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Chapter 2 Preparing International Travelers

Yellow Fever Vaccine & Malaria Prophylaxis Information, by Country

Mark D. Gershman, Emily S. Jentes, Rhett J. Stoney (Yellow Fever) Kathrine R. Tan, Paul M. Arguin (Malaria)

The following pages present country-specific information on yellow fever (YF) vaccine require­ments and recommendations (Table 2-06) and malaria transmission information and prophy­laxis recommendations. Country-specific maps of malaria transmission areas, country-specific maps depicting yellow fever vaccine recommen­dations, and a reference map of China are included to aid in interpreting the information. The information was accurate at the time of publication; however, this information is subject to change at any time as a result of changes in disease transmission or, in the case of YF, changing country entry requirements. Updated information reflecting changes since publication can be found in the online version of this book (www.cdc.gov/yellowbook) and on the CDC Travelers’ Health website (www.cdc.gov/travel). General recommendations for other vaccines to consider during the pretravel consultation can be found on the CDC Travelers’ Health website (www.cdc.gov/travel).

YELLOW FEVER

Since publication of the 2018 edition of the CDC Yellow Book, large YF outbreaks occurred in eastern Brazil in 2017 and 2018, involving states where YF was not previously considered endemic. Notably, human YF cases occurred within the greater metropolitan area of São Paulo City and not far from the metropolitan limits of Rio de Janeiro City. In response, the Brazil Ministry of Health conducted mass vaccination campaigns in the newly affected areas. Based on a review of the situation by the World Health Organization (WHO) Scientific and Technical Advisory Group on Geographical Yellow Fever Risk Mapping, in which CDC par­ticipates, preliminary expanded YF vaccination recommendations were made for international travelers to the eastern and southeastern states of Brazil. Given that the Brazil Ministry of Health has initiated its plan to vaccinate the entire population of Brazil against YF by mid-2019, these preliminary vaccination recommendations for international travel will likely be made permanent by the advisory group.

Revaccination against yellow fever was previously required by certain countries at 10-year intervals to comply with International Health Regulations (IHR). In 2014, the World Health Assembly (of WHO) adopted the recommendation to amend the IHR by removing the 10-year booster dose requirement, and stipulated a 2-year transition period for this change. Consequently, as of July 11, 2016, a completed International Certificate of Vaccination or Prophylaxis (ICVP) is valid for the lifetime of the vaccinee. Moreover, countries cannot require proof of revaccination (booster) against yellow fever as a condition of entry, even if the last vaccination was >10 years prior.

In the United States, the Advisory Committee on Immunization Practices (ACIP) published a new recommendation in 2015 that 1 dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. The recommendation also identifies specific groups of travelers who should receive additional doses and others for whom additional doses may be considered. For details, see Chapter 4, Yellow Fever. For the most up-to-date information about yellow fever vaccine boosters, consult the CDC Travelers’ Health website or the specific publication posted on the ACIP website (www.cdc.gov/mmwr/pdf/wk/mm6423.pdf).

Ultimately, the clinician’s decision whether or not to vaccinate any traveler must take into account the traveler’s risk of being infected with YF virus, country entry requirements, and individual risk factors for serious adverse events after YF vaccination (such as age and immune status). For a thorough discussion of YF and guidance for vaccination, see Chapter 4, Yellow Fever.

NOTE: Despite the recent changes to the IHR regarding YF vaccine boosters, it is uncertain whether all countries with YF vaccination entry requirements will fully adopt this change. Even if countries modify their official policies to extend the validity period of the ICVP from 10 years to the lifetime of the vaccinee, there is no guarantee that all national border officials will be aware of such policy change or be able to enforce it. CDC obtains information yearly from WHO about official country entry requirements. WHO likely will not be asking countries about YF vaccine booster entry requirements in the yearly questionnaires, because it will be assumed that countries are complying with the amended IHR. This could leave a gap in the foreseeable future in accurate published information about entry requirements for YF vaccine boosters for certain countries. Past experience has demonstrated that information given by consulates and embassies about vaccination requirements is often not accurate. Therefore, providers and travelers should not rely solely on such information when determining current YF vaccination entry requirements for specific destinations. With the caveats described above, readers should refer to the online version of this book (www.cdc.gov/yellowbook) and the CDC Travelers’ Health website (www.cdc.gov/travel) for any reported updates to country entry requirements since publication of this edition.

Table 2-06. Categories of recommendations for yellow fever (YF) vaccination

YF VACCINATION CATEGORY RATIONALE FOR RECOMMENDATION
Recommended Vaccination recommended for all travelers ≥9 months of age to areas with endemic or transitional YF risk, as determined by persistent or periodic YF virus transmission.
Generally not recommended Vaccination generally not recommended in areas where the potential for YF virus exposure is low, as determined by absence of reports of human YF and past evidence suggestive of only low levels of YF virus transmission. However, vaccination might be considered for a small subset of travelers who are at increased risk for exposure to YF virus because of prolonged travel, heavy exposure to mosquitoes, or inability to avoid mosquito bites.
Not recommended Vaccination not recommended in areas where there is no risk of YF virus transmission, as determined by absence of past or present evidence of YF virus circulation in the area or environmental conditions not conducive to YF virus transmission.

MALARIA

The following recommendations to protect travelers from malaria were developed by using the best available data from multiple sources. Countries are not required to submit malaria surveillance data to CDC. On an ongoing basis, CDC actively solicits data from multiple sources, including WHO (main and regional offices); national malaria control programs; international organizations, such as the International Society of Travel Medicine; CDC overseas staff; US military; academic, research, and aid organizations; and published records from the medical literature. The reliability and accuracy of those data are also assessed. If the information is available, trends in malaria incidence and other data are considered in the context of malaria control activities within a given country or other mitigating factors such as natural disasters, wars, and other events that may affect the ability to control malaria or accurately count and report it. Factors such as the volume of travel to that country and the number of acquired cases reported in the US surveillance system are also examined. Based on all those considerations, recommendations are developed to try to accurately describe areas of the country where transmission occurs, substantial occurrences of antimalarial drug resistance, the proportions of species present, and the recommended prophylaxis options.

These recommendations should be used in conjunction with an individual risk assessment, taking into account not only the destination country but also the detailed itinerary including specific cities, types of accommodation, season, and style of travel, as well as special health conditions such as pregnancy.

Several medications are available for malaria prophylaxis. When deciding which drug to use, clinicians should consider the specific itinerary, length of trip, drug costs, previous adverse reactions to antimalarials, drug allergies, and medical history.

For a thorough discussion of malaria and guidance for prophylaxis, see Chapter 4, Malaria.

