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, Commonwealth & Development Office (FCDO) 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.

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. Note that the EHIC will be valid until 31 December 2020. After this date, validity of the card will depend on arrangements with individual countries. Check the GOV.UK website for updates and advice.

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

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.
  • 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 FCDO 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

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, worldwide most cases follow a bite or scratch from an infected dog. Bats are also an important source of infection in some countries.

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 Spain
  • There is risk of rabies in the African territories of Ceuta and Melila in Spain.
  • Rabies has not been reported in domestic or wild animals in the rest of Spain (including the Balearic Islands and Canary Islands); therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies).

Prevention
  • Travellers to the African territories of Ceuta and Melila should avoid contact with animals.
  • For other areas in Spain 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 the rest of Spain, 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

For travellers to the African territories of Ceuta and Melila:

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).

For those travelling to other areas in Spain:

  • 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

Other risks

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 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.

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 Spain

There is a point of elevation in this country higher than 2,500 metres. Example places of interest: Mulhacen, Sierra Nevada on mainland Spain, 3,479m and Pico de Teide on Tenerife, 3,718m.

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

Biting insects or ticks

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 Southern Europe

There is a risk of insect or tick-borne diseases in some areas of Southern Europe. This includes diseases such as Crimean-Congo haemorrhagic feverleishmaniasis and West Nile virus.

Prevention
  • 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

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 Spain

During 2018 the first locally acquired cases were reported, with transmission occurring in the provinces of Cádiz, Catalonia and Murcia. 

Prevention
  • 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

Influenza (seasonal)

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 Spain

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.

Prevention

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

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

Outdoor air quality

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.

Prevention

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

COVID-19

COVID-19 disease is caused by the coronavirus SARS-CoV2. The main symptoms of COVID-19 are recent onset of a new continuous cough and/or a high temperature and/or a loss of, or change in, normal sense of taste or smell. Symptoms range from mild to life-threatening. Older people and those with underlying health problems are more likely to develop severe disease. Current evidence also shows that there is a higher risk of infection and of severe disease in Black, Asian and Minority Ethnic groups in the UK. The reasons for this are currently not clear.

The virus is mainly transmitted from human to human by breathing in droplets from the nose or mouth of an infected person or by touching the infected droplets on surfaces, then touching the eyes, nose or mouth. No vaccine is available to prevent COVID-19, and prevention relies on strict attention to social distancing guidance and personal and respiratory hygiene.

Travellers should always check the UK Foreign, Commonwealth & Development Office travel advice and their country-specific pages for the latest COVID-19 travel advisories which may include information on travel restrictions, quarantine or COVID-19 testing requirements. This includes considering the recommendations and requirements for any transit countries. Travellers should be aware that case numbers in individual countries/areas can increase rapidly. They should check this page regularly for updates.

COVID-19 in Spain

Based on currently available information, there is a high risk of exposure to COVID-19 in mainland Spain and the Balearic Islands. All travellers are advised to avoid non-essential travel to these areas.

Based on currently available information, there is a moderate risk of exposure to COVID-19 in the Canary Islands. All travellers should carefully consider the risks of exposure to COVID-19 before travel to the Canary Islands. This is particularly important in those in clinically extremely vulnerable groups who may wish to see seek advice before travel.

A high number of cases of COVID-19 has been reported in travellers returning from the Canary Islands. This is being monitored. Please check this page regularly for updates.

Individuals entering or returning to the UK from this country may be required to follow additional UK border measures which includes self-isolation for 14 days. These measures may vary depending on whether you have travelled from the Spanish mainland, the Balearic or Canary islands.

Prevention

If travel ito mainland Spain or the Balearic islands is essential, travellers should:

  • Discuss their plans with a health professional. This is particularly important for those at higher risk of severe COVID-19.

All travellers (including those visiting the Canary Islands) should:

  • Consider discussing their plans with a health professional. This is particularly important for those at higher risk of severe COVID-19.
  • Consider the risk at all destinations including any transit countries and the risk during travel itself.
  • Check with the airline/tour operator about physical distancing measures or other measures in place to reduce risk during travel.
  • Follow the latest social distancing guidance, including any local requirements and maintain good hand, respiratory, and personal hygiene at all times. This may be particularly important if staying with friends and family.

See guidance on factors to consider when assessing the risk of COVID-19 for travellers.

If travellers develop COVID-19 symptoms while abroad, they should:

  • Follow local guidelines on self-isolation, testing and avoiding travel.
  • Contact their travel insurance provider.
  • Seek medical advice if needed.

