Travel Notices in Effect
- Updated Measles Updatejune25, 2012
- Update: Dengue in Tropical and Subtropical Regionsjune16, 2012
Preparing for Your Trip to Nepal
Before visiting Nepal, you may need to get the following vaccinations and medications for vaccine-preventable diseases and other diseases you might be at risk for at your destination: (Note: Your doctor or health-care provider will determine what you will need, depending on factors such as your health and immunization history, areas of the country you will be visiting, and planned activities.)To have the most benefit, see a health-care provider at least 4–6 weeks before your trip to allow time for your vaccines to take effect and to start taking medicine to prevent malaria, if you need it.
Even if you have less than 4 weeks before you leave, you should still see a health-care provider for needed vaccines, anti-malaria drugs and other medications and information about how to protect yourself from illness and injury while traveling.
CDC recommends that you see a health-care provider who specializes in Travel Medicine. Find a travel medicine clinic near you. If you have a medical condition, you should also share your travel plans with any doctors you are currently seeing for other medical reasons.
If your travel plans will take you to more than one country during a single trip, be sure to let your health-care provider know so that you can receive the appropriate vaccinations and information for all of your destinations. Long-term travelers, such as those who plan to work or study abroad, may also need additional vaccinations as required by their employer or school.
Although yellow fever is not a disease risk in Nepal, the government requires some travelers arriving from countries with risk of yellow fever virus transmission to present proof of yellow fever vaccination. If you will be traveling to Nepal from any country other than the United States, this requirement may affect you. For specific requirement details, see Yellow Fever & Malaria Information, by Country.
Be sure your routine vaccinations are up-to-date. Check the links below to see which vaccinations adults and children should get.
Routine vaccines, as they are often called, such as for influenza, chickenpox (or varicella), polio, measles/mumps/rubella , and diphtheria/pertussis/tetanus (DPT) are given at all stages of life; see the childhood and adolescent immunization schedule and routine adult immunization schedule.
Routine vaccines are recommended even if you do not travel. Although childhood diseases, such as measles, rarely occur in the United States, they are still common in many parts of the world. A traveler who is not vaccinated would be at risk for infection.
Vaccine-Preventable Diseases
Vaccine recommendations are based on the best available risk information. Please note that the level of risk for vaccine-preventable diseases can change at any time.| Vaccination or Disease | Recommendations or Requirements for Vaccine-Preventable Diseases |
|---|---|
| Routine | Recommended if you are not up-to-date with routine shots, such as measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine, poliovirus vaccine, etc. |
| Hepatitis A or immune globulin (IG) | Recommended for all unvaccinated people traveling to or working in countries with an intermediate or high level of hepatitis A virus infection (see map) where exposure might occur through food or water. Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors. |
| Hepatitis B | Recommended for all unvaccinated persons traveling to or working in countries with intermediate to high levels of endemic HBV transmission (see map), especially those who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment (e.g., for an accident). |
| Typhoid | Recommended for all unvaccinated people traveling to or working in South Asia, especially if staying with friends or relatives or visiting smaller cities, villages, or rural areas where exposure might occur through food or water. |
| Japanese encephalitis | Recommended if you plan to visit rural farming areas and under special circumstances, such as a known outbreak of Japanese encephalitis, see country-specific information. |
| Rabies | Recommended for travelers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking. Also recommended for travelers with significant occupational risks (such as veterinarians), for long-term travelers and expatriates living in areas with a significant risk of exposure, and for travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. |
Malaria
Areas of Nepal with Malaria: Present throughout the country at altitudes <1,200 m (3,937 ft). None in Kathmandu and on typical Himalayan treks. (more information)
If you will be visiting an area of Nepal with malaria, you will need to discuss with your doctor the best ways for you to avoid getting sick with malaria. Ways to prevent malaria include the following:
Note: Chloroquine is NOT an effective antimalarial drug in Nepal and should not be taken to prevent malaria in this region.
To find out more information on malaria throughout the world, you can use the interactive CDC malaria map. You can search or browse countries, cities, and place names for more specific malaria risk information and the recommended prevention medicines for that area.
If you will be visiting an area of Nepal with malaria, you will need to discuss with your doctor the best ways for you to avoid getting sick with malaria. Ways to prevent malaria include the following:
- Taking a prescription antimalarial drug
- Using insect repellent and wearing long pants and sleeves to prevent mosquito bites
- Sleeping in air-conditioned or well-screened rooms or using bednets
Note: Chloroquine is NOT an effective antimalarial drug in Nepal and should not be taken to prevent malaria in this region.
To find out more information on malaria throughout the world, you can use the interactive CDC malaria map. You can search or browse countries, cities, and place names for more specific malaria risk information and the recommended prevention medicines for that area.
