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Where We Went Next

The Ultimate Utah Mighty 5 Road Trip Itinerary

Utah is home to five incredible National Parks known as the Mighty 5.

Utah’s Mighty 5 spans across southern and central Utah, making for an epic road trip route over some of the world’s most unique and confounding landscapes.

It would be impossible to choose just one park to visit, as each one of the Mighty 5 National Parks boasts its own captivating terrain and iconic adventures.

A Utah Mighty 5 road trip can be done in as little as a week. Although, a longer trip would allow you to fully see and experience even more of the parks’ natural wonders and surrounding highlights.

In this guide, I suggest a Utah Mighty 5 road trip itinerary, outline must-see stops within each park, and cover things to know before hitting the road.

Table of Contents

Epic Utah Mighty 5 Road Trip Itinerary

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Utah’s Mighty 5

Utah’s Mighty 5 refers to some of the most sought-after National Parks in the U.S.:

• Zion National Park
• Bryce Canyon National Park
• Capitol Reef National Park
• Arches National Park
• Canyonlands National Park

In the same week, you can scale the chains of Angels Landing, weave through the hoodoos of Bryce Canyon, sunbathe along the bank of the Colorado River in Capitol Reef, watch the sunrise peek over an arch in Arches, and explore the needles of the Canyonlands.

After completing your Utah Mighty 5 road trip it’s likely you’ll need a vacation from your vacation. The road trip is equally exhausting as it is phenomenal.

While this itinerary allows you to experience the highlights of each park, you’ll be eager to return for more, time and time again.

Where to Start Your Utah Mighty 5 Road Trip Itinerary

There are three prime options for where to begin your Utah Mighty 5 road trip itinerary: Las Vegas, Salt Lake City, or Denver.

The Mighty 5 road trip can be completed as a loop or a one-way route, arriving and departing from different airports. Likewise, the itinerary can also be done in the order it’s presented or in reverse sequence.

Utah National Parks Road Trip Map

We began and ended our trip from the Las Vegas airport, adding several stops to nearby State Parks and National Monuments.

Las Vegas is a great starting point as it is notorious for having cheap flight deals and affordable car rental options. Not to mention, the city is conveniently located just over two hours from the first road trip stop: Zion National Park.

As I mentioned earlier, the road trip can easily be done from any of the suggested starting points. Each National Park stop is relatively close to the next, requiring minimal driving time between adventures.

Commonly Asked Questions

How long does it take to see the mighty 5.

The trip can be executed in just over one week. Here is a suggested Utah Mighty 5 road trip itinerary:

Day 1: Drive to Zion National Park

Day 2: Explore Zion National Park

Day 3: Drive to Bryce Canyon National Park + Explore the park

Day 4: Explore Bryce Canyon National Park + Drive to Capitol Reef National Park

Day 5: Explore Capitol Reef + Drive to Arches National Park

Day 6: Explore Arches National Park

Day 7: Explore Canyonlands National Park

Day 8: Drive to Las Vegas

While this itinerary spans eight days, your Utah Mighty 5 road trip itinerary could easily be squeezed into seven days if need be. Just as easily, your trip could be stretched over the course of three weeks.

If you’re planning a longer trip and interested in incorporating even more iconic southwest destinations, check out my guide, The Ultimate Arizona-Utah Road Trip . This itinerary includes Utah’s Mighty 5, as well as attractions such as Horseshoe Bend and Lake Powell , to name a few.

When Is the Best Time to Visit Utah’s Mighty 5?

As long as you are prepared and know what to expect there is a wrong time to visit Utah’s Mighty 5, in my opinion.

While most people try and avoid southern Utah during the summer, we took our three-week road trip during the month of July and had an absolute blast.

If you’re like us and don’t mind 100+ temperatures summer is a great time to experience Utah parks. We were grateful for the long hours of daylight and used the impending heat as motivation to get up for sunrise hikes.

The parks were busy but nothing we didn’t already expect. Truthfully, I think high temperatures deter many park-goers during the summer months.

Spring and Fall

Spring and Fall are both great times for visiting the Utah Mighty 5. Prices for lodging begin dropping and crowds start thinning as shoulder season nears.

The temperatures are also more moderate during the Spring and Fall, creating perfect conditions for all-day adventures.

I can’t imagine anything more beautiful than witnessing the vibrant red rocks of Utah dusted in snow. If you can’t swing a Utah Mighty 5 road trip during the peak months, the winter time would warrant just as magical of an experience.

However, keep in mind there will be some road and trail closures during the winter.

Things to Know Before Starting the Utah Mighty 5 Road Trip Itinerary

Park Entry Fees

Each one of Utah’s Mighty 5 parks requires an entry fee. Entry fees range from $20-$35 per vehicle, per park, for 7-day entry.

Before setting out on your road trip, I recommend purchasing an $80 America the Beautiful Pass which allows annual access to all National Parks.

Annual passes can also be purchased directly from the park entrance booth upon arrival.

Permits and Timed Entry

Some parks like Arches National Park and hikes such as Angels Landing require some pre-planning. Make sure to plan ahead and obtain all necessary permits before arriving to ensure your trip itinerary runs smoothly.

Arches National Park Pilot Timed Entry System

In 2022, Arches National Park piloted a timed entry system that restricted the number of cars entering the park at one time. Reservations were required for all visitors planning a trip to the park during the dates of April 3, 2022 – October 3, 2022, from 6:00 a.m. to 5:00 p.m.

While information regarding the timed entry system for 2023 has not yet been released, it’s wise to periodically check the status of reservation requirements and plan accordingly for your trip.

You can learn more about the timed entry system  here .

Angels Landing Pilot Permit Program

With the appeal to conquer the infamous Angels Landing only getting more enticing each year, a permit system was implemented in 2022.

The permit system aims to control foot traffic, preserve the trail, and increase safety. You can apply in advance for the seasonal lottery or apply for the day-before lottery.

Learn more about the pilot permit process and apply here .

Backcountry Permits

If you’re planning to backpack at any of the stops along the Utah Mighty 5 road trip itinerary, make sure to acquire all necessary permits.

Permits purchased in advance are not required but are highly recommended. Depending on the area, some permits are extremely competitive, whereas others can be easily purchased the day of.

To be safe, plan ahead, purchase, and print your permit before setting out on your road trip. Permits must be carried with you at all times during your backpacking trip.

Stop #1: Zion National Park

Zion National Park is bursting with adventure — hiking, biking, canyoneering, climbing, you name it. While the park itself feels relatively small, you could spend days here and still not cover all there is to do.

For your one day in Zion, prioritize Angels Landing and the Narrows. While knocking out both quintessential attractions in one day is tough, it’s totally doable. Start your morning by hiking Angels Landing at sunrise, immediately followed by exploring the Narrows.

If you’re down to rent e-bikes, I suggest biking around the park to trails rather than taking the shuttle. It’s more fun and scenic and allows you to avoid shuttle lines.

For tips on knocking out both iconic hikes in Zion on the same day, check out my guide How to Hike Angels Landing and the Narrows in One Day .

Park Highlights

There are a plethora of incredible hikes in the park. Whether you’re looking for a family-friendly stroll, jaw-dropping views, or a unique adventure, Zion National Park has something for you.

Below are some of my favorite adventures in Zion:

• Angels Landing Trail
• The Narrows Trail
• Canyon Overlook Trail
• Emerald Pools Trail

Backpacking

We had just enough time to do one overnight trip while in Zion. We backpacked Kolob Arch via La Verkin Creek Trail and it was my favorite thing we did during our visit. If you have the time to explore an off-the-beaten path in Zion and away from the crowds, do it.

• Kolob Arch via La Verkin Creek Trail
• West Rim Loop Trail
• The Narrows Trail (Top Down)

Activities (Other Than Hiking)

While Zion is most known for its hiking trails, there are so many other incredible ways to enjoy the area. If you’re interested in exploring Zion but not keen on hiking, make sure to check out my guide Epic Things to Do in Zion National Park That Aren’t Hiking .

• Rock Climbing
• Canyoneering
• Mountain Biking
• Scenic Drive

Zion National Park is extremely busy. Maximize your time in the park and minimize your crowd interaction by starting your adventures in the park early.

Keep in mind that personal vehicles are not allowed on Zion Scenic Canyon Drive from March to November. All visitors will have to use the free shuttle to enter the park.

Be warned that shuttle lines within the park are notorious for long wait times. Plan accordingly and consider exploring the park via e-bike.

Stop #2: Bryce Canyon National Park

Of Utah’s Mighty 5, Bryce Canyon National Park exceeded our expectations the most. There is something undeniably spellbinding about the vibrant orange hoodoos of Bryce Canyon.

During your one day in the park, I recommend hiking both the Fairyland Loop Trail and the Navajo Loop and Queen’s Garden Trail .

Start your morning early with a sunrise hike on Fairyland Loop Trail, followed by nearby hike Navajo Loop and Queen’s Garden Trail. After you finish up your hikes, find a great picnic spot along the Rim Trail and soak in the views.

To finish your day, take a scenic drive at sunset through the park stopping at any overlooks that pique your interest.

• Navajo Loop Trail
• Queen’s Garden Trail
• Fairyland Loop Trail
• Peek-a-Boo Loop Trail
• Wall Street Trail
• Under-the-Rim Trail

While we couldn’t fit a backpacking trip in during our first trip to Bryce Canyon, you can bet we will be returning to backpack the Under-the-Rim Trail.

• Ranger Programs

While one day is enough to appreciate the beauty of the park, I highly consider spending two days in Bryce Canyon National Park if your schedule can swing it.

On the last note, don’t make the too-often mistake of choosing between Zion and Bryce Canyon. The two parks are incredibly unique and different in their landscapes and activities, and both are worth a visit.

Stop #3: Capitol Reef National Park

In comparison to the rest of Utah’s Might 5, I had heard the least about Capitol Reef National Park prior to our road trip. Truth be told, we almost skipped it.

In retrospect, I’m so grateful we didn’t as Capitol Reef boasts all of the beauty of the surrounding parks with a fraction of the crowds.

For your one day in Capitol Reef, check out the lesser-known Sulphur Creek Trail . We surprisingly enjoyed this hike even more than the Narrows. This trail is packed with adventure, canyon views, waterfalls, wading sections, and most likely very few other hikers.

After your hike, check out the petroglyphs before making the drive to end your day at Cassidy Arch.

• Sulphur Creek Trail
• Hickman Bridge Trail
• Grand Wash Trail
• Cassidy Arch Trail

One of my biggest regrets for our time in Capitol Reef is that we didn’t do more research prior to arriving. We had no idea about the opportunities available to backpack throughout the park.

• Pleasant Creek Trail
• Spring Canyon Trail
• Lower Muley Twist Canyon Trail
• Upper Muley Twist Canyon Trail
• Burro, Cottonwood, and Sheets Gulch Trail
• Halls Creek Narrows Trail

Capitol Reef, we will be back, backpacks in tow.

• Goosenecks Overlook
• Petroglyph Trail
• Fruit Orchard
• Temple of the Moon

While Capitol Reef isn’t as popular as the other parks in this Utah Mighty 5 road trip itinerary, that’s half of the allure. Fewer people, more off-the-beaten-path adventures.

Stop #4: Arches National Park

Arches National Park completely lived up to the hype. While we came for the iconic Delicate Arch, we fell in love with the park because of its lesser-known trails.

To maximize your one day in the park, I recommend checking out Delicate Arch for sunrise , then making the difficult choice between Tower Arch Trail and Devils Garden Trail for your mid-day adventure.

Choosing between the two trails is tough. It’s hard to say which hike was our favorite. Decide for yourself with the help of my guides: Tower Arch Trail: The Best Hike in Arches National Park and Devils Garden Trail: Epic Hike in Arches National Park .

After your hikes, pull over for a picnic lunch at either Park Avenue Viewpoint or the Windows. End your day, by driving into nearby Moab for a beer at Moab Brewery.

• Delicate Arch Trail
• Tower Arch Trail
• Devils Garden Trail
• Partition Arch Trail + Navajo Arch
• Windows Loop and Turret Arch Trail

Unfortunately, we didn’t realize you could backcountry camp off of Devils Garden Trail or we totally would have jumped on the opportunity to backpack and explore more of the incredible area.

• Courthouse Wash Trail
• SUP or Rafting

Arches National Park has exploded with tourism over the last couple of years so be prepared for crowded trails and parking lots.

While it’s tempting to get frustrated with crowds, keep in mind that public lands are for everyone and everyone equally deserves to enjoy them.

Stop #5: Canyonlands National Park

Canyonlands National Park is the last stop on this Utah Mighty 5 road trip itinerary and another park that completely surpassed our expectations.

It’s important to note that Canyonlands is divided into four districts by rivers: (1) Island in the Sky, (2) The Needles, (3) The Maze, and (4) the rivers themselves.

The Island in the Sky district is the most popular and accessible of the four districts. However, if you’re up for the drive, The Needles district is the most spectacular, in my opinion.

Spend your one day in the Canyonlands by either exploring the Island in the Sky district or hiking in the Needles District. If you have two days you could spend one day in both.

For a day in Island in the Sky, start your day by visiting Mesa Arch for sunrise. Following this short hike, head to the Gooseberry Trail. It’s a longer trail, steep, and packed with views. Spend the rest of the afternoon driving to various lookouts and soaking in the views. End your day by watching the sunset at Grand Viewpoint.

For one day in Needles District, I suggest connecting the three best hikes in the park: Elephant Hill, Chesler Park, and Druid Arch Trail. These three trails can be looped into one epic adventure, easily making it the Best Hike in the Needles District .

• Mesa Arch Trial (Island in the Sky)
• Gooseberry Trail (Island in the Sky)
• White Rim Overlook Trail (Island in the Sky)
• Druid Arch Trail (The Needles)
• Elephant Hill Trail (The Needles)
• Chesler Park Loop Trail (The Needles)
• Lower Red Lake Canyon (The Needles)
• Salt Creek Canyon (The Needles)

Activities (That Aren’t Hiking)

• Visitor Center Viewpoint
• Schafer Canyon Overlook
• Grand Viewpoint
• Green River Overlook

We visited both the Island in the Sky district and the Needles district during our time in Canyonlands National Park. While I do think that the Island in the Sky district is beautiful and worth seeing, it doesn’t compare to the Needless district in terms of raw adventure.

With that being said, keep in mind that the Needles district is located well out of the way and adds about 3 hours of driving time to your Utah Mighty 5 road trip itinerary.

And yes, it’s still worth it.

Stops to Add to Your Utah Mighty 5 Road Trip Itinerary

This one-week itinerary could easily be stretched into three weeks by including several detours to amazing nearby attractions. If you have a little extra time, I recommend extending your trip and adding some of these incredible stops to your itinerary:

Honaker Trail

Hiking the Honaker Trail was completely unplanned and yet one of our favorite trails we did during our Arizona-Utah road trip . The trail begins along the canyon rim and, through a series of switchbacks, leads hikers down into the floor of the canyon. The trail ends at the San Juan River where hikers can cool off in the water.

Lake Powell

Lake Powell truly has something for everyone, whether you wish to experience the lake’s grandeur from the water or from atop Wahweap Lookout. Visitors can choose to boat, jet ski, kayak, swim, or simply play along the shores.

Toadstool Hoodoos Trail

Toadstool Hoodoos Trail is extraordinary with its canyon views and gravity-defying geology. The trail is quick, easily accessible, and sure to be one of the most unique trails you explore in Southern Utah

Lower Calf Creek Falls Trail

Lower Calf Creek Falls Trail is a stunning 6-mile hike that allows hikers to experience the best of southern Utah all in one place. On the way to the falls, the trail winds hikers past towering canyon walls, through a valley of tall grass, and along the trout-filled calf creek.

Corona and Bowtie Arch Trail

Corona Arch and Bowtie Arch are two of Moab’s most spectacular natural wonders. This trail is a great option for hikers of all ages and experience levels. The arches are easily accessible and less crowded than other surrounding National Park hikes.

Castleton Tower Trail

Castleton Tower Trail in Moab is nothing short of iconic. It is one of, if not the most famous desert tower in the world. The trail is hot, steep, and scrambly. It is hands down the hike I recommend others do while visiting Moab.

Like it? Pin it!

If you have any further questions about this itinerary or things to know before hitting the road on your Utah Mighty 5 road trip, drop me a message in the comment section below.

Happy adventuring!

Complete Guide to Hiking Castleton Tower Trail

Wire Pass to Buckskin Gulch: Epic Slot Canyon Trail in Utah

Hiking Corona and Bowtie Arch Trail at Sunset

How to Spend Two Days in Bryce Canyon National Park

looking forward to our trip next April

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5-star Hotels: The Ultimate Accommodation Experience

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Hotel B: A Serene Escape

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Hotel C: The Epitome of Opulence

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5 Days in Istanbul Itinerary & The Best Travel Guide

Last updated on April 6th, 2024 at 12:32 pm

Istanbul is one of our favourite cities in the world and this is why we’ve put so much love into this 5 days in Istanbul Itinerary and Guide you’re about to read. If you’re planning to see Istanbul in 5 days, in this article, you’ll find everything you need to plan the perfect trip to this enchantress of a city.

Perhaps you’ve come across it in another post of ours and know it already. Or maybe this is the first time you hear about it. We love bridges. Not only in terms of architecture. We first and foremost love bridges for their superpower, which is their ability to connect. Places, people, cultures.

This is why we find Istanbul so fascinating. The entire city is a bridge that connects two continents, Europe and Asia. In fact, it connects two different worlds. The East and the West.

Throughout this 5 days in Istanbul itinerary, it is mostly this blend of cultures that you’ll be trying to explore. Ultimately, this is also what makes every traveller fall unconditionally in love with this unique and beyond-words charming global city.

Some of the links in this article are affiliate ones. This means that if you click through them to make a purchase, we may earn a small commission at no additional cost to you . Also, this article contains sponsored content. For more information, visit our Disclosure page .

Where Is Istanbul

Built along both banks of the Bosphorus Strait in northwestern Turkey , Istanbul might not be the country’s capital, but it’s the largest city in Turkey. It’s also the largest city in the world to span two continents.

