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• Section 2 - Interactions Between Travel Vaccines & Drugs
• Section 2 - Travelers’ Diarrhea

Yellow Fever Vaccine & Malaria Prevention Information, by Country

Cdc yellow book 2024.

Author(s): Mark Gershman, Rhett Stoney (Yellow Fever) Holly Biggs, Kathrine Tan (Malaria)

The following pages present country-specific information on yellow fever (YF) vaccine requirements and recommendations, and malaria transmission information and prevention recommendations. Country-specific maps are included to aid in interpreting the information. The information in this chapter was accurate at the time of publication; however, it is subject to change at any time due to changes in disease transmission or, in the case of YF, changing entry requirements for travelers. Updated information reflecting changes since publication can be found in the online version of this book and on the Centers for Disease Control and Prevention (CDC) Travelers’ Health website. Recommendations for prevention of other travel-associated illnesses can also be found on the CDC Travelers’ Health website .

Yellow Fever Vaccine

Entry requirements.

Entry requirements for proof of YF vaccination under the International Health Regulations (IHR) differ from CDC’s YF vaccination recommendations. Under the IHR, countries are permitted to establish YF vaccine entry requirements to prevent the importation and transmission of YF virus within their boundaries. Certain countries require proof of vaccination from travelers arriving from all countries ( Table 5-25 ); some countries require proof of vaccination only for travelers above a certain age coming from countries with risk for YF virus transmission. The World Health Organization (WHO) defines areas with risk for YF virus transmission as countries or areas where YF virus activity has been reported currently or in the past, and where vectors and animal reservoirs exist.

Unless issued a medical waiver by a yellow fever vaccine provider, travelers must comply with entry requirements for proof of vaccination against YF.

WHO publishes a list of YF vaccine country entry requirements and recommendations for international travelers approximately annually. But because entry requirements are subject to change at any time, health care professionals and travelers should refer to the online version of this book and the CDC Travelers’ Health website for any updates before departure.

CDC Recommendations

CDC’s YF vaccine recommendations are guidance intended to protect travelers from acquiring YF virus infections during international travel. These recommendations are based on a classification system for destination-specific risk for YF virus transmission: endemic, transitional, low potential for exposure, and no risk ( Table 2-08 ). CDC recommends YF vaccination for travel to areas classified as having endemic or transitional risk (Maps 5-10 and 5-11 ). Because of changes in YF virus circulation, however, recommendations can change; therefore, before departure, travelers and clinicians should check CDC’s destination pages for up-to-date YF vaccine information.

Duration of Protection

In 2015, the US Advisory Committee on Immunization Practices published a recommendation that 1 dose of YF vaccine provides long-lasting protection and is adequate for most travelers. The recommendation also identifies specific groups of travelers who should receive additional doses, and others for whom additional doses should be considered (see Sec. 5, Part 2, Ch. 26, Yellow Fever ). In July 2016, WHO officially amended the IHR to stipulate that a completed International Certificate of Vaccination or Prophylaxis is valid for the lifetime of the vaccinee, and YF vaccine booster doses are not necessary. Moreover, countries cannot require proof of revaccination (booster) against YF as a condition of entry, even if the traveler’s last vaccination was >10 years ago.

Ultimately, when deciding whether to vaccinate travelers, clinicians should take into account destination-specific risks for YF virus infection, and individual risk factors (e.g., age, immune status) for serious YF vaccine–associated adverse events, in the context of the entry requirements. See Sec. 5, Part 2, Ch. 26, Yellow Fever , for a full discussion of YF disease and vaccination guidance.

Table 2-08 Yellow fever (YF) vaccine recommendation categories 1

Malaria prevention.

The following recommendations to protect travelers from malaria were developed using the best available data from multiple sources. Countries are not required to submit malaria surveillance data to CDC. On an ongoing basis, CDC actively solicits data from multiple sources, including WHO (main and regional offices); national malaria control programs; international organizations; CDC overseas offices; US military; academic, research, and aid organizations; and the published scientific literature. The reliability and accuracy of those data are also assessed.

If the information is available, trends in malaria incidence and other data are considered in the context of malaria control activities within a given country or other mitigating factors (e.g., natural disasters, wars, the coronavirus disease 2019 pandemic) that can affect the ability to control malaria or accurately count and report it. Factors such as the volume of travel to that country and the number of acquired cases reported in the US surveillance system are also examined. In developing its recommendations, CDC considers areas within countries where malaria transmission occurs, substantial occurrences of antimalarial drug resistance, the proportions of species present, and the available malaria prophylaxis options.

Clinicians should use these recommendations in conjunction with an individual risk assessment and consider not only the destination but also the detailed itinerary, including specific cities, types of accommodations, season, and style of travel, as well as special health conditions (e.g., pregnancy). Several medications are available for malaria prophylaxis. When deciding which drug to use, consider the itinerary and length of trip, travelers’ previous adverse reactions to antimalarials, drug allergies, medical history, and drug costs. For a thorough discussion of malaria and guidance for prophylaxis, see Sec. 5, Part 3, Ch. 16, Malaria .

• Arrive within 6 days of leaving an area with risk for YF virus transmission, or
• Have been in such an area in transit (exception: passengers and members of flight crews who, while in transit through an airport in an area with risk for YF virus transmission, remained in the airport during their entire stay and the health officer agrees to such an exemption), or
• Arrive on a ship that started from or touched at any port in an area with risk for YF virus transmission ≤30 days before its arrival in India, unless such a ship has been disinsected in accordance with the procedure recommended by the World Health Organization (WHO), or
• Arrive on an aircraft that has been in an area with risk for YF virus transmission and has not been disinsected in accordance with the Indian Aircraft Public Health Rules, 1954, or as recommended by WHO.
• Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Togo, Uganda
• Americas: Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad & Tobago (Trinidad only), Venezuela

CDC recommendations : Not recommended

• Throughout the country, including the cities of Bombay (Mumbai) and New Delhi (the capital)
• No malaria transmission in areas >2,000 m (≈6,500 ft) elevation in Himachal Pradesh, Jammu and Kashmir, or Sikkim
• Chloroquine
• P. vivax (50%)
• P. falciparum (>40%)
• P. malariae and P. ovale  (rare)
• Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3

Other Vaccines to Consider

See Health Information for Travelers to India .

1 Current as of November 2022. This is an update of the 2010 map created by the Informal WHO Working Group on the Geographic Risk of Yellow Fever.

2 Refers to Plasmodium falciparum malaria, unless otherwise noted.

3 Tafenoquine can cause potentially life-threatening hemolysis in people with glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Rule out G6PD deficiency with a quantitative laboratory test before prescribing tafenoquine to patients.

4 Mosquito avoidance includes applying topical mosquito repellant, sleeping under an insecticide-treated mosquito net, and wearing protective clothing (e.g., long pants and socks, long-sleeve shirt). For additional details on insect bite precautions, see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods.

5 Primaquine can cause potentially life-threatening hemolysis in people with G6PD deficiency. Rule out G6PD deficiency with a quantitative laboratory test before prescribing primaquine to patients.

