Marshall Islands
Travel Destination – Marshall Islands
The Marshall Islands is one of the Pacific's most captivating and least-visited destinations, a far-flung nation of 29 atolls and over 1,000 islets spread across the central Pacific, best known for world-class diving, spectacular fishing, and a history unlike anywhere else on earth.
Bikini Atoll, a UNESCO World Heritage Site, is renowned for its shipwreck diving and WWII relics, and draws advanced divers from around the world. The world's only diveable aircraft carrier, the USS Saratoga, rests at the bottom of Bikini Atoll's lagoon, larger than the Titanic and lying alongside the Imperial Japanese Navy battleship that led the 1941 Pearl Harbor attack.
Beyond its remarkable underwater history, the Marshall Islands offers pristine beaches, traditional outrigger canoe sailing, deep-sea fishing for marlin, tuna, and swordfish, and a warm Marshallese culture deeply rooted in community and the sea. The capital Majuro is home to the Alele Museum, dedicated to preserving Marshallese history and culture through traditional canoes, tools, and artefacts.
The Marshall Islands is a remote destination where medical facilities are limited, making careful health preparation before departure essential for every traveller.
Health Risks
Pre-travel preparation
Before travelling to the Marshall Islands, booking an appointment with a travel doctor is strongly recommended, ideally six to eight weeks before departure. The Marshall Islands is a remote destination where the availability of medicines and medical supplies can be disrupted, and hospital facilities are limited. A travel health consultation allows your doctor to review your vaccination history, recommend appropriate immunisations, and provide personalised advice based on your itinerary, whether you are staying in Majuro, diving at Bikini Atoll, or venturing to outer islands where access to any healthcare is extremely limited.
Some vaccinations require multiple doses spread over several weeks, so early planning is particularly important. If your departure is approaching sooner, a last-minute consultation is still worthwhile as essential vaccines can often be given on an accelerated schedule.
Pack a comprehensive personal medical kit including any prescription medications needed for the duration of your trip, as reliable access to medicines cannot be assumed. Comprehensive travel insurance covering medical evacuation to Australia is essential, any serious illness will likely require transport out of the country.
Insect avoidance
The Marshall Islands does not carry a risk of malaria, but mosquito-borne infections including dengue and Zika virus are present. These infections are spread by the Aedes mosquito, which bites primarily during daylight hours, particularly around dawn and dusk.
Therefore insect protection is important throughout the day, not just at night. Apply insect repellent containing DEET, picaridin, or oil of lemon eucalyptus to all exposed skin, and reapply regularly after swimming or perspiring. Wear long-sleeved shirts, long trousers, and closed footwear when outdoors, particularly in more densely populated areas such as Majuro and Ebeye where mosquito-borne diseases tend to be more prevalent.
Ensure your accommodation is insect-proof, and use a permethrin-treated bed net when sleeping in rooms without fly screens. Treating clothing and gear with permethrin adds further protection, particularly on outer islands where accommodation may be more basic.
Food and water hygiene
Marshallese cuisine is a fresh and simple blend of reef fish, coconut, breadfruit, taro, and tropical fruits, with seafood at the heart of most traditional meals. Food and water safety standards may be inadequate in some settings, and moderate risk of gastroenteritis exists throughout the country, including in some hotel and resort accommodation.
Tap water is not reliably safe to drink across the Marshall Islands, and bottled or boiled water should be used throughout your stay. Avoid ice in drinks unless you are confident it has been prepared from treated water. Wash hands thoroughly with soap and water before eating and after using the toilet, or use an alcohol-based hand sanitiser when handwashing is unavailable. Choose freshly prepared, fully cooked food served hot, and avoid raw or undercooked seafood and meat. Fruit and vegetables are safest when freshly peeled.
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 the Marshall Islands?
Hepatitis A
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Hepatitis A is a viral liver infection spread through contaminated food and water, causing nausea, fatigue, abdominal pain, and jaundice, with more serious outcomes possible in older adults and those with underlying liver conditions.
Cases of hepatitis A have occurred in the Marshall Islands in recent years, and vaccination is recommended at least four weeks before travel. The vaccine is well tolerated, provides long-lasting protection after a two-dose course, and is one of the most important immunisations for this destination. Many Australians have not completed this course, making a travel health consultation a timely opportunity to check and update your vaccination history.
Typhoid
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Typhoid is a bacterial infection caused by Salmonella Typhi, spread through contaminated food and water. It causes sustained high fever, headache, fatigue, and abdominal pain, and can lead to serious complications without treatment.
Typhoid vaccination is recommended for most travellers to the Marshall Islands, particularly those staying beyond major hotels, spending time on outer islands, or eating local food from markets and smaller establishments. The vaccine provides partial but meaningful protection; careful food and water hygiene remains important throughout the trip regardless of vaccination status.
Measles
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Measles is a highly contagious viral illness spread through the air, causing fever, cough, runny nose, red eyes, and a characteristic blotchy rash.
The Marshall Islands currently requires all children under five years of age to have up-to-date measles-mumps-rubella MMR vaccination, including infants aged 6 to 11 months, and proof must be presented on arrival.
The CDC recommends all international travellers be fully vaccinated against measles with the MMR vaccine before departure. Australian travellers born during or since 1966 require two documented doses of a measles-containing vaccine. A travel doctor can review your records and confirm whether your protection is current.