Throughout its long history, the city of Istanbul has always been a significant cultural, political and trade centre because of its strategic position. The oldest part of the city, today’s Sultanahmet area, sits on a peninsula where three seas meet. The Golden Horn Strait, the Sea of Marmara and the Bosphorus Strait.

What Makes Istanbul So Special To Us

Taking a trip to Istanbul can be a rather emotional experience for us Greeks. Constantinople – Istanbul’s former Greek name – was a city where a large Greek community flourished in the past. However, the vast majority of Istanbul’s Greek residents were uprooted and abruptly separated from their beloved hometown in the previous century.

Therefore, at every mention of Istanbul, a haunting aura of nostalgia makes Greeks turn their eyes towards the East and daydream of the City. For that’s what Greeks used to call Istanbul. The City, η Πόλη. Because, to their minds, it was the prettiest, the most important city of all. The one and only in their hearts.

According to one theory, that’s also where the city’s current name, Istanbul, comes from: Εις την Πόλιν (is tin Polin), which means towards the City. To learn more about the Greeks of Istanbul and how they used to live in harmony with their Turkish neighbours, A Touch of Spice is one of our all-time favourite films.

Travel Resources To Help You Plan The Best 5-Day Istanbul Itinerary

• Find the best deals for your flights to Istanbul here .
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The Ultimate 5 Days in Istanbul Itinerary

Day 1: istanbul basics.

Your 5-day Istanbul itinerary starts with an overview of the city’s two most legendary neighbourhoods. Beyoğlu is one of the most charming districts in Istanbul, formerly known as Pera, which is the Greek word for across. On the other hand, Eminönü is in essence the core of Istanbul Old City.

Taksim Square

There’s no better place to start your first of 5 days in Istanbul than this iconic square in Beyoğlu. Considered the heart of modern Istanbul and for good reason, Taksim Square is buzzing with life all day and night long. Home to several hotels and restaurants, the square is also a major transportation hub and a favourite meeting point for locals and visitors alike.

Istiklal Street

Next up is a stroll along the elegant Istiklal Avenue. Busy with thousands of people all day long, Istiklal is a pedestrianised street lined with magnificent buildings that house shops, restaurants, cafés, consulates and many more.

Along Istiklal Street, you can see the Galatasaray High School , Turkey’s oldest secondary school, as well as Çiçek Pasajı , a beautiful historic shopping arcade built in 1876. The highlight of the avenue, though, is the old-fashioned red tram that runs between Istiklal’s two ends. From Taksim Square in the north to the area around Galata Tower in the south and vice-versa.

If you have enough time, you can also make a small detour to visit the Pera Museum , which is set in a gorgeous building that housed the Bristol Hotel in the past.

While walking along Istiklal Street, it’s mandatory to grab some typically Turkish snacks – simit and açma – from the omnipresent food carts and street vendors along the avenue, as well as some divine baklava from Hafiz Mustafa .

When strolling along Istiklal Street, don’t hesitate to get lost in its maze of charming side streets until you stumble upon hidden spots, such as Nevizade Street with its quaint restaurants and pubs, one of the many spots where the heart of Istanbul nightlife beats.

Galata Tower

At the southern end of Istiklal Street, several downhill cobbled streets descend towards the Galata Tower area. No matter which one you choose, you’ll end up wandering around one quaint street after another. This area is full of souvenir and other shops where you can buy gifts for your loved ones back home. Soon you will be at the foot of the Galata Tower .

This 67-metre medieval stone tower was built by the Genoese who lived in Istanbul in 1348. Back in the day, it was the tallest building in Istanbul.

Nowadays, it’s home to cafés and restaurants. Most importantly, the tower features a viewing terrace with breathtaking panoramic views of the entire city. However, the best time to go up there is sunset. Therefore, refrain from going up the tower and save this for your last day in Istanbul.

One of the best ways to appreciate the grandeur of Galata Tower and take in the area’s authentic Istanbulite vibe is to sit at a traditional coffee shop under the shadow of the tower and drink your first of many glasses of exquisite Turkish tea, paired with a Turkish delight – or three.

Galata Bridge

After your tea pit stop, it’s time to continue your walk further downhill towards the sea, via a set of some of the steepest streets in the city that will eventually lead you to the famous Galata Bridge on the Golden Horn Strait.

The Galata Bridge was completed quite recently, in 1994. It has vehicle and pedestrian lanes as well as tram tracks. On its first floor, closest to sea level that is, local restaurants and pubs line the bridge. The bridge connects the Beyoğlu area to the Eminönü district.

Once you step on Galata Bridge, the magic that is Istanbul unfolds before your very eyes. Iconic landmarks such as the Hagia Sophia and Topkapi Palace stand majestically over the waters of the Golden Horn Strait. Ferries come and go constantly with seagulls following them all along their short or longer trips.

All this and a lot more compose the image of a city whose beauty no artist’s brush could have painted in more enchanting colours.

Spice Bazaar

Once you cross the bridge, you are in the district of Eminönü. The first stop on your short walk on this side of the city should be the Egyptian or Spice Bazaar (Mısır Çarşısı). The beautiful covered market has always been and still is the go-to place for spices. That said, due to its popularity with tourists, the Spice Market is now also home to various other types of shops, such as patisseries, jewellery stores etc.

Grand Bazaar

If you liked the Spice Bazaar, you will love the Grand Bazaar (Kapalıçarşı) , by far the most impressive of all Istanbul markets. Home to 61 streets and 4000 shops, the Grand Bazaar is where you’ll find the best souvenirs to bring back home. From a hand-painted water pipe to a colourful Turkish tea set to impressive ceramics, the Grand Bazaar has it all, plus several antique shops if you’re into vintage shopping.

That said, the Grand Bazaar doesn’t appeal to avid shoppers alone but to anyone who appreciates gorgeous architecture, authentic vibes and mingling with locals.

The Grand Bazaar is not just another market, but an iconic landmark in its own right. It’s a magnificent maze of covered streets, utterly picturesque cafés and mesmerising sounds and smells of the East. In other words, it is one of the top places to visit in Istanbul.

Visit the Grand Bazaar with a local and go shopping like a pro!

Hodjapasha Cultural Centre

The best way to spend your first evening in Istanbul is to attend a top-rated traditional Turkish performance. Housed in a beautiful 550-year-old hammam in a very central location, the Hodjapasha Cultural Centre offers two different shows, the Whirling Dervishes and the Rhythm Of The Dance.

More of a ritual than a show, the Whirling Dervishes experience is available every day at 7 AM. The 60-minute Whirling Dervishes performance at the Hodjapasha Cultural Centre follows the actual Sema ritual, which represents the spiritual journey of the soul towards God and back.

Although immensely interesting and impressive, this performance is in essence a spiritual ceremony. Therefore, don’t expect lively tunes and an entertaining ambience as not even applause is allowed during the Sema ritual.

Buy your tickets for the Whirling Dervishes show before they sell out.

On the other hand, if an hour of genuine entertainment is what you’re after, you should go for the Rhythm Of The Dance show. A group of amazing professional dancers present traditional dances from various parts of Turkey. The belly dance and Turkish drum (darbuka) solos stand out. Yet our personal favourite was the fascinating Tanoura dance.

Both the Whirling Dervishes and Rhythm Of The Dance shows tend to sell out fast. Therefore, make sure you book your tickets in advance.

Make a reservation for the Rhythm Of The Dance Show here.

Day 2: Essential Istanbul Sightseeing

Your second day on this Istanbul in 5 days itinerary includes the bulk of your sightseeing in Istanbul. Brace yourselves and start early because there’s a lot of magic ahead.

Hippodrome of Constantinople (Sultanahmet Square)

Sultanahmet Square is a great place to get your bearings and take a deep breath before delving into this remarkable city’s vast history.

Today’s Sultanahmet Square is where the Hippodrome of Constantinople used to be. This public area hosted horse races, chariot races, gladiatorial games, celebrations and official ceremonies throughout the centuries. A 16th-century Egyptian obelisk stands in the middle of the Hippodrome since the 4th century AD.

Hagia Sophia

Probably the most recognisable landmark in Istanbul is Hagia Sophia. Constructed in the Middle Ages, this sacred place hides the very soul of Istanbul within its walls and is the visual embodiment of the unique blend of cultures that is Istanbul.

Throughout its long history, Hagia Sophia has served as a major religious site for both Christians and Muslims. Originally built as an Orthodox Christian church, it then became a Catholic church before being turned into a mosque. All these changes are reflected on the church’s interior walls where writings from the Quran are hanging next to Virgin Mary icons.

In 1935, Hagia Sophia stopped being a religious site and opened as a museum. This way, the whole world would be able to step inside and marvel at the grandeur of this architectural and cultural masterpiece.

Sadly and quite unexpectedly though, the UNESCO-listed Hagia Sophia was reverted into a mosque in 2020. You can still visit Hagia Sophia as a tourist outside prayer times. However, we can’t tell for sure if the experience will be the same as it was when it was still a museum.

Make the most of your time in Hagia Sophia on a guided tour led by a local.

Blue Mosque

Right across the street from Hagia Sophia stands the Blue Mosque in all its glory. Its official name is Sultan Ahmed Mosque, after Ahmed I, the Sultan who commissioned its construction.

Built between 1609 and 1617, the Blue Mosque was probably the Sultan’s effort to create a monumental mosque that would surpass the splendour of Hagia Sophia. Successful or not, the Blue Mosque with its characteristic blue tiles did manage to become one of Istanbul’s icons and a staple of the city’s skyline.

Book this 1-hour tour of the Blue Mosque or splurge on this in-depth walking tour that explains the artistic value and religious symbolism of this iconic monument .

Basilica Cistern

Dating back to the 6th century, the underground Basilica Cistern is one of the most impressive places to visit in Istanbul in 5 days. Although not the only ancient cistern in Istanbul – the city numbers several hundred of them – it’s definitely the largest and most famous of all.

After descending a few steps, you’ll find yourselves in a forest of 336 columns, many of which bear the marks of their former use, as they were parts of ruined temples. Although for visitors’ safety the underground cistern is now limited to a very small amount of water, it’s still a very beautiful place to visit.

Get into the depths of the Basilica Cistern on a short but sweet tour guided by a local.

Topkapı Palace

The main residence of Ottoman Sultans from the 1400s to the 1800s, Topkapi Palace is one of the top Istanbul attractions. One of the world’s largest palaces that have been turned into museums, Topkapi Palace is home to gorgeous interior courtyards and elaborate halls and rooms. The most striking area, though, is the Harem where the Sultan’s several wives and family members lived.

Book your guided tour of the Topkapi Palace.

Alternatively, you can book a combined tour of Topkapi Palace and the nearby Istanbul Archaeological Museum.

Suleymaniye Mosque

Commissioned by Suleiman the Magnificent and designed by the famous architect Mimar Sinan , the Suleymaniye Mosque is an amazing construction in its own right. The second largest mosque in Istanbul, the Suleymaniye Mosque is also one of the city’s best viewpoints as it boasts a prime location on the Third Hill of Istanbul.

Unlike other mosques, the Suleymaniye Mosque has a very bright interior. Among the things you shouldn’t miss during your visit to this UNESCO World Heritage Site are the tombs of Suleiman the Magnificent and his wife Hurrem Sultan .

Learn the secrets of this imposing structure on a guided tour.

Although these Istanbul attractions are in close proximity to one another, visiting all of them on your own might be overwhelming. That’s because there is a ton of history associated with each place. Therefore, we’d recommend visiting some or all of these places on guided tours. Several tour companies mix and match two or more of these major attractions on the same tour. Here are some of the best combinations that can save you valuable time: Blue Mosque & Hagia Sophia Small-Group Tour Topkapi, Hagia Sophia and Basilica Cistern Tour Hagia Sophia, Suleymaniye & Blue Mosque Tour

Fener & Balat

In the afternoon, you can explore two of the city’s most authentic neighbourhoods for a chance to get a glimpse of how life goes by for the real Istanbulites.

Fener and Balat are among the oldest neighbourhoods in Istanbul. They used to be populated by the city’s Greek, Jewish and Armenian communities. It’s safe to say that this less popular part of Istanbul is where the city acquired its unparalleled multicultural character.

Apart from wandering around the colourful streets of Fener and Balat, trying to imagine a day in the lives of all those ethnic groups that used to live side by side for centuries on end, these districts are home to several historical landmarks, too. The Greek Mary Blachernae Chruch and the Greek Orthodox Patriarchate are only a few of them.

The nearby Chora Church used to be yet another important landmark until 2020 when the museum was turned back into a mosque, following Hagia Sophia’s fate. Unlike Hagia Sophia though, Chora Church remains closed to visitors until further notice.

For a better understanding of Fener and Balat and a thorough account of how these areas formed part of the rich history of Istanbul, you should consider visiting these neighbourhoods on a guided tour. We highly recommend this 3-hour Fener and Balat walking tour, which we joined ourselves a few years ago. We have nothing but praise for the knowledgeable guide who showed us around the charms of this part of Istanbul.

You can read about all the walking tours we joined in Istanbul here .

Day 3: Princes Islands & Kadıköy

On your third day on this 5 days in Istanbul itinerary, we recommend taking a break from the hustle and bustle of the city to head to the peacefulness of the Princes Islands, before getting to know one of the most authentic Istanbul neighbourhoods.

Princes Islands

A day at the sea is an excellent idea for a day trip from Istanbul. The Princes Islands are an archipelago of nine islands in the Sea of Marmara. Only four of them are inhabited and open to visitors: Kınalıada, Burgazada, Heybeliada and Büyükada .

No cars or motorbikes are allowed on any of the islands. Therefore, their quiet streets and clean air come in huge contrast to Istanbul’s buzzing roads and smoggy sky.

It goes without saying that there’s no point trying to fit all four islands in a single day trip. It’s best to choose one island and spend a relaxing day there, taking in the views and easy-going vibes. In our opinion, you should go for Buyukada, the largest and most interesting island among the four.

In Buyukada, you’ll feel as though time has stood still. With its wooden mansions and tranquil streets, the island is the perfect getaway for long peaceful strolls and genuine mingling with locals in a setting of bittersweet neglect.

You can buy round-trip ferry tickets to Buyukada here. If you want to learn more about the Princes Islands, click here to read more about the day trip we enjoyed there a few years back .

On your way back to Istanbul from the Princes Islands, get off the ferry at Kadiköy on the Asian side of the city. Although not on the radar of tourists, Kadiköy is one of the most fascinating neighbourhoods in Istanbul to enjoy a walk, a lively district where you can feel the local rhythm of life and taste delicious Turkish food.

Speaking of good food, you can finish your third of five days in Istanbul with a journey through the exceptional tastes and flavours of one of the world’s most delectable cuisines. For an unparalleled experience, splurge on a private food tour in Kadikoy , one of the best places in Istanbul to sample the city’s diverse and mouthwatering dishes.

Day 4: Romantic Istanbul

Apart from all its other charms, Istanbul is one of the most romantic cities you’ve ever seen. That’s mainly because it’s a city built on the sea. Therefore, it makes sense your romantic day in Istanbul involves a lot of ferry rides and seascapes.

The Golden Horn

Start your fourth of 5 days in Istanbul with a ferry ride along the Golden Horn, from the Karaköy Station in Beyoğlu to the final stop at Eyüp. For about 40 minutes, the ferry will be zigzagging from one shore to the other as you sip one Turkish tea after another on this romantic cruise of sorts.

Eyüp is one of the lesser-known parts of Istanbul. At least for tourists. A former Christianity stronghold, the area became an important site for Muslims after the fall of Constantinople in 1453. So much so that in 1581 Christians were no longer allowed to live there.

Nowadays, the Eyüp Sultan Mosque represents one of the Islamic world’s most sacred sites while the entire district attracts more conservative Muslim residents. The mosque and the adjacent mausoleum and tombs are little architectural masterpieces. Moreover, the cobbled streets around the mosque are full of people and souvenir shops.

Pierre Loti Hill

Pierre Loti Hill is one of the most romantic places to visit in Istanbul. The hill took its name from the French novelist and keen Istanbul lover Pierre Loti.

You can get to the top of the hill either by car or cable car. There is also the option of walking through the enormous Eyüp Cemetery . However, we would advise against doing so without the company of a local friend or professional tour guide. For visitors, the cable car is the best way to climb to the top of Pierre Loti Hill.

The only drawback of the cable car is that there are always rather long queues at the entrance. Sometimes, at the exit as well. The reason for this is that there are only two sets of two cabins, each of which has a maximum capacity of just eight people.

That said, once inside the cabin, it takes less than three minutes to get to the top or vice versa. The views from the cable car to the Golden Horn and the Eyüp Cemetery are breathtaking.

Once at the top, there is a nice café with spectacular views of the Golden Horn and the historical centre of Istanbul in the distance. Probably the best time to visit is sunset but this is when the hill gets more crowded, too. Therefore, try to be there earlier.

If you prefer, you can tour the Golden Horn, Eyup and Pierre Loti Hill in the company of a knowledgeable guide instead.

When you’re done taking in the views, head back to downtown Istanbul in the same way: jumping on the ferry. This time, though, take the ferry to Üsküdar, on the Asian side of Istanbul. While on board the ferry, get a glimpse of the beautiful Maiden’s Tower .

Although you’re only here to catch a ferry to Ortaköy, your next romantic stop, take a step back and look around, breathing in Üsküdar’s ambience. In a way that it’s not easy to put your finger on, Üsküdar feels different from the neighbourhoods of the European side. Also, the views of the shore across the Bosphorus Strait are amazing.

Ortaköy 

On board the ferry to Ortaköy, the view of the Bosphorus Bridge is breathtaking. The same goes for the dreamy silhouette of the Ortaköy Mosque itself, the most iconic landmark in the somewhat fancy neighbourhood of Ortaköy.

From an architectural point of view, the mosque is gorgeous. But what makes it truly unique is its position, right there at the waterfront.

Apart from the mosque, Ortaköy is also famous for being the best place in Istanbul to try kumpir, which is jacket potato the Turkish way. Kumpir is Istanbul street food at its best. You will be surprised at how many food stalls in Ortaköy serve just that. Don’t miss it!

With a full stomach and a happy heart, linger in this area until it’s dark to marvel at the illuminated Ortaköy Mosque as you enjoy a glass of wine at one of the many waterfront bars nearby. If that’s not the perfect way to end a romantic day in Istanbul, we don’t know what is.

