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Diseases potentially acquired by travel to North Africa

David Murdoch, MD, MSc, DTM&H, FRACP, FRCPA, FFSc(RCPA)
Section Editor
Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
Deputy Editor
Elinor L Baron, MD, DTMH


North Africa refers to the region of the African continent north of the Sahara Desert. For the purposes of this discussion, the countries within this region are Algeria, the Canary Islands (Spain), Egypt, Libya, Morocco, and Tunisia. This region is characterized by fertile coastal areas and a desert hinterland.


Malaria — Malaria is of very limited risk for most travelers to North Africa, with most areas being malaria free. In Algeria, there have been small foci of local transmission in the six southern and southeastern wilayas (Adrar, El Oued, Ghardaia, Illizi, Ouargla, and Tamanrasset). The malaria risk in Egypt is limited to the El Faiyum area only. There is no malaria risk in the Canary Islands, Libya, Morocco, or Tunisia. (See "Prevention of malaria infection in travelers".)

Yellow fever — There is no risk for yellow fever in North Africa. However, Algeria, Egypt, Libya, and Tunisia require travelers to have a yellow fever vaccination certificate if they are coming from specified areas in South America or sub-Saharan Africa. (See "Yellow fever".)

Leishmaniasis — Both cutaneous and visceral leishmaniasis occur in the Mediterranean littoral areas of Algeria, Egypt, Libya, Morocco, and Tunisia. Sand flies of the genus Phlebotomus are the vectors. The main reservoirs are dogs, foxes, and humans. In this region, Leishmania infantum is the principal cause of visceral leishmaniasis, and Leishmania tropica is the principal cause of cutaneous leishmaniasis. (See "Cutaneous leishmaniasis: Epidemiology and control" and "Visceral leishmaniasis: Epidemiology and control".)

Rickettsioses — Several rickettsial diseases are endemic in North Africa, including epidemic typhus (caused by Rickettsia prowazekii) [1,2], murine typhus (caused by Rickettsia typhi) [3], and Mediterranean spotted fever (caused by Rickettsia conorii) [4]. Murine typhus has also been reported from the Canary Islands [5].

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Literature review current through: Nov 2017. | This topic last updated: Oct 19, 2017.
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