Got a big trip planned in the near future, or a long overseas holiday coming up? We have created this comprehensive guide to help you recognise the dangerous diseases you may encounter abroad, as well as the vaccinations and treatments you should take on in order to protect yourself. Read our guide to vaccinate yourself safely and enjoy a safer trip.
Cholera is a serious bacterial infection that is spread through contaminated water and food. It is often found in overcrowded areas with poor hygiene and sanitation. The symptoms of cholera include severe watery diarrhoea, nausea and vomiting, as well as ramps. This can lead to serious dehydration which in some cases can be fatal.
Caution should be exercised when eating and drinking abroad — preventative methods and hygiene are generally enough to safeguard you against cholera in most parts of the world.
If you are visiting rural areas, especially if they are known to have had cholera epidemics, you could be at an increased risk and may want to consider a preventative vaccine.
Cholera vaccination schedule
For adults and children over 6 years old, cholera is administered as two separate doses. The doses are given at least one week, and no more than six weeks apart, offering two years protection; after which a booster is required. The course should be completed at least one week before travel.
Diphtheria, Polio & Tetanus
Diphtheria is a bacterial infection spread via water droplets from coughing and sneezing and can also spread through unpasteurised dairy products. It releases a toxin that can infect your nose, throat, and skin, producing symptoms similar to severe flu.
Polio (poliomyelitis) is a virus that is spread through consuming contaminated water and food, as well as swimming in contaminated water or coming into close contact with someone carrying the polio virus. Although the majority of people carrying the polio virus have little or no symptoms, severe infections can occur resulting in fever and sickness that can progress to paralysis, and even death.
Tetanus is a bacterial infection that is spread in soil through animal faeces. The bacteria produce spores that reside in soil and dust that, if they get into an open wound, can cause an infection and release the tetanus toxin. Tetanus is a very serious infection that begins with muscle spams and stiffness that lead to paralysis and death.
Diphtheria, Polio & Tetanus vaccination schedule
The diphtheria, polio and tetanus vaccine is available as a booster for those who have not had a booster in the past 10 years. It is administered as a single dose and offers cover for a further 10 years. Diphtheria, polio and tetanus are all given routinely as part of the regular childhood vaccination regime so travellers are advised to check with their GP whether they require a booster. If you have not been vaccinated as a child will require a full vaccination schedule including three doses spaced one month apart.
Hepatitis A is a viral infection of the liver that is caught from ingesting contaminated water or food. It is often caused by poor hygiene where food or water has become contaminated by human faeces. The symptoms of hepatitis A usually occur two to six weeks after infection and can include fever, nausea and vomiting, stomach pain, jaundice (yellow skin and eyes, and rash or joint pains.
Those at risk from hepatitis A include long-term travellers, those staying with infected friends or relatives, and those visiting areas where the sanitation is poor.
Travellers with chronic liver disease or haemophilia should be vaccinated as well as injecting drug users and homosexual males.
Hepatitis A vaccine
For adults and children over 1-year-old, hepatitis A is usually administered as a single dose. The vaccination offers one year’s protection, after which a booster is required that will cover you for at least 20 years.
The course should be completed two weeks before travel, though can be given at shorter notice if required. The hepatitis A vaccine is also available in two different combinations, with either hepatitis B or typhoid, if these are also required for the same trip.
Hepatitis B is a viral infection of the liver that is caught following contact with bodily fluids (e.g. blood, semen, vaginal fluid) of a person carrying the hepatitis B virus. This means it can be caught from unprotected sex, injecting drugs or sharing needles, having a tattoo or piercing, having medical treatment without sterile equipment, or through an open wound.
The symptoms of hepatitis B usually take two to three months to develop after you become infected and can include flu-like symptoms including fever, nausea and vomiting, diarrhoea, stomach pain and jaundice (yellow skin and eyes).
Hepatitis B poses a risk to frequent or long-term travellers, those participating in contact sports, injecting drug users, and individuals who frequently change their sexual partner. Patients with chronic kidney failure, chronic liver failure or haemophilia should be vaccinated.
Hepatitis B is a blood-borne virus and therefore travellers that require emergency medical care abroad may be exposed to hepatitis B. Being vaccinated and taking a first aid kit that includes sterile equipment can reduce this risk of contraction.
Hepatitis B vaccine
The hepatitis B vaccine is usually administered as three separate doses. After a blood test confirming immunity, the vaccination offers five years of protection, after which a booster is required. The course is normally given over a period of six months though it can be given at shorter notice if required. The hepatitis B vaccine is also available in combination with hepatitis A if it is also required for your trip.
Japanese Encephalitis is a viral infection that is passed by night-biting mosquitoes, therefore bite avoidance is strongly recommended, even if you have been vaccinated. The virus infects the brain causing encephalitis (swelling of the brain) and causing symptoms such as vomiting, headache, seizures/fits and confusion.
Japanese Encephalitis vaccination is recommended for those who are staying in an endemic area for a period of one month or more, or if they are visiting high-risk areas such as rice fields or pig farming areas. All travellers should practice bite avoidance techniques such as wearing DEET-containing insect repellent, covering exposed skin at dawn and dusk, and using a mosquito net where required.
Japanese Encephalitis vaccine
For those over 18, Japanese encephalitis is normally administered as two separate doses. The doses are given 28 days apart offering 98% protection and after one year a booster is required. The course should be completed at least ten days before travel.
Malaria is a parasitic infection spread by the bite of infected mosquitoes. It causes severe flu-like symptoms including fever, vomiting, diarrhoea, muscle pain, and headache.
