ITH2011countrylist (Yellow Fever)

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InternatIonal travel and HealtH 2012

204

Country list1

Yellow fever vaccinationrequirements and recommendations;and malaria situation

Introduction

The inormation provided or each country includes the countrys statedrequirements or yellow ever vaccination, WHO recommendation or travellers

regarding yellow ever vaccinations, and details concerning the malaria situation

and recommended prevention o the disease.2,3

Yellow fever

Yellow fever vaccination

Yellow ever vaccination is carried out or two dierent purposes:

1. To prevent the international spread o the disease by protecting countries rom

the risk o importing or spreading the yellow ever virus. These are requirements

established by the country.

The countries that require proo o vaccination2 are those where the disease may or

may not occur and where the mosquito vector and potential non-human primate

hosts o yellow ever are present. Any importation o the virus into such countries

by inected travellers could result in its propagation and establishment, leading

to a permanent risk o inection or the human population. Proo o vaccination

is oten required or travellers arriving rom countries with risk o yellow ever

transmission and sometimes or travellers in transit through such countries.

1 For the purpose o this publication, the terms country and countries cover countries,territories and areas.

2 Please note that the requirements or vaccination o inants over 6 months o age by somecountries are not in accordance with WHOs advice (Chapter 6). Travellers should, however,be inormed that the requirement exists or entry into the countries concerned.

3 WHO publishes these requirements or inormational purposes only; this publication doesnot constitute an endorsement or confrmation that such requirements are in accordancewith the provisions o the International Health Regulations.


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Country lIst: yellow fever vaCCInatIon requIrements and reCommendatIons

A meeting o yellow ever experts organized in 2010 proposed that under 12 h o

airport transit the risk o yellow ever is almost non-existent and thereore that a

proo o vaccination might not be necessary. This inormation is being provided

to WHO Member States, but travellers are recommended to consult individual

country requirements by contacting the embassy(ies) o the country(ies) they

intend to visit. It should be noted that some countries require proo o vaccination

rom all travellers.

Countries requiring yellow ever vaccination or entry do so in accordance with the

International Health Regulations. Country requirements are subject to change at

any time. Updates can be ound at: http://www.who.int/ith. This chapter contains

inormation on yellow ever 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 ever inec-

tion.

The risk o yellow ever transmission depends on the presence o the virus in

the country in humans, mosquitoes or animals. As yellow ever is requently

atal or those who have not been vaccinated, vaccination is recommended or all

travellers (with ew exceptions, Chapter 6) visiting areas where there is a risk o

yellow ever transmission.

WHO determines those areas where a risk o yellow ever transmission is

present on the basis o the diagnosis o cases o yellow ever in humans and/or

animals, the results o yellow ever sero-surveys and the presence o vectors and

animal reservoirs.4

Decisions regarding the use o yellow ever vaccine or travellers must weigh several

actors, including the risk o travel-associated yellow ever virus disease, country

requirements, and the potential or serious adverse events ollowing yellow ever

vaccination (Chapter 6).

4 More extensive descriptions o the classifcations that defne areas with risk o yellow evervirus transmission can be ound at http://www.who.int/ith/YFrisk.pd. These classifca-tions inorm the vaccine recommendations listed here.


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The table below summarizes WHOs revised recommendations or yellow ever

vaccination or travellers.

Yellow fever vaccination category Rationale for recommendation

Recommended Yellow fever vaccination is recommended for all

travellers 9 months old in areas where thereis evidence of persistent or periodic yellow fever

virus transmission.

Generally not recommended Yellow fever vaccination isgenerally not recom-

mended in areas where there is low potentialfor yellow fever virus exposure (no human

yellow fever cases ever reported and evidenceto suggest only low levels of yellow fever virus

transmission in the past). However, vaccinationmight be considered for a small subset of tra-vellers to these areas, who are at increased riskof exposure to mosquitoes or unable to avoidmosquito bites. When considering vaccination,any traveller must take into account the risk ofbeing infected with yellow fever virus, countryentry requirements, as well as individual riskfactors (e.g. age, immune status) for seriousvaccine-associated adverse events.

Annex 1 provides a summary list o countries with risk o yellow ever transmission

in whole or in part, as well as a list o countries that require proo o yellow ever

vaccination as a condition or entry.

Other diseasesCholera. No country reports a requirement or a certifcate o vaccination against

cholera as a condition or entry. For inormation on selective use o cholera vac-

cines, Chapter 6.

Smallpox. Since the global eradication o smallpox was certifed in 1980, WHO

does not recommend smallpox vaccination or travellers.

Other infectious diseases. Inormation on the main inectious disease threats or

travellers, their geographical distribution, and corresponding precautions are

provided in Chapter 5. Chapter 6 provides inormation on vaccine-preventablediseases.


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a The areas where Type III prevention is still an option are parts of Colombia and India, Nepal, SriLanka and Tajikistan. If needed, Type IV prevention can be used instead.

b Alternatively, when travelling to rural areas with multidrug-resistant malaria and only a very low

risk of P. falciparum infection, mosquito bite prevention can be combined with stand-by emergencytreatment.

Malaria risk Type of prevention

Type I Very limited risk of malaria Mosquito bite prevention onlytransmission

Type II Risk of P. vivax malaria only; Mosquito bite preventionor fully chloroquine-sensitive plus chloroquineP. falciparum chemoprophylaxis

Type IIIa Risk of P. vivax and Mosquito bite preventionP. falciparum malaria plus chloroquine+proguaniltransmission, combined with chemoprophylaxisemerging chloroquineresistance

Type IV (1) High risk of P. falciparum Mosquito bite prevention plusmalaria, combined with atovaquoneproguanil,reported antimalarial drug doxycycline or mefloquineresistance; or chemoprophylaxis (select according

(2) Moderate/low risk of to reported resistance pattern)P. falciparum malaria,combined with reportedhigh levels of drug resistanceb

Malaria

General inormation about malaria, its geographical distribution and details o

preventive measures are included in Chapter 7. Protective measures against mos-quito bites are described in Chapter 3. Specifc inormation or each country is

provided in this section, including epidemiological details or 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 o the ollowing

actors: the risk o contracting malaria; the prevailing species o malaria parasites

in the area; the level and spread o drug resistance reported rom the country;

and the possible risk o serious side-eects resulting rom the use o the various

prophylactic drugs. Where Plasmodium falciparum and P. vivax both occur, pre-vention o alciparum 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 o any o the parasite species, including mixed inections.

