Travel Health Notices
Be aware of current health issues in Madagascar. Learn how to protect yourself.
Alert Level 2, Practice Enhanced Precautions
- Updated Global Polio November 30, 2022 Some international destinations have circulating poliovirus. Before any international travel, make sure you are up to date on your polio vaccines.
|Disease Name||Common ways the disease spreads||Advice||Clinical Guidance for Healthcare Providers|
Avoid contaminated water
Avoid bug bites
|African Tick-Bite Fever||
|Crimean-Congo Hemorrhagic fever||
|Plague (Bubonic, Pneumonic, Septicemic)||
|Rift River Valley||
Airborne & droplet
Stay Healthy and Safe
Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in Madagascar, so your behaviors are important.
Unclean food and water can cause travelers' diarrhea and other diseases. Reduce your risk by sticking to safe food and water habits.
- 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
- 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)
- 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
- Tap or well water
- Ice made with tap or well water
- Drinks made with tap or well water (such as reconstituted juice)
- Unpasteurized milk
Talk with your doctor about taking prescription or over-the-counter drugs with you on your trip in case you get sick.Hide
Bugs (like mosquitoes, ticks, and fleas) can spread a number of diseases in Madagascar. 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.
- Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
- Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
- 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?
For more detailed information on avoiding bug bites, see Avoid Bug Bites.Hide
If your travel plans in Madagascar 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 Madagascar. Avoid swimming in fresh, unchlorinated water, such as lakes, ponds, or rivers.Hide
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.Hide
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.
Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.
- 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 Madagascar’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 Madagascar. 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.Hide
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.
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.
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 Madagascar 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 Madagascar, 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.
- 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.
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.Hide
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 advisories 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.
Healthy Travel Packing List
Use the Healthy Travel Packing List for Madagascar for a list of health-related items to consider packing for your trip. Talk to your doctor about which items are most important for you.
Why does CDC recommend packing these health-related items?
It’s best to be prepared to prevent and treat common illnesses and injuries. Some supplies and medicines may be difficult to find at your destination, may have different names, or may have different ingredients than what you normally use.
After Your Trip
If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic. Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.
If your doctor prescribed antimalarial medicine for your trip, keep taking the rest of your pills after you return home. If you stop taking your medicine too soon, you could still get sick.
Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the doctor about your travel history.
For more information on what to do if you are sick after your trip, see Getting Sick after Travel.
Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Centers for Disease Control and Prevention concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked.