CDC Yellow Book 2024Popular Itineraries
The Arab Republic of Egypt covers a land area of approximately 1 million km2, the same size as Texas and New Mexico combined; >95% of the country is desert. With an estimated 106 million people, Egypt accounts for one-fourth of the Arab world’s population. Egypt has long been considered the cradle of civilization and may be the oldest tourist destination on earth. Throughout the world, Egypt is synonymous with the legends of the Pharaohs, the Great Pyramids, treasure-laden tombs, and hieroglyphs. Travelers visit Egypt to see ancient monuments and timeless river vistas along the Nile Valley. Egypt possesses one-third of the world’s monuments and is considered “the Mother of the World” by Arabs.
A typical visit to Egypt includes arrival in the capital city of Cairo, one of the largest cities in Africa and the Middle East, with a population of approximately 22 million. Cairo today is a modern, cosmopolitan mix of Arab, African, and European influences. Travelers generally spend at least a few days in Cairo seeing the Egyptian Antiquities Museum, National Museum of Egyptian Civilization (where the mummies are now housed), Pyramids at Giza, Citadel and Mosque of Al-Azhar, and Khan al-Khalili bazaar.
Most travelers include an Upper Nile River cruise as part of their itineraries (see Box 10-04). Egypt is a beach destination, with thousands of miles of Mediterranean and Red Sea coastlines. Alexandria, Egypt’s second largest city, with 5.5 million people, is located on the Mediterranean Sea and has a string of beaches and seafood restaurants. The World War II battlefield of El-Alamein lies along the Mediterranean coast, and divers will find an array of sunken cities and wartime wrecks to explore offshore. For a truly relaxing beach vacation, travelers can visit one of the many resorts along the North Coast referred to as “Sahel.” The resorts offer a wide array of very private secluded beaches as well as beaches with an active night life scene.
Egypt’s Red Sea coast has reefs offshore, with diving and snorkeling traditionally centered in Hurghada and Sharm El Sheikh. Edged by coral reefs and teeming with tropical fish, the Sinai Peninsula has excellent diving, snorkeling, and beaches; Sharm El Sheikh is the most developed and visited area of the Sinai. Visits to Mount Sinai (7,497 ft [2,285 m] above sea level) and Saint Catherine’s Monastery in the mountainous interior are popular destinations, especially with religious pilgrims. Adventure travelers favor desert jeep safaris and camel treks to remote oases and spectacular wadis. Travelers start in Cairo or Assyut and follow the “Great Desert Circuit” through four oases and the White Desert.
Map 10-15: Egypt
Infectious Disease Risks
In addition to being up to date on routine vaccines, travelers to Egypt should obtain hepatitis A and B, typhoid, and coronavirus disease 2019 (COVID-19) vaccines. Detailed Egypt-specific travel advice can be found on the Egypt destination page.
Enteric Infections & Diseases
Hepatitis A virus (see Sec. 5, Part 2, Ch. 7, Hepatitis A) is transmitted through ingestion of contaminated food or water. Those who are fully vaccinated against hepatitis A have lower risk of infection. Instruct travelers to follow food and water safety precautions (see Sec. 2, Ch. 8, Food & Water Precautions).
In most large international tourist hotels, the tap water is adequately chlorinated, but bottled water is generally provided for drinking. Tap water is not safe to drink outside of international tourist hotels because it might come from private water tanks not audited by the Ministry of Health. Eating thoroughly cooked meat and vegetables in tourist hotels, on Nile River cruise ships, and in tourist restaurants is generally safe. Eating raw or undercooked ground meat or shellfish should be avoided. As in many developing countries, the safety of uncooked vegetables and salads is questionable. The risk of travelers’ diarrhea in Egypt is high. Travelers affected by travelers’ diarrhea should hydrate to replace lost body fluids and minerals and use antimotility medications (e.g., loperamide). Clinicians could consider prescribing an antibiotic for travelers to Egypt to empirically self-treat travelers’ diarrhea (see Sec. 2, Ch. 6, Travelers’ Diarrhea).
