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.

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

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 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

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; 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 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.

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. An example place of interest: Mulhacen 3,479m.

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 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

Important News

27 Jun 2019

Alert: Heatwave alert for mainland Europe

Hot weather advice for travellers to mainland European countries Read more

22 Oct 2018

Dengue in France and Spain

Locally acquired dengue reported in southern France and Spain Read more

20 Dec 2017

Measles reminder

Ensure all travellers are up to date with measles vaccination 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

06 Jul 2017

Measles in Europe

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

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

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.

28 Jun 2019 Ceuta. Spain

On 24 June 2019 rabies virus was confirmed in a dog, which has since died. The last report of rabies in this region was in in 2009.

Animal

Miscellaneous

New Post

Verified

OIE - Read more

25 Jun 2019 Spain

On 14 June 2019, Iceland reported four cases of chikungunya virus disease associated with travel to Alicante, Spain, between 17-31 May 2019. Further testing has not confirmed the infection in Iceland. Additional verfication tests will be conducted.

Human

Miscellaneous

Updates 1

Verified

State - Read more

19 Nov 2018 Catalonia. Spain

As of 16 November 2018, the first case of locally acquired (autochthonous) dengue has been reported in Catalonia, in a resident with no history of travel abroad or to any other areas of Spain. This is the sixth verified case of autochthonous dengue in Spain, the previous five cases were detected in Murcia and Cádiz.

Human

Vector-Borne

Updates 1

Verified

State - Read more

10 Aug 2018 Palencia. Spain

As of 9 August 2018, a fatal case of locally acquired Crimean-Congo haemorrhagic fever has been confirmed in an local resident in Castilla y León who died on 8 August 2018. The patient reported a tick bite at the end of July 2018.

Human

Vector-Borne

New Post

Verified

State - Read more