Hepatitis B
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Hepatitis B is a viral liver infection spread through contact with infected blood or bodily fluids, including through unprotected sexual contact, unsterile medical or dental procedures, and tattooing or piercing with contaminated equipment.
Hepatitis B is endemic in the Marshall Islands, and travellers should seek medical advice on vaccination, particularly if their lifestyle or activities place them at risk of infection. Given the limited healthcare infrastructure, especially outside Majuro, the ability to guarantee sterile equipment or screened blood products in an emergency cannot be assured.
Hepatitis B vaccination is recommended for all unvaccinated travellers. Many younger Australians received this vaccine through the childhood immunisation program, but some adults remain unprotected. A travel doctor can confirm whether your vaccination history is complete.
Routine vaccinations
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Travelling to the Marshall Islands is an important opportunity to ensure all routine immunisations are up to date. Key vaccines to review include measles-mumps-rubella (MMR), tetanus, diphtheria, pertussis, polio, and hepatitis B.
A tetanus booster is recommended if more than ten years have passed since the last dose, particularly relevant given the risk of cuts and injuries in a remote, tropical environment with limited access to medical care.
Influenza circulates year-round in tropical climates and annual vaccination is recommended for all travellers aged six months and over.
COVID-19 vaccination should be current in line with Australian guidance, including booster doses for those aged 65 and over or with underlying health conditions.
A travel doctor can review your full vaccination history and tailor recommendations to your individual circumstances and itinerary.
Marshall Islands
Other health risks in the Marshall Islands
Gastroenteritis
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Gastroenteritis is one of the most common health problems for travellers in the Marshall Islands, typically caused by bacteria in contaminated food or water or viruses spread by close contact. Otherwise called traveller's diarrhoea, gastroenteritis is a largely avoidable inconvenience of international travel when preventative measures are applied.
Symptoms develop within 24 to 72 hours and include diarrhoea, nausea, vomiting, and abdominal cramping. Seek urgent medical attention if you develop a fever, diarrhoea, or suspect food poisoning. For mild cases, staying well hydrated with oral rehydration fluids is the most important treatment, and most episodes resolve within a few days. Consistent hand hygiene and careful food and water choices throughout your trip are the best preventive measures.
Dengue
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Outbreaks of dengue fever can occur in the Marshall Islands, and some outbreaks can be serious. Dengue is a viral infection spread by daytime-biting mosquitoes causing fever, severe headache, pain behind the eyes, and intense muscle and joint pain. In some cases it can progress to serious illness requiring hospitalisation, and there is no specific treatment.
Consistent mosquito bite prevention throughout the day is the most effective protective measure.
Zika virus
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Zika virus is a risk in the Marshall Islands. It is primarily spread through the bite of an infected mosquito but can also be sexually transmitted, and it can cause serious birth defects. Most people infected experience mild or no symptoms, which may include low-grade fever, rash, joint pain, and red eyes.
The primary concern is the risk to unborn babies, infection during pregnancy is associated with microcephaly and other serious congenital abnormalities. Pregnant travellers or those planning a pregnancy should discuss the risks of travel to the Marshall Islands with their healthcare provider and may choose to avoid or postpone travel.
All returning travellers should follow current Australian health guidelines around preventing sexual transmission of Zika, even in the absence of symptoms.
Tuberculosis
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Tuberculosis (TB) is an airborne bacterial infection that can be transmitted when an infected person coughs, speaks, or sings, primarily affecting the lungs. Symptoms include a persistent cough, fever, night sweats, and weight loss.
The Marshall Islands has high rates of TB transmission, although the risk to short-stay holidaymakers with limited contact with local communities is relatively low. However, travellers staying for extended periods, working in healthcare or community settings, or spending time in close-contact environments face a meaningfully elevated risk.
Higher-risk travellers should discuss TB screening before and after travel with their doctor. Anyone developing a persistent cough, unexplained fever, or night sweats after returning from the Marshall Islands should seek prompt medical review and mention their travel history.
Non-infectious conditions
Crime and unrest
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The overall crime rate in the Marshall Islands is low, but petty crime such as house break-ins, theft, and assaults does occur. Your risk of being affected by crime increases at night. Avoid walking alone after dark, and exercise caution when driving or walking on roads at night as drink-driving is common and there are very few footpaths, even in urban areas.
All taxis in Majuro are shared taxis, so avoid riding in taxis after dark. Keep valuables out of sight, avoid displaying signs of wealth, and use accommodation with secure locks. Civil unrest is uncommon, though public protests that draw large groups of people carry a risk of turning violent. Avoid protests and demonstrations and monitor local news for developments.
Always check the Australian Government's Smartraveller website for the most current advice before and during your trip.
Deep vein thrombosis
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Reaching the Marshall Islands from Australia involves long flights, typically via Guam, Honolulu, or another transit hub, meaning total travel time can be considerable. Extended periods of sitting during flights and inter-island travel can increase the risk of deep vein thrombosis (DVT), where slowed blood flow allows clots to form in the deep veins of the legs.
To reduce this risk, move around the cabin regularly during flights, perform simple seated leg exercises such as ankle circles and calf raises, and stay well hydrated throughout your journey. Travellers with additional risk factors should seek personalised advice from a travel doctor before departure, who may recommend below-knee compression stockings. Risk factors include a personal or family history of blood clots, recent surgery, pregnancy, use of the oral contraceptive pill or hormone replacement therapy, or obesity.