Malawi: General Health Risks
African Tick-Bite Fever
Risk of African Tick-Bite Fever is present throughout Malawi.
African Tick-Bite Fever (ATBF) is a tick-borne spotted fever, a bacterial infection carried by ticks infected with Rickettsia africae bacteria. It is a zoonosis – an animal infection that can spread to humans – transmitted by Amblyomma ticks that feed on livestock and wild animals. These ticks typically live in tall grass, vegetation, and brush of rural areas. Rickettsial infections are not transmitted from person to person.
>> See related travel health advice on Tick-borne Spotted Fevers.
Risk is present in sub-Saharan Africa and the eastern Caribbean. Travellers involved in outdoor activities in forested areas are at risk, including camping, hiking, hunting, and safaris. Brushing against vegetation or walking in areas known to have infected ticks can also put a person at risk. In sub-Saharan Africa, ticks that carry ATBF are typically most active during warm and rainy seasons, from November to April.
Symptoms of African Tick-Bite Fever usually appear within 2 weeks and include fever, headache, rash, muscle pain, and a red sore with a dark centre (known as an eschar) that develops at the site of the bite. ATBF can be treated with antibiotics. If you experience symptoms of ATBF, tell your doctor you were in an area with risk.
Travellers who participate in safaris, hiking, camping, or similar outdoor activities in rural regions of endemic areas should take measures to prevent tick bites. There is no preventive medication or vaccine against rickettsial infections.
- Use a repellent containing 20%-30% DEET or 20% Picaridin. Re-apply according to manufacturer's directions.
- Wear neutral-coloured (beige, light grey) and breathable garments, including long-sleeved shirts and pants. Tuck pants into socks.
- If available, apply a permethrin spray or solution to clothing and gear.
- When hiking in wooded areas, stay in the middle of the trail and avoid tall grasses and shrubs.
- Use a tarp when sitting on the ground.
- Carefully examine your body, clothing, gear, and pets for ticks before entering a dwelling.
- Promptly remove ticks using tweezers by grasping the tick's head and mouth parts as much as possible and by pulling perpendicular from the skin. See How to: Tick Edition for videos on removing ticks correctly.
- Thoroughly disinfect the bite site with soap and water or disinfectant. If travelling in an endemic area, save the tick in a zip-lock bag or container for up to 10 days (refrigerate live ticks; keep dead ticks in the freezer). Write down the date and location of your contact with the tick. Your healthcare practitioner may advise you to submit the tick for testing.
- If you develop symptoms of a tick-borne disease, contact your healthcare practitioner immediately.
- Apply sunscreen first followed by the repellent (preferably 20 minutes later.)
- For additional details, see IAMAT's insect bite prevention.
Information last updated: February 23, 2021.
Althaus, F., Greub, G., Raoult, D., & Genton, B. African tick-bite fever: a new entity in the differential diagnosis of multiple eschars in travelers. Description of five cases imported from South Africa to Switzerland. International Journal of Infectious Diseases, 2010. 14:3. e274-276 p. Centre for Disease Control – African Tick-Bite Fever Guerrant, R., Walker, D., & Weller, P. Tropical Infectious Diseases: Principles, Pathogens, & Practice: Volume 1. Philadelphia: Churchill Livingstone; 1999. 579-583 p. Wertheim, H. Horby, P., Woodall, J., eds. Atlas of Human Infectious Diseases. Oxford: Wiley-Blackwell; 2012. 93-95 p.