Afghanistan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: April–December in all areas <2,500 m (8,202 ft).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 95%, P. falciparum 5%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Afghanistan

Albania

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Albania

Algeria

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Algeria

American Samoa (US)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to American Samoa

Andorra

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Andorra

Angola

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. ovale 5%, P. vivax 5%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Angola

Anguilla (U.K.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Anguilla (U.K.)

Antarctica

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Antarctica

Antigua and Barbuda

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Antigua and Barbuda

Argentina

Related Maps

Map 2-1. Yellow fever vaccine recommendations in Argentina

Yellow Fever

Requirements: None

Recommendations: Recommended for travelers ≥9 months of age going to Corrientes and Misiones Provinces. Generally not recommended for travelers going to Formosa Province and designated areas of Chaco, Jujuy, and Salta Provinces (see Map 2-1). Not recommended for all travelers whose itineraries are limited to areas and provinces not listed above.

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Argentina

Armenia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Armenia

Aruba

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Aruba

Australia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission. This requirement excludes Galápagos Islands in Ecuador.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Australia

Austria

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Austria

Azerbaijan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Azerbaijan

Azores (Portugal)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Azores

Bahamas, The

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to The Bahamas

Bahrain

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Bahrain

Bangladesh

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: All areas, except in the city of Dhaka.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 10%, and P. malariae rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Bangladesh

Barbados

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1 This requirement excludes Guyana and the island of Trinidad.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Barbados

Belarus

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Belarus

Belgium

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Belgium

Belize

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Rare locally transmitted cases. None in Belize City and islands frequented by tourists such as Ambergris Caye.

Drug resistance3: None.

Malaria species: P. vivax 100%.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Belize

Benin

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Benin

Bermuda (U.K.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Bermuda (U.K.)

Bhutan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: Rare cases in rural areas <1,700 m (5,577 ft) in districts along the southern border shared with India. Rare seasonal cases May–September in Ha, Lhuentse, Monggar, Punakha, Trashigang, Trongsa, Tsirang, Yangtse, and Wangdue. None in districts of Bumthang, Gaza, Paro, and Thimphu.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 70%, P. vivax 30%.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Bhutan

Bolivia

Related Maps

Map 2-02. Yellow fever vaccine recommendations in Bolivia
Map 2-03. Malaria transmission areas in Bolivia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: Recommended for all travelers ≥9 months of age traveling to the following areas <2,300 m (7,546 ft) in elevation and east of the Andes Mountains: the entire departments of Beni, Pando, Santa Cruz, and designated areas (see Map 2-02) of Chuquisaca, Cochabamba, La Paz, and Tarija departments. Not recommended for travelers whose itineraries are limited to areas >2,300 m (7,546 ft) in elevation and all areas not listed above, including the cities of La Paz and Sucre.

Malaria

Areas with malaria: All areas <2,500 m (8,202 ft). None in the city of La Paz (see Map 2-03).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 93%, P. falciparum 7%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, primaquine,4 or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Bolivia

Bonaire

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Bonaire

Bosnia and Herzegovina

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Bosnia and Herzegovina

Botswana

Related Maps

Map 2-04. Malaria transmission areas in Botswana

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present in the following subdistricts: Botete, Chobe (including Chobe National Park), Ngami, Okavango, and Tuteme. Also present in the following districts: Bobirwa, Northeast (including Francistown), Ghanzi, Mahalapaye, and Serowe Palapye. Rare cases in the districts of Kgalagadi North, Keneng West, and Southern. None in the city of Gaborone (see Map 2-04).

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%, P. ovale 5%.

Recommended chemoprophylaxis: Subdistricts of Botete, Chobe (including Chobe National Park), Ngami, Okavango, and Tuteme and districts or Bobirwa, Northeast (including Francistown), Ghanzi, Mahalapaye, and Serowe Palapye: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Areas with rare cases: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Botswana

Brazil

Related Maps

Map 2-05. Yellow fever vaccine recommendations in Brazil
Map 2-06. Malaria transmission areas in Brazil

Yellow Fever

Requirements: None

Recommendations: Recommended for all travelers ≥9 months of age going to the following areas: the entire states of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Espirito Santo,* Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Paraná,* Rio de Janeiro (including the city of Rio de Janeiro and all coastal islands),* Rio Grande do Sul,* Rondônia, Roraima, Santa Catarina,* São Paulo (including the city of São Paulo and all coastal islands),* and Tocantins and designated areas (see Map 2-05) of the following states: Bahia* and Piauí. Vaccination is also recommended for travelers visiting Iguaçu Falls. Not recommended for travelers whose itineraries are limited to areas not listed above, including the cities of Fortaleza and Recife (see Map 2-05). *Note: In 2017, CDC expanded YF vaccination recommendations for travelers to Brazil in response to a large YF outbreak in multiple eastern states. A list of areas in Bahia state for which vaccination is now recommended can be found at www.who.int/ith/ith-country-list.pdf. The expanded YF vaccination recommendations for these states are preliminary. For updates, refer to the CDC Travelers’ Health website at www.cdc.gov/travel.

 

Malaria

Areas with malaria: All areas of the states of Acre, Amapá, Amazonas, Rondonia, and Roraima. Also present in the states of Maranhão, Mato Grosso, and Para, but rare cases in their capital cities. Rare cases in the rural areas of the states of Espirito Santo, Goias, Mato Grosso do Sul, Piaui, and Tocantins. Rare cases in the rural forested areas of the states of Rio de Janeiro and São Paolo. No malaria in the cities of Brasilia, Rio de Janeiro, São Paolo, and none at Iguaçu Falls (see Map 2-06).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 85%, P. falciparum 15%.

Recommended chemoprophylaxis: States of Acre, Amapá, Amazonas, Rondonia, and Roraima. States of Maranhão, Mato Grosso, and Para (but not their capital cities): Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Areas with rare cases: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Brazil

British Indian Ocean Territory; includes Diego Garcia (U.K.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to British Indian Ocean Territory (U.K.)

Brunei

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Brunei

Bulgaria

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Bulgaria

Burkina Faso

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >80%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Burkina Faso

Burma (Myanmar)

Related Maps

Map 2-07. Malaria transmission areas in Burma

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present at altitudes <1,000 m (3,281 ft), including Bagan. Rare transmission above 1,000 m (3,281 ft) (see Map 2-07).

Drug resistance3: Chloroquine and mefloquine.

Malaria species: P. falciparum 60%, P. vivax 35%, P. malariae, P. ovale, and P. knowlesi rare.

Recommended chemoprophylaxis: In the provinces of Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi <1,000 m (3,281 ft): Atovaquone-proguanil, doxycycline, or tafenoquine.4 All other areas <1,000 m (3,281 ft): Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Above 1,000 m (3,281 ft): None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Burma (Myanmar)

Burundi

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit in an airport located in a country with risk of YF virus transmission.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 86%, P. malariae, P. ovale, and P. vivax 14% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Burundi

Cambodia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present throughout the country, including Siem Reap city. None in the city of Phnom Penh or at the temple complex at Angkor Wat.

