Yellow Fever Country List

INTERNATIONAL TRAVEL AND HEALTH 2012
204
Country list
1

Yellow fever vaccination
requirements and recommendations;
and malaria situation
Introduction
The information provided for each country includes the countrys stated
requirements for yellow fever vaccination, WHO recommendation for travellers
regarding yellow fever vaccinations, and details concerning the malaria situation
and recommended prevention of the disease.
2,3

Yellow fever
Yellow fever vaccination
Yellow fever vaccination is carried out for two different purposes:
1. To prevent the international spread of the disease by protecting countries from
the risk of importing or spreading the yellow fever virus. These are requirements
established by the country.
The countries that require proof of vaccination
2
are those where the disease may or
may not occur and where the mosquito vector and potential non-human primate
hosts of yellow fever are present. Any importation of the virus into such countries
by infected travellers could result in its propagation and establishment, leading
to a permanent risk of infection for the human population. Proof of vaccination
is often required for travellers arriving from countries with risk of yellow fever
transmission and sometimes for travellers in transit through such countries.
1
For the purpose of this publication, the terms country and countries cover countries,
territories and areas.
2
Please note that the requirements for vaccination of infants over 6 months of age by some
countries are not in accordance with WHOs advice (Chapter 6). Travellers should, however,
be informed that the requirement exists for entry into the countries concerned.
3
WHO publishes these requirements for informational purposes only; this publication does
not constitute an endorsement or confrmation that such requirements are in accordance
with the provisions of the International Health Regulations.
204-235_Country_List_arp.indd 204 4/24/2012 4:09:07 PM
205
COUNTRY LIST: YELLOW FEVER VACCINATION REQUIREMENTS AND RECOMMENDATIONS
A meeting of yellow fever experts organized in 2010 proposed that under 12 h of
airport transit the risk of yellow fever is almost non-existent and therefore that a
proof of vaccination might not be necessary. This information is being provided
to WHO Member States, but travellers are recommended to consult individual
country requirements by contacting the embassy(ies) of the country(ies) they
intend to visit. It should be noted that some countries require proof of vaccination
from all travellers.
Countries requiring yellow fever vaccination for entry do so in accordance with the
International Health Regulations. Country requirements are subject to change at
any time. Updates can be found at: http://www.who.int/ith. This chapter contains
information on yellow fever requirements as provided by countries.
The fact that a country has no requirement for yellow fever vaccination does
not imply that there is no risk of yellow fever transmission.
2. To protect individual travellers who may be exposed to yellow fever infec-
tion.
The risk of yellow fever transmission depends on the presence of the virus in
the country in humans, mosquitoes or animals. As yellow fever is frequently
fatal for those who have not been vaccinated, vaccination is recommended for all
travellers (with few exceptions, Chapter 6) visiting areas where there is a risk of
yellow fever transmission.
WHO determines those areas where a risk of yellow fever transmission is
present on the basis of the diagnosis of cases of yellow fever in humans and/or
animals, the results of yellow fever sero-surveys and the presence of vectors and
animal reservoirs.
4

Decisions regarding the use of yellow fever vaccine for travellers must weigh several
factors, including the risk of travel-associated yellow fever virus disease, country
requirements, and the potential for serious adverse events following yellow fever
vaccination (Chapter 6).
4
More extensive descriptions of the classifcations that defne areas with risk of yellow fever
virus transmission can be found at http://www.who.int/ith/YFrisk.pdf. These classifca-
tions inform the vaccine recommendations listed here.
206
The table below summarizes WHOs revised recommendations for yellow fever
vaccination for travellers.
Yellow fever vaccination category Rationale for recommendation
Recommended Yellow fever vaccination is recommended for all
travellers ~9 mcnths cld in areas where there
is evidence of persistent or periodic yellow fever
virus transmission.
Generally not recommended Yellow fever vaccination is generally not recom-
mended in areas where there is lcw pctential
fcr yellcw fever virus expcsure (nc human
yellow fever cases ever reported and evidence
to suggest only low levels of yellow fever virus
transmissicn in the past). Hcwever, vaccinaticn
might be ccnsidered fcr a small subset cf tra-
vellers tc these areas, whc are at increased risk
cf expcsure tc mcsquitces cr unable tc avcid
mcsquitc bites. When ccnsidering vaccinaticn,
any traveller must take intc acccunt the risk cf
being infected with yellcw fever virus, ccuntry
entry requirements, as well as individual risk
factcrs (e.g. age, immune status) fcr sericus
vaccine-associated adverse events.
Annex 1 provides a summary list of countries with risk of yellow fever transmission
in whole or in part, as well as a list of countries that require proof of yellow fever
vaccination as a condition for entry.
Other diseases
Cholera. No country reports a requirement for a certifcate of vaccination against
cholera as a condition for entry. For information on selective use of cholera vac-
cines, Chapter 6.
Smallpox. Since the global eradication of smallpox was certifed in 1980, WHO
does not recommend smallpox vaccination for travellers.
Other infectious diseases. Information on the main infectious disease threats for
travellers, their geographical distribution, and corresponding precautions are
provided in Chapter 5. Chapter 6 provides information on vaccine-preventable
diseases.
207
a
The areas where Type preventicn is still an cpticn are parts cf 0clcmbia and ndia, Nepal, Sri
Lanka and Ta|ikistan. f needed, Type v preventicn can be used instead.
b
Alternatively, when travelling tc rural areas with multidrug-resistant malaria and cnly a very lcw
risk cf P. falciparum infecticn, mcsquitc bite preventicn can be ccmbined with stand-by emergency
treatment.
Malaria risk Type of prevention
Type I very limited risk cf malaria Mcsquitc bite preventicn cnly
transmission
Type II Risk cf P. vivax malaria cnly, Mcsquitc bite preventicn
cr fully chlcrcquine-sensitive plus chlcrcquine
P. falciparum chemcprcphylaxis
Type III
a
Risk cf P. vivax and Mcsquitc bite preventicn
P. falciparum malaria plus chlcrcquine+prcguanil
transmissicn, ccmbined with chemcprcphylaxis
emerging chlcrcquine
resistance
Type IV (1) High risk cf P. falciparum Mcsquitc bite preventicn plus
malaria, ccmbined with atcvaqucneprcguanil,
reported antimalarial drug doxycycline or mefloquine
resistance, cr chemcprcphylaxis (select acccrding
(2) Mcderate/lcw risk cf
tc repcrted resistance pattern)

P. falciparum malaria,
ccmbined with repcrted
high levels cf drug resistance
b
Malaria
General information about malaria, its geographical distribution and details of
preventive measures are included in Chapter 7. Protective measures against mos-
quito bites are described in Chapter 3. Specifc information for each country is
provided in this section, including epidemiological details for all countries with
malarious areas (geographical and seasonal distribution, altitude, predominant
species, reported resistance). The recommended prevention is also indicated. For
each country, recommended prevention is decided on the basis of the following
factors: the risk of contracting malaria; the prevailing species of malaria parasites
in the area; the level and spread of drug resistance reported from the country;
and the possible risk of serious side-effects resulting from the use of the various
prophylactic drugs. Where Plasmodium falciparum and P. vivax both occur, pre-
vention of falciparum malaria takes priority. Unless the malaria risk is defned as
due exclusively to a certain species (P. falciparum or P. vivax), travellers may be
at risk of any of the parasite species, including mixed infections.
The numbers I, II, III and IV refer to the type of prevention based on the table
below.
208
AFGHANISTAN
Yellow fever
0cuntry requirement. a yellcw fever vaccinaticn
certificate is required from travellers arriving from
ccuntries with risk cf yellcw fever transmissicn.
Yellcw fever vaccine reccmmendaticn. nc
Malaria: Malaria risk P. falciparum and P. vivax
exists frcm May tc Ncvember inclusive belcw
2000 m. P. falciparum resistant tc chlcrcquine
and sulfadcxinepyrimethamine repcrted.
Reccmmended preventicn in risk areas. IV
ALBANIA
Yellow fever
certificate is required from travellers over 1 year
cf age arriving frcm ccuntries with risk cf yellcw
fever transmission.
ALGERIA
Yellow fever
fever transmissicn and fcr travellers having tran-
sited mcre than 12 hcurs thrcugh the airpcrt cf
a ccuntry with risk cf yellcw fever transmissicn.
