India

Yellow fever

YELLOW FEVER vaccination is not required if you are departing from Europe. Yellow fever does not occur here. However, if you are travelling from another country where yellow fever can occur (see maps: Africa, South America),you should be vaccinated for certain countries; from the age of 1 year for Bhutan, Bangladesh, Maldives, Myanmar and Nepal; from the age of 9 months for Sri Lanka and from the age of 6 months for India.

Countries in Africa where the transmission of the yellow fever virus might occur - see:
www.reisgeneeskunde.be/kaarten/Gele-Koorts-Afrika.jpg
Countries in South America where the transmission of the yellow fever might occur - see:
www.reisgeneeskunde.be/kaarten/Gele-Koorts-Zuid-Amerika.jpg

Malaria

Last update: 27/06/2016
Malaria map India:
http://www.itg.be/ITG/Uploads/MedServ/India2015.jpg

In India there is risk of malaria infection (also on the Andaman and Nicobar islands), but this varies greatly according to the area and the season; there can also be strong annual variations.

We state the following:
- For travellers spending the night in good conditions (comfortable hotel rooms without mosquitoes) the precautions on mosquito bites in the evening and at night are sufficient.
- For the other travellers (backpackers, travellers on the night train or hikers staying in cheap hostels and lodges,…), the recommendations vary according to the visited regions:

No malaria risk > 2000 m and in large towns: Jammu & Kashmir, Sikkim & Himachal Pradesh. No preventive measures are therefore necessary there.

The risk of falciparum malaria can be high in:
- the Assam state (between Bangladesh, China and Myanmar)
- the Orissa state
- a small part of the Andhra Pradesh state – in the East Godavari, Srikakulam, Vishakhapatnam and Vizianagaram districts
- a small part of the Madhya Pradesh state – in the Balaghat, Dindori, Mandla and Seoni districts.
The protective measures against mosquito bites (*) and taking the malaria tablets to prevent malaria (**) are recommended.

• The risk of malaria is low to non-existent in the rest of the country (including the Andaman and Nicobar islands). Prevention against mosquito bites between dusk and dawn is recommended (*).

In case of adventurous travel with stays in primitive conditions at the countryside the traveller can choose between the preventive measures against mosquito bites during sunset and sunrise (in case of fever malaria should always be considered and a doctor consulted) or taking one of the malaria tablets as discussed below.

(*) use of repellents when going outside between sunset and sunrise; sleep underneath an impregnated mosquito net. In case of fever malaria should always be considered and a doctor consulted.

(**) Proposed malaria prevention:
ATOVAQUONE-PROQUANIL: 1 tablet daily from 1 day before departure until 7 days after leaving the risk area
DOXYCYCLINE: 1 tablet daily from 1 day before departure until 4 weeks after leaving the risk area; in some cases a tolerance test during a few days is necessary
MEFLOQUINE (LARIAM®): 1 tablet once a week, from 2-3 weeks before departure until 4 weeks after leaving the risk area.
All this should be discussed with your doctor or with the doctor at the travel advice centre.

For more information about malaria and malaria tablets, read:
http://www.itg.be/itg/Uploads/MedServ/emalaria.htm
In case of prolonged stay in the tropics, read: http://www.itg.be/itg/Uploads/MedServ/EMALTXT.pdf

Diarrhea

DIARRHOEA is a frequent problem when travelling. Even when travelling in good conditions, it is not always possible to avoid it. Some advice and the correct medications from a travel pharmacy are very useful.
Please consult the general text on travellers’ diarrhoea in the brochure HOW TO TRAVEL AND STAY HEALTHY at http://www.itg.be" - http://www.travelhealth.be" where the precautions and correct treatment are described.

Dengue and chikungunya

In Asia dengue and chikungunya fever frequently occur. These diseases are transmitted by mosquitoes that bite during daytime. There is no vaccine for tourists. Protection against mosquito bites during daytime is recommended (consult the measures).
For more information about dengue & chikungunya, consult this text.
Consult the world map on www.who.int/ith - "disease distribution maps".

Vaccinations

Going on a trip is also an ideal opportunity to update the TETANUS-, DIPHTHERIA-, PERTUSSIS, MEASLES and POLIOMYELITIS VACCINATIONS.
Anyone travelling to Asia, regardless of the duration and the circumstances of their stay, should be vaccinated against HEPATITIS A.
Vaccination against TYPHOID can be considered for adventurous journeys in suboptimal hygienic conditions and for migrants and their children going back to their country of origin and visiting their friends and relatives.
In a lot of cases vaccination against HEPATITIS B should also be considered. For more information, please consult the general text about hepatitis.
People spending more than 4 weeks trekking through the countryside or people who will be staying there for a long time, should consider vaccination against JAPANESE ENCEPHALITIS. For more information, please consult the general text about japanese encephalitis.
In specific circumstances also the vaccination against RABIES has to be considered as well. For further details see the general brochure & world map about rabies.
All this should be individually discussed with your doctor or with the doctor at a travel advice centre.