Drug resistance3: Chloroquine and mefloquine.

Malaria species: P. falciparum 60%, P. vivax 40%.

Recommended chemoprophylaxis: In the provinces of Banteay Meanchey, Battambang, Kampot, Koh Kong, Odder Meanchey, Pailin, Preah Vihear, Pursat, and Siem Reap bordering Thailand: Atovaquone-proguanil, doxycycline, or tafenoquine.4 All other areas with malaria: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Cambodia

Cameroon

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Cameroon

Canada

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Canada

Canary Islands (Spain)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Canary Islands (Spain)

Cape Verde

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Rare cases in São Tiago Island.

Drug resistance3: Chloroquine.

Malaria species: Primarily P. falciparum.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Cape Verde

Cayman Islands (U.K.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Cayman Islands (U.K.)

Central African Republic

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%, P. malariae, P. ovale, and P. vivax 15% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Central African Republic

Chad

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age traveling to areas south of the Sahara Desert (see Map 4-13). Not recommended for travelers whose itineraries are limited to areas in the Sahara Desert (see Map 4-13).

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%, P. malariae, P. ovale, and P. vivax 15% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Chad

Chile

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Chile

China

Related Maps

Map 2-08. China reference map

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit in an airport located in a country with risk of YF virus transmission.1 This requirement does not apply to travelers whose itineraries are limited to Hong Kong Special Administrative Region (SAR) and Macao SAR.

Recommendations: None

Malaria

Areas with malaria: Rare cases in the counties along the China-Burma (Myanmar) border in Yunnan Province and Motuo County in Tibet. No malaria in areas where most major river cruises pass.

Drug resistance3: Chloroquine and mefloquine.

Malaria species: Primarily P. vivax; P. falciparum in Yunnan Province.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to China

Christmas Island (Australia)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1 This requirement excludes Galápagos Islands in Ecuador.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Christmas Island (Australia)

Cocos (Keeling) Islands (Australia)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1 This requirement excludes Galápagos Islands in Ecuador and the island of Tobago; it is limited to Misiones Province in Argentina.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Cocos (Keeling) Islands (Australia)

Colombia

Related Maps

Map 2-09. Yellow fever vaccine recommendations in Colombia
Map 2-10. Malaria transmission areas in Colombia

Yellow Fever

Requirements: Required if arriving from Angola, Brazil, Democratic Republic of the Congo, or Uganda and ≥1 year of age and for travelers who have transited >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age except as mentioned below. Generally not recommended for travelers to the cities of Barranquilla, Cali, Cartagena, and Medellín (see Map 2-09). Not recommended for travelers whose itineraries are limited to all areas >2,300 m (7,546 ft) in elevation, the department of San Andrès y Providencia, and the capital city of Bogotá.

Malaria

Areas with malaria: All areas <1,700 m (5,577 ft). None in Bogotá, Cartagena, and Medellin. (See Map 2-10).

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 50%, P. vivax 50%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Colombia

Comoros

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: Primarily P. falciparum.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Comoros

Congo, Republic of the (Congo-Brazzaville)

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Congo, Republic of the

Cook Islands (New Zealand)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Cook Islands (New Zealand)

Costa Rica

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1 This requirement includes Tanzania and Zambia in the African region; excludes Argentina and Panama in the Americas; and has the following specifications for these countries: Colombia (the entire country except Barranquilla, Cali, Cartagena, Medellín and San Andrés Providencia y Bogotá); Ecuador (applies only to Morona-Santiago, Napo, Orellana, Pastaza, Sucumbíos y Zamora-Chinchipe, and excludes the rest of the country); Paraguay (the entire country except Asunción, the capital); Peru (the entire country except Lima, the capital, Cuzco, Machu Picchu, the Inca Trail, Lambayeque, Tumbes, Piura and Cajamarca); Trinidad and Tobago (the entire country except the urban areas of Port of Spain, and for travelers in transit or whose itineraries are limited to the island of Tobago).

Recommendations: None

Malaria

Areas with malaria: Rare local cases in Matina Canton in Limón Province, Sarapiquí Canton in Heredia Province, and Pital District in San Carlos Canton in Alajuela Province.

Drug resistance3: None.

Malaria species: P. vivax

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Costa Rica

Croatia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Croatia

Cuba

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Cuba

Curaçao

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See other recommended vaccines and medicines for travelers to Curaçao

Cyprus

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Cyprus

Czech Republic

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Czech Republic

Côte d'Ivoire (Ivory Coast)

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Côte d'Ivoire

Democratic Republic of the Congo (Congo-Kinshasa)

Yellow Fever

Requirements: Required for arriving travelers from all countries if travelers is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >90%, P. ovale 5%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Democratic Republic of the Congo

Denmark

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Denmark

Djibouti

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%–10%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Djibouti

Dominica

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Dominica

Dominican Republic

Yellow Fever

Requirements: A yellow fever vaccination certificate is required for travelers aged ≥1 year arriving from the states of Minas Gerais, Espirito Santo, Sao Paulo, and Rio de Janeiro in Brazil, including transit for >12 hours in an airport in these states.

Recommendations: None

Malaria

Areas with malaria: Primarily in the provinces by the border with Haiti, and the provinces (including resort areas) of Santo Domingo and La Altagracia. Rare locally transmitted cases in the city of Santo Domingo (Distrito Nacional) and other provinces.

Drug resistance3: None.

Malaria species: P. falciparum 100%

Recommended chemoprophylaxis: Provinces bordering Haiti, and provinces of Santo Domingo (except Santo Domingo city [Distrito Nacional]) and La Altagracia: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or tafenoquine.4 Santo Domingo (Distrito Nacional) city and other provinces: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Dominican Republic

Easter Island (Chile)

Yellow Fever

Requirements: This country has not stated its YF vaccination certificate requirements.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Easter Island (Chile).

Ecuador, including the Galápagos Islands

Related Maps

Map 2-11. Yellow fever vaccine recommendations in Ecuador
Map 2-12. Malaria transmission areas in Ecuador

Yellow Fever

Requirements: Required for travelers ≥1 year of age arriving from Brazil, Democratic Republic of the Congo, or Uganda, including transit in an airport for >12 hours in any of these countries.1

Recommendations: Recommended for all travelers ≥9 months of age traveling to areas <2,300 m (7,546 ft) in elevation in the following provinces east of the Andes Mountains: Morona-Santiago, Napo, Orellana, Pastaza, Sucumbios, and Zamora-Chinchipe (Map 2-11).
Generally not recommended for travelers whose itineraries are limited to areas <2,300 m (7,546 ft) in elevation in the following provinces west of the Andes mountains: Esmeraldas,* Guayas, Los Rios, Santa Elena, Santo Domingo de los Tsachilas, and designated areas of Azuay, Bolivar, Canar, Carchi, Chimborazo, Cotopaxi, El Oro, Imbabura, Loja, Pichincha, and Tungurahua (Map 2-11).
Not recommended for travelers whose itineraries are limited to all areas >2,300 m (7,546 ft) in elevation, the cities of Guayaquil and Quito, or the Galápagos Islands (Map 2-11).
*The CDC vaccination recommendation for Esmeraldas Province differs from that published on the WHO International Travel and Health website.

