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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

There are no certificate requirements under International Health Regulations
(2005).

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.
Rabies
Rabies is a viral infection which is usually transmitted following contact with
the saliva of an infected animal most often via a bite, scratch or lick to an
open wound or mucous membrane (such as on the eye, nose or mouth). Although
many different animals can transmit the virus, worldwide most cases follow a
bite or scratch from an infected dog. Bats are also an important source of
infection in some countries.
Rabies symptoms can take some time to develop, but when they do the condition
is almost always fatal.
The risk of exposure is increased by certain activities and length of stay (see
below). Children are at increased risk as they are less likely to avoid contact
with animals and to report a bite, scratch or lick.

Rabies in Canada

Rabies has only been reported in wild animals in this country; therefore most
travellers are considered to be at low risk for rabies. Bats may also carry
rabies-like viruses in this country.

Prevention


* Travellers should avoid contact with wild animals.  Rabies is preventable
  with prompt post-exposure 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 domestic animals, it is still
  sensible to seek prompt medical advice if bitten or scratched by all animals.
* Post-exposure treatment and advice should be in accordance with national
  guidelines.


Rabies vaccination


* Pre-exposure vaccines are recommended for those who are at increased risk due
  to their work (e.g. laboratory staff working with the virus, those working
  with animals or health care workers who may be caring for infected patients).
* Pre-exposure vaccines could be considered for those who are at increased risk
  of exposure to wild animals.

Rabies_in_brief


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Other risks

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

Altitude

There is a risk of altitude illness when travelling to destinations of 2,500
metres (8,200 feet) or higher. Important risk factors are the altitude gained,
rate of ascent and sleeping altitude. Rapid ascent without a period of
acclimatisation puts a traveller at higher risk.
There are three syndromes; acute mountain sickness (AMS), high-altitude
cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE). HACE and HAPE
require immediate descent and medical treatment.

Altitude illness in Canada

 There is a point of elevation in this country higher than 2,500 metres. An
example place of interest, Mt Logan 5,950m.

Prevention


* Travellers should spend a few days at an altitude below 3,000m.
* Where possible travellers should avoid travel from altitudes less than 1,200m
  to altitudes greater than 3,500m in a single day.
* Ascent above 3,000m should be gradual. Travellers should avoid increasing
  sleeping elevation by more than 500m per day and ensure a rest day (at the
  same altitude) every three or four days.
* Acetazolamide can be used to assist with acclimatisation, but should not
  replace gradual ascent.
* Travellers who develop symptoms of AMS (headache, fatigue, loss of appetite,
  nausea and sleep disturbance) should avoid further ascent. In the absence of
  improvement or with progression of symptoms the first response should be to
  descend.
* Development of HACE or HAPE symptoms requires immediate descent and emergency
  medical treatment.

Altitude_illness_in_brief


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Important News

_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

*

11 May 2015

Measles:_worldwide

A measles reminder for health professionals and travellers Read_more

*

06 May 2015

HPAI_viruses:_Canada_and_the_United_States_of_America

Novel highly pathogenic avian influenza (HPAI) viruses: Canada and the United
States of America Read_more

*

10 Feb 2015

Imported_avian_influenza_A_(H7N9):_Canada

First cases of influenza A (H7N9) infection in humans in North America Read
more

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All_News

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outbreaks


Hepatitis_A_in_Canada

18 Apr 2016 View Regions  +  Newfoundland and Labrador
Ontario
Quebec
As of 15 April 2016, 12 cases associated with a brand of frozen fruit have been
reported from three provinces. Individuals became sick in February and March
2016. Three cases have been hospitalised. The products have been recalled from
four provinces.
Human
Food and Water-borne
New Post
Verified
State_-_Read_more

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Measles_in_Canada

21 Mar 2016 Ontario. Canada
As of 19 March 2016, a case in a child who had recently returned from a
measles-endemic country has been reported. The public is warned about possible
exposure in Brampton, Ontario, between 12 and 17 March 2016.
Human
Close association
New Post
Verified
State_-_Read_more

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Listeriosis_in_Canada

27 Jan 2016 View Regions  +  New Brunswick
Newfoundland and Labrador
Ontario
Prince Edward Island
Quebec
As of  23 January 2016, a total of seven cases of Listeria monocytogenes have
been reported between September 2015 and early January 2016. A potential link
to packaged salads produced in a processing facility in the USA is being
investigated.
Human
Food and Water-borne
New Post
Verified
State_-_Read_more

