India (Asia)

Advice for All Destinations Vaccinations Malaria Malaria Map Other Health Risks Alerts News

Vaccinations

• Confirm primary courses and boosters are up to date as recommended for life in Britain - including for example, seasonal flu vaccine and COVID-19 (if eligible), MMR, 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: Hepatitis B; Rabies.
• Selectively advised vaccines - only for those individuals at highest risk: Cholera; Japanese Encephalitis.

• Yellow fever vaccination certificate requirements for India are specific and quite lengthy, to read the full details via the W.H.O Website

  Please Note: If you travel to India from the UK, transiting through Europe or the Middle East  (and you have not been in a South American or African country in the previous week) a yellow fever vaccination certificate is not required.

Notes on the diseases mentioned above

• Cholera:  spread through consumption of contaminated water and food. 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.

  Risk is higher during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water.

  Risk is highest for humanitarian aid workers; those working in refugee camps or slums; those caring for people with cholera.

• Diphtheria:  spread person to person through respiratory droplets. Risk is higher if mixing with locals in poor, overcrowded living conditions.
• Hepatitis A:  spread by consuming food or drinks that contain the virus (i.e. become contaminated by infected poo), or by touching things or people that have infected poo on them, and then touching your mouth.

  Risk is higher if travelling to countries where there hepatitis A is circulating in the local population, or to areas where personal hygiene and sanitation is poor.

  Risk is highest for those with underlying medical conditions where there is increased risk of developing severe disease e.g. liver/kidney disease; haemophilia (clotting disorder); and for men who have sex with men; people who inject drugs; those at risk of exposure through their jobs.

• Hepatitis B:  spread through exposure to infected blood or bodily fluids. Occurs from sexual contact or contact with contaminated needles and medical instruments (e.g. dental / medical procedures, tattooing, body piercing, sharing intravenous needles). Mothers with the virus can also transmit the infection to their baby during childbirth.

  Risk is higher for those visiting more frequently, staying longer, visiting friends and relatives, children through bites, cuts and scratches and those who may require medical treatment during travel.

  Risk is highest for those with underlying medical conditions where there is increased risk of severe disease e.g. chronic liver/kidney disease; haemophiliacs (clotting disorder) and in men who have sex with men; people who change sexual partners frequently; and people who inject drugs.

• Japanese Encephalitis:  spread through the bite of an infected mosquito. This mosquito breeds in rice paddies and mainly bites between dusk and dawn. Risk is highest for long stay travellers to rural areas, particularly if unable to avoid mosquito bites.
• Rabies:  spread through the saliva of infected animals (especially dogs, cats, bats and monkeys), usually through a bite, scratch or lick to broken skin. Risk is higher for those working or living in remote or rural areas (with no easy access to medical facilities), longer stay travellers, those planning on undertaking activities such as trekking, cycling or running in a 'high risk' country, those working with, or regularly handling animals or bats, as part of their job, and children. 

  Urgent medical advice should be sought after any animal bite, scratch or lick to broken skin, or bat bite, even after receiving pre-travel rabies vaccine.

• Tetanus:  spread 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.
• Typhoid:  spread mainly through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is limited.

Malaria

Malaria is a serious and sometimes fatal disease transmitted by mosquitoes.You cannot be vaccinated against malaria.

Malaria precautions

Malaria Map

Please note that the malaria risk text below supersedes the risk areas displayed on the India malaria map and should be followed. If in doubt, always consult with a travel health professional.

• Malaria risk is present throughout the year. Risk is highest in north-eastern states of Meghalaya, Mizoram, district of Amini in Arunachal Pradesh, north and south Chhattisgarh, Odisha (Orissa) and the city of Mangalore.
• In addition to the risk areas shown on the map, the four districts of Balaghat, Dindori, Mandla and Seoni in the state of Madhya Pradesh should be considered as 'high risk'.
• In central Chhattisgarh, Jharkhand, Tripura and Arunachal Pradesh 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 advice below under 'Low risk with additional advice').
• There is low to no risk in all other areas.
• 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. 

Dengue Fever

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. 

Alerts

Polio Vaccine Requirement for India

There is no risk of polio in this country. However, proof of polio vaccination may be necessary if you are travelling to India from a country where polio is still found. Please discuss this with a travel health professional. 

Zika Virus Infection

This country has been categorised as having a risk of Zika (ZIKV) virus transmission.

ZIKV is mainly spread through mosquito bites. The mosquito responsible most commonly bites during daylight hours and is common in towns and cities. 

The illness is usually mild but infection during pregnancy may lead to babies being born with birth defects. There is no vaccine currently available against ZIKV.

Advice for All Travellers

You should practice strict mosquito bite avoidance at all times.
Do not travel without adequate travel insurance.
Seek pre-travel health advice from a travel health professional 6 to 8 weeks in advance of travel.

Additional recommendations for pregnant travellers or those planning pregnancy

If you are planning pregnancy in the very near future you should consider whether you should avoid travel to this country.

• If you visit this country while pregnant, or become pregnant within 2 months after leaving this country you should:
  • contact your GP, obstetrician or midwife for further advice, even if you have not been unwell or had any symptoms of ZIKV infection
  • use barrier methods of contraception during and after travel and for the duration of your pregnancy, even in you have not been unwell or had any symptoms of ZIKV infection
• You should avoid becoming pregnant while travelling in this country
  • If you develop symptoms of ZIKV infection, it is recommended that you avoid becoming pregnant for a further 2 months following your recovery
• If you are planning pregnancy, you should use barrier methods of contraception during travel and for:
  • 2 months afterwards if you are female
  • 3 months afterwards if you are male or if both partners travelled

These measures reduce the chance of sexual transmission of ZIKV and/or the risk of ZIKV infection in pregnancy.

For further information, see Zika virus infection page.

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