Malaria is spread by the bite of an infected Anopheles mosquito and was reported in 83 countries in 2023 according to the WHO (via the CDC), mostly in Africa. Before a trip, the question is not only « is the country at risk? » but « are the region, the season and the type of trip at risk? » For example, the CDC lists no malaria transmission in the cities of Jakarta and Ubud or in the resort areas of Bali, but reports it in rural Lombok and in much of eastern Indonesia.
This guide gathers what the CDC Yellow Book (US Centers for Disease Control and Prevention) and the NHS say, checked on 12 November 2026. For 26 destinations covered on our site, we recorded exactly what each CDC destination page says in its malaria section. It does not replace a consultation: preventive medicine is decided with a doctor or travel clinic, based on your itinerary and health. For the other big mosquito-borne disease, see our page on dengue: at-risk countries and prevention.
Malaria when traveling: the essentials
- Transmission: bite of an infective female Anopheles mosquito, mostly between dusk and dawn (CDC).
- Symptoms: fever and flu-like illness, from 7 days after the bite and sometimes months later (CDC); the NHS gives 7 to 18 days as the usual range. Treat any fever during or after a trip to a malaria-risk area as urgent: get care immediately and report your travel (CDC).
- Prevention: bite avoidance plus preventive medicine if your doctor prescribes it. No regimen is 100% effective (CDC).
- Risk varies by place: big cities and high altitudes are often free of malaria; rural, forested and border areas often are not.
- Get advice 4 to 6 weeks before departure from a GP, nurse, pharmacist or travel clinic (NHS), or a travel medicine provider in the US.
What is malaria?
The CDC Yellow Book (last reviewed April 23, 2025) explains that malaria is caused by Plasmodium parasites transmitted by the bite of an infective female Anopheles mosquito; rarely it spreads through blood transfusion, needle sharing, organ transplant or from mother to fetus. It cites the WHO World malaria report 2024: about 263 million infections and 597,000 deaths in 2023 across 83 countries. In the United States about 2,000 cases occur each year, almost all imported, and of the 2019 US cases with a known country of acquisition, 93% were acquired in Africa. The risk therefore concerns travelers heading to areas where malaria is present.
Symptoms to watch for
According to the CDC, malaria causes fever and flu-like illness (chills, headache, muscle pain, malaise) that may come and go, starting as early as 7 days after an infectious bite and as late as several months or more. The NHS lists a fever or feeling hot, cold or shivery, sweating, headaches, confusion, tiredness, sickness, diarrhea, muscle pain, loss of appetite, jaundice, and sore throat, cough or breathing difficulty, and says symptoms usually appear 7 to 18 days after a bite. Severe disease can cause kidney injury, respiratory distress, confusion, severe anemia, seizures, coma and death, and P. falciparum malaria is a medical emergency.
- Diagnosis: the CDC says testing should give results within hours, using a blood smear and, if faster, a rapid diagnostic test.
- After you return: the CDC says to seek medical care immediately for a fever during travel or for up to 1 year after returning, report your travel history and get tested, even if you took preventive medicine. The NHS gives the same 12-month window and says to ask for an urgent GP appointment or contact NHS 111 in the UK.
- If symptoms start while you are still abroad, get medical advice immediately rather than waiting until you get home (NHS).
Where is the risk? What the CDC says, destination by destination
The table below summarizes the malaria section of each CDC destination page (malaria sections updated April 23, 2025; destination pages last reviewed between August 25 and November 10, 2026). We sorted the destinations into four groups. The grouping is Destination de Voyage’s, not an official classification.
