Sierra Leone
Travel Destination – Sierra Leone
Sierra Leone offers a mix of vibrant city life, rainforest, wildlife and beautiful beaches. Freetown sits on a forested peninsula with lively markets, historic architecture and beaches such as River No. 2, Bureh and Tokeh.
Nearby, Tacugama Chimpanzee Sanctuary provides guided visits, while Tiwai Island and Outamba-Kilimi National Park offer opportunities to see primates, hippos, elephants and diverse birdlife. Further afield, the Loma Mountains provide challenging trekking, while the Banana Islands offer quiet beaches, coral reefs and sea turtle nesting sites.
Sierra Leone has relatively limited infrastructure outside Freetown, with basic roads, medical facilities and accommodation in many areas. Travellers who are prepared for these conditions can enjoy a more immersive experience, so thorough health preparation before departure is important.
Health Risks
Pre-travel preparation
A travel medicine appointment is an important step in preparing for a visit to Sierra Leone, and booking it at least six to eight weeks ahead gives your doctor the time needed to review vaccination history, administer vaccines, and prescribe malaria prevention medications to be filled before departure.
Those with less time before departure should still make an appointment without delay, as many preparations can still be completed. Medical facilities in Sierra Leone are poor, including in Freetown. Comprehensive travel insurance that explicitly covers emergency medical evacuation is recommended.
Insect avoidance
Mosquito bites can transmit several infections in Sierra Leone, so consistent bite prevention is important throughout your trip. Malaria is widespread across Sierra Leone, and the Anopheles mosquitoes responsible feed mainly after dark. Dengue and yellow fever are also present, transmitted by Aedes mosquitoes that are most active during daylight hours. Because different mosquito species bite at different times, protection needs to be maintained throughout the full day, not just in the evenings.
Apply insect repellent containing DEET or picaridin to all exposed skin throughout the day and evening, reapplying after swimming or heavy sweating. Covering up with long-sleeved clothing and trousers reduces skin exposure, and is especially worthwhile from dusk onwards.
Accommodation with screened windows or air conditioning is preferable, and a permethrin-treated bed net is essential for sleeping in any room without reliable insect protection, which will apply across most accommodation outside Freetown's better hotels. Treating outer clothing with permethrin before travel provides additional protection, particularly for those spending time in Tiwai, Outamba-Kilimi, or any rural environment.
Food and water hygiene
Sierra Leonean cuisine is worth exploring, featuring fresh Atlantic fish and lobster grilled at beachside restaurants, palm butter stew with rice, cassava leaf sauce, and fried plantain. Taking precautions throughout your stay reduces the risk of gastroenteritis and allows you to enjoy this cuisine safely.
Food that is freshly cooked and served hot is the safest choice. Raw or cold pre-prepared dishes and food left out at room temperature for an unknown length of time carry a higher risk of causing illness. Fruit peeled yourself immediately before eating is safer than pre-peeled fruit.
Tap water in Sierra Leone is not safe to drink. Sealed bottled water should be used for drinking and brushing teeth at all times, and ice in drinks of uncertain origin should be avoided. Washing hands thoroughly with soap before eating and after using the toilet is one of the most effective things you can do to avoid gastroenteritis. Where running water is not available, alcohol-based hand sanitiser is a reliable alternative.
Rabies prevention
Rabies is present in Sierra Leone and can be spread by infected dogs, bats and other mammals. Avoid touching or approaching animals during your trip, including stray dogs and wildlife encountered around forests, parks and sanctuaries. Once symptoms develop, rabies is almost always fatal, while access to reliable treatment after an exposure may be limited, particularly outside Freetown.
Pre-travel rabies vaccination may be recommended if you are staying for an extended period, visiting wildlife areas or sanctuaries, or taking part in activities where animal contact is more likely.
Vaccination does not remove the need for medical care after an animal exposure, but it can make treatment simpler if you are bitten or scratched. If an animal bites or scratches you, or saliva gets onto broken skin, immediately wash the area thoroughly with soap and running water and seek prompt medical attention, even if you have been vaccinated.
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 Sierra Leone?
Yellow Fever
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A certificate proving yellow fever vaccination is required for all travellers entering Sierra Leone.
Yellow fever is a mosquito-borne viral illness that can cause fever, jaundice, and in serious cases internal bleeding and organ failure.
Vaccination is both a legal entry requirement and a genuine health protection measure, as yellow fever transmission risk is present throughout the country. The vaccine is given as a single dose at a registered yellow fever vaccination centre, must be received at least ten days before arrival, and provides lifelong protection in the great majority of people. A health assessment should be completed by a doctor before the vaccine is given.