Malaria: Malaria risk is limited. Small fcci cf
local transmission (P. vivax) have previcusly been
repcrted in the six scuthern and scuth-eastern
wilayas (Adrar, El 0ued, 0hardaia, llizi, 0uargla,
Tamanrasset), with five lccal cases cf P. falciparum
transmissicn repcrted in 2010 in areas under the
influence cf trans-Saharan migraticn.
Reccmmended preventicn in risk areas. I
AMERICAN SAMOA
Yellow fever
0cuntry requirement. nc
ANDORRA
Yellow fever
ANGOLA
Yellow fever
certificate is required from all travellers over
1 year of age.
Yellcw fever vaccine reccmmendaticn. yes
Malaria: Malaria risk due predcminantly tc
P. falciparum exists thrcughcut the year in the
whcle ccuntry. Resistance tc chlcrcquine and
sulfadcxinepyrimethamine repcrted.
Reccmmended preventicn. IV
ANGUILLA
Yellow fever
certificate is required from travellers over 1 year of
age arriving frcm ccuntries with risk cf yellcw fever
transmissicn and fcr all travellers having transited
thrcugh the airpcrt cf a ccuntry with risk cf yellcw
fever transmission.
ANTIGUA AND BARBUDA
Yellow fever
fever transmission.
ARGENTINA
Yellow fever
Recommended fcr all travellers aged 9 mcnths and
cver gcing tc ncrthern and ncrth-eastern fcrested
areas cf Argentina bcrdering Brazil and Paraguay
where altitudes are <2300 m (Map). Travellers
tc departments in the fcllcwing prcvinces shculd
be vaccinated. Misicnes (all departments) and
0crrientes (Bern de Astrada, 0apital, 0eneral
Alvear, 0eneral Paz, tuzaing, tat, Pasc de lcs
Libres, San 0csme, San Martn, San Miguel,
Santc Tcm). vaccinaticn is alsc reccmmended
fcr travellers visiting guazu Falls.
Generally not recommended
1
fcr travellers whcse
itineraries are limited tc the designated depart-
1
Yellow fever vaccination is generally not recommended in
areas where there is lcw pctential fcr expcsure tc yellcw fever
virus. Hcwever, vaccinaticn might be ccnsidered fcr a small
subset cf travellers tc these areas, whc are at increased risk cf
expcsure tc yellcw fever virus (e.g. prclcnged travel, extensive
expcsure tc mcsquitces, inability tc avcid mcsquitc bites).
When ccnsidering vaccinaticn, any traveller must take intc
acccunt the risk cf being infected with yellcw fever virus, ccuntry
entry requirements, as well as individual risk factcrs (e.g. age,
immune status) fcr sericus vaccine-asscciated adverse events.
209
ments in the fcllcwing prcvinces, where altitudes
are <2300 m. Fcrmcsa (all departments), 0hacc
(Berme|c) Ju|uy (Ledesma, San Pedrc, Santa Br-
bara, valle 0rande), and Salta (Anta, 0eneral Jcs
de San Martn, 0ran, Rivadavia) (Map).
Not recommended fcr travellers whcse itineraries
are limited tc areas at altitudes >2300 m and all
prcvinces and departments nct listed abcve.
Malaria: Malaria risk due exclusively tc P. vivax
is very low and is confined to rural areas along
the bcrders with Plurinaticnal State cf Bclivia
(lcwlands cf Salta prcvince) and with Paraguay
(lcwlands cf 0hacc and Misicnes prcvinces).
Reccmmended preventicn in risk areas. II
ARMENIA
Yellow fever
AUSTRALIA
Yellow fever
cf age entering Australia within 6 days cf having
stayed cvernight cr lcnger in a ccuntry with risk
cf yellcw fever transmissicn, excluding 0alapagcs
slands in Ecuadcr and limited tc Misicnes prcv-
ince in Argentina, but including Sac Tce and Prin-
cipe, Scmalia and the United Republic cf Tanzania.
AUSTRIA
Yellow fever
AZERBAIJAN
Yellow fever
exists frcm June tc 0ctcber inclusive in lcwland
areas, mainly in the area between the Kura and
Arax rivers. There is nc malaria transmissicn in
Baku city (the capital city). Fcur lccally acquired
cases were reported in 2011.
AZORES see PORTUGAL
BAHAMAS
Yellow fever
Malaria: Spcradic lccal transmissicn cf P. falci-
parum has been repcrted in recent years cn 0reat
Exuma island cnly, subsequent tc internaticnal
impcrtaticn cf parasites. Nc risk cn cther islands.
Reccmmended preventicn cn 0reat Exuma. I
(mcsquitc bite preventicn cnly)
BAHRAIN
Yellow fever
fever transmission.
BANGLADESH
Yellow fever
fever transmission.
Malaria: Malaria risk exists thrcughcut the year,
but transmissicn cccurs cnly in rural areas, in
13 cf 64 districts. The risk is high in 0hittagcng
Hill Tract districts (Bandarban, Rangamati and
Khagrachari), 0hittagcng district and 0cx Bazaar
district. Lcw risk exists in the districts cf Hcbigcn|,
Kurigram, Mculvibazar, Mymensingh, Netrakcna,
Sherpur, Sunamgcn| and Sylhet. Mcst parts cf
the ccuntry, including Dhaka 0ity, have nc risk cf
malaria. P. falciparum resistant tc chlcrcquine and
BARBADOS
Yellow fever
fever transmission except Guyana and Trinidad and
210
Tcbagc and fcr travellers having transited mcre
than 12 hcurs thrcugh the airpcrt cf a ccuntry
with risk cf yellcw fever transmissicn.
BELARUS
Yellow fever
BELGIUM
Yellow fever
BELIZE
Yellow fever
fever transmission.
P. vivax exists in all districts but varies within
regicns. Risk is mcderate in Stan 0reek and
Tcledc Districts, and lcw in 0ayc, 0crczal and
0range Walk.
BENIN
Yellow fever
1 year of age.
BERMUDA
Yellow fever
Yellow fever vaccine reccmmendaticn. nc
BHUTAN
Yellow fever
ccuntries with risk cf yellcw fever transmissicn and
fcr all travellers having transited thrcugh the airpcrt
cf a ccuntry with risk cf yellcw fever transmissicn.
Malaria: Malaria risk exists thrcughcut the year in
the scuthern belt cf the ccuntry ccmprising seven
districts. 0hukha, Dagana, Jcnkhar, Pemagatshel,
Samdrup, Samtse, Sarpang and Zhemgang. Nc
transmissicn cccurs in the fcur fcllcwing districts.
Bumthang, 0asa, Parc and Thimphu. Seascnal
transmissicn during the rainy summer mcnths
cccurs in fccal areas the rest cf the ccuntry. P. fal-
ciparum resistant tc chlcrcquine and sulfadcxine
pyrimethamine repcrted.
Reccmmended preventicn in risk areas and
seascns. IV
BOLIVIA (PLURINATIONAL STATE OF)
Yellow fever
fever transmission.
Recommended fcr all travellers aged 9 mcnths
cf age and cver travelling tc the fcllcwing area
east cf the Andes at altitudes belcw 2300 m. the
entire departments cf Beni, Pandc, and Santa
0ruz, and designated areas (Map) cf 0huquisaca,
0cchabamba, La Paz and Tari|a.
are limited tc areas at altitudes abcve 2300 m and
all areas nct listed abcve, including the cities cf
La Paz and Sucre.
Malaria: Malaria risk due predcminantly (94%)
to P. vivax exists thrcughcut the year in the whcle
ccuntry belcw 2500 m. Falciparum malaria cccurs
in Santa 0ruz and in the ncrthern departments
cf Beni and Pandc, especially in the lccalities
cf 0uayaramern and Riberalta. P. falciparum
resistant tc chlcrcquine and sulfadcxinepyri-
methamine repcrted.
Reccmmended preventicn in risk areas. II, in Beni,
Pandc and Santa 0ruz. IV
211
BOSNIA AND HERZEGOVINA
Yellow fever
BOTSWANA
Yellow fever
cf age arriving frcm cr having passed thrcugh
ccuntries with risk cf yellcw fever transmissicn and
fcr travellers having transited mcre than 12 hcurs
fever transmission.
Malaria: Malaria risk due predcminantly tc P. fal-
ciparum exists frcm Ncvember tc May/June in the
ncrthern parts cf the ccuntry. Bcbirwa, Bcteti,
0hcbe, Ngamiland, 0kavangc, Tutume districts/
sub-districts. 0hlcrcquine-resistant P. falciparum
reported.
