Inoculation regulations can change at short notice. Please take medical advice in the case of doubt.
1
A yellow fever vaccination certificate is required from travellers arriving from, or having passed through, an area considered by the Malagasy authorities to be infected within six days; enquire at Embassy.
2
A cholera vaccination certificate is recommended for travellers arriving from, or having passed through, an area considered by the Malagasy authorities to be infected; enquire at Embassy.
3
Immunisation against typhoid and poliomyelitis is often recommended.
4
Malaria risk, predominantly in the malignant falciparum form, exists all year throughout the country and is highest in coastal areas. Resistance to chloroquine has been reported. The recommended prophylaxis is mefloquine.
Food & drink
All water should be regarded as being potentially contaminated. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products that are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.
Other risks
Bilharzia (schistosomiasis) is present. Avoid swimming and paddling in fresh water; swimming pools which are well chlorinated and maintained are safe. Hepatitis A, B, and E are endemic and precautions are advised. Dysenteries and diarrhoeal diseases are common. Many viral diseases including severe haemorrhagic fevers have been reported. Natural foci of plague occur.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.
Health insurance is strongly recommended; it should include cover for emergency repatriation. Private and public healthcare is available, but public facilities can be very limited. It is highly recommended that visitors bring medication for stomach upsets.