Malaria

Areas with malaria: Areas at altitudes <1,500 m (4,921 ft) in the provinces of Carchi, Esmeraldas, Morona Santiago, Orellana, and Pastaza. Rare cases in other provinces in areas <1,500 m (4,921 ft). Not present in the cities of Guayaquil and Quito or the Galápagos Islands (see Map 2-12).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 72%, P. falciparum 28%.

Recommended chemoprophylaxis: Areas with malaria in Carchi, Esmeraldas, Morona Santiago, Orellana, and Pastaza Provinces: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Other areas with rare cases of malaria: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Ecuador.

Egypt

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission. This includes Eritrea, Rwanda, Somalia, Tanzania, and Zambia.1 In the absence of a vaccination certificate, the person will be detained in quarantine for up to 6 days afer departure from an area at risk of YF virus transmission.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Egypt.

El Salvador

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Rare cases along Guatemalan border.

Drug resistance3: None.

Malaria species: P. vivax 99%, P. falciparum <1%.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to El Salvador.

Equatorial Guinea

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%; P. malariae, P. ovale, and P. vivax 15% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Equatorial Guinea.

Eritrea

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Generally not recommended for travelers going to the following states: Anseba, Debub, Gash Barka, Mae Kel, and Semenawi Keih Bahri. Not recommended for all areas not listed above, including the Dahlak Archipelago (see Map 4-13).

Malaria

Areas with malaria: All areas <2,200 m (7,218 ft). None in Asmara.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%, P. vivax 10%–15%, P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Eritrea.

Estonia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Estonia.

Eswatini (Swaziland)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present in eastern areas bordering Mozambique and South Africa, including all of Lubombo district and the eastern half of Hhohho, Manzini, and Shiselweni districts.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%, P. ovale 5%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Swaziland.

Ethiopia

Related Maps

Map 3-27. Yellow fever vaccine recommendations in Ethiopia
Map 3-28. Malaria transmission areas in Ethiopia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age, except as mentioned below. Generally not recommended for travelers whose itinerary is limited to the Afar and Somali Provinces (see Map 3-27).

Malaria

Areas with malaria: All areas below 2,500 m (8,202 ft), except none in the city of Addis Ababa (see Map 3-28).

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 60%–70%, P. vivax 30%–40%, P. malariae and P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Ethiopia.

Falkland Islands (Islas Malvinas)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Falkland Islands (Islas Malvinas).

Faroe Islands (Denmark)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Faroe Islands (Denmark).

Fiji

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Fiji.

Finland

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Finland.

France

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to France.

French Guiana

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥1 year of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All areas, including Matoury, Macouria, and Kourou, except none in coastal areas west of Kourou and Cayenne City.

Drug resistance3: Chloroquine.

Malaria species: P. vivax >70%, P. falciparum 20%–30%, P. malariae rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to French Guiana (France).

French Polynesia, including the island groups of Society Islands (Tahiti, Moorea, and Bora-Bora); Marquesas Islands (Hiva Oa and Ua Huka); and Austral Islands (Tubuai and Rurutu)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to French Polynesia (France).

Gabon

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥1 year of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. malariae, P. ovale, and P. vivax 10% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Gabon.

Gambia, The

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum ≥85%, P. ovale 5%–10%, P. malariae and P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to The Gambia.

Georgia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Georgia.

Germany

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Germany.

Ghana

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Ghana.

Gibraltar (U.K.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Gibraltar (U.K.).

Greece

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: Rare local transmission May–November associated with imported malaria cases, in agricultural areas. None in tourist areas.

Drug resistance3: Not applicable.

Malaria species: P. vivax 100%.

Recommended chemoprophylaxis: None.

Other Vaccines to Consider

See Health Information for Travelers to Greece.

Greenland (Denmark)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Greenland (Denmark).

Grenada

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Grenada.

Guadeloupe

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Guadeloupe.

Guam (U.S.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Guam (U.S.).

Guatemala

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Rural areas only at altitudes <1,500 m (4,921 ft). None in Antigua, Guatemala City, or Lake Atitlán.

Drug resistance3: None.

Malaria species: P. vivax 97%, P. falciparum 3%.

Recommended chemoprophylaxis: Escuintla Province: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or tafenoquine.4 All other areas with malaria: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,4 or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Guatemala.

Guinea

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Guinea.

Guinea-Bissau

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥1 year of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Guinea-Bissau.

Guyana

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All areas. Rare cases in cities of Amsterdam and Georgetown.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 50%, P. vivax 50%.

Recommended chemoprophylaxis: Areas with malaria except cities of Amsterdam and Georgetown: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Cities of Amsterdam and Georgetown: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Guyana.

Haiti

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

Areas with malaria: All (including Port Labadee).

Drug resistance3: None.

Malaria species: P. falciparum 99%, P. malariae rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Haiti.

Honduras

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

Areas with malaria: Present throughout the country and in Roatán and other Bay Islands. None in San Pedro Sula and Tegucigalpa.

Drug resistance3: None.

Malaria species: P. vivax 93%, P. falciparum 7%.

Recommended chemoprophylaxis: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,4 or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Honduras.

Hong Kong SAR (China)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Hong Kong SAR (China).

Hungary

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Hungary.

Iceland

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Iceland.

India

Related Maps

Map 2-15. Malaria in India

Yellow Fever

Requirements: Any traveler (except infants <9 months old) arriving by air or sea without a yellow fever vaccination certificate is detained in isolation for up to 6 days if that person—

1) arrives within 6 days of departure from an area with risk of YF virus transmission,
2) has been in such an area in transit (except those passengers and members of flight crews who, while in transit through an airport in an area with risk of YF virus transmission, remained in the airport during their entire stay and the health officer agrees to such an exemption),
3) arrives on a ship that started from or touched at any port in an area with risk of YF virus transmission up to 30 days before its arrival in India, unless such a ship has been disinsected in accordance with the procedure recommended by WHO, or
4) arrives on an aircraft that has been in an area with risk of YF virus transmission and has not been disinsected in accordance with the Indian Aircraft Public Health Rules, 1954, or as recommended by WHO.

