Last year I visited Tanzania, an African country where malaria is rampant. In parts of the country, villagers receive 300 infective mosquito bites per year — meaning, on average, they’re exposed to malaria almost nightly. Did I smear insect repellent all over my body and down malaria pills during my stay? You bet. Without these measures, the malaria stakes in Africa are high. Even with them, there are no guarantees. And there is no vaccine.
A mosquito-borne scourge rarer than malaria is yellow fever. Although taking malaria precautions is a good idea, it’s voluntary; getting a yellow fever shot isn’t. Many African countries — mostly in the continent’s sub-Saharan midsection — require proof of vaccination before you can apply for a visa.
Years ago in my travel medicine practice, I saw safari-goers who wanted yellow fever shots and nothing else because a consular official or travel agent had told them that was the only official requirement. When I offered them malaria pills and optional vaccines (hepatitis A or typhoid, for example), they declined. I held my breath and prayed.