- Polio: Advice for travellers – February 4, 2020
- Extensively drug-resistant typhoid in Pakistan – October 10, 2019
- Global Measles Notice – July 23, 2019
Be sure that your routine vaccines, as per your province or territory, are up-to-date regardless of your travel destination.
Some of these vaccines include: measles-mumps-rubella (MMR), diphtheria, tetanus, pertussis, polio, varicella (chickenpox), influenza and others.
VACCINES TO CONSIDER
You may be at risk for these vaccine-preventable diseases while travelling in this country. Talk to your travel health professional about which ones are right for you.
Hepatitis A is a disease of the liver spread through contaminated food and water or contact with an infected person. All those travelling to regions with a risk of hepatitis A infection should get vaccinated.
Hepatitis B is a disease of the liver spread through blood or other bodily fluids. Travellers who may be exposed (e.g., through sexual contact, medical treatment, sharing needles, tattooing, acupuncture or occupational exposure) should get vaccinated.
Seasonal influenza occurs worldwide. The flu season usually runs from November to April in the northern hemisphere, between April and October in the southern hemisphere and year round in the tropics. Influenza (flu) is caused by a virus spread from person to person when they cough or sneeze or by touching objects and surfaces that have been contaminated with the virus. Get the flu shot.
Japanese encephalitis is a viral infection that can cause swelling of the brain. It is spread by the bite of an infected mosquito. Risk is low for most travellers. Vaccination should be considered for those who may be exposed to mosquito bites (e.g., spending a large amount of time outdoors) while travelling in regions with risk of Japanese encephalitis.
Measles is a highly contagious viral disease. It can spread quickly from person to person by direct contact and through droplets in the air.
Anyone who is not protected against measles is at risk of being infected with it when travelling internationally.
Regardless of where you are going, talk to a health care professional before travelling to make sure you are fully protected against measles.
Polio is present in this country. Polio can be prevented by vaccination, which is part of the routine vaccines for children in Canada.
- Be sure that your vaccination against polio is up to date.
- One booster dose of the polio vaccine is recommended as an adult.
Proof of vaccination:
If you are staying more than 4 weeks in this country, you may need to show proof of polio vaccination when you leave the country.
Make sure that the polio vaccination is documented on the International Certificate of Vaccination or Prophylaxis. This is the only document accepted as proof of vaccination.In Canada, they are provided at Yellow Fever Vaccination Centres.
Carry the certificate as proof of vaccination.
Rabies is a deadly illness spread to humans through a bite, scratch or lick from an infected animal. Vaccination should be considered for travellers going to areas where rabies exists and who have a high risk of exposure (e.g., are children, have an occupational risk, or in close contact with animals, including free roaming dogs in communities).
Typhoid is a bacterial infection spread by contaminated food or water. Travellers going to countries in South Asia should speak to a health care professional about getting vaccinated.
Yellow fever is a disease caused by a flavivirus from the bite of an infected mosquito.
Travellers get vaccinated either because it is required to enter a country or because it is recommended for their protection.
- There is no risk of yellow fever in this country.
Country Entry Requirement*
- Proof of vaccination is required if you are coming from a country where yellow fever occurs.
- Vaccination is not recommended.
- Discuss travel plans, activities, and destinations with a health care professional.
- There is currently a shortage of the yellow fever vaccine in Canada. It is important for travellers to contact a designated Yellow Fever Vaccination Centre well in advance of their trip to ensure that the vaccine is available.
About Yellow Fever
Yellow Fever Vaccination Centre
* It is important to note that country entry requirements may not reflect your risk of yellow fever at your destination. It is recommended that you contact the nearest diplomatic or consular office of the destination(s) you will be visiting to verify any additional entry requirements.
FOOD AND WATER-BORNE DISEASES
Travellers to any destination in the world can develop travellers’ diarrhea from consuming contaminated water or food.
In some areas in South Asia, food and water can also carry diseases like cholera, hepatitis A and typhoid. Practise safe food and water precautions while travelling in South Asia. Remember: Boil it, cook it, peel it, or leave it!
Food and drinks on aircraft, trains, and ferries may be exposed to contaminated water from local sources. Use a safe source of water, such as bottled water, for drinking, hand washing and brushing teeth.
Cholera is a risk in parts of this country. Most travellers are at very low risk.
To protect against cholera, all travellers should practise safe food and water precautions.
Travellers at higher risk of getting cholera include those:
- visiting, working or living in areas with limited access to safe food, water and proper sanitation
- visiting areas where outbreaks are occurring
Vaccination may be recommended for high-risk travellers, and should be discussed with a health care professional.
- Travellers’ diarrhea is the most common illness affecting travellers. It is spread from eating or drinking contaminated food or water.
- Risk of developing travellers’ diarrhea increases when travelling in regions with poor standards of hygiene and sanitation. Practise safe food and water precautions.
- The most important treatment for travellers’ diarrhea is rehydration (drinking lots of fluids). Carry oral rehydration salts when travelling.