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Salmonellosis_in_Canada

21 Dec 2015 Canada
As of 18 December 2015 there are 91 cases of Salmonella Infantis illness in
nine provinces: British Columbia (6), Alberta (11), Saskatchewan (2), Manitoba
(2), Ontario (53), Quebec (13) Nova Scotia (2), Prince Edward Island (1) andNew
Brunswick (1).
Human
Food and Water-borne
Update 1
Verified
Public_Health_Agency_of_Canada_-_Read_more

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Pertussis_in_Canada

01 Dec 2015 Canada
As of 26 November 2015, 61 cases of pertussis [whooping cough] have been
reported from the Saskatoon region.
Human
Close association
Update 1
Verified
State_-_Read_more

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Hepatitis_A_in_Canada

01 Dec 2015 Alberta. Canada
As of 19 November 2015 health authorities have confirmed a case of hepatitis A
in an individual who worked at the Powderkeg Lounge (located at the Lake Louise
Ski Resort), while infectious.
Human
Food and Water-borne
New Post
Verified
State_-_Read_more

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Cyclosporiasis_in_UK_and_Canada_ex_Mexico

06 Nov 2015 View Countries  +  Canada
Mexico
United Kingdom

Between 21 June and 22 September 2015 cyclospora cayetanensis was identified in
176 returned travellers (79 in the UK and 97 in Canada) from the Riviera Maya
region of Mexico.
Human
Imported
Food and Water-borne
Update 1
Verified
Eurosurveillance_-_Read_more

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E.coli_in_Canada

17 Sep 2015 Canada
As of 14 September 2015 there have been 31 cases of E.coli confirmed in Alberta
(1), Ontario (11), Quebec (17) and Nova Scotia (2). Individuals became sick
between July 6 and September 4, 2015, with the peak of illnesses reported to
date occurring between July 25 and August 1, 2015.
Human
Food and Water-borne
Update 1
Verified
State_-_Read_more

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Trypanosomiasis_–_African_(sleeping_sickness)_in_Canada_ex_Zambia

08 Sep 2015 View Countries  +  Canada
Zambia

A case of trypanosomiasis has been confirmed in a traveller to Zambia. The
patient from Canada had travelled to the South Luangwa National Park, Lower
Zambezi National Park and Lusaka during Jun 2015. Several local cases of East
African trypanosomiasis have recenty been treated in Zambia.
Human
Imported
Vector-born
New Post
Verified
Pro_Med_-_Read_more

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Legionnaires’_disease_in_Canada

27 Aug 2015 Canada
Since 20 Aug 2015, 16 cases of Legionnaires' disease were reported in
Berthierville. One person has died. The source of the outbreak is unknown.
Human
Air-borne
New Post
Media_-_Read_more

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Vibrio_parahaemolyticus_in_Canada

20 Aug 2015 View Regions  +  Alberta
British Columbia
As of 19 Aug 2015, a total of 72 Canadian cases of Vibrio parahaemolyticus
infections linked to raw shellfish have now been reported. The majority of
cases have been linked to eating raw oysters.
Human
Update 1
Verified
State_-_Read_more

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Cyclosporiasis_in_Canada

11 Aug 2015 Canada
A total of 83 Cyclospora infections have been reported from four Canadian
provinces: Ontario, British Columbia, Alberta and Quebec. The source of this
outbreak is not yet known.
Human
Food and Water-borne
New Post
Verified
State_-_Read_more

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Tick-borne_encephalitis_in_Canada

16 Jul 2015 Prince Edward Island. Canada
As of 10 July 2015 a suspected case of tick borne encephalitis has been
reported and is being investigated.
Human
Vector-born
New Post
Verified
Pro_Med_-_Read_more

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Salmonellosis_in_Canada

06 Jul 2015 View Regions  +  Alberta
British Columbia
Manitoba
Northwest Territories
Saskatchewan
As of 3 Jul 2015, 60 cases of Salmonella illness have been reported in four
provinces and one territory: Alberta (34); British Columbia (19); Saskatchewan
(five); Manitoba (one); and the Northwest Territories (one). Illness onset
dates ranged from 5 Apr and 17 Jun 2015; and all have reported contact with
live baby poultry.
Human
Food and Water-borne
New Post
Verified
State_-_Read_more

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Tetanus_in_Canada

03 Jun 2015 Canada
On 1 June 2015 a case of tetanus was reported in a 6 yr old boy. He is
receiving treatment.
Human
Miscellaneous
New Post
ProMED_-_Read_more

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