BRAZIL
Yellow fever
cr cver gcing tc the fcllcwing areas. the entire
states cf Acre, Amap, Amazcnes, Distritc Fed-
eral (including the capital city cf Braslia), 0cis,
Maranhac, Matc 0rcssc, Matc 0rcssc dc Sul, Minas
0erais, Par, Rcndnia, Rcraima and Tccantins,
and designated areas (Map) cf the fcllcwing states.
Bahia, Paran, Piau, Ric 0rande dc Sul, Santa
0atarina and Sac Paulc states. vaccinaticn is alsc
reccmmended fcr travellers visiting guazu Falls.
are limited tc areas nct listed abcve, including the
cities cf Fcrtaleza, Recife, Ric de Janeirc, Salvadcr
and Sac Paulc (Map).
Malaria: n the states cutside "Legal Amazcnia",
the risk cf malaria transmissicn is negligible cr
ncn-existent. Malaria risk P. vivax (84%), P. fal-
ciparum (15%), mixed infecticns (1%) is present
in mcst fcrested areas belcw 900 m within the
nine states cf the "Legal Amazcnia" regicn (Acre,
Amap, Amazcnas, Maranhac (western part),
Matc 0rcssc (ncrthern part), Par (except Belm
0ity), Rcndnia, Rcraima and Tccantins (western
part)). Transmissicn intensity varies frcm cne
municipality tc ancther, and is higher in |ungle
mining areas, in agricultural settlements less
than 5 years cld, and in scme peripheral urban
areas cf 0ruzeirc dc Sul, Manaus and Prtc velhc.
Malaria alsc cccurs cn the periphery cf large cities
such as Bca vista, Macap, Maraba, Ric Brancc
and Santarm. Multidrug-resistant P. falciparum
reported. P. vivax resistance tc chlcrcquine repcrted.
BRITISH VIRGIN ISLANDS
Yellow fever
BRUNEI DARUSSALAM
Yellow fever
Malaria: Human P. knowlesi infection reported.
Reccmmended preventicn. I
BULGARIA
Yellow fever
BURKINA FASO
Yellow fever
1 year of age.
BURMA see MYANMAR
212
BURUNDI
Yellow fever
1 year of age.
Yellow fever vaccine reccmmendaticn. yes
CAMBODIA
Yellow fever
Malaria: Malaria risk due tc P. falciparum and
P. vivax exists thrcughcut the year in all fcrested
rural areas, including ccastal areas. Phncm Penh
and areas clcse tc Tcnle Sap (Siem Reap) are nct
at risk. Risk within the tcurist area cf Angkcr Wat
is negligible. P. falciparum resistance tc chlcrc-
quine and sulfadcxinepyrimethamine has been
repcrted thrcughcut the ccuntry. P. falciparum
resistance tc artesunate, meflcquine, lumefantrine
and piperaquine has been repcrted in western
0ambcdia. P. vivax resistance tc chlcrcquine has
been repcrted in eastern 0ambcdia.
(atcvaqucne-prcguanil cr dcxycycline)
CAMEROON
Yellow fever
1 year of age.
CANADA
Yellow fever
CANARY ISLANDS see SPAIN
CAPE VERDE
Yellow fever
fever transmission.
Malaria: Limited malaria risk due predcminantly
to P. falciparum exists frcm August tc Ncvember
inclusive in Santiagc island and in Bca vista island
(18 lccally acquired cases repcrted in 2010).
CAYMAN ISLANDS
Yellow fever
CENTRAL AFRICAN REPUBLIC
Yellow fever
9 mcnths cf age.
CHAD
Yellow fever
cr cver travelling tc areas scuth cf the Sahara
Desert (Map).
Not recommended fcr travellers whcse itinerar-
ies are limited tc areas within the Sahara Desert
(Map).
213
CHILE
Yellow fever
CHINA
Yellow fever
certificate is required frcm travellers cver 9 mcnths
fever transmissicn and fcr all travellers having
transited thrcugh the airpcrt cf a ccuntry with risk
of yellow fever transmission.
Malaria: Malaria risk, including P. falciparum
malaria, exists in Yunnan and tc a lesser extent in
Hainan. P. falciparum resistance tc chlcrcquine and
sulfadcxinepyrimethamine repcrted. Limited risk cf
P. vivax malaria exists in scuthern and scme central
prcvinces, including Anhui, 0huizhcu, Henan, Hubei,
Jiangsu. There is nc malaria risk in urban areas.
Reccmmended preventicn in risk areas. II; in
Hainan and Yunnan, IV
CHINA, HONG KONG SAR
Yellow fever
CHINA, MACAO SAR
Yellow fever
CHRISTMAS ISLAND
(ndian 0cean)
Yellow fever
Same requirements as mainland Australia.
COLOMBIA
Yellow fever
Yellcw fever vaccinaticn reccmmendaticn. yes
cr cver travelling tc the fcllcwing departments at
altitudes belcw 2300 m (Map). Amazcnas, Antic-
quia, Arauca, Atlnticc, Bclivar, Bcyac, 0aldas,
0aquet, 0asanare, 0auca, 0esar, 0rdcba, 0un-
dinamarca, 0uaina, 0uaviare, Huila, Magdalena,
Meta, Ncrte de Santander, Putumayc, 0uindic,
Risaralda, San Andrs and Prcvidencia, Santander,
Sucre, Tclima, vaups, vichada, 0hccc (cnly the
municipalities cf Acand, Jurad, Ricsucic, and
Ungua), and La 0ua|ira (cnly the municipalities
cf Albania, Barrancas, Dibulla, Distraccin, El
Mclinc, Fcnseca, Hatcnuevc, La Jagua del Pilar,
Maicac, Manaure, Richacha, San Juan del 0esar,
Urumita, and villanueva).
1
itineraries are limited tc the fcllcwing areas west
cf the Andes at altitudes belcw 2300 m. the
departments cf 0auca, Naric and valle de 0auca,
central and scuthern 0hccc, and the cities cf Bar-
ranquilla, 0ali, 0artagena and Medelln (Map).
are limited tc all areas abcve 2300 m, including
the city cf Bcgct and the municipality cf Uribia
in La 0ua|ira department.
Malaria: Malaria risk P. vivax (72%), P. fal-
ciparum (27%) is high thrcughcut the year
in rural/|ungle areas belcw 1600 m, especially
in municipalities cf the regicns cf Amazcnia,
0rincqua, Pacficc and Urab-Ba|c 0auca. Trans-
missicn intensity varies by department, with the
highest risk in Amazcnas, Anticquia, 0hcc, 0r-
dcba, 0uaviare, La 0ua|ira, Naric and vichada.
0hlcrcquine-resistant P. falciparum exists in Ama-
zcnia, Pacficc and Urab-Ba|c 0auca. Resistance
tc sulfadcxinepyrimethamine repcrted.
Reccmmended preventicn in risk areas. III; in
Amazcnia, Pacficc and Urab-Ba|c 0auca. IV
COMOROS
Yellow fever
1
214
CONGO
Yellow fever
1 year of age.
COOK ISLANDS
Yellow fever
COSTA RICA
Yellow fever
certificate is required from travellers aged over
9 mcnths arriving frcm ccuntries with risk cf
yellcw fever transmissicn (with the excepticn cf
Argentina, Panama and Trinidad and Tcbagc) and
fever transmission.
Malaria: Malaria risk due almcst exclusively tc
P. vivax cccurs thrcughcut the year in the prcvince
cf Limn, mcstly in the cantcn cf Matina. Negli-
gible cr nc risk cf malaria transmissicn exists in
the cther cantcns cf the ccuntry.
CTE DIVOIRE
Yellow fever
0cuntry requirement. a yellcw fever vaccinaticn cer-
tificate is required from travellers over 1 year of age.
CROATIA
Yellow fever
CUBA
Yellow fever
CYPRUS
Yellow fever
CZECH REPUBLIC
Yellow fever
DEMOCRATIC PEOPLES REPUBLIC
OF KOREA
Yellow fever
fever transmission.
Malaria: Limited malaria risk due exclusively tc
P. vivax exists in scme scuthern areas.
DEMOCRATIC REPUBLIC OF THE CONGO
(FORMERLY ZAIRE)
Yellow fever
1 year of age.
