Medical Summary
The health risk information presented here is summarized from Shoreland Travax®, a decision-support tool used by health care providers to perform a detailed health risk analysis based on specific locations, individual travel styles, and traveler risk behaviors. Travax provides practitioners current, independently researched malaria risk and prevention recommendations in a map-based format that goes beyond the annual WHO and US CDC statements included here. Not included here are current reports from Travax of disease outbreaks or environmental events that may pose elevated risks to travelers’ health and safety. The Providers section of this site offers a directory of health care providers who utilize Shoreland Travax for travel health counseling. Learn more about the detailed reports and maps available from these practitioners (includes links to samples).
General Information
China is a developing nation classified as upper middle income. Located in Southeast Asia and bordered by 14 countries, the climate is extremely diverse, with classifications that range from dry (arid) in the north to humid temperate (no dry season) in the southeast, with cooler temperatures in some high-altitude areas. (Note: Hong Kong and Macau are treated separately and have their own listings in the Destination directory.)
Vaccinations
Yellow Fever
See also: Library article for Yellow Fever
Although yellow fever does not occur in China, an official yellow fever vaccination certificate may be required depending on your itinerary.
- Requirement: A certificate proving yellow fever vaccination is required for travelers aged ≥ 9 months coming from countries with risk of YF transmission. This also applies to airport transit stops (no exit through immigration checkpoint) longer than 12 hours in risk countries.
Other Vaccines
Depending on your itinerary, your personal risk factors, and the length of your visit, your health care provider may offer you vaccination against cholera, COVID-19, hepatitis A, hepatitis B, influenza, Japanese encephalitis, measles, mumps, rubella, rabies, tick-borne encephalitis, or typhoid fever. Routine immunizations, such as those that prevent tetanus/diphtheria or "childhood" diseases, should be reviewed and updated as needed.
Malaria
See also: Library article for Malaria
The following is current information as reported by the World Health Organization (WHO) and the US Centers for Disease Control (CDC):
WHO—International Travel and Health (current online update, Country List)
(2021) China has achieved tremendous success in malaria elimination. Since 2017, no indigenous cases have been reported.- Recommended prevention for non-border areas in Yunnan: A - Very limited risk of malaria transmission. Mosquito bite prevention only.
WHO Country List footnote: When available, the date of the most recent update or confirmation is indicated in parentheses in the country list. If no date is indicated, the most recent update or confirmation was provided before 2013.
CDC—Health Information for International Travel (current online edition)
Areas with malaria: Rare cases in the counties along the China-Burma (Myanmar) border in Yunnan Province and Motuo County in Tibet. No malaria in areas where most major river cruises pass.- Drug resistance3 : Chloroquine and mefloquine.
- Malaria species: Primarily P. vivax; P. falciparum in Yunnan Province.
- Recommended chemoprophylaxis: None (practice mosquito avoidance).
3 Refers to P. falciparum malaria unless otherwise noted.
4 Primaquine and tafenoquine can cause hemolytic anemia in people with G6PD deficiency. Patients must be screened for G6PD deficiency before starting primaquine or tafenoquine. See Tafenoquine Approved for Malaria Prophylaxis and Treatment for more information.
Other Concerns
Travelers' Diarrhea
See also: Library article for Travelers' Diarrhea
Moderate risk exists throughout the country, with minimal risk in deluxe accommodations. Community sanitation and food safety measures may be inadequate. Some itineraries (e.g., remote destinations, austere accommodations) and activities (e.g., ecotourism, eating street or local-market food) further increase risk.
Travelers should observe food and beverage precautions, which reduce the likelihood of illness.
Travelers should carry loperamide for self-treatment of diarrhea and, if risk is moderate to high, an antibiotic to add if diarrhea is severe. Consult a knowledgeable health care provider regarding which antibiotic is appropriate for you and most effective for your destination.
Other Food-Borne Illnesses
Precautions to prevent brucellosis, seafood poisoning may be needed.