Day 5: Istanbul Highlights

For your last day in Istanbul, we recommend a series of experiences that are quintessentially Istanbulite, truly enchanting moments that will make you vow to go back to this city of wonders before too long.

Turkish Bath Experience

One of the top things to do in Istanbul is to indulge in an original Turkish bath session. The city is dotted with hammams for all tastes. From luxury establishments housed in historic imperial baths to no-frills hammams that locals still frequent, Istanbul has a wide array of Turkish bath experiences to offer.

If it’s your first time in a Turkish bath though, we’d recommend opting for one of Istanbul’s top-rated hammams, such as Kilic Ali Pasa Hamami , a historic hammam that dates back to the 16th century, designed by no other than Mimar Sinan.

Kilic Ali Pasa Hamami was where we enjoyed our first-ever hammam. Since a Turkish bath is an utterly relaxing albeit very intimate experience, you’d want to choose an establishment with people who go out of their way to make you feel at home and relish those precious moments.

Book your Turkish Bath experience at Kilic Ali Pasa Hamami to enter a world of utter relaxation and rejuvenation.

If you’re feeling nervous about going to the hammam for the first time, we put together a guide to all the things you need to know before booking your first Turkish bath session.

Read our comprehensive guide on how to enjoy your Turkish bath experience here.

Bosphorus Cruise

No trip to Istanbul is complete without a chance to see the city from the water on a boat tour or cruise along the enchanting Bosphorus Strait. Rejuvenated from your Turkish bath experience, now’s the best time to enjoy this one-of-a-kind cruise.

Ranging from simple ferry rides to super luxurious boat trips, Bosphorus cruise options are endless. The public ferries of Şehir Hatları  offer both a full and a shorter Bosphorus tour departing from Eminönü. However, for a special experience, we’d recommend booking one of the Bosphorus cruises we handpicked for you:

• Istanbul: Sunset or Daytime Yacht Tour w/AudioGuide & Snacks
• Istanbul: Bosphorus Cruise with Stopover on the Asian Side

For an even more memorable experience, you can tweak this Istanbul itinerary a bit to enjoy one of the sunset or early evening Bosphorus cruises we recommend below:

• Istanbul: Bosphorus Dinner Cruise & Show with Private Table
• Istanbul: Sunset Yacht Cruise on Bosphorus

The Bosphorus Strait is the natural border between Europe and Asia. It’s also the only passage between the Mediterranean and the Black Sea. This is why it has always been extremely important for commercial and military reasons alike. For travellers, the Bosphorus Strait is one of the most spectacular ways to take in the beauty of Istanbul.

During a Bosphorus cruise, you can admire iconic landmarks such as the Dolmabahçe Palace, the Ortaköy Mosque and the Bosphorus Bridge. Further north, you have the chance to see the beautiful coloured houses in Arnavutköy as well as the stylish neighbourhood of Bebek .

One of the most impressive sights along the way is Rumelihisari , Istanbul’s imposing medieval fortress with its dreamy waterfront promenade.

After passing below the Fatih Sultan Mehmet Bridge , the ferry moves closer to the Asian shore of the Bosphorus Strait to start its southbound course.

The Asian side is lined with exquisite wooden mansions dating back to the 19th century. This type of residence, which is yet another symbol of Istanbul, is called a yalı . There are yalı on both shores of the Bosphorus Strait but the Asian side features the prettiest among them.

Places To Visit Along The Bosphorus Strait If You Have More Time

• Dolmabahce Palace: An impressive building with a great history, it is the largest palace in Turkey, boasting a spectacular location right on the Bosphorus waterfront. Inside the palace, you can visit many lavishly decorated rooms. Among them, is the very room where Kemal Atatürk died in 1938. Get fast-track entry tickets to Dolmabahçe Palace here.

• Beylerbeyi Palace: Built in the 1860s as a summer residence for the sultan and his family, Beylerbeyi Palace is a fine example of Ottoman Empire architecture and decoration. Small in size and with beautiful gardens overlooking the sea, it is well worth a visit.

Sunset at The Galata Tower

Finish your 5 days in Istanbul itinerary right where you started it, in Beyoglu, and more specifically, at the Galata Tower. This time, climb up the viewing terrace to take in the utter beauty of Istanbul painted in the colours of the golden hour. By now, you must be able to recognise several of the Istanbul landmarks you visited in the previous days and this is why we think that you should save this experience for last.

Grab your skip-the-line tickets to the Galata Tower here. Trust us, you’ll definitely want to skip THIS line.

If you’re anything like us, your sunset climb up the Galata Tower will leave you completely spellbound, your lips uttering vows of eternal love to the city. Your final stroll should be along one of the most picturesque streets of Istanbul. Serdar-ı Ekrem Street might just be the perfect place to kiss this magical city goodnight and promise to be back soon.

How Many Days in Istanbul

We could just say the more the better and leave it at that. However, we’re here to help you rather than simply state the obvious. We believe that spending 5 days in Istanbul is the absolute minimum. However, not everyone can afford a long vacation, so here are a couple of tips on what to include and what to skip if you only have a short time to spend in Istanbul.

4-Day Istanbul Itinerary

If you only have 4 days in Istanbul, just skip the Princes Islands day trip and follow the rest of this 5-day itinerary for Istanbul.

3-Day Istanbul Itinerary

If you’re planning to see Istanbul in 3 days, you could probably do most of the things included in this 5-day Istanbul itinerary – minus the day trip, of course – but in a pretty rushed way, which is not ideal if you ask us.

Depending on how slow you want to take it or not, consider skipping any (or all) of the Istanbul activities and main attractions mentioned on Day 4 of this Istanbul itinerary. You can catch up with all this during your second time in Istanbul. Believe us, once Istanbul gets you under its spell, there will definitely be a second time.

2 Days in Istanbul

We don’t think that 2 days in Istanbul are enough to even scratch the surface of a city this size and with so much to see and do. However, if an opportunity comes up for you to visit even for 2 days, don’t miss it. In that case, join this comprehensive Best of The City full day tour on your first day and use your second day to just wander around and take in the unfathomable beauty of this city.

Istanbul Travel Guide

How to get to istanbul.

Turkish Airlines flies you to Istanbul from several destinations around the world. There are two airports in Istanbul. The new Istanbul Airport , which opened its gates to the public in 2019, and the Sabiha Gokcen Airport .

Check out flights to Istanbul here.

Both airports are accessible by public transport. However, for a hassle-free arrival (or departure), we’d recommend booking a private airport transfer in advance . Before doing so though, check with your hotel if they’re offering an airport shuttle service as many hotels in Istanbul do.

Where To Stay in Istanbul

Istanbul is a huge, often chaotic, city. Therefore, deciding on the best places to stay in Istanbul might get a bit overwhelming. Here’s a very brief overview of the best areas to stay in Istanbul to help you decide where to stay in Istanbul.

• Where to stay in Istanbul for first-time visitors: Galata area or near Taksim Square
• Where to stay in Istanbul for sightseeing: Old Town near Sultanahmet Square
• Where to stay in Istanbul for couples: Cihangir
• Where to stay in Istanbul with family: Besiktas
• Where to stay in Istanbul for nightlife: Karakoy or Kadikoy
• Where to stay in Istanbul for shopping: Eminonu or Pera near Istiklal Street
• Where to stay in Istanbul as a digital nomad: Kadikoy

No matter where you decide to stay in Istanbul, make sure you opt for a hotel that takes pride in its Turkish breakfast. Turkey is renowned for offering a delicious breakfast experience that you shouldn’t miss out on. For more information about the best places to stay in Istanbul, read our full guide on where to stay in Istanbul .

How To Get Around Istanbul

Although claimed to be built on seven hills, like Rome , Athens , Barcelona , Bergamo , Lisbon, Madrid , Prague , Bucharest and so many others (wow, this list is endless!), Istanbul is a very walkable city. However, its size and the number of uphill streets and locations it has render the use of public transport necessary at times.

Using Public Transport in Istanbul

Public transport in Istanbul is very easy to figure out and use. There are buses, trams, metro lines, ferries and two funiculars. All these combined can take you literally everywhere in the city.

Our least favourite means of transport in Istanbul is the metro. That’s because travelling underground means you’re missing out on the spectacular views at every turn Istanbul offers.

For the needs of this 5-day Istanbul itinerary, you’ll be mostly using the city’s trams and the life-saving funiculars. Why life-saving? Because, thanks to the Tünel (F2) and the Taksim–Kabataş (F1) funicular lines that provide easy access to the upper part of the city, you’ll never have to climb any of Istanbul’s notoriously uphill streets.

Regarding trams, the Kabataş–Bağcılar (T1) line is the most useful. There are also two historic tram lines in Istanbul. On the European side, the T2 Line runs along the entire length of Istiklal Street . On the Asian side, the T3 Line does a circular route from Kadikoy to Moda and back .

The ferries are also a fantastic way to commute in Istanbul, especially between the European and the Asian sides of the city. Last but not least, buses in Istanbul are very efficient and quite straightforward. In most cases, they include something super recognisable in their displayed direction (e.g. Taksim Square or something similar). Therefore, it’s very unlikely that you’ll get lost.

Istanbulkart

The Istanbulkart is a contactless public transport smart card. It is valid for all of the above means of transport plus a couple more, such as the Eyüp cable car. Apart from offering discounts compared to single-ride fares, the Istanbulkart offers you the ease of hopping on and off public transportation in Istanbul without worrying about buying separate tickets all the time.

You can buy an Istanbulkart at any metro station or even a newsstand in the city and load it with the desired amount of Turkish lira. Then you can top up your Istanbulkart at the same places or automatic vending machines located at many metro, tram or bus stations.

The Istanbulkart is not personal. This means that it can be used by more than one person. If so, the discount made at certain transits will only be applied to one passenger.

Istanbul Weather & Best Time To Visit Istanbul

Winter in Istanbul can be really, really cold. Especially on board the ferries or in the evening. Istanbul is a dreamy city and you should be able to enjoy sitting outdoors as much as possible. This is why it would be better to visit in late spring or autumn. Try to avoid visiting Istanbul during the summer months to steer clear of the crowds and scorching heat the peak season brings.

Should I Get a Turkey SIM card?

Free roaming across Europe is one of the best things that has happened to the continent in the last decades. However, Turkey wasn’t invited to the party. If your data providers back home charge outrageous amounts of money for just a handful of MBs, check out this Unlimited 4G Pocket Wifi which can connect up to 10 mobile devices.

Alternatively, get an eSIM card from Airalo and pick one of their packages for a seamless Internet connection.

Is Istanbul Safe?

Apart from being beautiful, Istanbul is an incredibly friendly city where locals will amaze you with their warmth and kindness. That said, like anywhere else in the world, you need to use your common sense while in Istanbul.

Crowded places with many tourists tend to attract pickpockets while dark alleys should be avoided, especially by women travelling alone. On the contrary, popular places like Istiklal Street, Taksim and other squares are perfectly safe any time of the day or night – minus the pickpocket risk, of course.

Our Top 3 Reasons To Visit Istanbul

From what you’ve read so far it must be pretty clear that Istanbul is a remarkably enchanting city that has a special place in our hearts. There are certain little details about Istanbul that we love immensely that couldn’t find their place in the detailed 5-day Istanbul itinerary you just read. However, we felt the need to share with you the three things we love about Istanbul the most.

Served in small glasses rather than cups, Turkish tea has nothing to do with the fancy Afternoon Tea sessions you might have experienced in London – which we also adore. Tea is so much more than just a drink in Istanbul. It’s a mentality in its own right.

If you love cats, Istanbul is your heaven. You’ll be touched by the degree to which locals love cats. There are food and water bowls for them everywhere on the city’s streets. In fact, it seems that cats in Istanbul are literally treated as royalty.

What we love most about the city, though, are the Istanbulites themselves. They are among the most hospitable people we have met. The fact that they are even warmer towards us once they find out we are Greek is indescribably moving.

So much for the eternal-hate-between-Greeks-and-Turks stereotype. It only exists in narrow-minded people’s imaginations. This is why travel is the best antidote to stereotypes and intolerance. A window to the real, beautiful world that leaves no room for harmful misconceptions.

Now that you know what to do in Istanbul in 5 days, here’s one more thing to keep in mind. Istanbul is not just another city to visit. It is an entire world. A world of magic where all opposites converge to form an enchanting blend of cultures and peoples.

Istanbul is more than just the beautiful images of the Bosphorus and the Hagia Sophia. Istanbul is filled with the seductive smells of the East as they reach out to touch the West. Istanbul is carried along in the exciting sounds of a busy city that never sleeps but also in the melodious voice of the muezzin who brings the skies to life at each call to prayer.

Istanbul is all of this and so much more. Istanbul is unique. The one and only. The City.

WORDS & EDITING: Maria IMAGES: Katerina

Disclosure: To facilitate us in publishing this 5 days in Istanbul itinerary, Hodjapasha Cultural Centre and Walks in Istanbul offered us press tickets to their shows and tours respectively. Yet, as always, all opinions remain our own.

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Amazing locations in Istanbul, I truly enjoy all of it.

Thanks for your comment!

I appreciate you illustrating the best five-day itinerary for Istanbul.

i liked your post, soon i will be in istanbul and you blog was so amazing and helpful

Hi there! Thanks for your kind comment! We hope you enjoy your trip to Istanbul.

Thanks for this useful post. I want to do a cruise on the Bosphorus, there are so many choices, not sure which one to take but I found one, Bosphorus Sunset Cruise top-rated on trip advisor. Do you have any suggestions on that? I want to give it a try on this one www. bosphorustour. com Thanks for your feedback.

Hi Alex, thanks for your comment! You must definitely enjoy a sunset cruise along the Bosphorus Strait, you’re going to love it! We can’t give feedback on this specific cruise but you can find many top-rated sunset cruises by clicking on our affiliate link here !

Pingback: Where to eat in Istanbul, Turkey | The Winged Fork

Istanbul is a dream place for me, I hope one day to see it. Hagia Sophia, the Spice Bazaar and Grand Bazaar are on my list and I am sure that one day I will see and smell those wonderful places.

Hi dear Ferny! We are in love with Istanbul because it is indeed a dreamy destination. So special, so different from any other city we’ve been to. We really hope that you travel to Istanbul soon. You are going to love it!

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5 Day Pacific Coast Itinerary: Big Sur and beyond!

“Soon it got dusk, a grapy dusk, a purple dusk over tangerine groves and long melon fields; the sun the color of pressed grapes, slashed with burgundy red, the fields the color of love and Spanish mysteries.” – Jack Kerouac in ‘On The Road’

While I don’t care much for On The Road and the way it’s written, I can’t help but agree with Kerouac’s description of the beautiful California landscape.

We are following the quintessentially American Pacific Coast Highway Itinerary in 5 days and the purple sky, setting sun, wineries, and Spanish colonial mansions pass by in a blur.

As I look out, I understand why this San Francisco to Los Angeles drive itinerary is said to be one of the most scenic in the country.

Also known as California State Highway 1, this route passes through dramatic landscapes and incredible stops as it snakes its way down to Los Angeles, the city of angels. 

If you are venturing down this route, I suggest renting a convertible.

The wind in my hair is the only thing missing as I press my nose against the car window, staring at the blue ocean below.

The stops on San Francisco to Los Angeles road trip itinerary are truly incredible and can make the journey last as long as you want.

You can camp, hike, surf in laid-back beach towns, stay in cozy bread and breakfasts on wineries, bike along the way, even enjoy a romantic honeymoon or birthday as you make your way down the coast. 

Also Read: Best Things to do in Washington State

This is the perfect road trip whether you are traveling with kids, family, or friends.

We recommend spending at least 3 or 4 days to enjoy the road and make this trip at a leisurely pace.

San Francisco To La Road Trip Itinerary Along Pch 1

When we talk about a road trip from San Francisco to Los Angeles, we mean along the scenic PCH 1.

Actually, there are 3 routes that connect San Francisco to Los Angeles. Here’s a little information about all of them:

Along the I-5

The interstate or I-5 route is the quickest and shortest route connecting these vibrant cities on the West Coast. The distance is about 380 miles and takes roughly 6 hours.

This is the route you take when you are in a hurry to reach Los Angeles and not what we recommend in this road trip guide!

If you are making a round trip, you can use this route to return to San Francisco though we recommend the more scenic Highway 101 for your return journey.

US Highway 101

Not many people know this, but the US Highway 101 is a good intermediate option between the boring and practical I-5 and the scenic but winding PCH 1.

It partly follows the Californian coast and is 430 miles long. This route takes a little less than 8 hours.

The PCH 1 between SF and LA is the Holy Grail of beautiful road trips.

Though it is almost as long as the US Highway 101, it takes significantly longer – about 10 to 11 hours – to drive it along the central coast of California. 

However that is discounting the awesome stops along the way – some are overlooks worth stopping at for a quick look while other stops include charming seaside towns, state parks, and picturesque landscapes that need at least a day or two to explore properly. 

It is this route that we refer to in this San Francisco to Los Angeles road trip guide.

San Francisco To Los Angeles Drive Itinerary Travel Tips

You can also use this itinerary in the reverse direction i.e same itinerary, Los Angeles, to San Francisco.

However, if you are traveling from the north to the south, it is easier to stop at the scenic vistas and pull-outs.

Pay special attention to your GPS or navigation apps on the route, as they will try to redirect you towards the interstate or Highway 101.

The Pfeiffer Canyon Bridge on Highway 1 collapsed in early 2017, making Big Sur inaccessible and dividing the PCH 1 into two parts. That continued for almost 18 months.

However finally in August 2018, the Big Sur region is again accessible via California Highway 1. We recently did this trip again in April 2019 and the road was great. It can happen again anytime, however, so we recommend checking before you go.

The route is easily affected by the weather. In winter, it is frequently foggy which makes for incredible vistas but also dangerous driving conditions.

After heavy rainfall, mudslides can occur along the route.

We suggest keeping an eye on weather advisories and driving slowly and cautiously. Also, we do not recommend driving the PCH 1, especially around Big Sur, at night.

Our most popular posts: 22 Best City Breaks in the USA The Best Things to do in New York on your first visit Ultimate List of Best Places to visit in the USA

The road is heavily trafficked and congested during summer weekends and major holidays.

