Travel Vaccinations & Health

Japanese Encephalitis is a potentially severe viral brain infection spread by mosquitoes, found in parts of Asia and the Pacific. The mosquitoes that transmit JE are most active at night, especially in rural areas with rice fields and pig farming, but they can also be present in urban areas. 

For most travellers, the risk of JE is very low, particularly for short stays in cities. However, the risk increases for those spending extended time in rural areas during transmission seasons or engaging in outdoor activities like camping or fieldwork. 

Many infections show no symptoms, but severe cases can cause fever, headache, confusion, and may lead to death or long-term neurological damage. 

Prevention 

Preventing mosquito bites is essential, especially at night. Use insect repellent, wear protective clothing, and sleep under a mosquito net. 

Vaccination 

The JE vaccine (IXIARO®) is recommended for those staying in rural high-risk areas for extended periods or participating in activities that increase exposure. It is approved for individuals aged 2 months and older. Adults aged 18–65 can opt for an accelerated schedule with doses on day 0 and day 7. 

Tick-borne encephalitis (TBE) is a viral infection spread by infected ticks, found in parts of Europe, Russia, and eastern Asia, especially in woodlands and grasslands. The risk is higher in spring and summer.

If you're planning to spend time outdoors in these areas, vaccination is recommended, as TBE can cause serious brain and spinal cord infections. While rare in Europe, it can be fatal in up to 20% of cases in Asia, with long-term neurological complications. Vaccination is the best way to protect yourself if you're at risk. 

Yellow fever is a viral disease spread by mosquitoes, mainly found in tropical regions of Africa and South America. Symptoms can range from mild fever to severe illness with jaundice, organ failure, or death. The disease is preventable with a vaccine, recommended for travellers to endemic areas or those needing a vaccination certificate. 

Yellow fever is prevalent in specific regions, including: 

• Sub-Saharan Africa 
• Areas in South America, such as Trinidad and Tobago 
• Parts of Central America 

The yellow fever vaccine is a single-dose, highly effective vaccine that provides lifelong protection. It is recommended for travellers to areas where yellow fever is common and for those at higher risk due to their occupation. A vaccination certificate may be required for entry into certain regions. 

Varicella, also known as chickenpox, is a highly contagious viral infection caused by the varicella-zoster virus. It is characterised by an itchy rash with red spots and fluid-filled blisters, along with other symptoms like fever, fatigue, and loss of appetite. The virus spreads through direct contact with an infected person's rash or respiratory droplets from coughing or sneezing. 

Varicella is most common in children but can affect individuals of any age, especially those who haven't been vaccinated or previously infected. 

The Varicella vaccine safely prevents chickenpox, protecting you from illness, reducing transmission to vulnerable individuals, and preventing absences from school or work. It also provides long-term immunity. 

Cholera is a bacterial infection that affects the intestines, causing severe diarrhoea and dehydration. It is primarily spread through contaminated water or food, particularly in areas with poor sanitation. Cholera can lead to rapid dehydration, which can be life-threatening if not treated promptly. Symptoms include watery diarrhoea, vomiting, and muscle cramps. Cholera is preventable with proper hygiene, sanitation, and vaccination. Treatment involves rehydration and, in some cases, antibiotics. 

Cholera is most common in parts of Africa, Southeast Asia, the Indian subcontinent, and the Caribbean. It often occurs in regions with inadequate sanitation, poor water quality, and limited access to healthcare. 

Measles, Mumps, and Rubella (MMR) are viral infections that can lead to serious health issues: 

• Measles: Known for a rash and flu-like symptoms, it can cause pneumonia, brain inflammation, and death. Vaccination is essential to prevent outbreaks and protect at-risk groups. 
• Mumps: Causes swelling of the salivary glands and can lead to complications like meningitis, inflammation of the testicles, and hearing loss. The MMR vaccine offers effective protection. 
• Rubella: Also called German measles, it can result in severe birth defects such as hearing and vision problems or heart defects if contracted during pregnancy. Vaccination is vital for protecting both women and their babies. 

Who Needs the Vaccine? 

• Children: The MMR vaccine is given as part of routine immunisations at ages 12-15 months and again at 3-5 years. 
• Adults: Those who haven't been vaccinated or haven't had these diseases may need the vaccine, particularly if they are at increased risk, such as healthcare workers or travellers. 

Pregnant Women: Should not receive the vaccine during pregnancy, but it is important to ensure they are vaccinated before conception to protect future pregnancies from rubella. 

Stay protected against three serious infections with the Diphtheria, Tetanus & Polio (DTP) vaccine. Essential for childhood immunisation and recommended as a booster for adults travelling to high-risk areas, this vaccine safeguards against:

Diphtheria – A contagious bacterial infection affecting the throat, nose, and skin, potentially life-threatening if untreated.

Tetanus – A dangerous toxin-producing bacteria that enters through cuts or wounds, causing painful muscle spasms and stiffness.

Polio – A highly infectious virus that spreads through contaminated food, water, or contact, with the risk of paralysis and severe complications.

Ensure your protection with a booster dose every 10 years if travelling to at-risk regions.

Hepatitis B is a viral infection of the liver, transmitted through direct contact with the blood or body fluids of an infected person. It is found worldwide, with the highest infection rates in parts of East Asia, Sub-Saharan Africa, the Amazon, and some regions of Eastern and Central Europe, the Middle East, and the Indian subcontinent. Infection rates are lower in Western Europe and North America. If left untreated, it can lead to serious liver conditions such as cirrhosis, liver failure, or liver cancer. Vaccination is the most effective prevention method. 

