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.
A list of useful resources including advice on how to reduce the risk of certain health problems is available below.
Details of vaccination recommendations and requirements are provided below.
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.
There are no certificate requirements under International Health Regulations.
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 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.
Travellers should thoroughly clean all wounds and seek appropriate medical attention.
Country specific information on medical facilities may be found in the ‘health’ section of the FCO foreign travel advice website.
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 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.
Most travellers to this country are considered to be at low risk for rabies. However some animals may pose a greater risk of rabies for travellers, e.g. skunks, racoons and foxes. Bats may carry rabies-like viruses in this country.
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.
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. Example places of interest: Mt McKinley 6,194m, Mt Rainier 4,392m, Pikes Peak 4,301m, Leadville 3,100m and Mt Kea (Hawaii) 4,205m.
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.
There is a risk of insect or tick-borne diseases in some areas of North America. This includes diseases such as West Nile virus.
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 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 outbreaks are reported from time to time in United States. Affected states include Florida, Hawaii, and Texas.
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 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.
All travellers should:
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 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.
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.
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:
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.
Zika virus (ZIKV) is a viral infection transmitted by mosquitoes which predominantly feed between dawn and dusk. A small number of cases of sexual transmission of ZIKV have also been reported. Most people infected with ZIKV have no symptoms. When symptoms do occur they are usually mild and short-lived. Serious complications and deaths are not common. However, ZIKV is a cause of Congenital Zika Syndrome (microcephaly and other congenital anomalies) and neurological complications such as Guillain-Barré syndrome.
There is a very low risk of ZIKV in Florida and in Hidalgo and Cameron Counties, Texas.
Pregnant women should seek medical advice if they develop ZIKV symptoms or are concerned.
14 Feb 2019
Travel health advice for the World Scouting Jamboree in West Virginia USA, July 2019 Read more
19 Jan 2016
Depending on the destination, travellers may be at risk of a number of different diseases Read more
06 May 2015
Novel highly pathogenic avian influenza (HPAI) viruses: Canada and the United States of America Read more
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.
22 Jan 2020 United States
As of 21 January 2020, the US Centers for Disease Control and Prevention confirmed the first case of novel coronavirus in the United States in the state of Washington. The patient recently returned from Wuhan, China, where an outbreak of pneumonia caused by this novel coronavirus has been ongoing since December 2019. Latest case numbers can be found on Public Health England's website. Further novel coronavirus information is available here.
04 Dec 2019 Florida. United States
As of 30 November 2019, a total of 14 cases of locally acquired dengue fever have now been reported in Florida for 2019.
28 Nov 2019 United States
As of 24 September 2019, a total of 67 people from 19 states have been infected with E. coli O157:H7, possibly linked to romaine lettuce grown in Salinas California. Of these there have been 39 hospitalizations and 6 reports of haemolytic uremic sydrome.
06 Aug 2019 Florida. United States
On 9 July 2019, authorities issued a 60 day rabies alert for a two mile radius around the intersection of Interstate 4 and Epcot Center Drive in southwest Orange County. This is in response to a wild cat testing positive for rabies. The cat may have infected other animals in the area and contact with all wildlife should be avoided.
15 May 2019 United States
The US Department of Agriculture is investigating a multistate outbreak of Shiga toxin-producing Escherichia coli O103 infections linked to ground beef. As of 13 May 2019, a total of 196 people infected with the outbreak strain of E. coli O103 have been reported from 10 states.
10 Apr 2019 New York. United States
On April 9 2019, New York City has declared a public health emergency in Williamsburg, following a measles outbreak affecting the Orthodox Jewish community. 285 cases have been confirmed since the beginning of the outbreak in October, with many of these new cases being confirmed in the last two months. The vast majority of cases are children under 18 years of age (246 cases), and 39 cases are adults.