São Tomé and Príncipe
Travel Destination – São Tomé and Príncipe
São Tomé and Príncipe is a remote twin-island nation in the Gulf of Guinea, around 250 km off the coast of Gabon, and remains one of Africa’s less-visited destinations. The islands combine lush rainforest, pristine beaches and a distinctive Portuguese-Creole heritage, seen in colonial architecture and historic roças, or cocoa plantations.
São Tomé is home to the capital, historic port areas and Ôbo National Park, with its dense forests, waterfalls and endemic wildlife. Smaller Príncipe is known for its unspoilt beaches, clear waters and growing focus on ecotourism, while the dramatic Pico Cão Grande is one of São Tomé’s most striking natural landmarks.
Healthcare on both islands is limited. The main hospital is in São Tomé City, and facilities on Príncipe are minimal. Serious illness or injury is likely to require evacuation to mainland Africa or further afield.
Health Risks
Pre-travel preparation
Preparing for São Tomé and Príncipe should begin with a travel medicine appointment, ideally six to eight weeks before departure. This allows time to review your vaccination history, arrange recommended immunisations and start any required antimalarial medication. Advice can be tailored to your itinerary, whether you are visiting São Tomé City, trekking in Ôbo National Park or exploring Príncipe’s beaches and dive sites.
If you are departing sooner, seek medical advice as early as possible, as accelerated vaccination schedules may be available. Bring enough prescribed and everyday medication from Australia for the entire trip, as pharmaceutical supplies can be unreliable. Travel insurance with emergency medical evacuation cover is also strongly recommended.
Insect avoidance
Malaria is a significant risk in São Tomé and Príncipe, so your doctor may recommend antimalarial tablets such as atovaquone-proguanil, doxycycline or mefloquine. Malaria-transmitting Anopheles mosquitoes are most active after dusk. Dengue has also been reported in São Tomé and Príncipe, with transmission via Aedes mosquitoes that bite during daylight hours. Effective protection needs to span the entire day.
Use insect repellent containing DEET or picaridin on exposed skin and reapply after swimming or sweating. Wear loose, long-sleeved clothing and long trousers, especially around dawn and dusk. If your accommodation does not have screens or reliable air conditioning, sleep under a permethrin-treated mosquito net. Treating clothing with permethrin can also provide extra protection during forest activities or stays in basic accommodation.
Food and water hygiene
Santomean cuisine blends Portuguese and West African influences, featuring fresh seafood, rich calulu stew, tropical fruits, and locally produced chocolate. To enjoy the local food safely, follow simple food hygiene precautions throughout your stay.
Tap water may not be safe to drink, so use sealed bottled water for drinking and brushing your teeth. Only use ice if you know it was made from safe, purified water. Wash your hands with soap before eating and after using the toilet, or use alcohol-based hand sanitiser when soap and water are unavailable. Choose food that is freshly cooked and served hot, and be cautious with raw foods, cold prepared meals and street food. Peel fruit just before eating.
Rabies prevention
Rabies is present in São Tomé and Príncipe and can be spread through bites or scratches from infected dogs, bats and other mammals. While you are unlikely to encounter large wildlife such as gorillas on these islands, contact with stray dogs, monkeys, bats and other animals can occur, particularly when exploring rural areas, forests, beaches or local communities. Do not touch, feed or approach animals, even if they appear friendly or are used to people.
A rabies vaccination before travel may be recommended if you are staying for an extended period, travelling to remote areas, hiking or spending significant time outdoors where access to medical care may be limited. This is particularly worth discussing with your travel doctor if your activities are likely to bring you into closer contact with animals.
If you are bitten or scratched, or if an animal’s saliva gets into your eyes, mouth or broken skin, wash the area immediately with plenty of soap and running water and seek urgent medical attention. This is important even if you have received rabies vaccination before travelling. Post-exposure treatment may not be readily available in São Tomé and Príncipe, so any potential exposure should be treated as urgent.
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 São Tomé and Príncipe?
Hepatitis A
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Hepatitis A can enter the body through food or water contaminated with the virus, causing fatigue, nausea, and jaundice ranging in severity from a brief illness to weeks of significant liver inflammation.