The numbers I, II, III and IV reer to the type o prevention based on the table

below.


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AFGHANISTAN

Yellow feverCountry requirement: a yellow fever vaccination

certificate is required from travellers arriving fromcountries with risk of yellow fever transmission.

Yellow fever vaccine recommendation: no

Malaria: Malaria risk P. falciparum and P. vivax exists from May to November inclusive below2000 m. P. falciparum resistant to chloroquineand sulfadoxinepyrimethamine reported.

Recommended prevention in risk areas: IV

ALBANIA

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year

of age arriving from countries with risk of yellowfever transmission.


ALGERIA


of age arriving from countries with risk of yellowfever transmission and for travellers having tran-sited more than 12 hours through the airport ofa country with risk of yellow fever transmission.


Malaria: Malaria risk is limited. Small foci oflocal transmission (P. vivax) have previously beenreported in the six southern and south-easternwilayas (Adrar, El Oued, Ghardaia, Illizi, Ouargla,Tamanrasset), with five local cases of P. falciparumtransmission reported in 2010 in areas under the

influence of trans-Saharan migration.Recommended prevention in risk areas: I

AMERICAN SAMOA

Yellow feverCountry requirement: no


ANDORRA

Yellow fever

Country requirement: noYellow fever vaccine recommendation: no

ANGOLAYellow feverCountry requirement: a yellow fever vaccination

certificate is required from all travellers over1 year of age.

Yellow fever vaccine recommendation: yes

Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in thewhole country. Resistance to chloroquine andsulfadoxinepyrimethamine reported.

Recommended prevention: IV

ANGUILLAYellow feverCountry requirement: a yellow fever vaccination

certificate is required from travellers over 1 year ofage arriving from countries with risk of yellow fevertransmission and for all travellers having transitedthrough the airport of a country with risk of yellowfever transmission.


ANTIGUA AND BARBUDAYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 yearof age arriving from countries with risk of yellowfever transmission.


ARGENTINAYellow feverCountry requirement: no


Recommended for all travellers aged 9 months andover going to northern and north-eastern forestedareas of Argentina bordering Brazil and Paraguaywhere altitudes are


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ments in the following provinces, where altitudesare 2300 m and allprovinces and departments not listed above.

Malaria: Malaria risk due exclusively to P. vivaxis very low and is confined to rural areas along

the borders with Plurinational State of Bolivia(lowlands of Salta province) and with Paraguay(lowlands of Chaco and Misiones provinces).

Recommended prevention in risk areas: II

ARMENIA



AUSTRALIA


of age entering Australia within 6 days of having

stayed overnight or longer in a country with riskof yellow fever transmission, excluding GalapagosIslands in Ecuador and limited to Misiones prov-ince in Argentina, but including Sao Toe and Prin-cipe, Somalia and the United Republic of Tanzania.


AUSTRIA



AZERBAIJAN



Malaria: Malaria risk due exclusively to P. vivaxexists from June to October inclusive in lowlandareas, mainly in the area between the Kura andArax rivers. There is no malaria transmission inBaku city (the capital city). Four locally acquired

cases were reported in 2011.

Recommended prevention in risk areas: I

AZORES seePORTUGAL

BAHAMAS




Malaria: Sporadic local transmission of P. falci-parum has been reported in recent years on GreatExuma island only, subsequent to internationalimportation of parasites. No risk on other islands.

Recommended prevention on Great Exuma: I(mosquito bite prevention only)

BAHRAIN




BANGLADESH




Malaria: Malaria risk exists throughout the year,but transmission occurs only in rural areas, in13 of 64 districts. The risk is high in ChittagongHill Tract districts (Bandarban, Rangamati andKhagrachari), Chittagong district and Cox Bazaar

district. Low risk exists in the districts of Hobigonj,Kurigram, Moulvibazar, Mymensingh, Netrakona,Sherpur, Sunamgonj and Sylhet. Most parts ofthe country, including Dhaka City, have no risk ofmalaria. P. falciparum resistant to chloroquine andsulfadoxinepyrimethamine reported.


BARBADOS


of age arriving from countries with risk of yellowfever transmission except Guyana and Trinidad and


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Tobago and for travellers having transited morethan 12 hours through the airport of a countrywith risk of yellow fever transmission.


BELARUS



BELGIUM



BELIZE




Malaria: Malaria risk due predominantly toP. vivax exists in all districts but varies withinregions. Risk is moderate in Stan Creek andToledo Districts; and low in Cayo, Corozal andOrange Walk.


BENIN

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from all travellers over

1 year of age.




BERMUDA

Yellow fever

Country requirement: no


BHUTAN


certificate is required from travellers arriving fromcountries with risk of yellow fever transmission andfor all travellers having transited through the airportof a country with risk of yellow fever transmission.


Malaria: Malaria risk exists throughout the year inthe southern belt of the country comprising sevendistricts: Chukha, Dagana, Jonkhar, Pemagatshel,Samdrup, Samtse, Sarpang and Zhemgang. Notransmission occurs in the four following districts:Bumthang, Gasa, Paro and Thimphu. Seasonal

transmission during the rainy summer monthsoccurs in focal areas the rest of the country. P. fal-ciparum resistant to chloroquine and sulfadoxinepyrimethamine reported.

Recommended prevention in risk areas andseasons: IV

BOLIVIA (PLURINATIONAL STATE OF)


certificate is required from travellers over 1 yearof age arriving from countries with risk of yellowfever transmission.


Recommended for all travellers aged 9 monthsof age and over travelling to the following areaeast of the Andes at altitudes below 2300 m: theentire departments of Beni, Pando, and SantaCruz, and designated areas (Map) of Chuquisaca,Cochabamba, La Paz and Tarija.

Not recommended for travellers whose itinerariesare limited to areas at altitudes above 2300 m andall areas not listed above, including the cities ofLa Paz and Sucre.