The following are regarded as countries and areas with risk of YF virus transmission:
Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Togo, and Uganda.
Americas: Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago (Trinidad only), and Venezuela.
Note: When a case of yellow fever is reported from any country, that country is regarded by the government of India as a country with risk of YF virus transmission and is added to the above list.

Recommendations: None

Malaria

Areas with malaria: All areas throughout the country, including cities of Bombay (Mumbai) and Delhi, except none in areas >2,000 m (6,562 ft) in Himachal Pradesh, Jammu and Kashmir, and Sikkim (see Map 2-15).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 50%, P. falciparum >40%, P. malariae and P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to India.

Indonesia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: None

Malaria

Areas with malaria: All areas of eastern Indonesia (provinces of Maluku, Maluku Utara, Nusa Tenggara Timur, Papua, and Papua Barat), including the town of Labuan Bajo and Komodo Islands in the Nusa Tenggara region. Rural areas of Kalimantan (Borneo), Nusa Tenggara Barat (includes the island of Lombok), Sulawesi, and Sumatra. Low transmission in rural areas of Java, including Pangandaran, Sukalumi, and Ujung Kulong. None in cities of Jakarta and Ubud, resort areas of Bali and Java, and Gili Islands and the Thousand Islands (Pulau Seribu).

Drug resistance3: Chloroquine (P. falciparum and P. vivax).

Malaria species: P. falciparum 57%, P. vivax. 43%, P. malariae, P. knowlesi, P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Indonesia.

Iran

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: March—November in rural areas of Fars Province, Sistan-Baluchestan Province, and southern, tropical parts of Hormozgan and Kerman Provinces.

Drug resistance3: Chloroquine.

Malaria species: P. vivax 93%, P. falciparum 7%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Iran.

Iraq

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Iraq.

Ireland

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Ireland.

Israel

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Israel, including the West Bank and Gaza.

Italy including Holy See (Vatican City)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Italy.

Jamaica

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Jamaica.

Japan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Japan.

Jordan

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Jordan.

Kazakhstan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Kazakhstan.

Kenya

Related Maps

Map 2-16. Yellow fever vaccine recommendations in Kenya
Map 2-17. Malaria transmission areas in Kenya

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: Recommended for all travelers ≥9 months of age, except as mentioned below. Generally not recommended for travelers whose itinerary is limited to the following areas: the entire North Eastern Province; the states of Kilifi, Kwale, Lamu, Malindi, and Tanariver in the Coast Province; and the cities of Mombasa and Nairobi (see Map 2-16).

Malaria

Areas with malaria: Present in all areas (including game parks) at altitudes <2,500 m (8,202 ft) including the city of Nairobi (see Map 2-17).

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. vivax 5%–10%, P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Kenya.

Kiribati (formerly Gilbert Islands), includes Tarawa, Tabuaeran (Fanning Island), and Banaba (Ocean Island)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Kiribati.

Kosovo

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Kosovo.

Kuwait

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Kuwait.

Kyrgyzstan

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Kyrgyzstan.

Laos

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: All, except none in the city of Vientiane.

Drug resistance3: Chloroquine and mefloquine.

Malaria species: P. falciparum 65%, P. vivax 34%, P. malariae and P. ovale 1% combined.

Recommended chemoprophylaxis: Along the Laos-Burma (Myanmar) border in the provinces of Bokeo and Louang Namtha and along the Laos-Thailand border in the province of Champasak and Saravan, along the Laos-Cambodia border, and along the Laos-Vietnam border: Atovaquone-proguanil, doxycycline, or tafenoquine.4 All other areas with malaria: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Laos.

Latvia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Latvia.

Lebanon

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Lebanon.

Lesotho

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥6 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Lesotho.

Liberia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%-10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Liberia.

Libya

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Libya.

Liechtenstein

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Liechtenstein.

Lithuania

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Lithuania.

Luxembourg

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Luxembourg.

Macau SAR (China)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Macau SAR (China).

Madagascar

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: All areas, except rare cases in the city of Antananarivo.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%, P. vivax 5%–10%, P. ovale 5%.

Recommended chemoprophylaxis: All areas except the city of Antananarivo: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Antananarivo: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Madagascar.

Madeira Islands (Portugal)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Madeira Islands (Portugal).

Malawi

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%; P. malariae, P. ovale, and P. vivax 10% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Malawi.

Malaysia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present in rural areas. None in Georgetown, Kuala Lumpur, and Penang State (includes Penang Island).

Drug resistance3: Chloroquine.

Malaria species: P. falciparum, P. vivax, P. Knowlesi, P. malariae, and P. ovale.

Recommended chemoprophylaxis: Rural areas: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Malaysia.

Maldives

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Maldives.

Mali

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥1 year of age.

Recommendations: Recommended for all travelers ≥9 months of age going to areas south of the Sahara Desert (see Map 4-13). Not recommended for travelers whose itineraries are limited to areas in the Sahara Desert (see Map 4-13).

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Mali.

Malta

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1 If indicated on epidemiologic grounds, infants <9 months of age are subject to isolation or surveillance if coming from an area with risk of YF virus transmission.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Malta.

Marshall Islands

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Marshall Islands.

Martinique (France)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Martinique (France).

Mauritania

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: Recommended for all travelers ≥9 months of age traveling to areas south of the Sahara Desert (see Map 4-13). Not recommended for travelers whose itineraries are limited to areas in the Sahara Desert (see Map 4-13).

Malaria

Areas with malaria: All areas except Dakhlet-Nouadhibou and Tiris-Zemour in the north.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%-10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Mauritania.

Mauritius

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Mauritius.

Mayotte (France)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Rare cases.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 93%, P. vivax 5%, P. malariae and P. ovale 2%.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Mayotte (France).

Mexico

Related Maps

Map 2-18. Malaria transmission areas in Mexico

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: Present in Chiapas and southern part of Chihuahua. Rare cases in Campeche, Durango, Jalisco, Nayarit, Quintana Roo, San Luis Potosi, Sinaloa, Sonora, and Tabasco. No malaria along the US–Mexico border (see Map 2-18).

Drug resistance3: None.

Malaria species: P. vivax 100%.

Recommended chemoprophylaxis: States of Chiapas and southern part of Chihuahua: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,4 or tafenoquine.4 States of Campeche, Durango, Jalisco, Nayarit, Quintana Roo, San Luis Potosi, Sinaloa, Sonora, and Tabasco: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Mexico.

Micronesia, Federated States of; includes Yap Islands, Pohnpei, Chuuk, and Kosrae

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Micronesia, Federated States of.

Moldova

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Moldova.

Monaco

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Monaco.

Mongolia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Mongolia.

Montenegro

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Montenegro.

Montserrat (U.K.)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Montserrat (U.K.).

Morocco

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Morocco.