Typhoid is a bacterial infection spread by contaminated food or water. Risk is higher among children, travellers going to rural areas, travellers visiting friends and relatives or those travelling for a long period of time.
Travellers visiting regions with a risk typhoid, especially those exposed to places with poor sanitation should speak to a health care professional about vaccination.
INSECTS AND ILLNESS
In some areas in South Asia, certain insects carry and spread diseases like chikungunya, Crimean-Congo hemorrhagic fever, dengue fever, Japanese encephalitis, leishmaniasis, lymphatic filariasis and malaria.
Travellers are advised to take precautions against bites.
There is currently a risk of chikungunya in this country. Chikungunya is a virus spread through the bite of an infected mosquito. Chikungunya can cause a viral disease that typically causes fever and pain in the joints. In some cases, the joint pain can be severe and last for months or years.
Protect yourself from mosquito bites at all times. There is no vaccine available for chikungunya.
Crimean-Congo haemorrhagic fever is a viral disease that typically causes fever, bleeding under the skin, and pain. Risk is generally low for most travellers. It is spread to humans though contact with infected animal blood or bodily fluids, or from a tick bite. Protect yourself from tick bites and avoid animals. There is no vaccine available for Crimean-Congo haemorrhagic fever.
- In this country, dengue fever is a risk to travellers year-round. It is a viral disease spread to humans by mosquito bites.
- Dengue fever can cause severe flu-like symptoms. In some cases, it can lead to dengue haemorrhagic fever, which can be fatal.
- The level of risk of dengue fever changes seasonally, and varies from year to year. After a decline in reported dengue cases worldwide in 2017 and 2018, global numbers have been steeply rising again.
- Mosquitoes carrying dengue typically bite during the daytime, particularly around sunrise and sunset.
- Protect yourself from mosquito bites. There is no vaccine or medication that protects against dengue fever.
Cutaneous and mucosal leishmaniasis causes skin sores and ulcers. It is caused by a parasite spread through the bite of a female sandfly.
Risk is generally low for most travellers. Protect yourself from sandfly bites, which typically occur after sunset in rural and forested areas and in some urban centres. There is no vaccine or medication to protect against leishmaniasis.
Zika virus infection is a risk in this country. The mosquito that spreads the virus is found here.
All travellers should protect themselves from mosquito bites and other diseases spread by insects.
- There is a risk of malaria in certain areas and/or during a certain time of year in this country.
- Malaria is a serious and occasionally fatal disease that is spread by the bite of an infected mosquito. There is no vaccine against malaria.
- Protect yourself from mosquito bites. This includes covering up, using insect repellent and staying in enclosed air-conditioned accommodations. You may also consider pre-treating clothing and travel gear with insecticides and sleeping under an insecticide-treated bednet.
- Antimalarial medication may be recommended depending on your itinerary and the time of year you are travelling. See a health care professional or visit a travel health clinic, preferably six weeks before you travel to discuss your options.
ANIMALS AND ILLNESS
Travellers are cautioned to avoid contact with animals, including dogs, monkeys, snakes, rodents, and bats. Certain infections found in some areas in Southern Asia, like avian influenza and rabies, can be shared between humans and animals.
There have been human cases of avian influenza in this country.
Avian influenza is a viral infection that can spread quickly and easily among birds. In rare cases, it can infect people.
- avoid high risk areas such as poultry farms and live animal markets
- avoid areas where poultry may be slaughtered
- avoid contact with birds (alive or dead)
- avoid surfaces that may have bird droppings or secretions on them
- ensure all poultry dishes, including eggs, are well cooked
Crowded conditions can increase your risk of certain illnesses. Remember to wash your hands often and practice proper cough and sneeze etiquette to avoid colds, the flu and other illnesses.
Sexually transmitted infections (STIs) and HIV are spread through blood and bodily fluids; practise safer sex.
Tuberculosis is an infection caused by bacteria and usually affects the lungs.
For most travellers the risk of tuberculosis is low.
Travellers who may be at high risk while travelling in regions with risk of tuberculosis should discuss pre- and post-travel options with a health care professional.
High-risk travellers include those visiting or working in prisons, refugee camps, homeless shelters, or hospitals, or travellers visiting friends and relatives.
MEDICAL SERVICES AND FACILITIES
Basic non-emergency medical care is available in major Pakistani cities but is limited in rural areas. Facilities in the cities vary in quality and range of services, resources and sanitation. Most medical facilities require prepayment in cash.
Emergency services are virtually non-existent in most of Pakistan. Emergency and ambulance services are very limited, lack medical equipment and are not necessarily staffed by medical personnel.
KEEP IN MIND…
The decision to travel is the sole responsibility of the traveller. The traveller is also responsible for his or her own personal safety.
Be prepared. Do not expect medical services to be the same as in Canada. Pack a travel health kit, especially if you will be travelling away from major city centres.