World Country Guide

1
A yellow fever vaccination certificate is required by travellers over one year of age.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not an official condition of entry to the Democratic Republic of Congo. However, cholera is a serious risk in this country and precautions are essential. Up-to-date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness. See the Health appendix.

3
Immunisation or boosters for typhoid are recommended and vaccination against poliomyelitis is sometimes advised.

4
Malaria risk, predominantly in the malignant falciparum form, exists throughout the year in the whole country. The malignant form is reported to be highly resistant to chloroquine and sulfadoxine-pyrimethamine. Mefloquine is the recommended prophylaxis.

Food & Drink
All water should be regarded as being a potential health risk. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products that are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks
Bilharzia (schistosomiasis) is present. Avoid swimming and paddling in fresh water; swimming pools which are well chlorinated and maintained are safe. Hepatitis A, B and E are present and meningococcal meningitis may occur. Plague is present in natural foci. Further information should be sought from the Department of Health. There is a very high risk of diarrhoeal diseases, the dysenteries and various parasitic worm infections; observe strict food and drink caution. Leishmaniasis and human trypanosomiasis (sleeping sickness) are present. Ebola outbreaks have occurred. Avoid tick bites which spread African tick typhus. Wear shoes to avoid soil-borne parasites.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Health care
Government expenditure on health is low and the quality of hospitals is poor. It is advisable to take specific personal medicines as well as supplies such as syringes and drip needles, as medical facilities are available only in larger centres. Doctors and hospitals expect cash payment in full for health services. Health insurance is essential and it is advisable to include cover for emergency air evacuation.