| Destination | Group (our grouping) | What the CDC destination page says |
|---|---|---|
| Kenya | Widespread, with exceptions | All areas, including game parks, below 2,500 m (8,200 ft); no preventive medicine recommended in highly urbanized central Nairobi, where cases are rare. (CDC page) |
| Madagascar | Widespread, with exceptions | All areas except Antananarivo, where it is rare. (CDC page) |
| Senegal | Widespread, with exceptions | Listed for all areas; no area without transmission is identified. (CDC page) |
| Tanzania | Widespread, with exceptions | All areas below 1,800 m (5,900 ft). (CDC page) |
| India | Widespread, with exceptions | Throughout the country, including Mumbai and New Delhi; none above 2,000 m (6,500 ft). (CDC page) |
| China | Mentioned, no regional detail | No dedicated malaria section; the page says malaria is a risk in some parts of China and advises filling any prescription before departure. (CDC page) |
| Sri Lanka | Mentioned, no regional detail | No dedicated malaria section; the page says malaria is a risk in some parts of Sri Lanka. (CDC page) |
| Mexico | Localized: specific regions or settings | Campeche, Chiapas and southern Chihuahua; rare in Oaxaca, Sinaloa, Sonora and Tabasco; none along the US-Mexico border. (CDC page) |
| Brazil | Localized: specific regions or settings | All of Acre, Amapá, Amazonas, Rondônia and Roraima; present in Maranhão, Mato Grosso and Pará; rare cases in parts of other states; none in Brasília, Rio de Janeiro city, São Paulo city or Iguaçu Falls. (CDC page) |
| Colombia | Localized: specific regions or settings | All areas below 1,700 m (5,600 ft); none in Bogotá, Cartagena and Medellín. (CDC page) |
| Peru | Localized: specific regions or settings | Areas below 2,500 m (8,200 ft) east of the Andes, including Iquitos and Puerto Maldonado; rare in Tumbes and Piura; none in Lima Province or in highland tourist areas (Cusco, Machu Picchu, Lake Titicaca). (CDC page) |
| Indonesia | Localized: specific regions or settings | All of eastern Indonesia (including Labuan Bajo and the Komodo Islands); rural Kalimantan, Lombok, Sulawesi and Sumatra; low in rural Java; none in Jakarta, Ubud, the resort areas of Bali and Java, or the Gili Islands. (CDC page) |
| Malaysia | Localized: specific regions or settings | Zoonotic P. knowlesi malaria in rural, forested areas; none listed for Kuala Lumpur or Penang. (CDC page) |
| Philippines | Localized: specific regions or settings | Palawan province and the Mindanao island group; none in Metropolitan Manila and other urban areas. (CDC page) |
| Thailand | Localized: specific regions or settings | Higher risk in provinces bordering Myanmar (Burma), Cambodia and Malaysia; rare in Bangkok, Chiang Mai, Phuket, Koh Samui; none on the Krabi islands (Koh Lanta, Koh Phi Phi) or in Pattaya. (CDC page) |
| Cambodia | Localized: specific regions or settings | Mainly pockets in rural and forested areas; none or negligible in Phnom Penh, Siem Reap and Angkor Wat. (CDC page) |
| Laos | Localized: specific regions or settings | Present in the southern provinces; rare in the north; none in Luang Prabang and Vientiane. (CDC page) |
| Vietnam | Localized: specific regions or settings | Rural areas only, with rare cases in the Mekong and Red River deltas; none in Hanoi, Ho Chi Minh City, Da Nang, Nha Trang and other named cities. (CDC page) |
| South Africa | Localized: specific regions or settings | Kruger National Park; parts of Limpopo, Mpumalanga and KwaZulu-Natal, along the borders with Mozambique and Zimbabwe. (CDC page) |
| Dominican Republic | Localized: specific regions or settings | Mainly the provinces of Azua, Elías Piña, La Altagracia (including resort areas), San Juan and Santo Domingo; rare in other provinces. (CDC page) |
| Costa Rica | Localized: specific regions or settings | Present in Alajuela and Limón provinces; rare to none elsewhere. (CDC page) |
| Cape Verde | No malaria section on the page | The CDC destination page has no malaria section. (CDC page) |
| Cuba | No malaria section on the page | The CDC destination page has no malaria section. (CDC page) |
| Maldives | No malaria section on the page | The CDC destination page has no malaria section. (CDC page) |
| Egypt | No malaria section on the page | The CDC destination page has no malaria section. (CDC page) |
| Morocco | No malaria section on the page | The CDC destination page has no malaria section. (CDC page) |
This grouping shows what world maps hide: in 14 of the 26 destinations, risk is limited to certain regions, altitudes or settings. A Bangkok – Chiang Mai – Phuket circuit or a stay in Bali is not planned like a trek in Cambodian forest or a stay on the shores of Lake Victoria. That is precisely what the doctor will assess with you.