Hepatitis A
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Hepatitis A is a viral infection that affects the liver and is usually caught by eating contaminated food or drinking contaminated water. It can cause tiredness, nausea, stomach pain and loss of appetite, followed by yellowing of the skin and eyes in some people. Symptoms can last for several weeks and may leave you feeling quite unwell.
Vaccination is recommended for travellers to Sierra Leone who have not previously been vaccinated, as food and water hygiene can vary across the country. The hepatitis A vaccine is given in two doses and provides long-lasting protection. If you are unsure whether you have received the vaccine or completed the course, a travel doctor can check your vaccination history and advise whether you need further doses.
Typhoid
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Typhoid fever is a bacterial illness caused by Salmonella Typhi contaminating food or water, producing a sustained high fever, headache, fatigue, and abdominal discomfort that can progress to serious complications without antibiotic treatment.
Vaccination is recommended for most travellers to Sierra Leone, particularly those eating outside of closely managed hotel settings, spending time in local communities, or planning an extended stay. The vaccine provides partial protection, and maintaining careful food and water hygiene throughout the trip adds an important additional layer of defence against typhoid fever.
Rabies
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Rabies is present in Sierra Leone and can be spread by infected dogs, bats and other mammals. Avoid touching or approaching animals during your trip, including stray dogs and wildlife encountered around forests, parks and sanctuaries. Once symptoms develop, rabies is almost always fatal. Access to reliable treatment after an exposure may be limited, particularly outside Freetown.
Pre-travel rabies vaccination may be recommended if you are staying for an extended period, visiting wildlife areas or sanctuaries, or taking part in activities where animal contact is more likely.
Vaccination does not remove the need for medical care after an animal exposure, but it does make the treatment simpler. If an animal bites or scratches you, or saliva gets onto broken skin, immediately wash the area thoroughly with soap and running water and seek prompt medical attention, even if you have been vaccinated.
Measles
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Measles outbreaks continue to occur in many countries globally, and all international travellers should ensure they are protected against measles before departure.
Measles is a highly contagious viral infection that spreads very easily through the air and can persist in an enclosed space for an extended period after an infected person has left. Complications can include pneumonia and, in rare cases, brain inflammation. Australian travellers born in 1966 or later need two documented doses of a measles-containing vaccine.
Hepatitis B
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Hepatitis B is a viral infection that affects the liver and spreads through infected blood and bodily fluids, including through unprotected sex, contaminated tattoo or piercing equipment, and non-sterile medical or dental procedures.
Hepatitis B vaccination is recommended for many unvaccinated travellers to Sierra Leone, particularly those who may require medical care during their trip. Many Australians were vaccinated as children, but if you are unsure whether you are protected, check your vaccination history with a travel doctor.
Mpox
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Mpox is a viral infection transmitted through close physical contact with an infected person or animal, including direct skin-to-skin contact, prolonged face-to-face exposure, and contact with contaminated materials.
Travellers should avoid close contact with anyone showing a rash illness with fever, practise safe sex throughout the visit, and remain alert to any skin lesions, swollen lymph nodes, or unexplained fever developing during or after travel. Mpox vaccination may be appropriate for some travellers based on planned activities and risk profile, and a travel doctor can advise on eligibility and availability before departure.
Routine vaccinations
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Travelling to Sierra Leone is a good opportunity to check that your routine vaccinations are up to date before departure. This includes measles-mumps-rubella (MMR), tetanus, diphtheria and pertussis (whooping cough), hepatitis B, and polio. These vaccinations help protect against 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, particularly if you plan to trek through forests, visit wildlife sanctuaries or spend time at the beach, where cuts and minor injuries may be more likely and access to wound care can be limited.
An annual influenza vaccination is recommended for all travellers aged 6 months and over, while COVID-19 vaccination should be kept up to date in line with current Australian health advice. This is particularly important for people aged 65 and over and those with certain health conditions who may be at greater risk of severe illness.
Checking your vaccination records with a travel doctor before departure gives you time to catch up on any vaccines you may need.
Sierra Leone
Other health risks in Sierra Leone
Malaria
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Malaria is a serious disease and can be life-threatening. If you become ill with a fever while travelling in a malaria-risk area or after you return home, for up to four weeks, you should seek immediate medical attention and tell the doctor about your travel history.
Malaria risk due predominantly to Plasmodium falciparum is present year-round across the entire country, and the intensity of transmission is high. The parasite is carried in the bites of infected mosquitoes most active after dark, infecting red blood cells and causing fever, chills, headache, nausea, and muscle aching. Without prompt treatment, falciparum malaria can deteriorate rapidly into a life-threatening illness affecting the brain and other organs. Resistance to the antimalarial chloroquine is well established.
Antimalarial chemoprophylaxis is required for all travellers. There are a variety of options, and a travel doctor will recommend the most appropriate based on individual health history and planned itinerary. The full medication supply must be obtained in Australia before departure, as local availability is unreliable.
