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 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.

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 Canada

Rabies has only been reported in wild animals in this country; therefore most travellers are considered to be at low risk for rabies. Bats may also carry rabies-like viruses in this country.

Prevention
  • Travellers should avoid contact with wild animals.  Rabies is preventable with prompt post-exposure 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 domestic animals, it is still sensible to seek prompt medical advice if bitten or scratched by all animals.
  • Post-exposure treatment and advice should be in accordance with national guidelines.
Rabies vaccination
  • Pre-exposure vaccines are recommended for those who are at increased risk due to their work (e.g. laboratory staff working with the virus, those working with animals or health care workers who may be caring for infected patients).
  • Pre-exposure vaccines could be considered for those who are at increased risk of exposure to wild animals.

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 Canada

 There is a point of elevation in this country higher than 2,500 metres. An example place of interest, Mt Logan 5,950m.

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 North America

There is a risk of insect or tick borne diseases in some areas of North America.

This includes diseases such as 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.

 

Important News

05 Apr 2018

Worldwide rabies risk reminder

A reminder for travellers of the worldwide risk of rabies Read more

19 Jan 2016

Diseases transmitted by insects and ticks in the Americas

Depending on the destination, travellers may be at risk of a number of different diseases Read more

11 May 2015

Measles: worldwide

A measles reminder for health professionals and travellers Read more

06 May 2015

HPAI viruses: Canada and the United States of America

Novel highly pathogenic avian influenza (HPAI) viruses: Canada and the United States of America Read more

18 Feb 2015

Measles: worldwide

A measles reminder for health professionals and travellers Read more

10 Feb 2015

Imported avian influenza A (H7N9): Canada

First cases of influenza A (H7N9) infection in humans in North America Read more

Outbreaks

25 Jun 2018 Alberta. Canada

As of 19 June 2018, a confirmed case of diphtheria has been reported. Contact tracing is ongoing.

Human

Air-Borne

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11 May 2018 View Regions + Alberta
British Columbia
Ontario
Saskatchewan

As of 9 May 2018, there are six Canadian E. coli O157 cases (including one hospital admission) genetically similar to the USA outbreak linked to romaine lettuce from Yuma, Arizona, USA.

Human

Food and water-borne

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PHAC - Read more

17 Apr 2018 View Regions + Alberta
British Columbia
Ontario

As of 16 April 2018, a total of 126 cases of gastrointestinal illness linked to oyster consumption have been reported in three provinces: British Columbia (92), Alberta (9), and Ontario (25). Individuals who became sick reported eating raw oysters from British Columbia prior to the onset of their illness. Testing of several of the cases has confirmed the presence of a norovirus infection.

Human

Food and water-borne

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26 Mar 2018 Canada

As of 23 March 2018, three cases of Vibrio bacterial infection have been been confirmed in connection with consumption of herring eggs in Vancouver Island.

Human

Food and water-borne

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15 Dec 2017 View Regions + New Brunswick
Nova Scotia
Ontario
Quebec

As of 14 December 2017, an outbreak of E. coli O157 associated with consumption of Romaine lettuce has been reported. A total of 30 cases with a death have been reported since November in Newfoundland and Labrador (13), Ontario (6), New Brunswick (5), Quebec (5), and Nova Scotia (1). Twelve of the cases have been hospitalised. Investigations to identify the source is ongoing.

Human

Food and water-borne

Updates 1

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27 Nov 2017 Manitoba. Canada

As of 15 November 2017, a total of 1,268 cases have been reported in the province of Manitoba between 1 September 2016 and 15 November 2017. Cases continue to be reported. Initially the outbreak was focused on students in Winnipeg, but cases have since been reported in all ages and throughout Manitoba.

Human

Close association

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