General information

See also:

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.

Resources

Vaccine recommendations

Details of vaccination recommendations and requirements are provided below.

All Travellers

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.

Certificate Requirements

Please read the information below carefully, as certificate requirements may be relevant to certain travellers only. For travellers further details, if required, should be sought from their healthcare professional.

  • There is no risk of yellow fever in China, however, there is a certificate requirement.
  • Under International Health Regulations, a yellow fever vaccination certificate is required from travellers over 1 year of age arriving from countries with risk of yellow fever transmission and for all travellers having transited through an airport of a country with risk of yellow fever transmission. This requirement does not apply to travellers whose itineraries are limited to Hong Kong Special Administrative Region (SAR) and Macao SAR.
  • According to World Health Organization (WHO), from 11 July 2016 (for all countries), the yellow fever certificate will be valid for the duration of the life of the person vaccinated. As a consequence, a valid certificate, presented by arriving travellers, cannot be rejected on the grounds that more than ten years have passed since the date vaccination became effective as stated on the certificate; and that boosters or revaccination cannot be required. See WHO Q&A.
  • View the WHO list of countries with risk of yellow fever transmission.
 

Most Travellers

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

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.

Prevention

All travellers should take care with personal, food and water hygiene.

Hepatitis A vaccination

As hepatitis A vaccine is well tolerated and affords long-lasting protection, it is recommended for all previously unvaccinated travellers.

Hepatitis A in brief

Tetanus

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.

Prevention

Travellers should thoroughly clean all wounds and seek appropriate medical attention.

Tetanus vaccination
  • Travellers should have completed a primary vaccination course according to the UK schedule.
  • If travelling to a country where medical facilities may be limited, a booster dose of a tetanus-containing vaccine is recommended if the last dose was more than ten years ago even if five doses of vaccine have been given previously.

Country specific information on medical facilities may be found in the ‘health’ section of the FCO foreign travel advice website.

Tetanus in brief

Some Travellers

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

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.

Hepatitis B in China

2% or more of the population are known or thought to be persistently infected with the hepatitis B virus (intermediate/high prevalence).

Prevention

Travellers should avoid contact with blood or body fluids. This includes:

  • avoiding unprotected sexual intercourse.
  • avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile equipment is used).
  • not sharing needles or other injection equipment.
  • following universal precautions if working in a medical/dental/high risk setting.

A sterile medical equipment kit may be helpful when travelling to resource poor areas.

Hepatitis B vaccination

Vaccination could be considered for all travellers, and is recommended for those whose activities or medical history put them at increased risk including:

  • those who may have unprotected sex.
  • those who may be exposed to contaminated needles through injecting drug use.
  • those who may be exposed to blood or body fluids through their work (e.g. health workers).
  • those who may be exposed to contaminated needles as a result of having medical or dental care e.g. those with pre-existing medical conditions and those travelling for medical care abroad including those intending to receive renal dialysis overseas.
  • long-stay travellers
  • those who are participating in contact sports.
  • families adopting children from this country.

Hepatitis B in brief

Japanese Encephalitis (JE)

Japanese encephalitis (JE) is a viral infection transmitted to humans from animals (mainly pigs and birds) by mosquitoes which typically breed in rice paddy fields, swamps and marshes.  These mosquitoes predominantly feed between dusk and dawn.

Those at increased risk include travellers who are staying for a month or longer during the transmission season, especially if travel will include rural areas with rice fields and marshland.

Travellers on shorter trips (typically less than a month), or trips that take place outside the peak transmission season and those who restrict their visits to urban areas are usually considered to be at very low risk.

Japanese encephalitis in China

The affected areas include all provinces except Xizang (Tibet), Xinjiang and Qinghai. Rare cases have been reported in Hong Kong. The transmission seasons are typically:

  • Northern China; May to September
  • Southern China (Guangxi, Yunnan, Guangdong, Southern Fujian, Sichuan, Guizhou, Hunan and Jiangxi provinces); April to October
  • Hong Kong; April to October

Rarely cases in travellers are reported outside these months.

Prevention

All travellers should avoid mosquito bites particularly between dusk and dawn.

Japanese encephalitis vaccination
  • Vaccination is recommended for those whose activities put them at increased risk (see above).
  • Vaccination could be considered for those on shorter trips if the risk is considered to be sufficient e.g. those spending time in areas where the mosquito breeds such as rice fields or marshlands, or pig farming areas.

Japanese encephalitis in brief

Rabies

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 in China

Rabies has been reported in domestic and wild animals in this country. Bats may also carry rabies-like viruses.

Prevention
  • Travellers should avoid contact with all animals. Rabies is preventable with prompt post-exposure treatment.
  • Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial.
  • Post-exposure treatment and advice should be in accordance with national guidelines.
Rabies vaccination

Pre-exposure vaccinations are recommended for travellers whose activities put them at increased risk including:

  • those at risk due to their work (e.g. laboratory staff working with the virus, those working with animals or health workers who may be caring for infected patients).
  • those travelling to areas where access to post-exposure treatment and medical care is limited.
  • those planning higher risk activities such as running or cycling.
  • long-stay travellers (more than one month).

