Safari and Beach Holidays in Kenya, Tanzania and Zanzibar: Vaccines and Health Advice

Game drives across the Masai Mara and the Serengeti, a climb up Kilimanjaro, and a week on the white sands of Zanzibar: a trip to East Africa is the holiday of a lifetime for many people. It also comes with health risks that are very different from a city break in Europe, from malaria and tsetse flies to remote locations where medical help may be hours away.

This guide explains the vaccines and malaria protection commonly recommended for Kenya, Tanzania and Zanzibar, how to avoid the illnesses specific to safari and beach holidays, and how to stay well while you’re there.

Before you go: when to get advice

Aim to get travel health advice at least six to eight weeks before you leave, as some vaccines need several doses and malaria tablets must be started before you travel. Take your full itinerary, including each park, lodge, beach and stopover, the dates you’ll be in each area, and any activities such as trekking, camping or diving.

The risks vary by place. For example, Nairobi and the highlands are different from the coast and lowland parks, and a trip that combines Kenya and Tanzania can bring extra entry requirements.

Routine vaccines

Check your routine UK vaccinations first:

• MMR (measles, mumps and rubella): two doses are recommended.
• Tetanus, diphtheria and polio: a booster is usually advised if your last one was more than ten years ago. Polio cases have been reported in parts of Africa, so ask your travel health professional whether you need a booster.
• Seasonal flu and COVID-19: consider these if you’re eligible.
• Children: make sure childhood immunisations are up to date.

Vaccines commonly recommended for East Africa

Hepatitis A

Spread through contaminated food and water, hepatitis A is recommended for almost all travellers to East Africa. It is available on the NHS in England for travel.

Typhoid

Typhoid is usually recommended, particularly if you’ll be eating outside of hotels and lodges, staying for a longer period, or travelling in rural areas. It is available on the NHS in England for travel.

Hepatitis B

This may be advised for longer stays, those who may need medical or dental treatment, and people who may have new sexual partners.

Rabies

Rabies is present in Kenya and Tanzania, and stray dogs are a common source of risk. A pre-travel course may be recommended for longer stays, remote travel where medical care is distant, travelling with children, or working with animals. Wherever you go, seek urgent medical help after any bite or scratch from a mammal, even if you have been vaccinated.

Cholera

Cholera outbreaks occur from time to time in East Africa. The risk to most visitors is low if they follow food and water precautions, but vaccination may be considered for those going to outbreak areas or working in relief roles.

Yellow fever

Yellow fever is a risk in parts of Kenya, and the vaccine is commonly recommended for travellers there. Tanzania and Zanzibar require a yellow fever certificate from travellers arriving from a country with a risk of yellow fever, which can include Kenya. This means that a trip combining Kenya with Tanzania or Zanzibar often needs the vaccine and certificate, even if you don’t spend long in a risk area.

The certificate becomes valid 10 days after vaccination, and the vaccine is only available from registered yellow fever vaccination centres. Rules and risk areas change, so check the requirements for each country on your route, including stopovers.

Malaria: the biggest health risk for most visitors

Malaria is a serious risk across much of Kenya and Tanzania, including the coast, the lowland national parks and Zanzibar. The risk is generally lower in Nairobi and in the highlands at high altitude, but if your trip includes safari or the coast you will almost certainly be advised to take antimalarial tablets.

There are several types of tablet, and the right one depends on your health, your age, other medicines you take, whether you are pregnant or breastfeeding, and how long you’ll be away. Some have side effects or aren’t suitable for everyone. For example, doxycycline can make your skin more sensitive to the sun, which is worth knowing if you’re going to the beach. Ask your pharmacist or travel health professional which is best for you.

Remember:

• Start tablets before you travel, and continue after you return for the full period advised
• Tablets are not 100% effective, so also avoid bites
• Malaria can develop weeks or even months after you return. If you have a fever, headache or flu-like illness, seek medical help at once and tell the doctor where you’ve been
• Pregnant women and young children are at higher risk of severe illness. Seek specialist advice before travelling to a malaria area

Avoiding bites: mosquitoes, tsetse flies and ticks

Mosquitoes

Mosquitoes that spread malaria tend to bite from dusk to dawn, while those that carry dengue and chikungunya, which are found particularly on the coast, bite during the day. Protect yourself at all times:

• Use insect repellent containing 50% DEET on exposed skin, and reapply as directed
• Wear loose, long-sleeved tops and long trousers, especially in the evening
• Sleep under a mosquito net, or in screened or air-conditioned rooms, and check it has no holes
• Use mosquito coils or plug-in vaporisers where suitable
• Apply sunscreen first and repellent afterwards

Tsetse flies

Tsetse flies are found in some national parks and bush areas of Tanzania and Kenya. Their bites are painful, and they can occasionally spread sleeping sickness. They are attracted to dark colours, especially blue and black, and can bite through thin clothing. On a safari, wear light, neutral colours (such as khaki, beige or olive), keep vehicle windows closed in tsetse areas, and use repellent. There is no vaccine.

