-transmitted viral illness is common in the Indian Ocean and many countries in sub-Saharan Africa.
Ciguatera Fish Poisoning
Ciguatera poisoning is caused by eating fish that has been contaminated by a dinoflagellate-produced toxin. Large fish become contaminated with the toxin when they eat reef fish that feed on these small organisms. Ciguatera is the most commonly reported marine seafood toxin poisoning. Any reef fish can cause ciguatera poisoning, but species such as barracuda, moray eel, grouper, red snapper, amberjack, parrotfish, sturgeon, ulua, and sea bass are the most commonly involved. The occurrence of toxic fish is sporadic, and not all fish of a given species or from a given area will be toxic.
Travellers need to be aware of the areas where the toxin exists and of the local fish that have been associated with the toxin. Outbreaks are seasonal but can also occur after major storms. Ciguatoxin does not affect the taste or smell of fish. It cannot be destroyed by cooking, smoking, freezing or any other method of food preparation. Large fish (over 6 lbs or 13.2 kg) are more likely to contain ciguatoxin. It is recommended not to eat large reef fish, as well as not eating fish liver, intestines, heads, and roe, where the toxin is concentrated.
For more information, see Centers for Disease Control and Prevention.
Dengue Fever
Dengue is transmitted via the bite of an infected Aëdes aegypti mosquito. Aëdes aegypti mosquitoes feed predominantly in the daytime. Symptoms consist of sudden onset of fever, headache, muscle aches, and rash. Dengue hemorrhagic fever may occur particularly after a second infection with a different strain. Travellers at risk should take measures to prevent mosquito bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin and applying permethrin spray or solution to clothing and gear.
Dengue fever is endemic in the Seychelles. The risk of dengue is considered to be low but outbreaks of disease have been reported, especially during the rainy season. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in the Indian sub-Continent.
Giardiasis
Giardiasis is a worldwide intestinal parasitic infection. Symptoms include chronic diarrhea, bloating, low-grade fever, nausea and headaches. It is caused through the ingestion of contaminated food and water by cysts of the protozoa Giardia lamblia, G. intestinalis and G. duodenalis. It occurs in areas with poor sanitation and areas where surface water is used for drinking. Person-to-person transmission occurs when Giardia cysts from the stool of an infected person are passed from hand-to-mouth and is the cause of outbreaks in daycare centers, dormitories and chronic care centers. Fresh water bodies (lakes, rivers, streams, ponds) which are open to human and animal fecal contamination are the source of infection for canoers, kayakers, campers and hikers . Prevention includes: meticulous personal hygiene, food safety precautions and purification of drinking water (boiling water or other methods).
There is lower risk of food and water-borne disease in the Seychelles.
Hepatitis E
Hepatitis E is caused by infection with the hepatitis E virus. It is transmitted mainly through contaminated water or food by the fecal-oral route. It is common in countries with low standards of sanitation. Prevention includes good personal hygiene, ensuring water supply is safe, and following food safety measures (eating food well-cooked and hot, peeling your own fruits, etc...).
Leptospirosis
Leptospirosis is a worldwide bacterial disease affecting domestic and wild animals: cattle, dogs, cats, pigs, and rodents. Humans become infected through exposure to infected animals or through contact with water, soil and mud contaminated with the urine of infected animals. The bacteria can enter through skin and mucous membranes of the mouth, eyes, and nose. The disease is not known to spread from person to person.
Leptospirosis can occur sporadically, in epidemics (mostly after storms, heavy rainfalls and floods), or endemically (in agricultural areas with large livestock operations or rodent infestations). It is an occupational hazard for those who work outdoors or with animals (farmers, sewer workers, veterinarians, fish workers, rescue and military personnel). It is also a serious recreational risk for campers, hikers, swimmers, and outdoor sports enthusiasts who participate in whitewater rafting, kayaking, and canoeing.
The incubation period can range from 2 to 30 days. Most infections are relatively mild and include fever, myalgia, headache, red eyes, abdominal pain, and vomiting. Severe cases present with jaundice, hemorrhage, myocarditis, and renal failure. Prevention: Outdoor sports travellers may want to consult their doctor about taking preventive medication during their trip to avoid infection even through short-term exposure.
Sexually Transmitted Infections
Avoid unprotected sexual contact. If you are going to have sex with a stranger, use latex or polyurethane condoms consistently and correctly. Bring your own condoms from home.
Some countries have entry restrictions for travellers with HIV / AIDS. See The Global Database on HIV Related Travel Restrictions for details on this country.