6 P. knowlesi is a malaria species with a simian (macaque) host. Human cases have been reported from most countries in Southwest Asia and are associated with activities in forest or forest-fringe areas. P. knowlesi has no known resistance to antimalarials.

Yellow Fever Maps

2 In 2017, the Centers for Disease Control and Prevention (CDC) expanded its YF vaccination recommendations for travelers going to Brazil because of a large YF outbreak in multiple states in that country. Please refer to the CDC  Travelers’ Health website for more information and updated recommendations.

3 YF vaccination is generally not recommended for travel to areas where the potential for YF virus exposure is low. Vaccination might be considered, however, for a small subset of travelers going to these areas who are at increased risk for exposure to YF virus due to prolonged travel, heavy exposure to mosquitoes, or inability to avoid mosquito bites. Factors to consider when deciding whether to vaccinate a traveler include destination-specific and travel-associated risks for YF virus infection; individual, underlying risk factors for having a serious YF vaccine–associated adverse event; and destination entry requirements.

The following authors contributed to the previous version of this chapter: Mark D. Gershman, Emily S. Jentes, Rhett J. Stoney (Yellow Fever) Kathrine R. Tan, Paul M. Arguin (Malaria)

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India reopens to vaccinated travelers as more Asian countries loosen travel rules.

By Sameer Yasir and Jin Yu Young

The Indian government announced on Monday that it would allow vaccinated foreign visitors into the country for the first time in more than 20 months, delivering a boost to a battered tourism industry as coronavirus cases ease and vaccinations pick up across Asia.

As India emerges from a devastating second wave of the virus last spring — with new cases averaging about 20,000 daily, down from a peak of more than 400,000 — it has begun to allow quarantine-free entry to fully inoculated tourists from 99 reciprocating countries.

In 2020, the country drew just 2.74 million foreign tourists, down from 10.93 million the previous year, according to government data. Before the pandemic, tourism constituted about 7 percent of the country’s economic output and brought in $30 billion in foreign exchange in 2019.

Last month, India said it would resume allowing chartered flights, although few have arrived because those flights tend to be booked far in advance. Monday’s announcement expands the rule to all flights from 99 countries that allow vaccinated Indian travelers. But travelers from several major countries — including China, Britain and Canada — are not included because their countries have not reopened to visitors from India.

Rajiv Mehra, a top official at the Indian Association of Tour Operators, said that it would take months before the new arrivals would start making an impact on local economies. But he said that it was a sign of confidence in the country’s vaccination rollout that visitors from so many countries will be allowed to come in without going into quarantine.

India recently administered its billionth vaccine dose, and more than 30 percent of the eligible population has been fully vaccinated. But a sluggish start to the vaccine campaign, and a prolonged lockdown in 2020, have taken a toll. According to the National Council of Applied Economic Research, a private think tank, more than 10 million people in the tourism industry lost their jobs in just a three-month period last year.

The government plans to issue 500,000 free visas to bolster tourism.

“We are taking baby steps and we will see a good turnout in numbers in coming months,” said Jyoti Mayal, the president of the Travel Agents Association of India, a private trade body. “We are working hard to tell tourists to come and visit India and it is safe.”

India joins a host of Asian countries that are lifting travel restrictions on foreign tourists. South Korea and Singapore initiated a travel arrangement on Monday that allows fully vaccinated visitors to travel to either country without having to quarantine.

South Korea plans to open more international travel lanes with neighboring countries as it moves toward a phased reopening . Cambodia, which has fully vaccinated 80 percent of its population, according to the Our World in Data project at the University of Oxford, also ended its quarantine for inbound vaccinated travelers on Monday.

Sameer Yasir is a reporter for The New York Times, covering the intersection of identity politics, conflicts and society. He joined The Times in 2020 and is based in New Delhi.  More about Sameer Yasir

Jin Yu Young reports on South Korea and other countries in Asia from the Seoul newsroom. She joined The Times in 2021. More about Jin Yu Young

India reopens to tourists on regular commercial flights for first time in pandemic

NEW DELHI — India began on Monday allowing fully vaccinated foreign tourists to enter the country on regular commercial flights, in the latest easing of coronavirus restrictions as infections fall and vaccinations rise.

Tourists entering India must be fully vaccinated , follow all COVID-19 protocols and test negative for the virus within 72 hours of their flight, according to the health ministry. Many will also need to undergo a post-arrival COVID-19 test at the airport.

However, travelers from countries which have agreements with India for mutual recognition of vaccination certificates, such as the U.S. , U.K. and many European nations, can leave the airport without undergoing a COVID-19 test.

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This is the first time India has allowed foreign tourists on commercial flights to enter the country since March 2020, when it imposed one of the toughest lockdowns in the world in an attempt to contain the pandemic. Fully vaccinated tourists on chartered flights were allowed to enter starting last month .

It comes as coronavirus infections have fallen significantly, with daily new cases hovering at just above 10,000 for over a month.

To encourage travelers to visit India, the government plans to issue 500,000 free visas through next March. The moves are expected to boost the tourism and hospitality sector which was battered by the pandemic.

“The pandemic devastated the industry but things will return to normal once foreign tourists start to arrive,” said Jyoti Mayal, President of the Travel Agents Association of India.

►'Everything I expected': How international tourists spent their first hours in the US after travel ban lift

Mayal said coastal states like Kerala and Goa in the country's south and Uttarakhand and Himachal Pradesh in the Himalayan north are already witnessing a surge in domestic tourists. All four states are heavily dependent on earnings from tourism, and Mayal said foreign travelers scheduling their visits there would also help lift the local economy. “Tourism is a very resilient industry and the upcoming season looks very promising. We are hopeful of generating more jobs than we lost during the pandemic,” she said.

With more than 35 million reported coronavirus infections, India is the second-worst-hit country after the U.S. Active coronavirus cases stand at 134,096, the lowest in 17 months, according to the health ministry.

Nearly 79% of India’s adult population has received at least one vaccine dose while 38% is fully vaccinated. The federal government has asked state administrations to conduct door-to-door campaigns to accelerate the vaccine campaign.

Fewer than 3 million foreign tourists visited India in 2020, a drop of more than 75% from 2019, when tourism brought nearly $30 billion in earnings.

CDC in India

Nurses collect swab from participants with respiratory symptoms in a low-resource area in Kolkata as a part of a CDC supported study to estimate community burden of influenza and SARS-CoV-2 (INSPIRE).

For over 50 years, the U.S. Centers for Disease Control and Prevention (CDC) has engaged in highly successful technical collaboration with the Government of India and Ministry of Health and Family Welfare while addressing India’s public health priorities. As new health threats emerge, CDC and national partners are well-placed to leverage past successful initiatives to strengthen global health security capabilities and rapidly respond to new public health challenges.

Download India Factsheet [PDF – 756 KB]

Strengthening Public Health Systems

Tuberculosis (tb), field epidemiology training program (fetp), emergency management, antimicrobial resistance (amr), vaccine-preventable diseases.