To get an idea of the seasonal crowds, consider this: over three million tourists drive Highway 1 every year!

There is no cell service for long stretches of the Pacific Coast road trip itinerary, so print your detailed trip guide along with planned stops and hotel reservations before you go!

Spring is a great time to take this drive as the Californian landscape comes alive with vivid wildflower blooms, and the views along the Pacific Highway 1 are breathtaking.

We love driving this road from March to April.

Also Read: 24 Best Places to Visit in California in winter

The way we have written this article, we have detailed Pacific Coast Highway 4 day itinerary excluding time spent in San Francisco and Los Angeles.

You can use the extra day to see San Francisco or Los Angeles or use it to hike and explore the beautiful region of Big Sur beyond a one day trip to create your own custom Pacific Coast Highway Itinerary for 5 Days.

This route also makes for a perfect RV trip.

There are many campgrounds located along the Pacific Coast Highway and you can easily drive an RV or small campervan from San Francisco and to Los Angeles – or even better, rent a RV directly from other families for amazing deals.

Pacific Coast Highway Itinerary In 5 Days

This road trip is truly for the journey than the destination. 

Don’t get me wrong, I love Los Angeles with its touristy Walk of Fame, Hollywood Sign and the mansions of Beverly Hills – BUT – Los Angeles should not be the reason you make this trip. 

After all, you can drive like a maniac down I-5 and reach Los Angeles in under 6 hours. Not that we suggest driving like a maniac at any time!

In fact, we always, and I mean always, recommend driving with caution and calling it a day before you get too tired and sleepy.

No, the reason you take this long and winding road instead is to savor the breathtaking views and enjoy the open roads.

The PCH 1 between San Fran and Los Angeles is about 9 hours long and quite lovely! 

The PCH 1 hugs the Central Coast of California and with Big Sur finally being open again in late August 2018 (it was closed for most of 2017 due to a big landslide), the road is ready to receive its share of visitors.

Our San Francisco to Los Angeles road trip itinerary is perfect for those seeking out the dense fog-shrouded roads, dappled sunshine streaming through tall trees, and the waves crashing on the cliffs below.

If poetic road trips are your dream, then this one will make you thank your lucky stars forever! 

And with that, we introduce the perfect itinerary for a road trip along California Highway 1 from San Francisco to Los Angeles.

Exploring San Francisco And Renting A Car

San Francisco is your starting point for this itinerary.

The Golden Gate City is a delight to experience and perfect for exploring using your extra day i.e Day 5.

If you are flying into San Francisco, we recommend taking a couple of days to get around and find out for yourself what makes San Francisco so special. 

Also Read: Ultimate San Francisco to Big Sur Road Trip Planner

See the Golden Gate Bridge, visit Alcatraz Island, eat sourdough clam chowder soup at Fisherman’s Wharf, and drive down the twisting Lombard Street.

For an incredible experience, cycle down the Golden Gate Bridge like we did and explore the beautiful city of Sausalito.

Read our San Francisco posts now to plan this part of the trip: San Francisco 3 to 5-day itinerary ideas 17 Best Things to do in San Francisco on your first visit

You can also venture into San Jose, a trendy city with cool restaurants, cafes, and pubs.

Visit the famous Winchester Mystery House – a weird house with mysteries and haunted stories.

Drop-in into Silicon Valley to check out the headquarters of Facebook, Google, and many others.

When you are done exploring San Francisco and the surrounding area, you can rent a car for your trip down the coast.

This is a route made for convertibles, so if you can get your hands on one – don’t let it go!

Also see: 10 Best convertible road trips in the United States

Day 1: Half Moon Bay, Santa Cruz, Monterey Peninsula, 17 Mile Drive, And Carmel-By-The-Sea

Start by making a shortstop in Half Moon Bay.

Located just south of San Francisco, the town has an incredible stretch of beaches and is perfect for sunbathing, swimming, and surfing.

Other attractions in Half Moon Bay include kayaking, horseback riding, hiking among the redwoods, and wine tasting. 

The Fitzgerald Marine Reserve and its tide pools are teeming with marine life including crabs, sea anemones, sea urchins and more.

There’s actually enough to do in Half Moon Bay to warrant its own day trip but you can take a quick look around the area before you head south.

Next, we suggest stopping in Santa Cruz to check out the famous boardwalk.

The Santa Cruz beach boardwalk is a huge amusement park featuring many vintage rides including the wooden Giant Dipper roller coaster.

This is a great hit with kids of all ages and families.

The boardwalk is also a Mecca for state fair kind of foods including deep-fried Oreos, corn dogs, and cotton candy.

The nearby Santa Cruz Wharf is a great place to see sea lions.

The famous seaside town of Monterey is about 3 hours from San Francisco.

Monterey is famous for its Monterey Bay Aquarium – a huge facility with interactive exhibits and lots of marine animals and plants on display.

Monterey coast is also popular for whale watching cruises with various species being seen including blue whales, grey whales, humpback whales, and even killer orca whales.

Other things to do in the Monterey area include walking tour of the Cannery Row, seal watching and checking out the eateries along Fisherman’s Wharf.

It should come as no surprise that the Pacific Coast Highway trip itinerary is full of smaller famous stretches and drives like 17 Mile Drive in Monterey.

This winding road is very popular with tourists for its scenic views and gorgeous houses.

This drive is a ticketed private road through an exclusive neighborhood but at an entrance fee of ~$10 per car, it’s well worth the visit.

The famed Lone Cypress Tree and Pebble Beach are the most well-known attractions of 17 Mile Drive.

The final stop of the day is the quaint town of Carmel-By-The-Sea, just 4 miles away from 17 Mile Drive.

This town began as an artist colony and continues to provide inspiration with its bohemian vibe and highly scenic vistas.

The town is famous for its eclectic cottages, cape-cod style homes, and fine restaurants. 

We recommend spending the night here: preferably in the Mission Ranch owned by the famous actor, Clint Eastwood.

Carmel also happens to be quite welcoming of pets; you can check out this Dog-friendly Carmel Travel Guide written by our friend Paroma who loves taking her fur baby there. 

Also Read: 12 Stunning Spots on Carmel to Big Sur Road Trip

Day 2: Big Sur Highlights – Bixby Bridge, Point Sur Lighthouse, McWay Falls, Julia Pfeiffer Burns State Park, And San Simeon

This day is the highlight of the drive from San Francisco to Los Angeles; consequently, no itinerary for Pacific Coast Highway can skimp on Big Sur. 

The scenic Big Sur region starts just south of Carmel and is home to many state parks, nature trails, and wilderness areas.

Big Sur stretches along for 90 miles and is great for camping, backpacking, and hiking.

We recommend stopping at all the vistas and pull-outs in this stretch to appreciate the beauty of the area.

Whatever you chose to do in Big Sur, you won’t go wrong.

Start your drive by having breakfast either in Carmel or in Big Sur village.

Also fill up on gas here, preferably in Carmel, as gas further up the drive is expensive and limited. Next, you will drive along Big Sur’s popular attractions. 

We recommend checking out the Rocky Creek Bridge, the famous engineering marvel of Bixby Bridge, the charming Point Sur Lighthouse, and McWay Falls.

Pfeiffer Beach and Sand Dollar Beach are a must for beach lovers. 

We haven’t explained this information in detail here since we have already got your covered for everything in Big Sur in our Big Sur Visitor Guide .

The free guide also includes a complete list of attractions in the Big Sur area, you can read the complete article for details.

San Simeon is home to the Piedras Blancas Elephant Seal Rookery, the largest in North America.

It is free to visit and open every day and is a great hit with kids and families. The rookery is located 7 miles to the north of the city.

Elephant seals can be seen year-round. From January to April, elephant seal pups can be seen in the rookery. 

San Simeon is the perfect base for touring the Hearst Castle (see more below in ‘Detours along the way’ section).

We suggest spending the night at Cayucos, popularly known as the ‘Coolest small town in America’ or in nearby San Luis Obispo.

If you have an extra day or two, spend them in Big Sur – you can camp at Julia Pfeiffer State Park or stay in the many campgrounds or inns in the area.

Day 3: Cayucos, Morro Bay, San Luis Obispo, And Pismo Beach

Cayucos is a small beach town that you can easily walk around.

Walking through Cayucos is like stepping back into time. It is a 5 block long untouched town where everybody knows each other.

Beautiful murals pop out of nowhere, antique stores are laden with stories of the past, and whales and dolphins just happen to swim past the pier in Cayucos.

Surfing is a popular activity here as is hiking among the tidepools and rocky cliffs.

The charming Morro Bay town gets its name from the Morro Rock – a giant volcanic rock that juts out from the ocean near the beach.

In case you were wondering, this is the same Morro Bay referred to in the Disney movie ‘Finding Dory’.

Morro Bay is a delight to explore: the air is full of salty ocean scent and incredible marine life.

Morro Bay has a natural harbor and is home to a variety of wildlife including seals, sea lions, and otters.

The town is also full of charming restaurants and is popular with foodies.

San Luis Obispo is a hip college town with a very young and trendy vibe.

Popular daytime activities in San Luis Obispo include the Art Gallery and Mission San Luis Obispo while the town’s nightlife on Higuera Street is also worth checking out.

Another popular attraction (though we don’t really agree with the ‘attraction’ part, more like ewww..) is the Bubblegum Alley, similar to the one in Seattle.

The town also has a drive-in movie theatre which reminded us of small-town Americana.

Pismo Beach should be your last stop on this day.

The beach here is perfect for spending a day swimming or soaking the sun.

This relaxed coastal town is the perfect beach getaway.

The sand dunes next to the beach here are perfect for renting an ATV and dune bashing.

Pismo Beach is also great for viewing marine life including whales, dolphins, and sea otters.

The pier and boardwalk are also worth a visit and great to catch the sunset. You can stay for the night in Pismo Beach.

Day 4: Santa Barbara, Ventura, And Malibu

Note – As a friend who lives in Los Angeles informed us, technically, the stretch of Highway 1 from Santa Barbara to Los Angeles is actually known as Pacific Coast Highway. We think this jargon as confusing and have decided to leave aside the technicalities for this post. However, if you have to be precise about it – this is the day you are driving on the PCH!

Santa Barbara has beautiful houses, romantic views of the Pacific Ocean, and sparkling beaches.

There is a lot to do in this coastal town and it provides a charming distraction to the touristy and commercial Los Angeles. 

Spend some time walking along the historic Stearns Wharf and learn more about the history of the town and the ocean.

An exhibit about the Channel Islands National Park is also present on the pier.

However, to visit the Islands you will need to take a boat ride from Ventura. 

Santa Barbara also offers many other attractions including the Zoo, Museum of Fine Arts, Maritime Museum, Museum of Natural History, and a sprawling Farmer’s market.

From Santa Barbara, you can either head straight onwards to Los Angeles or make a stopover at Ventura or Malibu.

Located about 1.5 hrs away from Los Angeles, Ventura couldn’t be more different than LA.

Set amidst green hills and boasting of untouched beaches, Ventura is a hidden gem on the Pacific Coast.

Ignored by many tourists who prefer visiting Malibu, this small town has everything from art galleries, museums, restaurants, and cafes, to botanical gardens and great surfing.

The Ventura Pier is excellent for taking an evening stroll and people watching. 

Ventura is also the gateway to Channel Islands National Park, one of the less visited national parks in the country.

The Channel Islands make an off the beaten path detour on the Pacific Coast Hwy road trip.

Malibu is the famed beach town of California known for its beaches, oceanside mansions, and star-spotting – of the Hollywood variety!

Memorialized in countless movies and tv series, Malibu is a must-visit for most tourists.

We love visiting Zuma Beach and hanging out there while watching the surfers, sunsets, and seagulls. Malibu also has excellent whale watching opportunities, especially in the winter. 

This is a perfect spot to watch the sunset before you reach Los Angeles to stay for the night.

Have a drink in one of the area’s restaurants and rejoice to the most amazing road trip you have just undertaken!

Day 5: Reaching Los Angeles

LA is the perfect end to the San Francisco to Los Angeles road trip itinerary.

From here you can either take a return flight to your home city or use Day 5 to explore the city of angels a bit before you leave. 

There are many amazing things to do in Los Angeles.

For Hollywood fans, you can visit the famous Kodak and Oriental Theatres, go star-spotting in Beverly Hills, take pictures with the Hollywood sign or find your favorite stars on the Walk of Fame. 

I love heading up to Griffith Observatory and window shopping in Rodeo Drive.

Many of our friends live in the area, so we also utilize our time in the city to catch up with them.

You can check out our guide to Los Angeles for perfect itinerary ideas.

This need not be the end of your trip.

You can drive along the coast all the way down to San Diego to get the complete experience of the PCH road trip.

Or you can visit Death Valley on your way to Las Vegas to extend your road trip into the Californian desert landscape and see exceptional scenery on the way.

If you are making this trip in the opposite direction, you still have many options to extend your Pacific coast highway road trip itinerary.

Technically you can drive this route all the way to Portland, Oregon or even Seattle. 

Alternatively, you can drive from San Francisco to Yosemite to see the magnificent redwoods.

Or go from San Francisco to Reno and Lake Tahoe and then maybe Las Vegas? …As you can probably tell, we love stretching all our trips to accommodate Las Vegas!

The options to turn this 4-day long trip into an exciting American road trip adventure are potentially endless!

Great Detours to Add to your PCH Itinerary

While this Los Angeles to San Francisco itinerary mostly covers all the stops, there are also some amazing attractions and towns worth taking a short detour if you have more than 5 days.

Here are some of our favorite detours along the way:

Hearst Castle On The Enchanted Hill, San Simeon

If you take the detour from Cayucos to San Simeon, you will reach the famous Hearst Castle.

While the castle can be seen from Highway 1, visiting it requires a little detour.

The castle has a fascinating history. Newspaper magnate William Hearst commissioned San Francisco architect Julia Morgan to build his dream mansion and construction continued for almost 30 years. 

Visitors can view the property including the giant swimming pools on a guided tour.

The house is filled with artwork and furnishings from around the world.

The movie ‘Citizen Kane’ is based on Heart’s life and viewing the mansion is an excellent way to get a glimpse into his life.

Paso Robles

Paso Robles is Central California’s wine country capital.

Comparable to Napa Valley of Northern California, Paso Robles has world-class wineries, vineyards, and even craft breweries.

If you are interested in wine travel, Paso Robles is a must detour.

You can easily spend 2 -3 days in the area exploring the wineries, touring wine caves and checking out area’s breweries and distilleries.

Apart from its wine and spirits scene, Paso Robles is also famous for its thermal hot springs.

Carrizo Plain National Monument

Pretty at any time of the year and especially during spring, Carrizo Plain National Monument is simply unmissable during a super bloom.

The last super bloom was in 2017, we recommend keeping an eye on the news for the next super bloom and planning a visit accordingly. 

The plains are carpeted with orange poppies, yellow buttercups, and a host of other wildflowers in vivid colors and magnificent quantities.

Wildlife viewing opportunities in the natural reserve are plentiful and you can spot elks, pronghorns, coyotes, migratory birds, and butterflies. 

The monument is located about 60 miles east of San Luis Obispo and a perfect addition to the Pacific Highway 1 road trip.

Solvang makes for a great 30-mile detour from Santa Barbara. If you don’t know about the town, you are in for a pleasant surprise.

Solvang is California’s Danish Village and features pretty Danish architecture, windmills, and a holiday atmosphere throughout the year. 

We love tasting the yummy pastries and other baked goods available throughout the village and shopping for Danish souvenirs including cuckoo clocks.

Solvang also makes a great base for visiting exploring the Santa Ynez Wine Country and holds many wine-themed events during the grape harvest season.

Vineyards Of The Santa Ynez Valley

Located along the central coast of California, Santa Ynez Wine Country may not be as popular as Napa Valley but produces a vast variety of wine each year.

The best time to visit is in Fall when the harvest season begins but wine tastings and tours are available in Santa Ynez throughout the year.

While we always love spending a couple of days in Napa, Santa Ynez is the place to go for fewer crowds and cheaper wine tastings.

RESOURCES FOR PLANNING SAN FRANCISCO TO LOS ANGELES ROAD TRIP ITINERARY

Big Sur Day Trip and Beyond: Complete Travel Guide – Our detailed guide on planning a day trip or weekend getaway in the Big Sur region.

Our epic 10 day California road trip itinerary – find recommendations in where to go and what to see in the whole state

Along Big Sur – The trip of a lifetime! (CC 2.0 / Foundry)

We hope you liked our post on California Coast road trip of 5 days from San Francisco to Los Angeles. Did we miss out on any road trip pit stops or attractions? Let us know in the comments.

4 thoughts on “5 Day Pacific Coast Itinerary: Big Sur and beyond!”

Lived in Southern California for over 30 years and I’m finally going on a 6 day Highway 1 road trip from Orange County to Santa Cruz next week and this helped tremendously. Thank you so much!

Great itinerary. Thank you!! I will follow this

We leave Monday for a 3 week trip to do the PCH from Idaho! This was a fabulous article- best I’ve read on here. Thank you!

I’ve lived in the Bay Area my whole life and have never done this drive in its entirety, I’m thinking of doing it this winter! Thank you for this!

Comments are closed.

• Plan Your Trip
• Utah Itineraries

The Mighty 5: Ultimate Journey

10 Days   •   1040 Miles

Grab a national parks annual pass for the best access to The Mighty 5®.

Ready for the journey of all journeys? This 10-day itinerary is the granddaddy of all itineraries. You’ll hit The Mighty 5® — every national park in Utah — as well as state parks, national monuments, Monument Valley and several stunning spots in between.   You’ll find tranquil sunrises, fiery sunsets and unadulterated views of the Milky Way. You’ll gape at technicolor cliffs, massive arches and brilliant-hued hoodoos. You’ll discover wide-open spaces, tight slot canyons and vertiginous views. You’ll experience magical mountain biking, big time off-roading and monumental Jeep tours. You’ll explore ancient ruins, pioneer homesteads and slickrock labyrinths. You’ll wind through world-renowned scenic drives, thrilling rapids, and more world-renowned scenic drives.   One day of this trip could set you up with enough adventure for a year. These 10 days will fill you with enough adventure for a lifetime. Are you ready to catch the first few rays of sunlight streaming through Mesa Arch in Canyonlands National Park? Or to gape at the sheer scale of the narrow walls that surround you as you wade through the river that carved them in Zion National Park? Get out there.

