Unclean food and water can cause travelers' diarrhea and other diseases. Reduce your risk by sticking to safe food and water habits.

Eat

• Food that is cooked and served hot
• Hard-cooked eggs
• Fruits and vegetables you have washed in clean water or peeled yourself
• Pasteurized dairy products

Don't Eat

• Food served at room temperature
• Food from street vendors
• Raw or soft-cooked (runny) eggs
• Raw or undercooked (rare) meat or fish
• Unwashed or unpeeled raw fruits and vegetables
• Unpasteurized dairy products
• ”Bushmeat” (monkeys, bats, or other wild game)

Drink

• Bottled water that is sealed
• Water that has been disinfected
• Ice made with bottled or disinfected water
• Carbonated drinks
• Hot coffee or tea
• Pasteurized milk

Don’t Drink

• Tap or well water
• Ice made with tap or well water
• Drinks made with tap or well water (such as reconstituted juice)
• Unpasteurized milk

Take Medicine

Talk with your doctor about taking prescription or over-the-counter drugs with you on your trip in case you get sick.

Traveling with Children

For infants, breastfeeding is the best way to prevent illnesses spread through food and water. For older children, make sure they carefully follow the food and water advice above.

Diarrhea can be dangerous in small children because they become dehydrated quickly. Oral rehydration salts (ORS) packets are commonly available in developing countries. ORS should be used to prevent dehydration in children with diarrhea.

Watch for symptoms of severe dehydration (fast pulse, deep breathing, sunken eyes, crying without tears, weight loss of 10% or more), and seek medical attention immediately if these develop.

Bugs (like mosquitoes, ticks, and fleas) can spread a number of diseases in South Africa. Many of these diseases cannot be prevented with a vaccine or medicine. You can reduce your risk by taking steps to prevent bug bites.

What can I do to prevent bug bites?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). Do not use permethrin directly on skin.
• Stay and sleep in air-conditioned or screened rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• FOR PROTECTION AGAINST MOSQUITOES ONLY: Products with one of the following active ingredients can also help prevent mosquito bites. Higher percentages of active ingredient provide longer protection.
  • DEET
  • Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
  • Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
  • IR3535
  • 2-undecanone
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?

Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs.

For more detailed information on avoiding bug bites, see Avoid Bug Bites.

Traveling with Children

Is it safe to use insect repellent on my children?

Most insect repellent is safe to use on your children. However, products containing OLE should not be used on children less than 3 years old.

Children over 2 months old can use products containing DEET, up to 30% concentration.

Protect infants less than 2 months of age by using a carrier draped with mosquito netting with an elastic edge for a tight fit.

How should I use insect repellent on my children?

• Children should not handle insect repellent. Instead, adults should apply it to their own hands first, then gently spread on the child’s exposed skin.
• Do not apply insect repellent to children's hands, because they tend to put their hands in their mouths.
• Keep insect repellent out of reach of children.

If your travel plans in South Africa include outdoor activities, take these steps to stay safe and healthy during your trip.

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• Heat-related illness, such as heat stroke, can be deadly. Eat and drink regularly, wear loose and lightweight clothing, and limit physical activity during high temperatures.
  • If you are outside for many hours in heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation: use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if driving a boat, and always wear a life jacket.
• Do not dive into shallow water.
• Do not swim in freshwater in developing areas or where sanitation is poor.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• To prevent infections, wear shoes on beaches where there may be animal waste.

Schistosomiasis, a parasitic infection that can be spread in fresh water, is found in South Africa. Avoid swimming in fresh, unchlorinated water, such as lakes, ponds, or rivers.

Traveling with Children

Sun Safety for Children

Protect your children from the sun. Seek shade during the hottest part of the day (10 a.m.-4 p.m.), make sure your child wears protective clothing (including hats and sunglasses), and apply sunscreen. Take sunscreen with you to reapply during the day, especially after your child swims or exercises. All products do not have the same ingredients; if your child's skin reacts badly to one product, try another one or call a doctor.

Sunscreen is recommended for children over 6 months old. Babies under 6 months old are more sensitive to the sun and should be kept in the shade and wear clothing that covers most of their skin. A small amount of sunscreen can be used on parts of their body that are not covered, like the face and hands; follow the directions on the package for using sunscreen on babies less than 6 months old.

Children and Water Safety

Keep your child safe when swimming. Children should wear lifejackets and be supervised when they are in or near water. Make sure children do not swallow water while swimming or playing in the water.

Other Outdoor Tips for Traveling with Children

Germs in soil and dirt can spread disease. Be sure children wear shoes while outdoors. Children should play on a sheet or towel instead of directly on the ground.

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately. Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Consider buying medical evacuation insurance. Rabies is a deadly disease that must be treated quickly, and treatment may not be available in some countries.

Traveling with Children

Children love animals, but they are more likely than adults to suffer serious injuries if they are bitten or scratched. If you are traveling with a child, remind the child of these animal safety tips:

• Do not touch any animals without permission.
• Always tell an adult if the child has any contact with an animal. (Children may be afraid to tell if they think they will get in trouble.)
• Always tell an adult if the child sees a bat in a room. If you or a child wakes in a room with a bat, seek medical attention immediately.

Consider buying medical evacuation insurance. Rabies is a deadly disease that must be treated quickly, and treatment may not be available in some countries.

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Traveling with Children

Young children may need supervision when washing their hands to make sure that they get them clean.

Keep your child’s bottles, pacifiers, and teething rings thoroughly clean. Wash toys that the child drops or that are handled by others. Wash items only in clean (drinkable) water.

Be especially careful to wash your hands after changing diapers.

Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medications you take.
• Some prescription drugs may be illegal in other countries. Call South Africa’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website (www.jointcommissioninternational.org).

