Palau
Travel Destination – Palau
Crystal-clear waters, vibrant coral reefs, and warm hospitality make Palau a dream destination for many Australian travellers. Whether you're planning to dive among world-famous marine life, kayak through the Rock Islands, or simply unwind on a quiet beach, it’s worth taking a moment to understand the local health risks. A few simple precautions before you go can help ensure your trip is as smooth and enjoyable as it is unforgettable.
Health Risks
Pre-travel preparation
It’s a good idea to speak with a travel doctor before heading to Palau. They can create a personalised health plan based on your planned activities - whether you’ll be diving, exploring remote islands, or staying in Koror. Your doctor will review your immunisation history, recommend any additional vaccines, and ensure you have prescriptions for any medications you may need while travelling. Aim to book your appointment at least six to eight weeks before departure to allow time for any multi-dose vaccines. Even if you’re leaving soon, it’s still worth arranging a consultation - some vaccines can be given on an accelerated schedule, and essential advice and medications can still be provided.
Insect avoidance
In Palau, mosquito-borne illnesses such as dengue fever are present, and occasional cases of Zika virus have been reported in the broader region. While malaria and Japanese encephalitis are not major concerns in Palau, it’s still important to protect yourself from mosquito bites. Prevention strategies include staying in air-conditioned accommodation or rooms with intact fly screens, and using permethrin-treated mosquito nets if sleeping in open or unscreened areas. When outdoors, especially at dawn and dusk, wear long sleeves and long pants, and apply insect repellent containing DEET, picaridin, or oil of lemon eucalyptus. Mosquito coils and plug-in vaporisers can also help reduce bites in outdoor seating areas like verandas.
Food and water hygiene
Trying local food is a big part of the travel experience in Palau, and with a few simple precautions, you can reduce your risk of gastroenteritis and other bugs. Make sure to wash your hands or use hand sanitiser before eating, especially when dining away from main tourist centres. Avoid food that is raw, undercooked, or has been sitting out, and opt for dishes that are freshly prepared and served hot. Fruits like bananas and papayas are safest when you peel them yourself. Stick to bottled, boiled, or properly filtered water, and steer clear of untreated tap water and ice unless you’re confident it’s from a safe source.
Rabies prevention
Australia is one of the few countries in the world that is free from rabies. In contrast, rabies remains present in many other regions, where it can be carried by dogs, bats, and other mammals, and transmitted through bites or scratches. While rabies risk in Palau is considered low, the safest approach is to avoid contact with animals—particularly strays and wildlife. Rabies vaccination is generally not necessary for most travellers to Palau, but may be recommended if you’ll be working with animals or visiting remote areas where access to urgent medical care is limited. If you are bitten or scratched while in Palau, seek medical attention promptly. Life-saving post-exposure treatment, including rabies immunisation, is essential and should be started as soon as possible.
Our Travel Doctors
Our fully qualified doctors have an interest in travel medicine and immunisations. And they know travel. Their expert advice will be tailored for you, your travel companions and your trip.
Which shots do I need for Palau?
Hepatitis A
+
Hepatitis A is a viral infection of the liver, typically spread through contaminated food or water. While many people experience only mild symptoms, the illness can sometimes be severe and even life-threatening. In Australia, hepatitis A is uncommon due to high hygiene standards and routine vaccination. However, in regions like the Pacific Islands - including Palau - the virus is more prevalent. Travellers who haven’t completed a two-dose course of hepatitis A vaccination are advised to get immunised before visiting Palau, particularly if they plan to eat local foods or stay in areas with variable sanitation.
Typhoid
+
Typhoid is a bacterial infection caused by Salmonella Typhi or Paratyphi, usually contracted through contaminated food or water. It can lead to high fever, fatigue, abdominal pain, headache, and digestive upset. While the overall risk in Palau is relatively low, it may be higher in areas with limited sanitation or if you're planning an extended stay. A typhoid vaccine is available and provides protection for up to three years. Your travel doctor may recommend it based on your itinerary, duration of travel, and intended activities.