Mozambique

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >90%, P. malariae, P. ovale, and P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Mozambique.

Namibia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present in the regions of Kavango (East and West), Kunene, Ohangwena, Omusati, Oshana, Oshikoto, Otjozondjupa, and Zambezi.  Rare cases in other parts of the country. No malaria in city of Windhoek.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >90%; P. malariae, P. ovale, and P. vivax rare.

Recommended chemoprophylaxis: Kavango (East and West), Kunene, Ohangwena, Omusati, Oshana, Oshikoto, Otjozunupa, and Zambezi: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Other parts of the country with rare cases: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Namibia.

Nauru

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Nauru.

Nepal

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present throughout the country at altitudes <2,000 m (6,562 ft). None in Kathmandu and on typical Himalayan treks.

Drug resistance3: Chloroquine.

Malaria species: P. vivax 85%, P. falciparum 15%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Nepal.

Netherlands

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to The Netherlands.

Netherlands Antilles (Bonaire, Curaçao, Saba, St. Eustasius, and St. Maarten)

Yellow Fever

Requirements: See Bonaire, Curaçao, Saba, St. Eustasius, and St. Maarten for yellow fever information.

Recommendations: None

Malaria

Areas with malaria: See Bonaire, Curaçao, Saba, St. Eustasius, and St. Maarten for malaria information.

New Caledonia (France)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1 Note: In the event of an epidemic threat to the territory, a specific vaccination certificate may be required.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to New Caledonia (France).

New Zealand

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to New Zealand.

Nicaragua

Related Maps

Map 2-20. Malaria transmission areas in Nicaragua

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

Areas with malaria: Present in Región Autónoma Atlántico Norte (RAAN) and Región Autónoma Atlántico Sur (RAAS).  Rare cases in Boaco, Chinandega, Esteli, Jinotega, Leon, Matagalpa, and Nueva Segovia.  No malaria in the city of Managua (see Map 2-20).

Drug resistance3: None.

Malaria species: P. vivax 90%, P. falciparum 10%.

Recommended chemoprophylaxis: Región Autónoma Atlántico Norte (RAAN) and Región Autónoma Atlántico Sur (RAAS): Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or tafenoquine.4 Other areas with malaria: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Nicaragua.

Niger

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥1 year of age. The government of Niger recommends vaccine for travelers departing Niger.

Recommendations: Recommended for all travelers ≥9 months of age traveling to areas south of the Sahara Desert (see Map 4-13). Not recommended for travelers whose itineraries are limited to areas in the Sahara Desert (see Map 4-13).

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Niger.

Nigeria

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Nigeria.

Niue (New Zealand)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Niue (New Zealand).

Norfolk Island (Australia)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission. This requirement excludes Galápagos Islands in Ecuador.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Norfolk Island (Australia).

North Korea

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

Areas with malaria: Present in southern provinces.

Drug resistance3: None.

Malaria species: Presumed to be 100% P. vivax.

Recommended chemoprophylaxis: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,4 or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to North Korea.

North Macedonia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to North Macedonia.

Northern Mariana Islands (U.S.), includes Saipan, Tinian, and Rota Island

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Northern Mariana Islands (U.S.).

Norway

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Norway.

Oman

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Sporadic transmission in Dakhliyah, North Batinah, and North and South Sharqiyah.

Drug resistance3: Chloroquine

Malaria species: P. falciparum and P. vivax

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Oman.

Pakistan

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

Areas with malaria: All areas (including all cities) <2,500 m (<8,202 ft).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 70%, P. falciparum 30%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Pakistan.

Palau

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Palau.

Panama

Related Maps

Map 2-21. Yellow fever vaccine recommendations in Panama
Map 2-22. Malaria transmission areas in Panama

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age traveling to all mainland areas east of the area surrounding the canal (the entire provinces of Darién, Emberá, and Kuna Yala [also spelled Guna Yala] and areas of the provinces of Colón and Panamá that are east of the canal) (see Map 2-21). Not recommended for travelers whose itineraries are limited to areas west of the canal, the city of Panama, the canal area itself, and the Balboa Islands (Pearl Islands) and San Blas Islands (see Map 2-21).

Malaria

Areas with malaria: Present in the provinces of Darien, Kuna Yala (also spelled Guna Yala), Ngäbe-Buglé, and eastern Panama province. None in Panama Oeste, the Canal Zone, and Panama City (see Map 2-22).

Drug resistance3: Chloroquine (east of the Panama Canal).

Malaria species: P. vivax 99%, P. falciparum 1%.

Recommended chemoprophylaxis: Provinces of Darien, Guna Yala, and eastern Panama province: Atovaquone-proguanil, doxycycline, mefloquine, primaquine,4 or tafenoquine.4 Ngäbe-Buglé: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,4 or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Panama.

Papua New Guinea

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.

Recommendations: None

Malaria

Areas with malaria: Present throughout the country at altitudes <2,000 m (6,562 ft).

Drug resistance3: Chloroquine (both P. falciparum and P. vivax).

Malaria species: P. falciparum 65%–80%, P. vivax 10%–30%, P. malariae and P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Papua New Guinea.

Paraguay

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: Recommended for all travelers ≥9 months of age, except as mentioned below. Generally not recommended for travelers whose itinerary is limited to the city of Asunción.

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Paraguay.

Peru

Related Maps

Map 2-23. Yellow fever vaccine recommendations in Peru
Map 2-24. Malaria transmission areas in Peru

Yellow Fever

Requirements: None

Recommendations: Recommended for all travelers ≥9 months of age going to areas at elevations <2,300 m (7,546 ft) in the regions of Amazonas, Loreto, Madre de Dios, San Martin and Ucayali, Puno, Cusco, Junín, Pasco, and Huánuco, and designated areas (see Map 2-23) of the following regions: far north of Apurimac, far northern Huancavelica, far northeastern Ancash, eastern La Libertad, northern and eastern Cajamarca, northern and northeastern Ayacucho, and eastern Piura. Generally not recommended for travelers whose itineraries are limited to the following areas west of the Andes: regions of Lambayeque and Tumbes and the designated areas (see Map 2-23) of western Piura and south, west, and central Cajamarca. Not recommended for travelers whose itineraries are limited to the following areas: all areas >2,300 m (7,546 ft) in elevation, areas west of the Andes not listed above, the city of Cusco, the capital city of Lima, Machu Picchu, and the Inca Trail (see Map 2-23).

Malaria

Areas with malaria: All departments <2,000 m (6,562 ft), including the cities of Iquitos and Puerto Maldonado and only the remote eastern regions of La Libertad and Lambayeque. None in the following areas: Lima Province; the cities of Arequipa, Ica, Moquegua, Nazca, Puno, and Tacna; the highland tourist areas (Cusco, Machu Picchu, and Lake Titicaca); and along the Pacific Coast (see Map 2-24).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 85%, P. falciparum 15%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Peru.

