All travellers should ensure they have adequate travel health insurance.
Details of vaccination recommendations and requirements are provided below.
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.
Please read the information below carefully, as certificate requirements may be relevant to certain travellers only. For travellers further details, if required, should be sought from their healthcare professional.
Travellers should thoroughly clean all wounds and seek appropriate medical attention.
Hepatitis A is a viral infection transmitted through contaminated food and water or by direct contact with an infectious person. Symptoms are often mild or absent in young children, but the disease becomes more serious with advancing age. Recovery can vary from weeks to months. Following hepatitis A illness immunity is lifelong.
Those at increased risk include travellers visiting friends and relatives, long-stay travellers, and those visiting areas of poor sanitation.
All travellers should take care with personal, food and water hygiene.
Vaccination is recommended for those whose activities put them at increased risk. This includes:
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.
2% or more of the population are known or thought to be persistently infected with the hepatitis B virus (intermediate/high prevalence).
Travellers should avoid contact with blood or body fluids. This includes:
A sterile medical equipment kit may be helpful when travelling to resource poor areas.
Vaccination could be considered for all travellers, and is recommended for those whose activities or medical history put them at increased risk including:
Japanese Encephalitis (JE)
Japanese encephalitis (JE) is a viral infection transmitted to humans by the bite of an infected mosquito. These mosquitoes usually bite between dusk and dawn, mainly in rural areas; especially where there are rice fields, swamps and marshes. Mosquitoes become infected by biting JE infected animals (particularly pigs) or birds.
Travellers are at increased risk of infection when visiting rural areas. Short trips (usually less than a month) especially if only travelling to urban areas, are considered lower risk.
JE occurs in this country, with transmission considered to be year-round.
All travellers should avoid mosquito bites particularly between dusk and dawn.
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, most cases follow a bite or scratch from an infected dog. In some parts of the world, bats are an important source of infection.
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 is considered to be a risk in this country. Bats may also carry rabies-like viruses.
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.
Pre-exposure vaccinations are recommended for travellers whose activities put them at increased risk including:
TB is a bacterial infection transmitted most commonly by inhaling respiratory droplets from an infectious person. This is usually following prolonged or frequent close contact.
The average annual incidence of TB is greater than or equal to 40 cases per 100,000 population (further details).
Travellers should avoid close contact with individuals known to have infectious pulmonary (lung) TB.
Those at risk during their work (such as healthcare workers) should take appropriate infection control precautions.
According to current national guidance, BCG vaccine should be recommended for those at increased risk of developing severe disease and/or of exposure to TB infection e.g. when the average annual incidence of TB is greater than or equal to 40 cases per 100,000 population. See Public Health England’s Immunisation against infectious disease, the ‘Green Book’.
For travellers, BCG vaccine is also recommended for:
There are specific contraindications associated with the BCG vaccine and health professionals must be trained to administer this vaccine intradermally (just under the top layer of skin).
Following administration, no further vaccines should be administered in the same limb for 3 months.
The BCG vaccine is given once only, booster doses are not recommended.
Typhoid is a bacterial infection transmitted through contaminated food and water. Previous typhoid illness may only partially protect against re-infection.
Travellers who will have access to safe food and water are likely to be at low risk. Those at increased risk include travellers visiting friends and relatives, frequent or long-stay travellers to areas where sanitation and food hygiene are likely to be poor, and laboratory personnel who may handle the bacteria for their work.
Typhoid fever is known or presumed to occur in this country.
All travellers should take care with personal, food and water hygiene.
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.
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.
There is a point of elevation in this country higher than 2,500 metres.
Biting insects or ticks
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.
There is a risk of dengue in this country.
All travellers should:
Outdoor air quality
Current information on world air quality is available from the world air quality index project.
Based on currently available information, there is a moderate risk of exposure to COVID-19 in this country.
All travellers should check the FCDO travel advice and carefully consider the risks of exposure to COVID-19 before travel to this country. This is particularly important in those in clinically extremely vulnerable groups who may wish to seek advice before travel.
Individuals entering or returning to the UK may be required to follow additional UK border measures including self-isolation.
If travelling to this country, travellers should:
If travellers develop COVID-19 symptoms while abroad, they should:
05 Nov 2020
Advice for British travellers overseas during the pandemic Read more
12 Dec 2018
A review of the risk of typhoid and country-specific recommendations Read more
15 Jun 2017
NaTHNaC has reviewed and updated the hepatitis A country specific information and vaccine recommendations Read more
Further information on the Outbreak Surveillance section.