COVID-19 in brief

Important News

05 Nov 2020

Access to medications abroad during the coronavirus (COVID-19) pandemic

Advice for British travellers overseas during the pandemic Read more

05 Nov 2020

COVID-19: International travel during national restrictions

Foreign, Commonwealth & Development Office updates travel advisory notice Read more

05 Nov 2020

COVID-19 (coronavirus): general advice for travellers

Advice for travellers from the UK on travel abroad and reducing spread of respiratory viruses during the COVID-19 outbreak Read more

01 Sep 2020

Crimean-Congo haemorrhagic fever cases in Spain

CCHF cases reported in the Castilla y León region, north-western Spain Read more

24 Aug 2020

West Nile virus: province of Seville, Spain

An outbreak of West Nile virus has been confirmed in the province of Seville, Spain Read more

25 Jun 2020

Heatwave reminder for mainland Europe

Hot weather advice for travellers to mainland European countries Read more

21 Feb 2020

Rabies detected in a puppy imported to France

The dog located in Île de Ré developed symptoms on 1 February Read more

29 Aug 2019

Listeriosis outbreak in Spain

Cases have been associated with consumption of a shredded meat product from Seville Read more

22 Oct 2018

Dengue in France and Spain

Locally acquired dengue reported in southern France and Spain Read more

17 Oct 2017

Travel associated Legionnaires’ disease: Palmanova area, Majorca, Spain

Clusters of Legionnaires’ disease are reported in travellers who recently visited Palmanova in Majorca Read more

14 Jun 2017

World Pride in Spain

A reminder for those travelling to World Pride in Madrid, 23 June to 2 July 2017, to be aware of potential health risks, particularly sexual health ri Read more

26 May 2017

Crimean-Congo haemorrhagic fever (CCHF) in ticks in Spain

CCHF virus has been detected in ticks in the regions of Extremadura, Castilla-La Mancha, Castilla and León, and Madrid 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

16 Sep 2016

Crimean-Congo haemorrhagic fever in Spain

Two cases Crimean-Congo haemorrhagic fever, one fatal, have been reported in Spain Read more

27 Jun 2016

Enterovirus A71: Catalonia, Spain

An outbreak of enterovirus A71 (EV-A71) in children, with associated neurological symptoms, has been reported in Catalonia, Spain Read more

14 Sep 2015

Previously reported chikungunya in Spain – false positive

The previously reported chikungunya virus infection in Gandía, mainland Spain is not laboratory confirmed Read more

05 Aug 2015

Chikungunya: Spain

The first case of locally acquired chikungunya virus infection is reported in Gandía, mainland Spain Read more

Outbreaks

Using information collated from a variety of sources, we regularly review and update information on overseas disease outbreaks and other health issues that may affect the UK traveller.

Please note that not all cases of disease or outbreaks are reported; some diseases may only be reported if they occur outside of the usual recognised risk area or season, or they have been reported in greater than usual numbers.

Further information on the Outbreak Surveillance section.

West Nile virus in Spain

28 Sep 2020 Spain + Extremadura

As of 24 September 2020, one case of West Nile virus was reported in Extremadura.

Source: State

Human

Vector-Borne

New Post

Verified

West Nile virus in Spain

23 Sep 2020 Spain + Andalusia

As of 17 September 2020, a total of 61 locally acquired West Nile virus cases, including five deaths, have been reported in southern Spain for 2020.

Source: ECDC

Human

Vector-Borne

Updates 2

Verified

Crimean-Congo haemorrhagic fever in Spain

17 Aug 2020 Spain + Salamanca

As of 13 August 2020, a fatal case of Crimean-Congo haemorrhagic fever (CCHF) has been confirmed in 69 year-old resident of Salamanca who sustained a tick bite a week prior to hospital admission.

Source: State

Human

Vector-Borne

Updates 1

Verified

COVID-19 in Spain

27 Jul 2020 Spain

There is an overall increase in case numbers in Spain, particularly in the regions of Catalonia, Aragon, Pais Vasco and Navarro. Latest case numbers for Spain are provided by World Health Organization.

Source: State

Human

Air-Borne

Updates 10

Verified

COVID-19 (coronavirus) in brief

COVID-19 in Canary Islands

16 Mar 2020 Spain + Canary Islands

COVID-19 has been reported in Canary Islands. Latest case numbers are provided by World Health Organization.

Source: State

Human

Air-Borne

Imported

New Post

Verified

COVID-19 (coronavirus) in brief