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To find out more about visiting countries where there is a risk of acquiring travel related diseases, please follow national guidance as highlighted throughout this resource. 

Hajj and Umrah

Hajj, the annual pilgrimage to Makkah (Mecca) in the Kingdom of Saudi Arabia (KSA) takes place between the 8th and 12th day of the twelfth month of the Islamic calendar. It is one of the largest mass gatherings in the world.

British pilgrims wishing to undertake Hajj are advised to follow the of the Foreign, Commonwealth and Development Office (FCDO) for pilgrimage travellers or seasonal workers planning to go Saudi Arabia.

• Muslim Council of Britain: .
• Council of British Hajjis: . 
• NaTHNaC: General advice on Hajj and Umrah.
• TRAVAX: .
• Fitfortravel: . 

Rabies 

Rabies is an infectious viral disease and one of the deadliest diseases passed to humans from animals. , so travellers need to be aware of rabies in the destination and know what to do in the event of a potential exposure. Nurses should be aware of current guidance and advise travellers on the prevention and treatment options available to them.

As well as personal protection measures, a pre-exposure rabies vaccine is recommended to those travelling to a high-risk country, for example, Africa or Asia. This is especially important if travelling to remote areas, where medical care and rabies post-exposure treatment may be difficult to access or unavailable. Comprehensive travel health insurance is highly recommended.

Useful resources

• UKHSA. . Nurses in the UK should continue to follow guidance from the .
• UKHSA. Immunisation against infectious disease. . 
• National Travel Health Network and Centre (NaTHNaC): . 
• World Health Organisation: (2023).

Zika virus 

ZIKV is transmitted predominantly by the bite of an infected Aedes mosquito, most commonly Aedes aegypti. Aedes mosquitoes are more active during daylight hours both indoors and outdoors. Aedes spp. mosquitoes have adapted to living with humans including in urban environments, laying their eggs in any receptacle where water collects. 

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Those infected are often asymptomatic but illness similar to dengue or chikungunya (also transmitted by Aedes mosquitoes) can occur. Illness is usually short and mild, serious complications and deaths from ZIKV are uncommon. 

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ZIKV infection during pregnancy is a cause of congenital brain abnormalities, including microcephaly. ZIKV is a trigger of neurological complications such as Guillain-Barré syndrome (GBS).

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Assessing individual risk by conducting a comprehensive risk assessment is essential for those going to areas with ZIKV transmission allowing them to make an informed decision before departure. A risk assessment and a risk management form are available in the RCN competency document. 

In January 2024, UK Health Security Agency and NaTHNaC published . Further information on the Zika virus is available from the following websites:

• TravelHealthPro (NaTHNaC). .
• TRAVAX (login required). .
• Fitfortravel (Public Health Scotland). .

As more research becomes available, information and guidance on ZIKV can change. New vaccines are being developed for vector-borne diseases. 

The provides notification of new or amended information. Here you can sign up to receive email alerts to get the most current information for advising travellers.

Yellow fever 

Yellow fever (YF) is a viral disease transmitted by mosquitoes causing a spectrum of disease from mild to severe symptoms.

NaTHNaC (England Wales and Northern Ireland) and Public Health Scotland (PHS) TRAVAX are the designated State Parties for YF provision in the UK under the WHO International Health Regulations (IHRs). These parties have designed a mandatory training programme for designated YF Vaccinating Centres (YFVCs). 

Areas at risk of transmission are dynamic and subject to change. There may be lengthy periods between outbreaks of YF, while the virus may still be circulating in endemic areas but at a level unidentified through surveillance. Please source national websites for updates and refer to for individual country recommendations and vaccine recommendation maps.

(Green Book) was updated following the Medicines and Healthcare products Regulatory Authority (MHRA) alert after two fatal adverse reactions to the YF vaccine. The importance of a detailed individual risk assessment before administering the vaccine, was emphasised particularly for those who may be immunocompromised or aged 60 years and older. 

The and are frequently updated, so check details regularly. For NaTHNaC clinical and administrative resources for health care professionals running or managing a Yellow Fever Vaccinating Centre (YFVC), , which has news and quick links to Key YFVC resources.   

to view more information on YF (Scotland). NHS Wales users can gain free access to TRAVAX resources via the NHS Wales website .

Although related to travellers from the USA, the Centers for Disease Control and Prevention (CDC) website contains useful current information. View the .   

From January 2024, the NaTHNaC team will hold free webinar sessions via Zoom. Modelled on the "Getting to grips..." teach-in events for Yellow Fever Vaccination Centres, these sessions will be open to all health professionals interested in travel health. . 

Measles (MMR)

Measles is an ongoing global problem. Before travelling abroad, all travellers should be reminded that they should be fully protected against measles, either through a known history of infection or with a record of two doses of a measles containing vaccine. . 

Since the COVID-19 pandemic there has been a significant drop in the number of children vaccinated against measles, mumps and rubella (MMR) and other childhood diseases in the UK. Overseas, routine immunisation programmes, including MMR vaccination may also have been affected leaving populations, particularly children, susceptible to measles, a potentially fatal infection. 

The World Health Organization has called for countries to target all of those who have missed routine immunisations including measles vaccines and to offer catch up doses. Nurses advising travellers are uniquely placed to offer catch up MMR doses when conducting a travel health consultation.

Useful resources

• NHS England (2024). .
• NHS England (2024). .