.svg){kind=avatar}
Comoros
Risk:
Moderate
Health Overview
Comoros is Level 2 — ambulance services DO NOT EXIST. No permanent US presence (consular via Antananarivo Madagascar). P. falciparum malaria high risk all three islands. Mount Karthala active volcano (Grande Comore). CBD/cannabis illegal even with prescription. Coelacanths found in Comorian waters. Cyclone season Nov-April.
Key Health Risks
High
Healthcare Infrastructure
Ambulance services DO NOT EXIST (explicit State Dept). Healthcare limited to Moroni; very limited rural/outer islands. Cash payment before treatment. US Embassy Madagascar cannot provide on-ground help. Any serious condition = medevac.
Moderate
Political Unrest
Protests spontaneous in Moroni; have turned violent. Elections trigger unrest historically. US gov't personnel require prior approval for ALL travel to Comoros.
High
Malaria
P. falciparum all three islands; CQ-resistant. Year-round. No ambulance means febrile emergencies require self-transport. Carry RDT and standby Coartem.
Health Risk Callout
Ambulance services don't exist — that's the defining clinical reality. In a malaria emergency; in cardiac arrest: 'arrange your own transport.' Medevac insurance; malaria RDT; standby Coartem; inter-island evacuation plan all non-negotiable.
Other Health Risks
Cholera (periodic); Schistosomiasis (freshwater); Mount Karthala active volcano (2005/2007); Cyclone season Nov-Apr; inter-island boat safety (capsizings/fatalities); piracy (small craft); non-traditional healer deaths documented; CBD/cannabis illegal (even prescriptions) | 2026 UPDATE: Chikungunya: Comoros reported 4 confirmed chikungunya cases Jan 1-May 31 2025 amid a broader 2025 Indian Ocean outbreak (La Reunion, Mauritius 1,543 local cases, Kenya-Mombasa). Comoros case count is low, but the mosquito-borne risk is now regionally active and is not currently reflected in the stored dossier's mosquito-risk fields. (https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON581, 2025 (Jan-May reporting window))
Regional Information
Regional Risk Callout
Grande Comore (Moroni; most healthcare; protest frequency). Anjouan (separatist tensions history; more limited care). Mohéli (smallest; most remote; least infrastructure). Inter-island boats: poorly regulated; capsizings; fatalities documented.
Regional Healthcare Callout
Outside Moroni: extremely limited. Anjouan (Mutsamudu): basic only. Mohéli: minimal. No reliable regulated ferry system.
Vaccine and Malaria Prevention
💉 Entry Vaccine Required
No vaccines required for entry. Visa on arrival (30-500 EUR cash). CBD/cannabis/marijuana ILLEGAL even with prescription. Same-sex illegal (5 years). Photography of government/military illegal.
🛡️ Recommended Vaccines
Typhoid; Hep A; Hep B; Malaria prophylaxis (P. falciparum; CQ-resistant; all islands); routine (MMR; Tdap). YF NOT required and NOT recommended (Comoros not on WHO YF list). FAA has NOT assessed Comoros aviation.
🦟 Malaria Information
- Risk Level: High
- Areas: All three islands year-round (Grande Comore; Anjouan; Mohéli)
- Recommended Drug: Atovaquone-proguanil; Doxycycline; Mefloquine; Tafenoquine
- Drug Resistance: Yes
P. falciparum dominant; CQ-resistant. Year-round all islands. Ambulance services don't exist — febrile illness = potential emergency requiring self-arranged transport. Carry standby Coartem and malaria RDT.
Moderate
Physician Note
Dr. Robert
Emergency Medicine · 25+ Years · 40+ Countries
Comoros: 'ambulance services do not exist' is the defining reality. Level 2 sounds manageable; that sentence sounds like something else entirely. Malaria prophylaxis; medevac plan that doesn't depend on emergency services; complete pharmaceutical self-sufficiency.
CBD prohibition catches travelers who don't read fine print. Coelacanths in Comorian waters — extraordinary marine environment for self-sufficient ecotravelers.
Pre-Departure Checklist
8+ Weeks
- Be sure to consult your Dr. prior to travel to discuss
- CDC recommends Malaria prophylaxis + standby Coartem + RDT
- Typhoid
- Hep A/B
- MMR/Tdap. All medications for entire trip. Medevac insurance. Do NOT carry CBD/cannabis.
2-4 Weeks
- STEP
- Embassy Antananarivo +261-20-23-480-00
- Political calendar research
- Mayotte/Réunion evacuation route.
Day Of
- Police 17
- Emergency 772-03-73
- No ambulance — know your transport plan.
Trip Type Guidance
Mission
- Some faith-based (Islamic aid) and NGO operations. Marine/ecotourism: coelacanth encounters
- Pristine reefs
- Sea turtles (experienced self-sufficient ecotravelers only).
Notes
Special Evacuation Notes
No US presence in Comoros — consular via Antananarivo Madagascar. Medevac from Moroni (HAH) to Mayotte (~30 min); Réunion (~1.5 hours); Nairobi (~2.5 hours). Ambulances DO NOT EXIST — self-arranged transport for all emergencies.
Safety Notes
Avoid demonstrations (violent history). No photography of govt/military. Same-sex illegal (5 years). CBD/cannabis illegal even with prescription. Inter-island boats: avoid overcrowded/no life jackets. No ambulance — know your own transport plan.
partner recommendation
Medical Evacuation & Assistance
A medical crisis far from home can cost $50,000+ to evacuate. Global Rescue — the partner we personally trust — provides worldwide evacuation and round-the-clock medical assistance.
Good For
Mission