Protecting yourself: bites and preventive medicine
Against mosquito bites
The CDC lists staying in air-conditioned or well-screened places, sleeping under insecticide-treated nets, wearing covering clothing, and using repellent such as DEET. The NHS recommends repellent with 50% DEET on skin, insecticide-treated nets, and long sleeves and trousers in the evening, when mosquitoes are most active. Ask your pharmacist to help choose a repellent suited to children’s ages or to pregnancy. For stomach problems, our guide to traveler’s diarrhea covers hygiene habits.
Preventive medicine (chemoprophylaxis)
The CDC lists several preventive drugs, including atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine and tafenoquine, chosen according to the destination (resistance patterns), trip length and patient factors; a G6PD test is required before primaquine or tafenoquine. The NHS notes that antimalarial medicine usually starts a few days or weeks before you go and continues for a few weeks after you return. No online guide can tell you which drug to take, so plan the consultation well before departure, along with updating your travel vaccines.
What about a vaccine?
The Institut Pasteur (France) says the RTS,S vaccine targets only P. falciparum, with moderate efficacy, and is used alongside other measures to prevent severe forms. It replaces neither bite prevention nor preventive medicine.
Decision tree before you go
- Is your destination in the « no malaria section » group? Check the current CDC page before leaving; ask for advice anyway if you are going to a remote rural area.
- Is the risk « localized »? List your stops precisely (cities, parks, altitude, nights in rural areas) and show the list to the doctor.
- Is the risk « widespread » or unspecified? A travel medicine consultation is recommended; the doctor will decide on preventive medicine.
- Child, pregnancy, long-term medication? Always consult: age, pregnancy and interactions guide the choice of drug.
- Fever on return, even mild? Seek urgent care and name the countries you visited.
Common mistakes
- Stopping preventive medicine on your return when the doctor prescribed a course to continue after the trip.
- Believing that preventive medicine makes repellent and a bed net unnecessary.
- Judging risk by country: the CDC lists no malaria in the resort areas of Bali, but transmission exists in rural Lombok nearby.
- Blaming a fever on your return on the flu without telling the doctor about the trip.
- Also consider travel insurance that covers medical costs and repatriation.
Frequently asked questions
How do you catch malaria?
Through the bite of an infective female Anopheles mosquito. It does not spread by ordinary contact; rarely it can pass from mother to fetus or through blood transfusion, needle sharing or organ transplant (CDC).
Is there malaria in Bali?
Not in the resort areas of Bali or in Jakarta or Ubud, according to the CDC. Transmission does exist in rural parts of other islands, including Lombok.
Do I need malaria medicine for Thailand?
The CDC places higher risk in provinces bordering Myanmar, Cambodia and Malaysia, and recommends no preventive medicine for the areas with rare cases. It depends on your itinerary: only a doctor can decide.
How long after returning can malaria appear?
Symptoms can start from 7 days after a bite and sometimes months later (CDC); the NHS gives 7 to 18 days as usual. Seek care for any fever within 12 months of a trip to a malaria-risk area.
Is there a malaria vaccine for travelers?
The Institut Pasteur mentions the RTS,S vaccine, with moderate efficacy and targeting only P. falciparum, as a complement to other measures. Traveler prevention relies on bite protection and, if needed, preventive medicine prescribed by a doctor.
Where can I find up-to-date risk areas?
On the CDC Travelers’ Health destination page for your country, and with your doctor or a travel clinic.
Our sources
- CDC Yellow Book 2026, « Malaria » (last reviewed April 23, 2025), checked 12 November 2026.
- CDC Travelers’ Health, destination pages for the 26 countries in the table (malaria sections updated April 23, 2025; pages last reviewed from August 25 to November 10, 2026), checked 12 November 2026.
- NHS, « Malaria » (last reviewed 29 July 2025), checked 12 November 2026.
- Institut Pasteur, « Malaria » disease page (updated October 2026), consulted 23 October 2026, for the RTS,S vaccine.
- Our methodology
Updated November 2026.
