This page contains a Flash digital edition of a book.
TRAVEL MEDICINE GUIDE Malaria


Destination Abu Dhabi


Afghanistan Albania Algeria Angola


Antigua & Barbuda Argentina Armenia Australia Austria


Azerbaijan Bahamas Bahrain Bali


Bangladesh Barbados


Belarus Belize


Benin Republic Bermuda Bhutan Bolivia


Borneo Bosnia


Botswana Brazil


Brunei Bulgaria


Burkina Faso Burundi


Cambodia


Cameroon Canada


Cape Verde Islands Cayman Islands


Central African Rep. Chad Chile


China (Mainland) China (Hong Kong)


China (Macao) Colombia


Comoros Congo


Congo-Dem. Rep. Cook Islands Costa Rica Croatia Cuba


Cyprus


Czech Republic Djibouti


Dominican Republic Dubai


R R S R R S


S R East Timor (Timor Leste) R R S R S R


R R S S R


S R


S R R


S R R R


R R S R S R


R R S R R S


R R R R S R


R R S R


R R


R R S R R S R R S


S S S


R R S R R S S S C R


S S C


R S S S M S


S S S C C


S S S S


S S S S


S S S C


C S S C


R S S S C R S S S C


S S S S S S S S S C


S S S S M S S


S S S C R S S S R S S S S C S S S S S S S C


S S S S S S S S C


S S


S S S M S S S S M S


R S S S C


R R S R R S S S M S S


R R


R R S R R S R


S R S R


R S R


R R S R R S R R S R R


R S S S


S S S S


C


R S S S M S R S S S R S S S


S S S C S S


S S S S R S S R S S S M


R S S S M S S


S C S


S S S


S S S S C R S S S


S S S R S S S C S S S S S S C


S S


S No Yes, below 2000m, May-Nov S No


Yes, low risk vivax in South Yes, high risk No


W


Minimal risk in north & Iguaçu W No No


W S No


Low risk SW border Jun-Oct No No


Minimal risk No S No Low risk


Yes, high risk No


Yes, southern districts W ME or DO or MON PC Sh Le ME or DO or MON DRF Le


Yes, high risk in Amazon basin. ME or DO or MON PC Variable risk on Paraguayan and Argentine borders


PC for high risk groups S No High risk Northern half Minimal risk S No


Yes, high risk Yes, high risk


Yes- Western areas


Yes, high risk No


Yes, very low risk Aug-Nov No


Yes, high risk Yes, high risk No


No No


Yes, high Eastern half and


coastal areas. Very low around Medellin, Bogota & Cartagena


Yes, high risk Yes, high risk Yes, high risk No


Low risk


S No No No


S No Yes, high risk


Yes, high risk along Haitian border, variable risk elsewhere


No Yes, high risk


ME or DO or MON PC Sh Le C


P Sh Le Le ME or DO or MON PC Le


ME or DO or MON PC Le Ta W


ME or DO or MON PC Le ME or DO or MON PC Sh Ta ME or DO or MON PC Sh Ta


W


Le Tc Le


Le


ME or DO or MON PC Sh Le Ta ME or DO or MON PC Sh Ta DOor MON


PC


Yes, significant risk elsewhere. ME or DO or MON PC Minimal risk Phnom Pehn, Angkor W Wat, Siem Reap


ME or DO or MON PC Sh Ta W Le


ME or DO or MON PC Sh Ta ME or DO or MON PC Sh Ta Tc


S S Yes, in Yunnan and inland Hainan ME or DO or MON PC Sh Elsewhere, very low/no risk


W Indonesia R R S R S S S C S


Risk assess in other areas (see Travax)


High risk on islands to West of Sulawesi


Iran Iraq


Israel Italy


Ivory Coast Jamaica Japan Jordan


Kazakhstan Kenya


Kiribati


Korea (North) Korea (South) Kosovo Kuwait


Kyrgyzstan Laos


Latvia


Lebanon Lesotho Liberia


Key


M = immunisation mandatory R = immunisation recommended as risk of infection is substantial


S = immunisation sometimes recommended: – for more than three visits in a one-year period – a stay of more than three months in a rural area – for high-risk occupational groups – for backpackers staying more than one month – when entering the limited geographical risk area for the target disease


C = See Yellow fever, next column


Where S appears for cholera, it indicates that only high-risk travellers, usually healthcare workers in areas of known epidemics, should be immunised.


Vaccinations information Tetanus


Five tetanus doses are considered protective for life by the DH, although there is no evidence base for this. Travellers at risk of tetanus-prone


80 February 2016 Pulse S R S R


R R S R


S S R


R R S R R


S R S R


S R


R R S R R S


S


R R S R R S S S C R


S S C S S


R S S S M S S


S S


C S S C S S S C


R R S R R S S S R S S R


S S S S C S S S S C S S S S S S S


S S S C


R R S R R S S S C S S S S


S S S C


S S S S C S S S S M


S


S S


W W


Minimal risk coastal areas. Low W risk inland Sabah, Sarawak and ME or DO or MON PC all of Indonesian Kalimantan


Le ME or DO or MON PC Sh Ta


High risk in NW half in Amazonia ME or DO or MON PC Sh Le Tc states. Elsewhere, very low