Respiratory Infections & Diseases
Coronavirus Disease 2019
For current information on COVID-19 in Egypt, consult the US Embassy in Egypt website. See the US government’s COVID-19 international travel requirements and recommendations. All travelers going to Egypt should be up to date with their COVID-19 vaccines.
Sexually Transmitted Infections & HIV
Although the reported prevalence of HIV in Egypt is low, following standard precautions for prevention of sexually transmitted diseases is always advised. Egypt has historically had an alarmingly high prevalence of hepatitis C. However, in 2014 Egypt launched an intensive national elimination campaign that has led to a significant reduction in the prevalence of hepatitis C.
Soil- & Waterborne Infections
Egypt implemented a campaign to eliminate Schistosoma mansoni and Schistosoma haematobium, which were endemic. Although Egypt has made significant progress towards eliminating schistosomiasis, travelers should avoid wading, swimming, or other contact with freshwater, including the Nile River and irrigation canals. Swimming in saline pools of desert oases, chlorinated swimming pools, the Mediterranean Sea, or the Red Sea does not pose a risk for acquiring schistosomiasis (see Sec. 5, Part 3, Ch. 20, Schistosomiasis).
Mosquitoes and other biting insects can be problematic for travelers. Avoiding insect bites will prevent local discomfort and irritation and reduce the risk of vectorborne diseases (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods). Consider vectorborne diseases in the differential diagnosis of travelers with fever returning from Egypt (see Sec. 11, Ch. 4, Fever in the Returned Traveler).
Dengue & West Nile virus
Dengue (see see Sec. 5, Part 2, Ch. 4, Dengue) has been reported rarely in travelers who visited Egypt. Although some studies indicate that West Nile virus transmission is widely distributed, infections in returning travelers appear to be rare.
Isolated local transmission of malaria was last reported in Aswan Governorate in 2014. Although CDC does not recommend malaria prophylaxis for people going to Egypt, travelers should practice insect bite precautions.
There is no risk of yellow fever in Egypt. Egypt does, however, require travelers ≥9 months old arriving from countries with risk for yellow fever virus transmission to provide proof of vaccination against this disease. For more details, seeSec. 5, Part 2, Ch. 26, Yellow Fever, Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country, and International Certificate of Vaccination or Prophylaxis (ICVP).
Environmental Hazards & Risks
Animal Bites & Rabies
As in most other low-income countries, rabies is endemic throughout Egypt. For most travelers on a package tour, the risk will be minimal. However, travelers should be aware there are large numbers of stray dogs and cats in urban and tourist areas and are thus advised to avoid contact with all animals, wild, feral, and domestic. Rabies vaccine is available in Egypt for preexposure and postexposure prophylaxis; human rabies immune globulin is also available (see Sec. 5, Part 2, Ch. 18, Rabies). Shark attacks are rare in the Red Sea; however, sporadic incidents have been reported, including two attacks in 2020 and two in 2022.
Climate & Sun Exposure
Temperature and weather conditions vary widely in Egypt. The desert is extremely hot in summer (>100°F; >38°C) and can be cold in winter (<32°F; <0°C). Thirst is a late indicator of dehydration, and travelers should drink fluids regularly in the heat (see Sec. 4, Ch. 1, Extremes of Temperature). Because sweat evaporates immediately, people can become dehydrated without realizing it. Travelers who are elderly or take diuretic, anticholinergic, or neuroleptic medications are at increased risk of heat-associated illnesses. To stay cool and protect themselves from sun exposure, travelers should wear a hat and lightweight, loose-fitting clothing, as well as use sunscreen.
Sandstorms occur sporadically in the desert. Desert sand, dust, and smog can cause eye irritation and exacerbate asthma or other lung disorders (see Sec. 4, Ch. 3, Air Quality & Ionizing Radiation). Travelers who wear contact lenses should ensure to pack eyeglasses and contact lens care supplies.
