Malaria gets most of the attention, but the illness that actually catches out many safari visitors is tick bite fever, and the most common problems on a self-drive holiday are ordinary ones: heat, sun and an upset stomach. This guide covers ticks in detail, then snakes, scorpions, bilharzia, rabies, drinking water and medical help in and around the park. For malaria, read our malaria page and malaria myths vs facts.
Medical disclaimer: this article is general travel information, not medical advice. Speak to a travel clinic or your doctor before your trip, and see a doctor if you feel unwell during or after it.
What Is Tick Bite Fever?
"Tick bite fever" in South Africa covers two related bacterial infections, both spread by ticks:
| African tick bite fever | Mediterranean spotted fever | |
|---|---|---|
| Cause | Rickettsia africae | Rickettsia conorii |
| Typical tick | Cattle and game ticks (Amblyomma, the bont tick) | Dog ticks |
| Typical setting | Rural areas, game reserves, farms | Around homes and towns, often linked to dogs |
| Typical course | Usually mild | Ranges from mild to severe, rarely fatal |
For a Kruger visitor, African tick bite fever is the one that matters. South Africa's National Institute for Communicable Diseases (NICD) links it to cattle and game ticks in rural areas, and the US CDC lists safari travellers, park visitors and hunters as higher-risk groups. Cases often come in clusters, because a whole group walks through the same grass.
Mediterranean spotted fever is the more serious of the two, especially in older people, but it is mainly linked to dog ticks around homes, so it matters more if you stay on farms or with dog owners.
There is no vaccine for either, and taking antibiotics "just in case" to prevent tick bite fever is not recommended by the CDC or the NHS travel health service.
Symptoms: What to Watch For
Symptoms usually start about 5 to 7 days after the bite. The CDC gives a range of 5 to 10 days for most rickettsial infections, so you may fall ill during your trip or in the first week or two after you get home.
Typical signs:
- Fever, headache, tiredness and muscle aches, often feeling like flu
- An eschar: a small black scab with a red, inflamed rim where the infected tick fed. It is often painless, and with African tick bite fever there can be more than one
- Tender, swollen lymph nodes near the bite, for example in the groin if you were bitten on the leg
- A rash in some people. With African tick bite fever it is often sparse or missing; with the dog-tick form it is more typical and can involve the palms and soles
Eschars hide under the hairline, behind the ears, in the groin or along the waistband, and many people never notice the tick: the tiny larval "pepper ticks" are barely bigger than a full stop.
When to See a Doctor
See a doctor if you develop fever, a bad headache, or a dark scab with swollen glands within about two weeks of your visit. Tell the doctor you were in Kruger and whether you went on a walk or spent time in long grass.
- Fever after Kruger means a malaria test first. Early tick bite fever can look very like early malaria, which can be fatal and must be ruled out quickly. The CDC advises seeking care for any fever during travel and for up to a year after visiting a malaria area.
- Tick bite fever is treatable. Doctors usually prescribe a tetracycline-group antibiotic, most often doxycycline, and the CDC notes treatment should start as soon as the disease is suspected, without waiting for test results.
Do not self-medicate. If one person in your group is diagnosed, others from the same walk who develop symptoms should get checked too.
Which Activities Carry the Most Risk
On a self-drive safari you spend most of the day in your car, so the tick risk is low. It rises whenever you are on foot in vegetation:
- Guided bush walks and wilderness trails, especially through long grass. Our bush walks guide explains the options.
- Camping, walking to ablution blocks across grass, and sitting on the ground
- Stays on farms or private reserves around Kruger, especially where cattle or dogs are present
- Summer, when the grass is long and green after the rains
How to Prevent Tick Bites
Prevention is simple and works well:
- Repellent on skin. Use a product with DEET (the CDC suggests 20% or more) or picaridin on exposed skin, especially ankles and lower legs.
- Permethrin on clothes. The CDC recommends treating clothing and gear with products containing 0.5% permethrin. Treated clothing keeps working through several washes. Permethrin goes on fabric, never on skin.
- Cover up for walks. Wear long trousers tucked into socks and closed shoes. Light colours make crawling ticks easier to see.
- Check yourself after every walk. Do a full body check in the evening, including under the arms, behind the knees, in the hair and around the waistband. Check children too.
- Shower after a walk and look again.
Our packing list covers repellent and clothing for each season.
How to Remove a Tick
If you find a tick, remove it straight away. The CDC's method:
- Grasp the tick as close to the skin as possible with clean, fine-tipped tweezers.
- Pull upward with steady, even pressure. Do not twist or jerk.
- If the mouthparts stay in the skin, leave them if they do not come out easily. The skin usually pushes them out.
- Clean the bite and your hands with soap and water, alcohol or hand sanitiser.
- Do not crush the tick with your fingers.
Do not use petroleum jelly, nail polish or heat. Note the date and watch the spot over the next few weeks.
Heat, Sun and Dehydration
For most visitors, heat is a bigger day-to-day risk than any disease. Summer highs are typically in the low 30s °C, and Skukuza has recorded hot spells above 40°C in every month from September to April.
- Carry more drinking water in the car than you think you need.