Philippines

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present in Palawan and Mindanao Islands. None in metropolitan Manila and other urban areas.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 70%–80%, P. vivax 20%–30%, P. knowlesi rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Philippines.

Pitcairn Islands (U.K.)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Pitcairn Islands (U.K.).

Poland

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Poland.

Portugal

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Portugal.

Puerto Rico (U.S.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Puerto Rico (U.S.).

Qatar

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Qatar.

Romania

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Romania.

Russia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Russia.

Rwanda

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: Generally not recommended for travelers to Rwanda.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%, P. ovale 5%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Rwanda.

Réunion (France)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Réunion (France).

Saba

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Saba.

Saint Barthelemy

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Saint Helena (U.K.)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Saint Helena (U.K.).

Saint Kitts (Saint Christopher) and Nevis (U.K.)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Saint Kitts and Nevis.

Saint Lucia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Saint Lucia.

Saint Martin

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Saint Pierre and Miquelon (France)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Saint Pierre and Miquelon (France).

Saint Vincent and the Grenadines

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Saint Vincent and the Grenadines.

Samoa (formerly Western Somoa)

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Samoa (formerly Western Samoa).

San Marino

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to San Marino.

Saudi Arabia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Asir and Jizan emirates by border with Yemen. None in the cities of Jeddah, Mecca, Medina, Riyadh, and Ta’if.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum predominantly.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Saudi Arabia.

Senegal

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Senegal.

Serbia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Serbia.

Seychelles

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Seychelles.

Sierra Leone

Yellow Fever

Requirements: Required for arriving travelers from all countries.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale 5%–10%, P. malariae and P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Sierra Leone.

Singapore

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Singapore.

Sint Eustatius

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥6 months of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Sint Eustatius.

Sint Maarten

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Sint Maarten.

Slovakia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Slovakia.

Slovenia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Slovenia.

Solomon Islands

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age.1

Recommendations: None

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 60%, P. vivax 35%–40%, P. ovale <1%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Solomon Islands.

Somalia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Generally not recommended for travelers going to the following regions: Bakool, Banaadir, Bay, Galguduud, Gedo, Hiiraan, Lower Juba, Lower Shabelle, Middle Juba, and Middle Shabelle (see Map 4-13). Not recommended for all other areas not listed above.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%–10%, P. malariae and P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Somalia.

South Africa

Related Maps

Map 2-25. Malaria transmission areas in South Africa

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Present along the border with Zimbabwe and Mozambique. Specifically in Mopani, Vhembe, and Waterberg district municipalities of Limpopo Province; Ehlanzeni district municipality in Mpumalanga Province; and Umknanyakude in Kwazulu-Natal Province. Present in Kruger National Park (see Map 2-25).

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%, P. ovale 5%.

Recommended chemoprophylaxis: Areas in Limpopo, Mpumalanga, and Kwazulu-Natal Provinces with malaria: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to South Africa.

South Georgia and the South Sandwich Islands

Yellow Fever

Requirements: This country has not stated its yellow fever vaccination certificate requirements.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to South Georgia and the South Sandwich Islands (U.K.).

South Korea

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: Limited to the months of March–December in rural areas in the northern parts of Incheon, Kangwon-do, and Kyônggi-do Provinces, including the demilitarized zone (DMZ).

Drug resistance3: None.

Malaria species: P. vivax 100%.

Recommended chemoprophylaxis: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,4 or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to South Korea.

South Sudan, Republic of

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%–10%, P. malariae and P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to South Sudan.

Spain

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Spain.

Sri Lanka

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Sri Lanka.

Sudan

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1 A certificate may be required for travelers departing Sudan.

Recommendations: Recommended for all travelers ≥9 months of age traveling to areas south of the Sahara Desert (see Map 4-13). Not recommended for travelers whose itineraries are limited to areas in the Sahara Desert and the city of Khartoum (see Map 4-13).

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 90%, P. vivax 5%–10%, P. malariae and P. ovale rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Sudan.

Suriname

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: Present in the municipality of Tapanahony in Sipaliwini Province. Rare cases in Brokopondo Province, Marowijne Province, and Boven Saramacca municipality in Sipaliwini Province. No malaria in Paramaribo.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 70%, P. vivax 15%–20%.

Recommended chemoprophylaxis: Tapanahony municipality in Sipaliwini Province: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Other areas with malaria: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Suriname.

Sweden

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Sweden.

Switzerland

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Switzerland.

Syria

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Syria.

São Tomé and Príncipe

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit in an airport located in a country with risk of YF virus transmission.1

Recommendations: Generally not recommended for travelers to São Tomé and Príncipe.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%; P. malariae, P. ovale, and P. vivax 15% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to São Tomé and Príncipe.

Taiwan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Taiwan.

Tajikistan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: Rare indigenous cases.

Drug resistance3: Chloroquine.

Malaria species: P. vivax 90%, P. falciparum 10%.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Tajikistan.

Tanzania

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Generally not recommended for travelers to Tanzania.

Malaria

Areas with malaria: All areas <1,800 m (5,906 ft).

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%, P. ovale >10%, P. malariae and P. vivax rare.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Tanzania.

Thailand

Related Maps

Map 2-26. Malaria in Thailand

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: Primarily in provinces that border Burma (Myanmar), Cambodia, and Laos and the provinces of Kalasin, Krabi (Plai Phraya district), Nakhon Si Thammarat, Narathiwat, Pattani, Phang Nga (including Phang Nga City), Rayong, Sakon Nakhon, Songkhla, Surat Thani, and Yala, especially the rural forest and forest fringe areas of these provinces. Rare to few cases in other parts of Thailand, including other parts of Krabi Province and the cities of Bangkok, Chiang Mai, Chiang Rai, Koh Phangan, Koh Samui, and Phuket. None in the islands of Krabi Province (Koh Phi Phi, Koh Yao Noi, Koh Yao Yai, and Ko Lanta) and Pattaya City (see Map 2-26).

Drug resistance3: Chloroquine and mefloquine.

Malaria species: P. falciparum 50% (up to 75% in some areas), P. vivax 50% (up to 60% in some areas),  P. ovale and P. knowlesi rare.

Recommended chemoprophylaxis: Provinces that border Burma (Myanmar), Cambodia, and Laos, the provinces of Kalasin, Plai Phraya district of Krabi, Nakhon Si Thammarat, Narathiwat, Pattani, Phang Nga (including Phang Nga City), Rayong, Sakon Nakhon, Songkhla, Surat Thani, and Yala: Atovaquone-proguanil, doxycycline, or tafenoquine.4 All other areas of Thailand with malaria including the cities of Bangkok, Chiang Mai, Chiang Rai, Koh Phangan, Koh Samui, and Phuket: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Thailand.

