Jabs and tablets If you're heading for developing or tropical areas you should discuss your itinerary with your GP or local travel health centre at least six weeks before departure.

In this article

Cholera Diphtheria Hepatitis A Hepatitis B Japanese encephalitis

Malaria Meningitis Polio Rabies

Tick-borne encephalitis Tuberculosis Typhoid Yellow fever

Few vaccines provide complete protection - you should still take care with food, drink and personal hygiene. In addition, some countries have adopted HIV/AIDS-related entry restrictions. Travellers with HIV should consult their GP for a detailed assessment and advice before travelling.

When you have your check-up at your local surgery, it's a good idea to review your medical history, present state of health, medications and any allergies. Keep your immunisation certificates (and list of current medication) with your passport for use during your travels and as a record for the future.

The vaccinations you need will depend on the country you're visiting. Your GP or practice nurse will be able to give you specific, up-to-date information on the jabs required for your particular destination.

An oral vaccine is available in the UK for travellers to endemic or epidemic areas, where the risk of cholera is greatest. In most cases, a cholera vaccination certificate is no longer required. If it is, your travel company should alert you.

Diphtheria is one of the childhood immunisations in the UK. There have been recent outbreaks in some parts of the world - if you're travelling to one of these areas, a booster may be recommended.

The hepatitis A virus is present in faeces and can be spread from person to person, but it's usually caught by consuming contaminated food or water. Those travelling to places where sanitation is poor need to be especially aware of the risk of infection.

A vaccination can help to reduce the risk, but it's also vital to be scrupulous about personal hygiene. Be careful what you eat and drink, and wash your hands after using the toilet and before handling or eating food.

This serious infection of the liver is common in many parts of the world. It's caught via contact with contaminated blood - including sharing needles, blood transfusions or inadequately sterilised equipment - and intimate sexual contact.

Immunisation is available but not routinely recommended for travellers unless they're likely to be at increased risk through work or other activities.

This occurs throughout south-east Asia, mainly in rural areas and during the monsoon season. A vaccine is available for those who are travelling to rural areas in the monsoon season and staying more than two weeks. However, it isn't usually free on the NHS.

Malaria is transmitted by infected mosquitos and is common in many parts of Africa, Asia, Central and South America. If you're visiting or travelling through a country where there's a risk of malaria, preventative measures are essential.

Antimalarial drugs don't prevent infection, but do inhibit the parasite's development

Antimalarial drugs don't prevent infection, but do inhibit the parasite's development. In some regions, the parasite is resistant to some of the drugs used. It's therefore essential to get up-to-date, specific advice about the best antimalarial drugs for your destination.

You should start taking the tablets one to two weeks before departure, to ensure there's no adverse reaction and to establish an adequate level of protection before exposure. Tablets must be taken as prescribed while in the malarial zone and continued for a further four to six weeks after leaving. It's essential to finish taking the course of tablets, as the parasite can live in the body for some time after infection.

Remember, none of these precautions gives absolute protection against malaria. It's therefore vital to know the symptoms, so you can get prompt medical attention should any appear.

Malaria usually starts as a flu-like illness. A pattern of coldness and shivering, followed by fever (38°C/100°F or more), sweating, muscle aches and headaches must be taken seriously.

If you develop a fever or feel ill while abroad or up to eight weeks after returning, seek medical attention immediately. Tell your doctor you've been in a country where malaria is a health risk.

Meningococcal meningitis is more common in some areas of Africa and Asia than in the UK. A vaccine is available to protect against some strains. Saudi Arabia requires all pilgrims during the Hajj to be vaccinated. Consult your doctor for more information.

Vaccination against poliomyelitis is usually recommended for all destinations. In the UK, the vaccine is given as an injection. Booster doses are recommended every ten years.

Rabies occurs throughout the world, with most deaths taking place in developing countries, such as those in south-east Asia. In the UK, most cases occur in quarantined animals and people infected abroad.

It's usually contracted through being bitten or scratched by an infected mammal, such as a bat, dog, cat or fox. The incubation period is normally two to eight weeks, but can be as long as two years. It isn't usual practice to inoculate travellers against rabies.

This disease is caught from the bite of an infected tick. It occurs in warm, forested parts of central and eastern Europe and Scandinavia, especially where there's heavy undergrowth, and is more common in late spring and summer.

Those walking or camping in such areas should wear clothing that covers most of the skin and use insect repellents. A vaccine is available.

If you haven't been vaccinated against TB and staying for more than a month in eastern Europe, Asia, Africa, Central or South America, you should consider a bacille Calmette-Guerin (BCG) vaccination. Preferably, this should be given at least two months before departure.

Vaccination isn't necessary for short visits if you're staying in international-style hotels. Revaccination isn't necessary for those already vaccinated against TB.

Typhoid is caught from contaminated food, drink or water. A vaccination is recommended for all destinations apart from northern Europe, North America, Australia and New Zealand.

There are three different types of vaccine. Depending on which is given, boosters are required at intervals of one to three years.

Yellow fever is caught from the bite of an infected mosquito. An international certificate for yellow fever is required for travel to several countries in central and west Africa, and the northern part of South America. The certificate comes into effect ten days after vaccination and lasts for ten years. Certificates after subsequent doses are valid immediately.

This article was last medically reviewed by Dr Trisha Macnair in September 2006.
First published in May 2001.