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Health Information Sheets
Foreign and Commonwealth Office
Western Sahara
Welcome to the NaTHNaC Country Information page.
The information on this page should be used as part of a comprehensive pre-travel health consultation. Ideally this should be scheduled at least six weeks prior to travel. All travellers should have adequate travel health insurance.
Contents
On this page:
- Recent Clinical Updates
- General Health Risks
- Vaccine Preventable Risks
- Non-Vaccine Preventable Risks
Country Specific Links:
Clinical Updates provide information which may result in a change in travel health advice or practice.
Recent Clinical Updates for this country are listed below:
- There have been no Clinical Updates about this country in the last 6 months.
Some health risks apply to travellers to all countries. Please see below for a list of important health information sheets. A full list of information sheets is available through the Health Information Sheets link on the left hand side of the page.
Health Professionals |
Travellers |
Travellers should be up to date with routinely recommended vaccinations according to the UK schedule:
- NHS Immunisation Information
- Department of Health Immunisation Against Infectious Disease (Green book)
Additional Risks
The diseases below may be a risk in all or part of the country and are presented alphabetically:
Diphtheria,
Hepatitis A,
Hepatitis B,
Rabies,
Tetanus,
Tuberculosis,
Typhoid
DIPHTHERIA
Pharyngeal or cutaneous diphtheria is caused by toxigenic strains of Corynebacterium diphtheriae bacteria and occasionally by C. ulcerans.
Risk assessment
- EpidemiologyInformation on the occurrence of disease within this country - Diphtheria is known or presumed to occur in this country.
- ExposureInformation on the mode of transmission and factors that may increase disease risk - Travellers may be exposed through the respiratory route, contact with infected objects, or exudate from an infected skin lesion. Those who will be in close contact with the local population are at higher risk.
Risk management
- Travellers should have completed a primary vaccination course according to the UK schedule.
- A booster dose of a diphtheria-containing vaccine should be givenAll travellers in risk categories should receive vaccine to those who have not received a dose within the previous 10 years.
Resources
Health ProfessionalsNaTHNaC Health Information Sheet on Diphtheria Department of Health Immunisation Against Infectious Disease (Green Book) |
Travellers |
HEPATITIS A
Hepatitis A is a viral disease that causes inflammation of the liver. A map showing the global areas at risk for hepatitis A can be found here (102 KB GIF)
Risk assessment
- EpidemiologyInformation on the occurrence of disease within this country - Hepatitis A is known or presumed to occur in this country.
- ExposureInformation on the mode of transmission and factors that may increase disease risk - Hepatitis A is transmitted through contaminated food and water. Those at higher risk include travellers visiting friends and relatives, long stay travellers, and those visiting areas of poor sanitation.
Risk management
- Travellers should practice strict food, water and personal hygiene precautions.
- Vaccine should be givenAll travellers in risk categories should receive vaccine to travellers whose planned activities put them at risk (see above).
- Because hepatitis A vaccine is well tolerated and affords long-lasting protection, it may be givenMost travellers at low risk, consider vaccine for those in risk categories to all previously unvaccinated travellers.
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Vaccine should also be given to those with chronic liver disease or haemophilia, men who have sex with men, injecting drug users and those at occupational risk.
Resources
HEPATITIS B
Hepatitis B is a viral disease that causes inflammation of the liver and may lead to chronic complications.
Risk assessment
- EpidemiologyInformation on the occurrence of disease within this country - 2 - 7 % of the population in this country is a carrier of hepatitis B virus (intermediate endemicity).
- ExposureInformation on the mode of transmission and factors that may increase disease risk - Hepatitis B is transmitted via infected blood or bodily fluids. Travellers may be exposed when receiving medical or dental treatment, via direct contact between open skin lesions, or if participating in risk behaviour such as needle sharing, unprotected sex or contact sports. Healthcare workers are at higher risk.
Risk management
- Travellers should avoid contact with blood or bodily fluids. Where contact is unavoidable, appropriate protective precautions should be taken.
- A sterile medical kit should be carried.
- Vaccination should be considered for all adult and child travellers.
- Vaccination should be givenAll travellers in risk categories should receive vaccine to those at risk due to the nature of their activities or occupation (see above).
- Vaccine should also be givenAll travellers in risk categories should receive vaccine to those with chronic kidney failure, liver disease or haemophilia, injecting drug users, men who have sex with men and individuals who change sexual partners frequently.
Resources
Health ProfessionalsNaTHNaC Health Information Sheet on Hepatitis B Department of Health Immunisation Against Infectious Disease (Green Book) |
Travellers |
RABIES
Rabies is a neurological disease caused by viruses of the Lyssavirus genus.
Risk assessment
- EpidemiologyInformation on the occurrence of disease within this country - Rabies occurs or is presumed to occur in wild and domestic animals (including bats).
- ExposureInformation on the mode of transmission and factors that may increase disease risk - Transmission may occur following contact with the saliva from an infected wild or domestic animal (including bats), most often via a bite or lick to an open wound. Risk of exposure is increased by type of activity (e.g. running, cycling), occupation (e.g. veterinarians) and longer duration of stay. Children are at increased risk as they are less likely to avoid contact with animals and to report a bite or lick.
