Pre-travel Considerations
The information listed below is in most cases a
recommendation for travelers and not a requirement. Personal risks will
vary depending on itinerary, length of stay, style of travel
and season
of the year. Individual travel counseling is strongly
encouraged and is required before immunizations are given.
Routine immunizations should be up to date
before traveling to any destination. These include: tetanus/diphtheria
(booster dose within the last ten years), MMR (measles/mumps/rubella),
varicella (if no history of chicken pox disease), hepatitis B,
and influenza.
| Country |
Recommended Immunizations |
Malaria Risk |
Additional Insect-borne Diseases |
Other Considerations |
| Australia |
Routine |
No risk |
Dengue Fever Murray Valley Encephalitis Ross River Virus |
Heat-related illnesses/sunburn Marine hazards including jellyfish, coral and sharks Risk of ciguatera poisoning from reef fish |
| Austria |
Routine |
No risk |
Tick-borne diseases in rural and forested areas |
|
| Bolivia |
Routine Hepatitis A Hepatitis B Typhoid Yellow Fever * Rabies |
Risk is mainly in rural areas below 8,200 feet. |
Chagas' disease Dengue Fever Leishmaniasis Yellow Fever |
Altitude Sickness Food and beverage precautions Tuberculosis-->140/100,000 Pre and post-travel testing for TB for stays longer than 3 months |
| Botswana |
Routine Hepatitis A Hepatitis B Typhoid Polio * Rabies |
Mainly in northerrn districts from November to June. |
African Tick Typhus Rift Valley Fever West Nile Virus |
Food and beverage precautions HIV incidence 37% Poisonous snakes, spiders, and scorpions Schistosomiasis--avoid fresh water swimming/bathing Tuberculosis-->140/100,000 Pre and post-travel testing for TB for stays longer than 3 months |
| China |
Routine Hepatitis A Hepatitis B Typhoid * Rabies * Japanese Encephalitis |
Numerous provinces during warm weather. No risk in urban areas and popular rural sites on all usual tourist routes. |
Dengue Fever Japanese Encephalitis Leishmaniasis Tick-borne diseases |
Air Pollution Altitude Sickness (over 8,000 feet) Avian Influenza Food and beverage precautions Schistosomiasis--avoid fresh water swimming/bathing Tuberculosis-->140/100,000 Pre and post-travel testing for TB for stays longer than 3 months |
| Costa Rica |
Routine Hepatitis A Hepatitis B Typhoid * Rabies |
Risk exists in rural lowland areas. No risk in most tourist areas. |
Chagas' Disease Dengue Fever Leishmaniasis |
Food and beverage precautions |
| Ecuador |
Routine Hepatitis A Hepatitis B Typhoid Yellow Fever * Rabies |
Risk
exists in areas at less than 5,000 feet. Travelers on the Amazon
tributaries are at risk. There is no risk in the Galapagos
Islands. |
Chagas' Disease Dengue Fever Leishmaniasis Yellow Fever |
Altitude Sickness Food and beverage precautions Tuberculosis-->130/100,000 Pre and post-travel testing for TB for stays longer than 3 months. |
| France |
Routine |
No risk |
Tick-borne diseases in rural and forested areas |
|
| Germany |
Routine |
No risk |
Tick-borne diseases in rural and forested areas |
Measles outbreak 2006 |
| Greece |
Routine Hepatitis A |
No risk |
Leishmaniasis Tick-borne diseases in rural and forested areas |
Air Pollution Brucellosis--avoid un-pasteurized dairy products Food and beverage precautions in some areas Measles outbreak 2006 |
| Hungary |
Routine Hepatitis A Hepatitis B Typhoid--possibly * Rabies |
No risk |
Tick-borne diseases in rural and forested areas |
Brucellosis--avoid un-pasteurized dairy products Food and beverage precautions in some areas |
| India |
Routine Hepatitis A Hepatitis B Meningococcal Polio Typhoid * Rabies * Japanese Encephalitis |
Entire country throughout the year. |
Chikungunya Fever Dengue Fever Japanese Encephalitis Leishmaniasis |
Altitude Sickness Food and beverage precautions High HIV incidence Marine hazards including jellyfish and sting rays Poisonous snakes, spiders and scorpions Tuberculosis-->145/100,000 Pre and post-travel testing for TB for stays longer than 3 months |
| Ireland |
Routine |
No risk |
Tick-borne diseases in rural and forested areas |
|
| Italy | Routine Hepatitis A Hepatitis B |
No risk |
Leishmaniasis Tick-borne diseases in rural and forested areas |
Brucellosis--avoid un-pasteurized dairy products Tap water precautions in the south |
| Jamaica | Routine Hepatitis A Hepatitis B Typhoid |
No risk |
