Here we explain the most common diseases travelers may encounter while abroad, how and when to get vaccinated against those diseases, and ways to reduce your risk of illness while on vacation.
In this guide:
Areas at risk: Africa, Indian subcontinent, South Asia, Southeast Asia, South America
How it is administered: Vaccine (injection or oral medication) every 3 years
When to get vaccinated: At least one month before travel
What is typhoid fever?
Typhoid fever is caused by the Salmonella bacteria and is associated with fever, diarrhea (and sometimes constipation) and potentially serious complications. Drug resistance can make it difficult to treat.
What you need to know about the typhoid vaccine
It needs to be renewed every three years. For those who don't like injections, an oral typhoid vaccine is available as an alternative.
Back to Top
Areas at risk: Africa, Asia, Middle East, Latin America
Vaccination method: Injection
When to receive: 2 weeks before the trip
What is Hepatitis A?
Hepatitis A is a viral infection of the liver, and complications such as liver failure increase with age. The good news is that since a vaccine became available in the 1990s, hepatitis A is rare among travelers.
What you need to know about the Hepatitis A vaccine
The first dose confers protection for one year, which the second dose extends to more than 20 years.
Back to Top
Risk areas: Sub-Saharan Africa, South America, Central America, Trinidad in the Caribbean.
Vaccination method: Injection
When to collect: At least 10 days before travel
What is Yellow Fever?
Yellow fever is a viral infection spread by mosquitoes in Africa and Latin America. It gets its name from the yellow color caused by liver failure and jaundice, but the virus attacks every organ in the body. It strikes suddenly and unpredictably, with periods of inactivity.
What you need to know about the Yellow Fever Vaccine
The vaccine is only administered at duly authorized vaccination centers. A careful risk assessment is essential, as the vaccine contains a weakened live virus that can have adverse effects on older people and those with various pre-existing conditions. Yellow fever vaccination certificates are valid for life, but only 10 days after vaccination. Some experts recommend a booster vaccination after 10 years for those at continued high risk.
Pro tip: Countries with yellow fever-spreading mosquitoes often require travelers coming from yellow fever areas to show proof of vaccination as a condition of entry to prevent the spread of the disease, so be sure to check the requirements carefully.
Back to Top
Areas at risk: Asia, Africa, Latin America
Vaccination method: Three doses given as pre-travel vaccinations
When to take: At least 8 weeks before travel
What is rabies?
Rabies is a fatal viral infection that infects the brain and nervous system. Bites, licks, and scratches by dogs (or other mammals such as monkeys, cats, and bats) should all be treated as a potential risk for rabies. Rabies occurs in most countries, and animal bites are one of the most common reasons travelers seek medical care abroad.
What you need to know about rabies vaccines
Ideally, three vaccinations should be given over a three week period. Vaccinating before you travel will greatly simplify the treatment you need to give if you are bitten whilst on holiday. Clean any wounds to prevent infection and promote healing, and administer a booster vaccination as soon as possible.
If the dog has not been vaccinated beforehand, treatment is more complicated and urgent. Rabies immune globulin (RIG) is injected into the bite area. RIG is a product that contains antibodies that neutralize the rabies virus and is often unavailable in the highest-risk countries. This treatment is followed by an accelerated vaccination course, which may disrupt travel itineraries around medical appointments.
Expert advice: Never touch any animals when traveling. Stray dogs are particularly dangerous – they are not pets and should not be approached as they are very territorial. Tameness can be a sign of rabies and sick or injured animals should never be touched. Also, only observe the infamous “monkey temples” from afar.
Back to Top
Risk areas: Africa and parts of Asia, Central and South America, the Dominican Republic and Haiti, parts of the Middle East, and some Pacific islands.
Administration method: Tablet or capsule
When to take: Ask your doctor 4 to 6 weeks before traveling.
What is Malaria?