Malaria: Malaria risk due predominantly (94%)to P. vivax exists throughout the year in the wholecountry below 2500 m. Falciparum malaria occursin Santa Cruz and in the northern departmentsof Beni and Pando, especially in the localitiesof Guayaramern and Riberalta. P. falciparumresistant to chloroquine and sulfadoxinepyri-methamine reported.

Recommended prevention in risk areas: II; in Beni,Pando and Santa Cruz: IV


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BOSNIA AND HERZEGOVINA



BOTSWANA


of age arriving from or having passed throughcountries with risk of yellow fever transmission andfor travellers having transited more than 12 hoursthrough the airport of a country with risk of yellowfever transmission.


Malaria: Malaria risk due predominantly to P. fal-ciparum exists from November to May/June in thenorthern parts of the country: Bobirwa, Boteti,Chobe, Ngamiland, Okavango, Tutume districts/sub-districts. Chloroquine-resistant P. falciparumreported.


BRAZIL



Recommended for all travellers aged 9 monthsor over going to the following areas: the entirestates of Acre, Amap, Amazones, Distrito Fed-eral (including the capital city of Braslia), Gois,Maranho, Mato Grosso, Mato Grosso do Sul, MinasGerais, Par, Rondnia, Roraima and Tocantins,and designated areas (Map) of the following states:Bahia, Paran, Piau, Rio Grande do Sul, SantaCatarina and So Paulo states. Vaccination is also

recommended for travellers visiting Iguazu Falls.Not recommended for travellers whose itinerariesare limited to areas not listed above, including thecities of Fortaleza, Recife, Rio de Janeiro, Salvadorand So Paulo (Map).

Malaria: In the states outside Legal Amazonia,the risk of malaria transmission is negligible ornon-existent. Malaria risk P. vivax (84%), P. fal-ciparum (15%), mixed infections (1%) is presentin most forested areas below 900 m within thenine states of the Legal Amazonia region (Acre,Amap, Amazonas, Maranho (western part),Mato Grosso (northern part), Par (except BelmCity), Rondnia, Roraima and Tocantins (western

part)). Transmission intensity varies from onemunicipality to another, and is higher in junglemining areas, in agricultural settlements lessthan 5 years old, and in some peripheral urbanareas of Cruzeiro do Sul, Manaus and Prto Velho.Malaria also occurs on the periphery of large citiessuch as Boa Vista, Macap, Maraba, Rio Brancoand Santarm. Multidrug-resistant P. falciparumreported.P. vivax resistance to chloroquine reported.


BRITISH VIRGIN ISLANDS



BRUNEI DARUSSALAM




Malaria: Human P. knowlesi infection reported.

Recommended prevention: I

BULGARIA



BURKINA FASO


1 year of age.




BURMAseeMYANMAR


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BURUNDI






CAMBODIA




Malaria: Malaria risk due to P. falciparum andP. vivax exists throughout the year in all forestedrural areas, including coastal areas. Phnom Penhand areas close to Tonle Sap (Siem Reap) are notat risk. Risk within the tourist area of Angkor Wat

is negligible. P. falciparum resistance to chloro-quine and sulfadoxinepyrimethamine has beenreported throughout the country. P. falciparumresistance to artesunate, mefloquine, lumefantrineand piperaquine has been reported in westernCambodia. P. vivax resistance to chloroquine hasbeen reported in eastern Cambodia.

Recommended prevention in risk areas: IV(atovaquone-proguanil or doxycycline)

CAMEROON


1 year of age.




CANADA

Yellow fever



CANARY ISLANDS seeSPAIN

CAPE VERDE




Malaria: Limited malaria risk due predominantlyto P. falciparum exists from August to Novemberinclusive in Santiago island and in Boa Vista island(18 locally acquired cases reported in 2010).


CAYMAN ISLANDS



CENTRAL AFRICAN REPUBLIC


9 months of age.




CHAD

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers arriving from

countries with risk of yellow fever transmission.Yellow fever vaccine recommendation: yes

Recommended for all travellers aged 9 monthsor over travelling to areas south of the SaharaDesert (Map).

Not recommended for travellers whose itinerar-ies are limited to areas within the Sahara Desert(Map).

Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in thewhole country. Resistance to chloroquine and

sulfadoxinepyrimethamine reported.



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CHILE



CHINA

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 9 monthsof age arriving from countries with risk of yellowfever transmission and for all travellers havingtransited through the airport of a country with riskof yellow fever transmission.


Malaria: Malaria risk, including P. falciparummalaria, exists in Yunnan and to a lesser extent inHainan. P. falciparum resistance to chloroquine andsulfadoxinepyrimethamine reported. Limited risk ofP. vivax malaria exists in southern and some centralprovinces, including Anhui, Ghuizhou, Henan, Hubei,Jiangsu. There is no malaria risk in urban areas.

Recommended prevention in risk areas: II; inHainan and Yunnan, IV

CHINA, HONG KONG SAR



CHINA, MACAO SAR



CHRISTMAS ISLAND

(Indian Ocean)

Yellow feverSame requirements as mainland Australia.


COLOMBIA


Yellow fever vaccination recommendation: yes

Recommended for all travellers aged 9 monthsor over travelling to the following departments ataltitudes below 2300 m (Map): Amazonas, Antio-

quia, Arauca, Atlntico, Bolivar, Boyac, Caldas,Caquet, Casanare, Cauca, Cesar, Crdoba, Cun-dinamarca, Guaina, Guaviare, Huila, Magdalena,Meta, Norte de Santander, Putumayo, Quindio,Risaralda, San Andrs and Providencia, Santander,Sucre, Tolima, Vaups, Vichada, Choco (only themunicipalities of Acand, Jurad, Riosucio, andUngua), and La Guajira (only the municipalitiesof Albania, Barrancas, Dibulla, Distraccin, ElMolino, Fonseca, Hatonuevo, La Jagua del Pilar,Maicao, Manaure, Riohacha, San Juan del Cesar,Urumita, and Villanueva).