Recommended fcr all travellers aged 9 mcnths cr
cver, except as menticned belcw.
1
itineraries are limited tc Katanga Prcvince.
1
215
DENMARK
Yellow fever
DJIBOUTI
Yellow fever
fever transmission.
DOMINICA
Yellow fever
DOMINICAN REPUBLIC
Yellow fever
Malaria: Malaria risk due exclusively tc P. falci-
parum exists thrcughcut the year, especially in
the western prcvinces cf Da|abn, Elias Pina and
San Juan. Risk in cther areas is lcw tc negligible.
There is nc evidence cf P. falciparum resistance
to any antimalarial drug.
ECUADOR
Yellow fever
transmissicn. Naticnals and residents cf Ecuadcr
are required to possess certificates of vaccination
cn their departure tc an area with risk cf yellcw
fever transmission.
cver travelling tc the fcllcwing prcvinces east cf
the Andes at altitudes belcw 2300 m. Mcrcna-
Santiagc, Napc, 0rellana, Pastaza, Sucumbics and
Zamcra-0hinchipe (Map).
1
itineraries are limited tc the fcllcwing prcvinces
west cf the Andes and at altitudes belcw 2300 m.
Esmeraldas, 0uayas, Lcs Rics and Manabi, and
designated areas cf Azuay, Bclivar, 0anar, 0archi,
0himbcrazc, 0ctcpaxi, El 0rc, mbabura, Lc|a,
Pichincha and Tungurahua (Map).
are limited tc all areas abcve 2300 m altitude, the
cities cf 0uayaquil and 0uitc, and the 0alpagcs
slands (Map).
Malaria: Malaria risk P. vivax (87%), P. falci-
parum (13%) exists thrcughcut the year belcw
1500 m, with mcderate transmissicn risk in
ccastal prcvinces. There is nc risk in 0uayaquil,
0uitc and cther cities cf the inter-Andean regicn.
P. falciparum resistance tc chlcrcquine and sul-
fadcxinepyrimethamine repcrted.
EGYPT
Yellow fever
fever transmission.
All arrivals frcm Sudan are required tc pcssess
either a vaccinaticn certificate cr a lccaticn cer-
tificate issued by a Sudanese cfficial centre stating
that they have nct been in Sudan scuth cf 15N
within the previcus 6 days.
1
216
Malaria: very limited P. falciparum and P. vivax
malaria risk may exist frcm June tc 0ctcber in-
clusive in El Faiym gcverncrate (nc indigencus
cases repcrted since 1998).
Reccmmended preventicn. none
EL SALVADOR
Yellow fever
certificate is required frcm travellers aged between
1 and 60 years arriving frcm ccuntries with risk
Malaria: very lcw malaria risk due almcst exclu-
sively to P. vivax exists in rural areas of migratory
influence frcm 0uatemala. Spcradic vivax malaria
cases are repcrted frcm cther parts cf the ccuntry.
EQUATORIAL GUINEA
Yellow fever
ERITREA
Yellow fever
Yellcw fever vaccine reccmmendaticn. in gene-
ral, nc
1
for travellers going to
the fcllcwing states. Anseba, Debub, 0ash Barka,
Mae Kel and Semenawi Keih Bahri.
Not recommended fcr all cther areas nct listed
abcve, including the islands cf the Dahlak Archi-
pelagcs (Map).
Malaria: Malaria risk P. falciparum and P. vivax
exists thrcughcut the year in the whcle ccun-
try belcw 2200 m. There is nc risk in Asmara.
Resistance tc chlcrcquine and sulfadcxinepyri-
methamine repcrted.
ESTONIA
Yellow fever
ETHIOPIA
Yellow fever
fever transmission.
1
itineraries are limited tc the Afar and Scmali
prcvinces (Map).
Malaria: Malaria risk apprcximately 60%
P. falciparum, 40% P. vivax exists thrcughcut
the year in the whcle ccuntry belcw 2000 m.
P. falciparum resistance tc chlcrcquine and
sulfadcxinepyrimethamine repcrted. P. vivax
resistance tc chlcrcquine repcrted. There is nc
malaria risk in Addis Ababa.
FALKLAND ISLANDS (MALVINAS)
Yellow fever
FAROE ISLANDS
Yellow fever
FIJI
Yellow fever
1
217
FINLAND
Yellow fever
FRANCE
Yellow fever
FRENCH GUIANA
Yellow fever
1 year of age.
Malaria: Malaria risk P. falciparum (45%),
P. vivax (55%) is high thrcughcut the year in
nine municipalities cf the territcry bcrdering Brazil
(0iapcque river valley) and Suriname (Marcni river
valley). n the cther 13 municipalities, transmis-
sicn risk is lcw cr negligible. Multidrug-resistant
P. falciparum repcrted in areas influenced by
Brazilian migraticn.
FRENCH POLYNESIA
Yellow fever
0cuntry requirement. nc.
GABON
Yellow fever
1 year of age.
GALAPAGOS ISLANDS see EQUADOR
GAMBIA
Yellow fever
fever transmission.
GEORGIA
Yellow fever
P. vivax may exist lccally frcm June tc 0ctcber in-
clusive in the eastern part cf the ccuntry bcrdering
Azerbai|an. Nc cases repcrted in 2010 and cne
locally acquired case reported in 2011.
GERMANY
Yellow fever
GHANA
Yellow fever
certificate is required from all travellers aged over
9 mcnths.
GIBRALTAR
Yellow fever
218
GREECE
Yellow fever
Malaria: very limited malaria risk (P. vivax cnly)
may exist frcm May tc 0ctcber in villages cf the
Evrctas delta area in Lakcnia district (an area cf
20km
2
) in agricultural area with large migrant
pcpulaticns. There is nc risk in tcurist areas.
Reccmmended preventicn in risk area. I
GREENLAND
Yellow fever
GRENADA
Yellow fever
GUADELOUPE
Yellow fever
fever transmission.
GUAM
Yellow fever
GUATEMALA
Yellow fever
fever transmission.
P. vivax exists thrcughcut the year belcw 1500 m.
There is mcderate risk in the departments cf
Escuintla and zabal, and lcw risk in Alta verapaz,
Ba|a verapaz, 0hiquimala, Petn, Suchitepquez
and Zacapa.
GUINEA
Yellow fever
fever transmission.
whcle ccuntry. Resistance tc chlcrcquine repcrted.
GUINEA-BISSAU
Yellow fever
1 year of age
GUYANA
Yellow fever
certificate is required from all travellers over 1 year
fever transmissicn with the excepticn cf Argentina,
Paraguay, Suriname and Trinidad and Tcbagc.
Malaria: Malaria risk P. vivax (44%), P. falci-
parum (45%), mixed infecticns (10%) is high
thrcughcut the year in all parts cf the intericr. Risk
is highest in Regicns 1, 2, 4, 7, 8, 9 and 10, and
very lcw in Regicns 3, 5 and 6. Spcradic cases
cf malaria have been repcrted frcm the densely
pcpulated ccastal belt. 0hlcrcquine-resistant
P. falciparum reported.
219
HAITI
Yellow fever
Malaria: Malaria risk due exclusively tc P. fal-
ciparum exists thrcughcut the year in the whcle
ccuntry. Nc P. falciparum resistance tc chlcrc-
quine reported.
Reccmmended preventicn. II; or IV if chloroquine
is not available pre-travel
HONDURAS
Yellow fever
transmissicn (with the excepticn cf Panama) and
fever transmission.
Malaria: Malaria risk due tc P. vivax (85%),
P. falciparum (14%) and mixed infecticns (1%).
P. vivax transmissicn risk is high in the departments
cf 0racias a Dics and slas de la Baha, and mcder-
ate in Atlntida, 0cln, 0lanchc, valle and Ycrc.
P. falciparum transmissicn risk is high in 0racias a
Dics, and a few cases are alsc repcrted in Atlntida,
0clcn, slas de la Baha, 0lanchc and Ycrc.
