Travelers' Health: Africa

Globe Food and waterborne diseases are the number one cause of illness in travelers. Travelers' diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout the region and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera and parasites), fever (typhoid fever and toxoplasmosis) or liver damage (hepatitis). Make sure your food and drinking water are safe.

Malaria is a preventable infection that can be fatal if left untreated. Prevent infection by taking prescription antimalaria drugs and protecting yourself against mosquito bites. Most travelers should take chloroquine to prevent malaria. Depending on the areas visited in Africa is how high the chances are to contract malaria.

In Northern Africa, certain parts of Algeria, Egypt (El Faiyum area only), Libyan Arab Jamahiriya, Western Sahara and Morocco have limited risk. There is no risk for travelers visiting the major tourist areas in North Africa, including Nile cruises. For more detailed information about the risk in specific locations, see Malaria in North Africa.

If traveling to Central Africa BEWARE. There is a high risk for malaria which exists all year in all parts of these countries, including the cities. For more detailed information about the risk in specific locations, see Malaria in Central Africa.

In Southern Africa, travelers should take mefloquine to prevent malaria. Risk for malaria exists all year in the northern part of Botswana, rural areas of South Africa, all non-mountainous areas of Swaziland and all areas of Zimbabwe except the cities of Harare and Bulawayo. There is no reported risk for travelers visiting Lesotho and St. Helena. For more detailed information about risk in specific locations, see Malaria in Southern Africa.

Most travelers to malaria risk areas in this region should take mefloquine to prevent malaria. You can be infected with malaria in all areas of this region except the cities of Addis Ababa, Ismara and Nairobi, the islands of Reunion and Seychelles and in highland areas above 2,500 meters. For more detailed information about the risk in specific locations, see Malaria in East Africa.

If traveling to West Africa, your risk of malaria is high in all parts of these countries, including cities, except for most of the Cape Verde Islands. For more detailed information about the risk in specific locations, see Malaria in West Africa.

A certificate of yellow fever vaccination may be required for entry into certain countries if you are coming from a country in tropical South America or sub-Saharan Africa. (There is no risk for yellow fever in North Africa.) For detailed information, see Yellow Fever Comprehensive Vaccination Requirements.

Filariasis, leishmaniasis and onchocerciasis are diseases carried by insects that also occur in this region, but the risk to travelers is low. Protecting yourself against insect bites will help to prevent these diseases.

Schistosomiasis, a parasitic infection, is found in fresh water in the region, including the Nile River. Do not swim in fresh water (except in well-chlorinated swimming pools) in these countries.

Because motor vehicle crashes are a leading cause of injury among travelers, walk and drive defensively. Avoid nighttime travel if possible and always use seat belts.

CDC Recommends the Following Vaccines (as appropriate for age):

See your doctor at least 4-6 weeks before your trip to allow time for shots to take effect.
Hepatitis A or immune globulin (IG).
Hepatitis B if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay longer than 6 months in the region or be exposed through medical treatment.
Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
Typhoid, particularly if you are visiting developing countries in this region.
As needed, booster doses for tetanus-diphtheria, measles, and a one-time dose of polio vaccine for adults. Hepatitis B vaccine is recommended for all infants and for children ages 11–12 years who did not complete the series as infants.

To Stay Healthy:

Wash hands often with soap and water.
Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an "absolute 1-micron or less" filter AND adding iodine tablets to the filtered water. "Absolute 1-micron filters" are found in camping/outdoor supply stores.
Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: BOIL IT, COOK IT, PEEL IT OR FORGET IT!
If you will be visiting an area where there is risk for malaria, take your malaria prevention medication before, during and after travel, as directed. (See your doctor for a prescription.)
Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4-hour intervals) and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and long pants from dusk through dawn.
To prevent fungal and parasitic infections, keep feet clean and dry. Don't go barefoot.
Always use latex condoms to reduce the risk of HIV and other STDs.

To Avoid Getting Sick:

Don’t eat food purchased from street vendors.
Don’t drink beverages with ice.
Don’t eat dairy products unless you know they have been pasteurized.
Don’t share needles with anyone.
Don’t handle animals (especially monkeys, dogs and cats), to avoid bites and serious diseases (including rabies).
Don’t swim in fresh water, including the Nile. Salt water is usually safer.

What You Need To Bring with You:

Long-sleeved shirt and long pants to wear while outside whenever possible, to prevent illnesses carried by insects (e.g., malaria, dengue, filariasis, leishmaniasis and onchocerciasis).
Insect repellent containing DEET (diethylmethyltoluamide), in 30%–35% strength for adults and 6%–10% for children. Unless you are staying in air-conditioned or well-screened housing, purchase a bed net impregnated with the insecticide permethrin. (Bed nets can be purchased in camping or military supply stores.)
Over-the-counter anti-diarrheal medicine to take if you have diarrhea.
Iodine tablets and water filters to purify water if bottled water is not available.
Sun block, sunglasses and hat.
Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).

After You Return Home:

If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area.

If you become ill after your trip—even as long as a year after you return—tell your doctor where you have traveled.

For More Information:

Ask your doctor or check the Centers for Disease Control Web site for more information about how to protect yourself against diseases that occur in Africa.

Be sure to read the information about all the regions you are planning to visit.
CDC Travel Page

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