Risk management
- Travellers should avoid contact with wild or domestic animals.
- Pre-exposure vaccination should be givenAll travellers in risk categories should receive vaccine to adults and children who are:
- at risk of rabies (see above)
- travelling to remote areas where medical care is not readily available.
- Following an animal bite, wounds should be thoroughly cleansed and an urgent medical assessment sought, even if the wound appears trivial. Prompt post-exposure treatment is required, even if pre-exposure vaccine has been received.
- Suitable vaccines and immunoglobulin may be in short supply or unavailable in some countries.
Resources
Health ProfessionalsNaTHNaC Health Information Sheet on Rabies Department of Health. Immunisation Against Infectious Disease (Green Book) |
Travellers |
TETANUS
Tetanus is caused by a toxin released from Clostridium tetani bacteria.
Risk assessment
- EpidemiologyInformation on the occurrence of disease within this country - Tetanus bacteria are found worldwide.
- ExposureInformation on the mode of transmission and factors that may increase disease risk - Tetanus bacteria are present in soil and manure and may be introduced through open wounds such as a puncture wound, burn or scratch.
Risk management
- Travellers should thoroughly clean all wounds and seek appropriate medical attention
- Travellers should have completed a primary vaccination course according to the UK schedule.
- A booster dose should be givenAll travellers in risk categories should receive vaccine to travellers whose last dose of a tetanus-containing vaccine was given more than 10 years ago, and who will not have ready access to medical care; even if they have received five doses previously.
Resources
Health ProfessionalsNaTHNaC Health Information Sheet on Tetanus Department of Health Immunisation Against Infectious Disease (Green Book) |
Travellers |
TUBERCULOSIS
Tuberculosis (TB) is caused by the bacteria Mycobacterium tuberculosis. A map showing the global areas at risk for tuberculosis can be found here (78 KB GIF)
Risk assessment
- EpidemiologyInformation on the occurrence of disease within this country - The average annual incidence of TB is presumed to be greater than or equal to 40 cases per 100,000 population.
- ExposureInformation on the mode of transmission and factors that may increase disease risk - TB is transmitted following inhalation of infectious respiratory droplets. Most travellers are at low risk. Travellers at higher risk include healthcare workers, those who are visiting friends and relatives (particularly young children), long stay travellers, and those who have close contact with an infected individual.
Risk management
- The pre-travel visit is an opportunity to ensure that individuals in defined risk categories are vaccinated with BCG according to current UK guidance. For further details see the Department of Health Immunisation against infectious disease (The Green Book).
- Travellers should avoid close contact with individuals known to have infectious pulmonary TB.
- BCG vaccine should be considered for unvaccinated, tuberculin skin test negative children from 6 to under 16 years of age, who are going to live for more than 3 months in this country.
- BCG vaccine should be considered for unvaccinated children younger than 6 years of age, who are going to live for more than 3 months in this country. These children will usually not need a tuberculin skin test prior to vaccination.
- Healthcare workers should take appropriate infection control precautions. BCG vaccine should be considered for previously unvaccinated, tuberculin skin test negative health care workers younger than 35 years of age. This recommendation is irrespective of duration of stay.
- There are specific contraindications and adverse events associated with BCG vaccine. A careful risk assessment should be made before administration and specialist advice sought as appropriate.
- Travellers who are in the risk groups described and who do not receive BCG vaccine should be considered for pre-travel and post-travel testing for exposure to tuberculosis.
- Travellers who suspect that they may have been exposed to tuberculosis should receive an appropriate medical evaluation.
Resources
TYPHOID
Typhoid fever is a systemic disease caused by Salmonella Typhi bacteria.
Risk assessment
- EpidemiologyInformation on the occurrence of disease within this country - Typhoid fever is known or presumed to occur in this country.
- ExposureInformation on the mode of transmission and factors that may increase disease risk - Typhoid is transmitted through contaminated food and water. Those at higher risk include travellers visiting friends and relatives, young children, long-term travellers, and those exposed to conditions of poor sanitation.
Risk management
- Travellers should practice strict food, water and personal hygiene precautions even if vaccinated.
- Vaccine should be givenAll travellers in risk categories should receive vaccine to travellers whose planned activities put them at higher risk (see above). Current vaccines against Salmonella Typhi are only 50-80% protective and do not protect against Salmonella Paratyphi. Previous typhoid illness does not confer reliable immunity.
Resources
This section details infectious disease risks for which there are no vaccines as well as some non-infectious disease risks. This is not an exhaustive list. Further information about infectious and non-infectious disease risks can be found on the NaTHNaC Health Information Sheets. Travellers should be aware that accidents and injuries are a cause of serious illness during travel.
Malaria
MALARIA
There is no risk of malaria in this country.
The travel health information contained in these pages is intended for health professionals who assess a patients travel health needs. This document is not a complete medical guide for travellers and as such travellers using this site should consult with a health professional for specific information related to your travel and medical history. While every care has been taken to ensure the accuracy and timeliness of the travel health information, NaTHNaC cannot accept any liability for injury, loss or damage arising in any respect of any statement contained therein.
For the purpose of these web pages the term "country" covers countries, territories and areas. Areas within a country may be shown separately where it is felt necessary in order to provide travel health information.
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