Ticks

Ticks in bush and grassland can spread African tick-bite fever, which causes a fever, headache and a small black scab where the tick attached. Wear long trousers tucked into socks when walking in the bush, use repellent, check your skin every day, and remove any ticks promptly with fine-tipped tweezers or a tick-removal tool. Seek advice if you become unwell.

Animals and safari safety

• Never get out of your vehicle or approach wildlife unless your guide says it is safe, and always follow your guide’s instructions
• Don’t walk around camps and lodges at night without an escort, as animals such as hippos, buffalo and hyenas can wander through
• Don’t feed or approach monkeys and baboons: they can bite and scratch, and are a rabies risk
• Wear closed shoes and use a torch at night, as snakes and scorpions can be found in the bush
• For any bite, scratch or lick on broken skin, wash the wound immediately with soap and running water for at least 15 minutes, apply an antiseptic, and get urgent medical advice about rabies treatment

Antivenom is not always available in remote areas, so don’t put yourself at risk by approaching or handling snakes.

Beach, water and sun

Zanzibar and the Kenyan and Tanzanian coast are beautiful, but the sea and sun bring their own risks:

• Sea urchins and coral: wear reef shoes in the water, and clean and cover any cuts quickly, as they can become infected in warm, humid conditions
• Jellyfish: ask local staff about any current hazards
• Drowning: currents can be strong and lifeguards are often not present, so take care, particularly with children, and avoid swimming after drinking alcohol
• Freshwater and schistosomiasis: avoid swimming, paddling or wading in freshwater lakes and slow-moving rivers, including Lake Victoria and Lake Malawi, as they can carry the parasite that causes schistosomiasis (bilharzia). Swimming pools that are properly chlorinated, and the sea, aren’t affected
• Sun and heat: use high-factor sunscreen, a hat and sunglasses, drink plenty of water, and avoid the strongest midday sun

Altitude: Kilimanjaro, Ngorongoro and the highlands

If your trip includes a trek up Mount Kilimanjaro or Mount Kenya, or time at altitude, you may be at risk of altitude sickness. Symptoms include headache, nausea, dizziness and tiredness, and it can become serious. A slow ascent and plenty of time to acclimatise are the best protection. Speak to a healthcare professional well before you go, particularly if you have a heart or lung condition, and ask whether medicines to help prevent altitude sickness are suitable for you. Descend if symptoms get worse.

Food and water safety

Travellers’ diarrhoea is common. To reduce your risk:

• Drink bottled or treated water, and check the seal. Use it for brushing your teeth, too
• Avoid ice unless you’re sure it’s made from safe water
• Choose food that is freshly cooked and served hot
• Be careful with raw salads, unpeeled fruit, shellfish and unpasteurised dairy
• Wash your hands often, and carry hand gel
• Pack oral rehydration sachets

See a doctor if you have blood in your stools, a high temperature, severe symptoms, or can’t keep fluids down.

Healthcare, evacuation and insurance

Major cities such as Nairobi and Dar es Salaam have private hospitals, but healthcare on safari, at remote lodges and on the islands can be very limited, and it may take hours to reach help. You may need an air ambulance in an emergency, so take out comprehensive travel insurance that covers medical treatment, emergency evacuation and repatriation, and your planned activities, such as trekking and diving. Many safari operators also offer access to flying doctor services, so ask about this when booking.

Pack a good first aid kit, any regular medicines in their original packaging with a copy of your prescription, and enough for the whole trip plus a few days extra.

Your East Africa checklist

• Book a travel health appointment six to eight weeks before you go
• Check routine vaccines, and ask about hepatitis A, typhoid, rabies and any others
• Find out whether you need yellow fever vaccination and a certificate for your route
• Get antimalarial tablets suited to you, and plan when to start and stop them
• Pack repellent with 50% DEET, light neutral-coloured long clothing, sunscreen and reef shoes
• Carry oral rehydration sachets, hand gel and a first aid kit
• Arrange travel insurance with evacuation cover
• Check altitude advice if trekking
• Keep vaccination records and certificates with your passport

A safari or beach holiday in East Africa can be safe and unforgettable with the right preparation. The most important steps are to get malaria protection that suits you, check your yellow fever requirements early, avoid bites, and take sensible care around animals, water and the sun. Speak to your pharmacist or a travel health professional with your itinerary before you go.

Country advice changes, so check TravelHealthPro, Fit for Travel and the FCDO travel advice pages before you go.

This article is for general information only and isn’t a substitute for personalised travel health advice. Always seek advice tailored to your own health and itinerary before you travel.