Hepatitis B
+
Hepatitis B is a viral infection that can lead to long-term liver disease. It is spread through contact with blood or bodily fluids - for example, through unprotected sex, tattooing, or sharing personal items like razors or toothbrushes. Infections can vary from mild to severe and may require long-term antiviral treatment. While hepatitis B vaccination is part of the routine immunisation schedule in Australia, not all adults are fully protected. Travellers who haven’t completed the vaccine series should consider immunisation before visiting Palau, particularly if they’ll be staying for an extended period or making repeat visits.
Routine vaccinations
+
In Australia, widespread immunisation has kept many common infectious diseases - such as measles, mumps, rubella, and tetanus - at very low levels. In other countries, including Palau, these illnesses may still circulate more frequently. Travelling overseas is a good opportunity to review your routine vaccinations and update any that are due. This may include immunisations against measles-mumps-rubella (MMR), tetanus, diphtheria, influenza, COVID-19, and others.
Palau
Other health risks in Palau
Dengue
+
Dengue fever is a mosquito-borne viral illness that has been reported in Palau and is one of the more common infections affecting Australian travellers to the Pacific. It typically causes high fever, fatigue, joint and muscle pain, and sometimes a skin rash. Most people recover within one to two weeks, especially during a first infection. However, more serious forms of dengue can occur - particularly in cases of repeat infection - and may involve bleeding, low blood pressure, and life-threatening complications. Dengue is transmitted by Aedes mosquitoes, which are most active during daylight hours and are often found in urban and residential areas. There is no specific treatment and, for those travelling for a short time, prevention relies largely on avoiding mosquito bites.
Rabies
+
Rabies is a deadly viral infection transmitted through the bites or scratches of infected animals, including dogs, cats, and other mammals. While Australia is free of rabies, the virus is present in many parts of the world. Palau is considered low risk, but precautions are still advised - particularly if you will be spending time in rural areas or interacting with animals. The best prevention is to avoid contact with animals, especially strays.
A rabies vaccine is available and may be recommended for travellers who plan to work with animals, stay in remote areas, or take part in activities where access to urgent medical care may be limited. If you are bitten or scratched while in Palau, seek medical attention immediately. Post-exposure treatment - which includes rabies immunisation - is essential and must begin as soon as possible, even if you have been vaccinated previously.
Gastroenteritis
+
Gastroenteritis - commonly referred to as traveller’s diarrhoea - is usually caused by bacteria such as Campylobacter, Salmonella, or enterotoxigenic Escherichia coli, often ingested through contaminated food or water. Symptoms typically begin within 24 to 72 hours and may include nausea, vomiting, diarrhoea, and abdominal cramps.
The most important part of treatment is maintaining hydration. Oral rehydration solutions help replace lost fluids and electrolytes. Most cases resolve on their own within one to three days. Antibiotics are generally reserved for severe or prolonged infections, or for travellers at higher risk of complications. You should seek medical attention if symptoms are unusually severe, last more than a few days, or if you're unable to keep up with fluid losses.
To reduce your risk, practise good hand hygiene before eating and be cautious with food and water - especially in more remote parts of Palau, where food safety standards may vary.
Non-infectious conditions
Deep vein thrombosis
+
Travelling long distances to Palau increases the risk of deep vein thrombosis (DVT), a condition in which a blood clot forms in a deep vein, usually in the legs. This occurs due to prolonged immobility, which slows blood flow and increases the chance of clotting.
To reduce your risk, make sure to get up and move around regularly during long flights or drives, stretch your legs while seated, and stay well hydrated. Travellers at higher risk - such as those with a history of clots or recent surgery - may benefit from wearing below-knee compression stockings. If DVT does occur, it is typically treated with blood-thinning medications to prevent serious complications.
Safety on the roads and elsewhere
+
Trying new activities is one of the highlights of visiting Palau, but it’s important to be aware of the risks and take steps to stay safe. If you're considering riding a motorbike, make sure you’re confident in your skills, understand local road rules, and always wear a helmet. When using other forms of transport, opt for vehicles with functioning seatbelts whenever possible.
Palau is famous for its marine adventures, including diving, snorkelling, and kayaking. If you're new to any of these, choose a qualified instructor who prioritises safety and uses well-maintained equipment. For land-based activities like hiking or exploring jungle trails, wear comfortable, broken-in footwear, apply sunscreen and insect repellent, and avoid overexertion in hot or humid conditions.
Whatever your plans, make sure your travel insurance covers adventure activities and includes medical evacuation, in case you need urgent care while in a remote area.