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.

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

Hepatitis A (men who have sex with men)

There have been increased numbers of Hepatitis A cases in England, mainly affecting men who have sex with men. Many of these men have reported travel to Spain, where there has recently been a reported increase in hepatitis A among men.

Hepatitis A is a viral infection of the liver spread by a virus present in the faeces of an infected person. It is transmitted through infected faeces contaminating food and water or by direct contact with an infectious person including sexual transmission.

Hepatitis A is not usually life-threatening but severity can increase with age. Most people make a full recovery within a couple of months . Following hepatitis A illness, immunity is lifelong. Gay and bisexual men with multiple partners are particularly at risk.

Prevention
Hepatitis A vaccination

High risk men who have sex with men with multiple partners may benefit from vaccination and should seek advice from their sexual health or travel clinic prior to travelling.

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

Important News

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

10 Oct 2018 View Regions + Murcia
Cadiz

As of 4 October 2018, two locally acquired cases of dengue have been confirmed. A third case is under investigation.

Human

Vector-Borne

New Post

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

22 Jan 2018 View Countries + Afghanistan
Algeria
Andorra
Angola
Armenia
Bahrain
Bangladesh
Belgium
Benin
Bosnia and Herzegovina
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Chad
China
Colombia
Comoros
Congo
Côte d'Ivoire (Ivory Coast)
Cyprus
Czech Republic
Democratic Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
France
Gabon
Georgia
Germany
Greece
Guinea
Haiti
Hong Kong (China)
Hungary
Iraq
Ireland
Italy
Kosovo
Kuwait
Lebanon
Luxembourg
Macedonia
Madagascar
Mali
Mauritania
Monaco
Morocco
Netherlands
Niger
Nigeria
Pakistan
Paraguay
Peru
Poland
Portugal
Qatar
Romania
Rwanda
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Spain
Sri Lanka
St Martin
Sudan
Switzerland
Syria
Taiwan
Togo
Tunisia
Turkey
Ukraine
United Arab Emirates
United Kingdom
Venezuela
Vietnam
Yemen
Zambia

As of 19 January 2018, European Commission has updated the the list of countries affected by product withdrawal of infant powder milk products: Afghanistan, Algeria, Andorra, Angola, Armenia, Bahrain, Bangladesh, Belgium, Benin, Bosnia and Herzegovina, Bulgaria, Burkina Faso, Burundi, Cambodia, Cameroon, Chad, China, Colombia, Comoros, Republic of Congo, Cyprus, Czech Republic, Côte d'Ivoire, Democratic Republic of Congo, Djibouti, Egypt, Equatorial Guinea, France, Gabon, Georgia, Germany, Greece, Guinea, Haiti, Hong Kong, Hungary, Iraq, Ireland, Italy, Kosovo, Kuwait, Lebanon, Luxembourg, Madagascar, Mali, Mauritania, Monaco, Morocco, Netherlands, Niger, Nigeria, Pakistan, Paraguay, Peru, Poland, Portugal, Qatar, Romania, Rwanda, Saint Martin, Saudi Arabia, Senegal, Serbia, Seychelles, Sierra Leone, Singapore, Slovakia, Slovenia, Spain, Sri Lanka, Sudan, Switzerland, Syria, Taiwan, Togo, Tunisia, Turkey, Ukraine, United Arab Emirates, United Kingdom, Venezuela, Vietnam, Yemen, Zambia, and FYR Macedonia. 

Human

Food and water-borne

Updates 5

Verified

European Commission - Read more

21 Nov 2017 View Countries + Balearic Islands (Spain)
Spain

As of 16 November 2017, a total of 26 travel associated cases have been reported in European travellers. The majority of cases were reported in UK travellers, with cases also reported from the Czech Republic, Denmark, France and Sweden. An additional case has been reported in an employee at a hotel not associated with these cases.

Human

Air-Borne

Updates 2

Verified

ECDC - Read more