Travel Vaccines and Advice for South Africa

• Typhoid – Typhoid, caused by Salmonella Typhi, is primarily transmitted through tainted food and water. Protection against this disease involves vaccination combined with good hygiene and careful food consumption.
• Cholera – Cholera is an acute diarrheal illness caused by Vibrio cholerae bacteria. It primary spreads through contaminated food or water. The cholera vaccine provides effective protection against this potentially life-threatening disease. It is recommended for travelers to regions with poor water and sanitation or where cholera is present.
• Hepatitis A – Hepatitis A is a contagious liver infection caused by the hepatitis A virus, typically spread through ingestion of contaminated food or water, or close contact with an infected person. Symptoms include fatigue, stomach pain, and jaundice. The hepatitis A vaccine provides effective prevention against the virus. It is administered in a series of shots, usually starting in childhood, and is recommended for travel to areas with high infection rates.
• Chikungunya – Chikungunya is a viral disease transmitted by infected mosquitoes and can also spread through other means like blood transfusion. To prevent it, use mosquito repellents or wear protective clothing. Vaccination is available and considered the best form of protection.
• Rabies – Rabies, a deadly viral infection, spreads through the saliva of infected animals via bites or scratches. Timely vaccination is crucial to prevent the disease in humans. Pre-exposure vaccination is recommended for high-risk individuals, while post-exposure prophylaxis is essential after potential exposure.
• Hepatitis B – The hepatitis B vaccine is a vital tool in the prevention of this liver infection, recommended for all travelers and essential for healthcare workers and those at higher risk of exposure.
• Measles, Mumps, Rubella (MMR) – Measles, mumps, and rubella are contagious viral infections, causing various symptoms and complications. To prevent them, vaccination is key. The MMR vaccine, given in two doses, safeguards against all three diseases and helps establish herd immunity, reducing the risk of outbreaks.

Most of South Africa is low risk for malaria. But, the border areas near Mozambique and Zimbabwe are considered high risk for infection. This includes Kruger National Park, a very popular tourist destination.

Malaria in South Africa is chloroquine resistant, be sure to speak with a travel health specialist on which antimalarial is best for your trip.

Outside malaria zones, mosquito and tick bites still carry other risks in bushveld and the grasslands. Long sleeves and pants cut down on exposed skin, tucking pants into socks helps in tall grass. Check yourself for ticks each evening, especially after hiking or game drives, and remove any you find with fine-tipped tweezers.

Insect repellent containing DEET or picaridin works against both mosquitoes and ticks. Permethrin-treated clothing adds a second layer of protection for longer trips. If your lodging doesn’t have screens or air conditioning, pack a mosquito net.

Passport Health can help build a bite-prevention plan around your specific trip, whether that’s Cape Town or a multi-week trip through Kruger.

Travelers’ diarrhea, hepatitis A, and typhoid are the most common food and water risks in South Africa. Tap water is treated and considered safe to drink in most major cities, but rural areas, game reserves and townships often rely on borehole or untreated sources.

Stick to bottled or purified water outside of well-established urban areas, and skip ice unless you know it was made from safe water. Freshwater lakes, rivers, and dams, especially in rural or flood-prone regions, can carry contamination from mud, soil, and animal waste. Avoid swimming or wading in slow-moving or standing water.

Street food across South Africa’s cities and markets is often freshly prepared, but stick to vendors with high turnover and food served hot. Peel fruit yourself, and be cautious with unpasteurized dairy, especially in rural areas where refrigeration may be inconsistent.

A stomach bug shouldn’t be what you remember about a trip to South Africa. Passport Health’s specialists can walk you through vaccination options before you go.

Altitude sickness, characterized by symptoms like headaches and fatigue, occurs at high elevations due to oxygen deficiency. To prevent it, ascend gradually, hydrate sufficiently, and consider medication. If symptoms emerge, promptly descend to lower altitudes for recovery.

• African tick-bite fever – This bacterial infection spreads through the bite of infected ticks living in bushveld, savanna, and grassland habitat. Applying repellent before outdoor activity and inspecting your skin that evening catches most exposures early.
• Crimean-Congo hemorrhagic fever – A rare but severe viral illness spread through tick bites or contact with the blood or tissue of infected livestock. Cases have been reported in South Africa’s rural farming areas, often linked to handling cattle or sheep. Avoid direct contact with animal blood, and wear gloves around livestock.
• Hantavirus – This virus lives in the droppings, urine and saliva of infected rodents and spreads mainly when dust carrying those particles is breathed indoors. Cases in South Africa are uncommon but have occured in rural buildings with rodent activity. Seal food away from rodents.
• Leptospirosis – Infected animals shed this bacteria in their urine, contaminating soil and fresh water that people then touch, wade through, or accidentally swallow. South Africa’s wet season brings a rise in cases as flooding pushes contaminated runoff into rivers and low-lying areas. Skip barefoot walks near flooded ground, and towel off promptly after contact with natural water.
• Melioidosis – Caused by bacteria living in soil and fresh water that enter the body through skin cuts, contaminated water, or dust kicked up during storms. Risk increases after heavy rain in agricultural regions. Wear closed shoes around wet soil or mud, and avoid standing water after storms.
• Rift Valley fever – Spread through contact with the blood or tissue of infected livestock or by mosquito bite. Outbreaks have occurred in South Africa’s farming regions, often following heavy rainfall. Avoid handling sick or dead animals and use insect repellent around livestock.
• Schistosomiasis – This parasitic worm spends part of its life cycle in freshwater snails, entering human skin on contact with infested lakes, rivers or slow-moving streams. Much of South Africa’s inland freshwater carries some risk. Chlorinated pools and the ocean make safer alternatives to an untreated freshwater swim.
• Tuberculosis (TB) – This bacterial infection travels through the air in droplets released when an infected person coughs, talks, or sings. TB typically requires extended close contact to spread. South Africa carries one of the world’s heaviest TB burdens. Well-ventilated spaces and limited time in crowded indoor settings cut down exposure.