The symptoms of malaria usually appear within two weeks if you have been infected. If you experience any of the malarial symptoms up to a year after travelling to an area with a malaria risk, it is important to see a doctor.
Malaria infected over 1,700 British travellers in 2010; unfortunately, 7 people died. It is a very serious disease and strong bite avoidance techniques are advised as well as anti-malaria medication where applicable.
There is currently no widely-approved vaccine for malaria and protection is based on anti-malarial medication. There is a range of different anti-malarial tablets that are used in different situations depending on the country of travel and medical history of the traveller.
Unfortunately, no antimalarials can guarantee 100% protection against malaria although if they are taken correctly they can reduce the risk of contracting malaria very significantly.
You can use our Online Doctor to obtain a supply of antimalarial drugs for your trip.
Meningitis is caused by a bacterial infection that causes inflammation of the lining of the brain and spinal cord (the meninges). It is spread by coughing and sneezing as well as close contact with a person carrying the meningitis bacteria. Meningitis symptoms can include a severe headache, fever, cold extremities, vomiting, muscle and joint pain, sensitivity to light, drowsiness, confusion and, seizures/fits.
Those living or working with the local population in at-risk areas should consider vaccination. The meningococcal meningitis vaccination is mandatory for those participating in the Hajj and/or Umrah pilgrimage. All travellers should try to avoid overcrowded conditions where possible.
Meningococcal Meningitis vaccination
For adults and children over 5 years old, the meningococcal meningitis vaccine is usually administered as a single dose to cover the A, C, Y and W135 strains. The vaccination offers around five years of protection, after which a booster is required. The course should be completed two to three weeks before travel.
Rabies is a viral infection that affects the brain and central nervous system. You can become infected with rabies after being bitten by an infected animal, usually a dog. Rarely rabies can be passed through scratches after the animal has licked its paws/claws, or if it licks a wound. The symptoms of rabies normally appear 20 to 90 days after you have been bitten with symptoms including tingling or itchiness at the site of infection, fever, aggressive behaviour and an irrational fear of water. Rabies is an extremely serious condition that is often fatal.
The rabies vaccine is recommended for those likely to have regular contact with animals or those who are travelling for long periods in remote areas more than 24 hours from medical facilities.
The rabies vaccination is a course of three separate injections. The vaccinations offer one year of protection, after which a booster is required. The course is normally given over a period of four or five weeks depending on the vaccine you are given. It can be given at shorter notice if required.
Tick-borne encephalitis is a viral infection that is passed on by tick bites. It is commonly contracted by travellers who are walking or camping in long grass or woodland areas in the summer months.
The virus initially causes severe flu-like symptoms of fever, nausea, headache and muscle pain, which can then progress to meningitis and encephalitis (swelling of the brain and its lining). Bite avoidance techniques are strongly recommended even if you have been vaccinated.
Tick-Borne Encephalitis vaccination
The tick-borne encephalitis vaccination is a course of three separate injections. The vaccinations offer up to three years of protection once completed. The course is normally the second injection one to three months after the first, and the third injection five to twelve months after the second. The course can be altered and given at shorter notice if required.
Typhoid is a bacterial infection that is spread through contaminated water and food. It is often found in overcrowded areas with poor hygiene and sanitation and is spread through contamination with faeces and urine. Symptoms of typhoid can take up to a week to develop and will present as a flu-like illness with symptoms including fever, stomach pain, headache and constipation or diarrhoea. If treatment is not received, typhoid can develop a number of very serious complications such as internal bleeding, widespread infection from the bowel splitting open and seizures/fits.
Travellers are at risk from typhoid if they are staying in or visiting areas with poor sanitation. You are at higher risk if you are a long-term traveller or visiting infected family or friends. Travellers should be cautious when eating and drinking.
For adults and children over 2 years old, typhoid is usually administered as a single dose. The vaccination offers around three years of protection, after which a booster is required. The course should be completed four weeks before travel though it can be given at shorter notice if required. The typhoid vaccine is also available in combination with hepatitis A if it is also required for your trip. The typhoid vaccine is also available in capsule form.
Yellow fever is a viral infection that is spread through the bite of infected mosquitoes. The mosquitoes are particularly active around dawn and dusk so special effort to avoid bites at these times is necessary, even if you are vaccinated. The symptoms of yellow fever include fever, headache, nausea and vomiting, muscle pain and jaundice (yellowing of the skin and eyes). Yellow fever is very serious and can be fatal.
A Yellow Fever certificate may be required to enter some countries and this can depend on whether you are travelling from an area with a risk of transmission. More information can be found at :
In general, those travelling from the UK will not require a Yellow Fever certificate unless they also require a vaccine.
Yellow Fever vaccine
The Yellow Fever vaccine is usually given as a single dose. It must be administered by a certified centre and once administered the vaccination offers around ten years protection. The course should be completed at least ten days before travel. You should receive a certificate to confirm your vaccination that may need to be shown upon entering a country.
If you are pregnant, may be pregnant, or are breastfeeding, you should inform your GP before you have any vaccinations. Vaccination may not be advised for those who have a condition that affects the immune system (e.g. HIV/AIDS), those who are receiving treatment that affects the immune system (e.g. chemotherapy) or those who have recently undergone a transplant (including bone marrow). If you fall into any of these categories you should see your GP before deciding to book a holiday to an area that requires vaccination. As well as the precautionary action outlined in this guide, general travel health advice should be followed to further reduce the health risks you may experience during your trip. These include drinking bottled water, avoiding contact with animals, eating wisely, safe sex, and general good hygiene.