Generally not recommended1 for travellers whoseitineraries are limited to the following areas westof the Andes at altitudes below 2300 m: the

departments of Cauca, Nario and Valle de Cauca,central and southern Choco, and the cities of Bar-ranquilla, Cali, Cartagena and Medelln (Map).

Not recommended for travellers whose itinerariesare limited to all areas above 2300 m, includingthe city of Bogot and the municipality of Uribiain La Guajira department.

Malaria: Malaria risk P. vivax (72%), P. fal-ciparum (27%) is high throughout the yearin rural/jungle areas below 1600 m, especiallyin municipalities of the regions of Amazonia,

Orinoqua, Pacfico and Urab-Bajo Cauca. Trans-mission intensity varies by department, with thehighest risk in Amazonas, Antioquia, Choc, Cr-doba, Guaviare, La Guajira, Nario and Vichada.Chloroquine-resistantP. falciparum exists in Ama-zonia, Pacfico and Urab-Bajo Cauca. Resistanceto sulfadoxinepyrimethamine reported.

Recommended prevention in risk areas: III; inAmazonia, Pacfico and Urab-Bajo Cauca: IV

COMOROS



Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in the

1 Yellow fever vaccination is generally not recommended inareas where there is low potential for exposure to yellow fevervirus. However, vaccination might be considered for a smallsubset of travellers to these areas, who are at increased risk ofexposure to yellow fever virus (e.g. prolonged travel, extensiveexposure to mosquitoes, inability to avoid mosquito bites).When considering vaccination, any traveller must take into

account the risk of being infected with yellow fever virus, countryentry requirements, as well as individual risk factors (e.g. age,immune status) for serious vaccine-associated adverse events.


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whole country. Resistance to chloroquine andsulfadoxinepyrimethamine reported.


CONGO


1 year of age.




COOK ISLANDS



COSTA RICA

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers aged over

9 months arriving from countries with risk ofyellow fever transmission (with the exception ofArgentina, Panama and Trinidad and Tobago) andfor travellers having transited more than 12 hoursthrough the airport of a country with risk of yellowfever transmission.


Malaria: Malaria risk due almost exclusively toP. vivax occurs throughout the year in the provinceof Limn, mostly in the canton of Matina. Negli-gible or no risk of malaria transmission exists in

the other cantons of the country.Recommended prevention in risk areas: II

CTE DIVOIRE

Yellow feverCountry requirement: a yellow fever vaccination cer-tificate is required from travellers over 1 year of age.


Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in thewhole country. Resistance to chloroquine and

sulfadoxinepyrimethamine reported.


CROATIA



CUBA



CYPRUS



CZECH REPUBLIC



DEMOCRATIC PEOPLES REPUBLICOF KOREA


of age arriving from countries with risk of yellow

fever transmission.


Malaria: Limited malaria risk due exclusively toP. vivax exists in some southern areas.


DEMOCRATIC REPUBLIC OF THE CONGO(FORMERLY ZAIRE)


1 year of age.


Recommended for all travellers aged 9 months orover, except as mentioned below.

Generally not recommended1 for travellers whoseitineraries are limited to Katanga Province.

1 Yellow fever vaccination is generally not recommended inareas where there is low potential for exposure to yellow fevervirus. However, vaccination might be considered for a smallsubset of travellers to these areas, who are at increased risk ofexposure to yellow fever virus (e.g. prolonged travel, extensiveexposure to mosquitoes, inability to avoid mosquito bites).When considering vaccination, any traveller must take intoaccount the risk of being infected with yellow fever virus, countryentry requirements, as well as individual risk factors (e.g. age,immune status) for serious vaccine-associated adverse events.


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DENMARK



DJIBOUTI






DOMINICA




DOMINICAN REPUBLIC



Malaria: Malaria risk due exclusively to P. falci-parum exists throughout the year, especially inthe western provinces of Dajabn, Elias Pina andSan Juan. Risk in other areas is low to negligible.There is no evidence of P. falciparum resistanceto any antimalarial drug.


ECUADOR

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year of

age arriving from countries with risk of yellow fevertransmission. Nationals and residents of Ecuadorare required to possess certificates of vaccination

on their departure to an area with risk of yellowfever transmission.


Recommended for all travellers aged 9 months orover travelling to the following provinces east ofthe Andes at altitudes below 2300 m: Morona-Santiago, Napo, Orellana, Pastaza, Sucumbios andZamora-Chinchipe (Map).

Generally not recommended1 for travellers whoseitineraries are limited to the following provinceswest of the Andes and at altitudes below 2300 m:Esmeraldas, Guayas, Los Rios and Manabi, and

designated areas of Azuay, Bolivar, Canar, Carchi,Chimborazo, Cotopaxi, El Oro, Imbabura, Loja,Pichincha and Tungurahua (Map).

Not recommended for travellers whose itinerariesare limited to all areas above 2300 m altitude, thecities of Guayaquil and Quito, and the GalpagosIslands (Map).

Malaria: Malaria risk P. vivax (87%), P. falci-parum (13%) exists throughout the year below1500 m, with moderate transmission risk incoastal provinces. There is no risk in Guayaquil,

Quito and other cities of the inter-Andean region.P. falciparum resistance to chloroquine and sul-fadoxinepyrimethamine reported.


EGYPT



All arrivals from Sudan are required to possesseither a vaccination certificate or a location cer-tificate issued by a Sudanese official centre statingthat they have not been in Sudan south of 15Nwithin the previous 6 days.


1 Yellow fever vaccination is generally not recommended inareas where there is low potential for exposure to yellow fevervirus. However, vaccination might be considered for a smallsubset of travellers to these areas, who are at increased risk ofexposure to yellow fever virus (e.g. prolonged travel, extensiveexposure to mosquitoes, inability to avoid mosquito bites).When considering vaccination, any traveller must take intoaccount the risk of being infected with yellow fever virus, countryentry requirements, as well as individual risk factors (e.g. age,immune status) for serious vaccine-associated adverse events.


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Malaria: Very limited P. falciparum and P. vivaxmalaria risk may exist from June to October in-clusive in El Faiym governorate (no indigenouscases reported since 1998).

