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General information

The information on these pages should be used to research health risks and to
inform the pre-travel consultation. For advice regarding safety and security
please check the UK Foreign and Commonwealth Office (FCO) website.
Travellers should ideally arrange an appointment with their health professional
at least four to six weeks before travel. However, even if time is short, an
appointment is still worthwhile. This appointment provides an opportunity to
assess health risks taking into account a number of factors including
destination, medical history, and planned activities. For those with pre-
existing health problems, an earlier appointment is recommended.
While most travellers have a healthy and safe trip, there are some risks that
are relevant to travellers regardless of destination. These may for example
include road traffic and other accidents, diseases transmitted by insects or
ticks, diseases transmitted by contaminated food and water, sexually
transmitted infections, or health issues related to the heat or cold.
All travellers should ensure they have adequate_travel_health_insurance.
A list of useful resources including advice on how to reduce the risk of
certain health problems is available below.

Resources


* Food_and_water_hygiene
* Insect_and_tick_bite_avoidance
* Personal_safety
* Sexually_transmitted_infections
* Sun_protection


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Vaccine recommendations

Details of vaccination recommendations and requirements are provided below.

All Travellers

Travellers should be up to date with routine vaccination courses and boosters
as recommended_in_the_UK. These vaccinations include for example measles-mumps-
rubella (MMR) vaccine and diphtheria-tetanus-polio vaccine.
Those who may be at increased risk of an infectious disease due to their work,
lifestyle choice, or certain underlying health problems should be up to date
with additional recommended vaccines. See the individual chapters of the ‘Green
Book’ Immunisation_against_infectious_disease for further details.

Certificate Requirements

Please read the information below carefully, as certificate requirements may
be relevant to certain travellers only. For travellers further details, if
required, should be sought from their healthcare professional.
There is no risk of yellow fever on these islands, however, there are
certificate requirements as listed below:

* Bonaire, Saba, Sint Eustatius, Curacao: Under International Health
  Regulations (2005), a certificate of yellow fever vaccination is required
  from travellers over 6 months of age arriving from countries with risk of
  yellow fever transmission.
* For these islands, the yellow fever vaccination certificate is assumed to be
  valid for 10 years until further notice.
* Aruba and Sint Maarten:These islands have not stated their yellow fever
  vaccination certificate requirements.
* View_the_WHO_list_of_countries_with_risk_of_yellow_fever_transmission.
* See_also:_Saint_Martin_(France)


Most Travellers

The vaccines in this section are recommended for most travellers visiting this
country. Information on these vaccines can be found by clicking on the blue
arrow. Vaccines are listed alphabetically.
Tetanus
Tetanus is caused by a toxin released from Clostridium tetani and occurs
worldwide.  Tetanus bacteria are present in soil and manure and may be
introduced through open wounds such as a puncture wound, burn or scratch.

Prevention

Travellers should thoroughly clean all wounds and seek appropriate medical
attention.

Tetanus vaccination


* Travellers should have completed a primary vaccination course according to
  the UK schedule.
* If travelling to a country where medical facilities may be limited, a booster
  dose of a tetanus-containing vaccine is recommended if the last dose was more
  than ten years ago even if five doses of vaccine have been given previously.

Country specific information on medical facilities may be found in the ‘health’
section of the FCO_foreign_travel_advice website.
Tetanus_in_brief

Some Travellers

The vaccines in this section are recommended for some travellers visiting this
country. Information on when these vaccines should be considered can be found
by clicking on the arrow. Vaccines are listed alphabetically.
Hepatitis B
Hepatitis B is a viral infection; it is transmitted by exposure to infected
blood or body fluids. This mostly occurs during sexual contact or as a result
of blood-to-blood contact (for example from contaminated equipment during
medical and dental procedures, tattooing or body piercing procedures, and
sharing of intravenous needles). Mothers with the virus can also transmit the
infection to their baby during childbirth.

Hepatitis B in Netherlands (Caribbean Islands)

2% or more of the population are known or thought to be persistently infected
with the hepatitis B virus (intermediate/high prevalence).

