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.

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

There are no certificate requirements under International Health Regulations.

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.
  • Iftravelling 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 Japan
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 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 Japan
JE occurs in this country.  The transmission season is typically June to September, except on Ryuku Islands (Okinawa) where the season is typically April to December. Rarely cases in travellers are reported outside these months.  Local human JE incidence rates may not accurately reflect the risks to non-immune visitors because of high vaccination rates in local populations. High levels of viral transmission can occur in the absence of human disease.

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.

JE in brief

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 Japan
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.


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.

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 Japan

There is a risk of TBE in some areas of this country. The main affected area is Hokkaido. There is a possible risk in Shimane Prefecture, Honshu. 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

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.

Altitude illness in Japan

There is a point of elevation in this country higher than 2,500 metres. An example place of interest, Mt Fuji 3,776m.

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 Japan

Locally acquired cases of dengue have been reported in 2014 

Prevention

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

Dengue in brief

Schistosomiaisis

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 Japan

Cases of schistosomiasis have previously been reported from this country, however according to World Health Organization  in 2012, transmission of schistosoma larvae in fresh water may have been interrupted. Most travellers are considered to be at very low risk.

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

03 May 2017

Changes to the Country Information pages: Tick-borne encephalitis

NaTHNaC has reviewed and updated the tick-borne encephalitis country specific information in order to provide up-to-date recommendations for traveller Read more

17 Aug 2015

Meningococcal meningitis: scouts returned from Japan

Cases of meningococcal meningitis reported in scouts recently returned from the 23rd World Scout Jamboree in Japan 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

Outbreaks

31 Mar 2017 Japan

As of 17 February 2017, the cases have been reported in poultry November 2016 through February 2017

Human

Air-Borne

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Verified

OIE - Read more

10 Jan 2017 View Countries + Angola
Japan

As of 16 December 2016, a 21-year old Angolan resident from Luanda was diagnosed (PCR test positive for Chikungunya virus and negative for yellow fever virus) shortly after travelling to Japan in May 2016. She had been previously healthy and had not traveled out of Luanda in the past 6 months.

Human

Imported

Vector-Borne

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CDC - Read more

13 Sep 2016 Kansai. Japan

As 13 September 2016, a total of 33 cases among staff at Kansai International Airport have been reported. The public is warned about potential exposure at the airport since 23 August 2016.

Human

Close association

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Verified

State - Read more