The information on these pages should be used to research health risks and to inform the pre-travel consultation. For advice regarding safety and security please check the UK Foreign and Commonwealth Office (FCO) website.
Travellers should ideally arrange an appointment with their health professional at least four to six weeks before travel. However, even if time is short, an appointment is still worthwhile. This appointment provides an opportunity to assess health risks taking into account a number of factors including destination, medical history, and planned activities. For those with pre-existing health problems, an earlier appointment is recommended.
While most travellers have a healthy and safe trip, there are some risks that are relevant to travellers regardless of destination. These may for example include road traffic and other accidents, diseases transmitted by insects or ticks, diseases transmitted by contaminated food and water, sexually transmitted infections, or health issues related to the heat or cold.
All travellers should ensure they have adequate travel health insurance.
A list of useful resources including advice on how to reduce the risk of certain health problems is available below.
Details of vaccination recommendations and requirements are provided below.
Travellers should be up to date with routine vaccination courses and boosters as recommended in the UK. These vaccinations include for example measles-mumps-rubella (MMR) vaccine and diphtheria-tetanus-polio vaccine.
Those who may be at increased risk of an infectious disease due to their work, lifestyle choice, or certain underlying health problems should be up to date with additional recommended vaccines. See the individual chapters of the ‘Green Book’ Immunisation against infectious disease for further details.
There are no certificate requirements under International Health Regulations.
The vaccines in this section are recommended for most travellers visiting this country. Information on these vaccines can be found by clicking on the blue arrow. Vaccines are listed alphabetically.
Hepatitis A is a viral infection transmitted through contaminated food and water or by direct contact with an infectious person. Symptoms are often mild or absent in young children, but the disease becomes more serious with advancing age. Recovery can vary from weeks to months. Following hepatitis A illness immunity is lifelong.
Those at increased risk include travellers visiting friends and relatives, long-stay travellers, and those visiting areas of poor sanitation.
All travellers should take care with personal, food and water hygiene.
As hepatitis A vaccine is well tolerated and affords long-lasting protection, it is recommended for all previously unvaccinated travellers.
Tetanus is caused by a toxin released from Clostridium tetani and occurs worldwide. Tetanus bacteria are present in soil and manure and may be introduced through open wounds such as a puncture wound, burn or scratch.
Travellers should thoroughly clean all wounds and seek appropriate medical attention.
Country specific information on medical facilities may be found in the ‘health’ section of the FCO foreign travel advice website.
The vaccines in this section are recommended for some travellers visiting this country. Information on when these vaccines should be considered can be found by clicking on the arrow. Vaccines are listed alphabetically.
Hepatitis B is a viral infection; it is transmitted by exposure to infected blood or body fluids. This mostly occurs during sexual contact or as a result of blood-to-blood contact (for example from contaminated equipment during medical and dental procedures, tattooing or body piercing procedures, and sharing of intravenous needles). Mothers with the virus can also transmit the infection to their baby during childbirth.
2% or more of the population are known or thought to be persistently infected with the hepatitis B virus (intermediate/high prevalence).
Travellers should avoid contact with blood or body fluids. This includes:
A sterile medical equipment kit may be helpful when travelling to resource poor areas.
Vaccination could be considered for all travellers, and is recommended for those whose activities or medical history put them at increased risk including:
Rabies is a viral infection which is usually transmitted following contact with the saliva of an infected animal most often via a bite, scratch or lick to an open wound or mucous membrane (such as on the eye, nose or mouth). Although many different animals can transmit the virus, most cases follow a bite or scratch from an infected dog. In some parts of the world, bats are an important source of infection.
Rabies symptoms can take some time to develop, but when they do, the condition is almost always fatal.
The risk of exposure is increased by certain activities and length of stay (see below). Children are at increased risk as they are less likely to avoid contact with animals and to report a bite, scratch or lick.
Rabies has been reported in domestic and wild animals in this country. Bats may also carry rabies-like viruses.