Prevention

Travellers should avoid contact with blood or body fluids. This includes:

* avoiding unprotected sexual intercourse.
* avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile
  equipment is used).
* not sharing needles or other injection equipment.
* following universal precautions if working in a medical/dental/high risk
  setting.

A sterile medical equipment kit may be helpful when travelling to resource poor
areas.

Hepatitis B vaccination

Vaccination could be considered for all travellers, and is recommended for
those whose activities or medical history put them at increased risk including:

* those who may have unprotected sex.
* those who may be exposed to contaminated needles through injecting drug use.
* those who may be exposed to blood or body fluids through their work (e.g.
  health workers).
* those who may be exposed to contaminated needles as a result of having
  medical or dental care e.g. those with pre-existing medical conditions and
  those travelling for medical care abroad including those intending to receive
  renal dialysis overseas.
* long-stay travellers
* those who are participating in contact sports.
* families adopting children from this country.

Hepatitis_B_in_brief
Rabies (Bat Lyssavirus)
Although rare, bat lyssaviruses (bat rabies) can be transmitted to humans or
other animals following contact with the saliva of an infected bat most often
by a bite. The disease can also be transmitted if the saliva of an infected bat
gets into open wounds or mucous membranes (such as on the eye, nose or mouth).
Bat lyssaviruses can cause disease in humans that is indistinguishable from
rabies.
Symptoms can take some time to develop, but when they do the condition is
almost always fatal.

Bat Lyssavirus in Caribbean Islands (Netherlands)

Rabies has not been reported in domestic or wild animals in this country;
therefore most travellers are considered to be at low risk. However, bats may
carry bat lyssavirus (bat rabies).

Prevention


* Travellers should avoid contact with bats. Bites from bats are frequently
  unrecognised. Rabies-like disease caused by bat lyssaviruses is preventable
  with prompt post-exposure rabies treatment.
* Following a possible exposure, wounds should be thoroughly cleansed and an
  urgent local medical assessment sought, even if the wound appears trivial.
  Although rabies has not been reported in other animals in this country, it is
  sensible to seek prompt medical advice if bitten or scratched. It is
  possible, although very rare for bats to pass rabies like viruses to other
  animals including pets.
* Post-exposure treatment and advice should be in accordance with national
  guidelines.


Rabies vaccination


* Pre-exposure rabies vaccinations are recommended for those who are at
  increased risk due to their work (e.g. laboratory staff working with the
  virus and those working with bats).
* Pre exposure vaccines could be considered for those whose activities put them
  at increased risk of exposure to bats.

Rabies_in_brief


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Other risks

The risk below may be present in all or part of the country.

Dengue

Dengue is a viral infection transmitted by mosquitoes which predominantly feed
between dawn and dusk.  It causes a flu-like illness, which can occasionally
develop into a more serious life-threatening forms of the disease. Severe
dengue is rare in travellers.
The mosquitoes that transmit dengue are most abundant in towns, cities and
surrounding areas. All travellers to dengue areas are at risk.

Dengue in Netherlands (Caribbean Islands)

Dengue is known or has the potential to occur in this country.

Prevention


* All travellers should avoid mosquito bites particularly between dawn and
  dusk.
* There is no vaccination or medication to prevent dengue.

Dengue_in_brief

Zika Virus

Zika virus (ZIKV) is a viral infection transmitted by mosquitoes which
predominantly feed between dawn and dusk. A small number of cases of sexual
transmission of ZIKV have also been reported. Most people infected with ZIKV
have no symptoms. When symptoms do occur they are usually mild and, short-
lived. Serious complications and deaths are not common, however, an increase in
congenital anomalies (birth defects), neurological and autoimmune syndromes
have recently been reported in areas where ZIKV outbreaks have occurred.
Possible links to ZIKV infection are being investigated.