Vaccination is recommended for all previously unvaccinated travellers to São Tomé and Príncipe, given how variable food and water safety conditions can be across both islands. Protection from two doses lasts many years, and many Australians have not yet completed the full course.
Typhoid
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Typhoid fever is caused by Salmonella Typhi bacteria in contaminated food or water, producing symptoms of sustained high fever, headache, and abdominal pain that can progress to serious complications if left untreated.
Vaccination for typhoid fever is recommended depending on itinerary, personal risk factors, and length of stay, and is particularly relevant for those eating beyond the controlled environments of their hotel or resort, visiting local markets, or spending time outside São Tomé City. Food and water hygiene practices remain essential alongside vaccination throughout the trip.
Rabies
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Rabies is present in São Tomé and Príncipe and can be spread through bites or scratches from infected dogs, bats and other mammals. While you are unlikely to encounter large wildlife such as gorillas on these islands, contact with stray dogs, monkeys, bats and other animals can occur, particularly when exploring rural areas, forests, beaches or local communities. Do not touch, feed or approach animals, even if they appear friendly or are used to people.
A rabies vaccination before travel may be recommended if you are staying for an extended period, travelling to remote areas, hiking or spending significant time outdoors where access to medical care may be limited. This is particularly worth discussing with your travel doctor if your activities are likely to bring you into closer contact with animals.
If you are bitten or scratched, or if an animal’s saliva gets into your eyes, mouth or broken skin, wash the area immediately with plenty of soap and running water and seek urgent medical attention. This is important even if you have received rabies vaccination before travelling. Post-exposure treatment may not be readily available in São Tomé and Príncipe, so any potential exposure should be treated as urgent.
Measles
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Measles is a highly contagious viral infection that spreads through the air when an infected person coughs, sneezes or breathes. It can cause fever, cough, runny nose and a widespread rash, and in some cases can lead to serious complications such as pneumonia or inflammation of the brain.
Measles outbreaks continue to occur in many countries, so all international travellers should be fully covered before departure. The virus can remain in the air of an enclosed space after an infected person has left. Australian travellers born in 1966 or later should have two documented doses of a measles-containing vaccine. Check your vaccination history with a travel doctor before departure.
Hepatitis B
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Hepatitis B is a virus that can infect the liver and is spread through infected blood and other body fluids. You can be exposed through unprotected sex, tattoos or piercings using unsterile equipment, or medical and dental treatment where equipment has not been properly sterilised.
Vaccination may be recommended for travellers to São Tomé and Príncipe, particularly if they may need medical care while overseas. Many Australians received hepatitis B vaccination as children, so check your vaccination records before travelling. If you are unsure whether you have been vaccinated or need a booster, speak with a travel doctor.
Routine vaccinations
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Before travelling to São Tomé and Príncipe, make sure your routine vaccinations are up to date. This includes measles-mumps-rubella (MMR), tetanus, diphtheria and pertussis (whooping cough), hepatitis B, and polio. Keeping these vaccinations current helps protect you from infections that can occur during international travel.
A tetanus booster may be recommended if it has been more than 10 years since your last dose, especially if you plan to hike, trek through forests or take part in outdoor activities where cuts and injuries are more likely. Medical care may be less accessible when travelling in remote areas.
It is also recommended that travellers aged over 6 months have their annual influenza vaccination, while COVID-19 vaccination should be kept up to date according to current Australian health advice. This is particularly important for people aged 65 and over and those with certain medical conditions who may have a higher risk of severe illness.
Check your vaccination records before departure and speak with a travel doctor if you are unsure whether any vaccinations are due.
São Tomé and Príncipe
Other health risks in São Tomé and Príncipe
Malaria
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Malaria is a serious illness caused by infection of red blood cells with the Plasmodium parasite, transmitted by mosquitoes that predominantly feed between dusk and dawn. Symptoms begin with a fever of 38°C or more, accompanied by chills, headache, nausea, vomiting, and muscle aching, with symptoms appearing between eight days and around a year after the infective bite. Prompt diagnosis and treatment is required as people with malaria can deteriorate quickly. Plasmodium falciparum is the predominant species in São Tomé and Príncipe, year-round transmission occurs across both islands, and chloroquine resistance is established.