Rabies in brief

Tick-Borne Encephalitis (TBE)

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, forest fringes and meadows typically below 1,500 metres). Ticks are most active between spring and autumn.

Tick-borne encephalitis in China

There is a risk of TBE is some areas of the country. The areas mainly affected are Heilongjiang province, the north-eastern forested areas of the Changbai mountains, around Hunchun in Jilin province and Greater Khingan (Daxingan) Mountain in Inner Mongolia province. The transmission season varies, however, ticks are most active during early spring to late autumn (March to November).

Prevention
  • All travellers should avoid tick bites during outdoor activities.
  • Travellers should check their skin regularly for ticks and remove them as soon as possible with a recommended technique.
  • Travellers should not eat or drink unpasteurised milk products.
Tick-borne encephalitis vaccination

Vaccination is recommended for those visiting affected areas whose activities put them at increased risk including:

  • those who are going to live in TBE risk areas
  • those working in forestry, woodcutting, farming and the military
  • travellers to forested areas typically during spring to late autumn e.g. campers, hikers, hunters and individuals who undertake fieldwork
  • laboratory workers who may be exposed to TBE

Tick-borne encephalitis in brief

Tuberculosis (TB)

TB is a bacterial infection transmitted most commonly by inhaling respiratory droplets from an infectious person. This is usually following prolonged or frequent close contact.

Tuberculosis in China

The average annual incidence of TB is greater than or equal to 40 cases per 100,000 population (further details).

Prevention

Travellers should avoid close contact with individuals known to have infectious pulmonary (lung) TB.

Those at risk during their work (such as healthcare workers) should take appropriate infection control precautions.

Tuberculosis (BCG) vaccination

According to current national guidance, BCG vaccine should be recommended for those at increased risk of developing severe disease and/or of exposure to TB infection. See Public Health England’s Immunisation against infectious disease, the ‘Green Book’.

For travellers, BCG vaccine is also recommended for:

  • unvaccinated, children under 16 years of age, who are going to live for more than 3 months in this country. A tuberculin skin test is required prior to vaccination for all children from 6 years of age and may be recommended for some younger children.
  • unvaccinated, tuberculin skin test negative individuals under 35 years of age at risk due to their work such as healthcare workers, prison staff and vets. Healthcare workers may be vaccinated over the age of 35 years following a careful risk assessment.

There are specific contraindications associated with the BCG vaccine and health professionals must be trained to administer this vaccine intradermally (just under the top layer of skin).

Following administration, no further vaccines should be administered in the same limb for 3 months.

The BCG vaccine is given once only, booster doses are not recommended.

Tuberculosis in brief

Typhoid

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 in China

Typhoid fever is known or presumed to occur in this country.

Prevention

All travellers should take care with personal, food and water hygiene.

Typhoid vaccination
  • Both oral and injectable typhoid vaccinations are available, and vaccination is recommended for laboratory personnel who may handle the bacteria for their work.
  • Vaccination could be considered for those whose activities put them at increased risk (see above).

Typhoid in brief

Malaria

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.

Prevention

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.

Risk Areas

  • There is a high risk of malaria in Yunnan and Hainan provinces in China: atovaquone/proguanil OR doxycycline OR mefloquine recommended.
  • There is a very low risk of malaria in southern and some central provinces, including Anhui, Ghuizhou, Henan, Hubei, Jiangsu below 1,500m: awareness of risk and bite avoidance recommended.
  • The rest of China, including the main tourist areas and cruises on the Yangtze river, are also very low risk: awareness of risk and bite avoidance recommended.

Antimalarial Recommendations Map

China-malaria-map

Recommended Antimalarials

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.

Atovaquone/Proguanil

Atovaquone 250mg/Proguanil 100mg combination preparation:

  • start one to two days before arrival in the malaria risk area
  • for adults, one tablet is taken every day, ideally at the same time of day for the duration of the time in a malaria risk area and daily for seven days after leaving the malaria risk area
  • take with a fatty meal if possible
  • for children paediatric tablets are available and the dose is based on body weight (see table below)

Doxycycline

Doxycycline 100mg:

  • start one to two days before arrival in the malaria risk area
  • adults and children over 12 years of age take 100mg daily, ideally at the same time of day for the duration of the time in a malaria risk area and daily for four weeks after leaving the malaria risk area
  • take with food if possible; avoid taking this drug just before lying down
  • not suitable for children under 12 years of age

Mefloquine

Mefloquine 250mg:

  • this drug is taken weekly, adults take one 250mg tablet each week
  • start two to three weeks before arrival in the malaria risk area and continue weekly until four weeks after leaving the malaria risk area
  • for children the dose is based on the body weight (see table below)

Resources

Other risks

The risks below may be present in all or part of the country and are presented alphabetically.

