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. If visiting European Economic Area (EEA) countries carry an European health insurance card (EHIC) as this will allow access to state-provided healthcare in EEA countries, at a reduced cost, or sometimes for free. The EHIC, however, is not an alternative to travel 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

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.

There are no certificate requirements under International Health Regulations.

For Saint Martin, Saint Barthélemy and Guadeloupe (France –  islands in the Caribbean Sea) only

  • There is no risk of yellow fever on these islands, however, there is a certificate requirement.
  • Under International Health Regulations, a yellow fever vaccination certificate is required for travellers over 1 year of age arriving from countries with risk of yellow fever transmission and for travellers having transited more than 12 hours through the airport of a country with risk of yellow fever transmission.
  • According to World Health Organization (WHO), from 11 July 2016 (for all countries), the yellow fever certificate will be valid for the duration of the life of the person vaccinated. As a consequence, a valid certificate, presented by arriving travellers, cannot be rejected on the grounds that more than ten years have passed since the date vaccination became effective as stated on the certificate; and that boosters or revaccination cannot be required. See WHO Q&A.
  • View the WHO list of countries with risk of yellow fever transmission.

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 (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 France

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 management.
  • 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.

Rabies in brief

Tick-Borne Encephalitis (TBE)

Tick-borne encephalitis (TBE) is a viral infection transmitted by the bite of infected ticks. Less commonly, cases of TBE occur following ingestion of unpasteurised milk products.

Travellers are at increased risk of exposure during outdoor activities in areas of vegetation (gardens, parks, meadows, forest fringes and glades). Ticks are usually most active between early spring and late autumn.

Tick-borne encephalitis in France

There is a risk of TBE in some areas of this country. The main affected areas are in the departments of Bas-Rhin and Haut-Rhin. Cases have also been reported near the cities of Nancy, Grenoble, Faverges, and in the department of Gironde. The transmission season varies, however, ticks are most active during early spring to late autumn.

Prevention
  • All travellers should avoid tick bites during outdoor activities.
  • Travellers should check their skin regularly for ticks and remove them as soon as possible with a recommended technique.
  • Travellers should not eat or drink unpasteurised milk products.
Tick-borne encephalitis vaccination
  • If vaccination is being considered, please seek specialist advice.

Tick-borne encephalitis 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 Illness

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 France

There is a point of elevation in this country higher than 2,500 metres. An example place of interest; Mt Blanc 4,807m.

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

Insects 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 Western Europe

There is a risk of insect or tick-borne diseases in some areas of Western Europe. This includes diseases such as West Nile virus.

Diseases in Caribbean

There is a risk of insect or tick-borne diseases in some areas of the Caribbean. This includes diseases such as chikungunya and 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.

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 Guadeloupe, St Barthelemy, and St Martin

There is a risk of dengue in Guadeloupe, St Barthelemy, and St Martin.

Dengue in France

Since 2010, dengue outbreaks have been reported in southern France in the region of Provence-Alpes-Côte d'Azur (PACA): departments of Alpes Maritimes [Nice, St. Laurent du Var], Bouches-du-Rhone [Aubagne] and Var [Toulon-Hyères] and in the region of Occitanie, department of Herault [Clapiers].

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.

Dengue in brief

Schistosomiasis

Schistosomiasis is a parasitic infection. Schistosoma larvae are released from infected freshwater snails and can penetrate intact human skin following contact with contaminated freshwater. Travellers may be exposed during activities such as wading, swimming, bathing or washing clothes in freshwater streams, rivers or lakes. Schistosomiasis infection may cause no symptoms, but early symptoms can include a rash and itchy skin (‘swimmer’s itch’), fever, chills, cough, or muscle aches. If not treated, it can cause serious long term health problems such as intestinal or bladder disease.

Schistosomiasis in French Island of Corsica

Cases of schistosomiasis have been reported in Corsica.

Prevention

  • There is no vaccine or tablets to prevent schistosomiasis.
  • All travellers should avoid wading, swimming, or bathing in freshwater where possible. Swimming in chlorinated water or sea water is not a risk for schistosomiasis.
  • Topical application of insect repellent before exposure to water, or towel drying after accidental exposure to schistosomiasis are not reliable in preventing infection.
  • All travellers who may have been exposed to schistosomiasis should have a medical assessment

Schistosomiasis in brief

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, there is now scientific consensus that Zika virus is a cause of congenital Zika syndrome (microcephaly and other congenital anomalies) and Guillain-Barré syndrome.

Zika virus in St Martin

This island is considered to have a moderate risk of Zika virus transmissionPregnant women should consider postponing non-essential travel until after the pregnancy. Details of specific affected areas within this country are not available.