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CDC Impact in India

CDC supports global health security   priorities in India by providing technical expertise in strengthening public health systems to prevent, detect, and respond to emerging infectious diseases, such as COVID-19. CDC focuses on real-time disease surveillance, laboratory systems and diagnostics, workforce development, and emergency management. Efforts include developing the evidence base and leading technical guidance for Integrated Public Health Laboratory (IPHL) implementation; strengthening surveillance and reporting for antimicrobial resistance (AMR), Healthcare Associated Infections (HAI), Acute Febrile Illness (AFI), Acute Encephalitis Syndrome (AES), and zoonotic diseases. CDC also supported training for over 10,000 workers in epidemiology and disease surveillance, public health emergency management, laboratory diagnostic testing, and biosafety and quality management.

CDC’s ongoing efforts to strengthen molecular detection capabilities increase the capacity of district laboratories to detect emerging pathogens like COVID-19

CDC-supported AFI and AES surveillance efforts across 13 high burden states produced data-driven change in national policy. India adopted algorithmic testing for AFI/AES cases which translated into early diagnosis and better treatment outcomes of patients

CDC supported Government of India in the conceptualization, development, and implementation of Integrated Public Health Laboratories, and is now supporting the scale-up of IPHL across all 730 districts in India. IPHLs have streamlined district- and block-level laboratory practices and increased laboratory diagnostic capacity

CDC helped improve infection prevention and control (IPC) at 50 hospitals led by the All India Institute for Medical Sciences

As a key implementer of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC works with the National AIDS Control Organization (NACO) to implement evidence-based, high impact, sustainable interventions in prevention, testing, treatment, and viral load monitoring. CDC uses an equity lens while striving to close access gaps among key populations. Through Project Sunshine, CDC implements strategies to improve prevention, testing, and treatment options for people in northeastern states where HIV prevalence is highest (Manipur, Mizoram, and Nagaland). In collaboration with NACO and State AIDS Control Societies, CDC supported treatment optimization and differentiated service delivery models, such as multi-month dispensation, decentralized drug dispensation in the community and health system settings, and person-centered package of services. NACO later adopted these strategies across a network of 540 antiretroviral treatment (ART) centers throughout the country.

CDC supports India’s nationwide HIV behavioral sentinel surveillance — the largest in the world— and integrated biological and behavioral surveillance among key populations

CDC supported implementation of full package of Advanced Disease Management (ADM) for early screening of cryptococcosis (a fungal infection) and tuberculosis

In addition, CDC helped integrate screening and management of hypertension into HIV care to ensure treatment continuity

CDC was instrumental in drafting the national operational guidelines for ART services and national guidelines for HIV care and treatment. These guidelines were disseminated to staff from 625 ART centers and 29 state AIDS Control Societies

CDC helped enhance laboratory quality toward ISO accreditation for 130 HIV reference labs and over 5,000 HIV testing sites, leading to early and accurate diagnosis of HIV

CDC used diagnostic network optimization and workforce development to strengthen HIV viral load testing capacity and increased access to services for focus populations

CDC supports the National Tuberculosis Elimination Program (NTEP) to end TB by supporting four strategic pillars: detect, treat, prevent, and strengthen capacity. CDC provides technical support and implements projects, such as external quality assessment (EQA) for rapid molecular tests that ensure accurate and timely results. This EQA is applied to over 800 machines annually; NTEP plans to eventually cover all 3,000 testing sites.

During the COVID-19 pandemic, CDC’s Dharavi project improved treatment outcomes among patients with drug-resistant TB in Mumbai’s informal urban settlements. The project retained nearly all patients on treatment, even those who migrated elsewhere

CDC successfully implemented early TB preventive treatment programs in India to diagnose and treat latent TB infection among household contacts in Nagpur and Mumbai, Maharashtra. CDC used patient-friendly diagnostic tests and treatment regimens

CDC implemented and integrated TB IPC activities in health facilities throughout Mumbai. CDC is expanding these IPC activities to 61 sites in ten states to support NTEP’s TB Mukt Bharat (TB-free India) campaign

CDC helped increase capacity for next generation sequencing at the National Institute of Research in TB (NIRT) in Chennai

With CDC support, NIRT conducted next generation sequencing on a prospective cohort of patients with drug resistant TB across India. This effort identified common and new TB mutations and led to the first Indian TB catalogue of mutations

CDC works with NTEP to strengthen state- and district-level capacity to use local data to accelerate TB control and elimination efforts in 11 states across India

FETP strengthens the public health workforce’s abilities to detect, respond, and control disease outbreaks at the source. CDC continues to support FETPs across India through mentorship for outbreak investigations, surveillance evaluations, COVID-19 activities, and regular remote training. As of January 2023, India FETP has trained over 900 officers across three tiers (advanced, intermediate, and frontline), with over 200 officers currently enrolled. Moving forward, CDC is collaborating with institutions to meet India’s goal of having one epidemiologist per 200,000 people.

Since 2012, India FETP officers investigated over 550 outbreaks and conducted over 300 surveillance evaluations

FETP officers have responded to the COVID-19 pandemic in 22 states and union territories and support measles and rubella elimination efforts

CDC’s influenza program focuses on strengthening three main areas: the influenza surveillance network, public health research, and pandemic preparedness. Influenza viruses change constantly and require continued vigilance. CDC helps India prepare for pandemics in alignment with India’s Pandemic Influenza Preparedness and Response Plan by strengthening laboratories and training clinicians on effective case management and infection control. Many of these activities were  developed during the 2009 influenza A/H1N1 pandemic but are directly relevant to the current COVID-19 pandemic. Strong influenza surveillance has enabled India to detect influenza seasonal peaks during monsoons, understand the seasonality of influenza in tropical countries, and guide timing for influenza vaccination.

In collaboration with the All India Institute of Medical Sciences, CDC helps determine the disease and economic burdens of influenza and other respiratory viruses, evaluates effectiveness of influenza vaccines, and identifies optimal timing for influenza vaccination

CDC’s advanced molecular diagnostic trainings helped the National Institute of Virology to scale up PCR SARS-CoV-2 testing across India’s influenza laboratory network

CDC partners with the Government of India to enhance emergency response capabilities that are critical for the country’s response to infectious diseases and other public health threats. CDC provides technical support to apply modern emergency management concepts and principles using a common framework for public health response and exercises. CDC focuses on increasing emergency management human resource capacity; strengthening national and sub-national emergency operations centers (EOCs); developing emergency response plans, protocols, and procedures; training rapid response teams; and providing real-time support for multiple activations of EOCs and outbreak response systems.

CDC’s Emergency Management Program helps establish, operate, and manage national and sub-national EOCs that respond to disease outbreaks, natural or manmade disasters, and other public health emergencies

CDC partners with WHO to strengthen rapid response teams, enabling state and district surveillance teams to rapidly respond to health threats like COVID-19

CDC has supported training for thousands of staff on COVID-19 and other emergencies

CDC works to increase AMR and Healthcare-Associated Infections (HAI) surveillance and institutionalize IPC capacity nationally and sub-nationally. CDC supported the Government of India to establish the National Antimicrobial Surveillance Network, which increased the country’s network from 10 laboratories in 2013 to 40 laboratories across 29 states and union territories. CDC partnered with the Indian Council of Medical Research and the All India Institute of Medical Sciences to develop and implement a network for surveillance and prevention of HAIs. These networks were used to quickly disseminate COVID-19 information to hospitals.

