General information

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. If visiting European Economic Area (EEA) countries carry an European health insurance card (EHIC) as this will allow access to state-provided healthcare in EEA countries, at a reduced cost, or sometimes for free. The EHIC, however, is not an alternative to travel 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. Country specific diphtheria recommendations are not provided here. Diphtheria tetanus and polio are combined in a single vaccine in the UK. Therefore, when a tetanus booster is recommended for travellers, diphtheria vaccine is also given. Should there be an outbreak of diphtheria in a country, diphtheria vaccination guidance will be provided.

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 are no certificate requirements under International Health Regulations.

For Saint Martin, Saint Barthélemy and Guadeloupe (France –  islands in the Caribbean Sea) only

  • There is no risk of yellow fever on these islands, however, there is a certificate requirement.
  • Under International Health Regulations, a yellow fever vaccination certificate is required for travellers over 1 year of age arriving from countries with risk of yellow fever transmission and for travellers having transited more than 12 hours through the airport of a country with risk of yellow fever transmission.
  • Due to an outbreak of yellow fever in Brazil 2017, country certificate requirements may be updated at short notice. Please check Pan American Health Organisation for updated or additional requirements for the international certificate of vaccination or prophylaxis
  • 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.

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.

Rabies (Bat Lyssavirus)

Although rare, bat lyssaviruses (bat rabies) can be transmitted to humans or other animals following contact with the saliva of an infected bat most often by a bite. The disease can also be transmitted if the saliva of an infected bat gets into open wounds or mucous membranes (such as on the eye, nose or mouth). Bat lyssaviruses can cause disease in humans that is indistinguishable from rabies.

Symptoms can take some time to develop, but when they do the condition is almost always fatal.

The risk to most travellers is low. However, it is increased for certain occupations for example bat handlers and veterinarians, or certain activities such as caving.

 Bat Lyssavirus in France

Rabies has not been reported in domestic or wild animals in this country; therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies).

Prevention

Travellers should avoid contact with bats. Bites from bats are frequently unrecognised. Rabies-like disease caused by bat lyssaviruses is preventable with prompt post-exposure rabies treatment.

Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial. Although rabies has not been reported in other animals in this country, it is sensible to seek prompt medical advice if bitten or scratched. It is possible, although very rare for bats to pass rabies like viruses to other animals including pets.

Post-exposure treatment and advice should be in accordance with national guidelines.

Rabies vaccination
  • Pre-exposure rabies vaccinations are recommended for those who are at increased risk due to their work (e.g. laboratory staff working with the virus and those working with bats).
  • Pre exposure vaccines could be considered for those whose activities put them at increased risk of exposure to bats.

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, meadows, forest fringes and glades). Ticks are usually most active between early spring and late autumn.

Tick-borne encephalitis in France

There is a risk of TBE in some areas of this country. The main affected areas are in the departments of Bas-Rhin and Haut-Rhin. Cases have also been reported near the cities of Nancy, Grenoble, Faverges, and in the department of Gironde. The transmission season varies, however, ticks are most active during early spring to late autumn.

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
  • If vaccination is being considered, please seek specialist advice.

Tick-borne encephalitis in brief

Other risks

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

Altitude Illness

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 France

 There is a point of elevation in this country higher than 2,500 metres. An example place of interest; Mt Blanc 4,807m.

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 Guadeloupe and St Barthelemy

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 French Island of Corsica

Cases of schistosomiasis have been reported in Corsica.

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

Zika Virus

Zika virus (ZIKV) is a viral infection transmitted by mosquitoes which predominantly feed between dawn and dusk. A small number of cases of sexual transmission of ZIKV have also been reported. Most people infected with ZIKV have no symptoms. When symptoms do occur they are usually mild and short-lived. Serious complications and deaths are not common. However, there is now scientific consensus that Zika virus is a cause of congenital Zika syndrome (microcephaly and other congenital anomalies) and Guillain-Barré syndrome.

Zika virus in Guadeloupe, St Barthélemy and St Martin

These islands are considered to have a high risk of  ZIKV transmission. Increasing or widespread transmission has been reported. Pregnant women are advised to postpone non-essential travel until after pregnancy.  Details of specific affected areas are not available.