The malaria parasite is transmitted by the Anopheles mosquito. Symptoms include fever, chills, muscle and joint pain, headache, abdominal pain, diarrhea and jaundice, and if untreated can lead to loss of consciousness, coma and even death. The onset of symptoms may be delayed for several weeks, by which time any connection to travel may be forgotten. (Read more about the rise in malaria cases in our guide to preventing malaria abroad.)
What you need to know about antimalarial treatments
Antimalarial tablets or capsules (most commonly Malarone and Doxycycline) are usually taken once a day before, during and after travel.
Expert tip: If you feel unwell after returning home, be sure to tell your doctor that you've been traveling so you can get properly tested for malaria.
Back to Top
Areas at risk: Parts of Africa and Asia, Central and South America, the Caribbean, the Pacific Islands, and parts of southern North America. (However, rising temperatures are creating more favorable conditions for dengue fever, and the disease is spreading, with sporadic cases occurring in southern Europe.)
Vaccination method: Vaccine injection (high-risk travelers only)
When to get it: If you're at high risk for illness, talk to your doctor at least three months before traveling.
What is dengue fever?
Dengue fever is the most common mosquito-borne viral infection in the world. Also known as “breakbone fever,” symptoms include a rash and pain in the muscles, joints and behind the eyes. There are four different strains, and infection with one strain only partially protects against future infection with another strain; subsequent infections may be more severe.
What you need to know about the dengue vaccine
A dengue vaccine has recently been licensed in the UK. It is given in two doses, three months apart. If this is not possible, the first dose is 80% protective. Some experts are concerned that there may be an increased risk of developing severe dengue in the future, and only recommend the vaccination for travellers who have had dengue, so it's best to discuss any concerns with your GP or a travel health specialist.
Expert tip: The best way to prevent dengue fever infection is to avoid mosquito bites.
Back to Top
How to protect yourself while traveling
We all want our travels to be relaxing and carefree. Taking a proactive approach to health, prevention, and your own safety is key to a successful trip. Follow these tips to stay safe while on vacation:
Protecting yourself from insect bites is a good way to avoid some of the diseases mentioned above, as well as the nuisance of the bites themselves. In fact, careful insect bite prevention measures can reduce the number of bites you get by more than 90 percent. The combination of insect bite prevention measures, vaccines, and antimalarial drugs is highly effective.
When you are outdoors during mosquito biting season, cover up and use repellent containing 50 percent DEET on clothing and exposed skin (repellents containing picaridin are also effective). Clothing can be sprayed with permethrin, which is safe for humans but deadly to insects on contact. When outdoors, burn mosquito coils to repel mosquitoes. Use a combination of spray and insert insecticides indoors, behind screens and in air-conditioned rooms. Sleep under insecticide-treated mosquito nets at night if mosquitoes may enter your lodgings.
Back to Top
There's no polite way to say this: Food, water, and hands contaminated directly or indirectly with human waste spread diarrheal diseases, viruses, parasites, bacteria, and their toxins. High temperatures and poor hygiene increase the risk and make it harder to avoid, especially if you're not careful. (On a recent trip to the U.S., a bout of dysentery brought on by contaminated guacamole severely damaged my pride, although I was promptly tested and treated.)
Food that is fresh, fully cooked and served hot is safest. Remember to wash your hands frequently and use hand sanitizer and wipes. Buffets can be very dangerous, especially if the temperature is high and there are flies. Instead, choose freshly cooked food. Avoid salads and raw food if hygiene is poor.
Here's some tricky but effective advice for warmer climates: stick to bottled water instead of ice in your drinks, and travel with a medical kit that includes diarrhea medication, oral rehydration solutions, and antibiotics in case the worst happens.
Back to Top
The best way to stay safe before traveling abroad is to consult your doctor and tell them about your upcoming travel itinerary and any high-risk activities you're planning, such as animal encounters or nature excursions. Your doctor can also help identify any routine vaccinations you need, such as for measles, diphtheria, whooping cough, tetanus, polio, and more common diseases like COVID-19 and influenza.
Back to Top
Want to learn more?
Check out Travel Health Pro and Fit For Travel for more information.
Dr Richard Dawood is a travel medicine specialist at Fleet Street Clinic.
