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).
Pakistan is a developing nation in the lower half of the world's economies. Located between India and Iran in southern Asia, its climate varies with geography but is mostly hot, dry desert. The northwest is temperate and the north is arctic.
See also: Library article for Yellow Fever
Although yellow fever does not occur in Pakistan, 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. Note: This applies to airport layovers longer than 12 hours in these countries.
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.
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)(2016) Malaria risk – P. vivax and P. falciparum – exists throughout the year in the whole country below 2000 m, especially in rural areas from July to December inclusive.
- 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: All areas (including all cities) < 2,500 m (< 8,202 ft).
- Estimated relative risk of malaria for US travelers: Moderate.
- Drug resistance4: Chloroquine.
- Malaria species: P. vivax 70%, P. falciparum 30%.
- Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, or mefloquine.
4 Refers to P. falciparum malaria unless otherwise noted.
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
Other Disease and Health Risks
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.
Consular Travel Advice
Due to ongoing security concerns, Canada (GAC) and Australia (DFAT) advise avoiding travel to areas reporting military or militant activity; all borders (except the Wagah official border crossing point); the provinces of Azad Kashmir, Gilgit-Baltistan, Balochistan, and Khyber Pakhtunkhwa; and the Federally Administered Tribal Areas and advises reconsidering travel (or avoiding nonessential travel) to the rest of the country. U.S. (DOS) and U.K. (FCO) have more limited warnings.
High risk of attack by domestic terrorist groups exists throughout the country, especially in Islamabad, Karachi, Lahore, Peshawar, and other cities. Targets may include domestic and international organizations and businesses; public places and events, including those frequented by tourists; and transportation systems.
High risk of kidnapping by terrorist groups exists throughout the country, especially in Karachi, the provinces of Balochistan and Khyber Pakhtunkhwa, and Federally Administered Tribal Areas. Targets may include foreigners (especially Westerners), journalists, and aid workers.
High risk of violent crime (armed robbery and carjacking) and petty crime exists throughout the country, especially in Karachi, Islamabad (particularly F-8, F-9, G-8, and G-9 sectors), and other cities and in rural areas of Sindh Province.
Scams involving credit cards and extortion have been reported.
Risk exists of robberies and/or assaults occurring after consuming intentionally drugged food or drink; tourists are frequently targeted.
Protests and demonstrations frequently occur throughout the country 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.
Travel overland into Sindh Province is discouraged unless police are notified well in advance and are able to make the necessary security arrangements. Rural areas of the provinces of Sindh and Punjab should be avoided due to banditry. The province of Balochistan, which borders Iran and Afghanistan, is notorious for cross-border smuggling.
Due to security concerns, avoid the Centaurus mall in Islamabad. Remain vigilant, keep a low profile, and continue to exercise caution while in Pakistan, particularly in areas regularly frequented by Westerners.
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.
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 < 10 in most high-income countries. Speed laws are poorly enforced. 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.
U.S. Federal Aviation Administration has determined that the civil aviation authority of this country oversees its air carriers in accordance with minimum international safety standards.
The monsoon season is from July through September, coinciding with the cyclone season (in coastal areas). Floods, mudslides, and landslides may occur, especially along the Indus River.
Avalanches may occur in mountainous areas.
Seismic activity frequently occurs, especially in northern and western areas.
Selected Embassies or Consulates in Pakistan
- United States: [+92] 51 201 4000; pk.usembassy.gov
- Canada: [+92] 51-208-6000; www.pakistan.gc.ca
- United Kingdom: [+92] 51-201-2000; www.gov.uk/world/organisations/british-high-commission-islamabad
- Australia: [+92] 51-835-5500; www.pakistan.embassy.gov.au
Pakistan's Embassies or Consulates in Selected Countries
- In the U.S.: www.embassyofpakistanusa.org
- In Canada: www.mofa.gov.pk/ottawa
- In the U.K.: www.phclondon.org
- In Australia: www.pakistan.org.au
HIV testing is not required to obtain a tourist, work, or residence visa.