CDC helped strengthen antimicrobial resistance and healthcare-associated infection surveillance across 29 states

CDC supports efforts to eradicate or control vaccine-preventable diseases in India through the Universal Immunization Program. Since the mid 1990’s, CDC has helped strengthen epidemiology and laboratory methods, routine immunization services, training methods, data systems, case-based disease surveillance, and outbreak preparedness and response. CDC’s support of the National Public Health Surveillance Project strengthened implementation of polio , measles , and COVID-19 vaccination campaigns, outbreak response activities, and surveillance.

People living with HIV in Mumbai receive uninterrupted medication

More India Success Stories

• 8 U.S. Assignees
• 30 Locally Employed
• Population: > 1.4 billion
• Per capita income: > $7,220
• Life expectancy: F 71 / M 68 years
• Infant mortality rate: 28/1,000 live births

Sources: Population Reference Bureau 2022, India

• Ischemic heart disease
• Chronic obstructive pulmonary disease (COPD)
• Diarrheal diseases
• Neonatal disorders
• Lower respiratory infections
• Tuberculosis
• Cirrhosis and other chronic liver diseases

Source: GBD Compare 2019, India

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CDC India Anniversary Report | CDC Global Health

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• India Articles All Issues | Emerging Infectious Diseases journal | CDC
• Progress Toward Measles and Rubella Elimination — India, 2005–2021
• India Field Epidemiology Training Program Response to COVID-19 Pandemic, 2020–2021 

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• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

Update May 10, 2024

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India Travel Advisory

Travel advisory june 23, 2023, india - level 2: exercise increased caution.

Reissued with updates to health information.

Exercise increased caution in India due to crime and terrorism.

Do not travel to:

• The union territory of Jammu and Kashmir (except the eastern Ladakh region and its capital, Leh) due to terrorism and civil unrest .
• Within 10 km of the India-Pakistan border due to the potential for armed conflict .

Country Summary : Indian authorities report rape is one of the fastest growing crimes in India. Violent crime, such as sexual assault, has occurred at tourist sites and in other locations.

Terrorists may attack with little or no warning, targeting tourist locations, transportation hubs, markets/shopping malls, and government facilities.

The U.S. government has limited ability to provide emergency services to U.S. citizens in rural areas from eastern Maharashtra and northern Telangana through western West Bengal as U.S. government employees must obtain special authorization to travel to these areas.

Read the country information page for additional information on travel to India.

The Centers for Disease Control and Prevention (CDC) has determined India has a moderate level of COVID-19.  Visit the CDC page for the latest Travel Health Information related to your travel.

If you decide to travel to India:

• Do not travel alone, particularly if you are a woman. Visit our website for Women Travelers .
• Review your personal security plans and remain alert to your surroundings.
• Enroll in the Smart Traveler Enrollment Program ( STEP ) to receive Alerts and make it easier to locate you in an emergency.
• Follow the Department of State on Facebook and Twitter .
• Review the  Country Security Report for India.
• Prepare a contingency plan for emergency situations. Review the Traveler’s Checklist .

Union Territory of Jammu and Kashmir – Level 4: Do Not Travel

Terrorist attacks and violent civil unrest are possible in the union territory of Jammu and Kashmir. Avoid all travel to this state (with the exception of visits to the eastern Ladakh region and its capital, Leh). Sporadic violence occurs particularly along the Line of Control (LOC) separating India and Pakistan, and in tourist destinations in the Kashmir Valley: Srinagar, Gulmarg, and Pahalgam. The Indian government prohibits foreign tourists from visiting certain areas along the LOC.

Visit our website for Travel to High-Risk Areas .

India-Pakistan Border – Level 4: Do Not Travel

India and Pakistan maintain a strong military presence on both sides of the border. The only official India-Pakistan border crossing point for persons who are not citizens of India or Pakistan is in the state of Punjab between Attari, India, and Wagah, Pakistan. The border crossing is usually open but confirm the current status of the border crossing prior to commencing travel. A Pakistani visa is required to enter Pakistan. Only U.S. citizens residing in India may apply for a Pakistani visa in India. Otherwise apply for a Pakistani visa in your country of residence before traveling to India.

Northeastern States – Level 4: Do Not Travel

Incidents of violence by ethnic insurgent groups, including bombings of buses, trains, rail lines, and markets, occur occasionally in the northeast.

U.S. government employees at the U.S. Embassy and Consulates in India are prohibited from traveling to the states of Assam, Arunachal Pradesh, Mizoram, Nagaland, Meghalaya, Tripura, and Manipur without special authorization from the U.S. Consulate General in Kolkata.

Central and East India – Level 4: Do Not Travel

Maoist extremist groups, or “Naxalites,” are active in a large swath of India from eastern Maharashtra and northern Telangana through western West Bengal, particularly in rural parts of Chhattisgarh and Jharkhand and on the borders of Telangana, Andhra Pradesh, Maharashtra, Madhya Pradesh, Uttar Pradesh, Bihar, West Bengal, and Odisha. The Naxalites have conducted frequent terrorist attacks on local police, paramilitary forces, and government officials.

Due to the fluid nature of the threat, all U.S. government travelers to states with Naxalite activity must receive special authorization from the U.S. consulate responsible for the area to be visited. U.S. officials traveling only to the capital cities in these states do not need prior authorization.

Visit our website for Travel to High-Risk Areas . 

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CDC issues ‘Level One’ Covid-19 travel health notice for India

The cdc in its health travel notice 'level one' said, "your risk of contracting covid-19 and developing severe symptoms may be lower if you are fully vaccinated with an fda (food and drug administration) authorised vaccine.".

The US Centers for Disease Control and Prevention (CDC) has issued a ‘Level One’ COVID-19 notice for Americans travelling to India, saying the risk of contracting the infection and developing severe symptoms may be lower if one is fully vaccinated.

The travel health notice has also been issued for Pakistan.

However, the US State Department issued level two and three travel advisories for India and Pakistan, saying while citizens are urged to reconsider travel to Pakistan due to terrorism and sectarian violence, those going to India must exercise increased caution due to crime and terrorism.

The CDC in its health travel notice ‘Level One’ said, “Your risk of contracting COVID-19 and developing severe symptoms may be lower if you are fully vaccinated with an FDA (Food and Drug Administration) authorised vaccine.”

In its advisory for India, the State Department urged US citizens not to travel to Jammu and Kashmir due to terrorism and civil unrest, and also within 10 kilometres of the India-Pakistan border due to the potential for armed conflict.

“Indian authorities report rape is one of the fastest growing crimes in India. Violent crimes, such as sexual assault, has occurred at tourist sites and in other locations,” it said.