Recommended prevention: none

EL SALVADOR

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers aged between1 and 60 years arriving from countries with riskof yellow fever transmission.


Malaria: Very low malaria risk due almost exclu-

sively to P. vivax exists in rural areas of migratoryinfluence from Guatemala. Sporadic vivax malariacases are reported from other parts of the country.


EQUATORIAL GUINEA


countries with risk of yellow fever transmission.




ERITREA



Yellow fever vaccine recommendation: in gene-ral, no

Generally not recommended1 for travellers going to

the following states: Anseba, Debub, Gash Barka,Mae Kel and Semenawi Keih Bahri.

Not recommended for all other areas not listedabove, including the islands of the Dahlak Archi-pelagos (Map).

Malaria: Malaria risk P. falciparum and P. vivax exists throughout the year in the whole coun-try below 2200 m. There is no risk in Asmara.Resistance to chloroquine and sulfadoxinepyri-methamine reported.


ESTONIA



ETHIOPIAYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year




Generally not recommended1 for travellers whose

itineraries are limited to the Afar and Somaliprovinces (Map).

Malaria: Malaria risk approximately 60%P. falciparum, 40% P. vivax exists throughoutthe year in the whole country below 2000 m.P. falciparum resistance to chloroquine andsulfadoxinepyrimethamine reported. P. vivaxresistance to chloroquine reported. There is nomalaria risk in Addis Ababa.


FALKLAND ISLANDS (MALVINAS)



FAROE ISLANDS



FIJI





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GREECE



Malaria: Very limited malaria risk (P. vivax only)may exist from May to October in villages of theEvrotas delta area in Lakonia district (an area of20km2) in agricultural area with large migrantpopulations. There is no risk in tourist areas.

Recommended prevention in risk area: I

GREENLAND

Yellow fever


GRENADA




GUADELOUPE




GUAM



GUATEMALA




Malaria: Malaria risk due predominantly toP. vivax exists throughout the year below 1500 m.

There is moderate risk in the departments ofEscuintla and Izabal, and low risk in Alta Verapaz,Baja Verapaz, Chiquimala, Petn, Suchitepquezand Zacapa.


GUINEA




Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in thewhole country. Resistance to chloroquine reported.


GUINEA-BISSAU


1 year of age




GUYANA

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from all travellers over 1 year

of age arriving from countries with risk of yellowfever transmission with the exception of Argentina,Paraguay, Suriname and Trinidad and Tobago.


Malaria: Malaria risk P. vivax (44%), P. falci-parum (45%), mixed infections (10%) is highthroughout the year in all parts of the interior. Riskis highest in Regions 1, 2, 4, 7, 8, 9 and 10, andvery low in Regions 3, 5 and 6. Sporadic casesof malaria have been reported from the denselypopulated coastal belt. Chloroquine-resistant

P. falciparum reported.



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HAITI




Malaria: Malaria risk due exclusively to P. fal-ciparum exists throughout the year in the wholecountry. No P. falciparum resistance to chloro-quine reported.

Recommended prevention: II; or IV if chloroquineis not available pre-travel

HONDURASYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year of

age arriving from countries with risk of yellow fevertransmission (with the exception of Panama) andfor travellers having transited more than 12 hoursthrough the airport of a country with risk of yellowfever transmission.


Malaria: Malaria risk due to P. vivax (85%),P. falciparum (14%) and mixed infections (1%).P. vivax transmission risk is high in the departmentsof Gracias a Dios and Islas de la Baha, and moder-ate in Atlntida, Coln, Olancho, Valle and Yoro.P. falciparum transmission risk is high in Gracias aDios, and a few cases are also reported in Atlntida,Colon, Islas de la Baha, Olancho and Yoro.


HONG KONG SPECIAL ADMINISTRATIVEREGION OF CHINAseeCHINA,

HONG KONG SAR

HUNGARY



ICELAND

Yellow fever


INDIA

Yellow feverCountry requirement: anyone (except infants up

to the age of 9 months) arriving by air or seawithout a yellow fever vaccination certificateis detained in isolation for up to 6 days if thatperson (i) arrives within 6 days of departure froman area with risk of yellow fever transmission, or(ii) has been in such an area in transit (exceptthose passengers and members of the crew who,while in transit through an airport situated inan area with risk of yellow fever transmission,remained within the airport premises during theperiod of their entire stay and the Health Officeragrees to such exemption), or (iii) arrives on a

ship that started from or touched at any port inan area with risk of yellow fever transmissionup to 30 days before its arrival in India, unlesssuch a ship has been disinsected in accordancewith the procedure laid down by WHO, or (iv)arrives on an aircraft that has been in an areawith risk of yellow fever transmission and hasnot been disinsected in accordance with theIndian Aircraft Public Health Rules, 1954, oras recommended by WHO.

The following are regarded as countries and areas

with risk of yellow fever transmission:

Africa: Angola, Benin, Burkina Faso, Burundi,Cameroon, Central African Republic, Chad, Congo,Cte dIvoire, Democratic Republic of the Congo,Equatorial Guinea, Ethiopia, Gabon, Gambia,Ghana, Guinea, Guinea-Bissau, Kenya, Liberia,Mali, Niger, Nigeria, Rwanda, Senegal, SierraLeone, Sudan, Togo and Uganda.

America: Bolivarian Republic of Venezuela, Bra-zil, Colombia, Ecuador, French Guiana, Guyana,

Panama, Peru, Plurinational State of Bolivia,Suriname and Trinidad and Tobago.

Note. When a case of yellow fever is reported fromany country, that country is regarded by the Gov-ernment of India as a country with risk of yellowfever transmission and is added to the above list.

Yellow fever vaccine recommendations: no

Malaria: Malaria risk exists throughout the yearin the whole country at altitudes below 2000 m,with overall 4050% of cases due to P. falciparumand the remainder due to P. vivax. There is notransmission in parts of the states of Himachal


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Pradesh, Jammu and Kashmir, and Sikkim. Riskof falciparum malaria and drug resistance are

relatively higher in the north-eastern states, inthe Andaman and Nicobar Islands, Chhattisgarh,Gujarat, Jharkhand, Karnataka (with the excep-tion of the city of Bangalore) Madhya Pradesh,Maharasthra (with the exception of the cities ofMumbai, Nagpur, Nasik and Pune), Orissa andWest Bengal (with the exception of the city ofKolkata). P. falciparum resistance to chloroquineand sulfadoxinepyrimethamine reported.

