South Africa
South Africa
From the wide savannahs of Kruger National Park to the vibrant streets of Cape Town, South Africa is a land of striking contrasts. The country’s rich mix of cultures and wildlife experiences can be both exhilarating and overwhelming. Whether you’re an experienced traveller or embarking on your first safari adventure, it’s important to be aware of the health risks and take a few simple precautions to stay well during your trip.
Health Risks
Pre-travel preparation
Before travelling to South Africa, it’s a good idea to consult a travel doctor. They can create a personalised health plan that takes into account your itinerary - whether you’ll be on safari, spending time in major cities, or travelling through rural regions. Your doctor will review your vaccination history, advise on any additional immunisations relevant to South Africa, and ensure you have prescriptions for any recommended medications.
Ideally, book your appointment six to eight weeks before departure so there is time to complete multi-dose vaccines if needed. Even if your trip is approaching soon, a last-minute consultation is still worthwhile, as accelerated vaccination schedules and essential travel health advice can be arranged.
Food and water hygiene
South Africa is known for its diverse cuisine, from traditional braais (barbecues) to vibrant street food. By taking a few simple precautions, you can enjoy these experiences while reducing your risk of gastroenteritis and other stomach infections.
Always wash your hands or use antiseptic hand gel before meals. Avoid food that is raw, undercooked, or has been reheated, and choose dishes that are freshly prepared and served hot. Street food can be safe if it is cooked in front of you and eaten immediately. Fruits and vegetables are best when you can peel them yourself, such as bananas, papayas, or oranges.
It is generally safest to drink bottled, boiled, or properly filtered water. As tap water quality varies by location.
Insect avoidance
In South Africa, malaria is an important risk in particular areas, especially for travellers visiting game parks and rural regions.
One component of protection is avoiding mosquito bites. Stay in air-conditioned rooms or accommodation with effective fly screens, and if this is not possible, sleep under a mosquito net treated with permethrin. When outdoors - particularly from dusk to dawn, when malaria-carrying mosquitoes are most active - wear long sleeves and long pants. Apply insect repellents containing DEET, picaridin, or oil of lemon eucalyptus to exposed skin for added protection.
Your travel doctor may also recommend preventive malaria tablets, depending on your itinerary.
Rabies prevention
Australia is one of the few countries in the world free of rabies, but the virus is present in many others, including South Africa. Rabies is carried by dogs, cats, bats, and other mammals, and can be transmitted through bites or scratches. Once symptoms appear, the illness is almost always fatal, making prevention essential.
The best protective measure is to avoid contact with animals, particularly strays and wildlife. Rabies vaccination is not always required for short-term visitors but may be recommended if you plan to work with animals, spend extended time in rural or remote areas, or travel where medical facilities may be difficult to access.
If you are bitten or scratched in South Africa, seek medical attention immediately. Prompt post-exposure treatment - which includes a series of rabies immunisations - is required to prevent the disease from developing, even if you've been vaccinated previously.
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 South Africa?
Hepatitis A
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Hepatitis A is a viral infection of the liver, spread through contaminated food or water. While many people experience only mild illness, it can occasionally be severe and even life-threatening. In Australia, hepatitis A is rare due to good sanitation and widespread vaccination, but the virus is far common in many other countries, including South Africa.
Travellers who have not completed a two-dose course of hepatitis A vaccine are advised to be immunised before travelling. The vaccine provides long-lasting protection and is particularly important if you plan to eat local street food, travel outside major cities, or spend time in rural areas.
Typhoid
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Typhoid is a bacterial infection caused by Salmonella Typhi and Paratyphi, spread through contaminated food or water. It can cause high fever, fatigue, abdominal pain, headache, and gastrointestinal upset. While typhoid is rare in Australia, it remains more common in parts of Africa, including South Africa, particularly in areas where sanitation may be limited.
A vaccine is available and provides protection for up to three years. It is recommended for most travellers to regions where typhoid is present - especially those visiting friends and relatives, staying for extended periods, or planning to eat street food.
Hepatitis B
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Hepatitis B is a viral infection that can cause long-term liver disease. It spreads through blood and bodily fluids, most often via unprotected sex, tattooing or piercing with unsterile equipment, or sharing personal items such as razors or toothbrushes. Infections can range from mild illness to severe chronic disease requiring prolonged courses of antiviral medication.
In Australia, hepatitis B vaccination has been part of the standard childhood immunisation schedule since 2000, so not all adults have had it. Non-immune travellers should consider it before visiting South Africa, particularly if they are planning frequent trips, extended stays, or activities that may increase their risk of exposure.
Rabies
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Rabies is a deadly viral infection carried by dogs, cats, bats, and other mammals in many parts of the world, including South Africa. It is transmitted through bites or scratches, and once symptoms appear, the illness is almost always fatal.
The best prevention is to avoid contact with animals, particularly stray dogs and cats, as well as wildlife such as monkeys and bats. A rabies vaccine is available prior to travel and may be recommended if you plan to work with animals, spend significant time outdoors in rural areas, or travel to regions where urgent medical care may be limited.
If you are bitten or scratched in South Africa, seek medical attention immediately. Post-exposure treatment - which includes a series of rabies immunisations - is essential and must be started as soon as possible, even if you have been vaccinated previously.
Routine vaccinations
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In Australia, routine immunisation programs have kept many common infections—such as measles, mumps, rubella, and tetanus—at very low levels. In other parts of the world, including South Africa, these illnesses can be more prevalent.