Zika virus in Caribbean Islands (Netherlands): Bonaire and Sint Maarten

This country has reported locally acquired cases of ZIKV in the last 2 months
(so are considered to have current active ZIKV transmission). Sporadic
transmission has been reported. Details of specific affected areas within this
country are not available.

Zika virus in Caribbean Islands (Netherlands): Arubaand Curaçao

This country has reported locally acquired cases of ZIKV in the last 2 months
(so are considered to have current active ZIKV transmission). Increasing or
widespread transmission has been reported. Details of specific affected areas
within this country are not available.

Prevention


* All travellers should avoid mosquito bites particularly between dawn and
  dusk.
* There is no vaccination or medication to prevent ZIKV infection.
* It is recommended that pregnant women planning to travel to areas with active
  ZIKV transmission should postpone non-essential travel until after pregnancy.
* Women should avoid becoming pregnant while travelling in, and for 28 days
  after leaving an area with active ZIKV transmission.
* If a woman develops symptoms compatible with ZIKV infection, it is
  recommended she avoids becoming pregnant for a further 28 days following.
* Pregnant women who visited this country while pregnant, or who become
  pregnant within 28 days of leaving this country, should contact their GP,
  obstetrician or midwife for further advice, even if they have not been
  unwell. Further_information_about_when_to_perform_fetal_ultrasound_scanning,
  and,_if_necessary,_referral_to_the_local_fetal_medicine_service_is_available.


Preventing sexual transmission


* Almost all cases of ZIKV are acquired via mosquito bites. A small number of
  cases of sexual transmission of ZIKV have been reported, although reports are
  increasing, the risk of sexual transmission of ZIKV is thought to be low.
* See_further_information_for_women_who_are_pregnant,_at_risk_of_getting
  pregnant,_or_planning_pregnancy,_and_their_male_partners.

See_detailed_guidance_on_factors_to_consider_when_assessing_the_risk_of_ZIKV.
Zika_virus_in_brief


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Important News

_Aedes-mosquito_
15 Apr 2016

Zika_virus_–_update_and_advice_for_travellers_including_pregnant_women_and
those_planning_pregnancy

It is recommended that pregnant women planning to travel, postpone non-
essential travel to areas with active ZIKV transmission until after pregnancy
Read_more

*

_yellow-globe-Americas_
19 Jan 2016

Diseases_transmitted_by_insects_and_ticks_in_the_Americas

Depending on the destination, travellers may be at risk of a number of
different diseases Read_more

*

_Mosquito_
19 Nov 2015

Chikungunya_virus:_Caribbean_and_the_Americas

Ongoing surveillance and updated case report numbers for Chikungunya virus in
Caribbean and the Americas Read_more

*

_Mosquito_
21 Jul 2015

Chikungunya_virus:_Caribbean_and_the_Americas

Ongoing surveillance on Chikungunya virus in Caribbean and the Americas Read
more

*

All_News

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outbreaks


Zika_virus_in_St_Maarten

26 Feb 2016 St Maarten. Caribbean Islands (Netherlands)
As of 25 Feb 2016, the first case of locally transmitted Zika virus has been
reported.
Human
Vector-born
New Post
Verified
ECDC_-_Read_more

*


Zika_virus_in_Aruba

17 Feb 2016 View Countries  +  Aruba
Caribbean Islands (Netherlands)

As of 16 February, the first cases of locally transmitted Zika virus have been
reported in Aruba.
Human
Vector-born
New Post
Verified
State_-_Read_more

*


Zika_Virus_in_Bonaire

16 Feb 2016 Bonaire. Caribbean Islands (Netherlands)
As of 15 February 2016, the first case of locally transmitted Zika virus has
been reported in Bonaire.
Human
Vector-born
New Post
Verified
State_-_Read_more

*


Zika_virus_in_Curacao

29 Jan 2016 Curacao. Caribbean Islands (Netherlands)
As of 28 January 2016, a case of Zika has been reported in Curacao.
Human
Vector-born
New Post
Verified
National_Institute_for_Public_Health_and_the_Environment,_Netherlands_-_Read
more

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