Malaria Contact for Health-Care Providers
For assistance with the diagnosis or management of suspected cases of malaria, call the CDC Malaria Hotline: 770-488-7788 or toll-free 1-855-856-4713 (M-F, 9 am-5 pm, Eastern time). For clinicians needing emergency consultation after hours, call 770-488-7100 and ask to speak with a CDC Malaria Branch clinician.
A Special Note about Antimalarial Drugs
You should purchase your antimalarial drugs before travel. Drugs purchased overseas may not be manufactured according to United States standards and may not be effective. They also may be dangerous, contain counterfeit medications or contaminants, or be combinations of drugs that are not safe to use.
Halofantrine (marketed as Halfan) is widely used overseas to treat malaria. CDC recommends that you do not use halofantrine because of serious heart-related side effects, including deaths. You should avoid using antimalarial drugs that are not recommended unless you have been diagnosed with life-threatening malaria and no other options are immediately available.
For detailed information about these antimalarial drugs, see Choosing a Drug to Prevent Malaria.
More Information About Malaria
Malaria is always a serious disease and may be a deadly illness. Humans get malaria from the bite of a mosquito infected with the parasite. Prevent this serious disease by seeing your health-care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites (see below).Travelers to malaria risk-areas in Nepal, including infants, children, and former residents of Nepal, should take one of the antimalarial drugs listed in the box above.
Symptoms
Malaria symptoms may include- fever
- chills
- sweats
- headache
- body aches
- nausea and vomiting
- fatigue
Malaria may cause anemia and jaundice. Malaria infections with Plasmodium falciparum, if not promptly treated, may cause kidney failure, coma, and death. Despite using the protective measures outlined above, travelers may still develop malaria up to a year after returning from a malarious area. You should see a doctor immediately if you develop a fever anytime during the year following your return and tell the physician of your travel.
Items to Bring With You
Medicines you may need:- The prescription medicines you take every day. Make sure you have enough to last during your trip. Keep them in their original prescription bottles and always in your carry-on luggage. Be sure to follow security guidelines
, if the medicines are liquids.
- Antimalarial drugs, if traveling to a malaria-risk area in Nepal and prescribed by your doctor.
- Medicine for diarrhea, usually over-the-counter.
for the country(s) you intend to visit or the embassy or consulate for that country(s). If your medication is not allowed in the country you will be visiting, ask your health-care provider to write a letter on office stationery stating the medication has been prescribed for you. Other items you may need:
- Iodine tablets and portable water filters to purify water if bottled water is not available. See A Guide to Water Filters, A Guide to Commercially-Bottled Water and Other Beverages, and Safe Food and Water for more detailed information.
- Sunblock and sunglasses for protection from harmful effects of UV sun rays. See Basic Information about Skin Cancer for more information.
- Antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60% alcohol.
- To prevent insect/mosquito bites, bring:
- Lightweight long-sleeved shirts, long pants, and a hat to wear outside, whenever possible.
- Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
- Bed nets treated with permethrin, if you will not be sleeping in an air-conditioned or well-screened room and will be in malaria-risk areas. For use and purchasing information, see Insecticide Treated Bed Nets on the CDC malaria site. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.
Note: Check the Air Travel section
of the Transportation Security Administration website for the latest information about airport screening procedures and prohibited items.Other Diseases Found in South Asia
Risk can vary between countries within this region and also within a country; the quality of in-country surveillance also varies.
The following are disease risks that might affect travelers; this is not a complete list of diseases that can be present. Environmental conditions may also change, and up to date information about risk by regions within a country may also not always be available.Dengue fever has caused epidemics in most South Asian countries. In 2005-2006, an outbreak of chikungunya affected thousands of persons in India. Filariasis is common. A sharp rise in the incidence of visceral leishmaniasis has been observed in several South Asian countries. Cutaneous leishmaniasis is present in Afghanistan (where it has infected US troops). Japanese encephalitis occurs widely except in mountainous areas of South Asia. Protecting yourself against insect bites (see below) will help to prevent these diseases.
Leptospirosis, a bacterial infection often contracted through recreational water activities in contaminated water, is common in tropical areas of the South Asia region.
Indigenous wild polio was present in 2005-2006 in India, Pakistan, and Afghanistan; cases from Bangladesh and Nepal were confirmed in 2005-2006.
Measles occurs in the South Asia region and can be a source of infection for unvaccinated travelers.
Highly pathogenic avian influenza (H5N1) continues to cause outbreaks in domestic and wild bird populations and has caused human cases in several South Asian countries. Avoid all direct contact with birds, including domestic poultry (such as chickens and ducks) and wild birds, and avoid places such as poultry farms and bird markets where live birds are raised or kept. For a current list of countries reporting outbreaks of H5N1 among poultry and/or wild birds, view updates from the World Organization for Animal Health (OIE), and for total numbers of confirmed human cases of H5N1 virus by country see the World Health Organization (WHO) Avian Influenza website
.
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