Traveller's Diarrhea
Diarrhea is the most common cause of illness during travel. The source of illness is the ingestion of contaminated food or water, person-to-person transmission, or recreational exposure to water bodies. The infective agents can be bacteria, viruses, protozoa or toxins found in food. Good personal hygiene practices (including frequent and thorough hand washing), proper food handling, and water purification are the most effective methods to prevent infection.
Consult your doctor for the best treatment options tailored to your needs, including taking prescription medication on your trip in case you suffer from diarrhea. Travellers with chronic conditions are more susceptible to infections and should consider taking preventive medication.
See our Guide to Healthy Travel for prevention and treatment tips.
DISEASES PRESENT - LOW RISK TO TRAVELLERS
Echinococcosis
Echinococcosis is a potentially fatal parasitic disease that affecting wildlife, commercial livestock and humans. Humans become infected by accidentally swallowing the eggs of the E. multilocularis tapeworm. Humans can be exposed to these eggs by directly ingesting food contaminated with stool from infected foxes or coyotes. This might include grass, herbs, greens or berries collected from fields. Humans may also be contaminated by petting infected cats or dogs. These pets may shed the tapeworm eggs in their stool and their fur may be contaminated.
Basic hygiene practices such as thoroughly cooking food and vigorous hand washing before meals can prevent the infective eggs entering the human digestive tract.
Tungiasis
Tungiasis is a skin infestation of the Tunga penetrans flea found in tropical parts of Africa. Tungiasis affects persons walking barefoot or lying in infested sand or soil.
Food and Water Safety
Drinking water is chlorinated and has no ill effect on the local population. However, some strains of E. coli (naturally occurring bacteria found in your gastro-intestinal system) may be present in very small concentrations in the local water supply. Some local strains are different than those that you may be used to, and may cause diarrhea in travellers since immunity is not developed as a result of short-term exposure. Using bottled water for the first few weeks will help you adjust and decrease the chance of traveller's diarrhea.
Milk is pasteurized and safe to drink. Butter, cheese, yoghurt, and ice cream are safe.
Local meat, poultry, seafood, vegetables, and fruits are safe to eat.
Gastro-intestinal infections are the most common illnesses affecting travellers and can occur in any country you are visiting. Proper food handling, drinking purified water, and maintaining good personal hygiene are key to prevention. Below is a summary of the agents causing gastro-intestinal illnesses.
Bacterial Contamination
It is estimated that about 85% of traveller’s diarrhea is caused by bacteria of which the following are the most important agents:
Enterotoxigenic Escherichia coli (ETEC) and Enteroaggregative Escherichia coli (EAEC) account for most cases of traveller’s diarrhea associated with contaminated food and water world wide. They are the cause of large outbreaks in developed countries when food and water sanitation have not been properly maintained. Symptoms include watery stools, abdominal cramps, and possible vomiting lasting three to seven days.
Campylobacter jejuni is more prevalent in developing countries and is associated with contaminated water, undercooked food, and unpasteurized milk. Symptoms include diarrhea, abdominal cramps, and fever lasting from two to ten days.
Salmonella enteritidis is associated with contaminated eggs, poultry, milk, fruits, and uncooked vegetables. Symptoms include diarrhea, vomiting, abdominal cramps, and fever lasting from four to seven days. Infected persons can become asymptomatic carriers and shed the bacteria for years, becoming the source of infection for others through poor hygiene practices.
Shigellosis is a human infection caused by one of four species and transmitted by fecal-oral route due to unsanitary conditions, contaminated food and water, and overcrowded living conditions. Symptoms include diarrhea, abdominal cramps, fever, and may cause bloody diarrhea and mucous lasting four to seven days.
Vibrio cholera is associated with contaminated water, raw and undercooked seafood. Cholera infection in travellers is rare; symptoms include watery diarrhea and vomiting lasting three to seven days, but can lead to severe dehydration and death in undernourished persons. Vibrio parahaemolyticus is also related to the consumption of raw and undercooked seafood. Vibrio vulnificus is associated with contaminated shellfish and raw oysters in particular, and has caused septicemia in persons with liver disorders.
Viral Contamination
Gastro-intestinal infections caused by viruses account for about 5%. The main agents are Norovirus, associated with outbreaks at large gatherings and on cruise ships, and Rotavirus, which is more prevalent in developing countries. Symptoms include vomiting, diarrhea, fever, and myalgia lasting 12 to 60 hours.