DRF W W


Yes, SE and Chittagong Hill Tracts. ME or DO or MON PC Le Elsewhere, low risk


W Le Le Le


ME or Do or MON PC Le Le


Sh Le ME or DO or MON PC Sh Ta


Destination Ecuador


Egypt El Salvador


Equatorial Guinea Eritrea


Estonia Ethiopia


Falklands (Tristan da C.) Fiji


Finland France


French Guiana


French Polynesia Gabon


Gambia Georgia Germany Ghana Goa


Greece and Islands Greenland Grenada


Guadeloupe Guam


Guatemala Guinea


Guinea Bissau Guyana


Haiti Hawaii


Honduras Hungary India


R S R


S R R


R R S R R S R


R R S R R S


S


S S M S


R S S S M


S S S R S S S S


R S S S M S S S S S C S S


S S


S S C S S


C S S S C


R R S R S S S S R S R R S S R


R R S R R


R R S


R S S S C S S S C


S S S S S C S


S S S S M S S S S R


S R R


R R R R


S S S R


S S C S S C


R R S R R S S S R R R S


R S S S S S S


R R S R R S S S R S R R S S S C Malaria


Yes - high risk coastal provinces and ME or DO or MON PC Tc on Peru and Colombia borders. Elsewhere low risk


W No


Yes, low risk Yes, high risk


S No


Yes, high risk below 2,000m (No risk in Addis Ababa)


No No


S No S No


High risk west & south.


Yes, high risk Yes, high risk


S No


Yes, high risk Low risk


S Low risk Evrotas Delta No No No No


ME or DO or MON PC Sh Ta W W


Le Le


Coast and central inland low risk W No


ME or DO or MON PC Sh ME or DO or MON PC Sh Ta


Yes, v. low risk SE villages July-Oct W Le ME or DO or MON PC Sh Tc ME or DO or MON PC Sh W ME or DO or MON PC Sh Ta


Yes, High risk below 2200 metres, ME or DO or MON PC Sh Le no risk in Asmara


Yes, low risk below 1500 metres W/C Yes, high risk Yes, high risk


Yes, high risk all areas except coastal strip


Yes, risk variable S No


High risk in east and Assam Complex central zone


ME or DO or MON PC Le


W, see Travax & advice


Low risk north and south zones W Very low Bali and cities


W Usually W ME or Do or MON PC


Yes, rural SE provinces Mar-Nov ME or Do or MON PC Sh Le Yes, v. low risk rural north May-Nov W No


S No


Yes, high risk No


S S No No


S No Yes, high risk


(Nairobi and highlands low risk) No


Yes, limited risk extreme south W Yes, limited risk extreme north W


S No No


S Yes, low risk some S & W areas W Yes, high risk (minimal risk


Vientiane)


S No No No


Yes, high risk


Le Sh


ME or DO or MON PC Sh Ta ME or DO or MON PC Le Le


P Sh Le Le Le


ME or DO or MON PC Ta


Sh Le Le


ME or DO or MON PC Sh Le Ta


P


ME or DO or MON PC Sh Ta ME or DO or MON PC Sh Ta ME or DO or MON PC Sh


Yes, high risk throughout country ME or DO or MON PC No


W/C P Le


wounds should be given 10-yearly boosters if they are going to poorer countries in Africa, Asia and South America where specific immunoglobulin


may be unavailable. Polio


All travellers should have completed the British vaccination schedule for polio immunisation in


childhood or as adults. Yellow fever


⦁ An international certificate of vaccination may be required for those entering from, or transiting


through airports in YF endemic countries where C, S, R or M appears indicated in the yellow fever column. For details consult CDC Yellow Book at tinyurl.com/lnxngfwt ⦁ M = Mandatory generally indicates that all travellers aged >12 months should carry an international certificate of vaccination. Country specific ages are indicated on the CDC web site


above. Information source and updates


This chart is based on information from the UK TRAVAX website and other databases. TRAVAX is an information service provided by Health Protection Scotland (www.travax.nhs.uk; telephone 0141 300 1130).


NaTHNaC should also be consulted. NaTHNaC and Travax are independently administered and may occasionally differ in the advice offered.


The chart is updated regularly. Readers are advised to use the latest chart only, to ensure that their practice reflects the most recent advice.


Travel vaccinations and malaria information author


Dr Michael Jones, Consultant in Infectious Diseases, Edinburgh.


Parasitic infections Short-term travellers staying in good conditions are usually at low risk of acquiring parasitic infections. Schistosomiasis is common and potentially serious. Leishmaniasis and trypanosomiasis are less common but potentially lethal. Expatriates in remote areas at risk of other


rare diseases are not shown in this chart. Sh = schistosomiasis. Travellers should avoid swimming in freshwater lakes and rivers in


endemic areas. Ta = African trypanosomiasis (sleeping sickness). Transmitted by tse-tse flies, and a risk in some African game parks and rural areas. Travellers


weeks later. Tc = South American trypanosomiasis (Chagas’ disease). Transmitted by reduvid bugs that feed at night and reside in the thatch and crevices of rural dwellings. Travellers should avoid sleeping


in huts. Le = Leishmaniasis. Transmitted by sandflies in arid areas (including Mediterranean coastal areas), mostly at night. Travellers should use insecticide-impregnated mosquito nets and insect repellent.


Key to malaria prophylaxis regimens


Regimen MON


Malarone (atovaquone/proguanil), one tablet daily. Begin 1-2 days before departure, continue while in malarious area and for 7 days after return. Advisory Committe on Malaria Prophylaxis suggest Malarone is safe in continuous use of at least 1 year and possibly longer. Safety in pregnancy has not been established, and should only be considered if


should use insect repellents, close windows if fly swarms approach and seek medical attention for any signs of infection around bites one to three


Main parasitic hazards Alternative regimen


Recommended regimen


Risk areas and seasons Tick-borne encephalitis Hepatitis B


Hepatitis A Typhoid


Cholera


Tuberculosis Diptheria Polio


Japanese enceph Mening/ACWY Yellow fever Rabies


Main parasitic hazards Alternative regimen


Recommended regimen


Risk areas and seasons Tick-borne encephalitis Hepatitis B


Hepatitis A Typhoid


Cholera


Tuberculosis Diptheria Polio


Japanese enceph Mening/ACWY Yellow fever Rabies


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108