Madagascar (Africa)

Advice for All Destinations Vaccinations Malaria Malaria Map Other Health Risks Alerts News

Vaccinations

• Confirm primary courses and boosters are up to date as recommended for life in Britain - including for example, seasonal flu vaccine and COVID-19 (if eligible), MMR, vaccines required for occupational risk of exposure, lifestyle risks and underlying medical conditions.
• Courses or boosters usually advised: Diphtheria; Hepatitis A; Poliomyelitis; Tetanus.
• Other vaccines to consider: Hepatitis B; Rabies; Typhoid.
• Selectively advised vaccines - only for those individuals at highest risk: Cholera.

• Yellow fever vaccination certificate required for travellers aged 9 months or over arriving from countries with risk of yellow fever transmission and for travellers having transited for more than 12 hours through an airport of a country with risk of yellow fever transmission.

Notes on the diseases mentioned above

• Cholera:  spread through consumption of contaminated water and food. It would be unusual for travellers to contract cholera if they take basic precautions with food and water and maintain a good standard of hygiene.

  Risk is higher during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water.

  Risk is highest for humanitarian aid workers; those working in refugee camps or slums; those caring for people with cholera.

• Diphtheria:  spread person to person through respiratory droplets. Risk is higher if mixing with locals in poor, overcrowded living conditions.
• Hepatitis A:  spread by consuming food or drinks that contain the virus (i.e. become contaminated by infected poo), or by touching things or people that have infected poo on them, and then touching your mouth.

  Risk is higher if travelling to countries where there hepatitis A is circulating in the local population, or to areas where personal hygiene and sanitation is poor.

  Risk is highest for those with underlying medical conditions where there is increased risk of developing severe disease e.g. liver/kidney disease; haemophilia (clotting disorder); and for men who have sex with men; people who inject drugs; those at risk of exposure through their jobs.

• Hepatitis B:  spread through exposure to infected blood or bodily fluids. Occurs from sexual contact or contact with contaminated needles and medical instruments (e.g. dental / medical procedures, tattooing, body piercing, sharing intravenous needles). Mothers with the virus can also transmit the infection to their baby during childbirth.

  Risk is higher for those visiting more frequently, staying longer, visiting friends and relatives, children through bites, cuts and scratches and those who may require medical treatment during travel.

  Risk is highest for those with underlying medical conditions where there is increased risk of severe disease e.g. chronic liver/kidney disease; haemophiliacs (clotting disorder) and in men who have sex with men; people who change sexual partners frequently; and people who inject drugs.

• Poliomyelitis:  spread mainly through person to person contact (faecal-oral route) and by consuming contaminated food and water. A total of 5 doses of polio-containing vaccine are recommended in the UK for lifetime cover. Boosters are usually recommended for travel to countries where polio remains a problem.

  Countries may require proof of polio vaccination when you leave them: check the 'Alerts' section below to see if there are any 'Polio Vaccination Exit recommendations' for this country.

• Rabies:  spread through the saliva of infected animals (especially dogs, cats, bats and monkeys), usually through a bite, scratch or lick to broken skin. Risk is higher for those working or living in remote or rural areas (with no easy access to medical facilities), longer stay travellers, those planning on undertaking activities such as trekking, cycling or running in a 'high risk' country, those working with, or regularly handling animals or bats, as part of their job, and children. 

  Urgent medical advice should be sought after any animal bite, scratch or lick to broken skin, or bat bite, even after receiving pre-travel rabies vaccine.

• Tetanus:  spread through contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil worldwide. A total of 5 doses of tetanus vaccine are recommended for life in the UK. Boosters are usually recommended in a country or situation where the correct treatment of an injury may not be readily available.
• Typhoid:  spread mainly through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is limited.

Malaria

Malaria is a serious and sometimes fatal disease transmitted by mosquitoes.You cannot be vaccinated against malaria.

Malaria precautions

Malaria Map

• Malaria risk is high throughout the year in all areas.
• Malaria precautions are essential. Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.
• Check with your doctor or nurse about suitable antimalarial tablets.
• See malaria map – additional information can be found by clicking on the Regional Information icon below the map.
• High risk areas: atovaquone/proguanil OR doxycycline OR mefloquine is usually advised.
• If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
• If travelling to an area remote from medical facilities, carrying standby emergency treatment for malaria may be considered.

Other Health Risks

Altitude and Travel

This country has either areas with high altitude (2400m or more) or/and areas with very high altitude (3658m or more). Travellers who may go into areas of high altitude should take care to avoid ill effects of being at altitude including Acute Mountain Sickness, a potentially life-threatening condition. For further information see Altitude and Travel. 

Dengue Fever

A viral illness that is transmitted to humans by mosquito bites. The mosquito that spreads dengue bites during the day and is more common in urban areas. Symptoms include fever, headache, severe joint, bone and muscular pain - hence its other name 'breakbone fever'. There is no vaccine and prevention is through avoidance of mosquito bites. For further information see Dengue Fever. 

Schistosomiasis

A parasitic infection (also known as bilharzia) that is transmitted to humans through contact with fresh water. The parasite enters humans through the skin and prevention is dependant on avoidance of swimming, bathing or paddling in fresh water lakes and streams. For further information see Schistosomiasis. 

Alerts

Polio Vaccination Exit Recommendations

If you are visiting this country for longer than 4 weeks, you may be advised to have a booster dose of a polio-containing vaccine if you have not had one in the past 12 months. You should carry proof of having had this vaccination. Please speak to a travel health professional to discuss.

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