Protozoal Contamination
Gastro-intestinal infections with protozoa account for about 10% of traveller’s diarrhea, but may cause prolonged illnesses (lasting weeks) and cause serious complications if not diagnosed in a timely manner.
Giardia lamblia (Giardiasis) and Entamoeba hystolytica (Amebiasis) are the most important agents in this category and both infections are acquired through contaminated food and water, as well as person to person transmission due to poor hygiene practices. Cryptosporidium and Cyclospora cayetanensis are implicated with contaminated food, water, and fresh produce (berries).
Toxins Causing Food Poisoning
Clostridium perfringens is the most important agent causing food poisoning in developed countries. The spores of the bacterium germinate on cooked food that is cooled and stored at room temperature over a prolonged period of time. After ingestion, the spores produce an enterotoxin in the small intestine causing abdominal pain, diarrhea, and vomiting. Foods implicated are meats and poultry.
Staphylococcus aureus enterotoxins are spread by unsanitary practices of infected persons. The foods implicated are custards, creamy desserts, meats, and salads.
Clostridium botulinum bacteria produce a very potent toxin. It is associated with improperly canned food, lightly preserved vegetables, salted fish, and meats. Symptoms include nausea, vomiting, and neurological symptoms such as blurred and double vision, paralysis of respiratory and motor muscles that may progress rapidly.
Seafood Poisoning
Fish and shellfish can be contaminated with the toxins produced by marine micro-organisms called dinoflagellates found in all oceans, especially in coral reef areas. Larger fish have usually more toxins accumulated in the skin, musculature, and organs, as these toxins are passed up through the food chain. The toxins are not destroyed through cooking, smoking, or freezing, they are odorless and tasteless, and do not alter the appearance of the fish.
Ciguatera Fish poisoning is the most common illness in this category. The most affected fish are amberjack, barracuda, grouper, kahala, parrotfish, sea bass, red snapper, surgeon fish, ulua. Symptoms usually appear within a few hours but can be delayed for a day or more and include nausea, vomiting diarrhea, muscle pain, itchiness, dizziness and temperature reversal (hot feels cold and cold feels hot). Symptoms can last for months. Persons who had a previous episode of ciguatera fish poisoning should avoid a second exposure as symptoms will be more severe. Prevention: Avoid large fish (more than 2.5 to 3 kilos [6 lbs]) or fillet of large fish, avoid head, roe, intestines and liver where the toxin is more concentrated.
Scombroid poisoning is the result of improper handling and refrigeration of fish containing high levels of natural occurring histidine (amino acid in protein). Contamination with bacteria will convert histidine to histamine-causing symptoms similar to allergic reactions, which occur very rapidly and include headache, abdominal cramps, diarrhea, itching, flushed face, and paralysis may occur. Scombroid poisoning occurs worldwide and affects fish from the Scombridae family: yellow tuna, mackerel, skipjack, and bonito. It can also affect other species such as herring, bluefish, sardine, anchovy, amberjack, and mahi-mahi. Prevention: Proper handling and immediate refrigeration of catch.
Shellfish poisoning is associated with the algal blooms (red tides) occurring in temperate and tropical areas. Shellfish – oysters, clams, cockles, mussels, crabs, lobsters – filter or ingest toxins produced by dinoflagellates micro-organisms. Each different toxin produces characteristic symptoms:
- Symptoms of diarrheic shellfish poisoning occur about 30 minutes to hours after ingestion and include nausea, vomiting, and diarrhea. Recovery occurs within two to three days.
- Symptoms of neurotoxic shellfish poisoning appear rapidly after ingestion and include tingling of mouth, arms and legs, stomach upset, and severe muscle pain. Recovery occurs within two to three days.
- Symptoms of paralytic shellfish poisoning appear rapidly after ingestion and include nausea, numbness of face arms and legs, headache, loss of coordination and dizziness, in severe cases respiratory failure and paralysis may lead to death.
- Symptoms of amnesic shellfish poisoning occur within 24 hours of ingestion and include vomiting, diarrhea, and disorientation. Permanent short-term memory loss has been observed, and in severe cases seizures, paralysis, and death may occur. Persons with kidney disease are especially vulnerable.
Puffer Fish poisoning (Fugu) is caused by a tetrodotoxin accumulating mainly in the liver, intestines and ovaries of puffer fish, ocean sunfish, globe fish, and porcupine fish. Symptoms appear between six and 20 hours and include profuse sweating, salivation, headache, hypothermia, and neurological symptoms of paralysis and respiratory failure. The mortality rate is very high.