The department in its advisory for Pakistan urged US citizens not to travel to Balochistan province and Khyber Pakhtunkhwa (KPK) province, including the former Federally Administered Tribal Areas (FATA), due to terrorism and kidnapping, and also in the immediate vicinity of the Line of Control due to terrorism and the potential for armed conflict.

“Terrorist groups continue plotting attacks in Pakistan. A local history of terrorism and ongoing ideological aspirations of violence by extremist elements have led to indiscriminate attacks on civilian as well as local military and police targets,” it said.

“Terrorists may attack with little or no warning, targeting transportation hubs, markets, shopping malls, military installations, airports, universities, tourist locations, schools, hospitals, places of worship, and government facilities,” it said.

Terrorists have targeted US diplomats and diplomatic facilities in the past, the advisory on Pakistan said.

The Canadian authorities on Saturday arrested a fourth Indian national for his role in the killing of separatist Khalistan Hardeep Singh Nijjar, according to an official release. Twenty-two-year-old Amardeep Singh, a resident of Brampton, Surrey, and Abbotsford areas of Canada, has been charged with first degree murder and conspiracy to commit murder.

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U.S. Restricts Travel From India Amid COVID-19 Surge

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Key Takeaways

• On May 4, the United States government restricted the travel of foreign nationals from India to the U.S.
• The restriction is in response to a surge of COVID-19 cases in India and will significantly impact Indian Americans and immigrants who will not be able to go home and visit their families.
• Individuals can help by supporting and donating to mutual aid and fundraising efforts.

On May 4, the United States government enacted travel restrictions on India amid a surge in COVID-19 cases in the country, limiting most non-U.S. citizens from traveling to the U.S.

The ban does not apply to U.S. citizens and permanent residents, journalists, certain students and academics, and people traveling for humanitarian, public health, or national security reasons.

“What happens in India—or really anywhere in the world—affects all of us,” Krutika Kuppalli, MD , assistant professor of medicine in the division of infectious diseases at the Medical University of South Carolina, tells Verywell. “The situation in India will have downstream global effects and it is in our best interests to get this under control.”

Why Is There a Surge of COVID-19 Cases in India?

About three months after India's Ministry of Health and Family Welfare announced that the country's COVID-19 infections and mortality reached an all-time low , the country experienced the highest daily tally of new COVID-19 infections ever recorded globally.

With 314,835 new cases recorded on April 22, India's case count exceeded the previous highest one-day rise of COVID-19 cases set by the U.S. back in January. The country's numbers continued to set and surpass a new global record as the days passed. As of May 8, India reported 401,078 new infections.

“The surge is due to a complex number of things and not just one thing,” Kuppalli says. “India has very complicated population density issues that intersect its socio-economic dynamics. This, along with the relaxing of public health measures, set up a perfect storm for the surge to occur. I also think there was a false narrative [that] India ‘beat’ the pandemic because they did relatively well compared to other countries during the first wave.”

Kartik Cherabuddi, MD, FACP , hospital epidemiologist and associate professor of infectious diseases and global medicine at the University of Florida, tells Verywell that other factors contributing to the surge may include “poor leadership, mass gatherings, a slow vaccination drive, lack of public health infrastructure, and variants that are more communicable with inadequate protective immunity from prior infection."

The Impact on India's Healthcare System

The massive surge of cases continues to overwhelm India’s healthcare system, leading to shortages of basic supplies and hospital beds.

“For context, this is like what we experienced in New York City, only exponentially widespread and worse,” Cherabuddi says. “We have not yet seen the peak of this second wave and that is concerning as deaths will follow.”

India currently needs:

• Oxygen cylinders
• Delivery equipment and concentrators
• Pulse oximeters
• Frontline medical provider supplies
• COVID-19 tests
• COVID-19 vaccines and raw materials to produce it
• Hospital beds

“We are witnessing an unprecedented humanitarian crisis in India and neighboring countries,” Cherabuddi adds. “This is not just about medical care. It will affect every aspect of human life in the Indian subcontinent and beyond. The repercussions include regional and global spread, delayed supply of COVID-19 vaccines from India to the world, and impact on global medicine supply.”

Why Is a Travel Restriction Necessary?

Throughout the pandemic, countries have enacted travel restrictions and bans in an effort to contain the spread of COVID-19. 

“Travel restrictions and lockdowns are epidemiological tools that help prevent spread when there is a huge surge in cases,” Cherabuddi says. “We have learned from prior experiences during this pandemic that they must be implemented in a humane manner. Travel advisories and restrictions are consistent with standard public health response to any epidemic or pandemic.”

However, “travel restrictions don’t prevent these variants from spreading and that by the time a variant is detected in another country, it has likely already spread,” Kuppalli says, adding that these bans will only slow the spread of variants—not prevent them.

According to Cherabuddi, a supervised or mandatory quarantine upon return to the U.S. in addition to a travel warning was a possible alternative.

Travel Restrictions Are Affecting Indian Americans

The current travel restrictions were implemented as a necessary public health measure, but now some Indian Americans and Indian immigrants in the U.S. are unable to see their families in person. "Even figuring out how to send supplies to them is a challenge as well," Kuppalli says.

“Indian Americans and communities are dealing with their friends and family members, including immediate family, becoming seriously ill or passing away,” Cherabuddi says. “There is a strong sense of helplessness, guilt, and grief of not being there for their loved ones in this time of need.”

Fully vaccinated individuals with relatives in India may have been looking forward to visiting their families. But travel restrictions make the situation even more fraught.

“It is really difficult to not be able to visit family, and stay away from loved ones,” Lija Joseph, MD , adjunct associate professor of pathology & laboratory medicine at the Boston University School of Medicine, tells Verywell. “I know of some who are not able to go home for the funerals of their loved ones, which makes it really difficult to bring closure in addition to the tragedy of the pandemic.”

Cherabuddi says the COVID-19 crisis in India may lead to some long-term effects including “the negation of gains made over the past decade in poverty, literacy, hunger, malaria, [and] HIV and TB control and mortality. On a global scale, most of humanity has not been vaccinated and this surge will spread like wildfire unless swift action is taken."

What This Means For You

You can show your solidarity by supporting and donating to mutual aid and fundraising initiatives working to help India contain the surge of COVID-19 cases and recover. Cash supplies will be used to provide medical equipment, food, and other necessary provisions.

How Can I Help?

The U.S. government is stepping up to help India, Joseph says. The U.S. promised to send about 60 million doses of the AstraZeneca COVID-19 vaccine when it receives approval from the Food and Drug Administration (FDA). The U.S. Agency for International Development (USAID) has also provided cash assistance, oxygen cylinders and regulators, rapid diagnostic tests, and N-95 respirators.

“The U.S. government has supported waiver of IP protections on COVID-19 vaccines which is helpful, but we must do more, including active intervention with provision of vaccine supplies and partnering with agencies in the production of vaccines which is crucial to curb further surges and deaths,” Cherabuddi says. “This is the time to help build capacity, exert influence on the government, and galvanize the international community in tackling this crisis.”

Kartik Cherabuddi, MD, FACP

It is not too late. Many communities and agencies have already led the way to action and are making a difference.

Other countries aside from the U.S. are also offering aid, but individuals can make a difference, too. 