In some countries, medicine (prescription and over-the-counter) may be substandard or counterfeit. Bring the medicines you will need from the United States to avoid having to buy them at your destination.

Malaria is a risk in some parts of South Africa. If you are going to a risk area, fill your malaria prescription before you leave, and take enough with you for the entire length of your trip. Follow your doctor’s instructions for taking the pills; some need to be started before you leave.

Traveling with Children

• Infant formula that you buy abroad may not be the same as in the United States. If you feed your child formula, bring enough for your entire trip, plus extra in case of travel delays.
• Double-check medical insurance for overseas coverage for the children who are traveling with you. Consider travel health and medical evacuation insurance for things your regular insurance will not cover.
• Diarrhea in babies and young children can quickly lead to dehydration. Learn the signs and symptoms of dehydration, including what you can do and when you should see a doctor.
• More information: Traveling with Children.

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

In many places cars, buses, large trucks, rickshaws, bikes, people on foot, and even animals share the same lanes of traffic, increasing the risk for crashes.

Walking

Be smart when you are traveling on foot.

• Use sidewalks and marked crosswalks.
• Pay attention to the traffic around you, especially in crowded areas.
• Remember, people on foot do not always have the right of way in other countries.

Riding/Driving

Choose a safe vehicle.

• Choose official taxis or public transportation, such as trains and buses.
• Ride only in cars that have seatbelts.
• Avoid overcrowded, overloaded, top-heavy buses and minivans.
• Avoid riding on motorcycles or motorbikes, especially motorbike taxis. (Many crashes are caused by inexperienced motorbike drivers.)
• Choose newer vehicles—they may have more safety features, such as airbags, and be more reliable.
• Choose larger vehicles, which may provide more protection in crashes.

Think about the driver.

• Do not drive after drinking alcohol or ride with someone who has been drinking.
• Consider hiring a licensed, trained driver familiar with the area.
• Arrange payment before departing.

Follow basic safety tips.

• Wear a seatbelt at all times.
• Sit in the back seat of cars and taxis.
• When on motorbikes or bicycles, always wear a helmet. (Bring a helmet from home, if needed.)
• Avoid driving at night; street lighting in certain parts of South Africa may be poor.
• Do not use a cell phone or text while driving (illegal in many countries).
• Travel during daylight hours only, especially in rural areas.
• If you choose to drive a vehicle in South Africa, learn the local traffic laws and have the proper paperwork.
• Get any driving permits and insurance you may need. Get an International Driving Permit (IDP). Carry the IDP and a US-issued driver's license at all times.
• Check with your auto insurance policy's international coverage, and get more coverage if needed. Make sure you have liability insurance.

Flying

• Avoid using local, unscheduled aircraft.
• If possible, fly on larger planes (more than 30 seats); larger airplanes are more likely to have regular safety inspections.
• Try to schedule flights during daylight hours and in good weather.

Medical Evacuation Insurance

If you are seriously injured, emergency care may not be available or may not meet US standards. Trauma care centers are uncommon outside urban areas. Having medical evacuation insurance can be helpful for these reasons.

Helpful Resources

Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, auto insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

For information traffic safety and road conditions in South Africa, see Travel and Transportation on US Department of State's country-specific information for South Africa.

Traffic flows on the left side of the road in South Africa.

• Always pay close attention to the flow of traffic, especially when crossing the street.
• LOOK RIGHT for approaching traffic.

Traveling with Children

Motor Vehicles

Vehicle-related crashes are the leading cause of death in children who travel.

• Children who weigh less than 40 lbs should be restrained in car seats or booster seats.
• You may need to bring your own car or booster seat from home, since safety seats may be limited or unavailable.
• Children who weigh more than 40 lbs should always wear a seatbelt.
• Ride only cars that have seatbelts.
• In general, children are safest riding in the back seat.
• Do not allow children to ride in the bed of a pickup truck or an open vehicle without restraints.

Air Travel

• Children who are less than 1 year old or who weigh less than 20 lbs should be placed in a rear-facing FAA-approved child-safety seat.
• Children at least 1 year old who weigh 20 to 40 lbs should use a forward-facing FAA-approved child-safety seat.
• Children may have intense ear pain as a plane is landing. Swallowing and chewing can help equalize the pressure. You may want to try letting infants breastfeed or suck on a bottle, and older children chew gum.

Use the same common sense traveling overseas that you would at home, and always stay alert and aware of your surroundings.

Before you leave

• Research your destination(s), including local laws, customs, and culture.
• Monitor travel warnings and alerts and read travel tips from the US Department of State.
• Enroll in the Smart Traveler Enrollment Program (STEP).
• Leave a copy of your itinerary, contact information, credit cards, and passport with someone at home.
• Pack as light as possible, and leave at home any item you could not replace.

While at your destination(s)

• Carry contact information for the nearest US embassy or consulate.
• Carry a photocopy of your passport and entry stamp; leave the actual passport securely in your hotel.
• Follow all local laws and social customs.
• Do not wear expensive clothing or jewelry.
• Always keep hotel doors locked, and store valuables in secure areas.
• If possible, choose hotel rooms between the 2nd and 6th floors.

Traveling with Children

Conditions at hotels and other lodging may not be as safe as those in the United States. It’s a good idea to check your accommodations for potential hazards to children, such as exposed wiring or inadequate stairway or balcony railings.

Your children should carry their own identifying information and contact numbers, in case family members become separated. Develop a family plan for what to do in an emergency or if a child gets lost.

If you are the only parent traveling with the child, you may need to carry custody papers or a notarized permission letter from the other parent, as there is worldwide concern about child abductions.