All of Palawan is a CDC malaria area. El Nido's niknik are the daily itch.
- Travel clinic CDC recommends medicine or vaccines for some areas · which ones
- No CDC travel notice for mosquito-borne disease
The CDC recommends malaria prevention medicine for the Province of Palawan, which takes in El Nido, Coron, Port Barton and the Underground River. Dengue concentrates in Puerto Princesa, and the tiny beach biters called niknik are what visitors complain about most.
Yes. Palawan and the Mindanao Island group are the two areas of the Philippines where the CDC recommends malaria prevention medicine, and the listing covers the whole province, El Nido, Coron, Port Barton and the Underground River included. Day to day, the bites visitors notice most come from niknik on the beaches and from the day-flying dengue mosquito in the towns.
Malaria: the whole province is listed
The CDC's Philippines page names the malaria areas as "Province of Palawan and the Mindanao Island group" and reports "No malaria transmission in metropolitan Manila (the capital) or other urban areas."
The CDC's recommendation. "CDC recommends that travelers going to certain areas of the Philippines take prescription medicine to prevent malaria," and for these areas it lists "Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine." Book a travel-medicine appointment 4–6 weeks before departure and bring the plan town by town, with the nights in each. The CDC doesn't say whether Puerto Princesa's city center counts among the "other urban areas" it exempts, so if you'll sleep there, ask the clinician whether that changes anything.
Malaria mosquitoes bite from dusk to dawn, so repellent at sunset, long sleeves after dark and a screened or air-conditioned room or a bed net matter whatever the clinic decides. Yellow fever vaccine is not recommended, and the Philippines checks proof only from travelers arriving from countries with yellow fever risk.
Dengue centers on Puerto Princesa
Palawan recorded 746 dengue cases in the first nine weeks of 2026, 48% fewer than the 1,425 in the same weeks of 2025, and Puerto Princesa accounted for 221, nearly a third, Palawan Daily News reported in March, citing the provincial epidemiology and surveillance unit. Nationally, the Department of Health counted 117,952 cases from January to August 2026, against 201,533 a year earlier.
The dengue mosquito bites in daylight in El Nido, Coron and Puerto Princesa, so repellent goes on over sunscreen in the morning and again after every swim stop. The CDC also says there is elevated chikungunya risk in the Philippines, carried by the same mosquito. Our dengue & Zika routine has the schedule.
Niknik, lakes and mangroves
Niknik, the local name for tiny biting sand flies or midges, are the signature Palawan nuisance. El Nido's beaches, Lio and Nacpan among them, have the strongest reputation, and the bites can itch for weeks. Reviewers describe them as worst in the morning and in shade and vegetation near the sand, easing in the midday heat. Sabang and Port Barton have a reputation for sand flies too. Treat ankles and calves before you sit down, use a lounger or mat, and leave the bites alone. Our Barbados sandfly guide explains how these biters work.
In Coron the mosquitoes are mostly on land. The forested steps up to Kayangan Lake and the mangrove stops on island tours have a reputation for mosquitoes, especially after rain, so spray your legs before the climb or a mangrove paddle.
When to go
The drier months, roughly December to May, are the main island-hopping season for El Nido and Coron, and June to November is the wetter typhoon season. The dry months aren't dengue-free, as Palawan's early-2026 count shows, and the CDC's malaria listing names no season.
Where you're going
El Nido island-hopping tours
Lagoons, beaches and snorkel stops by boat, by day, inside the CDC's Palawan malaria listing. Niknik turn up on some beaches and around island resorts, so reapply repellent after each swim stop.
Coron town & the Coron Island lakes
Coron town sits on Busuanga and the lakes on Coron Island. The forested climb to Kayangan Lake has a reputation for mosquitoes, especially after rain, so spray your legs before the steps.
Puerto Princesa & the Underground River
Puerto Princesa had nearly a third of Palawan's dengue cases in early 2026, so the daytime routine matters most here. Sabang and the Underground River are rural and inside the CDC's malaria listing.
Port Barton & San Vicente
Quieter rural beaches between Puerto Princesa and El Nido, inside the CDC's Palawan listing. Port Barton has a reputation for sand flies, so treat ankles before you sit on the sand at dawn or dusk.
