The information on these pages should be used to research health risks and to inform the pre-travel consultation.
Travellers should ideally arrange an appointment with their GP practice or travel clinic at least four to six weeks before travel. 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. However, even if time is short, an appointment is still worthwhile.
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.
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.
As hepatitis A vaccine is well tolerated and affords long-lasting protection, it is recommended for all previously unvaccinated travellers.
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.
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 is a viral infection transmitted to humans from animals (mainly pigs and birds) by mosquitoes which typically breed in rice paddy fields, swamps and marshes. These mosquitoes predominantly feed between dusk and dawn.
Those at increased risk include travellers who are staying for a month or longer during the transmission season, especially if travel will include rural areas with rice fields and marshland.
Travellers on shorter trips (typically less than a month), or trips that take place outside the peak transmission season and those who restrict their visits to urban areas are usually considered to be at very low risk.
JE occurs in this country. The transmission season is typically April to October. Rarely cases in travellers are reported outside these months.
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. 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.
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 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.
Insect or tick bites can cause irritation and infections of the skin at the site of a bite. They can also spread certain 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 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.
22 May 2015
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