“It is not too late. Many communities and agencies have already led the way to action and are making a difference,” Cherabuddi says. “Individuals can show solidarity, advocate for support, and participate in donating effort or money to recognized agencies.”

You can support initiatives like OxygenForIndia to provide medical oxygen to hospitals and patients at home or Mazdoor Kitchen to supply meals to daily wage workers in Delhi. Online fundraising platforms like Mutual Aid India and Give India have plenty of crowdfunding campaigns on their website as well.

Many community organizers are also running mutual aid and fundraisers for vulnerable communities in India without social safety nets, and you may donate directly to the tribal families in Maharashtra , rural transgender people in Tamil Nadu , or Indians living in resettlement colonies in Chandigarh .

“There are many organizations that are providing online fundraising portals,” Joseph says. “Please support these efforts.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our  coronavirus news page .

The White House. A Proclamation on the Suspension of Entry as Nonimmigrants of Certain Additional Persons Who Pose a Risk of Transmitting Coronavirus Disease .

U.S. Department of State - Bureau of Consular Affairs. Presidential Proclamation on the Suspension of Entry as Nonimmigrants of Certain Additional Persons Who Pose a Risk of Transmitting Coronavirus Disease .

World Health Organization (WHO). WHO Coronavirus Tracker .

U.S. Agency for International Development. United States Airlifts Emergency Supplies to Help India Address Deadly Second Wave of Covid-19 Pandemic .

By Carla Delgado Delgado is a health and culture writer specializing in health, science, and environmental sustainability.

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Travel Vaccines and Advice for India

The Taj Mahal, Hampi, the Himalayans and the Caves of Ajanta are just the beginning for amazing sights in India. For thousands of years, the subcontinent has been the cradle of one of the most amazing cultures to visit.

Every year, tourists from around the globe flock to India to see its amazing sights and sounds. Whether you are a spiritual pilgrim, a business executive or an adventure seeker, India is sure to have something for you.

Do I Need Vaccines for India?

Yes, some vaccines are recommended or required for India. The National Travel Health Network and Centre and WHO recommend the following vaccinations for India: hepatitis A , hepatitis B , typhoid , cholera , yellow fever , Japanese encephalitis , rabies , polio and tetanus .

See the bullets below to learn more about some of these key immunisations:

• Hepatitis A – Food & Water – Recommended for most travellers to the region, especially if unvaccinated.
• Hepatitis B – Blood & Body Fluids – Recommended for travellers to most regions.
• Tetanus – Wounds or Breaks in Skin – Recommended for travellers to most regions, especially if not previously vaccinated.
• Typhoid – Food & Water – Jab lasts 3 years. Oral vaccine lasts 5 years, must be able to swallow pills. Oral doses must be kept in refrigerator.
• Cholera – Food & Water – A risk for travellers throughout India. Avoid swimming in popular rivers or streams as cholera may be present.
• Yellow Fever – Mosquito – Required if travelling from a country with risk of yellow fever transmission.
• Japanese Encephalitis – Mosquito – Recommended for all regions except: Dadra, Daman, Diu, Gujarat, Himachal Pradesh, Jammu and Kashmir, Lakshadweep, Meghalaya, Nagar Haveli, Punjab, Rajasthan, and Sikkim.
• Rabies – Saliva of Infected Animals – High risk country. Vaccine recommended for long-stay travellers and those who may come in contact with animals.
• Polio – Food & Water – May be required if arriving from countries with active transmission. Recommended for some travellers to the region. Single adult booster recommended.

See the tables below for more information:

Some mosquito-borne diseases are also prevalent in India including:

• Malaria – Antimalarial medication is recommened for many regions in India. Speak with a travel health specialist to learn if these are right for your itinerary.
• Dengue Fever – Another mosquito-borne disease, dengue affects millions each year. Unfortunately, there is no vaccination against dengue approved in the United States. Ensure you take precautions against mosquitoes like using repellents and mosquito netting.

Fortunately, the Zika virus has yet to arrive in India.

To learn more about these infections, see their respective vaccination or infection pages.

If you are travelling to India, ensure you are protected. Visit your local Passport Health to receive a comprehensive consultation on what you will need to stay safe. Book your appointment online now or ring us up at and ensure your dream trip doesn’t become a nightmare.

How To Prevent Delhi Belly (Traveller’s diarrhoea)

Delhi Belly (or traveller’s diarrhoea ) is very common amongst travellers. Up to 70 percent of international travellers will come down with traveller’s diarrhoea during their trips. This is especially true for visitors to India.

Causes can range from viral or bacteria infections to just a difference in cuisine. But, no matter how it happens, traveller’s diarrhoea can ruin a trip.

There are a few precautions you can take to avoid traveller’s diarrhoea:

• Avoid risky eating – Be smart about where and what you eat. Street carts may not be the best place to grab a snack, but you also don’t need to only eat pre-packaged foods. Use good judgement to decide where would be best to chow down.
• Consider preventative care – Some products, like Travelan, will provide you with some protection against traveller’s diarrhoea.

Be sure to bring a traveller’s diarrhoea kit that includes antibiotics or similar products that can help stop diarrhoea if it occurs.

To learn more about what you can do to avoid Delhi Belly, see our traveller’s diarrhoea page . Or, book an appointment with your local Passport Health by calling or scheduling online now .

Do I Need a Visa or Passport for India?

Visas are required for all travellers to India. Passport requirements are a bit more intensive than other regions. Passports must have 180 days validity from the date of visa application and another 180 days from the time of entry. Ensure you have this amount of remaining time before expiration at minimum. Proof of yellow fever vaccination may be required if you are travelling from a region where yellow fever is present.

Sources: Embassy of India and GOV.UK

What Is the Climate Like In India?

India is generally classified as a hot tropical country, except for the Himalayan north. The country has three distinct seasons:

• Summer (March to June) – Indian summers are very hot. Temperatures often climb to over 43 degrees.
• Monsoon (July to August) – The rainy season brings thunderstorms and heavy rains. These sometimes cause flooding or other damage. Bring an umbrella and be sure to take other precautions.
• Winter (October to February) – Winter temperatures are generally mild. Except in the northern regions where they will dip to near or below freezing. Remember, the higher into the mountains you go, the chillier it will get.

How Safe Is India?

India is generally safe, but is still a developing country in many ways. Try to avoid the Indian-Pakistani border, as growing tensions have led to a less safe situation.

Petty crime, especially theft is common. This happens mostly in trains and buses. Pickpocketing is known to occur in some tourist areas. Violent crime is traditionally uncommon, though there has been a slight increase in recent years.

Scamming has become more common in many popular areas. Be especially careful in airports and train stations. If an offer for transportation or hotel rooms on the cheap seems too good, it probably is. Only use well-known travel agencies when booking your trip and planning activities in-country.

LGBT individuals will want to be especially careful as laws on homosexuality are unclear. While prosecution is rare, LGBT visitors may wish to avoid drawing attention.

What Should I Pack For India?

