Eritrea
Travel Destination – Eritrea
Eritrea sits on the Horn of Africa with over 1,200 kilometres of Red Sea coastline and a history shaped by successive waves of Ottoman, Egyptian, Italian, and British influence.
The capital, Asmara, is one of Africa's most striking cities, renowned for its remarkably intact collection of buildings dating from the Italian colonial period. The port city of Massawa, known as the Pearl of the Red Sea, blends Ottoman and Egyptian architecture with coral-lined streets. It serves as the gateway to the Dahlak Archipelago, a scattering of over 200 largely uninhabited islands offering world-class snorkelling, diving, and pristine coral reefs.
The highland city of Keren features colourful markets and multicultural heritage, while the archaeological site of Qohaito near Senafe preserves ruins and cave paintings from the ancient Aksumite civilisation.
Eritrea is an interesting destination that requires preparation before travel, with permits required for travel outside Asmara.
Health Risks
Pre-travel preparation
Seeing a travel doctor is the most important step Australian travellers can take before visiting Eritrea. This appointment should ideally be booked at least six to eight weeks before departure to allow time for multi-dose vaccines and the prescription of antimalarial medication. Accelerated vaccination courses and personalised health advice are still available with imminent departure. Advice can be tailored your specific plans, whether you are staying in Asmara, diving at the Dahlak Archipelago, or trekking to highland archaeological sites.
Medications are often unavailable and can be expensive throughout Eritrea. Travellers are strongly advised to carry a comprehensive medical kit when venturing away from Asmara. Medical care in Eritrea is limited, even in the capital, and emergency evacuation would almost certainly be required for any serious illness. Comprehensive travel insurance that clearly includes medical evacuation cover is not optional here.
Insect avoidance
Malaria is present in all areas below approximately 2,200 metres, meaning it is a risk in most parts of the country outside the capital Asmara, which sits at around 2,325 metres. Malaria-transmitting Anopheles mosquitoes feed predominantly between dusk and dawn.
Dengue and chikungunya are also present, with transmission occurring through Aedes mosquitoes that are active mainly during the day. Around dusk, both mosquito types may be active simultaneously, making that period particularly important for protection.
Apply an insect repellent containing DEET or picaridin to all exposed skin throughout the day and evening, and reapply after sweating or washing. Long sleeves, long trousers, and closed footwear when outdoors reduce the surface area available to biting insects.
Accommodation with screened windows or air conditioning is preferable, and a permethrin-treated bed net is essential when sleeping in any room that is not properly screened, which will apply across most accommodation in coastal and rural areas. Treating outer clothing and gear with permethrin before departure provides additional protection.
Food and water hygiene
Eritrean food draws on Italian influence alongside traditional Tigrinya and Afar cooking, with fresh seafood along the Red Sea coast. Enjoying the local cuisine whilst preventing gastroenteritis and hepatitis A requires consistent preventative measures.
A high risk of gastrointestinal illness exists throughout Eritrea, including in some hotel accommodation. Before eating, hands should be washed thoroughly with soap and water, and alcohol-based hand sanitiser carried for situations where running water is not accessible. Choose meals that are freshly cooked and piping hot, peel fruit immediately before eating, and avoid raw or reheated dishes from informal vendors.
Drinking water supply problems occur across the country, and tap water should not be consumed during a visit. Bottled water should be used consistently for drinking and brushing teeth, and ice from unverified sources avoided.
Rabies prevention
Rabies is a viral infection spread through the saliva of infected mammals, usually by a bite or scratch, and is almost always fatal once symptoms develop. Rabies is present in Eritrea and is carried by dogs and other mammals, including bats.
Access to post-exposure treatment within Eritrea is unreliable, particularly outside Asmara, making prevention the most critical consideration. Keep your distance from all animals during the visit, including stray dogs in towns and any wildlife encountered in rural or highland environments.
Pre-exposure rabies vaccination may be recommended for travellers visiting rural or highland areas, those spending extended time in the country, and those whose planned activities increase the likelihood of animal contact, including trekking, wildlife observation, and cycling. Consult with a travel doctor whether pre-exposure rabies vaccination is appropriate for you.
Any bite, scratch, or lick to broken skin from any animal requires the wound to be washed immediately and thoroughly with soap and running water, followed by urgent medical assessment, regardless of prior vaccination status.
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 Eritrea?
Meningococcal disease
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Parts of Eritrea fall within Africa's meningitis belt, the band of sub-Saharan nations where meningococcal disease rates are substantially elevated. This bacterial infection affects the lining of the brain and spinal cord and can cause death or permanent disability without rapid treatment.
