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The food at hotels is well cooked and usually quite safe
Health Issues
Aside from our own page on safety and security, two other great resources are the Center for Disease Control and the US State Department. Both have a lot of information on foreign travel and update issues you should be aware of.
Shots and pills
A yellow fever certificate is required to enter the country by the Tanzanian government. They also recommend you take anti-malaria pills. Larium is the most common malaria pill prescribed. It needs to be taken once a week, beginning with the week before you leave for your trip and continuing a couple of weeks after you return. Check with your insurance plan to see if immunizations and malaria pills are covered. On some plans, they'll also give you the other major immunizations (typhoid, hepatitis A, tetanus, etc...) if you haven't already received them, just to be safe. Be sure to get your immunizations early, since you may need to go back more than once.
It's also wise to bring some sort of anti-diarrhea medication like Immodium AD or something stronger, just in case. Your doctor should be able to prescribe something. Anytime you travel to a foreign country, it may take your body awhile to adjust to the new food.
Water, Fruit Juices, Etc...
It's recommended that you always drink bottled water or boiled water while you're in Africa. If you're not sure, use your purification tablets or make sure the water is boiled before you drink it.
While staying at the lodges, you will be served fruit juice upon your arrival and it will be available at the buffets. It's recommend that you don't drink anything that's not bottled or in a can because you don't know where the water is coming from or if it's been boiled. Most people feel that it's safe enough to drink fruit juices given to you at a tourist hotel. After all, they know that they are catering to tourists and it's in their best interest not to make you sick. Again, use your common sense, and if you think it unwise, don't drink it.
Food
We advise the same thing for fresh fruit as we do for fruit juices - if in doubt, don't eat it. We had no problems eating any of the food served at the buffets or while climbing Kilimanjaro. Just stick to fruits that are cooked or that you can peal.
You should expect that your body will need to adjust to the new food being served to you. The Tanzanians go out of their way to offer "Western" food, but it is still different than what you are used to. Once again, use your best judgment. No one wants you to get sick on your vacation!
Altitude
Many people recommend using Diamox to counteract altitude sickness. If you don't have a lot of experience with altitude, you may also want to get a prescription from your doctor for this, even if you don't intend to take it. It's better to be safe than sorry. If you decide to take Diamox, it is better to start the day before you climb. Diamox is a diuretic and can make it hard for you to keep hydrated if you don't start until you're already climbing.
Most people tend to feel the effects of the altitude at 12,000 ft. or higher. You might feel nauseous or have a splitting headache. One of the easiest and best prevention for altitude sickness is to be properly hydrated. Most guides recommend drinking at least 1 full litter of water before you even leave your tent in the morning. Then at least 3-4 more throughout the day. Ideally you should have 4-5 litters a day. If you do feel sick, try to rest and take some medication. For most people, it goes away after a night of sleeping at altitude.
On summit day all bets are off. Nobody feels good on the summit. You just have to know how far to push yourself. But remember, the summit isn't the top of the mountain, it's getting back safely!
The glacial water is very fresh. But the porters boiled water each night for you to drink.