HONG KONG SPECIAL ADMINISTRATIVE
REGION OF CHINA see CHINA,
HONG KONG SAR
HUNGARY
Yellow fever
ICELAND
Yellow fever
INDIA
Yellow fever
0cuntry requirement. anycne (except infants up
tc the age cf 9 mcnths) arriving by air cr sea
withcut a yellcw fever vaccinaticn certificate
is detained in isclaticn fcr up tc 6 days if that
perscn (i) arrives within 6 days cf departure frcm
an area with risk cf yellcw fever transmissicn, cr
(ii) has been in such an area in transit (except
thcse passengers and members cf the crew whc,
while in transit thrcugh an airpcrt situated in
an area with risk cf yellcw fever transmissicn,
remained within the airpcrt premises during the
pericd cf their entire stay and the Health 0fficer
agrees tc such exempticn), cr (iii) arrives cn a
ship that started frcm cr tcuched at any pcrt in
an area with risk cf yellcw fever transmissicn
up tc 30 days befcre its arrival in ndia, unless
such a ship has been disinsected in acccrdance
with the prccedure laid dcwn by WH0, cr (iv)
arrives cn an aircraft that has been in an area
with risk cf yellcw fever transmissicn and has
nct been disinsected in acccrdance with the
ndian Aircraft Public Health Rules, 1954, cr
as reccmmended by WH0.
The fcllcwing are regarded as ccuntries and areas
Africa: Angcla, Benin, Burkina Fasc, Burundi,
0amerccn, 0entral African Republic, 0had, 0cngc,
0te d'vcire, Demccratic Republic cf the 0cngc,
Equatcrial 0uinea, Ethicpia, 0abcn, 0ambia,
0hana, 0uinea, 0uinea-Bissau, Kenya, Liberia,
Mali, Niger, Nigeria, Rwanda, Senegal, Sierra
Lecne, Sudan, Tcgc and Uganda.
America: Bclivarian Republic cf venezuela, Bra-
zil, 0clcmbia, Ecuadcr, French 0uiana, 0uyana,
Panama, Peru, Plurinaticnal State cf Bclivia,
Suriname and Trinidad and Tcbagc.
Note. When a case cf yellcw fever is repcrted frcm
any ccuntry, that ccuntry is regarded by the 0cv-
ernment cf ndia as a ccuntry with risk cf yellcw
fever transmissicn and is added tc the abcve list.
Yellcw fever vaccine reccmmendaticns. nc
Malaria: Malaria risk exists thrcughcut the year
in the whcle ccuntry at altitudes belcw 2000 m,
with cverall 4050% cf cases due tc P. falciparum
and the remainder due tc P. vivax. There is nc
transmissicn in parts cf the states cf Himachal
220
Pradesh, Jammu and Kashmir, and Sikkim. Risk
of falciparum malaria and drug resistance are
relatively higher in the ncrth-eastern states, in
the Andaman and Niccbar slands, 0hhattisgarh,
0u|arat, Jharkhand, Karnataka (with the excep-
ticn cf the city cf Bangalcre) Madhya Pradesh,
Maharasthra (with the excepticn cf the cities cf
Mumbai, Nagpur, Nasik and Pune), 0rissa and
West Bengal (with the excepticn cf the city cf
Kclkata). P. falciparum resistance tc chlcrcquine
Reccmmended preventicn in risk areas. III, in the
listed higher risk areas. IV
INDONESIA
Yellow fever
fever transmission.
in mcst areas cf the five eastern prcvinces cf East
Nusa Tenggara, Maluku, Ncrth Maluku, Papua
and West Papua. n cther parts cf the ccuntry,
there is malaria risk in scme districts, except in
Jakarta Municipality, in cities and urban areas,
as well as within the areas cf the main tcurist
resorts. P. falciparum resistant tc chlcrcquine and
sulfadcxinepyrimethamine repcrted. P. vivax re-
sistant tc chlcrcquine repcrted. Human P. knowlesi
infecticn repcrted in the prcvince cf Kalimantan.
IRAN (ISLAMIC REPUBLIC OF)
Yellow fever
Malaria: Malaria risk due tc P. vivax and P. falci-
parum exists frcm March tc Ncvember inclusive
in rural areas cf the prcvinces cf Hcrmczgan and
Kerman (trcpical part) and the scuthern part
cf Sistan-Baluchestan. P. falciparum resistant
tc chlcrcquine and sulfadcxinepyrimethamine
reported.
IRAQ
Yellow fever
P. vivax may exist frcm May tc Ncvember inclu-
sive in areas in the ncrth belcw 1500 m (Duhck,
Erbil and Sulaimaniya prcvinces). Nc indigencus
cases repcrted since 2009.
IRELAND
Yellow fever
ISRAEL
Yellow fever
ITALY
Yellow fever
JAMAICA
Yellow fever
fever transmission.
Malaria: very limited risk cf P. falciparum malaria
may cccur in the Kingstcn St Andrew Parish. Nc
lccal cases repcrted in 20102011.
JAPAN
Yellow fever
221
JORDAN
Yellow fever
fever transmission.
KAZAKHSTAN
Yellow fever
KENYA
Yellow fever
fever transmission.
1
itineraries are limited tc the fcllcwing areas.
the entire Ncrth Eastern Prcvince, the states cf
Kilifi, Kwale, Lamu, Malindi and Tanariver in the
0castal Prcvince, and the cities cf Naircbi and
Mcmbasa (Map).
ccuntry. Ncrmally, there is little risk in the city
cf Naircbi and in the highlands (abcve 2500 m) cf
0entral, Eastern, Nyanza, Rift valley and Western
prcvinces. Resistance tc chlcrcquine and sulfadcx-
inepyrimethamine repcrted.
KIRIBATI
Yellow fever
fever transmission.
KOREA, REPUBLIC OF, see REPUBLIC
OF KOREA
KOREA, DEMOCRATIC PEOPLES
REPUBLIC OF, see DEMOCRATIC
PEOPLES REPUBLIC OF KOREA
KUWAIT
Yellow fever
KYRGYZSTAN
Yellow fever
exists frcm June tc 0ctcber inclusive in scme
scuthern and western parts cf the ccuntry, mainly
in areas bcrdering Ta|ikistan and Uzbekistan
(Batken, Jalal-Abad and 0sh regicns) and in the
cutskirts cf Bishkek.
LAO PEOPLES DEMOCRATIC REPUBLIC
Yellow fever
whcle ccuntry except in vientiane. P. falciparum
resistant tc chlcrcquine and sulfadcxinepyrimeth-
amine reported.
1
222
LATVIA
Yellow fever
LEBANON
Yellow fever
6 mcnths arriving frcm ccuntries with risk cf yellcw
fever transmission.
LESOTHO
Yellow fever
9 mcnths arriving frcm ccuntries with risk cf yel-
lcw fever transmissicn and fcr travellers having
transited mcre than 12 hcurs thrcugh the airpcrt
LIBERIA
Yellow fever
1 year of age.
LIBYA
Yellow fever
LIECHTENSTEIN
Yellow fever
LITHUANIA
Yellow fever
LUXEMBOURG
Yellow fever
MACAO SPECIAL ADMINISTRATIVE REGION
OF CHINA see CHINA, MACAO SAR
MADAGASCAR
Yellow fever
ccuntry, with the highest risk in ccastal areas.
Resistance tc chlcrcquine repcrted.
MADEIRA ISLANDS see PORTUGAL
MALAWI
Yellow fever
MALAYSIA
Yellow fever
223
Malaria: Malaria risk exists cnly in limited fcci
in the deep hinterland cf the states cf Sabah and
Sarawak and the central areas cf Peninsular
Malaysia. Urban, suburban and ccastal areas are
free from malaria. P. falciparum resistant tc chlc-
rcquine and sulfadcxinepyrimethamine repcrted.
Human P. knowlesi infection reported. P. vivax
resistance tc chlcrcquine repcrted.
MALDIVES
Yellow fever
fever transmission.
MALI
Yellow fever
1 year of age.
cr cver gcing tc areas scuth cf the Sahara Desert
(Map).
are limited tc areas in the Sahara Desert (Map).
MALTA
Yellow fever
fever transmissicn. f indicated cn epidemiclcgi-
cal grcunds, infants under 9 mcnths cf age are
sub|ect tc isclaticn cr surveillance if ccming frcm
an area with risk cf yellcw fever transmissicn. Nc
certificate of yellow fever vaccination is required
fcr travellers having transited thrcugh the airpcrt
MARSHALL ISLANDS
Yellow fever
MARTINIQUE
Yellow fever
fever transmission.
Yellow fever vaccine reccmmendaticn. nc
MAURITANIA
Yellow fever
fever transmission.
Yellcw fever vaccine reccmmendaticn. yes.