Prevention

  • All travellers should avoid mosquito bites particularly between dawn and dusk.
  • There is no vaccination or medication to prevent ZIKV infection.
  • It is recommended that pregnant women planning to travel to areas with a moderate risk of ZIKV transmission should postpone non-essential travel until after pregnancy.
  • Women should avoid becoming pregnant while travelling in, and for 8 weeks after leaving an area with active ZIKV transmission or 8 weeks after last possible ZIKV exposure.
  • Couples should follow guidance on prevention of sexual transmission of Zika and avoid conception while travelling and for up to 6 months on return.
  • If a woman develops symptoms compatible with ZIKV infection, it is recommended she avoids becoming pregnant for a further 8 weeks following recovery.
  • Pregnant women who visited this country while pregnant, or who become pregnant within 8 weeks of leaving this country or within 8 weeks after last possible ZIKV exposure, should contact their GP, obstetrician or midwife for further advice, even if they have not been unwell. Further information about when to perform fetal ultrasound scanning, and, if necessary, referral to the local fetal medicine service is available.

Preventing sexual transmission

See detailed guidance on factors to consider when assessing the risk of ZIKV.

Zika virus in Guadeloupe, and St Barthélemy 

These islands are considered to have a low risk of Zika virus transmission.

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, and contact their GP on return.

Zika virus in brief

Important News

22 Oct 2018

Dengue in France and Spain

Locally acquired dengue reported in southern France and Spain Read more

14 Aug 2018

West Nile virus transmission season 2018

An early start to the transmission season and an upsurge of human cases in Europe and neighbouring countries is reported Read more

27 Mar 2018

Measles in Europe reminder

A reminder for travellers to mainland Europe to check they are up to date with measles vaccine Read more

20 Dec 2017

Measles reminder

Ensure all travellers are up to date with measles vaccination Read more

25 Sep 2017

Malaria cases in Europe - Summer 2017

Information about malaria cases in Europe, Summer 2017, and advice on awareness and prevention Read more

21 Sep 2017

Typhoid fever cases linked to Italian Rainbow gathering – Summer 2017

Advice for travellers and health professionals Read more

14 Aug 2017

Chikungunya: Var department, Provence-Alpes-Côte d'Azur region, mainland France

First locally acquired case of chikungunya reported in France since 2014 Read more

03 Aug 2017

Zika virus – update and advice for travellers

Following an expert review, three risk ratings for areas of Zika virus transmission have been defined - Advice for travellers visiting these areas has Read more

06 Jul 2017

Measles in Europe

A reminder for travellers to be up to date with measles vaccine Read more

03 May 2017

Changes to the Country Information pages: Tick-borne encephalitis

NaTHNaC has reviewed and updated the tick-borne encephalitis country specific information in order to provide up-to-date recommendations for traveller Read more

26 Apr 2017

Measles in Europe

A reminder for travellers to be up to date with measles vaccine Read more

06 Apr 2017

European cluster of cases of hepatitis A

Outbreaks of hepatitis A have been reported in Europe mostly affecting men who have sex with men (MSM) Read more

19 Jan 2016

Schistosomiasis in Corsica, France - update

A further case of schistosomiasis, probably associated with bathing in the River Cavu, Southern Corsica Read more

15 Oct 2015

West Nile virus: France

The first locally acquired case human case of West Nile virus since 2003 has been reported in France Read more

01 Sep 2015

Dengue in France

2 cases of locally acquired dengue reported in Nimes, Languedoc-Roussillon region of France Read more

21 Aug 2015

Schistosomiasis: Corsica, France - update

Further cases of (presumed) locally acquired schistosomiasis associated with the River Cavu, Corsica Read more

22 Jun 2015

MERS-CoV update: Republic of Korea and China

Ongoing surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) in Republic of Korea (South Korea) and China Read more

05 Jun 2015

MERS-CoV: Republic of Korea and China

Middle East respiratory syndrome coronavirus (MERS-CoV) update: Republic of Korea and China Read more

02 Jun 2015

Schistosomiasis: Corsica, France

Transmission of schistosomiasis (locally acquired): Corsica, France Read more

27 May 2015

Imported canine rabies: France

A report of a confirmed case of rabies in a domestic dog, Le Chambon Feugerolles, Loire, Rhône-Alpes, France
Read more

11 May 2015

Measles: worldwide

A measles reminder for health professionals and travellers Read more

18 Feb 2015

Measles: worldwide

A measles reminder for health professionals and travellers 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.

31 Oct 2018 View Countries + Austria
Bulgaria
Croatia
France
Greece
Hungary
Israel
Italy
Romania
Serbia

In 2018, several European and neighbouring countries observed an increase in cases of West Nile Virus compared to previous years. The 2018 transmission season started earlier than usual but as expected for November, the weekly number of cases has started to decrease. Precautionary measures for travellers, mainly elderly and immunocompromised, should be highlighted.

