Asmara has no malaria. Massawa and the Dahlak Islands do.
- Travel clinic CDC recommends medicine or vaccines for some areas · which ones
- No CDC travel notice for mosquito-borne disease
CDC says there is no malaria transmission in Asmara and recommends prevention medicine for every area of Eritrea below 7,200 feet (2,200 m), which takes in the Red Sea coast, the Dahlak Islands and the lowland towns. Yellow fever vaccine isn't required on a direct trip from the US.
Yes, mostly on the coast and in the lowlands. The CDC says there is no malaria transmission in Asmara, the capital, and recommends prevention medicine for all areas below 7,200 feet (2,200 m), which takes in the Red Sea port of Massawa and the Dahlak Islands. Yellow fever vaccine isn't required when you fly in from the US.
CDC draws the malaria line by altitude
The CDC's wording is "CDC recommends that travelers going to certain areas of Eritrea take prescription medicine to prevent malaria." The areas are "All areas <2,200 m (<7,200 ft) elevation," and CDC adds "No malaria transmission in Asmara (the capital)." Massawa and the Dahlak Islands sit at sea level, so they're inside the line, and so is any lowland town on a family visit. CDC also notes that people visiting friends and relatives are the travelers most often caught out, because they often skip prevention medicine.
What we suggest you do with this: if your trip stays in Asmara, CDC lists no malaria transmission there. If it reaches Massawa, the Dahlak Islands or anywhere below 7,200 feet (2,200 m), CDC recommends malaria medicine (atovaquone-proguanil, doxycycline, mefloquine or tafenoquine). Book a travel-medicine appointment 4–6 weeks before departure with your itinerary night by night, and ask about meningococcal vaccine, which CDC recommends for meningitis-belt areas of Eritrea in the dry season, roughly December to June. Our malaria-zone checklist covers everything around the prescription.
For yellow fever, CDC says "Vaccine is generally not recommended for travel to the regions of: Anseba, Debub (also known as South or Southern Region), Gash Barka, Ma'ekel (also known as Ma'akel or Central Region), or Semenawi K'eyih Bahri (also known as Northern Red Sea Region)," and "Vaccine is not recommended for travel to any areas not listed above, including the Dahlak Archipelago." Eritrea's entry rule is "Direct travel from United States: Vaccine is not required," while travelers 9 months and older arriving from countries with yellow fever risk need proof.
Day and night biters on the coast
Massawa had a dengue outbreak in 2010, a published review of national surveillance found, and CDC's Eritrea page lists dengue. Its mosquito, Aedes aegypti, bites by day with peaks after sunrise and in the late afternoon, so on the coast repellent goes on in the morning as well as at dusk. Malaria mosquitoes take over from dusk to dawn, so wear long sleeves after dark and sleep in a screened or air-conditioned room. CDC's page also lists leishmaniasis, spread by sand flies that bite from dusk to dawn, and African tick-bite fever. CDC says schistosomiasis is found in Eritrea, so avoid swimming in fresh, unchlorinated water. Asmara's highland air tends to keep biting insects scarce.
When to go
Asmara has no malaria transmission in any month. On the coast, roughly November to March tends to be the comfortable time to visit, and June to September is extremely hot. CDC's malaria advice for areas below 7,200 feet applies all year.
Where you're going
Asmara
CDC lists no malaria transmission in the capital, and CDC generally doesn't recommend yellow fever vaccine for Ma'ekel. A day trip down the escarpment can take you below 7,200 feet and into CDC's malaria area.
Massawa
A Red Sea port at sea level, inside CDC's malaria area, and the site of a dengue outbreak in 2010. Repellent goes on in the morning for dengue's day biter and again at dusk.
Dahlak Islands
Below 7,200 feet like the rest of the coast, so CDC's malaria advice applies. CDC says yellow fever vaccine is not recommended for the Dahlak Archipelago.
Connecting through Addis Ababa or adding Ethiopia? Our Ethiopia briefing covers the malaria and yellow fever rules there.
The Eritrea kit
- Picaridin 20% travel sprays for mornings and evenings on the coast. One 3.4 oz bottle lasts one person about a week.
- A light long-sleeved layer for evenings in Massawa and on the islands.
What travelers report
Paraphrased from a 2014 TripAdvisor forum thread and linked so you can read it in full. Where forum advice and the CDC differ, go with the CDC.
- Asmara and Massawa · 2014
A traveler planning a week in Asmara with day trips to Massawa and the Dahlak Islands asked whether malaria pills were needed. A reply said no pills were needed and that malaria had been reported only around Assab. CDC disagrees for the coast: it recommends malaria medicine for all areas below 2,200 m, which includes Massawa and the Dahlak Islands. TripAdvisor ↗
One more rule outlasts the trip. Any fever during or after your trip means a doctor visit, and you tell them you were in Eritrea and whether you went down to the coast or the lowlands. WHO reports that more than 15% of malaria parasites in Eritrea carry gene deletions that standard rapid tests miss, so mention that too.
Traveler questions
Is there malaria in Asmara?
No. The CDC's malaria listing for Eritrea says "No malaria transmission in Asmara (the capital)." A trip that stays in Asmara sits outside CDC's malaria area. If you go down to Massawa, the Dahlak Islands or any town below 7,200 feet (2,200 m), you're inside it.
Do I need malaria pills for Massawa and the Dahlak Islands?
CDC recommends malaria prevention medicine for "All areas <2,200 m (<7,200 ft) elevation" in Eritrea, and Massawa and the Dahlak Islands sit at sea level. CDC notes that people visiting friends and relatives are at higher risk because they often skip prevention medicine, so a family visit to a lowland town needs the same plan as a hotel stay. Which medicine fits you is a call for a travel clinic, made 4–6 weeks before departure. Our malaria-zone checklist covers the rest of the preparation.
Do I need a yellow fever vaccine for Eritrea?
Not on a direct trip from the US. CDC's entry listing says "Direct travel from United States: Vaccine is not required," and the vaccine is generally not recommended for Anseba, Debub, Gash Barka, Ma'ekel or Semenawi K'eyih Bahri and not recommended elsewhere, the Dahlak Archipelago included. Eritrea does require it for travelers 9 months and older arriving from countries with yellow fever risk, so give the clinic your full routing.
Sources
Health authorities, surveillance reports and news coverage of official bulletins used for this briefing, last checked October 2026. Traveler reports are linked where they appear. This page summarizes public-health guidance and is not medical advice.