Safety & Security
The majority of criminal acts in Egypt are crimes of opportunity such as purse snatching and pickpocketing. Travelers should be alert to being overcharged for various services and for being victimized in scams common to tourist destinations worldwide. The Department of State advises against travel to Sinai Peninsula (with the exception of air travel to Sharm El Sheikh), the Western Desert, and border areas due to risk of terrorism. Military and police road checkpoints are common, and security services enforce official travel restrictions. Travelers should check the US Department of State Egypt International Travel Information for up-to-date information on travel restrictions and safety precautions before travel.
Traffic incidents are common in Egypt due to overcrowded roads and reckless driving. Travelers should wear seat belts at all times (see Sec. 8, Ch. 5, Road & Traffic Safety). Pedestrians should be very careful because traffic rules are different in Egypt and pedestrians do not have right of way when in a crosswalk.
Availability & Quality of Medical Care
Hotels in Egypt are required by law to have an onsite clinic and resident physician. If further clinical care is required, the traveler would be referred to a hospital. Hospitals are available throughout the metropolitan areas. Most medications are available without a prescription; however, travelers should bring an adequate supply of any routine prescription medications (see Sec. 6, Ch. 3, . . . perspectives: Avoiding Poorly Regulated Medicines & Medical Products During Travel).
Box 10-04. Nile River cruises
Nile River cruises are usually 3–7-day trips to Aswan and Luxor. Approximately 200 riverboats are based on the Nile, and the average boat accommodates 120 passengers. The largest boats accommodate upwards of 300 passengers; chartered yachts might have just a few cabins. Riverboats have a range of accommodations from basic to 5-star luxury, and nights aboard are generally spent cruising from one port to the next while enjoying the passing riverside scenes of ancient villages, minarets, traditional feluccas (small boats), and farmers in galabiyas (traditional dress worn by farmers).
When travelers disembark they can visit the High Dam and Philae Temple in Aswan or Karnak Temple, Luxor Temple, Valley of the Kings, and Hatshepsut Temple in Luxor. The temples of Edfu, Esna, and Kom Ombo are all a must-see.
Generally, the Nile is a slow, smooth river. The combination of diesel fuel, heat, and motion can, however, cause distress for travelers. Most travelers do not consider the possibility of motion sickness on a river, so they are unprepared. Onboard medical services vary greatly. Travelers who know that they are sensitive to motion should carry motion sickness medication (see Yellow Book chapter, Motion Sickness). It is also important to keep in mind that the living conditions on river cruises worldwide, not only in Egypt, could be associated with spread of highly infectious diseases. Examples of this were seen during the COVID-19 pandemic, when cruise ships served as foci for spread of the virus not only on the cruise ship but onward transmission globally.
The following authors contributed to the previous version of this chapter: Ann M. Buff and Erik J. Reaves
Guagliardo, Sarah Anne J, et al. COVID-19 on the Nile: A Cross-Sectional Investigation of COVID-19 among Nile River Cruise Travellers Returning to the United States, February–March 2020. Journal of Travel Medicine, 29 Dec. 2022, 10.1093/jtm/taac153.
Hassanin a, Kamel S, Waked I, Fort M. Egypt’s ambitious strategy to eliminate hepatitis C virus: a case study. Glob Health Sci Pract. 2021;9(1):187–200.
HIV, Global Hepatitis And Sexually Transmitted Infections Programmes. Criteria for Validation of Elimination of Viral Hepatitis B and C: Report of 7 Country Pilots. 1 Sept. 2022, www.who.int/publications/i/item/9789240055292.
Saifullin MA, Laritchev, VP, Grigorieva YE, Zvereva NN, Domkina AM, Saifullin RF, Bazarova MV, et al. Two cases of Dengue Fever imported from Egypt to Russsia, 2017. Emerging Infectious Diseases 2018; 24 (4): 813-814.
Selim A, Radwan A, Arnaout F. Seroprevalence and molecular characterization of West Nile virus in Egypt. Comparative Immunology, Microbiology, and Infectious Diseases. Vol 71; 2020, 101473.
Yameny AA. The evolving schistosomiasis agenda 2017–2020 in Egypt: moving from control toward final elimination. J Biosci Appl Res. 2017; 3(2);48–54.