Prevention

  • All travellers should avoid mosquito bites particularly between dawn and dusk.
  • There is no vaccination or medication to prevent ZIKV infection.
  • It is recommended that pregnant women planning to travel to areas with a high risk of ZIKV transmission should postpone non-essential travel until after pregnancy.
  • Women should avoid becoming pregnant while travelling in, and for 8 weeks after leaving an area with active ZIKV transmission or 8 weeks after last possible ZIKV exposure (see further information and advice if male partner has travelled).
  • If a woman develops symptoms compatible with ZIKV infection, it is recommended she avoids becoming pregnant for a further 8 weeks following recovery.
  • Pregnant women who visited this country while pregnant, or who become pregnant within 8 weeks of leaving this country or within 8 weeks after last possible ZIKV exposure, should contact their GP, obstetrician or midwife for further advice, even if they have not been unwell. Further information about when to perform fetal ultrasound scanning, and, if necessary, referral to the local fetal medicine service is available.

Preventing sexual transmission

See detailed guidance on factors to consider when assessing the risk of ZIKV.

Zika virus in brief

Important News

26 Apr 2017

Measles in Europe

A reminder for travellers to be up to date with measles vaccine Read more

06 Apr 2017

European cluster of cases of hepatitis A

Outbreaks of hepatitis A have been reported in Europe mostly affecting men who have sex with men (MSM) Read more

19 Jan 2016

Schistosomiasis in Corsica, France - update

A further case of schistosomiasis, probably associated with bathing in the River Cavu, Southern Corsica Read more

16 Jan 2016

Zika virus - update and advice for pregnant women

Pregnant women are advised to reconsider travel to areas where Zika virus (ZIKV) outbreaks are currently reported as further evidence for a possible l Read more

15 Oct 2015

West Nile virus: France

The first locally acquired case human case of West Nile virus since 2003 has been reported in France Read more

01 Sep 2015

Dengue in France

2 cases of locally acquired dengue reported in Nimes, Languedoc-Roussillon region of France Read more

21 Aug 2015

Schistosomiasis: Corsica, France - update

Further cases of (presumed) locally acquired schistosomiasis associated with the River Cavu, Corsica 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

02 Jun 2015

Schistosomiasis: Corsica, France

Transmission of schistosomiasis (locally acquired): Corsica, France Read more

27 May 2015

Imported canine rabies: France

A report of a confirmed case of rabies in a domestic dog, Le Chambon Feugerolles, Loire, Rhône-Alpes, France
Read more

11 May 2015

Measles: worldwide

A measles reminder for health professionals and travellers Read more

18 Feb 2015

Measles: worldwide

A measles reminder for health professionals and travellers Read more

Outbreaks

28 Apr 2017 France

As of 26 April 2017, the first confirmed locally acquired case of eosinophilic meningitis caused by Angiostrongylus cantonensis has been reported in Paris, France. Onset was in 2016.

Human

Food and water-borne

New Post

Verified

Journal of Emerging Infectious Diseases - Read more

14 Dec 2016 View Countries + Austria
Croatia
Denmark
Finland
France
Germany
Hungary
Netherlands
Poland
Romania
Russia
Serbia
Sweden
Switzerland

As 8 December 2016, outbreaks have been reported from 30 October to 6 December in 14 countries in the European region: Austria, Croatia, Denmark, Finland, France, Germany, Hungary, Netherlands, Poland, Romania, Russia, Serbia, Switzerland, Sweden. In 2016, outbreaks in poultry holdings have been reported in eight countries: Austria, Denmark, France, Germany, Hungary, Netherlands, Poland, Sweden. Six European countries were affected by outbreaks in the 2014/15 winter: Germany, Italy, Hungary, Netherlands, Sweden, and the UK.

Animal

Air-Borne

New Post

Verified

Eurosurveillance - Read more

02 Dec 2016 View Countries + Austria
Belgium
Czech Republic
Denmark
France
Germany
Ireland
Italy
Lithuania
Netherlands
Norway
Portugal
Slovenia
Spain
Sweden

As of 25 November 2016, a range of Dutch cured fish products exported to 16 European countries have been recalled due to the risk of food poisoning with Clostridium botulinum Type E

Human

Food and water-borne

New Post

Verified

European Commission - Read more

29 Nov 2016 Pas-de-Calais. France

As of 28 November 2016, the first case was reported amongst wild ducks.

Animal

Air-Borne

New Post

Verified

State - Read more