Recommended prevention in risk areas: III; in thelisted higher risk areas: IV

INDONESIAYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 9 monthsof age arriving from countries with risk of yellowfever transmission.


Malaria: Malaria risk exists throughout the yearin most areas of the five eastern provinces of EastNusa Tenggara, Maluku, North Maluku, Papuaand West Papua. In other parts of the country,

there is malaria risk in some districts, except inJakarta Municipality, in cities and urban areas,as well as within the areas of the main touristresorts. P. falciparum resistant to chloroquine andsulfadoxinepyrimethamine reported. P. vivax re-sistant to chloroquine reported. Human P. knowlesiinfection reported in the province of Kalimantan.


IRAN (ISLAMIC REPUBLIC OF)




Malaria: Malaria risk due to P. vivax and P. falci-parum exists from March to November inclusivein rural areas of the provinces of Hormozgan andKerman (tropical part) and the southern partof Sistan-Baluchestan. P. falciparum resistantto chloroquine and sulfadoxinepyrimethamine

reported.


IRAQ




Malaria: Limited malaria risk due exclusively toP. vivax may exist from May to November inclu-sive in areas in the north below 1500 m (Duhok,Erbil and Sulaimaniya provinces). No indigenouscases reported since 2009.


IRELANDYellow feverCountry requirement: no


ISRAEL



ITALYYellow feverCountry requirement: no


JAMAICA


age arriving from countries with risk of yellow fevertransmission and for all travellers having transited

through the airport of a country with risk of yellowfever transmission.


Malaria: Very limited risk of P. falciparum malariamay occur in the Kingston St Andrew Parish. Nolocal cases reported in 20102011.


JAPAN

Yellow fever




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JORDAN




KAZAKHSTAN




KENYA





Generally not recommended1 for travellers whoseitineraries are limited to the following areas:the entire North Eastern Province; the states ofKilifi, Kwale, Lamu, Malindi and Tanariver in theCoastal Province; and the cities of Nairobi andMombasa (Map).

Malaria: Malaria risk due predominantly to P. fal-ciparum exists throughout the year in the wholecountry. Normally, there is little risk in the cityof Nairobi and in the highlands (above 2500 m) ofCentral, Eastern, Nyanza, Rift Valley and Westernprovinces. Resistance to chloroquine and sulfadox-inepyrimethamine reported.


KIRIBATI




KOREA, REPUBLIC OF, seeREPUBLICOF KOREA

KOREA, DEMOCRATIC PEOPLESREPUBLIC OF, seeDEMOCRATICPEOPLES REPUBLIC OF KOREA

KUWAIT



KYRGYZSTAN




Malaria: Malaria risk due exclusively to P. vivaxexists from June to October inclusive in somesouthern and western parts of the country, mainlyin areas bordering Tajikistan and Uzbekistan(Batken, Jalal-Abad and Osh regions) and in theoutskirts of Bishkek.


LAO PEOPLES DEMOCRATIC REPUBLIC




Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in thewhole country except in Vientiane. P. falciparumresistant to chloroquine and sulfadoxinepyrimeth-

amine reported.





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LATVIA



LEBANON


6 months arriving from countries with risk of yellowfever transmission.


LESOTHOYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers aged over

9 months arriving from countries with risk of yel-low fever transmission and for travellers havingtransited more than 12 hours through the airportof a country with risk of yellow fever transmission.


LIBERIA


1 year of age.




LIBYA




LIECHTENSTEIN

Yellow fever



LITHUANIA



LUXEMBOURG



MACAO SPECIAL ADMINISTRATIVE REGIONOF CHINAseeCHINA, MACAO SAR

MADAGASCARYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers arriving from



Malaria: Malaria risk due predominantly to P. fal-ciparum exists throughout the year in the wholecountry, with the highest risk in coastal areas.Resistance to chloroquine reported.


MADEIRA ISLANDS seePORTUGAL

MALAWI


of age arriving from countries with risk of yellowfever transmission and for travellers having tran-sited more than 12 hours through the airport of

a country with risk of yellow fever transmission.Yellow fever vaccine recommendation: no



MALAYSIA




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fever transmission and for travellers having tran-sited more than 12 hours through the airport ofa country with risk of yellow fever transmission.

Yellow fever vaccine recommendation: noMalaria: Malaria risk exists only in limited fociin the deep hinterland of the states of Sabah andSarawak and the central areas of PeninsularMalaysia. Urban, suburban and coastal areas arefree from malaria. P. falciparum resistant to chlo-roquine and sulfadoxinepyrimethamine reported.Human P. knowlesi infection reported. P. vivaxresistance to chloroquine reported.


MALDIVESYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year



MALI


1 year of age.


Recommended for all travellers aged 9 monthsor over going to areas south of the Sahara Desert(Map).

Not recommended for travellers whose itinerariesare limited to areas in the Sahara Desert (Map).

Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in the

whole country. Resistance to chloroquine andsulfadoxinepyrimethamine reported.


MALTA

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 9 monthsof age arriving from countries with risk of yellowfever transmission. If indicated on epidemiologi-cal grounds, infants under 9 months of age aresubject to isolation or surveillance if coming froman area with risk of yellow fever transmission. Nocertificate of yellow fever vaccination is required

for travellers having transited through the airportof a country with risk of yellow fever transmission.


MARSHALL ISLANDS



MARTINIQUE




MAURITANIA



Yellow fever vaccine recommendation: yes:



Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in thewhole country, except in northern areas (Dakhlet-Nouadhibou and Tiris-Zemour). In Adrar andInchiri there is malaria risk during the rainy season

(from July to October inclusive). Resistance tochloroquine reported.


MAURITIUS


of age arriving from countries with risk of yellowfever transmission and for travellers having tran-sited more than 12 hours through the airport of

a country with risk of yellow fever transmission.