Before travelling, it’s a good opportunity to review your vaccination history and update any boosters that may be due. Important vaccines to consider include those against measles-mumps-rubella (MMR), tetanus, diphtheria, polio, influenza, and COVID-19.
South Africa
Other health risks
Malaria
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Malaria is a serious parasitic infection of the liver and red blood cells. It typically causes high fevers, chills, fatigue, and muscle aches, and in severe cases can lead to life-threatening complications such as severe anaemia or brain infection.
In South Africa, malaria occurs in low-lying areas of the north and northeast, including popular safari destinations like Kruger National Park.
Prevention involves avoiding mosquito bites - especially at night - and taking anti-malarial medication if you are visiting areas where malaria is present. Your travel doctor can recommend the most suitable tablets based on your itinerary, health, and length of stay. This advice applies equally to Australians returning to visit family and friends, as any partial immunity gained from living in a malaria-endemic area is lost within a few months of leaving.
Gastroenteritis
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Gastroenteritis, often referred to as traveller’s diarrhoea, is one of the most common health issues for travellers. It is usually caused by bacteria such as Campylobacter, Salmonella, or enterotoxigenic Escherichia coli ingested through contaminated food or water. Symptoms typically appear within 24 to 72 hours and include nausea, diarrhoea, vomiting, and abdominal cramps.
The most important part of treatment is maintaining hydration. Oral rehydration solutions are ideal, as they replace both fluids and electrolytes. Most cases resolve within one to three days without medical treatment. Antibiotics are generally reserved for more severe or prolonged illness, or for people at higher risk of complications. You should seek medical care if symptoms are unusual, severe, or prolonged, or if you are unable to drink enough to replace lost fluids.
Prevention relies on practising good hand hygiene before eating and being cautious with food and drink. Choosing freshly prepared, thoroughly cooked meals and drinking safe bottled or treated water can significantly reduce the risk.
Non-infectious conditions
Altitude sickness
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Acute mountain sickness (AMS) comprises headaches plus dizziness, fatigue, loss of appetite, nausea, or vomiting. It occurs in around a quarter of non-acclimatized people entering altitudes of over 2450 metres. The condition needs to be carefully distinguished from high altitude cerebral oedema (HACE) and high altitude pulmonary oedema (HAPE). HACE affects the brain and involves symptoms such as confusion and altered behaviour and HAPE affects the lungs and involves shortness of breath, cough and other respiratory symptoms. Both HACE and HAPE can occur below 4300 metres, but this is rare. While AMS usually resolves in 12 to 48 hours if travellers do not ascend further, HACE and HAPE can be rapidly fatal without immediate descent, with or without other treatments.
Prevention of all three conditions involves gradual ascent to high altitudes. Preventive medications are also available on prescription by your travel doctor. For those travelling to areas above 4300 metres it is also a good idea to carry medication for treatment of HACE and HAPE in case they occur. If hiking in alpine areas above 4300 metres and unfamiliar with AMS, HACE and HAPE, it is best to travel with an experienced guide who is well versed in these conditions, their prevention and treatment.
The Centres for Disease Control in the US provides the following advice for travellers in order to reduce the risk of severe and life threatening illness:
1) Know the early symptoms of altitude illness and be willing to acknowledge when symptoms are present.
2) Never ascend to sleep at a higher elevation when experiencing symptoms of altitude illness, no matter how minor the symptoms seem.
3) Descend if the symptoms become worse while resting at the same elevation.
Deep vein thrombosis
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Travelling long distances by air, rail, or road can increase the risk of deep vein thrombosis (DVT). This occurs when reduced movement slows blood flow in the veins, usually in the legs, allowing a clot to form. If part of the clot breaks away and travels to the lungs, it can cause a potentially life-threatening pulmonary embolism.
To lower your risk, make a point of moving regularly during long trips - stretch your legs, walk the aisle on flights, and take breaks on road journeys. Staying well hydrated is also important, while limiting alcohol and sedating medications that may encourage immobility. Travellers at higher risk, such as those with a personal or family history of clots, recent surgery, or certain medical conditions, may benefit from wearing below-knee compression stockings.
If DVT does occur, treatment usually involves blood-thinning medications to prevent further clotting and reduce the risk of complications.
Safety on the roads and elsewhere
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Travelling in South Africa often means stepping outside your routine. New experiences can be highlights of your trip, but it’s important to be aware of the risks and take sensible precautions.
If you’re considering riding a motorbike, ensure you have the necessary skills, understand the road rules, and always wear a helmet. For other road travel, choose vehicles with working seatbelts and avoid overcrowded or unsafe transport options.
South Africa offers excellent opportunities for diving, surfing, and water-based activities. If you’re new to these, choose instructors and tour providers with proper safety training and reliable equipment. For hiking or bushwalking, wear sturdy boots that are already broken in, apply sunscreen and insect repellent, carry enough water, and stay within your physical limits, especially in hot or rugged terrain.
Whatever your plans, comprehensive travel insurance is strongly recommended. Make sure it covers medical care and medical repatriation, so you’re protected if an accident or unexpected illness occurs.
Crime and civil unrest
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In some countries, including South Africa, rates of violent crime can be higher than what many Australian travellers are used to. It’s important to stay informed and exercise caution, particularly in unfamiliar areas or when travelling at night.
Before you go, check the latest travel advisories on the Australian Government Smartraveller website. These advisories are updated regularly and provide detailed guidance on security, health, and other risks.