Gastroenteritis
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Gastroenteritis and other forms of gastrointestinal illness are common conditions that can affect travellers to Sierra Leone. Gastroenteritis can be caused by bacteria, viruses or parasites in contaminated food or water.
Symptoms such as diarrhoea, nausea, abdominal cramps and vomiting typically develop within one to three days. Most cases settle within a few days, with oral rehydration solutions and adequate fluids forming the mainstay of treatment.
Seek medical care if symptoms are severe or persistent, blood is present in the stool, or fever or dehydration develops. Because access to medical care can be limited outside Freetown, careful food and water hygiene is particularly important throughout the trip.
Dengue
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Dengue is a viral infection spread by Aedes mosquitoes, which are most active during the day. The infection can involve high fever, severe headache, muscle and joint pain.
For shirt-term travellers, there is currently no routine vaccine for dengue, so preventing mosquito bites is the main protection. Use insect repellent containing DEET or picaridin, wear long, loose-fitting clothing, and stay in accommodation with screens or air conditioning where possible. If you develop fever, rash, joint pain or other symptoms during or after your trip, seek medical advice and mention your travel history.
Lassa fever
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Lassa fever is an acute viral illness endemic to West Africa and regularly reported in Sierra Leone. The Lassa virus spreads through contact with food, household items, or surfaces contaminated by the urine or droppings of the multimammate rat, a common rodent throughout the region.
Person-to-person transmission through direct contact with bodily fluids of an infected individual can also occur in healthcare settings. Symptoms include fever, weakness, headache, and abdominal pain, with haemorrhagic complications in severe cases.
No licensed vaccine is available for lassa fever. Prevention involves keeping food in sealed containers, avoiding rodent contact and their droppings, and maintaining hygiene around accommodation. Any fever developing during or after travel to Sierra Leone should prompt immediate medical assessment with full travel history disclosed.
Schistosomiasis
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Schistosomiasis (also known as bilharzia) is a parasitic infection that can be picked up when larvae released by infected freshwater snails penetrate the skin during contact with contaminated water.
Rivers, streams, ponds and lakes throughout Sierra Leone may carry this risk, including waterways near wildlife sanctuaries. There is no vaccine or medication that can prevent infection, so avoid swimming, wading, bathing or washing in untreated freshwater, including natural pools and streams.
Seawater and properly chlorinated swimming pools are safer alternatives. If you have had freshwater exposure during your trip, speak with your doctor about testing after returning to Australia, as effective treatment is available.
Tuberculosis
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Tuberculosis (TB) is a bacterial infection that mainly affects the lungs and spreads through the air when someone with active TB coughs, speaks or breathes nearby. Symptoms can develop gradually and include a persistent cough, fever, night sweats, tiredness and unexplained weight loss.
TB is common in Sierra Leone, although the risk to short-term travellers with limited close contact with local communities is relatively low. Those staying longer, working in healthcare or community settings, or having frequent close contact with local people may have a higher risk and should discuss TB screening with a doctor before and after travel. If you develop a persistent cough after returning to Australia, seek medical advice and mention your travel history.
Non-infectious conditions
Crime and unrest
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Crime, including armed robbery, assault, carjacking, burglary, pickpocketing and bag snatching, occurs frequently in Sierra Leone, including in Freetown, and foreigners may be targeted. Avoid isolated or poorly lit areas, public transport and taxis; use only chartered taxis arranged through your accommodation.
Protests can turn violent with little warning, so follow local authorities’ instructions and monitor local media. Drink spiking has been reported in Freetown entertainment areas, so keep food and drinks with you.
Check the Australian Government's Smartraveller website before and during your trip for current advice.
Safety on the roads and elsewhere
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Road conditions in Sierra Leone can be challenging, particularly outside Freetown and during the May–October rainy season, when some routes become impassable. Vehicle standards and public transport safety can be variable, so use only chartered taxis arranged through your accommodation.
Travel to remote beaches, wildlife sanctuaries and islands may involve rough tracks, river crossings or small boats. Engage an experienced local guide and check boat condition and life-jacket availability. Take care when swimming at unmonitored beaches, where strong currents can occur.
Deep vein thrombosis
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Flights from Australia to Sierra Leone can take 18 hours or more, increasing the risk of deep vein thrombosis (DVT), a blood clot in a deep vein, usually in the leg. Risk is increased by prolonged sitting, which slows blood flow in the legs and can allow a clot to form.
To reduce this risk, move around the cabin regularly, perform seated exercises such as calf raises and ankle rotations, and drink water throughout the journey. Travellers with risk factors including previous blood clots, recent surgery, pregnancy, hormonal contraceptive use or significant overweight should discuss with a travel doctor whether below-knee compression stockings are appropriate.