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Travel Essentials

Health and Medical: Disease Risks and Prevention

Diseases of concern in India include malaria, giardiasis, dengue, tuberculosis, schistosomiasis, and hepatitis A, B, C, and E. Vaccinations can protect you against some of these, listed under Immunizations below. For others, no vaccine exists; protective measures appear under Precautions.

See a Doctor Before You Travel

Visit a travel medicine specialist, or a doctor familiar with travel medicine, at least a month before your trip.

Recommendations of the Centers for Disease Control and Prevention are below, but appropriate vaccines and medicines depend on many factors that are specific to each person. Inform your doctor:

Where you are traveling within a country
The length of your trip
What types of activities you might do
Other personal matters such as your age, medical and vaccine history, and current medical state

Many hospitals and many county health departments have a Travel Medicine office. A directory of private travel clinics is available at the International Society of Travel Medicine, www.istm.org.

Immunizations

Required: Yellow fever for travelers over six months of age arriving from countries where yellow fever is present, as well as from Zambia, where yellow fever was formerly endemic. Vaccination should be given 10 days before travel and at 10-year intervals if there is ongoing risk.
Recommended
Yellow fever	Travelers at least nine months of age.
Hepatitis A or immune globulin (IG)	Recommended for all unvaccinated people traveling to or working in countries with an intermediate or high level of hepatitis A virus infection where exposure might occur through food or water. Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors.
Hepatitis B	Recommended for all unvaccinated persons traveling to or working in countries with intermediate to high levels of endemic HBV transmission, especially those who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment (e.g., for an accident).
Typhoid	Recommended for all unvaccinated people traveling to or working in India, especially if staying with friends or relatives or visiting smaller cities, villages, or rural areas where exposure might occur through food or water.
Japanese encephalitis	Recommended for those who plan to visit rural farming areas and under special circumstances, such as a known outbreak of Japanese encephalitis
Polio	Recommended for adult travelers who have received a primary series with either inactivated poliovirus vaccine (IPV) or oral polio vaccine (OPV). They should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.
Rabies	Recommended for travelers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking. Also recommended for travelers with significant occupational risks (such as veterinarians), for long-term travelers and expatriates living in areas with a significant risk of exposure, and for travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites.
Routine	Before traveling, update any vaccinations you would normally receive, such as measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine, poliovirus vaccine.

COVID-19 Information

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. Older people and those with underlying medical conditions such as cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illness. Anyone can get sick with COVID-19 and become seriously ill or die at any age.

The best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 meter (3 feet) apart from others, wearing a properly fitted mask, and washing your hands or using an alcohol-based rub frequently. Vaccinations also are available from healthcare providers.

The virus can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing, or breathe. These particles range from larger respiratory droplets to smaller aerosols. It is important to practice respiratory etiquette, for example by coughing into a flexed elbow and staying home to self-isolate if feeling unwell.

Entry and Exit Requirements

Are there COVID-related entry requirements? 

All travelers will undergo thermal screening upon arrival. Symptomatic travelers will be isolated and tested.

Is a negative COVID-19 test required for entry?

Two percent of all international passengers, regardless of vaccination status, are selected for random RT-PCR testing upon their arrival to India. Travelers selected for testing on arrival will be permitted to depart the airport following collection of the test sample and do not have to wait for results. All travelers are required to self-monitor for 14 days after arrival.

Precautions

Malaria
Malaria is present year-round in all areas throughout India except none in areas above 2,000 m (6,560 ft) in Himachal Pradesh, Jammu, Kashmir, and Sikkim. Present in cities of Delhi and Mumbai. Discuss with your doctor the best ways for you to avoid getting sick with malaria. Ways to prevent malaria include the following: Taking a prescription antimalarial drug Preventing insect bites (see below) All of the following antimalarial drugs are equal options for preventing malaria in India: Atovaquone/proguanil, doxycycline, or mefloquine. Note: Chloroquine is NOT an effective antimalarial drug in India and should not be taken to prevent malaria in this region.
Dengue, Chikungunya, and Japanese encephalitis
Prevent bites of mosquitoes (malaria, dengue, Japanese encephalitis): Use insect repellent (bug spray) with 30–50 percent DEET. Picaridin, available in 7 and 15 percent concentrations, needs more frequent application. There is less information available on how effective picaridin is at protecting against all of the types of mosquitoes that transmit malaria. Wear long-sleeved shirts, which should be tucked in, long pants, and hats to cover exposed skin. When you visit areas with ticks and fleas, wear shoes, not sandals, and tuck pants into socks. After a hike, check for attached ticks, especially in skin creases such as the back of the knee or behind the ear. Remain indoors in a screened or air-conditioned area during the peak biting period for malaria (dusk and dawn). Sleep in beds covered by nets treated with permethrin, if not sleeping in an air-conditioned or well-screened room. Spray rooms with products effective against flying insects, such as those containing pyrethroid.
Tuberculosis
Tuberculosis is serious health concern in India. Longer-term visitors and those in the health care field will need to take precautions. Avoid exposure to known TB patients in crowded environments such as hospitals, prisons, or homeless shelters. Avoid unpasteurized dairy products.
Schistosomiasis
Do not swim in unchlorinated fresh water.
Meliodosis and Leptospirosis
Avoid contact with contaminated water or soil. Risk of infection chiefly occurs among people working in agriculture. Travelers who plan to engage in water activities should consider protective clothing and/or prophylaxis with doxycycline.
Plague
Travelers in the wild should avoid contact with wild rodents. Outbreaks have occurred in Himalchal Pradesh, Tamil Nadu, Maharashtra, and Gujarat. Plague infection can be cured with antibiotics.
Food- and water-borne illness, including hepatitis E, cholera, typhoid, brucellosis, and giardiasis
Observe food safety practices: Wash your hands often with soap and water, especially before eating. If soap and water are not available, use an alcohol-based hand gel (with at least 60 percent alcohol). Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, learn how to make water safer to drink. Do not eat food purchased from street vendors. Make sure food is fully cooked. Avoid dairy products unless you know they have been pasteurized.
Fungal and parasitic infections
Keep feet clean and dry, and do not go barefoot, especially on beaches where animals may have defecated.
HIV, hepatitis C, and other infections
To avoid infections such as HIV and viral hepatitis, do not share needles for tattoos, body piercing, or injections. To reduce the risk of HIV and other sexually transmitted diseases, always use latex condoms.

Pack a Travel Health Kit

A travel health kit serves three purposes: to manage any pre-existing conditions, prevent illnesses related to traveling, and take care of minor health matters.

When packing medications for travel, remember the following considerations.

Original containers: All medications should be carried in their original containers with clear labels, so the contents are easily identified. Although many travelers like placing medications into small containers or packing them in the daily-dose containers, officials at ports of entry may require proper identification of medications.
Prescriptions: Travelers should carry copies of all prescriptions, including their generic names.
Physician notes: For controlled substances and injectable medications, travelers are advised to carry a note from the prescribing physician on letterhead stationery.
Restricted medications: Travelers should be aware that certain medications are not permitted in certain countries. If there is a question about these restrictions, particularly with controlled substances, travelers are recommended to contact the embassy or consulate of the destination country.
Availability: A travel health kit is useful only when it is available. It should be carried with the traveler at all times (e.g., in a carry-on bag). Due to airline security rules, sharp objects and some liquids and gels must remain in checked luggage.

Sources: World Health Organization; Centers for Disease Control and Prevention

Note: World Trade Press is not in the healthcare business and accepts no liability for statements on this page.