Malawi
Travel Destination – Malawi
Malawi, often called “The Warm Heart of Africa,” is a welcoming destination known for its friendly communities, diverse wildlife, and stunning natural scenery. Lake Malawi is one of Africa’s largest freshwater lakes, offering crystal-clear waters, sandy beaches, and colourful fish. Inland, travellers can explore forested highlands, rolling plateau’s, and national parks with elephants, hippos, and other wildlife. Malawi offers rewarding cultural and nature-based experiences, but infrastructure and healthcare services can be limited outside major towns. Travellers should plan carefully, particularly when visiting rural areas or engaging in outdoor activities. Good preparation, including health planning and safety awareness, helps ensure a safe and enjoyable journey.
Health Risks
Pre-travel preparation
Before travelling to Malawi, booking an appointment with a travel doctor is strongly recommended. A travel health consultation allows your doctor to review your vaccination history, recommend travel-specific immunisations, and prescribe any necessary medications.
Your travel doctor can provide personalised advice based on your itinerary, length of stay, and activities, whether you are visiting Lake Malawi, going on safari, or travelling to rural communities. Ideally, schedule your appointment six to eight weeks before departure to allow time for multi-dose vaccines. If travel is soon, a last-minute consultation is still valuable, as accelerated vaccination schedules and essential health advice can still be provided.
Insect avoidance
In Malawi, mosquitoes are common and can transmit diseases such as dengue, malaria, and chikungunya. Tse-tse flies can carry African Sleeping Sickness and ticks can carry African Tick Bite Fever. Preventing insect bites is one of the most important health measures for travellers.
Stay in accommodation with screened windows or air-conditioning where possible, and use a permethrin-treated mosquito net if these are unavailable. Wear long-sleeved shirts, long trousers, and closed footwear when venturing outside. Apply insect repellent containing DEET, picaridin, or oil of lemon eucalyptus to exposed skin. Treating clothing and gear with permethrin provides additional protection. When returning indoors after spending time in bushland, check for ticks within 2 hours.
Food and water hygiene
Malawian cuisine often includes maize-based dishes, vegetables, fish, and meats. Maintaining good food and water hygiene helps reduce the risk of gastroenteritis and other gastrointestinal infections.
Wash hands thoroughly with soap and water or use alcohol-based hand sanitiser before eating. Choose food that is freshly prepared, fully cooked, and served hot. Avoid raw or undercooked foods and reheated meals. Fruits and vegetables are safer when they can be peeled before eating. Drink only bottled, boiled, or filtered water, and avoid untreated tap water and ice made from it.
Rabies prevention
Although Australia is free of rabies, rabies is present in Malawi and is commonly carried by dogs and other mammals. Travellers should avoid contact with animals, including stray dogs, cats, and wildlife.
Before travelling, discuss with a travel doctor whether pre-exposure rabies vaccination is recommended, particularly if you will be spending time in rural areas, working with animals, or travelling far from medical facilities. Any bite, scratch, or saliva exposure requires immediate medical attention. Rabies is almost always fatal once symptoms develop, making prevention essential.
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 Malawi?
Hepatitis A
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Hepatitis A is a viral infection of the liver spread through contaminated food and water. Symptoms can range from mild illness to severe disease with yellowing skin and prolonged fatigue.
Hepatitis A is more common in Malawi than in Australia, and many Australians are not routinely immunised. Travellers who have not completed a two-dose Hepatitis A vaccination course are strongly advised to be vaccinated before travel, particularly when visiting rural areas or eating local food.
Typhoid
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Typhoid is a bacterial infection that can lead to prolonged fever, fatigue, headache and abdominal pain. It is caused by Salmonella Typhi and Paratyphi which is spread through contaminated food or water.
The risk of typhoid is higher than in Australia, so food and water hygiene is essential. Vaccination is recommended for travellers to Malawi, particularly those planning longer stays, rural travel, or frequent consumption of street food.
Hepatitis B
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Hepatitis B is a viral infection of the liver spread through contact with infected blood or bodily fluids. Transmission can occur through unprotected sex, unsterile medical or dental procedures, tattooing or piercing, or sharing personal items such as razors.
While many younger Australians are vaccinated, some adults remain unprotected. Hepatitis B vaccination may be recommended for travellers to Malawi who are not immune depending on the length of stay and other risk factors. A travel doctor can review your vaccination history and provide personalised advice.
Mpox
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Mpox (formerly called monkeypox) is a virus that can cause fever, rash, and swollen lymph nodes. It is spread through close contact with infected people or animals, including body fluids, sores, or contaminated materials. Mpox is rare in Malawi, but vaccination or preventive measures may be advised for travellers at higher risk. A travel doctor can provide personalised advice based on your plans.
Yellow Fever
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Yellow Fever is a mosquito-borne viral disease that can cause fever, headache, muscle pain, and, in severe cases, liver and kidney failure with a fatality rate of up to 30–60%.
Yellow Fever does not occur in Malawi, and vaccination is not routinely recommended for travellers whose journeys are limited to Malawi. However, proof of Yellow Fever vaccination may be required if you are arriving from, or transiting through, a country where Yellow Fever is present. Entry requirements can change, so discuss your itinerary with a travel doctor.
Cholera
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Cholera is a bacteria that is spread through contaminated food and water. It can cause sudden, severe diarrhoea and dehydration. Outbreaks occur in some parts of Malawi, particularly where sanitation is limited.
Cholera is rare in travellers, and vaccination is generally only recommended for those visiting outbreak areas and working in healthcare or humanitarian roles. Your travel doctor can determine whether vaccination is recommended based on your itinerary.
