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:
Diphtheria; Hepatitis A; Tetanus; Typhoid.
- Other vaccines to consider:
Cholera; Hepatitis B; Japanese Encephalitis; Rabies.
- Yellow fever vaccination certificate requirements for India are specific and quite lengthy; read the full details via the WHO website (external weblink).
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.
person to person through respiratory droplets. Risk is higher if mixing with locals in poor, overcrowded living conditions.
- 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. Risk is highest in north-eastern states including Assam and Orissa.
- In the Andaman and Nicobar islands, Andhra Pradesh, Chhattisgarh, Goa, Gujarat, Madhya Pradesh, Maharashtra and West Bengal risk is not high enough to warrant antimalarial tablets for most travellers, however, it may be considered for certain groups who may be at higher risk (see below under Low risk with additional advice).
- There is low to no risk in parts of the states of Himachel Pradesh, Jammu and Kashmir and Sikkim, and also in the cities of Bangalore, Kolkata, Mumbai, Nagpur, Nasik and Pune.
- Malaria precautions are essential, avoid mosquito bites by covering up with clothing such as 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 – additional information can be found by clicking on the Regional Information icon below the map.
- High risk areas: atovaquone/proguanil OR doxycycline OR mefloquine are usually advised.
- Low risk with additional advice: antimalarial tablets are not usually recommended, however, they can be considered for certain travellers who may be at higher risk e.g. longer stay in rural areas, visiting friends or relatives, those with medical conditions, immunosuppression or those without a spleen. Atovaquone/proguanil OR doxycycline OR mefloquine is advised for those at risk.
- Low to no risk: 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 an area remote from medical facilities, carrying standby emergency treatment for malaria 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.
Polio Vaccine Requirement for India
5 February 2014: As of 1 March 2014, there is a requirement for oral polio vaccination (OPV) for international travellers between India and polio-infected countries. Read the fitfortravel News item.
Read full details of the new travel requirements on the Ministry of Health and Family Welfare website.
Zika Virus Infection
This country has been categorised as having a moderate risk of Zika (ZIKV) virus transmission.
ZIKV is mainly spread through mosquito bites. The mosquito responsible most commonly bites during daylight hours and is abundant in urban settings. There is a low risk of sexual transmission.
The illness itself is usually mild but there is a link between infection during pregnancy and babies being born with birth defects. There is no vaccine currently available against ZIKV.
Advice for All Travellers
All travellers should practice strict mosquito bite avoidance at all times.
Do not travel without adequate travel insurance.
Seek pre-travel health advice from your health care provider 6-8 weeks in advance of travel.
- Pregnant women are advised to consider postponing non-essential travel.
- Those planning pregnancy, or where there is a risk of pregnancy should avoid the risk of ZIKV in pregnancy and sexual transmission of ZIKV by the use of contraception and condoms during travel and for:
• 8 weeks afterwards if female
• 6 months afterwards if male
For further information, see Zika virus infection page.
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