Start: Moab, about three and a half hours southeast of Salt Lake City by car. End: Zion National Park

Read these  resources  to learn how to travel thoughtfully and experience Utah most fully on your journey.

Consider taking pit stops along your journey. You need to refuel, eat, answer the call of nature, and stretch your legs anyway, so why not make them into  mini-adventures ?

Moab to Arches

• Arches Scenic Drive
• Fiery Furnace
• Delicate Arch Hike

Adventure in Arches National Park where 300 million years of erosion has resulted in unbelievably dramatic landscapes that look like they were sculpted by giant mythological beings rather than the processes of time. Arches National Park contains about 2,000 windowed arches, towering spires, harrowing hoodoos and precarious pinnacles on display, including Delicate Arch, perhaps Utah's most iconic feature. A paved 36-mile scenic drive from the park entrance provides numerous parking areas for trail access and scenic overlooks. Tip: If you're planning to visit Arches between April and October, you'll need to reserve a timed entry ticket for access to the park. Visitors without a timed entry ticket may enter the park before 7 a.m. or after 4 p.m. Overnight in  Devils Garden Campground  or  Moab . (Read: How to Visit Arches )

Moab to Canyonlands

• Grand View Point
• Dead Horse Point State Park

Imagine wave after wave of deep canyons, formed by the currents and tributaries of Utah's Green and Colorado rivers, divided with towering mesas, pinnacles, cliffs and spires, and spread out over tens of thousands of acres of some of the world's most breathtaking red rock country. Though Canyonlands National Park is made up of three distinct land districts, today focuses on the photogenic Island in the Sky and neighboring Dead Horse Point State Park. Camp in the parks or return to Moab.

Canyonlands and the La Sal Loop

• White Rim Trail
• La Sal Loop Drive
• Grandstaff Hiking Trail
• Rafting in Utah

A solid hike up Grandstaff Trail will give your legs a good stretch before continuing along a scenic loop into the very mountains that Delicate Arch frames. There’s also access to the thrilling Porcupine Rim Trail from up here. For even bigger adventure, consider a 2-5 day rafting trip on the Colorado River to extend this trip to its logical extreme. (Don’t worry, there’s the popular Moab Daily stretch for just a taste of the Colorado.) Two or more days on the White Rim Trail is another great way to linger in Moab.

Adventure Epicenter

• Colorado White Water
• Hummer Tour
• Restaurants in Moab

Use this additional day in the Moab area to hit the rapids if you haven’t yet, pick up trails you may have missed in either of the national parks, or take an off-road tour with an experienced guide at the Sand Flats Recreation Area. Enjoy the legendary slickrock from the vantage point of an all-terrain vehicle in this off-road enthusiast's paradise. Save time for a relaxing meal in Moab to refresh yourself for the second half of this Ultimate Journey.

Moab to Monument Valley

• Newspaper Rock
• Bluff Fort Historic Site
• Goulding's Lodge

The large petroglyph panel of Newspaper Rock is on the scenic road to the the Needles District of Canyonlands. It’s worth an early start to sneak in a hike here, but be warned: You may not want to leave so soon. Except what awaits is Monument Valley Navajo Tribal Park, an iconic symbol of the American West and the sacred heart of the Navajo Nation. The rugged landscapes are infused with ancestral spirits, yet they are hauntingly familiar thanks to Hollywood's long love affair with this land. Tour Edge of the Cedars State Park and Bluff Fort along the way. Overnight in Monument Valley.

Monument Valley to Goblin Valley

• Monument Valley Jeep Tour
• Natural Bridges National Monument
• Goblin Valley State Park

While Goulding Film and Cultural History Museum at Goulding's Lodge provides a great introduction to the area, guided jeep tours and hikes will get you up close and personal with Monument Valley's incredible landforms. Next, head north on S.R. 261 up the switchbacks of the Moki Dugway and across Cedar Mesa for a stop at Natural Bridges National Monument. You may only have time for the scenic overlooks if you lingered in Monument Valley. Continue to Goblin Valley State Park where you can overnight in a yurt or grab a room in  Hanksville  or  Torrey .

Capitol Reef Country

• Things to Do in Capitol Reef
• Gifford Homestead
• Hickman Bridge + Navajo Knobs

The contrast of red Entrada and white Navajo sandstones and the magnificent warp in the crust of the Earth create surreal landscapes unlike any you have seen. Capitol Reef National Park splashes color for 100 miles through an inviting wilderness of sandstone formations, rock art petroglyphs telling the story of the early indigenous people of the Fremont Culture, and the large fruit orchards of Fruita, an early pioneer settlement. With a high-clearance vehicle, you can explore the backcountry, but there’s also plenty to see and miles of unique trails in the front country along S.R. 24 and the Capitol Reef Scenic Drive. Overnight in  Torrey .

Torrey to Kodachrome Basin

• Lower Calf Creek Falls
• Anasazi State Park Museum
• Kodachrome Basin State Park
• Escalante Petrified Forest State Park

Utah's All-American Road Scenic Byway 12 is a spectacular experience by itself, and this itinerary gives you breathing room to slow down and experience a little more of what this stunning route through Grand Staircase–Escalante National Monument has to offer. Boulder, Utah, is home to the renowned Hell’s Backbone Grill and the starting point of the Burr Trail Scenic Backway. Consider stops at Anasazi, Escalante Petrified Forest and Kodachrome Basin state parks, and definitely plan time for the hike to Lower Calf Creek Falls. Charming towns dot the highway for overnight options or land at Bryce Canyon for the night. (Read: Dining Between the Mighty 5 )

Bryce Canyon

• Queens Garden to Navajo Trail
• Bryce Canyon Lodge
• Dark Skies of Bryce Canyon

Bryce Canyon National Park is a series of natural amphitheaters sunk into pink cliffs and filled with delicate red rock "hoodoos." The most brilliant hues of the park come alive with the rising and setting of the sun. Summertime offers a myriad of walking and hiking trails and a 37-mile scenic drive overlooking incredible vistas (with a summer shuttle option to avoid driving in traffic). Historic Bryce Canyon Lodge’s location within the park means great access to the sites, hikes and starry skies of the park. Overnight in the lodge or Bryce Canyon City.

Bryce Canyon to Zion

• Zion-Mt. Carmel Drive and Hikes
• Angels Landing
• The Narrows

Zion translates to "The Promised Land," and for you that means some of the most spectacular hiking of your lifetime and impossibly beautiful landscapes you will never forget. Carved by water and time beyond the stretch of the imagination, Zion National Park is a canyon that invites you to participate in the very forces that created it. Park at the visitor center and take the multi-passenger shuttle through the canyon to as many stops as you have time and energy to enjoy. One day will give you a taste of Zion. But if you have some extra time, add an another day or two to explore additional hikes , the surrounding Springdale community, or even venture north to Zion's Kolob Canyons .

Well-prepared travel is responsible travel.

Do your part by planning ahead

5 Google Maps Tips You Need To Know When Planning Your Next Trip

W hether a brief weekend escape or an extensive expedition across continents, planning a trip can be a daunting task. The challenge of selecting the ideal destinations, navigating through unfamiliar territories, and ensuring that you experience all the essential sights without overlooking anything, can quickly become overwhelming for any traveler. This is where online maps come into play, and one prominent tool that almost everyone has used at some point is Google Maps.

Google Maps goes beyond basic directions . It offers a suite of features designed to make trip planning not just easier, but also more enjoyable. You can map out itineraries, discover new attractions, get insights into local restaurants and services, and even find electric vehicle charging stations . The platform's real-time updates, user reviews, and detailed information on points of interest can help you make informed decisions while exploring new destinations. Moreover, its customization features allow you to create personalized maps that cater specifically to your travel plans, which are also shareable. Here are five essential Google Maps tips that every traveler should know. These tips will not only help you streamline your trip-planning process but also ensure that your travels are as smooth and enjoyable as possible.

Read more: 12 Smart Gadgets You Didn't Know Existed

Utilizing Offline Maps

When you're heading out on a trip, one thing you definitely don't want to worry about is losing access to your maps when your signal drops. That's where offline maps come in handy. Google Maps allows you to download maps for offline use, ensuring you never get lost even when you're off the grid.

Downloading maps for offline use is a straightforward process. Follow these steps:

• Open the Google Maps app on your smartphone or tablet. 
• Tap on your profile icon in the top-right corner.
• Choose Offline maps.
• Tap Select your own map in the following window.
• Drag the map window to your desired area.
• Select Download.

Depending on the size of the area you're downloading and your internet connection speed, this process may take a few moments.

Once the download is complete, you'll be able to access the map even without an internet connection. Offline maps are not only convenient, but they can also save you time and frustration. Imagine hiking in a remote area and losing your cell signal — having the offline map ensures you can still navigate your way back to your starting point without any hassle. This is also one of the many secret Google Maps features that can come in handy.

Customizing Your Route With Multiple Stops

We all have days packed with errands or sightseeing, where we just wish we could plan the routes efficiently. Google Maps allows you to do that by customizing your route with multiple stops. It's a nifty feature that can save you time and make your trips more organized.

Follow these steps:

• Open Google Maps on your device and enter your final destination.
• Click on the three buttons next to your starting point and select Add stop. 
• You can add multiple stops by repeating this step. 
• Rearrange stops by dragging the three lines next to each destination.

Now, Google Maps will calculate the most efficient route for you, taking into account all your stops along the way. This is perfect for those days when you have several places to visit or errands to run, but you want to make sure you're not zigzagging all over town. It can also save you time and fuel. Plus, it's a great way to ensure you don't forget any important stops along the way. 

When customizing your route with multiple stops on Google Maps, keep in mind to arrange your stops in a logical order to minimize backtracking and optimize efficiency. Additionally, consider traffic conditions and estimated travel times between each stop to plan your schedule accordingly. Lastly, ensure that all stops are accurately inputted to avoid any confusion or missed destinations along the way.

Taking Advantage Of Live Traffic Updates

This feature provides real-time information about traffic conditions, allowing you to avoid packed routes and save valuable time.

As you navigate with Google Maps, the app constantly monitors traffic conditions along your route. If there is heavy traffic, accidents, or road closures ahead, Google Maps will highlight the problematic area on the map using yellow or red markers.

To enable live traffic updates, open the Google Maps app and enter your destination. Once your route is set, Google Maps will display real-time traffic information along the way, including any incidents or slowdowns. You can then choose to follow the suggested route or explore alternative options based on the traffic conditions. 

When using live traffic updates on Google Maps, keep in mind to regularly check for updates throughout your journey to stay informed about changing road conditions. You can also report problems on the road yourself on Google Maps . Lastly, be flexible with your travel plans and prepared to follow alternative routes suggested by Google Maps to avoid congestion and minimize travel time.

By taking advantage of live traffic updates, you can make informed decisions about your route and avoid getting stuck in gridlock. Whether you're commuting to work or heading out on a road trip, this feature can help you reach your destination more efficiently.

Exploring Nearby Attractions And Restaurants

When you're in a new area, or even just exploring your own neighborhood, Google Maps can be a great tool for discovering nearby attractions and restaurants. 

To start exploring:

• Open Google Maps and zoom in on the area of your interest. You should see several options below the search bar, including Restaurants, Gas, Coffee, Shopping, ATMs, and more. 
• Click on the option you want to explore. For instance, if you are looking for places to eat nearby, select Restaurants to see a list of dining options in the area. Each restaurant will be marked with its location on the map, along with details such as the establishment's name, its rating, and sometimes photos or reviews. 
• Refine your search further by applying filters for rating and distance. 
• After selecting a restaurant that catches your interest, click on it to view more detailed information, including its address, hours of operation, contact details, and directions on how to get there. 

Google Maps also allows you to call the restaurant directly from the app if you wish to make a reservation or inquire about menu items.

You can explore all these categories by swiping right on the options pane below the search bar. To view the full list, click on the More button (three dots) at the very end.

Create A Custom Map To Share With Friends And Family

You can also easily create a custom map and share it with whoever you want on Google Maps. It's a great way to collaborate on travel plans, recommend must-visit places, or simply share your favorite local hangouts.

• Open Google Maps on your computer and sign into your Google account. 
• Click on the menu icon and choose Saved > Maps > Open My Maps. 
• Start a new map by clicking the Create A New Map button. 
• Give your map a title and a description that encapsulates the essence of your adventure or theme. This could be anything from "Family Road Trip to Yellowstone" to "Best Coffee Shops in New York City." 
• Populate your map with markers. Click on the marker icon, then click on the location on the map you wish to mark. For each marker, you can add a detailed description, upload photos, and even include links for more information. 
• Additionally, Google My Maps allows you to draw paths and shapes, perfect for outlining routes or highlighting areas of interest. 
• Once your map is ready, click on the Share button. Here, you'll be prompted to set the map's privacy settings. You can choose to make it public, share it with specific people, or keep it private with a link.
• Finally, invite your friends via email or simply send them the link.

Read the original article on SlashGear .

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• Large & Multigenerational Travel

5 Best Vacations for a Family of 5

Mar 22, 2018

See recent posts by Amanda Norcross

If you have a family of 5, you know that planning vacations can be challenging. Booking an affordable hotel room is frustrating, and appeasing everyone in the group at all times is equally challenging. Luckily, the travel industry is responding to the growing family vacation segment — particularly large and multigenerational families — with more offerings that make vacations for families of 5 easier. Consider one of these vacations for your family of 5, priced for every budget.

Vacation Rental Trips For Families

When we think of vacations for a family of 5, the first option that comes to mind is vacation rentals! We love that vacation rentals provide all the comforts of home — not to mention plenty of space — but what we love even more is the affordability factor. You can cook your own meals, throw in a load (or 20) of laundry and more — sans resort fees. Many vacation rentals come with added perks as well — think bicycles, beach gear, and pools! Find the perfect vacation rental for your family here .

Cruise Vacations for Families of 5

More and more cruise lines are offering two-room suites for families. Disney offers concierge-level suites for up to seven people, Norwegian’s newest ships feature staterooms for five guests (plus connecting rooms), and don’t even get us started on the “Ultimate Family Suite” on Royal Caribbean’s Symphony of the Seas . Aside from spacious accommodations, cruises offer activities for every family member — ropes courses and bumper cars for teens, kids’ clubs and character dining experiences for youngsters, spas and adults-only pools for parents, and meals and shore excursions for everyone to enjoy together. See 5 Best Cruise Lines for Families .

All-Inclusive Resort Vacations for Families of 5

All-inclusive resorts are another great vacation option for families of 5. Families can choose two-bedroom suites or large guestrooms at many resorts and enjoy a wide array of activities, including pools, water sports and beaches! Plus, some all-inclusive resorts offer nanny services so that mom and dad can enjoy some time alone. Visit 8 Beautiful All Inclusive Resorts for Families of Five (or More) to see our favorites for large groups.

Camping Vacations for Families of 5

Camping is fun, cheap, and in most cases, doesn’t require a long car ride. Plus, you can easily tailor your camping trip to your family’s size. Going on a camping trip with your family of 5? Opt for a tent that has separators so you can make your own two-room suite with separate “rooms” for parents and kids! Read our 12 Expert Tips for Your Family Camping Trip for more camping hacks.

National Park Vacations for Families of 5

National parks are great for families of 5 because you pay per car load to enter the park, not per person. Inside the park, you’ll enjoy free and fun activities — hiking, swimming, picnics and Junior Ranger programs, offered by the National Park Service at no cost. You can go camping or stay at hotels in the parks, or stay at a budget-friendly hotel or motel outside of the park. See 10 Best National Parks for Families to decide which park to visit.

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I've traveled 18,000 miles in an electric car. Here are the 4 things that surprised me about long-distance EV road trips.

• Gia Mora bought the Hyundai Ioniq 5, an EV with a 250-mile range, to reduce her need to fly.
• She and her partner have traveled 18,000 miles in the electric car on multiple road trips. 
• Mora was surprised by how temperature affects charging times and how often she charges at Walmart.

When I decided I would fly only once every three years for environmental reasons in 2021, my main concern was how to tackle long-distance travel.

My partner and I live in Los Angeles, but my family is in Colorado, and my adventurous other half fretted over the limitations on our holidays.

We compromised last June when we traded in our hybrid SUV for the all-electric Hyundai Ioniq 5 . With its fast-charging 350-kilowatt capacity and 250-mile range battery, the Ioniq 5 allows us to travel long distances for a third of the emissions of our hybrid. 

We paid the sticker price of $54,000, before the $7,500 federal rebate. 

Our first EV excursion to Scottsdale, Arizona, from LA was a success. We've since gone to San Diego, visited family in Colorado, and did a mountain-bike road trip through Nevada, Utah, and New Mexico, racking up over 18,000 miles. 

The Ioniq 5 also came with two years of free charging at any Electrify America charging station — the largest public-charging network in the country. 

We can charge the car at any station or at home, but we plan around Electrify America locations. We only charged somewhere else three times last year. According to the Electrify America app, it's saved us over $2,600 in fees. 

Initially, I was skeptical about owning an electric car, let alone road-tripping in one. Fears of long charging times at isolated stations or getting stranded with a dead battery are enough to stop anyone from switching to electric.

A year after purchase, I'm sold on long-range EVs.

Here are four things people should know if they're planning to travel long distances in an EV.

Plotting out charging is a breeze

Because charging stations aren't as ubiquitous as gas stations, traveling long distances in an electric vehicle requires more planning than a traditional road trip.

The Electrify America app makes finding and getting directions to chargers easy. Plus, it's compatible with Apple Maps and Hyundai's Car Play system, so we can view the route on our dashboard display.  

We arrange to fill up at an Electrify America station every 150 miles or so. The network offers 3,500 fast chargers at 800 stations in 47 states. 

We've never had trouble finding a station and never had to drive more than a mile or two off a major highway to access one.

If we are driving on a Sunday afternoon, we build extra time into our plans, because that's when charging stations are the busiest. 

Related stories

In all our travels, we've only encountered one situation when we had to wait 20 minutes for an open charger. With proper preparation, we can avoid charging during peak hours and reduce any delays to our adventures. 

