Vaccinations and medical advice for vacation in IndiaThe German Foreign Office recommends having your vaccination status checked before starting your trip. You can find out which vaccinations are standard and which vaccinations should be given in special cases from your family doctor and according to the current vaccination calendar of the Robert Koch Institute. If you enter directly from Europe from countries where dangerous diseases such as yellow fever, cholera or typhoid are not rampant, there are no mandatory vaccination requirements. Nevertheless, due to the subtropical climate and the sometimes poor medical and hygienic infrastructures in India, there is some risk of infection, which can be avoided with the right vaccinations before the start of the trip.
– Tetanus – Diphtheria – Pertussis – Polio – Measles, Mumps, Rubella (MMR) – Influenza – Pneumococcus – Herpes Zoster (Shingles) – Hepatitis A – Hepatitis B – Poliomyelitis – Typhoid – Meningococcal disease (ACWY) – Japanese Encephalitis – Rabies
Which diseases to watch out for? Cholera breaks out due to unhygienic conditions. Occurs epidemically after a short incubation period. Vaccination protection lasts for six months. If certain hygienic measures are observed, such as regular hand washing, there is little risk of infection. Avoid eating fruit and food on the open road. Also in your hotel, make sure that the cold chain is not interrupted in the food offered and that the temperatures are generally not too high. Drink only water from bottled water, but never tap or well water. Those who follow these simple measures are at little risk, so cholera vaccination is not generally recommended.
Diarrhea and intestinal diseases Diseases of the gastrointestinal tract are among the most common infectious diseases abroad. Diarrheal diseases are a problem throughout the country due to poor hygienic conditions. It is recommended to consume only boiled food and not to drink tap water or use it for brushing teeth. Use only drinking water in sealed bottles.
A nationwide high risk of infection exists for shigella, salmonella and typhoid diseases. Hepatitis A and B as well as diseases caused by worms, amoebae and lamblia are also common throughout India. Washing hands regularly and avoiding food offered on the street can prevent the risk of infection.
Malaria As in all subtropical countries, the risk of malaria infection is high in India. It is transmitted by the nocturnal Anopheles mosquito. There are different types of malaria, which are dangerous in different ways and can lead to death if left untreated. The symptoms of fever, chills, headache and aching limbs are similar to influenza and are therefore often underestimated. Vaccination prevents such complications. Except at altitudes above 1.500 meters, there is a year-round medium risk of infection with seasonal fluctuations throughout India. The risk is highest in the lowlands in the northeast and in the state of Orissa. The risk of infection decreases from the north through the central parts of the country to the south. Exposure prophylaxis, light-colored clothing impregnated against mosquitoes, mosquito nets and skin rubbed with a repellent can provide adequate protection against mosquitoes.
Dengue fever Dengue fever is transmitted by diurnal mosquitoes. Headache and pain in the limbs, fever and skin rash are typical symptoms of this disease. A differential diagnosis to malaria is often difficult. As with malaria, careful exposure prophylaxis is the only effective protective measure. Dengue fever occurs nationwide to 1.500 meters above sea level, but especially on the coasts. Even urban areas are not safe. During and after the monsoon the number of cases increases.
Chikungunya Chikungunya is transmitted by diurnal mosquitoes and is associated with the same symptoms as malaria and dengue fever. There is no effective vaccination and medication against these viruses. In this case, too, careful exposure prophylaxis is the only effective measure to protect against infection. Chinkungunya occurs mainly during and immediately after the rainy season in densely populated coastal areas and large cities.
Japanese encephalitis Japanese encephalitis is an inflammation of the brain caused by viruses and transmitted by nocturnal mosquitoes. Especially waterfowl and pigs are carriers of this virus without falling ill themselves. However, they can transmit this to humans, but the case numbers are very low. Whoever is infected, however, must expect a severe course of the disease, which can lead to death. Since there is no effective medication, preventive vaccination and mosquito prophylaxis are highly recommended. The low risk of transmission is nationwide, more so in rural areas than in urban areas, where people live in closer proximity to pigs and waterfowl. Frequent cases of meningitis and encephalitis occur in the states of Bihar and Uttar Pradesh. However, their cause cannot always be clearly identified, which makes differential diagnosis difficult.
Influenza The seasonal influenza waves are spread throughout the country, even the swine flu has been detected several times. These circulate mainly in the northern part of the country during the winter months, in the south the flu viruses are detectable throughout the year, but with lower strength. Flu hotspots are Maharashtra, Haryana, Pradesh, Andhra, Rajastan and Gujarat. The major city of Delhi is also affected.
Rabies Rabies is a dangerous, fatal disease, which is transmitted in India mainly by stray dogs. The route of transmission to humans is through bites. Monkeys, which can be found everywhere in India, can also be carriers of this infectious disease and should therefore not be fed. For travelers to India, a preventive rabies vaccination is therefore essential.
Tuberculosis Tuberculosis is much more common in India than in Europe. It takes place by droplet transmission from person to person. The disease is aggravated by treatment that begins too late or is inappropriate. In this way multi-resistant tuberculosis pathogens develop, the effective treatment of which is thus made more difficult. Vaccination is the only effective means of protection.
STDs, HIV and AIDS are rampant throughout the country. Resulting hepatitis B infections should also not be underestimated. Therefore, the Ministry of Health strongly advises against unprotected sexual contact with casual acquaintances. Commercial sexual services should also be avoided. In India, these diseases are not a problem specific to homosexual men, as a sharp increase in cases has been recorded in recent years, especially in heterosexual circles.
The medical infrastructure in India is not comparable with the European standard. Especially outside the big cities in the rural area there are hardly any medical facilities. In the big cities, on the other hand, the urban clinics are equipped at a very high technical level, which makes treatments in case of illness possible without any problems. However, in this case often high deposits are to be paid, which can easily break the travel budget.
Patients who are dependent on regular medication due to physical or mental illnesses should carry sufficient quantities with them, as the supply of high-quality medication is not guaranteed everywhere in India. Many medicines are not available, and there is also a risk of counterfeiting. Seek advice from your family doctor or a tropical medicine specialist before starting your trip. The consulates general in Bangalore, Mumbai, Kolkata and Chennai as well as the German embassy in Delhi have lists of doctors and hospitals in the respective travel area.
Vaccination entry requirements to India
If you are entering from countries where dangerous infectious diseases are considered eradicated due to above-average medical care and infrastructure, there are no special entry requirements. This includes in particular the USA, Europe and Australia.
Residents entering India from countries with proven polio cases are required to show proof of oral polio vaccination. Countries at risk of polio include Syria, Kenya, Ethiopia, Somalia, Afghanistan, Pakistan and Nigeria. The oral vaccination must not be given younger than six weeks. Not be older than one year. A vaccination certificate according to WHO standard has to be carried along. German citizens entering India from the countries mentioned above do not need to present proof of vaccination. This also applies to German citizens living in India who travel to the seven countries at risk of polio.
A valid vaccination against yellow fever is only required if you are entering from a yellow fever endemic area. The yellow fever virus occurs mainly in most African and South American countries and in French Guiana.