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General Map

General map of Nepal

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 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

Nepal is a developing nation in the lowest 25% of the world's economies. Located in southern Asia (north of India and south of China), the climate is classified as subtropical dry winter in the south, with cooler temperatures in some high-altitude areas (in the north).

Immunizations

Yellow Fever

See also: Library article for Yellow Fever

Although yellow fever does not occur in Nepal, an official yellow fever vaccination certificate may be required depending on your itinerary.

  • Requirement: A vaccination certificate (recognition of lifetime validity is uncertain) is required for travelers aged ≥ 1 year 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, hepatitis A, hepatitis B, influenza, Japanese encephalitis, measles, mumps, rubella, rabies, typhoid fever, or a one time polio booster if you haven't previously received one for travel. 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 U.S. Centers for Disease Control (CDC):

WHO—International Travel and Health (current online update, Country List)

(2018) Malaria risk due predominantly to P. vivax exists throughout the year in rural areas of the 20 Terai districts bordering India, withoccasional outbreaks of P. falciparum from July through October. Seasonal transmission of P. vivax takes place in 45 districts of the inner Terai and mid‐hills.
  • Recommended prevention in risk areas: C – Risk of P. falciparum malaria, in combination with reported chloroquine and sulfadoxine–pyrimethamine resistance. Mosquito bite prevention plus atovaquone–proguanil or doxycycline or mefloquine chemoprophylaxis (select according to reported side effects and contraindications) a
    aAlternatively, for travel to rural areas with low risk of malaria infection, mosquito bite prevention can be combined with stand–by emergency treatment (SBET).

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: Present throughout the country at altitudes <2,000 m (6,562 ft). None in Kathmandu and on typical Himalayan treks.
  • Estimated relative risk of malaria for US travelers: Low.
  • Drug resistance4: Chloroquine.
  • Malaria species: P. vivax 85%, P. falciparum 15%.
  • Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, or mefloquine.
    4 Refers to P. falciparum malaria unless otherwise noted.

Other Concerns

Travelers' Diarrhea

See also: Library article for Travelers' Diarrhea

High risk exists throughout the country, including in deluxe accommodations. Food and beverage precautions may 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.

Insect- and Arthropod-Borne Diseases

Chikungunya, dengue, leishmaniasis, 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, avian influenza, helminths, monkey bites, plague, snakebites, tuberculosis.

Consular Advice

The material below includes information from the U.S. Department of State (DOS), U.K. Foreign & Commonwealth 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.

Terrorism Risk

Low risk of attack by transnational terrorist groups exists throughout the country. Targets may include public places and events, including those frequented by tourists, and transportation systems.

Crime

Risk of violent crime (armed robbery and sexual assault) and high risk of petty crime exist throughout the country, especially in Kathmandu (particularly in Thamel neighborhood and Boudhanath), in national parks, and on buses.

Scams involving ATMs, fraudulent charities, and bargain treks (where guides deliberately misdiagnose severe altitude illness to profit from inflated helicopter rescues and hospital admissions) have been reported.

Civil Unrest

Protests and demonstrations occur in southern zones, including Kathmandu, 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.

Water Safety

Passenger boats may be unsafe. Decline water transportation in vessels that appear overloaded or lack personal flotation devices or life jackets.

Basic safety standards for recreational water activities (including rafting) are often not in place. Rent water sports equipment from reputable operators.

Outdoor Safety

Basic safety standards for adventure activities (including paragliding and ultralight aircraft tours) may not be in place. Travelers should only use reputable adventure-sport operators for activities and equipment rentals.

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. Driving at night is not advised. Seek local advice before traveling on roads outside urban areas after dark.

Traffic flows on the left-hand side of the road. Travelers (including drivers and pedestrians) accustomed to traffic moving on the opposite side should be vigilant when navigating traffic.

Natural Disasters

The monsoon season is from June through September. Floods, mudslides, and landslides may occur.

Seismic activity frequently occurs.

Consular Information

Selected Embassies or Consulates in Nepal

  • United States: [+977] 1-423-4000; np.usembassy.gov
  • Canada: [+977] 1-444-1976; travel.gc.ca/assistance/embassies-consulates/nepal
  • United Kingdom: [+977] 1-4237100; www.gov.uk/world/organisations/british-embassy-kathmandu
  • Australia: [+977] 1-4371-678; www.nepal.embassy.gov.au

Nepal's Embassies or Consulates in Selected Countries

  • In the U.S.: www.nepalembassyusa.org
  • In Canada: nepalembassy.ca
  • In the U.K.: www.nepembassy.org.uk
  • In Australia: www.necan.gov.np

Visa/HIV Testing

HIV testing is not required to obtain a tourist, work, or residence visa.