Altitude

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 higher 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.

Altitude illness in China

 There is a point of elevation in this country higher than 2,500 metres.

Prevention

  • Travellers should spend a few days at an altitude below 3,000m.
  • Where possible travellers should avoid travel from altitudes less than 1,200m to altitudes greater than 3,500m in a single day.
  • Ascent above 3,000m should be gradual. Travellers should avoid increasing sleeping elevation by more than 500m per day and ensure a rest day (at the same altitude) every three or four days.
  • Acetazolamide can be used to assist with acclimatisation, but should not replace gradual ascent.
  • Travellers who develop symptoms of AMS (headache, fatigue, loss of appetite, nausea and sleep disturbance) should avoid further ascent. In the absence of improvement or with progression of symptoms the first response should be to descend.
  • Development of HACE or HAPE symptoms requires immediate descent and emergency medical treatment.

Altitude illness in brief

Dengue

Dengue is a viral infection transmitted by mosquitoes which predominantly feed between dawn and dusk.  It causes a flu-like illness, which can occasionally develop into a more serious life-threatening form of the disease. Severe dengue is rare in travellers.

The mosquitoes that transmit dengue are most abundant in towns, cities and surrounding areas. All travellers to dengue areas are at risk.

Dengue in China

Dengue is known or has the potential to occur in this country.

 Prevention

  • All travellers should avoid mosquito bites particularly between dawn and dusk.
  • There is no vaccination or medication to prevent dengue.

Dengue in brief

Schistosomiasis

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.

Schistosomiasis in China

According to World Health Organization (WHO), cases of schistosomiasis were reported in this country in 2012.

Prevention

  • There is no vaccine or tablets to prevent schistosomiasis.
  • All travellers should avoid wading, swimming, or bathing in freshwater where possible. Swimming in chlorinated water or sea water is not a risk for schistosomiasis.
  • Topical application of insect repellent before exposure to water, or towel drying after accidental exposure to schistosomiasis are not reliable in preventing infection.
  • All travellers who may have been exposed to schistosomiasis should have a medical assessment.

Schistosomiasis in brief

Important News

05 Jan 2017

Avian flu: Chinese New Year Travel Advice

Travelling to China to celebrate the New Year? Read more

31 Mar 2016

Yellow Fever in Angola

Yellow Fever outbreak in Angola and imported cases reported in China, the Democratic Republic of Congo and Kenya Read more

27 Jan 2016

Avian flu advice for travellers going to China

Travellers should be aware of the risk of avian flu when travelling to China for Chinese New Year Read more

22 Jun 2015

MERS-CoV update: Republic of Korea and China

Ongoing surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) in Republic of Korea (South Korea) and China Read more

05 Jun 2015

MERS-CoV: Republic of Korea and China

Middle East respiratory syndrome coronavirus (MERS-CoV) update: Republic of Korea and China Read more

22 May 2015

Hand, foot and mouth disease in the Western Pacific region

Japan has reported 15,285 cases of Hand, foot and mouth disease (HFMD) Read more

11 May 2015

Measles: worldwide

A measles reminder for health professionals and travellers Read more

18 Mar 2015

Avian influenza: Egypt and worldwide

Human infections with avian influenza viruses in Egypt and worldwide
Read more

18 Feb 2015

Measles: worldwide

A measles reminder for health professionals and travellers Read more

10 Feb 2015

Imported avian influenza A (H7N9): Canada

First cases of influenza A (H7N9) infection in humans in North America Read more

Outbreaks

17 Nov 2016 China

On 11 November 2016, two additional cases of laboratory-confirmed human infection with avian influenza A(H7N9) virus have been reported. 1 case from Zhejiang Province and 1 case from Jiangsu Province. A total of 800 laboratory-confirmed cases with avian influenza A (H7N9) virus infection have been reported since early 2013.

Human

Air-Borne

Updates 1

Verified

WHO - Read more

25 Jul 2016 View Countries + Angola
China

As of 24 July 2016, the first imported case in a 45-year old male. The case fell ill 14 July whilst in Angola and was diagnosed upon return to Beijing 23 July 2016. The patient is currently undergoing treatment in an isolation unit.

Human

Imported

Vector-Borne

New Post

Verified

State - Read more

09 Jun 2016 Hunan. China

As of 30 May 2016, a human case of influenza A (H5N6) has been confirmed in a 50 year old male from Xiangxi Autonomous Prefecture, Hunan Province.

Human

Air-Borne

New Post

Verified

WHO - Read more

04 Apr 2016 View Countries + Angola
China

As of 2 April 2016, four imported cases have been reported in Fujian Province.

Human

Imported

Vector-Borne

Updates 2

Verified

State - Read more