Advice for All Destinations
Other Health Risks
Advice for All Destinations
The risks to health whilst travelling will vary between individuals and many issues need to be taken into account, e.g. activities abroad, length of stay and general health of the traveller. It is recommended that you consult with your General Practitioner or Practice Nurse 6-8 weeks in advance of travel. They will assess your particular health risks before recommending vaccines and /or antimalarial tablets. This is also a good opportunity to discuss important travel health issues including safe food and water, accidents, sun exposure and insect bites. Many of the problems experienced by travellers cannot be prevented by vaccinations and other preventive measures need to be taken.
Measles occurs worldwide and is common in developing countries. The pre-travel consultation is a good opportunity to check that you are immune, either by previous immunisation or natural measles infection.
Ensure you are fully insured for medical emergencies including repatriation. UK travellers visiting other European Union countries should also carry the European Health Insurance Card (EHIC) as it entitles travellers to reduced cost, sometimes free, medical treatment in most European countries. Online applications normally arrive within seven days. Applications may also be made by telephone on 0300 330 1350 or by post using the form which can be downloaded from the website
For Travel Safety Advice you should visit the UK Foreign and Commonwealth Office website.
A worldwide list of clinics, run by members of the International Society of Travel Medicine is available on the ISTM website.
- Confirm primary courses and boosters are up to date as recommended for life in Britain - including for example, vaccines required for occupational risk of exposure, lifestyle risks and underlying medical conditions.
- Courses or boosters usually advised:
Hepatitis A; Tetanus; Typhoid.
- Other vaccines to consider:
Cholera; Hepatitis B; Japanese Encephalitis; Rabies.
- Yellow fever vaccination certificate required for travellers arriving from countries with risk of yellow fever transmission and for all travellers having transited through the airport of a country with risk of yellow fever transmission.
Notes on the diseases mentioned above
through consumption of contaminated water and food. More common during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water. It would be unusual for travellers to contract cholera if they take basic precautions with food and water and maintain a good standard of hygiene.
- Hepatitis A:
through consuming contaminated food and water or person to person through the faecal-oral route. Risk is higher where personal hygiene and sanitation are poor.
- Hepatitis B:
through infected blood and blood products, contaminated needles and medical instruments and sexual intercourse. Risk is higher for those at occupational risk, long stays or frequent travel, children (exposed through cuts and scratches) and individuals who may need, or request, surgical procedures abroad.
- Japanese Encephalitis:
through the bite of an infected mosquito. This mosquito breeds in rice paddies and mainly bites between dusk and dawn. Risk is higher for long stay travellers to rural areas, particularly if unable to avoid mosquito bites.
through the saliva of an infected animal, usually through a bite, scratch or lick on broken skin. Particularly dogs and related species, but also bats. Risk is higher for those going to remote areas (who may not be able to promptly access appropriate treatment in the event of a bite), long stays, those at higher risk of contact with animals and bats, and children. Even when pre-exposure vaccine has been received, urgent medical advice should be sought after any animal or bat bite.
through contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil worldwide. A total of 5 doses of tetanus vaccine are recommended for life in the UK. Boosters are usually recommended in a country or situation where the correct treatment of an injury may not be readily available.
mainly through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is limited.
Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria.
Malaria precautionsMalaria Map
- Malaria risk is present throughout the year, in the southern belt comprising Chukha, Dagana, Pemagatshel, Samtse, Sarpang, Sandrup, Jonkhar, and Zhemgang. Seasonal risk is reported in other areas. Low to no risk in Bumthangi, Gasa, Paro and Thimphu.
- Malaria precautions are essential. Avoid mosquito bites by covering up with long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.
- Check with your doctor or nurse about suitable antimalarial tablets.
- See malaria map – the map.
- High risk areas: atovaquone/proguanil OR doxycycline OR mefloquine is usually advised for risk areas.
- Low to no risk areas: antimalarial tablets are not usually advised .
- If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
- If travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby medication may be considered.
Other Health Risks
Altitude and Travel
This country has either areas with high altitude (2400m or more) or/and areas with very high altitude (3658m or more). Travellers who may go into areas of high altitude should take care to avoid ill effects of being at altitude including Acute Mountain Sickness, a potentially life-threatening condition.
For further information see Altitude and Travel.
A viral illness that is transmitted to humans by mosquito bites. The mosquito that spreads dengue bites during the day and is more common in urban areas. Symptoms include fever, headache, severe joint, bone and muscular pain - hence its other name 'breakbone fever'. There is no vaccine and prevention is through avoidance of mosquito bites.
For further information see Dengue Fever.
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