- Drive early and late, and rest in camp at midday.
- Wear a hat and sunscreen: the sun burns through an open window.
- Watch children and older travellers. Headache, dizziness, nausea and heavy sweating are signs of heat exhaustion: get into shade, cool down and drink.
Our month-by-month weather guide shows what to expect when.
Snakes and Scorpions
Kruger has many snake species, including dangerously venomous ones such as the black mamba, Mozambique spitting cobra and puff adder. Visitors rarely see snakes, though. Take extra care when you are on foot in camps after dark and at picnic sites.
- Wear closed shoes and use a torch in camp at night.
- Do not put your hands into holes, woodpiles or under rocks.
- If you see a snake, back away and tell camp staff.
If someone is bitten: keep them calm and still, remove rings and watches, and get them to medical help as fast as possible. Do not cut the bite, suck out venom, apply ice or use a tourniquet. If it is safe, take a photo of the snake from a distance. Pressure bandages are only advised for certain snakes, so do not delay transport to apply one.
Scorpions are common too. Most stings are painful rather than dangerous, but one thick-tailed species in the Kruger area, the Transvaal thicktail, can cause serious, potentially life-threatening illness, especially in children. Shake out shoes, and seek help after any sting with more than local pain.
Bilharzia: Never Swim in Rivers or Dams
Bilharzia (schistosomiasis) is a parasite carried by freshwater snails. According to the WHO, the larvae get into your body through the skin when you are in contaminated water, so you do not need to drink it. Limpopo and Mpumalanga are among the provinces where it occurs.
In Kruger, crocodiles and hippos are even better reasons to stay out. Never swim or wade in rivers, dams or pools. Chlorinated camp swimming pools are fine.
Rabies: Do Not Touch or Feed Animals
Rabies occurs in South Africa, mainly in dogs but also in some wild animals. In Kruger, the animals you will get closest to are vervet monkeys and baboons in camps and picnic sites. Feeding them is against park rules and makes them aggressive.
- Never feed or touch any animal, and keep food out of sight.
- If you are bitten or scratched by any mammal, wash the wound thoroughly with soap and running water for several minutes and see a doctor the same day. Rabies treatment after exposure is very effective if started promptly.
Drinking Water and Food
Kruger's rest camps treat their own water, often from boreholes, and it is generally regarded as safe to drink. Ask at reception if you are unsure, and anyone with a sensitive stomach can buy bottled water in the camp shops. If you book a sleepover hide, bring your own drinking water.
Outside the park, water quality varies by town, so ask your accommodation.
On a self-catering trip, keep meat cold, braai it thoroughly, wash your hands and do not leave food standing in the heat.
Medical Help In and Around Kruger
- Skukuza: a private doctor's practice operates in Skukuza, the main camp. Check current hours and contact details on the SANParks website or at camp reception before you need them.
- Mbombela (Nelspruit): the main hospital centre for the southern park, including Mediclinic Nelspruit. Allow roughly an hour's drive from the nearest southern gates, and more from inside the park.
- Hoedspruit: Hoedspruit Private Hospital, opened in early 2025, offers 24-hour emergency care and is the nearest private hospital for the Orpen area and central-west.
- Phalaborwa: has medical facilities, but services change, so confirm before you rely on them.
In an emergency, tell camp reception or any SANParks staff immediately. South Africa's ambulance number is 10177, and 112 works from mobile phones. Cell reception is patchy away from camps and main roads, so save numbers from your booking confirmation before you set off. The Kruger Companion app keeps camp and emergency information available offline.
Travel insurance with medical evacuation is essential. Private care in South Africa is good but expensive, and serious cases may need air transfer.
Vaccinations
Check vaccine advice at least 8 weeks before travel with a travel clinic or an official site such as the CDC or NHS fitfortravel. For South Africa, they generally advise:
- Routine vaccines up to date, including tetanus, diphtheria and measles
- Hepatitis A for most travellers
- Hepatitis B: the CDC recommends it for unvaccinated travellers under 60, the NHS lists it as one to consider
- Typhoid for some travellers, for example on longer stays or in rural areas
- Rabies to consider, depending on activities and how far you will be from medical care
Yellow fever: there is no yellow fever risk in South Africa, but you need a vaccination certificate if you arrive from, or have transited for more than 12 hours through, a country with yellow fever risk.
Frequently Asked Questions
Is tick bite fever common in Kruger? It is one of the more common infections in visitors returning from southern African safaris, mostly after walks or time in long grass. If you stay in the car, the risk is low.
Can tick bite fever be dangerous? African tick bite fever, the type linked to game reserves, is usually mild and responds well to treatment. The dog-tick form (Mediterranean spotted fever) can be severe, especially in older people. Either way, see a doctor if you develop fever or a dark scab after your trip.
Should I take antibiotics to prevent tick bite fever? No. Preventive antibiotics are not recommended. Use repellent, wear treated clothing on walks and check for ticks instead.
Is there a doctor in Kruger? Yes, there is a private doctor's practice in Skukuza. Larger hospitals are in Mbombela, Hoedspruit and other towns outside the park, so travel insurance with evacuation cover is essential.