It's faster to travel long distances in the summer in an EV 

EVs are the opposite of gas cars when it comes to temperature regulation. All electric cars, including the Ioniq 5, use more energy to heat than to cool.

That's why EVs experience range loss in colder weather . By our estimates, the Ioniq 5 travels about 15% fewer miles on the same charge in the cold as it does in the heat. It also drastically affects charging times. 

In moderate temperatures, with the 350-kilowatt Hyper-Fast chargers, the Ioniq 5 can go from 10% to 80% charged in under 20 minutes. But on days when the temperature falls below 20 degrees Fahrenheit, it can take as long as 30 or 35 minutes.

Because we charge so frequently, the distance we can cover in a day isn't affected by the cold, but it does mean that we have to be prepared to spend more time waiting for the car to charge.

Conversely, cooling the Ioniq 5 has very little effect on range and charge time.

Last summer in the Phoenix heat, it only took an extra minute or so to reach full charge, and it's much more comfortable to wait 20 minutes in air-conditioning than it is to spend five minutes outside in 100-degree temperatures filling up at the gas pump. 

I gained a newfound appreciation for Walmart

Walmart plays a bigger role in our road-tripping than I ever anticipated.

The vast majority of our charging stops are at one of the 280 Walmart and Sam's Club locations that host Electrify America and EVgo stations. 

I feel safe charging in Walmart's well-lit parking lots, even at night. While charging, we can use the sparkling-clean restrooms or take advantage of the store's extended operating hours to grab any necessities. 

It felt like a serious upgrade from grungy gas-station toilets and limited convenience stores typical of highway pit stops. 

Last month, Walmart announced plans to quadruple its network of chargers. Since 90% of Americans live within 10 miles of a Walmart , this expanded infrastructure could make road-tripping easier and make EV adoption accessible to more people.

More remote charging stations can be adventures in themselves

Plenty of charging stations look exactly as you'd expect, but when we ventured outside of major metropolitan areas, we discovered some unique stops. 

Green River, Utah, is home to 847 people, one Tesla Supercharger, and four Electrify America stations located beside the tiny, quirky Green River Coffee Company . A painting of the establishment's mascot — a scraggly but disarming vulture holding a steaming cup of coffee — keeps watch over the chargers which are available for use 24/7.

One night just outside of Yosemite National Park, we pulled in to charge at a small lodge. Seeking respite from the rain and a public restroom, we went into the Lucky Buck Cafe . 

The locals at the bar welcomed us and were delighted when I sat in with the live guitarist to sing a few country classics.

Road-tripping in the Ioniq 5 is enjoyable 

Despite any challenges, road-tripping along the Electrify America network in our Ioniq 5 is an enjoyable option compared to costly airline tickets and pollution. 

With more charging infrastructure on the horizon, I'm excited to see more people opting for all-electric travel plans.

Watch: Why it's so hard to recycle electric-car batteries

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More From Forbes

Business travel comeback pushes global spending past $1.5 trillion.

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Cropped shot of three unrecognizable businesspeople walking and pulling suitcases while in the ... [+] office during the day

The International Air Transport Association (IATA) significantly upgraded its profitability projections for airlines in 2024. The trade group now expects net profits to reach $30.5 billion, an increase from $27.4 billion in 2023.

This surge in profitability is accompanied by record-high traveler numbers and revenues. A new record number of passengers is expected to fly in the U.S. this summer. For the full year, the total global number of travelers is forecasted to reach approximately 5 billion, with revenues projected to soar to $996 billion, a 9.7% increase from 2023.

Global airline industry profits forecast to increase again in 2024

The recovery in travel has been nothing short of remarkable. Domestic travel bounced back to pre-pandemic levels by the spring of 2023, while international routes have recently surpassed 2019 numbers. The IATA now expects the number of world passengers to grow by an average of 3.8% per year over the next 20 years, resulting in over 4 billion additional passenger journeys by 2043.

“The human need to fly has never been stronger,” said Willie Walsh, IATA’s Director General.

Business Travel Spending Set To Surpass $1.5 Trillion This Year

Best tax software of 2022, best tax software for the self-employed of 2022, income tax calculator: estimate your taxes.

While leisure travel has been leading the recovery, business travel is steadily gaining momentum, albeit at a slower rate. A Morning Consult survey found that only 10% of U.S. adults had traveled domestically for work in March 2024.

The trend appears to be headed in the right direction, however, with corporations prioritizing domestic trips over long-haul international travel. The Global Business Travel Association (GBTA) predicts global business travel spending will surpass $1.5 trillion in 2024, up from $1.02 trillion in 2022.

Regarding the hotel market, investors are optimistic, but forecasts are being downgraded. Profitability still lags pre-pandemic levels. Earlier this week, STR and Tourism Economics revised down their 2024-2025 U.S. hotel forecast, reflecting lower-than-expected performance in early 2024 and reduced growth projections for the rest of the year.

Domestic Travel Spending In China

On the other hand, I’m encouraged to see the return of Chinese outbound travel. The World Travel & Tourism Council (WTTC) predicts that China’s travel and tourism sector will contribute a record-breaking 12.62 trillion yuan ($1.7 trillion) to the country’s economy by the end of this year.

Domestic travel spending in China is also expected to reach new heights, providing a significant boost to the luxury market. As I’ve shared with you before, Chinese shoppers were major luxury-goods spenders before the pandemic. These shoppers are gradually returning, with domestic luxury spending up by 50%, according to Bloomberg Intelligence. The resurgence is encouraging for long-term luxury investments, both in mainland China and Europe.

Services See A Marked Improvement

The airline industry’s recovery is part of a broader positive trend in the services sector. The S&P Global US Services PMI, which includes the airline industry, rose to a one-year high of 54.8 in May, accelerating past its three-month moving average. This points to a marked expansion in services activity, reflecting strong consumer demand and business confidence.

Sharp rise in U.S. business activity

The airline industry presents a unique blend of recovery and growth opportunities. I believe the group is well-positioned for sustained growth, with strong profitability projections, an ongoing recovery in both leisure and business travel and positive market dynamics. The rebound in Chinese travel and its impact on the luxury market further supports the sector.

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Naomi Klein and V. V. Ganeshananthan win Women's Prize literary awards

Author-activist Naomi Klein has won the inaugural Women’s Prize for Nonfiction with “Doppelganger: A Trip into the Mirror World.”

LONDON — Author-activist Naomi Klein won the inaugural Women’s Prize for Nonfiction on Thursday with “Doppelganger,” a personal account of her plunge into the world of online misinformation.

Its sister award, the Women’s Prize for Fiction, went to U.S. writer V. V. Ganeshananthan for her novel “Brotherless Night,” about a family torn apart by Sri Lanka’s long civil war. Both come with 30,000 pounds ($38,000) in prize money.

Both winners referenced the conflict-clouded international situation, at a time when the arts world is grappling with divisions over the Israel-Hamas war and corporate sponsorship of the arts.

Klein, author of “No Logo” and “The Shock Doctrine,” delves into her experience being mistaken for Naomi Wolf, author of “The Beauty Myth” and more recently a promulgator of anti-vaxx ideas and other conspiracy theories. Part memoir and part reportage, “Doppelganger” — subtitled “A Trip into the Mirror World” — investigates how online life has distorted reality, and asks what might be done about it.

Historian Suzannah Lipscomb, who headed a panel of judges for the nonfiction award, called Klein’s book “a courageous, humane and optimistic call-to-arms that moves us beyond black and white, beyond Right and Left.”

Klein thanked the prize for “not shying away from controversy.” She has backed calls for book festivals to stop taking money from companies with investments in fossil fuels or Israel’s defense sector, a campaign that has led to U.K. events cancelling funding from finance firm Baillie Gifford.

Some argue that starves the arts of much-needed funds, but Klein said she “wanted to use the platform to call for more courage from cultural institutions.”

Ganeshananthan’s victorious second novel, which traces an aspiring medic’s journey through the brutality and moral uncertainties of war, took almost two decades to complete. Novelist Monica Ali, who chaired the fiction judging panel, said “Brotherless Night” is “a brilliant, compelling and deeply moving novel that bears witness to the intimate and epic-scale tragedies of the Sri Lankan civil war.”

Ganeshananthan’s first novel, “Love Marriage,” was published in 2008, and she started “Brotherless Night” in 2004. She said writing historical fiction “carefully and thoughtfully” about a traumatic conflict well within living memory that was true to people’s experience was “hard work.”

“It took such a long time because of the chorus of people it was necessary to talk to,” she said.

She said that faced with conflicts like the Israel-Hamas war , “what can writing do? Hopefully push people to collective actual action.”

The nonfiction award was launched this year to help fix the gender imbalance in the publishing world, where men buy more nonfiction than women — and write more prize-winning nonfiction books.

Prize organizers say that in 2022, only 26.5% of nonfiction books reviewed in Britain’s newspapers were by women, and male writers dominated established nonfiction writing prizes.

Both fiction and nonfiction prizes are open to female English-language writers from any country.

The fiction prize was founded in 1996, and past winners include Zadie Smith, Tayari Jones and Barbara Kingsolver , who won last year for “Demon Copperhead.”

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• Section 5 - Leishmaniasis, Visceral
• Section 5 - Onchocerciasis / River Blindness

CDC Yellow Book 2024

Author(s): Kathrine Tan, Francisca Abanyie

Infectious Agent

Transmission, epidemiology, clinical presentation.

INFECTIOUS AGENT:  Plasmodium spp.

Multiple countries in Africa, the Americas, and Asia

TRAVELER CATEGORIES AT GREATEST RISK FOR EXPOSURE & INFECTION

PREVENTION METHODS

Avoid insect bites

Use malaria chemoprophylaxis

DIAGNOSTIC SUPPORT

• 770-488-7788 (M–F 9 a.m.–5 p.m. Eastern)
• 770-488-7100 (after hours)

Parasitological diagnosis: DPDx

Malaria in humans is caused by protozoan parasites of the genus Plasmodium , including Plasmodium falciparum , P. malariae , P. ovale , and P. vivax . In addition, zoonotic forms have been documented as causes of human infections and some deaths, especially P. knowlesi , a parasite of Old World (Eastern Hemisphere) monkeys, in Southeast Asia.

Plasmodium species are transmitted by the bite of an infective female Anopheles mosquito. Occasionally, transmission occurs by blood transfusion, needle sharing, nosocomially, organ transplantation, or vertically from mother to fetus. Malaria transmission occurs in large areas of Africa, Latin America, and parts of the Caribbean, Eastern Europe, the South Pacific, and in Asia including South Asia, Southeast Asia, and the Middle East ( Map 5-12 , Map 5-13 , and Map 5-14 ).

Map 5-12 Malaria-endemic destinations in the Americas & the Caribbean

View Larger Figure

Malaria-endemic destinations are labeled using black font; destinations not endemic for malaria are labeled using gray font. Countries with areas endemic for malaria are shaded completely even if transmission occurs only in a small part of the country. For more specific within-country malaria transmission information, see Section 2, Yellow Fever Vaccine & Malaria Prevention Information, by Country .

Map 5-13 Malaria-endemic destinations in Africa & the Middle East

Map 5-14 Malaria-endemic destinations in Asia & Oceania

Malaria is a major international public health problem. According to the World Health Organization (WHO) World Malaria Report 2019, >90 countries reported ≈228 million infections and ≈405,000 deaths in 2018. Travelers going to malaria-endemic countries are at risk of contracting the disease, and almost all the ≈2,000 cases of malaria that occur each year in the United States are imported.

The risk of acquiring malaria differs substantially from traveler to traveler and from region to region, even within a single country. This variability is a function of the intensity of transmission within the various regions and the itinerary, duration, season, and type of travel. Risk also varies by travelers’ adherence to mosquito precautions and prophylaxis recommendations. In 2016, 2,078 cases of malaria (including 7 deaths) were diagnosed in the United States and its territories and were reported to the Centers for Disease Control and Prevention (CDC). Of cases for which country of acquisition was known, 85% were acquired in Africa, 9% in Asia, 5% in the Caribbean and the Americas, and 1% in Oceania or the Eastern Mediterranean. Of US residents with malaria who reported a reason for travel, 69% were visiting friends and relatives.

Information about malaria transmission in specific countries is derived from various sources, including WHO (see Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country ). The information presented here was accurate at the time of publication; the risk for malaria can change rapidly and from year to year, however, because of changes in local weather conditions, mosquito vector density, and prevalence of infection. See updated information CDC website.

Malaria is characterized by fever and influenza- like symptoms, including chills, headache, myalgias, and malaise; symptoms can occur intermittently. In severe disease, acute kidney injury, acute respiratory distress syndrome, mental confusion, seizures, coma, and death can occur. Malaria symptoms can develop as early as 7 days after being bitten by an infectious mosquito in a malaria-endemic area and as late as several months or more after exposure. Suspected or confirmed malaria, especially P. falciparum , is a medical emergency requiring urgent intervention, because clinical deterioration can occur rapidly and unpredictably. See Box 5-10 for frequently asked clinical questions.

Box 5-10 Frequently asked clinical questions

How do i address concerns about side effects from prophylaxis.

• Prophylaxis can be started earlier if the traveler has concerns about tolerating a particular medication. For example, mefloquine can be started 3–4 weeks in advance to allow potential adverse events to occur before travel. If unacceptable side effects develop, the clinician has time to change the medication before the traveler’s departure.
• The drugs used for antimalarial prophylaxis are generally well tolerated. Side effects can occur, however. Minor side effects usually do not require stopping the drug. Clinicians should determine if symptoms are related to the medicine and make a medication change if needed.

WHAT SHOULD A TRAVELER DO IF THEY MISS A DOSE OF PROPHYLAXIS?

• Compared with drugs with short half-lives, which are taken daily, drugs with longer half-lives, which are taken weekly, offer the advantage of a wider margin of error if the traveler is late with a dose.
• For a weekly drug, prophylactic blood levels can remain adequate if the dose is only 1–2 days late. If this is the case, the traveler can take a dose as soon as possible, then resume weekly doses on the originally scheduled day. If the traveler is >2 days late, blood levels might not be adequate. The traveler should take a dose as soon as possible. The weekly doses should resume at this new day of the week (the next dose is 1 week later, then weekly thereafter).
• For a daily drug, if the traveler is 1–2 days late, protective blood levels are less likely to be maintained. The traveler should take a dose as soon as possible and resume the daily schedule at the new time of day.

WHAT HAPPENS IF TOO HIGH A DOSE OF PROPHYLAXIS IS TAKEN?

• Overdose of antimalarial drugs, particularly chloroquine, can be fatal. Medications should be stored in childproof containers out of reach of infants and children.

ISN’T MALARIA A TREATABLE DISEASE? WHY NOT CARRY A TREATMENT DOSE OF ANTIMALARIALS INSTEAD OF TAKING MALARIA PROPHYLAXIS?

• Malaria could be fatal even when treated, which is why prevention is always preferable to treating infections after they occur.

WHAT SHOULD BE DONE IF FEVER DEVELOPS WHILE TRAVELING IN A MALARIA-ENDEMIC AREA?

• Malaria and other potentially life-threatening infections acquired during travel could be fatal if treatment is delayed. Travelers should promptly seek medical help and continue to take malaria prophylaxis while in the malaria-endemic area.

WHAT SHOULD BE DONE IF A TRAVELER WHO TOOK MALARIA PROPHYLAXIS DEVELOPS FEVER AFTER RETURNING FROM THEIR TRIP?

• Malaria prophylaxis, while highly effective, is not 100% effective. Travelers should be advised to seek medical care immediately if fever develops, report their travel history, get tested for malaria, and get treated promptly if infection is confirmed.
• Malaria smear or a rapid diagnostic test must be performed, and results obtained immediately (within a few hours). These tests should not be sent out to reference laboratories that take days to weeks to return results. Empiric treatment with antimalarial drugs is not recommended because the malaria smear provides critical information for appropriate treatment. If a patient has an illness suggestive of severe malaria and a compatible travel history in an area where malaria transmission occurs, and malaria testing is not immediately available, start treatment as soon as possible, even before the diagnosis is established. See CDC recommendations for malaria treatment .

Travelers with symptoms of malaria should seek medical evaluation as soon as possible, even if still traveling. Consider malaria in any patient with a febrile illness who has recently returned from a malaria-endemic country. Diagnostic assistance is available from state public health laboratories or CDC. The CDC malaria laboratory can assist in speciating malaria by blood smear microscopy, or confirm species by PCR testing. The CDC laboratory also can assess malaria parasites for mutations that confer resistance to medications. Serologic testing , used in certain situations (e.g., case investigations), can also be done by CDC laboratories.

In the United States, malaria is a notifiable disease. Health care providers must report cases of malaria diagnosed via microscopy or PCR in the United States and its territories to local or state health departments. See more information on reporting malaria .

Blood Smear Microscopy

Blood smear microscopy remains the most important method for malaria diagnosis. Microscopy can provide immediate information about the presence of parasites, allow quantification of the density of the infection, and allow determination of the species of the malaria parasite—all of which are necessary for providing the most appropriate treatment. Tests should be performed immediately when ordered by a health care provider, and microscopy results should be available as soon as possible, ≤24 hours of the patient’s presentation. Assistance with speciation of malaria on smears is available from state health departments or CDC.

In resource-limited settings, and particularly in sub-Saharan Africa, overdiagnosis and the rate of false-positive microscopy for malaria can be high; warn travelers that a local diagnosis of malaria could be incorrect. In such cases, acutely ill travelers should seek the best available medical services and continue their prophylaxis regimen until they have a definitive diagnosis.

Rapid Diagnostic Testing

Rapid diagnostic tests (RDTs) for malaria detect antigens derived from malaria parasites. Malaria RDTs are immunochromatographic tests that most often use a dipstick or cassette format and provide results in 2–15 minutes. RDTs offer a useful alternative to microscopy in situations where reliable microscopic diagnosis is not immediately available. Although RDTs can detect malaria antigens within minutes, they have several limitations. RDTs cannot distinguish between all Plasmodium species that affect humans, they might be less sensitive than expert microscopy or PCR for diagnosis, they cannot quantify parasitemia, and an RDT-positive test result might persist for days or weeks after an infection has been treated and cleared. Thus, RDTs are not useful for assessing response to therapy. Furthermore, in some areas, mutations are increasingly being observed in malaria parasites, resulting in an absence of the malaria antigen usually detected by many RDTs, including the only RDT used in the United States. The absence of this parasite antigen in peripheral blood can lead to false-negative RDT test results.

