There is a general perception that the risk of acquiring African tropical infections is uniform throughout the continent. However, most communicable diseases, especially those that are vector-borne, are seasonal and have distinct geographic location. South Africa, eg, is not a yellow fever–affected country, and there is therefore
no risk of contracting the infection. However, travelers visiting the World Cup from yellow fever–affected countries must show proof of immunization on arrival. Although malaria is endemic HIF inhibitor in South Africa, the malaria risk for visitors to the World Cup should be low, considering the rarity of transmission in the winter months during which the competition will be staged, the successes of the National Malaria Control Programme, and the fact that all the stadia are outside recognized malaria transmission areas. Visitors who take the
opportunity to visit game reserves such as the Kruger National Park should take precautions against mosquito bites, and there should always be a high index of suspicion of malaria for those who subsequently develop febrile illness.12,13 PD-1 antibody Chemoprophylaxis is recommended for those who visit neighboring countries such as Mozambique, Zimbabwe, or Zambia, where transmission rates are higher. As with malaria, DEET-based insect repellents and protective clothing should be used by those exploring the bush and other outdoor areas of South Africa to reduce the risk of tick bites and hence African tick bite fever (ATBF). ATBF should be on the list of differential diagnoses in travelers returning from South Africa, particularly if the classical eschar and (variably) a maculopapular rash are present, prompting early treatment with doxycycline.14 Tick-borne
transmission of Crimean-Congo fever would be expected to be low, given the season and unlikely exposure risk. Northern and eastern areas of the country are endemic for schistosomiasis but visitors are unlikely to be exposed unless they are keen white-water Abiraterone canoeists or open cold water swimmers. South Africa is regarded as a rabies-endemic country, mainly related to dog exposure, with Mpumalanga, Eastern Cape, and KwaZulu-Natal Provinces being specific risk areas. Considering that risks, particularly in cities, for visitors to the World Cup are likely to be low, and that there is easy access to good quality biologicals for postexposure prophylaxis, preexposure vaccination is not a priority.15 Although South Africa may be perceived as an exotic locale for many intending World Cup visitors, the likely communicable disease risks will differ little from those affecting mass events elsewhere. Pretravel preparation and appropriate vaccinations will ensure an illness-free event for the majority of football fans.
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