World Country Guide

1
Some travellers from areas infected with yellow fever have been asked to provide vaccination certificates, but this is not an official policy.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not an official condition of entry to the Comoro Islands. However, outbreaks of cholera still occur periodically. Up-to-date advice should be sought before deciding whether precautions should include vaccination, as medical opinion is divided over its effectiveness; see the Health appendix.

3
Typhoid fevers are present.

4
Malaria risk exists all year throughout the whole country, predominantly in the malignant falciparum form. 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 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
Hepatitis A and E are widespread. Hepatitis B is hyperendemic. Both cutaneous and visceral leishmaniasis may be found. Outbreaks of yellow fever occur periodically.

Health care
There is no reciprocal health agreement with the UK. In order to secure even basic medical care, visitors are strongly advised to take out comprehensive health insurance.