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MAYOTTE (FRENCH TERRITORIALCOLLECTIVITY)

Yellow fever

Country requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year



Malaria: Malaria risk due predominantly to P. fal-ciparum exists throughout the year. Resistanceto chloroquine and sulfadoxinepyrimethaminereported.


MEXICOYellow feverCountry requirement: no


Malaria: Malaria risk due almost exclusively toP. vivax exists throughout the year in some ruralareas that are not often visited by tourists. Thereis moderate risk in some localities in the states ofChiapas and Oaxaca (mainly in Costa and Loxi-chas); very low-risk localities are also found in the

states of Chihuahua, Durango, Nayarit, QuintanaRoo and Sinaloa.

Recommended prevention in moderate risk areas:II. In low risk areas: I

MICRONESIA (FEDERATED STATES OF)



MONACO



MONGOLIA



MONTENEGRO

Yellow fever



MONTSERRAT




MOROCCO



MOZAMBIQUE






MYANMAR (FORMERLY BURMA)


1 year arriving from countries with risk of yellowfever transmission and for travellers having tran-sited more than 12 hours through the airport ofa country with risk of yellow fever transmission.Nationals and residents of Myanmar are requiredto possess certificates of vaccination on their

departure to an area with risk of yellow fevertransmission.


Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in remoterural, hilly and forested areas of the country aswell as in some coastal areas in Rahkine State.There is no transmission in cities and urban areas.The central plains and the dry zone are generallyfree of malaria but some pockets of transmissionstill exist. P. falciparum resistant to chloroquineand sulfadoxinepyrimethamine reported. Meflo-quine resistance reported in Kayin state and theeastern part of Shan state. Emerging artemisinin


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resistance suspected in south-eastern Myanmar.P. vivax resistance to chloroquine reported. HumanP. knowlesi infection reported.

Recommended prevention in risk areas: IVNAMIBIA


countries with risk of yellow fever transmission.The countries, or parts of countries, included in theendemic zones in Africa and South America are re-garded as areas with risk of yellow fever transmis-sion. Travellers who are on scheduled flights thatoriginated outside the countries with risk of yellowfever transmission, but who have been in transitthrough these areas, are not required to possessa certificate provided that they remained at thescheduled airport or in the adjacent town duringtransit. All travellers whose flights originated incountries with risk of yellow fever transmission orwho have been in transit through these countrieson unscheduled flights are required to possess acertificate. The certificate is not insisted upon inthe case of children under 1 year of age, but suchinfants may be subject to surveillance.


Malaria: Malaria risk due predominantly to P. fal-ciparum exists from November to June inclusivein the following regions: Ohangwena, Omaheke,Omusati, Oshana, Oshikoto and Otjozondjupa.Risk exists throughout the year along the Kuneneriver and in Caprivi and Kavango regions. Resis-tance to chloroquine and sulfadoxinepyrimeth-amine reported.


NAURUYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year



NEPAL




Malaria: Malaria risk due predominantly toP. vivax exists throughout the year in rural areas

of the 20 Terai districts bordering India, withoccasional outbreaks of P. falciparum from Julyto October inclusive. Seasonal transmission ofP. vivax takes place in 45 districts of the inner Teraiand mid-hills. P. falciparum resistant to chloro-quine and sulfadoxinepyrimethamine reported.

Recommended prevention in risk areas: III

NETHERLANDS



NETHERLANDS ANTILLES (BONAIRE,CURAAO, SABA, ST EUSTASIUS,ST MARTIN)

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 6 monthsof age arriving from countries with risk of yellowfever transmission.


NEW CALEDONIA AND DEPENDENCIESYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year


Note. In the event of an epidemic threat to theterritory, a specific vaccination certificate maybe required.


NEW ZEALAND



NICARAGUA



fever transmission.



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Malaria: Low malaria risk due predominantlyto P. vivax (82%) exists throughout the year ina number of municipalities, mainly in ReginAutnoma del Atlntico Norte, with sporadictransmission also reported in Boaca, Chinan-dega, Jinoteca, Lon and Matagalpa. Cases arereported from other municipalities in the centraland western departments but the risk in theseareas is considered to be very low or negligible.No chloroquine-resistant P. falciparum reported.


NIGER


1 year of age and recommended for travellers

departing Niger.




Malaria: Malaria risk due predominantly to P. falci-

parumexists throughout the year in the whole coun-try. Chloroquine-resistant P. falciparum reported.


NIGERIA






NIUE

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 9 monthsof age arriving from countries with risk of yellow

fever transmission.


NORFOLK ISLAND seeAUSTRALIA

NORTHERN MARIANA ISLANDSYellow feverCountry requirement: no


NORWAY



OMANYellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year



Malaria: Sporadic transmission of P. falciparumand P. vivax may occur subsequent to internationalimportations of parasites. In 2010, local outbreaksof P. falciparum and P. vivax were reported in

North Sharqiya region. Local cases were alsoreported in 2011.

Recommended prevention: I

PAKISTAN

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 9 monthsof age arriving from any part of a country wherethere is a risk of yellow fever transmission and fortravellers having transited more than 12 hours

through the airport of a country with risk of yellowfever transmission.


Malaria: Malaria risk P. vivax and P. falciparum exists throughout the year in the whole countrybelow 2000 m. P. falciparum resistant to chloro-quine and sulfadoxinepyrimethamine reported.


PALAU

Yellow fever




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PANAMA


certificate is required from all travellers arrivingfrom countries with risk of yellow fever transmission.

Yellow fever vaccination recommendation: yes

Recommended for all travellers aged 9 monthsor over travelling to all mainland areas east of theCanal Zone, (the entire comarcas of Ember andKuna Yala, the province of Darin and areas of theprovinces of Coln and Panama that are east ofthe Canal Zone) (Map).

Not recommended1 for travellers whose itinerariesare limited to areas west of the canal zone, the cityof Panama, the canal zone itself, and the Balboaand San Blas Islands (Map).