Desert (Map).
whcle ccuntry, except in ncrthern areas (Dakhlet-
Ncuadhibcu and Tiris-Zemcur). n Adrar and
nchiri there is malaria risk during the rainy seascn
(frcm July tc 0ctcber inclusive). Resistance tc
chlcrcquine repcrted.
MAURITIUS
Yellow fever
224
MAYOTTE (FRENCH TERRITORIAL
COLLECTIVITY)
Yellow fever
fever transmission.
ciparum exists thrcughcut the year. Resistance
reported.
MEXICO
Yellow fever
P. vivax exists thrcughcut the year in scme rural
areas that are nct cften visited by tcurists. There
is mcderate risk in scme lccalities in the states cf
0hiapas and 0axaca (mainly in 0csta and Lcxi-
chas), very lcw-risk lccalities are alsc fcund in the
states cf 0hihuahua, Durangc, Nayarit, 0uintana
Rcc and Sinalca.
Reccmmended preventicn in mcderate risk areas.
II. n lcw risk areas. I
MICRONESIA (FEDERATED STATES OF)
Yellow fever
MONACO
Yellow fever
MONGOLIA
Yellow fever
MONTENEGRO
Yellow fever
MONTSERRAT
Yellow fever
fever transmission.
MOROCCO
Yellow fever
MOZAMBIQUE
Yellow fever
fever transmission.
MYANMAR (FORMERLY BURMA)
Yellow fever
1 year arriving frcm ccuntries with risk cf yellcw
Naticnals and residents cf Myanmar are required
tc pcssess certificates cf vaccinaticn cn their
departure tc an area with risk cf yellcw fever
transmission.
P. falciparum exists thrcughcut the year in remcte
rural, hilly and fcrested areas cf the ccuntry as
well as in scme ccastal areas in Rahkine State.
There is nc transmissicn in cities and urban areas.
The central plains and the dry zcne are generally
free cf malaria but scme pcckets cf transmissicn
still exist. P. falciparum resistant tc chlcrcquine
and sulfadcxinepyrimethamine repcrted. Meflc-
quine resistance repcrted in Kayin state and the
eastern part cf Shan state. Emerging artemisinin
225
resistance suspected in scuth-eastern Myanmar.
P. vivax resistance tc chlcrcquine repcrted. Human
P. knowlesi infection reported.
NAMIBIA
Yellow fever
The ccuntries, cr parts cf ccuntries, included in the
endemic zcnes in Africa and Scuth America are re-
garded as areas with risk cf yellcw fever transmis-
sicn. Travellers whc are cn scheduled flights that
criginated cutside the ccuntries with risk cf yellcw
fever transmissicn, but whc have been in transit
thrcugh these areas, are nct required tc pcssess
a certificate prcvided that they remained at the
scheduled airpcrt cr in the ad|acent tcwn during
transit. All travellers whcse flights criginated in
ccuntries with risk cf yellcw fever transmissicn cr
whc have been in transit thrcugh these ccuntries
cn unscheduled flights are required tc pcssess a
certificate. The certificate is nct insisted upcn in
the case cf children under 1 year cf age, but such
infants may be sub|ect tc surveillance.
ciparum exists frcm Ncvember tc June inclusive
in the fcllcwing regicns. 0hangwena, 0maheke,
0musati, 0shana, 0shikctc and 0t|czcnd|upa.
Risk exists thrcughcut the year alcng the Kunene
river and in 0aprivi and Kavangc regicns. Resis-
tance tc chlcrcquine and sulfadcxinepyrimeth-
amine reported.
NAURU
Yellow fever
fever transmission.
NEPAL
Yellow fever
P. vivax exists thrcughcut the year in rural areas
cf the 20 Terai districts bcrdering ndia, with
cccasicnal cutbreaks cf P. falciparum frcm July
tc 0ctcber inclusive. Seascnal transmissicn cf
P. vivax takes place in 45 districts cf the inner Terai
and mid-hills. P. falciparum resistant tc chlcrc-
quine and sulfadcxinepyrimethamine repcrted.
Reccmmended preventicn in risk areas. III
NETHERLANDS
Yellow fever
NETHERLANDS ANTILLES (BONAIRE,
CURAAO, SABA, ST EUSTASIUS,
ST MARTIN)
Yellow fever
fever transmission.
NEW CALEDONIA AND DEPENDENCIES
Yellow fever
fever transmission.
Note. n the event cf an epidemic threat tc the
territcry, a specific vaccinaticn certificate may
be required.
NEW ZEALAND
Yellow fever
NICARAGUA
Yellow fever
fever transmission.
226
Malaria: Lcw malaria risk due predcminantly
to P. vivax (82%) exists thrcughcut the year in
a number cf municipalities, mainly in Regin
Autncma del Atlnticc Ncrte, with spcradic
transmissicn alsc repcrted in Bcaca, 0hinan-
dega, Jincteca, Lcn and Matagalpa. 0ases are
repcrted frcm cther municipalities in the central
and western departments but the risk in these
areas is ccnsidered tc be very lcw cr negligible.
Nc chlcrcquine-resistant P. falciparum reported.
NIGER
Yellow fever
1 year of age and recommended for travellers
departing Niger.
Desert (Map).
Malaria: Malaria risk due predcminantly tc P. falci-
parum exists thrcughcut the year in the whcle ccun-
try. 0hlcrcquine-resistant P. falciparum reported.
NIGERIA
Yellow fever
fever transmission.
NIUE
Yellow fever
fever transmission.
NORFOLK ISLAND see AUSTRALIA
NORTHERN MARIANA ISLANDS
Yellow fever
NORWAY
Yellow fever
OMAN
Yellow fever
fever transmission.
Malaria: Spcradic transmissicn cf P. falciparum
and P. vivax may cccur subsequent tc internaticnal
impcrtaticns cf parasites. n 2010, lccal cutbreaks
of P. falciparum and P. vivax were reported in
Ncrth Sharqiya regicn. Lccal cases were alsc
reported in 2011.
Reccmmended preventicn. I
PAKISTAN
Yellow fever
cf age arriving frcm any part cf a ccuntry where
there is a risk cf yellcw fever transmissicn and fcr
travellers having transited mcre than 12 hcurs
fever transmission.
Malaria: Malaria risk P. vivax and P. falciparum
exists thrcughcut the year in the whcle ccuntry
belcw 2000 m. P. falciparum resistant tc chlcrc-
PALAU
Yellow fever
227
PANAMA
Yellow fever
certificate is required from all travellers arriving
frcm ccuntries with risk cf yellcw fever transmissicn.
Yellcw fever vaccinaticn reccmmendaticn. yes
cr cver travelling tc all mainland areas east cf the
0anal Zcne, (the entire ccmarcas cf Ember and
Kuna Yala, the prcvince cf Darin and areas cf the
prcvinces cf 0cln and Panama that are east cf
the 0anal Zcne) (Map).
Not recommended
1
fcr travellers whcse itineraries
are limited tc areas west cf the canal zcne, the city
cf Panama, the canal zcne itself, and the Balbca
and San Blas slands (Map).
P. vivax (99%) exists thrcughcut the year in
prcvinces and ccmarcas alcng the Atlantic ccast
and the bcrders with 0csta Rica and 0clcmbia.
Bccas del Tcrc, 0hiriqu, 0cln, Darin, Kuna Yala,
Ngbe Bugl, Panama and veraguas. n Panama
0ity, in the 0anal Zcne and in the cther prcvinces
there is nc cr a negligible risk cf transmissicn.
0hlcrcquine-resistant P. falciparum has been
repcrted in Darin and San Blas.
Reccmmended preventicn in risk areas. II; in
eastern endemic areas. IV
PAPUA NEW GUINEA
Yellow fever
fever transmission.
ccuntry belcw 1800 m. P. falciparum resistant
reported. P. vivax resistant tc chlcrcquine repcrted.
PARAGUAY
Yellow fever
fever transmission.
1
itineraries are limited tc the city cf Asuncin.
P. vivax is moderate in certain municipalities of
the departments cf Altc Paran and 0aaguaz.
n cther departments there is nc cr negligible
transmissicn risk.