Pre-exposure vaccinations are recommended for travellers whose activities put them at increased risk including:
A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure treatment and removes the need for rabies immunoglobulin which is in short supply world-wide.
Typhoid is a bacterial infection transmitted through contaminated food and water. Previous typhoid illness may only partially protect against re-infection.
Travellers who will have access to safe food and water are likely to be at low risk. Those at increased risk include travellers visiting friends and relatives, frequent or long-stay travellers to areas where sanitation and food hygiene are likely to be poor.
Typhoid fever is known or presumed to occur in this country.
All travellers should take care with personal, food and water hygiene.
Malaria is a serious illness caused by infection of red blood cells with a parasite called Plasmodium. The disease is transmitted by mosquitoes which predominantly feed between dusk and dawn.
Symptoms usually begin with a fever (high temperature) of 38°C (100°F) or more. Other symptoms may include feeling cold and shivery, headache, nausea, vomiting and aching muscles. Symptoms may appear between eight days and one year after the infected mosquito bite.
Prompt diagnosis and treatment is required as people with malaria can deteriorate quickly. Those at higher risk of malaria, or of severe complications from malaria, include pregnant women, infants and young children, the elderly, travellers who do not have a functioning spleen and those visiting friends and relatives.
Travellers should follow an ABCD guide to preventing malaria:
Awareness of the risk – Risk depends on the specific location, season of travel, length of stay, activities and type of accommodation.
Bite prevention – Travellers should take mosquito bite avoidance measures.
Chemoprophylaxis – Travellers should take antimalarials (malaria prevention tablets) if appropriate for the area (see below). No antimalarials are 100% effective but taking them in combination with mosquito bite avoidance measures will give substantial protection against malaria.
Diagnosis – Travellers who develop a fever of 38°C [100°F] or higher more than one week after being in a malaria risk area, or who develop any symptoms suggestive of malaria within a year of return should seek immediate medical care. Emergency standby treatment may be considered for those going to remote areas with limited access to medical attention.
The recommended antimalarials are listed below. They are recommended for certain areas only (see description of risk areas above). If these are not suitable please seek further specialist advice.
Please note, the advice for children is different, the dose is based on body weight and some antimalarials are not suitable.
The risks below may be present in all or part of the country and are listed alphabetically.
There is a risk of altitude illness when travelling to destinations of 2,500 metres (8,200 feet) or higher. Important risk factors are the altitude gained, rate of ascent and sleeping altitude. Rapid ascent without a period of acclimatisation puts a traveller at increased risk.
There are three syndromes; acute mountain sickness (AMS), high-altitude cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE). HACE and HAPE require immediate descent and medical treatment.
There is a point of elevation in this country higher than 2,500 metres. An example place of interest, Mt Ararat 5,185m.
Schistosomiasis is a parasitic infection. Schistosoma larvae are released from infected freshwater snails and can penetrate intact human skin following contact with contaminated freshwater. Travellers may be exposed during activities such as wading, swimming, bathing or washing clothes in freshwater streams, rivers or lakes.
Schistosomiasis infection may cause no symptoms, but early symptoms can include a rash and itchy skin (‘swimmer’s itch’), fever, chills, cough, or muscle aches. If not treated, it can cause serious long term health problems such as intestinal or bladder disease.
Cases of schistosomiasis have previously been reported from this country, however according to World Health Organization (WHO) in 2012, transmission of schistosoma larvae in fresh water may have been interrupted. Most travellers are considered to be at very low risk.
Human cases of Tick-borne encephalitis (TBE) for this country are unknown, but there is some evidence that there is a possible risk.
Tick-borne encephalitis (TBE) is a viral infection transmitted by the bite of infected ticks. Less commonly, cases of TBE occur following ingestion of unpasteurised milk products.
Travellers are at increased risk of exposure during outdoor activities in areas of vegetation (gardens, parks, meadows, forest fringes and glades). Ticks are usually most active between early spring and late autumn.
03 May 2017
NaTHNaC has reviewed and updated the tick-borne encephalitis country specific information in order to provide up-to-date recommendations for traveller Read more