World Country Guide

1
A yellow fever vaccination certificate is required of travellers arriving from infected areas.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not a condition of entry to Nepal. 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. For more information, see the Health appendix.

3
Typhoid is common.

4
Malaria risk, mainly in the benign vivax form, exists throughout the year in rural areas of the Terai districts (including forested hills and forest areas) of Bara, Dhanukha, Kapilvastu, Mahotari, Parsa, Rautahat, Rupendehi, Sarlahi, and especially along the Indian border. The malignant falciparum form resistant to chloroquine and sulfadoxine-pyrimethamine has been reported. The recommended prophylaxis is chloroquine plus proguanil.

Food & drink
All water should be regarded as being potentially contaminated. 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 which 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
High altitude sickness is a hazard for trekkers, so it is important to be in good health before travelling. Advice can be obtained from the Himalayan Rescue Association near the Kathmandu Guest House, Thamel. It is advisable, particularly when in rural areas, to carry a medical kit containing items such as rehydration mixture for the treatment of severe diarrhoea and ‘dry spray’ for cuts and bruises. Contact the Nepal Tourism Board for advice (see Contact Addresses section). Giardiasis, dysenteries and diarrhoeas are all common. Japanese encephalitis occurs in southern lowland, rural areas. Hepatitis A, B and E occur. Meningitis has been reported in some areas. There has been a sharp rise in visceral leishmaniasis, and trachoma is fairly common.
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, see the Health appendix.

Health care
The most convenient hospital for visitor care is Patan Hospital in Lagankhel. Other hospitals include the Western Regional Hospital and the Manipal Hospital in Pokhara and the Mission Hospital in Tansen. Most hospitals have English-speaking staff and larger hotels have doctors. Pharmacies in Kathmandu, mainly along New Road, offer a wide range of Western drugs at low prices. In Kathmandu, you can get certain vaccinations free of charge at the Infectious Diseases Clinic. Full medical insurance is essential.