Both positive and negative RDT results must always be confirmed by microscopy. Microscopy confirmation of the RDT result should occur as soon as possible, because the information on the presence, density, and parasite species is critical for optimal management of malaria. The US Food and Drug Administration (FDA) has approved an RDT (the BinaxNOW Malaria test) for hospital and commercial laboratory use; the test is not approved for use by clinicians or patients. Laboratories that do not provide in-house, on-the-spot microscopy services should maintain a stock of malaria RDTs so that they will be able to perform immediate malaria diagnostic testing when needed.

PCR Testing

PCR tests also are available to detect malaria parasites. These tests are more sensitive than routine microscopy, but results are not usually available as quickly as microscopy results, thus limiting the utility of PCR for acute diagnosis and initial clinical management. Use of PCR testing is encouraged to confirm the species of malaria parasite and detect mixed infections.

Malaria can be treated effectively if treatment begins early in the disease; delaying therapy, however, can have serious or even fatal consequences. Specific treatment options depend on the species of malaria, the severity of infection, the likelihood of drug resistance (based on where the infection was acquired), the patient’s age, and whether the patient is pregnant or breastfeeding.

See detailed CDC recommendations for malaria treatment . For assistance with the diagnosis or treatment of malaria, call the CDC Malaria Hotline (770-488-7788 or toll-free at 855-856-4713) from 9 a.m. to 5 p.m. Eastern Time. After hours, on weekends, or on holidays, call the CDC Emergency Operations Center at 770-488-7100 and ask the operator to contact the subject matter expert on call for the Malaria Branch. In addition, consult a clinician specializing in travel or tropical medicine or infectious diseases.

Travelers who decline to take prophylaxis, who choose a suboptimal drug regimen (e.g., chloroquine in an area with chloroquine-resistant P. falciparum ), or who require a less-than-optimal drug regimen for medical reasons are at increased risk for acquiring malaria and then needing prompt treatment while abroad. Medications not used in the United States to treat malaria (e.g., halofantrine, sulfadoxine-pyrimethamine) are widely available abroad. CDC does not recommend halofantrine for treatment because of documented adverse cardiac events, including deaths. These adverse events have occurred in people with and without preexisting cardiac problems, and both in the presence and absence of other antimalarial drugs. Sulfadoxine-pyrimethamine is not recommended because of widespread drug-resistant Plasmodium .

Reliable Supply of Malaria Treatment

Some travelers who take effective prophylaxis but who will be in remote areas might decide, in consultation with their travel health provider, to also carry a reliable supply of a full course of an approved malaria treatment regimen. In the event a traveler carrying a reliable supply is diagnosed with malaria, they will have immediate access to an approved treatment.

CDC recommends that the reliable supply be acquired in the United States, so clinicians can consider the traveler’s other medical conditions or medications when selecting an antimalarial drug and to avoid the possibility of travelers obtaining counterfeit drugs in the local pharmacy or market, or depleting local resources. In rare instances when access to medical care is not available and the traveler develops a febrile illness consistent with malaria, the reliable supply medication can be self-administered presumptively. Advise travelers that self-treatment of a possible malarial infection is only a temporary measure, and that prompt medical evaluation is imperative.

Two malaria treatment regimens available in the United States can be prescribed as a reliable supply for self-treatment: atovaquone-proguanil and artemether-lumefantrine. To treat malaria, CDC recommends against using the same (or related) drug that has been taken for prophylaxis. For example, atovaquone-proguanil can be used as a reliable supply medication by travelers who are not taking atovaquone-proguanil for prophylaxis. See Table 5-26 for dosing recommendations.

Table 5-26 Reliable supply regimens for malaria treatment 1

PEDIATRIC DOSE

ATOVAQUONE-PROGUANIL 2 Adult tablets:

• Atovaquone 250 mg
• Proguanil 100 mg

Pediatric tablets:

• Atovaquone 62.5 mg
• Proguanil 25 mg

4 adult tablets taken orally (as a single daily dose) for 3 consecutive days

Weight-based daily dose taken orally (as a single daily dose) for 3 consecutive days

5–8 kg: 2 pediatric tablets 9–10 kg: 3 pediatric tablets 11–20 kg: 1 adult tablet 21–30 kg: 2 adult tablets 31–40 kg: 3 adult tablets >41 kg: 4 adult tablets

Contraindicated in people with severe renal impairment (creatinine clearance <30 mL/min).

Not recommended for people taking atovaquone-proguanil prophylaxis.

Not recommended for children weighing <5 kg, or people who are pregnant or breastfeeding infants weighing <5 kg.

ARTEMETHER-LUMEFANTRINE 2 One tablet

• Artemether 20 mg
• Lumefantrine 120 mg

ADULT & PEDIATRIC DOSE

Weight-based treatment schedule for both adult and pediatric patients. Patients should take an initial dose, followed by a second dose 8 hours later, then 1 dose twice a day for the next 2 days (total of 6 oral doses over 3 days).

5 kg to <15 kg: 1 tablet per dose 15 kg to <25 kg: 2 tablets per dose 25 kg to <35 kg: 3 tablets per dose ≥35 kg: 4 tablets per dose

Not recommended for people taking mefloquine prophylaxis.

Not recommended for children weighing <5 kg, or people breastfeeding infants weighing <5 kg.

1 A reliable supply is a complete course of an approved malaria treatment regimen obtained in the United States before travel. A reliable supply is not counterfeit or substandard; will not interact adversely with the patient’s other medicines, including malaria chemoprophylaxis; will not deplete local resources in the destination country.

2 If used for presumptive self-treatment, patients should seek medical care as soon as possible.

Malaria prevention consists of a combination of mosquito avoidance measures and chemoprophylaxis. Prevention measures must address all malaria species in the travel area and apply to both short-term and long-term travelers. Although highly efficacious, interventions are not 100% effective, so all febrile persons returning from malaria-endemic areas should be tested for malaria even if they took chemoprophylaxis.

Preventing malaria involves striking a balance between effectiveness and safety: ensuring that all people at risk for infection use the recommended prevention measures, and preventing rare occurrences of adverse effects. Conduct an individual risk assessment for every traveler by collecting a detailed travel itinerary, including countries, specific areas to be visited in those countries (e.g., cities, rural areas, both), types of accommodation, season, and style of travel. Modify the risk assessment depending on traveler characteristics (e.g., pregnancy, underlying health conditions) and malaria characteristics at the destination (e.g., intensity of transmission, local parasite resistance to drugs). Depending on the level of risk, it might be appropriate to recommend no specific interventions, mosquito avoidance measures only, or mosquito avoidance measures plus chemoprophylaxis.

Several factors increase a traveler’s risk for malaria. Travel, even for short periods of time, to areas with intense malaria transmission can result in infection. Malaria transmission is not distributed homogeneously throughout a country, so review the exact itinerary to determine if travel will occur in highly endemic areas. In countries where malaria is seasonal, travel during peak transmission season also increases risk. Travelers going to rural areas or staying in accommodations without screens or air conditioning also will be at greater risk. The greatest risk for malaria is associated with first- and second-generation immigrants living in nonendemic countries who return to their countries of origin to visit friends and relatives (VFRs). VFR travelers might perceive themselves to be at no risk because they grew up in a malaria-endemic country and consider themselves immune to the disease. Tolerance acquired through continuous exposure to malaria is quickly lost, however; consider VFRs to have the same risk as other nonimmune travelers (see Sec. 9, Ch. 9, Visiting Friends & Relatives: VFR Travel ). Also remind travelers that they could become infected even if they had malaria before, and they still need to take preventive measures.

Mosquito Avoidance Measures

Because of the nocturnal feeding habits of Anopheles mosquitoes, malaria transmission occurs primarily between dusk and dawn. Travelers can reduce contact with mosquitoes by remaining in enclosed air-conditioned rooms or well-screened areas, sleeping under mosquito nets (preferably insecticide-treated), using an effective insecticide spray or mosquito coils in living and sleeping areas during evening and nighttime hours, and wearing clothes that cover most of the body.

All travelers should use an effective mosquito repellent, such as those that contain DEET (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods ). Repellents should be applied to exposed parts of the skin. If travelers are also wearing sunscreen, they should apply sunscreen first and insect repellent second. In addition to using a topical insect repellent, a permethrin-containing product can be applied to mosquito nets and clothing for additional protection against mosquitoes. Mosquito repellant–impregnated clothing also is available.

Chemoprophylaxis

Choosing a drug to prevent malaria.

All recommended primary prophylaxis regimens involve taking a medicine before, during, and after travel to an area with malaria. Beginning the drug before travel allows the antimalarial agent to be in the blood before the traveler is exposed to malaria parasites. In choosing a prophylaxis regimen before travel, the traveler and the travel health provider should consider several factors, including the presence of antimalarial drug resistance in the area of travel, length of travel, the patient’s other medical conditions, allergy history, other medications prescribed or already being taken (to assess possible drug interactions), potential side effects, and the cost of the antimalarial. Long-term travelers, defined as people who travel for ≥6 months, have additional considerations (see Box 5-11 ). Table 5-27 lists some of the benefits and limitations of medicines used for malaria prophylaxis; see additional information about choosing a malaria prophylaxis regimen .

Recommendations for drugs to prevent malaria by country of travel can be found in Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country . Recommended drugs for each country are listed in alphabetical order and have comparable efficacy in that country. When >1 drug is recommended,  Table 5-27  can help with the decision-making process. No antimalarial drug is 100% protective; therefore, travelers must combine prophylaxis with mosquito avoidance and personal protective measures (e.g., insect repellent, long sleeves, long pants, sleeping in a mosquito-free setting, using an insecticide-treated mosquito net).

Table 5-27 Malaria chemoprophylaxis: prescribing considerations

REASONS TO CONSIDER USING THIS DRUG

REASONS TO CONSIDER AVOIDING THIS DRUG

ATOVAQUONE-PROGUANIL

Good for last-minute travelers because the drug is started 1–2 days before travel.

Some people prefer to take a daily medicine.

Good choice for shorter trips because the traveler takes the medicine for only 7 days after leaving malaria-endemic area, rather than for 4 weeks.

Well tolerated and side effects uncommon.

Pediatric tablets are available and might be more convenient.

Cannot be used by people who are pregnant or who are breastfeeding a child that weighs <5 kg.

Cannot be taken by people with severe renal impairment.

Tends to be more expensive than some of the other options, especially for long trips.

Some people (including children) would rather not take medicine every day.

CHLOROQUINE

Some people would rather take medicine weekly.

Good choice for long trips because it is taken only weekly.

Some people are already taking hydroxychloroquine chronically for rheumatologic conditions; in those instances, they might not have to take an additional medicine.

Can be used in all trimesters of pregnancy.

Cannot be used in areas with chloroquine or mefloquine resistance.

Can exacerbate psoriasis.

Some people would rather not take a weekly medication.

For short trips, some people would rather not take medication for another 4 weeks after leaving malaria-endemic areas.

Not a good choice for last-minute travelers, because drug needs to be started 1–2 weeks before travel.

DOXYCYCLINE

Tends to be the least expensive antimalarial drug.

People already taking doxycycline chronically to prevent acne do not have to take an additional medicine.

Doxycycline also can prevent other infections (e.g., rickettsial infections, leptospirosis); thus, might be preferred by people planning to camp, hike, and swim in fresh water where risk is high

Cannot be used by people who are pregnant or who are breastfeeding a child, or by children aged <8 years.

Some people would rather not take medicine every day.

People prone to getting vaginal yeast infections when taking antibiotics might prefer taking a different medicine.

People might want to avoid the increased risk of sun sensitivity.

Some people are concerned about the potential of getting an upset stomach from doxycycline.

Can be used in all trimesters of pregnancy and during breastfeeding.

Cannot be used in areas with mefloquine-resistant Plasmodium spp.

Cannot be used in patients with certain psychiatric conditions; some travelers without psychiatric conditions would prefer not taking a medication with known neuropsychiatric side effects.

Cannot be used in patients with a seizure disorder.

Not recommended for people with cardiac conduction abnormalities.

Not a good choice for last-minute travelers because drug needs to be started ≥2 weeks before travel.

One of the most effective drugs for prevention of P. vivax; thus, a good choice for travel to places with >90% P. vivax .

Good choice for shorter trips because the traveler takes the medicine for 7 days after leaving a malaria-endemic area, rather than for 4 weeks.

Cannot be used in patients with G6PD deficiency.

Cannot be used in patients who have not been tested for G6PD deficiency.

Costs and delays associated with getting a quantitative G6PD test might prohibit testing; however, the test only has to be done once. After a normal G6PD level is verified and documented, the test does not have to be repeated the next time primaquine or tafenoquine is considered.

Cannot be used by people who are pregnant.

Cannot be used by people who are breastfeeding unless the infant has also been tested for G6PD deficiency.

Some people are concerned about the potential of getting an upset stomach from primaquine.

TAFENOQUINE

One of the most effective drugs for prevention of P. vivax malaria but also prevents P. falciparum .

Good choice for shorter trips because the traveler takes the medicine once, 1 week after leaving malaria-endemic area, rather than for 4 weeks.

Good for last-minute travelers because the drug is started 3 days before travel.

Cannot be used in people with G6PD deficiency.

Costs and delays associated with getting a quantitative G6PD test might prohibit testing; however, the test only has to be done once. After a normal G6PD level is verified and documented, the test does not have to be repeated the next time tafenoquine or primaquine is considered.

Cannot be used by children.

Not recommended for patients with psychotic disorders.

Abbreviations: G6PD, glucose-6-phosphate-dehydrogenase

Box 5-11 Malaria prevention & prophylaxis considerations for the long-term traveler (travel >6 months)

Considerations.

• Malaria prevention measures are the same for both short- and long-term travelers.
• Longer stays mean longer duration of exposure and increased risk of acquiring malaria.
• Travelers’ attention to mosquito avoidance can wane over time.
• Travelers might not adhere to a lengthy course of malaria prophylaxis due to forgetfulness, fear of side effects, and the possible declining sense of risk and need over time.
• Travelers might move between highly endemic or low endemic areas within a country or region.
• Travelers might have a decreased sense of risk and concern about malaria after engaging in local conversations and lore, particularly regarding malaria immunity over time.
• Travelers who become ill with malaria in countries with limited access and quality of health care might not receive appropriate or effective treatment.

ADDITIONAL ADVICE FOR LONG-TERM TRAVELERS

• Travelers should not count on being able to obtain safe, reliable malaria prophylaxis medication abroad; strongly advise that before leaving the United States they purchase enough medication to last them for the entire duration of their travel to malaria-endemic areas.
• Emphasize continued adherence to and safety of malaria prophylaxis drugs.
• Develop a plan for seeking immediate care when ill with fever, including where to get promptly tested and treated for malaria.
• Advise travelers to purchase travel insurance, including contingencies for medical evacuation.
• Consider having a reliable supply of a treatment dose of antimalarial drugs available in case malaria is diagnosed while traveling.

Medications Used for Prophylaxis

Atovaquone-proguanil.

Atovaquone-proguanil (Malarone) is a fixed combination of the drugs atovaquone and proguanil. Prophylaxis should begin 1–2 days before travel to malaria-endemic areas; the medication should then be taken daily, at the same time each day, while in the malaria-endemic areas, and daily for 7 days after leaving the endemic areas (see Table 5-28 for recommended dosages). Atovaquone-proguanil is well tolerated, and side effects are rare. The most common adverse effects reported in people using atovaquone-proguanil for prophylaxis or treatment are abdominal pain, nausea, vomiting, and headache.

Atovaquone-proguanil is not recommended for prophylaxis in children weighing <5 kg (11 lb), pregnant people, people breastfeeding infants <5 kg, or patients with severe renal impairment (creatinine clearance <30 mL/min). Proguanil can increase the effect of warfarin, so travelers might need international normalized ratio monitoring or adjustment of warfarin dosage. No data are available, however, regarding the clinical impact of taking atovaquone-proguanil and warfarin at the same time.

Table 5-28 Malaria chemoprophylaxis: dosing information

INDICATIONS

DOSING / CONTRAINDICATIONS / PRECAUTIONS

Prophylaxis in all malaria-endemic areas

Adult tablets:

1 adult tablet taken orally, 1×/day

Weight-based daily dosing schedule (taken orally, 1×/day) 5 kg to <8 kg: 1/2 pediatric tablet 8 kg to <10 kg: 3/4 pediatric tablet 10 kg to <20 kg: 1 pediatric tablet 20 kg to <30 kg: 2 pediatric tablets 30 kg to <40 kg: 3 pediatric tablets ≥40 kg: 1 adult tablet

Begin taking 1–2 days before travel to malaria-endemic areas.

Take 1×/day, at the same time each day, while in malaria-endemic areas. Continue taking 1×/day for an additional 7 days after leaving endemic areas.

Take with food or a milky drink.

A pharmacist might need to prepare and dispense partial tablet doses in individual capsules, as described in the text.

Prophylaxis only in areas with chloroquine-sensitive malaria

300 mg base (500 mg salt) taken orally, once a week

5 mg/kg base (8.3 mg/kg salt), up to a maximum dose of 300 mg base (500 mg salt), taken orally, 1×/week

Begin taking 1–2 weeks before travel to malaria-endemic areas.

Take 1×/week, on the same day each week, while in malaria-endemic areas.

Continue taking 1×/week for another 4 weeks after leaving endemic areas.

100 mg taken orally, 1×/day

≥8 years of age: 2.2 mg/kg, up to a maximum dose of 100 mg, taken orally, 1×/day

Take 1×/day, at the same time each day, while in malaria-endemic areas. Continue taking 1×/day for another 4 weeks after leaving endemic areas.

Contraindicated in children aged <8 years and in people who are pregnant.