Combining Palawan with Manila, Boracay or Cebu? The Philippines briefing covers the other islands.
The Palawan kit
- Picaridin 20% travel sprays: odorless in the heat, layers over sunscreen and deters niknik as well as mosquitoes. One 3.4 oz bottle covers about a week of daily use for one person.
- Permethrin 0.5% for evening clothes: treat a long-sleeved shirt and light trousers at home 48 hours before you fly. Treated fabric repels and kills mosquitoes on contact through several washes. Fabric only, never skin.
- Anti-itch cream and a light bed net for niknik bites and unscreened rooms.
What travelers report
Paraphrased from TripAdvisor reviews and forum threads and linked so you can read them in full. None is dated, and niknik in particular vary from beach to beach, day to day and season to season.
- Pangulasian Island resort, El Nido
A reviewer said sand flies ruined their El Nido stay and reported that many guests, including two in their group, ended up hospitalized with severe infections from the bites. This is an outlier, but a reminder not to scratch bites. TripAdvisor ↗
- Lio Beach, El Nido · a seasonal peak (month not shown)
A reviewer called Lio Beach beautiful but full of sand fleas at that time of year. TripAdvisor ↗
- Kayangan Lake, Coron · after rain
A reviewer called mosquitoes a major problem on the way to the lake, worse after rain, and advised bringing repellent. TripAdvisor ↗
- Coron island-hopping tour
A reviewer of an island-hopping trip warned of lots of sandflies on the beaches and advised bringing plenty of insect repellent. TripAdvisor ↗
- El Nido town beach
A reviewer liked the beach but warned visitors about niknik. TripAdvisor ↗
- Lio Beach, El Nido · varies by season
In a thread asking how bad Lio Beach's sandflies are, replies said it varies by day and season and that some visitors had no trouble at all. TripAdvisor ↗
One more rule outlasts the trip. Any fever during or after your trip means a doctor visit, and you tell them you were on Palawan. Dengue usually shows up within two weeks; malaria can take longer.
Traveler questions
Do I need malaria pills for El Nido or Coron?
The CDC recommends malaria prevention medicine for the "Province of Palawan and the Mindanao Island group," and it names the whole province, so El Nido, Coron, Port Barton and the Underground River are all inside. It lists atovaquone-proguanil, doxycycline, mefloquine and tafenoquine. Which one, if any, fits your health and route is a call for a travel clinic, made 4–6 weeks before departure. Our malaria-zone checklist covers the rest.
Is Puerto Princesa a malaria area?
The countryside around Puerto Princesa, including Sabang and the Underground River, is inside the CDC's Palawan listing. The CDC also reports "No malaria transmission in metropolitan Manila (the capital) or other urban areas," but it doesn't say whether Puerto Princesa's city center counts as one of those urban areas. If you'll sleep in the city, ask a travel clinic whether that changes the advice for your trip.
What are niknik, and how do I avoid them?
Niknik is the local name for the tiny biting sand flies, or midges, on Palawan's beaches. El Nido's beaches have the strongest reputation for them, and the bites can itch for weeks. Treat ankles and calves before you sit on the sand, use a lounger or mat instead of a towel, and spend beach time in the breezier middle of the day. Leave the bites alone, and see a doctor if one turns red, hot or swollen.
When is the best time to visit El Nido and Coron for fewer bites?
Roughly December to May, the drier months and the main island-hopping season. June to November is wetter, and Coron's trails tend to bite more after rain. El Nido's niknik are seasonal by reviewers' accounts, without a clear month pattern. Dengue turns up in the dry months too, and the CDC's malaria listing applies year-round.
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.
- CDC destination page for travelers
- palawandailynews.com
- palawandailynews.com
- Government source (pia.gov.ph)
- Government source (alpha.pna.gov.ph)
- European Centre for Disease Prevention and Control
- World Health Organization
- sunstar.com.ph
- insights-philippines.de
- sunstar.com.ph
- tribune.net.ph
- sunstar.com.ph
- newsinfo.inquirer.net
- mb.com.ph
- newsinfo.inquirer.net
- newsinfo.inquirer.net
- outbreaknewstoday.substack.com
- CDC Travel Health Notice