Timor-Leste

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: Present in Oecusse District. Rare cases in other districts.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 50%, P. vivax 50%, P. ovale <1%, P. malariae <1%.

Recommended chemoprophylaxis: Oecusse District: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Other districts: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Timor-Leste (East Timor).

Togo

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥9 months of age.

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 85%, P. ovale 5%–10%, remainder P. vivax.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Togo.

Tokelau (New Zealand)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Tokelau (New Zealand).

Tonga

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Tonga.

Trinidad and Tobago

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Recommended for all travelers ≥9 months of age traveling to densely-forested areas on the island of Trinidad. Not recommended for cruise ship passengers and airplane passengers in transit, or travelers whose itineraries are limited to the island of Tobago.

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Trinidad and Tobago.

Tunisia

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Tunisia.

Turkey

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Turkey.

Turkmenistan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Turkmenistan.

Turks and Caicos Islands (U.K.)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Turks and Caicos Islands (U.K.).

Tuvalu

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Tuvalu.

Uganda

Yellow Fever

Requirements: Required for arriving travelers from all countries if traveler is ≥1 year of age.1

Recommendations: Recommended for all travelers ≥9 months of age.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >85%; remainder P. malariae, P. ovale, and P. vivax.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Uganda.

Ukraine

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Ukraine.

United Arab Emirates

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to United Arab Emirates.

United Kingdom (with Channel Islands and Isle of Man)

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to United Kingdom.

United States

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to United States.

Uruguay

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Uruguay.

Uzbekistan

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Uzbekistan.

Vanuatu

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 60%, P. vivax 35%–40%, P. ovale <1%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Vanuatu.

Venezuela

Related Maps

Map 2-27. Yellow fever vaccine recommendations in Venezuela
Map 2-28. Malaria transmission areas in Venezuela

Yellow Fever

Requirements: Required if traveling from Brazil and ≥1 year of age, including transit >12 hours in an airport located in Brazil

Recommendations: Recommended for all travelers ≥9 months of age, except as mentioned below. Generally not recommended for travelers whose itineraries are limited to the following areas: the states of Aragua, Carabobo, Miranda, Vargas, and Yaracuy, and the Distrito Capital (see Map 2-27). Not recommended for travelers whose itineraries are limited to the following areas: all areas >2,300m (7,546 ft) in elevation in the states of Merida, Tachira, and Trujillo; the states of Falcón and Lara; Margarita Island; the capital city of Caracas; and the city of Valencia (see Map 2-27).

Malaria

Areas with malaria: All areas <1,700 m (5,577 ft). Present in Angel Falls (see Map 2-28).

Drug resistance3: Chloroquine.

Malaria species: P. vivax 83%, P. falciparum 17%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Venezuela.

Vietnam

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: Rural areas only. Rare cases in the Mekong and Red River Deltas. None in the cities of Da Nang, Haiphong, Hanoi, Ho Chi Minh (Saigon), Nha Trang, and Qui Nhon.

Drug resistance3: Chloroquine and mefloquine.

Malaria species: P. falciparum 50%–90%, P. vivax. 10%–50%, P. knowlesi rare.

Recommended chemoprophylaxis: Southern part of the country in the provinces of Dac Lac, Gia Lai, Khanh Hoa, Kon Tum, Lam Dong, Ninh Thuan, Song Be, Tay Ninh: Atovaquone-proguanil, doxycycline, or tafenoquine.4 Other areas with malaria except Mekong and Red River Deltas: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Mekong and Red River Deltas: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Vietnam.

Virgin Islands, British

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Virgin Islands, British .

Virgin Islands, U.S.

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Virgin Islands, U.S..

Wake Island, U.S.

Yellow Fever

Requirements: None

Recommendations: None

Malaria

No malaria transmission.

Other Vaccines to Consider

See Health Information for Travelers to Wake Island.

Western Sahara

Yellow Fever

Requirements: This territory has not stated its yellow fever vaccination certificate requirements.

Recommendations: None

Malaria

Areas with malaria: Rare cases.

Drug resistance3: Chloroquine.

Malaria species: Unknown.

Recommended chemoprophylaxis: None (practice mosquito avoidance).

Other Vaccines to Consider

See Health Information for Travelers to Western Sahara.

Yemen

Yellow Fever

Requirements: None

Recommendations: None

Malaria

Areas with malaria: All areas <2,000 m (6,562 ft). None in Sana’a.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum 95%; P. malariae, P. vivax, and P. ovale 5% combined.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Yemen.

Zambia

Related Maps

Map 2-29. Yellow fever vaccine recommendations in Zambia

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: Generally not recommended for travelers going to the North West and Western Provinces (see Map 2-29). Not recommended in all other areas not listed above.

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >90%, P. vivax up to 5%, P. ovale up to 5%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Zambia.

Zimbabwe

Yellow Fever

Requirements: Required if traveling from a country with risk of YF virus transmission and ≥9 months of age, including transit >12 hours in an airport located in a country with risk of YF virus transmission.1

Recommendations: None

Malaria

Areas with malaria: All.

Drug resistance3: Chloroquine.

Malaria species: P. falciparum >90%, P. vivax up to 5%, P. ovale up to 5%.

Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4

Other Vaccines to Consider

See Health Information for Travelers to Zimbabwe.

FOOTNOTES

Yellow Fever
1 The official WHO list of countries with risk of YF virus transmission can be found in Table 4-23. Proof of yellow fever vaccination should be required only if traveling from a country on the WHO list, unless otherwise specified. The following countries, containing only areas with low potential for exposure to YF virus, are not on the WHO list: Eritrea, Rwanda, São Tomé and Príncipe, Somalia, Tanzania, Zambia.
2 An elevation of 2,300 m is equivalent to 7,546 ft.

Malaria
3 Refers to P. falciparum malaria unless otherwise noted.
4 Primaquine and tafenoquine can cause hemolytic anemia in people with G6PD deficiency. Patients must be screened for G6PD deficiency before starting primaquine or tafenoquine. See Tafenoquine Approved for Malaria Prophylaxis and Treatment for more information.

Yellow Fever Maps
1 This map is an updated version of the 2010 map crated by the Informal WHO Working Group on the Geographic Risk of Yellow Fever.
2 Yellow fever (YF) vaccination is generally not recommended in areas where there is low potential for YF virus exposure. However, vaccination might be considered for a small subset of travelers to these areas who are at increased risk for exposure to YF virus because of prolonged travel, heavy exposure to mosquitoes, or inability to avoid mosquito bites. Consideration for vaccination of any traveler must take into account the traveler’s risk of being infected with YF virus, country entry requirements, and individual risk factors for serious vaccine-associated adverse events (such as age or immune status).

 

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