HYDROXY-CHLOROQUINE

An alternative to chloroquine for prophylaxis only in areas with chloroquine-sensitive malaria

310 mg base (400 mg salt) taken orally, 1×/week

5 mg/kg base (6.5 mg/kg salt), up to a maximum dose of 310 mg base (400 mg salt), taken orally, 1×/week

Prophylaxis in areas with mefloquine-sensitive malaria

228 mg base (250 mg salt) taken orally, 1×/week

Weight-based weekly dosing schedule (taken orally, 1×/week) ≤9 kg: 4.6 mg/kg base (5 mg/kg salt) >9–19 kg: 1/4 tablet >19–30 kg: 1/2 tablet >30–45 kg: 3/4 tablet >45 kg: 1 tablet

Begin taking ≥2 weeks before travel to malaria-endemic areas.

Contraindicated in people allergic to mefloquine or related compounds (quinidine, quinine) and in people with active depression, a recent history of depression, generalized anxiety disorder, psychosis, schizophrenia, other major psychiatric disorders, or seizures.

Use with caution in people with psychiatric disturbances or a previous history of depression.

PRIMAQUINE 1

Prophylaxis for short-duration travel to areas with principally P. vivax . Terminal prophylaxis (presumptive antirelapse therapy) to decrease the risk for relapses of P. vivax and P. ovale .

30 mg base (52.6 mg salt) taken orally, 1×/day. Same dose used for both primary and terminal prophylaxis; duration of therapy differs.

0.5 mg/kg base (0.8 mg/kg salt), up to maximum dose of 30 mg base (52.6 mg salt), taken orally, 1×/day Same dose for used both primary and terminal prophylaxis; duration of therapy differs.

Terminal prophylaxis indicated for people with prolonged exposure to P. ovale , P. vivax , or both. Take daily for 14 days after departure from the malaria-endemic area.

Contraindicated in people with G6PD deficiency.

Also contraindicated during pregnancy and breastfeeding unless the breastfed infant has a documented normal G6PD level.

TAFENOQUINE 1

200 mg orally

Not indicated for use in children

Begin taking 3 days before travel to malaria-endemic areas. Take 1×/week, on the same day each week, while in malaria-endemic areas. Take 1 additional dose 1 week after leaving endemic areas. Contraindicated in people with G6PD deficiency. Also contraindicated during pregnancy and breastfeeding unless the breastfed infant has a documented normal G6PD level.

1 Before prescribing primaquine or tafenoquine to any patient, document a normal G6PD level using a quantitative test.

Chloroquine & Hydroxychloroquine

Chloroquine phosphate or hydroxychloroquine sulfate (Plaquenil) can be used to prevent malaria only in destinations where chloroquine-resistant Plasmodium spp. are not active (see Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country ). Prophylaxis should begin 1–2 weeks before travel to malaria-endemic areas. Travelers should continue taking the drug once a week, on the same day of the week, during travel in malaria-endemic areas, and for 4 weeks after they leave endemic areas (see  Table 5-28  for recommended dosages).

Reported side effects of chloroquine and hydroxychloroquine include blurred vision, dizziness, gastrointestinal disturbance, headache, insomnia, and pruritus, but generally, these effects do not require travelers to discontinue the drug. High doses of chloroquine (e.g., those used to treat rheumatoid arthritis) have been associated with retinopathy; this serious side effect appears to be extremely unlikely when chloroquine is used for routine weekly malaria prophylaxis. Chloroquine and related compounds reportedly can exacerbate psoriasis. People who experience uncomfortable side effects after taking chloroquine might tolerate the drug better by taking it with meals. As an alternative, a traveler experiencing side effects might better tolerate the related compound, hydroxychloroquine sulfate.

Doxycycline

Doxycycline prophylaxis should begin 1–2 days before travel to malaria-endemic areas. Doxycycline should then be taken once a day, at the same time each day, during travel in malaria-endemic areas and daily for 4 weeks after the traveler leaves endemic areas. Insufficient data exist on the antimalarial prophylactic efficacy of related compounds (e.g., minocycline, commonly prescribed for the treatment of acne). People on a long-term regimen of minocycline who need malaria prophylaxis should stop taking minocycline 1–2 days before travel and start doxycycline instead. Minocycline can be restarted after the full course of doxycycline is completed (see  Table 5-28  for recommended dosages).

Doxycycline can cause photosensitivity, usually manifested as an exaggerated sunburn reaction. The risk for such a reaction can be minimized by avoiding prolonged, direct exposure to the sun and by using sunscreen (see Sec. 4, Ch. 1, Sun Exposure ). In addition, doxycycline use is associated with an increased frequency of vaginal yeast infections.

Gastrointestinal side effects (nausea, vomiting) can be minimized by taking the drug with a meal or by specifically prescribing doxycycline monohydrate or the enteric-coated doxycycline hyclate, rather than the generic doxycycline hyclate, which is often less expensive. To reduce the risk for esophagitis, advise travelers to swallow the medicine with sufficient fluids and to avoid taking doxycycline shortly before going to bed.

Doxycycline is contraindicated in people with an allergy to tetracyclines, in pregnant people, and in infants and children aged <8 years. Vaccination with the oral typhoid vaccine Ty21a should be completed ≥24 hours before taking a dose of doxycycline.

Mefloquine prophylaxis should begin ≥2 weeks before travel to malaria-endemic areas. Travelers should continue taking the drug weekly, on the same day each week, during travel in malaria-endemic areas and for 4 weeks after leaving endemic areas (see Table 5-28 for recommended dosages).

At prophylactic doses, mefloquine has been associated with rare but serious adverse reactions (e.g., psychosis, seizures); these reactions are more frequent with the higher doses used for treatment. Other side effects reported in prophylaxis studies include abnormal dreams, anxiety disorder, depression, dizziness, gastrointestinal disturbance, headache, insomnia, and visual disturbances. Other neuropsychiatric disorders occasionally reported include aggressive behavior, agitation or restlessness, confusion, encephalopathy, forgetfulness, hallucinations, mood changes, panic attacks, paranoia, and sensory and motor neuropathies (e.g., ataxia, paresthesia, tremors). On occasion, psychiatric symptoms have been reported to continue long after mefloquine has been stopped. FDA also includes a boxed warning about rare reports of persistent dizziness after mefloquine use.

Mefloquine is contraindicated for travelers with a known hypersensitivity to the drug or related compounds (e.g., quinidine, quinine) and in people with active depression, a recent history of depression, generalized anxiety disorder, psychosis, schizophrenia and other major psychiatric disorders, or seizures. Mefloquine should be avoided in people with psychiatric disturbances or a history of depression.

A review of available data suggests that mefloquine can be used safely in people concurrently taking beta-blockers if they have no underlying arrhythmia. Mefloquine is not recommended for people with cardiac conduction abnormalities, however. Any traveler receiving a prescription for mefloquine must also receive a copy of the FDA medication guide  [PDF].

Primaquine can cause potentially life-threatening hemolysis in people with glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Rule out G6PD deficiency with a quantitative laboratory test before prescribing primaquine to patients.

Primaquine phosphate has 2 distinct uses for malaria prevention in people with normal G6PD levels: primary prophylaxis in areas with primarily P. vivax , and terminal prophylaxis for travelers who have had prolonged exposure in malaria-endemic areas. Among people with normal G6PD levels taking primaquine, the most common adverse event is gastrointestinal upset; this occurs most commonly if the drug is taken on an empty stomach, and can be minimized or eliminated if it is taken with food.

Primary Prophylaxis

When taken for primary prophylaxis, primaquine should be taken 1–2 days before travel to malaria-endemic areas, daily (at the same time each day) while in the malaria-endemic area, and daily for 7 days after leaving the area (see Table 5-28 for recommended dosages).

Terminal Prophylaxis

In addition to primary prophylaxis, terminal prophylaxis (also known as presumptive antirelapse therapy) generally is indicated for long-term travelers (e.g., military personnel, missionaries, Peace Corps volunteers) with prolonged exposure to P. ovale or P. vivax malaria. Terminal prophylaxis involves taking primaquine toward the end of the exposure period (or immediately thereafter) for the presumptive purpose of eliminating hypnozoites (dormant liver stages) of P. ovale or P. vivax , thereby preventing relapses or delayed-onset clinical presentations of malaria. Because most malaria-endemic areas of the world (except the Caribbean) have ≥1 species of relapsing malaria, travelers to these areas have some risk for acquiring either P. ovale or P. vivax , although the actual risk for an individual traveler is difficult to define.

When indicated, travelers should take primaquine for 14 days after leaving a malaria-endemic area, concurrently with their primary prophylaxis medication. If chloroquine, doxycycline, or mefloquine are used for primary prophylaxis, prescribe primaquine for travelers to take during the last 2 weeks of postexposure prophylaxis. When atovaquone-proguanil is used for primary prophylaxis, travelers can take primaquine during the final 7 days of atovaquone-proguanil, and then for an additional 7 days. If concurrent administration of primary and terminal prophylaxis is not feasible, instruct travelers to take primaquine after completing their primary prophylaxis medication. Primary prophylaxis with primaquine or with tafenoquine (see the following section) obviates the need for terminal prophylaxis.

Tafenoquine

Tafenoquine can cause potentially life-threatening hemolysis in people with G6PD deficiency. Rule out G6PD deficiency with a quantitative laboratory test before prescribing tafenoquine to patients.

Tafenoquine (Arakoda 100 mg tablets) can be used to prevent malaria in adults (see  Table 5-28  for recommended dosages). Travelers should take a daily loading dose of tafenoquine for 3 days before leaving for a malaria-endemic area; starting 7 days after the loading dose is complete, they should take a weekly maintenance dose while in the malaria-endemic area; then take a final dose in the week after leaving the malaria-endemic area. Doses should be taken on the same day each week.

Tafenoquine is contraindicated in pregnant people and during breastfeeding. Avoid prescribing tafenoquine for people with a history of psychotic disorder; rare psychiatric adverse events have been observed in people with a history of psychotic disorder using higher doses of tafenoquine. The most common adverse events reported with use of tafenoquine are dizziness, gastrointestinal disturbances, headache, and clinically insignificant decreases in hemoglobin. Tafenoquine should be taken with food.

As of 2020, CDC no longer recommends tafenoquine for terminal prophylaxis of P. ovale or P. vivax malaria.

Prophylaxis for Infants, Children & Adolescents

All children traveling to malaria-endemic areas should use recommended prevention measures, which often include taking an antimalarial drug. In the United States, antimalarial drugs are not available in liquid formulation and can taste bitter. Calculate pediatric doses carefully according to the patient’s body weight, but never exceed the adult dose. Pharmacists can pulverize tablets and prepare gelatin capsules for each measured dose. If a child is unable to swallow capsules or tablets, parents should prepare the child’s medication dose by breaking open the gelatin capsule or crushing the pill and mixing the drug with a small amount of something sweet (e.g., condensed milk, chocolate syrup, chocolate spread) to ensure the entire dose is delivered to the child. Giving the dose on a full stomach can minimize stomach upset and vomiting.

Atovaquone-proguanil can be used as prophylaxis for infants and children weighing ≥5 kg (11 lb); prophylactic dosing for children weighing <11 kg (24 lb) constitutes off-label use in the United States. Chloroquine and mefloquine are options for infants and children of all ages and weights, depending on drug resistance at the destination. Doxycycline can be used for children aged ≥8 years. Primaquine can be used for children who are not G6PD-deficient and who are traveling to areas with principally P. vivax. Pediatric dosing regimens are included in Table 5-28 .

Prophylaxis During Pregnancy

Malaria infection can be more severe in pregnant than in nonpregnant people. Malaria increases the risk for adverse pregnancy outcomes, including premature birth, spontaneous abortion, and stillbirth; thus, because no prophylaxis regimen is completely effective, advise people who are pregnant or likely to become pregnant to avoid travel to areas with malaria transmission if possible (see Sec. 7, Ch. 1, Pregnant Travelers ). If travel to a malaria-endemic area cannot be deferred, an effective prophylaxis regimen and mosquito avoidance measures are essential.

Pregnant people traveling to areas where chloroquine-resistant P. falciparum has not been reported can take chloroquine prophylaxis. Chloroquine has not been found to have harmful effects on the fetus when used in the recommended doses for malaria prophylaxis; therefore, pregnancy is not a contraindication for malaria prophylaxis with chloroquine or hydroxychloroquine.

For travel to areas with known chloroquine-resistant Plasmodium , mefloquine is the only medication recommended for malaria prophylaxis during pregnancy. Studies of mefloquine use during pregnancy have found no indication of adverse effects on the fetus.

Atovaquone-proguanil is not recommended for use during pregnancy because of limited availability of data on its safety, and because other options are available. If other antimalarial drug options are not feasible, however, clinicians and patients should weigh the options, risks, and benefits of using atovaquone-proguanil to make the best decision for the patient. Doxycycline is contraindicated for malaria prophylaxis during pregnancy because of the risk for adverse effects seen with tetracycline, a related drug, on the fetus. These adverse effects include discoloration and dysplasia of the teeth and inhibition of bone growth. Neither primaquine nor tafenoquine should be used during pregnancy; both drugs can be passed transplacentally to a G6PD-deficient fetus and cause hemolytic anemia in utero.

People planning to become pregnant can use the same medications recommended for use during pregnancy (chloroquine or mefloquine, depending on the area of travel). CDC does not make recommendations about delaying pregnancy after the use of malaria prophylaxis medicines. If the traveler or their health care provider wishes to decrease the amount of antimalarial drug in the body before conception, however, Table 5-29 provides information on the half-lives of the recommended malaria prophylaxis medicines. After 2 half-lives, ≈25% of the drug remains in the body, ≈6% remains after 4 half-lives, and ≈2% remains after 6 half-lives.

Table 5-29 Malaria chemoprophylaxis: half-lives

Prophylaxis during breastfeeding.

The quantities of antimalarial drugs excreted in the breast milk of lactating people are insufficient to provide adequate protection to nursing infants. Therefore, infants who require prophylaxis should receive the recommended dosages of antimalarial drugs listed in Table 5-28 . Because chloroquine and mefloquine can be prescribed safely to infants, infants also can be safely exposed to the small amounts excreted in breast milk. Data about the use of doxycycline in lactating people are very limited; most experts, however, consider the theoretical possibility of adverse events to the infant to be remote.

Although no information is available on the amount of primaquine or tafenoquine that enters human breast milk, test both the person breastfeeding and the infant for G6PD deficiency before initiating chemoprophylaxis with either one of these drugs. Because data are not yet available on the safety of atovaquone-proguanil prophylaxis in infants weighing <5 kg (11 lb), CDC does not recommend this drug to prevent malaria in people who are breastfeeding infants weighing <5 kg. Atovaquone-proguanil can, however, be used to treat people who are breastfeeding infants of any weight when the potential benefit outweighs the potential risk to the infant (e.g., treating a breastfeeding person who has acquired P. falciparum malaria in an area of multidrug-resistant strains and who cannot tolerate other treatment options).

Travel to Areas with Chloroquine-Resistant Malaria

Chloroquine-resistant P. falciparum is found in all parts of the world except the Caribbean and countries west of the Panama Canal. Although chloroquine-resistant P. falciparum predominates in Africa, it is found in combination with chloroquine-sensitive P. vivax malaria in South America and Asia. Chloroquine-resistant P. vivax has been confirmed only in Papua New Guinea and Indonesia. For destinations with known chloroquine-resistant Plasmodium spp., in addition to mosquito avoidance measures, prescribe atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine as prophylaxis.

Travel to Areas with Chloroquine-Sensitive Malaria

Areas with chloroquine-sensitive Plasmodium spp. include many Latin American countries where malaria predominantly is caused by P. vivax . Chloroquine-sensitive P. falciparum is present in the Caribbean and Central American countries west of the Panama Canal. For destinations with known chloroquine-sensitive Plasmodium spp., in addition to mosquito avoidance measures, the many effective prophylaxis options include chloroquine, atovaquone-proguanil, doxycycline, mefloquine, and tafenoquine. In countries where P. vivax predominates, primaquine is also an option.

Travel to Areas With Mefloquine-Resistant Malaria

Mefloquine-resistant P. falciparum has been confirmed in Southeast Asia on the borders of Thailand with Burma (Myanmar) and Cambodia, in the western provinces of Cambodia, in the eastern states of Burma on the border between Burma and China, along the borders of Burma and Laos, and in southern Vietnam. For destinations with known mefloquine-resistant Plasmodium spp., in addition to mosquito avoidance measures, prophylaxis options are atovaquone-proguanil, doxycycline, and tafenoquine.

Travel to Areas With Limited Malaria Transmission

For destinations where malaria cases occur sporadically and risk for infection to travelers is considered low, CDC recommends that travelers use mosquito avoidance measures only, and no chemoprophylaxis (see Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country ).

Changing Medications as a Result of Side Effects During Prophylaxis

Medications recommended for malaria prophylaxis have different modes of action that affect the parasites at different stages of the life cycle. Thus, if the medication needs to be changed because of side effects before a full course has been completed, some special considerations exist (see Table 5-30 ).

Table 5-30 Malaria chemoprophylaxis: changing medications due to side effects

Obtaining medications overseas.

Medications recommended for malaria prophylaxis might be available at overseas destinations. Combinations of these medications and additional drugs that are not recommended might be commonly prescribed and used in other countries, however. Strongly discourage travelers from obtaining prophylaxis medications while abroad. The quality of these products is not known; products might be produced under substandard manufacturing practices, be counterfeit, contain contaminants, not be protective, or be dangerous. Additional information on medications obtained while traveling can be found in Sec. 6, Ch. 3, . . . perspectives: Avoiding Poorly Regulated Medicines & Medical Products During Travel , and on the FDA website .

Blood Donation After Travel to Malaria-Endemic Areas

People who have been in an area where malaria transmission occurs should defer donating blood after returning from the malaria-endemic area to prevent transmission of malaria through blood transfusion (see Table 5-31 ).

Risk assessments can differ between travel health providers and blood banks. A travel health provider advising a traveler going to a country with relatively low malaria transmission for a short period of time and engaging in low-risk behaviors might suggest the traveler use only mosquito bite precautions and no prophylaxis. Upon the traveler’s return, however, a blood bank might still choose to defer blood donations from that traveler for 1 year because of travel to an area where transmission occurs.

Table 5-31 US Food and Drug Administration recommendations for deferring blood donation in people returning from malaria-endemic areas

CDC website: Malaria

The following authors contributed to the previous version of this chapter: Kathrine R. Tan, Paul M. Arguin

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