The risk of Hepatitis B for travellers is generally low, but certain activities can increase the risk, especially in areas where the virus is more common. These include unprotected sex, occupational exposure to blood, sharing needles or undergoing medical/dental procedures with unsterile equipment, adopting children from high-risk countries, and long-term stays in affected areas. 

Typhoid fever is a bacterial infection caused by Salmonella typhi, commonly spread through contaminated food or water, leading to symptoms like fever, abdominal pain, and fatigue. Without prompt treatment, it can cause serious complications and can be fatal.  

Most cases of typhoid are found in Asia, though it is also a concern in parts of Africa, Central America, and South America. 

In the UK, most travel-related infections occur among individuals visiting friends and family in the Indian subcontinent, including Bangladesh, India, and Pakistan. 

Typhoid Vaccine  

Vaccination is recommended for travellers at higher risk of exposure, especially in areas with poor sanitation and food hygiene.  

Both oral and injectable vaccines are available, and some combine protection against Hepatitis A. Public Health England advises that children aged 12 months to two years should be immunised if the risk is high. For younger children, strict hygiene measures should be followed. 

To maintain protection, a booster dose should be administered every three years for those at continued risk following the initial injectable dose or a complete course of the oral typhoid vaccine. For the oral vaccine, this consists of an extra three capsules. 

Typhoid and Hepatitis A vaccines are often given together as both are spread through contaminated food and water. This combination offers convenient protection for travellers at risk of both diseases. 

Meningococcal disease is a serious bacterial infection caused by Neisseria meningitidis. It can lead to meningitis (inflammation of the lining around the brain and spinal cord) or septicaemia (blood infection). The disease can develop rapidly and is potentially fatal without prompt treatment. 

 Meningococcal disease is transmitted through respiratory droplets from coughing, sneezing, or close contact with an infected person. 

Vaccination is key to preventing the disease, particularly for high-risk groups such as infants, adolescents, and individuals with weakened immune systems. 

There are vaccines available that protect against the most common serogroups (A, B, C, W, and Y) of the bacteria. These vaccines are recommended at various ages, with specific guidance for those living in close-contact environments, like university students, or for those traveling to areas where the disease is more common. 

Prevention 

Travellers should seek advice about meningitis risks before their trip, especially when visiting areas prone to outbreaks. Higher-risk groups include long-stay travellers in close contact with locals, healthcare workers, those visiting friends and relatives, backpackers, and individuals with spleen issues or certain immune deficiencies. 

Meningococcal Disease Vaccines  

Travellers to high-risk areas should consider both the Meningitis B vaccine and the ACWY vaccine if their activities may increase their risk of infection. 

Human Papillomavirus (HPV) describes a group of around 100 viruses, although most of them are not dangerous. These viruses are common with most people getting the virus at some stage in their life, and usually the immune system alone is enough to fight them off. Certain types of HPV belong to a high-risk group due to their ability to cause genital warts and abnormal cell changes which can lead to cancer. Cancers linked to HPV include cancers of the cervix, anus, penis, vagina, and certain other cancers in the head and neck.

The HPV vaccine protects against the types of HPV which are known to cause cancer. The vaccine used, under the brand name Gardasil, contains highly purified strains of HPV type 6,11,16 and 18 which are the strains most likely to cause cancers.

Hepatitis A is a liver infection caused by a virus spreading through contaminated food, water, or contact with an infected person. It is more common in areas with poor sanitation, including parts of Africa, Asia, South and Central America, and the Middle East. 

The virus can cause symptoms such as fatigue, nausea, abdominal pain, jaundice (yellowing of the skin), and fever. Symptoms are usually mild in children but can be more serious in adults. Recovery can take weeks to months, and once recovered, immunity is lifelong. 

Certain travellers are at higher risk, including those staying with locals, long-term travellers, people with liver conditions, men who have sex with men, and those exposed through work or drug use. Vaccination is recommended for those visiting high-risk areas. 

Hepatitis A and Typhoid vaccines are often given together as both are spread through contaminated food and water. This combination offers convenient protection for travellers at risk of both diseases. 

Shingles is a viral infection caused by the varicella-zoster virus, the same virus responsible for chickenpox. It usually presents as a painful rash with blisters. Shingles occurs when the virus, which lies dormant in the body after a chickenpox infection, reactivates. It spreads through direct contact with the fluid from shingles blisters. 

Anyone can get shingles, but the risk is higher for individuals aged 50 and older, especially those with weakened immune systems. Shingrix, the shingles vaccine, is over 90% effective in preventing shingles and its complications, such as long-lasting nerve pain. The vaccine is given in two doses, spaced 2 to 6 months apart. It is recommended for individuals aged 50 and older, even if they have previously had shingles. Vaccination is the best way to reduce the risk of shingles and its painful complications. 

Rabies is a deadly viral infection transmitted to humans through bites or scratches from infected animals, usually dogs. It attacks the nervous system, causing severe brain and spinal cord damage, and is almost always fatal once symptoms appear. Vaccination is recommended for those at higher risk, such as long-term travellers or those engaging in activities like cycling or running in rabies-endemic areas. With proper precautions and timely treatment, rabies is preventable. 

Prevention 

When travelling in rabies-endemic areas avoid contact with stray or wild animals and wash any wounds with soap and water immediately before seeking medical advice.  

Rabies Vaccine 

Pre-exposure rabies vaccination is recommended for people at high risk of regular exposure, such as laboratory workers handling the rabies virus, bat handlers, and those working with imported animals or in rabies-risk areas, including some healthcare workers. 

Most travelers to rabies-affected regions are at low risk, but pre-exposure vaccination is advised for those engaging in higher-risk activities, such as cycling, running, or travelling to remote areas with limited access to post-exposure treatment.