Insect- and Arthropod-Borne Diseases
Chikungunya, dengue, leishmaniasis, Lyme disease, murine typhus, scrub typhus, West Nile virus may pose a risk. Personal protective measures are important.
Other Disease and Health Risks
Additional concerns include air pollution, altitude illness, anthrax disease, Crimean-Congo hemorrhagic fever, enteroviruses, hantavirus, helminths, hepatitis C, leptospirosis, marine hazards, melioidosis, monkey bites, Nipah virus, plague, schistosomiasis, snakebites, tuberculosis.
Consular Advice
The material below includes information from the US Department of State (DOS), the UK Foreign, Commonwealth & Development Office (FCO), Global Affairs Canada (GAC), and Australia's Department of Foreign Affairs and Trade (DFAT), as well as from additional open-source material. Standard safety precautions that apply to all international travel can be found in the Library article Safety and Security.
Consular Travel Advice
Due to arbitrary enforcement of local laws and the risk of arbitrary detention, US (DOS) advises reconsidering travel (or avoiding nonessential travel) to this country. UK (FCO), Canada (GAC), and Australia (DFAT) have more limited warnings.
Terrorism Risk
Risk of attack by domestic terrorist groups exists throughout the country, especially in Xinjiang Uygur Autonomous Region. Targets may include domestic and international organizations and businesses; public places and events, including those frequented by tourists; and transportation systems.
Crime
Low risk of violent crime (armed robbery, sexual assault, assault, and murder) exists in remote areas and areas popular with expatriates, mainly in shopping and nightlife areas of major cities.
Moderate risk of petty crime exists throughout the country, especially in major cities; on public transportation and overnight trains; at popular tourist sites; in areas frequented by foreigners.
Scams involving counterfeit currency, ATMs, and exorbitant fees for services (including for tea ceremonies or massages) have been reported.
Risk exists of robberies and/or assaults occurring after consuming intentionally drugged food or drink; tourists are frequently targeted.
Civil Unrest
Protests and demonstrations may infrequently occur and have the potential to turn violent without warning. Bystanders are at risk of harm from violence or from the response by authorities. Disruption to transportation, free movement, or the ability to carry out daily activities may occur.
Unsafe Areas
Piracy (involving commercial and private leisure vessels) may occur in coastal and international waters of the South China Sea.
Water Safety
Passenger boats may be unsafe, including ferries. Decline water transportation in vessels that appear overloaded or lack personal flotation devices or life jackets.
Rent water sports equipment from reputable operators. Scuba dive only with personnel certified by PADI or NAUI, and use equipment only from PADI- or NAUI-certified dive operators.
Transportation Safety
High risk of traffic-related injury or death exists. The road traffic death rate is 12 to 24 per 100,000 population. The rate is less than 10 in most high-income countries.
Airline Safety
The US Federal Aviation Administration has determined that the civil aviation authority of this country oversees its air carriers in accordance with minimum international safety standards.
Natural Disasters
The typhoon season is from May through November, especially in southern and eastern coastal areas. The monsoon season is from April through November. Floods, mudslides, and landslides may occur, especially in central, western, and southern areas, including areas bordering the Yangtze River.
Seismic and volcanic activity frequently occur, especially in Xinjiang and Tibet autonomous regions and Sichuan Province.
Consular Information
Selected Embassies or Consulates in China
- United States: [+86] 10-8531-3000; china.usembassy-china.org.cn
- Canada: [+86] 10-5139-4000; www.china.gc.ca
- United Kingdom: [+86] 10-5192-4000; www.gov.uk/world/organisations/british-embassy-beijing
- Australia: [+86] 10-5140-4111; www.china.embassy.gov.au
China's Embassies or Consulates in Selected Countries
- In the U.S.: china-embassy.org/eng
- In Canada: ca.china-embassy.org/eng
- In the U.K.: www.chinese-embassy.org.uk/eng
- In Australia: au.china-embassy.org/eng
Visa/HIV Testing
HIV testing may be required to obtain a work or residence visa.
