VACCINES AND HYGIENE RULES

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1 VACCINES AND HYGIENE RULES Paraguay Bolivia Argentina Paraguay, Argentina and Bolivia are not considered countries "at risk". Better safe than sorry, however, so here are a few important recommendations: - take special care to stay hydrated and well fed (drink several litres of water every day, even if you do not feel thirsty, and eat the rations provided); flavor your water with a brick of fruit juice. - stick to the usual health and hygiene rules; - drink a lot, but only water from capped bottles or boiled water; - always have a powerful mosquito repellent with you, especially in Paraguay! - get the yellow fever vaccine (protection lasts for 10 years), especially if you come from a country where yellow fever is widespread. This preventative tips are not meant to scare you, but to make sure you get adequate protection and enjoy your Dakar experience to the fullest. Have fun, everyone! Doctor Florence POMMERIE Medical Director

2 Vaccines Usual vaccines required at the rally: hepatitis A hepatitis B polio, tetanus and diphtheria (DTCP) Yellow fever (strongly recommended but not compulsory) Warning: competitors from countries with a high incidence of yellow fever must be up-to-date on their vaccination (at least 10 days before the start)

3 MALARIA Paraguay and Argentina : No significant risk of malaria in the regions hosting the rally (only very low risk in the rural lowlands in Jujuy and Salta). Bolivia : No risk in big cities and in regions situated above 2500 meters. That means that there will be no problemin the highlands located in the South (Oruro region). No preventative treatment recommended. Advice: sleep in a tent equipped with mosquito netting and use a mosquito repellent with DEET to protect yourself

4 Yellow fever An acute viral haemorrhagic disease transmitted by infected mosquitoes. Very low infection risk in the regions hosting the race because of a short stay in Paraguay. Nevertheless, vaccination is mandatory for competitors from an "infected" or "at risk" country (see countries in red below). An immunisation card with this vaccine up-to-date is needed to enter South America.

5 Dengue fever: Other specific risks Dengue is a viral infection spread by a specific mosquito which bites mainly throughout the day and early evening. Dengue is particularly widespread during the wet season. No vaccine exists for this disease, which is rarely lethal but causes severe fatigue for several weeks. Use a mosquito repellent with DEET, sleep under mosquito netting and wear long clothes to keep these insects at bay. Seek medical attention straight away if you experience a high fever, muscle and joint pain and/or a rash. Traveller's diarrhea: Advice: - wash your hands; - only drink water from capped bottles or boiled water; - use drinking water for disinfection, to brush your teeth and washing hands; - in the event of diarrhoea: treat dehydration with saline solutions (ORS) available from pharmacies and "anti-diarrhoeic" or "intestinal antiseptics". Influenza A (H1N1) and Chikungunya: very rare, no epidemics reported Zika : viral infection transmitted by Aedes mosquitoes (usually bite during the day). There is also a risk of sexual transmission. Protection against mosquito bites/safe sex. There is no vaccine available. Wary climate change and height during the ascent in Bolivia, particularly if diarrhea or current infectious syndromes; Make sure to have adequate clothes and correct level of hydration.