The health risk information presented here is summarized from Shoreland Travax®, a decision-support tool used by health care providers to perform a detailed health risk analysis based on specific locations, individual travel styles, and traveler risk behaviors. Travax provides practitioners current, independently researched malaria risk and prevention recommendations in a map-based format that goes beyond the annual WHO and US CDC statements included here. Not included here are current reports from Travax of disease outbreaks or environmental events that may pose elevated risks to travelers’ health and safety. The Providers section of this site offers a directory of health care providers who utilize Shoreland Travax for travel health counseling. Learn more about the detailed reports and maps available from these practitioners (includes links to samples).
South Africa is a developing nation classified as upper middle income. Located at the southern tip of Africa (south of Botswana and Namibia), the climate is extremely diverse with classifications that range from humid temperate (no dry season) to dry (arid).
See also: Library article for Yellow Fever
Although yellow fever does not occur in South Africa, an official yellow fever vaccination certificate may be required depending on your itinerary.
- Requirement: A certificate proving yellow fever vaccination is required for travelers aged ≥ 1 year coming from countries with risk of YF transmission. This also applies to airport transit stops (no exit through immigration checkpoint) longer than 12 hours in risk countries.
Depending on your itinerary, your personal risk factors, and the length of your visit, your health care provider may offer you vaccination against cholera, COVID-19, hepatitis A, hepatitis B, influenza, measles, mumps, rubella, rabies, or typhoid fever. Routine immunizations, such as those that prevent tetanus/diphtheria or "childhood" diseases, should be reviewed and updated as needed.
See also: Library article for Malaria
The following is current information as reported by the World Health Organization (WHO) and the US Centers for Disease Control (CDC):
WHO—International Travel and Health (current online update, Country List)(2020) Malaria risk due predominantly to P. falciparum exists throughout the year in the low-altitude areas of Mpumalanga Province (including the Kruger National Park), Limpopo Province, and north-eastern KwaZulu-Natal Province. Risk is highest from October through May.
- Recommended prevention in risk areas: C – Risk of P. falciparum malaria, in combination with reported chloroquine and sulfadoxine–pyrimethamine resistance. Mosquito bite prevention plus atovaquone–proguanil or doxycycline or mefloquine chemoprophylaxis (select according to reported side effects and contraindications) a
aAlternatively, for travel to rural areas with low risk of malaria infection, mosquito bite prevention can be combined with stand–by emergency treatment (SBET).
WHO Country List footnote: When available, the date of the most recent update or confirmation is indicated in parentheses in the country list. If no date is indicated, the most recent update or confirmation was provided before 2013.
CDC—Health Information for International Travel (current online edition)Areas with malaria: Present along the border with Zimbabwe and Mozambique. Specifically in Mopani, Vhembe, and Waterberg district municipalities of Limpopo Province; Ehlanzeni district municipality in Mpumalanga Province; and Umknanyakude in Kwazulu-Natal Province. Present in Kruger National Park (see Map 2-25).
- Drug resistance3 : Chloroquine.
- Malaria species: P. falciparum 90%, P. vivax 5%, P. ovale 5%.
- Recommended chemoprophylaxis: Areas in Limpopo, Mpumalanga, and Kwazulu-Natal Provinces with malaria: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4
3 Refers to P. falciparum malaria unless otherwise noted.
4 Primaquine and tafenoquine can cause hemolytic anemia in people with G6PD deficiency. Patients must be screened for G6PD deficiency before starting primaquine or tafenoquine. See Tafenoquine Approved for Malaria Prophylaxis and Treatment for more information.
See also: Library article for Travelers' Diarrhea
Moderate risk exists throughout the country, with minimal risk in deluxe accommodations. Community sanitation and food safety measures may be inadequate. Some itineraries (e.g., remote destinations, austere accommodations) and activities (e.g., ecotourism, eating street or local-market food) further increase risk.
Travelers should observe food and beverage precautions, which reduce the likelihood of illness.
Travelers should carry loperamide for self-treatment of diarrhea and, if risk is moderate to high, an antibiotic to add if diarrhea is severe. Consult a knowledgeable health care provider regarding which antibiotic is appropriate for you and most effective for your destination.
Insect- and Arthropod-Borne Diseases
Other Disease and Health Risks
Additional concerns include air pollution, anthrax disease, Crimean-Congo hemorrhagic fever, helminths, leptospirosis, Marburg virus disease, marine hazards, melioidosis, plague, schistosomiasis, sexually transmitted infections, tuberculosis.
The material below includes information from the US Department of State (DOS), the UK Foreign, Commonwealth & Development Office (FCO), Global Affairs Canada (GAC), and Australia's Department of Foreign Affairs and Trade (DFAT), as well as from additional open-source material. Standard safety precautions that apply to all international travel can be found in the Library article Safety and Security.
Risk of attack by transnational terrorist groups exists throughout the country. Targets may include domestic and international organizations and businesses; public places and events, including those frequented by tourists; and transportation systems.
High risk of violent crime (armed robbery, sexual assault, carjacking, and murder) exists throughout the country, especially in the central business districts of major cities, in townships on the outskirts of major cities, in airports, and on hiking trails.
High risk of petty crime exists throughout the country, including areas frequented by foreigners, especially in Johannesburg, Pretoria, Durban, and other cities (particularly in the central business districts), in crowded areas (including sporting events, restaurants, and bars), and on or near public transportation.
Theft of items from checked baggage in airports is common.
Theft of valuables from unattended vehicles and accommodations is common.
Scams involving false identity (such as criminals posing as police officers) have been reported.
Risk exists of robberies and/or assaults occurring after consuming intentionally drugged food or drink; tourists are frequently targeted.
Protests and demonstrations frequently occur throughout the country and have the potential to turn violent without warning. Bystanders are at risk of harm from violence or from the response by authorities. Disruption to transportation, free movement, or the ability to carry out daily activities may occur.
Hazardous water conditions (including currents, tides, and undertows) may occur. Heed posted warnings, and avoid beaches that are not patrolled. Do not swim alone or after dark, and do not walk on any beach after dark.
Rent water sports equipment from reputable operators. Scuba dive only with personnel certified by PADI or NAUI, and use equipment only from PADI- or NAUI-certified dive operators.
Other Safety Threats
Risk exists for fatal wildlife attacks on safaris and in game parks and reserves. Travelers should closely follow park regulations, always maintain a safe distance from wildlife, and should not exit vehicles or protected enclosures.
Significant risk of traffic-related injury or death exists. The road traffic death rate is more than 24 per 100,000 population, the highest risk category. Carefully assess the safety of transportation options before any road travel.
Speed laws are poorly enforced.
Seat belt laws are poorly enforced.
Drunk driving laws are poorly enforced.
Structural standards for vehicles may not meet international standards.
The US Federal Aviation Administration has determined that the civil aviation authority of this country oversees its air carriers in accordance with minimum international safety standards.
Selected Embassies or Consulates in South Africa
- United States: [+27] 12-431-4000; za.usembassy.gov
- Canada: [+27] 12-422-3000; www.canadainternational.gc.ca/southafrica-afriquedusud
- United Kingdom: [+27] 12-421-7500; www.gov.uk/world/organisations/british-high-commission-pretoria
- Australia: [+27] 12-423-6000; www.southafrica.embassy.gov.au
South Africa's Embassies or Consulates in Selected Countries
- In the U.S.: www.saembassy.org
- In Canada: www.southafrica-canada.ca
- In the U.K.: southafricahouseuk.com
- In Australia: www.sahc.org.au
HIV testing is not required to obtain a tourist, work, or residence visa.