The Travel Health and Vaccine Specialists

Health Alert


Malaria in South Africa

Updated April 11, 2017

What is the current situation?

Cases of malaria( have been reported in parts of three provinces in South Africa where transmission of the disease does not usually occur. As of March 12, 2017, 53 cases have been reported, most of them in the cities of Thabazimbi and Lephalale in Limpopo Province. Two of the cases were reported in Swartruggens, North West Province, and two more cases in the Doornpoort neighborhood north of Pretoria in Gauteng Province.

The South African National Institute for Communicable Diseases is investigating the cases and working to control mosquitos that spread malaria. Health care providers and the public are being informed about the symptoms, as well as treatment of the disease.

CDC now recommends that travelers to the western Waterberg district of Limpopo Province take prescription medicine to help prevent malaria. CDC previously recommended these medicines only for people traveling to Vembe or Mopane cities in Limpopo province. Medicine to help prevent malaria is not recommended for travelers to North West and Gauteng provinces; however, these travelers should continue to take normal precautions to avoid mosquito bites, including covering exposed skin, using insect repellent, and sleeping in accommodations that are not exposed to the outdoors.

What can travelers do to prevent malaria?

Travelers can protect themselves from malaria by taking certain prescription medicine, if recommended by a health care provider, and by preventing mosquito bites.

Prevent mosquito bites:

  • Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
    • Use an EPA-registered insect repellent as directed. If you are also using sunscreen, apply sunscreen first, allow it to dry, then apply insect repellent.
    • Follow package directions when applying repellent on children. Avoid applying repellent to their hands, eyes, and mouth.
    • Higher percentages of active ingredient provide longer protection. Use products with the following active ingredients:
      • DEET
      • Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
      • Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
      • IR3535 
      • 2-undecanone (methyl nonyl ketone)
  • Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself.
    • Treated clothing remains protective after multiple washings. See the product information to find out how long the protection will last.
    • If treating items yourself, follow the product instructions carefully.
    • Do not use permethrin directly on skin.
  • Stay and sleep in screened-in or air-conditioned rooms.
  • Use a bed net if the area where you are sleeping is exposed to the outdoors.

If you feel sick and think you may have malaria:

  • Talk to a health care provider immediately if you feel seriously ill, especially if you have a fever up to 1 year after travel.
  • Tell your health care provider about your travel.
  • For more information about medical care abroad, see Getting Health Care Abroad
  • Take steps to avoid additional mosquito bites to help further spread of the disease.

Traveler Information

Clinician Information