Routine vaccinations
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Australia's immunisation program keeps diseases such as measles, mumps, rubella, and tetanus uncommon at home. However, these infections circulate more widely in Malawi.
Before travelling, ensure your routine vaccinations are up to date. A travel health consultation can identify whether boosters are required for vaccines such as measles-mumps-rubella (MMR), tetanus, influenza, COVID-19, and pertussis.
Malawi
Other health risks in Malawi
Malaria
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Malaria is a parasitic infection of the liver which is common throughout Malawi. It is transmitted by mosquitoes, primarily at night. Symptoms include fever, chills, headache, muscle aches, and fatigue. Severe malaria can be life-threatening if not treated promptly.
Prevention includes strict mosquito avoidance and taking antimalarial medication. A travel doctor can advise whether malaria tablets are recommended for your itinerary and which option is most suitable.
Gastroenteritis
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Gastroenteritis, or travellers’ diarrhoea, is common in Malawi and is usually caused by bacteria ingested in contaminated food or water. Symptoms include diarrhoea, nausea, vomiting, and abdominal cramps, typically developing within 24 to 72 hours.
The most important treatment is maintaining hydration, ideally with oral rehydration solutions. Most cases resolve within a few days. Medical attention is required if symptoms are severe, prolonged, or associated with dehydration. Prevention focuses on good hand hygiene and careful food and water choices.
Dengue
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Dengue fever is a mosquito-borne viral infection that can cause fever, severe joint and muscle pain, headache, and fatigue. Dengue mosquitoes often bite during the day, especially in urban settings. When more severe forms of dengue fever occur, it is usually in the context of repeat infection. In these cases, complications of bleeding and dangerously low blood pressure can occur which may be fatal without appropriate treatment.
There are no specific treatments or widely available vaccines for travellers, so prevention relies on avoiding mosquito bites through repellents, protective clothing, and appropriate accommodation.
Rabies
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The rabies virus is carried by dogs and other wildlife species in most parts of the world. Whilst rabies transmission does not occur in Australia, it can be spread through bites and scratches of dogs and other wildlife in Malawi. Once symptoms have started, the illness is almost universally fatal. Prevention involves avoiding animals and getting a vaccination prior to travel if advised by your travel doctor. It is recommended for those who will be working with or spending considerable time with animals and those who will be travelling to areas with limited health care. After animal bites, vaccination is required to protect against the development of symptoms, even if the person has received earlier immunisation. This needs to be started as soon as possible, so those suffering an animal bite in Malawi should seek immediate medical attention.
Schistosomiasis
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Schistosomiasis is present in Malawi, particularly around Lake Malawi and other freshwater lakes, rivers, and streams, where the parasite is transmitted through contact with contaminated water. Travelers are at risk when swimming, wading, bathing, or washing in untreated freshwater. To reduce risk, avoid freshwater exposure whenever possible; choose well-maintained swimming pools or the open ocean instead, use safe water for bathing (filtered, heated or treated).
Non-infectious conditions
Crime and unrest
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A high degree of caution is advised when travelling to Malawi due to the threat of violent crime. Refer to the Australian government's Smartraveller website for up to date information. Petty crime can also occur, including pickpocketing and theft, particularly in urban areas and markets. Occasional demonstrations or periods of civil unrest may take place. Travellers should remain alert, avoid large crowds or protests, and keep valuables secure.
Altitude sickness
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Altitude sickness is generally uncommon in Malawi, but it can still affect travellers visiting higher-elevation areas, particularly the Mulanje Massif in southern Malawi, where Mount Mulanje rises to approximately 3,002 metres. Trekkers, hikers, and climbers ascending quickly to these elevations without adequate acclimatisation may experience acute mountain sickness (AMS), especially if coming directly from low-altitude regions. AMS can affect a proportion of travellers at elevations above 2,400 metres, particularly with rapid ascent.
Common symptoms of altitude sickness include headache, dizziness, fatigue, nausea, vomiting, shortness of breath on exertion, and reduced appetite. Mild symptoms often improve within 12 to 48 hours if travellers pause their ascent, rest, and allow time for acclimatisation.
To minimise the risk of altitude sickness in Malawi, travellers planning hikes or climbs in highland regions should ascend gradually, avoid overexertion, stay well hydrated, and include rest days in their itinerary. Preventive medications may be discussed with a travel health professional for individuals with a history of altitude illness or those who are unable to avoid ascending quickly. Anyone trekking in remote or mountainous areas, particularly on Mount Mulanje, is strongly advised to use a qualified local guide and to understand the early warning signs of altitude sickness. Descending to a lower altitude if symptoms worsen is the most effective and important treatment for altitude-related illness.
Deep vein thrombosis
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Long-haul flights to Malawi and extended road travel can increase the risk of deep vein thrombosis. DVT occurs when slowed blood flow allows clots to form in deep veins, usually in the legs.
To reduce risk, stand and move regularly during long journeys, stretch your legs, and stay well hydrated. Travellers with additional risk factors may benefit from wearing below-knee compression stockings. DVT is typically treated with blood-thinning medication.
Safety on the roads and elsewhere
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Road conditions in Malawi vary, with some rural roads poorly maintained and limited lighting at night. Choose reputable transport providers, wear seatbelts when available, and avoid night driving where possible. If riding a motorbike, only do so if experienced and always wear a helmet.
For activities such as hiking, safaris, or lake-based activities, follow local safety advice, wear appropriate footwear, use sunscreen and insect repellent, and stay within your physical limits. Comprehensive travel insurance covering medical care and evacuation is strongly recommended.