Human

Vector-Borne

New Post

Verified

ECDC - Read more

22 Oct 2018 Herault. France

One locally acquired case of dengue fever was identified in Hérault on 10 October 2018. There is no epidemiological link to the cases in Alpes-Maritimes.

Human

Vector-Borne

Updates 2

Verified

State - Read more

10 Aug 2018 Nice. France

As of 2 August 2018, three cases of West Nile virus were reported in Nice.

Human

Vector-Borne

New Post

Verified

State - Read more

21 May 2018 France

On 14 May 2018, seven cases of Escherichia coli infection were reported, including six haemolytic uremic syndrome (HUS) cases among children under three years of age. The cases are epidemiologically linked to the consumption of Reblochon cheese made with raw milk. The implicated cheese batches are being recalled.

Human

Food and water-borne

New Post

Verified

ECDC - Read more

17 May 2018 France

Between 6 November 2017 and 13 May 2018, a total of 2,231 cases of measles have been reported. Nouvelle-Aquitaine region (SW) has reported 48% of cases (n = 1,068). The highest incidence is in children under 1 year of age.

Human

Close association

Updates 3

Verified

State - Read more

05 Apr 2018 France

As of 30 March 2018, the first cases for France have been reported in poultry.

Animal

Air-Borne

New Post

Verified

OIE - Read more

26 Jan 2018 Nouvelle-Aquitaine. France

As of 18 January 2018, an outbreak with 229 cases focussed on the Gironde Department in 2017 has been reported. Mid-summer, there was a spike in cases related to infections at a restaurant. From September the outbreak was predominantly among men. In the latest month of reporting, December 2017, 16 male and two female cases alone were reported. 

Human

Miscellaneous

New Post

Verified

State - Read more

22 Jan 2018 View Countries + Afghanistan
Algeria
Andorra
Angola
Armenia
Bahrain
Bangladesh
Belgium
Benin
Bosnia and Herzegovina
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Chad
China
Colombia
Comoros
Congo
Côte d'Ivoire (Ivory Coast)
Cyprus
Czech Republic
Democratic Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
France
Gabon
Georgia
Germany
Greece
Guinea
Haiti
Hong Kong (China)
Hungary
Iraq
Ireland
Italy
Kosovo
Kuwait
Lebanon
Luxembourg
Macedonia
Madagascar
Mali
Mauritania
Monaco
Morocco
Netherlands
Niger
Nigeria
Pakistan
Paraguay
Peru
Poland
Portugal
Qatar
Romania
Rwanda
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Spain
Sri Lanka
St Martin
Sudan
Switzerland
Syria
Taiwan
Togo
Tunisia
Turkey
Ukraine
United Arab Emirates
United Kingdom
Venezuela
Vietnam
Yemen
Zambia

As of 19 January 2018, European Commission has updated the the list of countries affected by product withdrawal of infant powder milk products: Afghanistan, Algeria, Andorra, Angola, Armenia, Bahrain, Bangladesh, Belgium, Benin, Bosnia and Herzegovina, Bulgaria, Burkina Faso, Burundi, Cambodia, Cameroon, Chad, China, Colombia, Comoros, Republic of Congo, Cyprus, Czech Republic, Côte d'Ivoire, Democratic Republic of Congo, Djibouti, Egypt, Equatorial Guinea, France, Gabon, Georgia, Germany, Greece, Guinea, Haiti, Hong Kong, Hungary, Iraq, Ireland, Italy, Kosovo, Kuwait, Lebanon, Luxembourg, Madagascar, Mali, Mauritania, Monaco, Morocco, Netherlands, Niger, Nigeria, Pakistan, Paraguay, Peru, Poland, Portugal, Qatar, Romania, Rwanda, Saint Martin, Saudi Arabia, Senegal, Serbia, Seychelles, Sierra Leone, Singapore, Slovakia, Slovenia, Spain, Sri Lanka, Sudan, Switzerland, Syria, Taiwan, Togo, Tunisia, Turkey, Ukraine, United Arab Emirates, United Kingdom, Venezuela, Vietnam, Yemen, Zambia, and FYR Macedonia. 

Human

Food and water-borne

Updates 5

Verified

European Commission - Read more

21 Dec 2017 France

As of 20 December 2017, an outbreak of Salmonella Agona among infants exposed to various products of baby formula milk (product list 1 and product list 2) has been reported. The outbreak involves 35 cases across France with onset between August and 2 December.

Human

Food and water-borne

New Post

Verified

State - Read more