Vaccination with a quadrivalent MenACWY vaccine is recommended for travellers visiting Eritrea, particularly during the dry season from December to June when dusty conditions and crowded indoor settings facilitate transmission. A travel doctor can advise on the appropriate schedule based on vaccination history and when you plan to travel.
Hepatitis A
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Hepatitis A is a viral liver infection acquired through food or water that has been contaminated with the virus, causing fatigue, nausea, abdominal discomfort, and yellowing of the eyes and skin. More severe illness is possible, especially in older travellers and those with existing liver conditions.
Vaccination is recommended for all previously unvaccinated travellers to Eritrea. Given the variable food safety standards and documented drinking water challenges across the country, the risk of exposure exists regardless of where you eat or stay. Two doses provide durable, long-lasting protection, and many Australians have not yet completed this course.
Typhoid
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Typhoid fever is a bacterial illness caused by Salmonella Typhi, contracted through contaminated food or water and responsible for sustained fever, headache, fatigue, and abdominal pain that can lead to serious complications if untreated.
Vaccination is recommended for most travellers to Eritrea, particularly those eating outside strictly controlled hotel environments, visiting smaller cities or rural communities, or spending extended periods in the country. Food and water hygiene remains an important protective measure alongside vaccination throughout the trip.
Rabies
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Rabies is a viral infection spread through the saliva of infected mammals, usually by a bite or scratch, and is almost always fatal once symptoms develop. Rabies is present in Eritrea and is carried by dogs and other mammals, including bats.
Access to post-exposure treatment within Eritrea is unreliable, particularly outside Asmara, making prevention the most critical consideration. Keep your distance from all animals during the visit, including stray dogs in towns and any wildlife encountered in rural or highland environments.
Pre-exposure rabies vaccination may be recommended for travellers visiting rural or highland areas, those spending extended time in the country, and those whose planned activities increase the likelihood of animal contact, including trekking, wildlife observation, and cycling. Consult with a travel doctor whether pre-exposure rabies vaccination is appropriate for you.
Any bite, scratch, or lick to broken skin from any animal requires the wound to be washed immediately and thoroughly with soap and running water, followed by urgent medical assessment, regardless of prior vaccination status.
Measles
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Measles is a highly contagious infection that spreads through the air, capable of remaining viable in an enclosed space for up to two hours after an infected person has left. It causes fever, cough, and a characteristic spreading rash, and can lead to serious complications including pneumonia and, rarely, brain inflammation.
Measles cases are rising globally, and the likelihood of transmission is increased in airports, planes and any form of public transport. Australian travellers born in 1966 or later should have two documented doses of the MMR vaccine before departure.
Hepatitis B
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Hepatitis B is transmitted through blood and other bodily fluids, including through unprotected sexual contact, tattooing or piercing with non-sterile instruments, and medical or dental procedures carried out with contaminated equipment.
Vaccination is recommended for travellers to Eritrea, where the disease circulates at a higher rate than in Australia. Many Australians received this vaccine through childhood immunisation programs, but some adults remain unprotected, and vaccination status is worth confirming before departure.
Yellow Fever
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Eritrea is a low-risk destination for yellow fever and vaccination is generally not required. However, a valid yellow fever vaccination certificate is required for travellers aged nine months and over who are arriving from a country where yellow fever transmission occurs. If any part of your journey to Eritrea passes through a yellow fever risk country in sub-Saharan Africa or South America, you must carry documented proof of vaccination. Entry requirements of this kind can change, and your specific routing should be confirmed with a travel doctor before departure.
Routine vaccinations
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Before travelling to Eritrea, it's worth checking that your routine vaccinations are up to date to help protect against illnesses that are still common in many parts of the world. This includes measles, mumps and rubella (MMR), tetanus, diphtheria, and pertussis, as well as hepatitis B and polio. A tetanus booster is recommended if it has been more than ten years since your last dose, particularly if you plan to hike, dive, or visit remote historical sites where cuts and scrapes are more likely and medical care may not be readily available. Annual influenza vaccination is recommended for all travellers aged six months and older, and COVID-19 vaccination should be current according to Australian recommendations, including booster doses for older adults and those with underlying medical conditions.
Eritrea
Other health risks in Eritrea
Malaria
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Malaria is present throughout Eritrea at elevations below approximately 2,200 metres, covering the majority of the country including all coastal regions and most rural areas. Transmission is absent in Asmara due to its elevation, but travellers heading to Massawa, the Dahlak Islands, or any lowland or highland areas below 2,200 metres require antimalarial chemoprophylaxis. Plasmodium falciparum accounts for the predominant share of malaria cases in the region, and chloroquine resistance is well established.
