Confirm primary courses and boosters are up to date as recommended - including for example, vaccines required for occupational risk of exposure, lifestyle risks and underlying medical conditions.

• Diphtheria

  Travel health advice relating to diphtheria.

  Spread person to person through respiratory droplets. Risk is higher if mixing with locals in poor, overcrowded living conditions.

  Last Updated: 8th Sep, 2016

• Hepatitis A

  Travel health advice relating to hepatitis A.

  Spread through consuming contaminated food and water or person to person through the faecal-oral route. Risk is higher where personal hygiene and sanitation are poor.

  Last Updated: 6th Aug, 2014

• Rabies

  Travel health advice relating to rabies.

  Spread through the saliva of an infected animal, usually through a bite, scratch or lick on broken skin. Particularly dogs and related species, but also bats. Risk is higher for those going to remote areas (who may not be able to promptly access appropriate treatment in the event of a bite), long stays, those at higher risk of contact with animals and bats, and children. Even when pre-exposure vaccine has been received, urgent medical advice should be sought after any animal or bat bite.

  Last Updated: 11th Aug, 2016

• Tetanus

  Travel health advice relating to tetanus.

  Spread through contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil worldwide. A total of 5 doses of tetanus vaccine are recommended for life in the UK. Boosters are usually recommended in a country or situation where the correct treatment of an injury may not be readily available.

  Last Updated: 11th Aug, 2016

• Typhoid

  Travel health advice relating to typhoid.

  Spread mainly through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is limited.

  Last Updated: 11th Aug, 2016

• Yellow Fever

  Travel health advice relating to yellow fever.

  Spread by the bite of an infected, day-biting mosquito. The disease is mainly found in rural areas but outbreaks in urban areas do occur. Vaccination is usually recommended for those who travel into risk areas. View yellow fever risk areas here. Some travellers may require vaccination for certificate purposes.

  Last Updated: 11th Aug, 2016

No yellow fever vaccination certificate required for this country.

Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria.

Precaution

• Malaria risk is high throughout the year in forested areas below 900m within the nine states of Amazonia (Acre, Amape, Amazonas, Maranhao (western part), Mato Grosso (northern part), Para (except Belem City), Rondonia, Roraima and Tocantis (western part). Transmission is highest in jungle, mining, and agricultural areas and in some peripheral urban areas of Cruzeiro do sol, Manaus and Porto Velho. Malaria also occurs in the periphery of large cities such as Boa Vista, Macapa, Maraba, Rio Branco and Santarem.
• Risk is high for those going on cruises up the Amazon, especially as boats enter populated parts of the rain forest where infected mosquitoes may be taken on board. Most cruises up the Amazon river end up or start at the city of Manaus where there is a risk of malaria.
• Risk is low in all states outside Amazonia including the populated eastern coast from Fortazela south to Rio de Janeiro and Sao Paulo.
• There is usually only minimal risk in the tourist resort of Iguazu Falls but those exploring outside the resort itself into rural or jungle areas, should consider antimalarial tablets.
• Malaria precautions are essential. Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.
• Check with your doctor or nurse about suitable antimalarial tablets.
• See malaria map – additional information can be found by clicking on the Regional      Information icon below the map.
• High risk areas: atovaquone/proguanil OR doxycycline OR mefloquine is usually advised for those visiting risk areas.
• Low to no risk areas: antimalarial tablets are not usually advised .
• If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
• If travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby medication may be considered.

• Altitude and Travel
  This country has either areas with high altitude (2400m or more) or/and areas with very high altitude (3658m or more). Travellers who may go into areas of high altitude should take care to avoid ill effects of being at altitude including Acute Mountain Sickness, a potentially life-threatening condition.

• Dengue Fever
  A viral illness that is transmitted to humans by mosquito bites. The mosquito that spreads dengue bites during the day and is more common in urban areas. Symptoms include fever, headache, severe joint, bone and muscular pain - hence its other name 'breakbone fever'. There is no vaccine and prevention is through avoidance of mosquito bites.

• Schistosomiasis
  A parasitic infection (also known as bilharzia) that is transmitted to humans through contact with fresh water. The parasite enters humans through the skin and prevention is dependant on avoidance of swimming, bathing or paddling in fresh water lakes and streams.

This country has reported cases of ZIKV virus infection. ZIKV is most commonly spread by mosquito bites, but there is also a risk of sexual transmission. There is a link between ZIKV infection and babies being born with birth defects.

Advice for Travellers:

• All travellers should practice strict mosquito bite avoidance, at all times.
• Do not travel without adequate travel insurance.
• Seek pre-travel advice from your health care provider 6-8 weeks in advance of travel, particularly important if you are pregnant or planning pregnancy.
• Pregnant women are advised to postpone non-essential travel to countries or areas with High risk of ZIKV transmission.
• Pregnant women are advised to consider postponing non-essential travel to countries or areas with Moderate risk of ZIKV transmission.
• If you develop any feverish illness whilst travelling or on return medical attention must be sought quickly.

Look at the additional advice on the ZIKV Infection page, which includes how to avoid sexual transmission of ZIKV.

• Yellow Fever in Brazil (Sao Paulo State) - published 10th May, 2016

• Microcephaly in Brazil (Update) - published 3rd Feb, 2016

• Microcephaly in Brazil - published 7th Dec, 2015

• Yellow Fever in Brazil (Monkeys) - published 3rd Aug, 2015

• Dengue Fever in Brazil - published 22nd Jul, 2015

• Zika Virus Infection in Brazil (Update) - published 10th Jun, 2015

• Yellow Fever in Brazil - published 8th Jun, 2015

• Yellow Fever in Brazil - published 27th May, 2015

• Dengue Fever in Brazil (Update) - published 1st Apr, 2015

• Increased Malaria in State of Rio de Janeiro - published 20th Mar, 2015

• Dengue Fever in Brazil (Update) - published 16th Mar, 2015

• Yellow Fever in Brazil (Goias) - published 17th Feb, 2015

• Dengue Fever in Brazil (Update) - published 20th Jan, 2015

• Dengue Fever in Brazil (Update) - published 30th Sep, 2014

• Dengue Fever in Brazil (Update) - published 4th Jun, 2014

• Dengue Fever in Brazil (Update) - published 29th May, 2014

• Dengue Fever in Brazil (Update) - published 21st May, 2014

• Dengue Fever in Brazil (Update) - published 23rd Apr, 2014

• Dengue Fever in Brazil - published 13th Mar, 2014

• Dengue Fever in Brazil (Update) - published 26th Nov, 2013

• Measles in Brazil - published 4th Nov, 2013

• Dengue Fever in Brazil (Update) - published 24th Oct, 2013

• Dengue Fever in Brazil (Update) - published 23rd Jul, 2013

• Dengue Fever in Brazil (Update) - published 28th May, 2013

• Dengue Fever in Brazil (Update) - published 27th Feb, 2013

• Dengue Fever in Brazil - published 12th Dec, 2012

• Dengue Fever in Brazil - published 17th Jul, 2012

• Dengue Fever in Brazil - published 24th Apr, 2012