Malaria: Malaria risk due predominantly toP. vivax (99%) exists throughout the year inprovinces and comarcas along the Atlantic coastand the borders with Costa Rica and Colombia:Bocas del Toro, Chiriqu, Coln, Darin, Kuna Yala,Ngbe Bugl, Panama and Veraguas. In PanamaCity, in the Canal Zone and in the other provincesthere is no or a negligible risk of transmission.Chloroquine-resistant P. falciparum has beenreported in Darin and San Blas.

Recommended prevention in risk areas: II; ineastern endemic areas: IV

PAPUA NEW GUINEA




Malaria: Malaria risk due predominantly to P. fal-ciparum exists throughout the year in the wholecountry below 1800 m. P. falciparum resistantto chloroquine and sulfadoxinepyrimethaminereported. P. vivax resistant to chloroquine reported.


PARAGUAY





Generally not recommended1 for travellers whoseitineraries are limited to the city of Asuncin.

Malaria: Malaria risk due almost exclusively toP. vivax is moderate in certain municipalities of

the departments of Alto Paran and Caaguaz.In other departments there is no or negligibletransmission risk.


PERU



Recommended for all travellers aged 9 months or

over going to the following areas at altitudes below2300 m: the entire regions of Amazonas, Loreto,Madre de Dios, San Martin and Ucayali, anddesignated areas (Map) of the following regions:far-north-eastern Ancash; northern Apurmac;northern and north-eastern Ayacucho; northernand eastern Cajamarca; north-western, northern,and north-eastern Cusco; far-northern Huan-cavelica; northern, central and eastern Hunuco;northern and eastern Junn; eastern La Libertad;central and eastern Pasco; eastern Piura; andnorthern Puno.

Generally not recommended1 for travellers whoseitineraries are limited to the following areas west ofthe Andes: the entire regions of Lambayeque andTumbes and the designated areas (Map) of westernPiura and west-central Cajamarca.

Not recommended for travellers whose itinerariesare limited to the following areas: all areas above2300 m altitude, areas west of the Andes notlisted above, the cities of Cuzco and Lima, MachuPicchu, and the Inca Trail (Map).

Malaria: Malaria risk P. vivax (89%), P. fal-ciparum (11%) exists throughout the yearin rural areas at altitudes below 2000 m. The




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23 highest-risk districts are concentrated in theregions of Ayacucho, Junn, Loreto, Madre deDios, Piura, San Martin and Tumbes. Ninety-ninepercent of P. falciparum cases are reported from

Loreto, which is situated in the Amazon andcontains 18 of the highest-risk districts in thecountry. P. falciparum resistance to chloroquineand sulfadoxinepyrimethamine reported. P. vivaxresistance to chloroquine reported.

Recommended prevention in risk areas: II inP. vivax risk areas; IVin Loreto

PHILIPPINES


age arriving from countries with risk of yellow fevertransmission and for all travellers having transitedthrough the airport of a country with risk of yellowfever transmission.


Malaria: Malaria risk exists throughout the year inareas below 600 m, except in the 22 provinces ofAklan, Albay, Benguet, Biliran, Bohol, Camiguin,Capiz, Catanduanes, Cavite, Cebu, Guimaras,Iloilo, Northern Leyte, Southern Leyte, Marinduque,Masbate, Eastern Samar, Northern Samar, Western

Samar, Siquijor, Sorsogon, Surigao Del Norte andmetropolitan Manila. No risk is considered to existin urban areas or in the plains. P. falciparum resis-tant to chloroquine and sulfadoxinepyrimethaminereported. Human P. knowlesi infection reported inthe province of Palawan.


PITCAIRN




POLAND



PORTUGAL

Yellow fever


PUERTO RICO



QATAR



REPUBLIC OF KOREA


Yellow fever vaccine recommendation: noMalaria: Limited malaria risk due exclusively toP. vivax exists mainly in the northern areas of Gang-won-do and Gyeonggi-do Provinces and IncheonCity (towards the demilitarized zone or DMZ).


REPUBLIC OF MOLDOVA



REUNION



ROMANIA



RUSSIAN FEDERATION

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from travellers over 9 monthsof age arriving from countries with risk of yellowfever transmission.


Malaria: Very limited malaria risk due exclusivelyto P. vivax may exist in areas under influence of

intense migration from southern countries in the

Commonwealth of Independent States.

Recommended prevention: none


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RWANDA






SAINT HELENA

Yellow fever

Country requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year



SAINT KITTS AND NEVIS




SAINT LUCIA




SAINT PIERRE AND MIQUELON



SAINT VINCENT AND THE GRENADINES



fever transmission.


SAMOA




SAN MARINO



SAO TOME AND PRINCIPE


1 year of age.


Generally not recommended1 for travellers to SaoTome and Principe.

Malaria: Malaria risk due predominantly to P. fal-ciparum exists throughout the year. Chloroquine-resistant P. falciparum reported.


SAUDI ARABIA

Yellow feverCountry requirement: a yellow fever vaccinationcertificate is required from all travellers arriving

from countries with risk of yellow fever transmission.


Malaria: Limited malaria risk due predominantlyto P. falciparum exists mainly from September to

January inclusive in foci along the southern borderwith Yemen (except in the high altitude areas ofAsir Province). No risk in Mecca or Medina cities.Chloroquine-resistant P. falciparum reported.





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SENEGAL


certificate is required from travellers over 9 monthsof age arriving from countries with risk of yellowfever transmission and for all travellers havingtransited through the airport of a country with riskof yellow fever transmission.


Malaria: Malaria risk due predominantly toP. falciparum exists throughout the year in thewhole country. There is less risk from Januaryto June inclusive in the central western regions.Resistance to chloroquine and sulfadoxinepyri-

methamine reported.Recommended prevention: IV

SERBIA



SEYCHELLES

Yellow fever

Country requirement: a yellow fever vaccinationcertificate is required from travellers over 1 year ofage arriving from countries with risk of yellow fevertransmission and for all travellers having transitedthrough the airport of a country with risk of yellowfever transmission.


SIERRA LEONE


certificate is required from all travellers.Yellow fever vaccine recommendation: yes



SINGAPORE

Yellow feverCountry requirement: certificates of vaccination arerequired from travellers over 1 year of age who,within the preceding 6 days, have been in or have

transited more t

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ITH2011countrylist (Yellow Fever)

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