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 all travellers over one year of age. Travellers arriving from non-endemic zones should note that vaccination is strongly recommended for travel outside the urban areas, even if an outbreak of the disease has not been reported and they would normally not require a vaccination certificate to enter the country.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not a condition of entry to São Tomé e Príncipe. However, cholera is a risk in this country and precautions are essential. Up-to-date advice should be sought before deciding whether these precautions should include vaccination, as medical opinion is divided over its effectiveness; see the Health appendix for further information.

3
Vaccination against typhoid is advised.

4
Malaria risk, predominantly in the malignant falciparum form exists all year throughout the country. Chloroquine resistance has been reported.

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 which 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 and E are also present; hepatitis B is endemic. Meningococcal disease may 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, see the Health appendix.

The island has very basic medical facilities, with one hospital. It is important to carry a basic first aid kit. Health insurance is essential.