My husband, my 16-year-old granddaughter and I are going to Zimbabwe in six months. What inoculations should we get, and where can we get them?

N.

For readers who don't know, Zimbabwe is in the southern part of Africa. When you travel to many areas in Africa and to other less-developed regions of the world, you should make preparations to prevent infection. I cannot list all of the precautions that you should take while traveling, but I will discuss the special risks in this part of the world.

Traveler's diarrhea, a syndrome that can be caused by many different bacteria and parasites, is probably the most common illness encountered in southern Africa. Water must be considered unsafe unless it is boiled or treated. (There are many techniques to treat water, but boiling is probably safer.) Raw foods are also possibly contaminated and should generally be avoided. We usually do not recommend taking antibiotics as a preventive measure, but your doctor may give you some to take if you begin to become ill.

Malaria, a potentially life-threatening infection spread by mosquitoes, is present in all areas of Zimbabwe except the cities of Harare and Bulawayo, according to the U.S. Centers for Disease control (CDC). The antimalarial drug mefloquine (trade name Lariam) is currently recommended for all people traveling to Zimbabwe. It is taken weekly, starting before you get there and continuing until after you leave. In addition to taking the mefloquine, you should also take precautions to prevent insect bites. These precautions will decrease the risk of malaria and all other infections spread by biting insects. These and other precautions can be found on the CDC travel advisory webpage.

Yellow fever, a serious infection also spread by mosquitoes, is not seen in Zimbabwe but is endemic in other areas. The CDC states that Zimbabwe currently requires that visitors be vaccinated for yellow fever if they have traveled to an endemic area before coming to Zimbabwe. You should call the consulate or your travel adviser to determine if your itinerary means you will need this vaccine.

The CDC has the following additional recommendations for vaccinations before traveling to Southern Africa:

• Hepatitis A: This form of hepatitis is very common in areas of poor sanitation.
  
• Hepatitis B: This virus is spread by contact with blood or body fluids. The vaccine is only recommended if you anticipate contact with these fluids, as would occur if you expect to have sexual contact with residents or if you are a health-care worker.
  

• Rabies: This vaccine is recommended if you are expecting to be exposed to animals, either wild or domestic.
  
• Typhoid: Typhoid fever is a life-threatening bloodstream infection acquired by consuming contaminated water or foods. The typhoid vaccine should be taken if there is any threat of consuming such items. The vaccine is available in an oral and injection form. Both are between 50 and 80 percent effective in preventing disease.
  
• Other infections: You should also make sure you are up-to-date on your boosters for tetanus and diphtheria. If you have never had measles and have not been vaccinated, you should be. And, adults should probably have a booster vaccine for polio.
  
• The best place to get these immunizations is at a travel clinic. You should contact your primary physician or insurance company to determine where it is most appropriate for you to receive this care. All of the vaccines except yellow fever can usually be ordered or given by your primary doctor. To give yellow fever vaccine (and you probably do not need it), special certification is required.