Packing for India can be a bit tricky, as the country is different from many popular travel destinations:

• Pack light – Moving from place to place in India can be a bit tricky. Many forms of transportation have a tight fit and having something you can easily haul around is key. Brining an extra rucksack isn’t a bad idea either as a purse or small bag may not be enough to carry water, an umbrella and similar items.
• Prepare for weather – Be sure to pack according to what season you’ll be in the country. Where you are headed is also a key factor as the Himalayas are a much cooler region.
• Wear the right footwear – You’ll likely be doing a lot of walking (or even standing) in India. Ensure your shoes are up for the trip, your feet will thank you.

Where Is the Embassy of the United Kingdom in India?

If you are in India and have an emergency (for example, been attacked, arrested or someone has died) contact the nearest consular services. Contact the embassy before arrival if you have additional questions on entry requirements, safety concerns or are in need of assistance.

British High Commission New Delhi Shantipath, Chanakyapuri New Delhi 110021 India Telephone: +91 (11) 2419 2100 Emergency Phone: +91 (11) 2419 2100 Fax: +91 (11) 2419 2492 Contact Form: Click Here

Whether you are travelling for business or pleasure, India is an amazing destination. From the Himalyas to the coast of the Indian Ocean, the country’s peculiar culture and feel has something for every type of traveller.

To learn more about what you can do to prepare for an Indian trip, visit your local Passport Health clinic. Book your appointment today by calling or scheduling online now.

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Health Risks To Be Aware Of When Traveling To India

W here do you start with a country as vast as India? From its mountainous north to its tropical south — with scorching deserts and countless mega cities in between — you could spend a lifetime here and barely scratch the surface. It's a must-see destination for all travelers and one that begs to be explored beyond well-known tourist hotspots like the Taj Mahal . But you'd be forgiven for feeling an ounce of trepidation, given the number of health-related scare stories you may have heard from other visitors. Here's the thing — yes, you need to familiarize yourself with the risks of a trip to India before you travel. Still, it certainly doesn't mean you can't do so safely.

Let's take hygiene and sanitation first. The standards in India, in some regions, are not as high as you'd expect from mainland Europe or Australia, but there are plenty of ways to arm yourself with protection during your trip. Vaccines, for one, are super important here. And then there's personal hygiene, not to mention educating yourself on the risks of altitude sickness and air pollution, depending on where in India you'll be exploring. To help get the ball rolling, book an appointment with your doctor at least eight weeks before you jet off — they'll be able to provide ample travel advice tailored specifically to you. But for now, here are some of the most important health risks to consider before you explore the many wonders of India.

Read more: Dangerous European Destinations To Skip On Your Next Trip

Get Yourself Up To Date With These Vaccines

Many of the vaccines here will have been given to you as a child, but it's possible that one could have slipped through the net, or you may need a booster shot. You likely had 2 doses of the chickenpox vaccine at 12 months and 4 years old, but if you didn't, get yourself up to date — a new variant (clade 9) has been detected in India. Diphtheria, tetanus, and pertussis are also present in the country. As a baby, you probably had three shots of the combined vaccine and three boosters as a child. If you didn't, get 1 shot before heading to India and a booster dose every 10 years thereafter. Make sure you're fully vaccinated against measles, mumps, rubella (MMR) and polio, too. The MMR vaccine should have been given to you in 2 shots — at 12 months and 4 years old. And the polio vaccine comes in four doses — usually given at two months, four months, six months, and four years old.

The CDC also recommends that everyone over 6 months get the flu vaccine yearly, and those over 50, or those with a weakened immune system, should have the shingles vaccine. You must be protected against both illnesses in India — more than 1 million cases of shingles are recorded here yearly, and the country's peak flu season coincides with what's considered the best time to visit India — October to May.

These Additional Jabs Are Also Recommended

Traveling to exotic, new places is one of life's ultimate pleasures, but it brings with it the risk of new diseases. First up is cholera — thought to be present in India and spread through dirty water or contaminated food. The vaccine is given as a drink in two doses, each taken a week apart. Japanese encephalitis is next — this rare but dangerous infection is spread by mosquitoes, with outbreaks in India typically occurring during the rainy season — from May to October. If you're traveling during this time, especially if you'll be staying in rural areas, consider this two-dose vaccine for peace of mind.

You should also protect yourself from typhoid fever, especially if you plan to stay with friends or relatives. It's spread through unclean water and food and is especially prevalent in rural parts of the country. Two types of vaccine are available for typhoid — one in pill form (four pills taken every other day) or a shot vaccine. Both should be given at least two weeks before traveling.

Ensure your doses of Hepatitis A and B are up to date, too. Each is spread in similar ways, whether that's contaminated food or drink, having sex with an infected person, or sharing needles with one. Both vaccines are routine and given to children in the U.S., but as an adult traveling to India, you should get the combined vaccine as a booster shot to make sure you're still protected.

Keep Away From All Animals

Do you love to pet every dog, stroke every cat, and take pictures of every monkey you see? Well, this isn't advised in India. In fact, it will increase your risk of contracting certain diseases. Animal bites and wounds can play host to a whole load of these — cellulitis and fasciitis are just some examples common in India, with both almost always requiring strong antibiotics for treatment.

What's more, India has the highest number of reported cases of rabies in the world — a rare but serious infection that's usually fatal once symptoms appear. Rabid dogs are often the problem here, but you can get rabies from any infected animal if it bites you, scratches you, or licks a wound on your body. It all sounds terrifying, but there are easy ways to stay safe. 

First, steer clear of all animals, including those cute-looking monkeys at temples. Second, get the pre-exposure vaccine before traveling — this is two doses (one given seven days after the other), and a third dose is needed within three years if you continue to visit high-risk areas. It'll protect you from a rabies infection for a little while (if you've been exposed to the virus), giving you time to reach a hospital in India for the two-dose post-exposure vaccine. Depending on where you are in the country, this may be difficult to come by. So, having a medical evacuation insurance policy covering emergency travel to receive it can give you peace of mind.

Consider Your Malaria Risk

You've probably heard about malaria — a serious flu-like illness caused by a parasite that infects certain types of mosquitoes. Whether you'll need extra special medication depends on where your adventures in India are taking you and when you plan to travel. Most regions are low-risk — malaria has been found in cities like Mumbai and Delhi. Still, most cases occur in West Bengal, Jharkhand, Chhattisgarh, Gujarat, Madhya Pradesh, and Odisha. There's also a higher risk if you're traveling to India during its monsoon season (June to September), when hot temperatures, heavy rains, and a risk of flooding bring more mosquitoes.

Make sure to have a strong insect repellent on hand, and wear long, loose-fitted clothing to avoid being bitten. But if you're going to high-risk areas, get prescription antimalarials, too. Some of these tablets will need to be taken before your trip, during your travels, and after you get back — your doctor can help you determine which medication is best for you.

Another mosquito-borne illness to be aware of is Dengue — it's become more common in India over recent years. The mosquitos that carry it are often found in urban areas, but there's no vaccine. This means using a strong insect repellent, sleeping under a mosquito net, and covering your skin is your best defense. Dengue can cause nausea, vomiting, headache, and joint and muscle pain, but not everyone infected will feel sick.

