Cholera is a serious bacterial disease and has a high mortality rate if untreated.  It is mainly water-borne, and causes profuse watery diarrhoea.  Death, due to dehydration, can occur rapidly. 

Cholera epidemics are most common in places of civil unrest.  Relief or disaster aid workers should consider requesting the vaccine.

The immunisation consists of 2 doses of an oral vaccine, given at an interval of 6 weeks.  The course must be completed at least 1 week prior to exposure, and provides 2 years of protection.

Cholera vaccination is not available on the NHS.  Patients wishing to have this will be given a private prescription.  There is no charge for the prescription itself, but patients will be liable to pay the cost of the medication at the pharmacy.  This is approximately £25, but may vary slightly between pharmacies.

Diptheria vaccination is currently recommended as part of the routine vaccination schedule and is available for free to all patients under the NHS, regardless of whether or not they are travelling.  The primary course is usually given during the first year of life, but booster doses are required every 10 years.

Hepatitis A is a viral infection spread through contaminated food or water.  It is highly contagious and is the most common vaccine-preventable disease in travellers.  The risk of Hepatitis A can be markedly reduced by following the advice on food and water in our Staying Healthy Whilst Abroad section.

Symptoms include fever, nausea, vomiting, dark-coloured urine and jaundice (turning yellow). 

A single dose of vaccine followed by a booster 6 to 12 months later provides an estimated 25 years protection.

This is currently available for free on the NHS, if recommended for travel purposes.

• Sharing of needles (e.g. tattooing, body piercing, acupuncture and drug misuse)
• Sexual contact
• Medical procedures with non sterile equipment
• Blood transfusion

See our Staying Healthy Whilst Abroad section for advice on minimizing your risk.

There is no vaccination against Hepatitis C or HIV.

Hepatitis B is one hundred times more infectious than HIV and is a leading cause of liver cancer.  There is an effective vaccination against hepatitis B, but the course consists of 3-4 doses of the vaccine, given over a period of about 6 months.  If the course is incomplete it is much less effective, and hence Hepatitis B vaccination is not usually a realistic option for most travellers.

Hepatitis B vaccination is not available for free on the NHS for the general population.

Current price:   £30 per dose

Most cases of the disease go unnoticed.  However but about 1 in 250 cases becomes clinically apparent and in these individuals the disease can lead to severe inflammation of the brain, leading to permanent brain damage or death.

The Japanese B encephalitis vaccine is a course of three injections given over 4 weeks.  Please note that the course must be completed at least 2 weeks prior to travel, as some patients experience a delayed reaction to the vaccination.

Current price: £35 per dose

These strains are found in Africa and some parts of Asia, especially India.  The ACWY vaccine is particularly recommended for those travelling on public transport, living in crowded conditions or working closely with the local population.

A vaccination certificate is required for all travellers to the Hajj and for the Umrah. 

A single dose of vaccine provides 3-5 years protection.

Current price: £30

Please note that there is also a single vaccination against Meningitis C i.e. one of these 4 strains.  The meningitis C vaccination and the meningitis ACWY vaccination are NOT the same, and are not interchangeable.  The Meningitis C vaccination is currently part of the NHS vaccination schedule for all children.  It is also currently recommended to all students in the UK under the age of 25, regardless of whether or not they are travelling.  Please see our student vaccinations page.

Polio vaccination is currently recommended as part of the NHS vaccination schedule and is available for free to all patients under the NHS, regardless of whether or not they are travelling.  The primary course is usually given during the first year of life, but booster doses are required every 10 years.

If rabies develops, death is 100% certain.  There is no cure.  Rabies is responsible for approximately 40 000 deaths worldwide every year.

Prevention is paramount.

• Do not be complacent
• Do not touch any animal, particularly dogs, cats, monkeys and bats
• If travelling to a remote area, consider having the rabies vaccine prior to departure

Even if vaccinated, if bitten by a mammal in a country where rabies is present:

• Vigorously clean wound with soap and running water for 10 minutes
• Encourage the wound to bleed a little
• Apply tincture of aqueous iodine solution if available, or alternatively 40% alcohol or stronger (e.g. whisky)
• Do not allow the wound to be stitched unless absolutely necessary
• Obtain information about the animal concerned
• SEEK MEDICAL HELP IMMEDIATELY.  There are treatments which help prevent rabies from developing, but they must be administered promptly and may not be available in very rural areas.  They are much more effective in those who are already vaccinated, but are usually recommended regardless of vaccination status, albeit at a different dose.  It is vital that this course of treatment is completed if offered
• Report back to the Health Centre as soon as possible on your return to the UK

Immunisation consists of three doses of the vaccine.

Current price: £40 per dose

Tetanus is a disease caused by the toxin of a bacterium present in soil or manure, which may enter the body through a wound, burn or scratch.  The disease leads to muscle stiffness which usually involves the jaw (lockjaw) and can cause death.

Tetanus vaccination is currently recommended as part of the NHS vaccination schedule and is available for free to all patients under the NHS, regardless of whether or not they are travelling.  The primary course is usually given during the first year of life, but booster doses are required every 10 years.

This is a viral disease spread by ticks, but can also be acquired by consuming unpasteurised dairy products from infected animals, especially goats.  It occurs mostly in the summer months, in forested areas of Central and Eastern Europe and Scandinavia. 

Prevention is by avoiding tick bites.  See our Staying Healthy Whilst Abroad section.  In particular, wear long trousers, avoid long grass and undergrowth if possible and use insect repellent containing at least 50% DEET.

Only 1-2% of ticks carry the virus.  However armpits, groin and navel should be checked regularly for tick bites.  If a tick is found attached to the skin, it should be removed by grasping with tweezers or fingers, holding as close to the skin as possible, and pulling gently and consistently.  If the mouthparts remain stuck in the skin, they should be removed as soon as possible.

Vaccination is recommended for those planning to spend long periods in infected areas and those camping or working in forests, especially during the summer. 

The tick-borne encephalitis vaccine is a course of 3 injections given over 12 months. 

The vaccination is not available on the NHS.  Patients wishing to have this will be given a private prescription.  There is no charge for the prescription itself, but patients will be liable to pay the cost of the medication at the pharmacy.  This is approximately £56, but may vary slightly between pharmacies.

In addition, there is a vaccination administration fee, payable to Imperial College Health Centre, currently £10 per dose.

The tuberculosis vaccination (BCG) does not give very good protection against TB.  However it remains part of the NHS vaccination schedule in many parts of the UK, and for those most at risk.

Even when vaccinated, travellers to endemic areas should take care with food and water.  See our Staying Healthy Whilst Abroad Section.

A single dose of vaccine lasts for 3 years.

This is currently available for free on the NHS, if recommended for travel purposes.

Some countries will not allow entry without a valid International Certificate of Vaccination.  These certificates can only be issued at the time of vaccination, which must be at least 10 days before entry into the area.

Find out more about the Yellow Fever Centre and certification here.

A single vaccination provides 10 years protection.

Current price: £40 (this includes the certificate)
Current certificate charge (to re-issue lost certificates – please see our Yellow Fever Centre page for terms): £10