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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.
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 Cuba

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 Cuba

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
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 Cuba

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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Other risks

The risks below may be present in all or part of the country and are presented
alphabetically.

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 form 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 Cuba

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, 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 Cuba

This country has reported locally acquired cases of ZIKV in the last 2 months
(so is considered to have current active ZIKV transmission). Sporadic
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

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_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

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outbreaks


Zika_virus_in_Cuba

16 Mar 2016 City of Havana Ciudadde La Habana. Cuba
On 15 March 2016 the first locally acquired case of zika virus was confirmed.
Human
Vector-born
New Post
Verified
State_-_Read_more

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Cholera_in_Cuba

22 Oct 2015 Cuba
As of 21 October 2015 it is reported that there are eight confirmed cases of
cholera and two awaiting diagnosis in Las Tunas, Puerto Padre.
Human
Food and Water-borne
Update 2
ProMed_-_Read_more

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