Dengue Fever Leishmaniasis |
Hurricanes potentially from June through November Marine hazards including jellyfish, corals, and sea urchins. Risk of ciguatera poisoning from reef fish Schistosomiasis--avoid fresh water swimming/bathing |
| Jordan |
Routine Hepatitis A Hepatitis B Polio |
No risk |
Dengue Fever Leishmaniasis |
Brucellosis--avoid un-pasteurized dairy products Food and beverage precautions Schistosomiasis--avoid fresh water swimming/bathing |
| Martinique | Routine Hepatitis A Hepatitis B Typhoid |
No risk |
Dengue Fever |
Food and beverage precautions Marine hazareds including jellyfish, corals, sea urchins, and sharks Risk of ciguatera poisoning from reef fish |
| Mexico | Routine Hepatitis A Hepatitis B Typhoid * Rabies |
Rural areas at less than 3,200 feet. |
Chagas' Disease Dengue Fever Leishmaniasis West Nile Virus |
Air Pollution Brucellosis--avoid un-pasteurized dairy products Food and water precautions Marine hazards including jellyfish, coral and sea urchins Risk of ciguatera poisoning from eating reef fish Tuberculosis--<60/100,000 Pre and post-travel TB testing for stays longer than 3 months Wear shoes in rural areas to prevent parasitic infections |
| Namibia |
Routine Hepatitis A Hepatitis B Polio Typhoid * Rabies |
Certain provinces including Etosha National Park from November to June. |
African Sleeping Sickness Leishmaniasis Rift Valley Fever |
Food and beverage precautions HIV incidence 21% Poisonous snakes, spiders and scorpions Schistosomiasis--avoid fresh water swimming/bathing Tuberculosis-->170/100,000 Pre and post-travel TB testing for stays longer than 3 months |
| New Zealand |
Routine |
No risk |
||
| Norway |
Routine |
No risk |
Tick-borne diseases in rural and forested areas |
|
| Senegal |
Routine Hepatitis A Hepatitis B Meningococcal Polio Typhoid Yellow Fever * Rabies |
Entire country throughout the year. |
African Sleeping Sickness Dengue Fever Leishmaniasis Onchocerciasis Relapsing Fever Yellow Fever |
Food and beverage precautions Heat-related illness/sunburn, dusty wind during dry season Schistosomiasis--avoid fresh water swimming/bathing Tuberculosis-->160/100,000 Pre and post-travel testing for TB for stays longer than 3 months |
| South Africa |
Routine Hepatitis A Hepatitis B Polio Typhoid * Rabies |
No risk in major cities Present in low altitude areas along NE border including Kruger National Park |
African Tick Typhus Chikungunya Fever Sindbis Fever West Nile Fever |
Food and beverage precautions HIV incidence >21%, has more people living with HIV than any other nation Marine hazards include jellyfish, stingrays and poisonous fish Poisonous snakes and spiders Schistosomiasis--avoid fresh water swimming/bathing Tuberculosis-->150/100,000 Pre and post-travel TB testing for stays longer than 3 months |
| Spain |
Routine Hepatitis A Hepatitis B |
No risk |
Leishmaniasis Tick-borne diseases in rural and forested areas |
Brucellosis--avoid un-pasteurized dairy products Measles outbreak 2006 Tuberculosis-->45/100,000 Pre and post-travel TB testing for stays longer than 3 months |
| Trinidad & Tobago |
Hepatitis A Hepatitis B Typhoid Yellow Fever * Rabies |
No risk |
Dengue Fever Yellow Fever |
Food and beverage precautions Marine hazards including jellyfish, coral, sea urchins and sharks Risk of ciguatera poisoning from eating reef fish. It is illegal for civilians to wear army or camouflage clothing. |
| United Kingdom | Routine Meningococcal---for those in dormitory settings |
No risk |
Measles outbreak 2006 Mumps outbreak 2005-06 |
|
|
Virgin Islands |
Routine Hepatitis A |
No risk |
Dengue Fever Leishmaniasis |
Food and beverage precautions HIV--second most affected area in the world after sub-saharan Africa Hurricanes potentially from June through November Marine hazards including jellyfish, coral, sea urchins and sharks Risk of ciguatera poisoning from eating reef fish |
* Rabies vaccine is recommended for occupational exposure; adventure
travelers, cave explorers, especially individuals who will be
more than 24 hours travel from a reliable source of post-exposure
vaccine. Animal bites and scratches should be taken seriously.
* Japanese Encephalitis vaccine is recommended for travelers who will
be staying in rural areas for more than 30 days, or those who may have
extensive outdoor night-time exposure such as campers and bicyclists.