World Country Guide

1
Any person (including infants over six months old) arriving by air or sea from an infected country must obtain a yellow fever certificate. Otherwise, isolated detainment may occur for up to six days. Those countries that are considered infected are all African countries (except Algeria, Botswana, Djibouti, Egypt, Eritrea, Lesotho, Libya, Malawi, Mauritania, Morocco, Mozambique, Namibia, South Africa, Swaziland, Tunisia and Zimbabwe) and all South American countries (except Argentina, Chile, Paraguay and Uruguay). When a case of yellow fever is reported from any country, that country is regarded by the government of India as being infected.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not a condition of entry to India. However, cholera is a serious risk in this country and precautions are essential. Up-to-date advice should be sought before deciding whether these precautions should include vaccination, as medical opinion is divided over its effectiveness.

3
Poliomyelitis is widespread. Immunisation is generally recommended.

4
Malaria risk exists, mainly in the benign vivax form, throughout the year in the whole country below 2000m excluding parts of the states of Himachal Pradesh, Jammu and Kashmir and Sikkim. High resistance to chloroquine and sulfadoxine-pyrimethamine is reported in the malignant falciparum form. The recommended prophylaxis is chloroquine plus proguanil in risk areas and mefloquine in Assam.

Food & drink
All water should be regarded as being potentially contaminated. Well water near the Ganges and in West Bengal may contain traces of arsenic chemical. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products that are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks
Visceral leishmaniasis occurs in rural areas of eastern India. Cutaneous leishmaniasis occurs in Rajasthan. Filariasis is common throughout India and sandfly fever is increasing. An outbreak of plague occurred in 1994 and was contained by adequate government measures. Tick-borne relapsing fever is reported, as is typhus, and outbreaks of haemorrhagic dengue fever have occurred in eastern India. Tick-borne haemorrhagic fever has been reported in the forest areas in Karnataka State. Hepatitis A and E are common. Hepatitis B is endemic. Outbreaks of Japanese encephalitis occur, particularly in eastern coastal areas. Meningococcal meningitis is present in Delhi from November to May. Vaccination is advisable.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Note
All visitors aged between 18 and 70 years of age who are wishing to extend their visa for one year or more are required to take an AIDS test.

Health care
Health care facilities are limited and travellers are strongly advised to take out full medical insurance before departing for India. It is advisable to bring specific medicines from the UK. There are state-operated facilities in all towns and cities and private consultants and specialists in urban areas.

On leaving India
Visitors leaving for countries which impose health restrictions on arrivals from India are required to be in possession of a valid certificate of inoculation and vaccination.