China-Tibet.txt

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General information


See also:


* China
* China_(Hong_Kong)
* China_(Macao)

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 in Tibet, however, there is a certificate
  requirement.
* Under International Health Regulations (2005), a yellow fever vaccination
  certificate is required from travellers over 1 year of age arriving from
  countries with risk of yellow fever transmission and for all travellers
  having transited through an airport of a country with risk of yellow fever
  transmission.
* For this country, the yellow fever vaccination certificate is assumed to be
  valid for 10 years until further notice.
* View_the_WHO_list_of_countries_with_risk_of_yellow_fever_transmission.


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.
Hepatitis A
Hepatitis A is a viral infection transmitted through contaminated food and
water or by direct contact with an infectious person. Symptoms are often mild
or absent in young children, but the disease becomes more serious with
advancing age.  Recovery can vary from weeks to months. Following hepatitis A
illness immunity is lifelong.
Those at increased risk include travellers visiting friends and relatives,
long-stay travellers, and those visiting areas of poor sanitation.

Prevention

All travellers should take care with personal, food and water hygiene.

Hepatitis A vaccination

As hepatitis A vaccine is well tolerated and affords long-lasting protection,
it is recommended for all previously unvaccinated travellers.
Hepatitis_A_in_brief
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 Tibet

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
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, most cases follow a bite or
scratch from an infected dog. In some parts of the world, bats are an important
source of infection.
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 Tibet

Rabies has been reported in domestic and wild animals in this country. Bats may
also carry rabies-like viruses.

Prevention


* Travellers should avoid contact with all 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.
* Post-exposure treatment and advice should be in accordance with national
  guidelines.


Rabies vaccination

Pre-exposure vaccinations are recommended for travellers whose activities put
them at increased risk including:

* those at risk due to their work (e.g. laboratory staff working with the
  virus, those working with animals or health workers who may be caring for
  infected patients).
* those travelling to areas where access to post-exposure treatment and medical
  care is limited.
* those planning higher risk activities such as running or cycling.
* long-stay travellers (more than one month).

Rabies_in_brief
Tuberculosis (TB)
TB is a bacterial infection transmitted most commonly by inhaling respiratory
droplets from an infectious person. This is usually following prolonged or
frequent close contact.

Tuberculosis in China

The average annual incidence of TB from 2010 to 2012 was greater than or equal
to 40 cases per 100,000 population.

Prevention

Travellers should avoid close contact with individuals known to have infectious
pulmonary (lung) TB.
Those at risk during their work (such as healthcare workers) should take
appropriate infection control precautions.

Tuberculosis (BCG) vaccination

According to current national guidance, BCG vaccine should be recommended for
those at increased risk of developing severe disease and/or of exposure to TB
infection. See Public Health England’s Immunisation against infectious disease,
the_‘Green_Book’.
For travellers, BCG vaccine is also recommended for:

* unvaccinated, children under 16 years of age, who are going to live for more
  than 3 months in this country. A tuberculin skin test is required prior to
  vaccination for all children from 6 years of age and may be recommended for
  some younger children.
* unvaccinated, tuberculin skin test negative individuals under 35 years of age
  at risk due to their work such as healthcare workers, prison staff and vets.
  Healthcare workers may be vaccinated over the age of 35 years following a
  careful risk assessment.

There are specific contraindications associated with the BCG vaccine and health
professionals must be trained to administer this vaccine intradermally (just
under the top layer of skin).
Following administration, no further vaccines should be administered in the
same limb for 3 months.
The BCG vaccine is given once only, booster doses are not recommended.
Tuberculosis_in_brief
Typhoid
Typhoid is a bacterial infection transmitted through contaminated food and
water.  Previous typhoid illness may only partially protect against re-
infection.
Travellers who will have access to safe food and water are likely to be at low
risk. Those at increased risk include travellers visiting friends and
relatives, frequent or long-stay travellers to areas where sanitation and food
hygiene are likely to be poor.

Typhoid in Tibet

Typhoid fever is known or presumed to occur in this country.

Prevention

All travellers should take care with personal, food and water hygiene.

Typhoid vaccination


* Both oral and injectable typhoid vaccinations are available, and vaccination
  is recommended for laboratory personnel who may handle the bacteria for their
  work.
* Vaccination could be considered for those whose activities put them at
  increased risk (see above).

Typhoid_in_brief

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Malaria


* There is no risk of malaria in Tibet, however there is a malaria risk in some
  areas of mainland China.


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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 Tibet

 There is a point of elevation in this country higher than 2,500 metres. An
example place of interest, Lhasa 3,658m.

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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