A travel doctor should prescribe the most appropriate antimalarial based on your health history and specific itinerary. The full course must be obtained in Australia before departure and carried throughout the trip.
The possibility of malaria is always taken seriously as it has potential fatal consequences. If you develop a fever at any point during your trip or within one year of returning home, seek immediate medical assessment and inform your treating doctor of your travel history.
Gastroenteritis
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Gastroenteritis, otherwise called travellers' diarrhoea is the most common health problem affecting visitors to Eritrea and can occur even in larger towns and established accommodation. It is usually caused by bacteria or viruses picked up through contaminated food or drinking water, although parasites can occasionally be responsible. Symptoms often begin within one to three days and commonly include diarrhoea, nausea, vomiting, stomach cramps, bloating, and sometimes fever.
The biggest concern is dehydration, particularly in Eritrea's hot climate, so replacing lost fluids with water and oral rehydration solutions is the most important part of treatment. Most cases improve within several days with rest and good hydration.
Medical attention should be sought if diarrhoea is severe, lasts more than a few days, contains blood, or is accompanied by a high fever or persistent vomiting. As healthcare facilities become increasingly limited outside Asmara, careful food and water precautions should be maintained throughout your trip.
Dengue and chikungunya
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Both dengue and chikungunya are mosquito-borne viral illnesses that occur in Eritrea and are spread by Aedes mosquitoes, which bite mainly during the day. Both infections commonly cause sudden fever, headache, muscle aches, and fatigue, although chikungunya is particularly known for severe joint pain that can last for weeks or even months after the initial illness. Dengue can occasionally progress to a more serious form requiring hospital care.
There are no specific antiviral treatments for either illness, making prevention especially important. Applying insect repellent during daylight hours, wearing long, loose-fitting clothing, and reducing mosquito bites remain the most effective ways to lower your risk.
Schistosomiasis
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Schistosomiasis is a parasitic infection acquired when larvae released by infected freshwater snails penetrate intact skin following contact with contaminated water. Rivers, lakes, and slow-flowing freshwater bodies in parts of Eritrea carry this risk.
Any contact with freshwater bodies including wading, swimming, or washing should be avoided throughout the visit. No vaccine or preventive medication is available, and travellers who may have had freshwater exposure should arrange testing on returning to Australia, as effective treatment exists.
Tuberculosis
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Tuberculosis (TB) is a bacterial infection spread through the air when an infected person coughs, speaks, or sings nearby, primarily affecting the lungs and producing persistent cough, fever, night sweats, and unexplained weight loss.
The risk to most short-stay tourists is relatively low. Travellers spending extended periods in Eritrea, working in healthcare or community settings, or in close ongoing contact with local populations should discuss TB screening with their travel doctor before departure and after returning to Australia. Any persistent cough or unexplained systemic illness developing after travel should be reported to a general practitioner alongside full travel history.
Non-infectious conditions
Crime and unrest
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Refer to the Australian government's Smartraveller website for up to date safety information regarding Eritrea.
Crime can occur, particularly in Asmara, so keep valuables secure and avoid walking alone at night. Additional security risks exist near the Ethiopian border, where landmines remain and travel within 25 kilometres of the border should be avoided.
Photography of government buildings, military sites, and security infrastructure is prohibited.
Safety on the roads and elsewhere
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Road conditions are generally reasonable around Asmara but become poorer in rural areas, and night driving outside the capital should be avoided. Travel permits are required for visiting many parts of Eritrea, and identification may be checked at police or military checkpoints, so carry your passport and permits at all times.
Travellers visiting the Red Sea coast or Dahlak Archipelago should be aware of the risk of piracy in surrounding waters and use reputable operators. Coastal areas can experience extreme heat, particularly around Massawa, making good hydration, sun protection, and avoiding strenuous activity during the hottest part of the day especially important.
Deep vein thrombosis
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The journey from Australia to Eritrea typically involves long-haul flights with at least one major connection, adding up to well over fifteen to twenty hours of total travel time. Prolonged immobility of this kind can slow venous blood return from the legs and increase the risk of deep vein thrombosis (DVT), where a clot forms in a deep vein. Travelling to Massawa and the coast from Asmara by road can add further hours of seated travel.
Moving around the cabin regularly during flights, performing seated leg exercises including ankle circles and calf raises, and drinking water consistently throughout the journey all help mitigate this risk. Travellers with additional predisposing factors, including a prior clotting event, recent surgery, pregnancy, hormonal contraceptive use, or significant overweight, should discuss whether compression stockings are appropriate with a travel doctor before departure.