There are some risks that are relevant to all 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.
Some additional risks (which may be present in all or part of this country) are mentioned below and are presented alphabetically. Select risk to expand information.
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 India
There is a point of elevation in this country higher than 2,500 metres. Some example places of interest, Leh 3,514m and Darjeeling 2,127m.
- 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
Insect or tick bites can cause irritation and infections of the skin at the site of a bite. They can also spread certain diseases.
Diseases in South Asia
There is a risk of insect or tick-borne diseases in some areas of South Asia. This includes diseases such as chikungunya, Crimean-Congo haemorrhagic fever, leishmaniasis and scrub typhus.
- All travellers should avoid insect and tick bites day and night.
- There are no vaccinations (or medications) to prevent these diseases.
Further information about specific insect or tick-borne diseases for this country can be found, if appropriate on this page, in other sections of the country information pages and the insect and tick bite avoidance factsheet.
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 India
There is a risk of dengue in this country.
- All travellers should avoid mosquito bites particularly between dawn and dusk.
- There is currently no medication or vaccination available for travellers to prevent dengue.
Dengue in brief
Seasonal influenza is a viral infection of the respiratory tract and spreads easily from person to person via respiratory droplets when coughing and sneezing. Symptoms appear rapidly and include fever, muscle aches, headache, malaise (feeling unwell), cough, sore throat and a runny nose. In healthy individuals, symptoms improve without treatment within two to seven days. Severe illness is more common in those aged 65 years or over, those under 2 years of age, or those who have underlying medical conditions that increase their risk for complications of influenza.
Seasonal influenza in India
Seasonal influenza occurs throughout the world. In the northern hemisphere (including the UK), most influenza occurs from as early as October through to March. In the southern hemisphere, influenza mostly occurs between April and September. In the tropics, influenza can occur throughout the year.
All travellers should:
- Avoid close contact with symptomatic individuals
- Avoid crowded conditions where possible
- Wash their hands frequently
- Practise ‘cough hygiene’: sneezing or coughing into a tissue and promptly discarding it safely, and washing their hands
- Avoid travel if unwell with influenza-like symptoms
- A vaccine is available in certain circumstances (see below)*
*In the UK, seasonal influenza vaccine is offered routinely each year to those at higher risk of developing of severe disease following influenza infection, and certain additional groups such as healthcare workers and children as part of the UK national schedule (see information on vaccination). For those who do not fall into these groups, vaccination may be available privately.
If individuals at higher risk of severe disease following influenza infection are travelling to a country when influenza is likely to be circulating they should ensure they received a flu vaccination in the previous 12 months.
The vaccine used in the UK protects against the strains predicted to occur during the winter months of the northern hemisphere. It is not possible to obtain vaccine for the southern hemisphere in the UK, but the vaccine used during the UK influenza season should still provide important protection against strains likely to occur during the southern hemisphere influenza season, and in the tropics.
Avian influenza viruses can rarely infect and cause disease in humans. Such cases are usually associated with close exposure to infected bird or animal populations. Where appropriate, information on these will be available in the outbreaks and news sections of the relevant country pages. Seasonal influenza vaccines will not provide protection against avian influenza.
Avian influenza in brief
Poor air quality is a significant public health problem in many parts of the world. Exposure to high levels of air pollution over short time periods (e.g. minutes/hours/days) and longer time periods (e.g. years) is linked to many different acute and chronic health problems. These effects are mainly on the respiratory (lungs and airways) and cardiovascular (heart function and blood circulation) systems.
Current information on world air quality is available from the world air quality index project.
Travellers with health problems that might make them more vulnerable to the effects of air pollution who are travelling to areas of high pollution should:
- discuss their travel plans with their doctor, and carry adequate supplies of their regular medication
- take sensible precautions to minimise their exposure to high levels of air pollution
- check local air quality data and amend their activities accordingly
- take notice of any health advisories published by the local Ministry of Health and Department for Environment, and follow the guidance provided.
It is unclear if face masks are beneficial at reducing exposure and may make breathing more difficult for those with pre-existing lung conditions. Those who choose to use one should make sure that the mask fits well and know how to wear it properly.
Outdoor air quality in brief
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 India
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.
- 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 (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 ZIKV is a cause of Congenital Zika Syndrome (microcephaly and other congenital anomalies) and neurological complications such as Guillain-Barré syndrome.
Zika virus in India
There is a risk of ZIKV in this country. Pregnant women should consider avoiding travel to this country until after the pregnancy. In the event that travel is unavoidable, the pregnant traveller must be informed of the risks which ZIKV presents.
- All travellers should avoid mosquito bites particularly between dawn and dusk.
- There is no vaccination or medication to prevent ZIKV infection.
- Women should avoid becoming pregnant while travelling in this country, and for 2 months (8 weeks) after their last possible ZIKV exposure* (see below if male partner has travelled).
- If a woman develops symptoms compatible with ZIKV infection, it is recommended she avoids becoming pregnant for a further 2 months following recovery.
- Pregnant women who visited this country while pregnant, or who become pregnant within 2 months after their last possible ZIKV exposure*, should contact their GP, obstetrician or midwife for further advice, even if they have not been unwell.
Please note screening of returning travellers without ZIKV symptoms is not available on the NHS. Couples planning pregnancy in the very near future should consider whether they should avoid travel to a country or area with risk of ZIKV, rather than delay conception for the recommended period (see below) after travel. This particularly includes couples in assisted fertility programmes.
Preventing sexual transmission
Couples should follow guidance on prevention of sexual transmission of ZIKV and avoid conception as follows:
- If both partners travelled, for 3 months after last possible ZIKV exposure*
- Male traveller only, for 3 months after last possible ZIKV exposure*
- Female traveller only, for 2 months after last possible ZIKV exposure*
See further information for pregnant women, their partners and couples planning pregnancy.
*Last possible Zika virus exposure is defined as the later of either the date of leaving a country or area with risk for ZIKV transmission, or the date on which unprotected sexual contact with a potentially infectious partner took place.
See detailed guidance on factors to consider when assessing the risk of ZIKV.
Zika virus in brief