Prepare For Diarrhea

One key symptom across many of the illnesses we've spoken about already is (the dreaded) diarrhea. While you can "get the runs" from anywhere in the world, "Delhi belly" is fairly common for visitors to India. From a 24-hour bout of loose stools to a full-on episode of travelers' diarrhea (TD) or giardiasis, the risk is exceptionally high here. You have a 60% chance of getting TD during a two-week trip. It's usually caused by eating or drinking contaminated foods or liquids, so it pays to be vigilant at all times.

Washing your hands as often as possible or using an antibacterial gel (when running water isn't available) can help protect you from germs. But you'll also want to avoid drinking tap water (even when brushing your teeth) and always ask for drinks without ice when you're out and about. Stick to filtered, boiled, or bottled water wherever you can. Oh, and when it comes to eating at restaurants or from food stalls in India, say no to anything that's been reheated, not to mention seafood and meat, which can also pose real risks if they're not fresh. Steering clear of raw, unpeeled fruit and veg is a good idea, too. If you're concerned about getting diarrhea while you're away, bring along some anti-diarrhea medication and oral rehydration salts, which can help relieve symptoms and give you peace of mind.

Protect Yourself From COVID-19

Sorry — it's likely you're a bit fed up hearing about this virus and the three-year-long global emergency it caused. Nevertheless, it's another jab you should consider getting before you make your way to India. True, there are no COVID-19 testing requirements to enter the country — you don't even need to prove you're vaccinated — but it's a good idea to make sure you're covered should you become infected while you're out there. Why? India is so densely populated. 

Despite being one-third the size of the U.S., it has four times the population, which increases the likelihood of virus transmission. Daily cases in the country are indeed low at this time. Still, the virus appears to circulate during specific seasons — India's last spike saw a total of 12,193 people infected with COVID-19 on April 21, 2023. With all this in mind, it's better to be safe than sorry, so do your part to stay protected from the illness. The CDC recommends everyone over the age of 5 get one dose of an updated COVID-19 vaccine yearly, especially those traveling internationally.

Air Quality Is A Huge Problem

With its sumptuous mix of traditions, stunning architecture, and jaw-dropping landscapes, India is a real sight to behold. But if you're planning a trip here, you'll want to think carefully about the time of year you visit. Perhaps more so than any other country in the world, India has an air quality problem, thanks to many of its mega-cities with dangerous pollution levels , especially during the annual "pollution season" — from October to December.

If you need any more convincing, the air quality index in Delhi hit 500 in November 2023. For context, this is the highest measurement the index will go to and is 100 times the limit deemed healthy by the World Health Organisation (WHO). Thick smog covering the capital, brought on by car emissions, construction, and farmers burning their fields during the crop planting season, has forced schools to shut and all but non-essential construction work to be paused in the past. Avoiding India's urban areas may help, but beware that air quality is a real problem in rural settings, too.

To properly take in the sights and smells of this wondrous country, you're much better off timing your trip outside of the pollution season. But if you must travel at this time, take plenty of precautions. You'll want to bring multiple face masks and avoid going outside wherever possible, especially if you have a preexisting health condition like asthma or chronic lung disease.

Beware Of Altitude Sickness

Frankly, India is ginormous — you'd need years, perhaps decades, to explore every ounce of its captivating land mass. For this reason, some travelers choose to visit the country in sections, organizing trips to and from India over the course of many years. But if this holiday sees you planning to take in all that the north has to offer — a word of caution. The high-elevation Himalayan areas that are both stunningly beautiful and have a perfect climate during India's summertime can also bring on the symptoms of altitude sickness. We're talking about places like the home of the 14th Dalai Lama — Dharamshala, mountainous Manali, the hill resort of Shimla, and spiritual Rishikesh.

But what exactly is altitude sickness? It's when your body doesn't have time to adjust to lower oxygen levels in the atmosphere. You're looking for the tell-tale signs of a headache, nausea and vomiting, a loss of appetite, fatigue (even when resting), trouble sleeping, and dizziness. To fight altitude sickness , make sure you ascend gradually and give yourself time to acclimate to your surroundings. If your symptoms worsen, especially at rest, you should descend slowly. Planning on taking a hiking or trekking excursion in the Himalayas? Your doctor can advise you on how to physically prepare for trips to high altitudes , including using a preventative altitude sickness treatment, such as acetazolamide. But if you notice troublesome symptoms on this medication, follow the safety guidance above.

Protect Yourself From The Sun

Regardless of the time of year, you're visiting India, you need to be careful when it comes to sun exposure. In Mumbai, for example, the UV Index (UVI) has been recorded as 8.2, which falls under the high-risk category — meaning you should avoid direct sunlight wherever possible, especially in the middle of the day. This is particularly important during the summer months (March to May) and where elevation is high, such as in the Himalayan areas in the north.

Other ways to stay as safe as possible are using a high-SPF sunscreen and reapplying it every two hours to protect yourself from sunburn . Wear loose, lightweight clothing and a sun hat to ward off heat-related illnesses like heat stroke . Steering clear of any physical activity when temperatures are high is also advised. So, too, is drinking plenty of water often and eating small, regular meals throughout the day.

Be Aware Of Sexually Transmitted Infections (STIs)

Arming yourself with protection against STIs is always a good idea, whether you're exploring new sights abroad or going about your normal routine at home. But make sure you stay extra vigilant during your trip to India — especially if you're a member of a high-risk population group, such as someone who's transgender, a man who has sex with men, or a female sex worker. Why? In 2019, it was found that 2.3 million people in India were living with HIV, especially in areas such as Manipur, Mizoram, and Nagaland. Compare this with 1.2 million people living with HIV in the U.S.

None of this is anything to worry about, though — you just need to be sensible and follow all the same general advice as you would at home. First off — don't have unprotected sex. If you do choose to have sex while in India, make sure you use latex condoms correctly. Second, don't share any needles, including needles used for getting a new tattoo, a piercing, or health therapies like acupuncture. Lastly, don't inject drugs. HIV can be spread through each of these means via bodily fluids, such as saliva, blood, and semen. Not to mention other STIs that can be contracted in similar ways, including chlamydia, gonorrhea, and syphilis.

Get Pre-Travel Advice, Even If Visiting People You Know

Are you jetting off to India to visit relatives or old friends? Chances are you're counting down the days until you're reunited with your loved ones. But before you hop on a flight, make sure you've checked in with a doctor. While your trip to India may technically be a return to your homeland, it's just as important for you to be made aware of the health risks at play, if not more so. For instance, you might be staying in a rural area not set up properly for tourists — somewhere that doesn't have a hospital or medical facilities nearby. Or maybe you'll be eating all of your meals with local family members who don't have adequate running water or the same sanitation measures you're used to when it comes to preparing food.

Even if you think it's a waste of time, book an appointment with your doctor at least eight weeks before you travel anyway. It can give you peace of mind that you're up to date with all the necessary vaccines, are aware of the risks you might be facing, and have all the right precautions in place should something go wrong.

Read the original article on Explore .