Antimalarial chemoprophylaxis must be prescribed by a travel doctor and obtained in Australia before departure, with the full supply carried throughout the trip. Any fever that develops during travel or within one year of returning home requires immediate medical assessment, with travel history clearly communicated to the treating clinician.
Gastroenteritis
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Contaminated food and water introduce bacteria, viruses, or parasites that cause gastroenteritis. Symptoms can include diarrhoea, stomach cramps, nausea, and vomiting, typically within one to three days of exposure. The risk applies across all accommodation settings in São Tomé and Príncipe, including established hotels.
Maintaining fluid intake using oral rehydration solutions is the primary approach to managing straightforward cases, and most episodes improve within several days. Medical attention should be sought if symptoms are severe, contain blood, are accompanied by fever, or show no sign of improvement, acknowledging that healthcare options outside São Tomé City are very limited.
Schistosomiasis
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There is a risk of schistosomiasis in São Tomé and Príncipe. The parasite enters the body by penetrating skin during contact with contaminated freshwater. Early symptoms can include a rash, itchy skin, fever, chills, cough, or muscle aches. If not treated, schistosomiasis can cause serious long-term health problems such as intestinal or bladder disease.
There is no vaccine or tablets to prevent schistosomiasis. All travellers should avoid wading, swimming, or bathing in fresh water. Swimming in adequately chlorinated water or sea water carries no risk of schistosomiasis. Any traveller with potential freshwater exposure should seek testing on returning to Australia, where effective treatment is available.
Tuberculosis
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Tuberculosis (TB) is an infection that mainly affects the lungs and spreads through the air when a person with active TB coughs, talks or breathes. It can cause a persistent cough, fever, night sweats and unexplained weight loss.
For most short-term visitors to São Tomé and Príncipe, the risk of TB is relatively low, particularly if you have limited close contact with local communities. The risk is higher if you are staying for a long time, working in healthcare or community settings, or spending prolonged periods in close contact with local people.
If you are travelling for an extended period or have a higher risk of exposure, speak with your doctor about whether TB screening before and after your trip is appropriate. If you develop a persistent cough or other symptoms after returning, see your GP and let them know you have recently travelled to São Tomé and Príncipe.
Non-infectious conditions
Crime and unrest
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Travellers to São Tomé and Príncipe should take precautions against petty crime, including pickpocketing and bag snatching, particularly in busy areas such as markets and bus stations. Keep passports, money and valuables secure, avoid displaying expensive jewellery or large amounts of cash, and remain aware of your surroundings.
Political tensions and demonstrations may occur, and local conditions can change with limited warning. Power outages are also common and may disrupt essential services.
Monitor local news and traveller safety advice before and during your trip, particularly around periods of political activity.
Safety on the roads and elsewhere
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Roads in São Tomé City and surrounding areas are generally paved but often narrow and poorly maintained, while routes into the interior of both islands become significantly rougher and can be difficult or impassable during heavy rain. Deserted beaches and poorly lit areas should be avoided after dark, and walking alone at night is inadvisable. Transport should be arranged through reputable operators rather than informal or roadside providers.
Inter-island travel to Príncipe is available by small aircraft or boat, and sea crossings can be rough. Travellers taking boat transport between the islands or to more remote beaches should use licensed operators, confirm vessel condition and life-jacket availability before boarding, and be mindful of the strong Atlantic currents around both islands. Ocean swimming at unmonitored beaches requires caution, as currents can be powerful even close to shore.
Deep vein thrombosis
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Long journeys from Australia to São Tomé and Príncipe often involve one or two connections through Europe or West Africa and can take more than 15–20 hours. Sitting for long periods can slow blood flow in the legs and increase the risk of developing a deep vein thrombosis (DVT), a blood clot in the deep veins.
To help reduce this risk, walk around the cabin regularly, do simple exercises such as ankle rotations and calf raises while seated, and drink water throughout the journey. If you have a higher risk of blood clots due to factors such as previous clots, recent surgery, pregnancy, hormonal contraceptive use or significant overweight, speak with a travel doctor about whether below-knee compression stockings are suitable.