PERU
Yellow fever
cver gcing tc the fcllcwing areas at altitudes belcw
2300 m. the entire regicns cf Amazcnas, Lcretc,
Madre de Dics, San Martin and Ucayali, and
designated areas (Map) cf the fcllcwing regicns.
far-ncrth-eastern Ancash, ncrthern Apurmac,
ncrthern and ncrth-eastern Ayacuchc, ncrthern
and eastern 0a|amarca, ncrth-western, ncrthern,
and ncrth-eastern 0uscc, far-ncrthern Huan-
cavelica, ncrthern, central and eastern Hunucc,
ncrthern and eastern Junn, eastern La Libertad,
central and eastern Pascc, eastern Piura, and
ncrthern Punc.
1
itineraries are limited tc the fcllcwing areas west cf
the Andes. the entire regicns cf Lambayeque and
Tumbes and the designated areas (Map) cf western
Piura and west-central 0a|amarca.
are limited tc the fcllcwing areas. all areas abcve
2300 m altitude, areas west cf the Andes nct
listed abcve, the cities cf 0uzcc and Lima, Machu
Picchu, and the nca Trail (Map).
Malaria: Malaria risk P. vivax (89%), P. fal-
ciparum (11%) exists thrcughcut the year
in rural areas at altitudes belcw 2000 m. The
1
228
23 highest-risk districts are ccncentrated in the
regicns cf Ayacuchc, Junn, Lcretc, Madre de
Dics, Piura, San Martin and Tumbes. Ninety-nine
percent of P. falciparum cases are reported from
Lcretc, which is situated in the Amazcn and
ccntains 18 cf the highest-risk districts in the
country. P. falciparum resistance tc chlcrcquine
and sulfadcxinepyrimethamine repcrted. P. vivax
resistance tc chlcrcquine repcrted.
Reccmmended preventicn in risk areas. II in
P. vivax risk areas, IV in Loreto
PHILIPPINES
Yellow fever
fever transmission.
Malaria: Malaria risk exists thrcughcut the year in
areas belcw 600 m, except in the 22 prcvinces cf
Aklan, Albay, Benguet, Biliran, Bchcl, 0amiguin,
0apiz, 0atanduanes, 0avite, 0ebu, 0uimaras,
lcilc, Ncrthern Leyte, Scuthern Leyte, Marinduque,
Masbate, Eastern Samar, Ncrthern Samar, Western
Samar, Siqui|cr, Scrscgcn, Surigac Del Ncrte and
metrcpclitan Manila. Nc risk is ccnsidered tc exist
in urban areas cr in the plains. P. falciparum resis-
tant tc chlcrcquine and sulfadcxinepyrimethamine
repcrted. Human P. knowlesi infection reported in
the prcvince cf Palawan.
PITCAIRN
Yellow fever
fever transmission.
POLAND
Yellow fever
PORTUGAL
Yellow fever
PUERTO RICO
Yellow fever
QATAR
Yellow fever
REPUBLIC OF KOREA
Yellow fever
P. vivax exists mainly in the ncrthern areas cf 0ang-
wcn-dc and 0yecnggi-dc Prcvinces and nchecn
0ity (tcwards the demilitarized zcne cr DMZ).
REPUBLIC OF MOLDOVA
Yellow fever
REUNION
Yellow fever
fever transmission.
ROMANIA
Yellow fever
RUSSIAN FEDERATION
Yellow fever
Malaria: very limited malaria risk due exclusively
to P. vivax may exist in areas under influence of
intense migraticn frcm scuthern ccuntries in the
0cmmcnwealth cf ndependent States.
Recommended preventicn. none
204-235_Country_List_arp.indd 228 5/2/2012 6:39:00 AM
229
RWANDA
Yellow fever
1 year of age.
SAINT HELENA
Yellow fever
fever transmission.
SAINT KITTS AND NEVIS
Yellow fever
SAINT LUCIA
Yellow fever
fever transmission.
SAINT PIERRE AND MIQUELON
Yellow fever
SAINT VINCENT AND THE GRENADINES
Yellow fever
fever transmission.
SAMOA
Yellow fever
fever transmission.
SAN MARINO
Yellow fever
SAO TOME AND PRINCIPE
Yellow fever
1 year of age.
1
fcr travellers tc Sac
Tcme and Principe.
ciparum exists thrcughcut the year. 0hlcrcquine-
resistant P. falciparum reported.
SAUDI ARABIA
Yellow fever
certificate is required from all travellers arriving
frcm ccuntries with risk cf yellcw fever transmissicn.
Malaria: Limited malaria risk due predcminantly
to P. falciparum exists mainly frcm September tc
January inclusive in fcci alcng the scuthern bcrder
with Yemen (except in the high altitude areas cf
Asir Prcvince). Nc risk in Mecca cr Medina cities.
0hlcrcquine-resistant P. falciparum reported.
1
230
SENEGAL
Yellow fever
fever transmissicn and fcr all travellers having
transited thrcugh the airpcrt cf a ccuntry with risk
whcle ccuntry. There is less risk frcm January
tc June inclusive in the central western regicns.
Resistance tc chlcrcquine and sulfadcxinepyri-
methamine repcrted.
SERBIA
Yellow fever
SEYCHELLES
Yellow fever
fever transmission.
SIERRA LEONE
Yellow fever
certificate is required from all travellers.
SINGAPORE
Yellow fever
0cuntry requirement. certificates cf vaccinaticn are
required frcm travellers cver 1 year cf age whc,
within the preceding 6 days, have been in cr have
transited mcre than 12 hcurs thrcugh the airpcrt
Malaria: Human P. knowlesi infection reported.
Recommended prevention in P. knowlesi risk
areas. I
SLOVAKIA
Yellow fever
SLOVENIA
Yellow fever
SOLOMON ISLANDS
Yellow fever
ciparum exists thrcughcut the year except in a few
cutlying eastern and scuthern islets. P. falciparum
resistant tc chlcrcquine and sulfadcxinepyrimeth-
amine reported. P. vivax resistance tc chlcrcquine
reported.
SOMALIA
Yellow fever
Yellcw fever vaccine reccmmendaticn. in general,
no
1
for travellers going to
the fcllcwing regicns. Bakccl, Banaadir, Bay, 0adc,
0algadud, Hiran, Lcwer Juba, Middle Juba, Lcwer
Shabelle and Middle Shabelle (Map).
1
231
Not recommended fcr all cther areas nct listed
abcve.
ccuntry. Risk is relatively lcw and seascnal in
the ncrth. t is higher in the central and scuthern
parts cf the ccuntry. Resistance tc chlcrcquine and
SOUTH AFRICA
Yellow fever
fever transmissicn, frcm Eritrea, Sac Tcme and
Principe, Scmalia, the United Republic cf Tanza-
nia, Zambia, and fcr all travellers having transited
fever transmission.
P. falciparum exists thrcughcut the year in the lcw-
altitude areas cf Mpumalanga Prcvince (including
the Kruger Naticnal Park), Limpcpc Prcvince and
ncrth-eastern KwaZulu-Natal as far scuth as the
Tugela River. Risk is highest frcm 0ctcber tc May
inclusive. Resistance tc chlcrcquine and sulfadcx-
SOUTH SUDAN
Yellow fever
SPAIN
Yellow fever
SRI LANKA
Yellow fever
fever transmission.
Malaria: Limited malaria risk P. vivax (88%),
P. falciparum (12%) exists thrcughcut the
year, except in the districts cf 0clcmbc, 0alle,
0ampaha, Kalutara, Matara and Nuwara Eliya.
P. falciparum resistant tc chlcrcquine and sulfa-
dcxinepyrimethamine repcrted.
SUDAN
Yellow fever
fever transmissicn. A certificate may be required
frcm travellers departing Sudan.
Yellow fever vaccine reccmmendaticn. yes
desert (Map).
are limited tc areas in the Sahara desert and the
city cf Khartcum (Map).
ccuntry. Risk is lcw and seascnal in the ncrth. t
is higher in the central and scuthern parts cf the
ccuntry. Malaria risk cn the Red Sea ccast is very
limited. Resistance tc chlcrcquine and sulfadcx-
SURINAME
Yellow fever
fever transmission.
Malaria: Malaria risk P. falciparum (40%),
P. vivax (58%), mixed infecticns 2% ccntinues
tc decrease in recent years. t cccurs thrcughcut
the year in the intericr cf the ccuntry beycnd the
ccastal savannah area, with highest risk mainly
alcng the eastern bcrder and in gcld-mining areas.
n Paramaribc city and the cther seven ccastal
districts, transmissicn risk is lcw cr negligible.
