An Introduction to Cook Islands
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.
Hepatitis A
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.
Prevention
All travellers should take care with personal, food and water hygiene.
Hepatitis A vaccination
As hepatitis A vaccine is well tolerated and affords long-lasting protection, it is recommended for all previously unvaccinated travellers.
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.
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.
Hepatitis B
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.
Hepatitis B in Cook Islands
2% or more of the population are known or thought to be persistently infected with the hepatitis B virus (intermediate/high prevalence).
Prevention
Travellers should avoid contact with blood or body fluids. This includes:
- avoiding unprotected sexual intercourse.
- avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile equipment is used).
- not sharing needles or other injection equipment.
- following universal precautions if working in a medical/dental/high risk setting.
A sterile medical equipment kit may be helpful when travelling to resource poor areas.
Hepatitis B vaccination
Vaccination could be considered for all travellers, and is recommended for those whose activities or medical history put them at increased risk including:
- those who may have unprotected sex.
- those who may be exposed to contaminated needles through injecting drug use.
- those who may be exposed to blood or body fluids through their work (e.g. health workers).
- those who may be exposed to contaminated needles as a result of having medical or dental care e.g. those with pre-existing medical conditions and those travelling for medical care abroad including those intending to receive renal dialysis overseas.
- long-stay travellers
- those who are participating in contact sports.
- families adopting children from this country.
Rabies (Bat Lyssavirus)
Although rare, bat lyssaviruses (bat rabies) can be transmitted to humans or other animals following contact with the saliva of an infected bat most often by a bite. The disease can also be transmitted if the saliva of an infected bat gets into open wounds or mucous membranes (such as on the eye, nose or mouth). Bat lyssaviruses can cause disease in humans that is indistinguishable from rabies.
Symptoms can take some time to develop, but when they do the condition is almost always fatal.
The risk to most travellers is low. However, it is increased for certain occupations for example bat handlers and veterinarians, or certain activities such as caving.
Bat Lyssavirus in Cook Islands
Rabies has not been reported in this country; therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies).
Prevention
- 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 this country, 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
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 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.
Typhoid
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 in Cook Islands
Typhoid fever is known or presumed to occur in this country.
Prevention
All travellers should take care with personal, food and water hygiene.
Typhoid vaccination
- Vaccination could be considered for those whose activities put them at increased risk (see above).
- Oral and injectable typhoid vaccinations are available.
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.
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 Oceania Pacific Islands
There is a risk of insect or tick borne diseases in some areas of the Oceania Pacific Islands.
This includes diseases such as chikungunya.
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 Cook Islands
There is a risk of dengue in this country.
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.
Influenza (Seasonal)
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 Cook Islands
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.
Prevention
All travellers should:
- Avoid close contact with symptomatic individuals
- Avoid crowded conditions where possible
- Wash their hands frequently
- Practise ‘cough hygiene’: sneezing or coughing into a tissue and promptly discarding it safely, and washing their hands
- Avoid travel if unwell with influenza-like symptoms
- A vaccine is available in certain circumstances (see below)*
*In the UK, seasonal influenza vaccine is offered routinely each year to those at higher risk of developing of severe disease following influenza infection, and certain additional groups such as healthcare workers and children as part of the UK national schedule (see information on vaccination). For those who do not fall into these groups, vaccination may be available privately.
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
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.
Zika Virus
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.
Zika virus in Cook Islands
There is a very low risk of ZIKV in this country.
Prevention
- All travellers should avoid mosquito bites particularly between dawn and dusk.
- There is no vaccination or medication to prevent ZIKV infection.
Pregnant women should seek medical advice if they develop ZIKV symptoms or are concerned.
Download as PDFImportant News
27 Feb 2019
Zika virus (ZIKV) update to guidance
The guidance on preventing sexual transmission of ZIKV and risk area classification has been reviewed Read more
28 Nov 2015
Chikungunya virus: Pacific Islands and Oceania
Ongoing surveillance and updated case report numbers for Chikungunya virus in Oceania and the Pacific Islands Read more
21 Jul 2015
Chikungunya virus: Pacific Islands and Oceania
Locally acquired transmission of chikungunya virus in Pacific Islands and Oceania Read more
Outbreaks
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.
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