World Country Guide

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

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not an official condition of entry to Vietnam. 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
Vaccination against typhoid is advised.

4
Malaria risk exists, predominantly in the falciparum form, throughout the year everywhere except urban areas, the Red River delta and the coastal plains of Central Vietnam. The risk is highest in the three central highlands provinces of Dak Lak, Gia Lai and Kon Tum, as well as the southern provinces of Ca Mau, Bac Lieu and Tay Ninh. The malignant falciparum form is reported to be highly resistant to chloroquine and sulfadoxine-pyrimethamine. The recommended prophylaxis is mefloquine.

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 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
Bilharzia (schistosomiasis) is present in the delta of the Mekong River. Avoid swimming and paddling in fresh water; swimming pools which are chlorinated and well maintained are safe.
Japanese encephalitis is a risk in Hanoi and in rural areas. A vaccine is available and travellers are advised to consult their doctor prior to departure. Hepatitis A, B and E occur; precautions should be taken. Dengue fever can be epidemic and filariasis is endemic in some rural areas. Typhoid fever, amoebic and bacillary dysentry can occur. Trachoma and plague occur rarely. Diagnoses of avian influenza have once again increased since December 2004, although the number infected is still minimal. All visitors are advised against close contact, and under-cooked consumption of, poultry.
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.

Health care
There are hospitals in major towns and cities, and health care centres in all provinces, but facilities are limited everywhere and there is a lack of medicines. Health insurance is essential and should include cover for emergency repatriation by air. Immediate cash payment is expected for services.