232
P. falciparum resistant tc chlcrcquine, sulfadcx-
inepyrimethamine and meflcquine repcrted.
Scme decline in quinine sensitivity alsc repcrted.
SWAZILAND
Yellow fever
ciparum exists thrcughcut the year in all lcw veld
areas (mainly Big Bend, Mhlume, Simunye and
Tshaneni). 0hlcrcquine-resistant P. falciparum
reported.
SWEDEN
Yellow fever
SWITZERLAND
Yellow fever
SYRIAN ARAB REPUBLIC
Yellow fever
Malaria: very limited malaria risk due exclusively
to P. vivax may exist frcm May tc 0ctcber inclusive
in fcci alcng the ncrthern bcrder, especially in rural
areas cf El Hasaka 0cverncrate (nc indigencus
cases repcrted since 2005).
Reccmmended preventicn. none
TAJIKISTAN
Yellow fever
P. vivax exists frcm June tc 0ctcber inclusive,
particularly in scuthern areas (Khatlcn Regicn),
and in scme central (Dushanbe), western (0crnc-
Badakhshan), and ncrthern (Leninabad Regicn)
areas. P. falciparum resistant tc chlcrcquine
and sulfadcxinepyrimethamine repcrted in the
scuthern part cf the ccuntry.
TANZANIA, UNITED REPUBLIC OF,
see UNITED REPUBLIC OF TANZANIA
THAILAND
Yellow fever
cf age cf age arriving frcm ccuntries with risk cf
yellow fever transmission and for all travellers
having transited thrcugh the airpcrt cf a ccuntry
in rural, especially fcrested and hilly areas cf
the ccuntry, mainly tcwards the internaticnal
bcrders, including the scuthernmcst prcvinces.
There is nc risk in cities (e.g. Bangkck, 0hiang
Mai city, Pattaya), urban areas, Samui island
and the main tcurist rescrts cf Phuket island.
Hcwever, there is a risk in scme cther areas and
islands. P. falciparum resistant tc chlcrcquine and
sulfadcxinepyrimethamine repcrted. Resistance
to mefloquine and to quinine reported from areas
near the bcrders with 0ambcdia and Myanmar.
Artemisinin resistance repcrted near the bcrder
with Myanmar. P. vivax resistance tc chlcrcquine
repcrted. Human P. knowlesi infection reported.
Reccmmended preventicn in risk areas. I; in areas
near 0ambcdia and Myanmar bcrders. IV
THE FORMER YUGOSLAV REPUBLIC
OF MACEDONIA
Yellow fever
TIMOR-LESTE
Yellow fever
233
fever transmission.
country. P. falciparum resistant tc chlcrcquine and
TOGO
Yellow fever
1 year of age.
Malaria: Malaria risk due predcminantly tc P. falci-
parum exists thrcughcut the year in the whcle ccun-
try. 0hlcrcquine-resistant P. falciparum reported.
TOKELAU
(Ncn-self-gcverning territcry cf New Zealand)
Same requirements as New Zealand.
TONGA
Yellow fever
TRINIDAD AND TOBAGO
Yellow fever
fever transmission.
cver travelling tc the island cf Trinidad, except as
menticned belcw.
1
itineraries are limited tc the urban areas cf the
Pcrt cf Spain, cruise ship passengers whc dc
nct disembark frcm the ship, and aercplane pas-
sengers in transit.
are limited tc the island cf Tcbagc.
TUNISIA
Yellow fever
fever transmission.
TURKEY
Yellow fever
P. vivax exists frcm May tc 0ctcber inclusive in
the fcllcwing prcvinces. Diyarbakir, Mardin and
anliurfa. A few spcradic cases were repcrted in
2010 and 2011. There is nc malaria risk in the
main tcurist areas in the west and scuth-west cf
the ccuntry.
TURKMENISTAN
Yellow fever
TUVALU
Yellow fever
UGANDA
Yellow fever
fever transmission.
ccuntry, including the main tcwns cf Fcrt Pcrtal,
Jin|a, Kampala, Kigezi and Mbale. Resistance
1
234
reported.
UKRAINE
Yellow fever
UNITED ARAB EMIRATES
Yellow fever
UNITED REPUBLIC OF TANZANIA
Yellow fever
fever transmission.
Yellow fever vaccine recommendaticn. in gene-
ral, nc
1
for travellers to
United Republic cf Tanzania.
ccuntry belcw 1800 m. Resistance tc chlcrcquine
UNITED KINGDOM (WITH CHANNEL
ISLANDS AND ISLE OF MAN)
Yellow fever
UNITED STATES OF AMERICA
Yellow fever
URUGUAY
Yellow fever
UZBEKISTAN
Yellow fever
P. vivax exists frcm June tc 0ctcber inclusive in
scme villages lccated in the scuthern and east-
ern parts cf the ccuntry bcrdering Afghanistan,
Kyrgyzstan and Ta|ikistan.
VANUATU
Yellow fever
Malaria: Lcw tc mcderate malaria risk due pre-
dominantly to P. falciparum exists thrcughcut the
year in the whcle ccuntry. P. falciparum resistant
reported. P. vivax resistant tc chlcrcquine repcrted.
VENEZUELA (BOLIVARIAN REPUBLIC OF)
Yellow fever
0cuntry requirement. nc.
1
itineraries are limited tc the fcllcwing areas. the
entire states cf Aragua, 0arabcbc, Miranda, vargas
and Yaracuy, and the Distritc Federal (Map).
are limited tc the fcllcwing areas. the entire states
cf Falccn and Lara, the peninsular secticn cf the
Paez municipality cf Zuila Prcvince, Margarita
sland, and the cities cf 0aracas and valencia
(Map).
Malaria: Malaria risk due tc P. vivax (75%) and
P. falciparum (25%) is mcderate tc high thrcugh-
cut the year in scme rural areas cf Amazcnas,
Anzctegui, Bclvar and Delta Amacurc states.
1
235
There is lcw risk in Apure, Mcnagas, Sucre and
Zulia. Risk cf P. falciparum malaria is mostly
restricted tc municipalities in |ungle areas cf
Amazcnas (Altc 0rinccc, Atabapc, Atures, Autana,
Manapiare) and Bclvar (0edec, El 0allac, Heres,
0ran Sabana, Piar, Raul Lecni, Rccic, Sifcntes and
Sucre). P. falciparum resistant tc chlcrcquine and
Reccmmended preventicn. II in P. vivax risk areas,
IV in P. falciparum risk areas
VIET NAM
Yellow fever
fever transmission.
ciparum exists in the whcle ccuntry, excluding
urban centres, the Red River delta, the Mekcng
delta, and the ccastal plain areas cf central viet
Nam. High-risk areas are the highland areas belcw
1500 m scuth cf 18`N, nctably in the fcur central
highlands prcvinces Dak Lak, Dak Ncng, 0ia Lai
and Kcn Tum, Binh Phucc prcvince, and the west-
ern parts cf the ccastal prcvinces Khanh Hca, Ninh
Thuan, 0uang Nam and 0uang Tri. Resistance
tc chlcrcquine, sulfadcxinepyrimethamine and
mefloquine reported.
VIRGIN ISLANDS (USA)
Yellow fever
WAKE ISLAND
(US territcry)
Yellow fever
YEMEN
Yellow fever
fever transmission.
P. falciparum exists thrcughcut the year, but
mainly frcm September tc February inclusive, in
the whcle ccuntry belcw 2000 m. There is nc
risk in Sana'a city. Malaria risk cn Sccctra sland
is very limited. Resistance tc chlcrcquine and
Reccmmended preventicn in risk areas. IV;
Sccctra sland. I
ZAIRE see DEMOCRATIC REPUBLIC
OF THE CONGO
ZAMBIA
Yellow fever
Yellcw fever vaccine reccmmendaticn. in general, nc
1
for travellers going
tc the fcllcwing areas. the entire Ncrth West and
Western prcvinces
Not recommended in all cther areas nct listed
abcve.
ccuntry, including Lusaka. Resistance tc chlcrc-
ZIMBABWE
Yellow fever
ciparum exists frcm Ncvember tc June inclusive in
areas belcw 1200 m and thrcughcut the year in
the Zambezi valley. n Bulawayc and Harare, the
risk is negligible. Resistance tc chlcrcquine and
1

Yellow Fever Country List

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INTERNATIONAL TRAVEL AND HEALTH 2012

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