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).
India is a developing nation classified as lower middle income. Located in southern Asia (between the Arabian Sea and the Bay of Bengal), the climate is extremely diverse with classifications that range from humid equatorial (no dry season) to subtropical dry winter.
See also: Library article for Yellow Fever
Although yellow fever does not occur in India, an official yellow fever vaccination certificate may be required depending on your itinerary.
- Requirement: A vaccination certificate is required for travelers aged ≥ 9 months arriving within 6 days of departure from countries with risk of YF transmission. Note: At the discretion of the local Health Officer, this requirement may apply to air passengers who have transited risk countries and to persons who arrive on craft (plane or ship) originating in or transiting risk countries that were not properly disinsected following WHO guidelines or Indian regulations. In addition, some airlines may impose a boarding requirement for a vaccination certificate for passengers transiting a risk country en route to India.
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)(2019) Malaria risk due to P. falciparum and P. vivax exists throughout the year in the entire country below 2000 m. The majority of malaria in India is reported from the eastern and central parts of the country and from states which have large forest, hilly and tribal areas. These states include Odisha, Chhattisgarh, Jharkhand, Madhya Pradesh, Maharashtra and some north-eastern states such as Tripura, Meghalaya and Mizoram. There is no transmission in parts of the states of Himachal Pradesh, Jammu and Kashmir, and Sikkim.
- 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 throughout the country, including cities of Bombay (Mumbai) and Delhi, except none in areas >2,000 m (6,562 ft) in Himachal Pradesh, Jammu and Kashmir, and Sikkim (see Map 2-15).
- Drug resistance3 : Chloroquine.
- Malaria species: P. vivax 50%, P. falciparum >40%, P. malariae and P. ovale rare.
- Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4
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.
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.
Other Food-Borne Illnesses
Insect- and Arthropod-Borne Diseases
Other Disease and Health Risks
Additional concerns include air pollution, avian influenza, Crimean-Congo hemorrhagic fever, helminths, leptospirosis, marine hazards, melioidosis, monkey bites, Nipah virus, plague, schistosomiasis, snakebites, tuberculosis.
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 terrorism, civil unrest, and other ongoing security concerns, Canada (GAC) advises avoiding travel to Jammu and Kashmir State (except the Ladakh area via the town of Manali or by air to the city of Leh); areas bordering Bangladesh and Burma in the states of Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, and Nagaland; and areas bordering Pakistan in the states of Gujarat, Rajasthan, and Punjab (except the Wagah border crossing). Canada also advises reconsidering travel (or avoiding nonessential travel) to the rest of Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, and Nagaland states. U.S. (DOS), U.K. (FCO), and Australia (DFAT) have more limited warnings.
High risk of attack by domestic and transnational terrorist groups exists throughout the country. 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 in rural areas throughout the country. Targets may include foreigners (especially Westerners).
Moderate risk of sexual assault, including verbal and physical harassment, exists throughout the country, especially in New Delhi (particularly in Vasant Kunj area), Bangalore, and other cities; in Bodh Gaya; in Goa and Rajasthan states; in other areas frequented by tourists.
High risk of petty crime exists throughout the country, especially in New Delhi and crowded places, including areas frequented by tourists, public transportation, markets, trade fairs, and airports.
Scams involving gems and precious metals and false identity (such as criminals posing as tour guides) 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, especially in Jammu and Kashmir State, 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.
A dangerous security environment may exist in Jammu and Kashmir State.
Territorial disputes occur. Military presence, landmines, other unexploded ordnance, and unmarked borders exist in areas bordering Pakistan (except for the international border crossing at Atari, India and Wagah, Pakistan).
Piracy (involving commercial vessels) may occur in coastal or international waters of the Indian Ocean.
Hazardous water conditions (including currents, tides, and undertows) may occur, especially at beaches in Mumbai and the Bay of Bengal. Heed posted warnings, and avoid beaches that are not patrolled. Do not swim alone or after dark, and do not walk on any beach after dark.
Passenger boats may be unsafe, including ferries and small crafts. 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.
Other Safety Threats
Risk exists for fatal wildlife attacks on safaris and in game parks and reserves. Travelers should closely follow park regulations, always maintain a safe distance from wildlife, and should not exit vehicles or protected enclosures.
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. Speed laws are poorly enforced. Seek local advice before traveling on roads outside urban areas after dark. Driving at night is not advised.
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.
Road-traffic collisions can lead to violent confrontations.
Many taxis are unsafe. Use taxis from official ranks or dispatched via smart phone app or radio from a reputable company and ascertain the license or identification number of the dispatched vehicle.
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 cyclone season is from April through December, especially in coastal areas of the Bay of Bengal. The monsoon season is from June through October. Floods, mudslides, and landslides may occur, especially in the northern states of Uttarakhand, Uttar Pradesh, and Bihar and in the southern states of Andhra Pradesh and Karnataka.
Seismic activity frequently occurs, especially in the northern states of Uttar Pradesh, Bihar, and West Bengal.
Selected Embassies or Consulates in India
- United States: [+91] 11-2419-8000; in.usembassy.gov
- Canada: [+91] 11-4178-2000; www.canada.ca/CanadaAndIndia
- United Kingdom: [+91] 11-2419-2100; www.gov.uk/world/organisations/british-high-commission-new-delhi
- Australia: [+91] 11-4139-9900; www.india.highcommission.gov.au
India's Embassies or Consulates in Selected Countries
- In the U.S.: www.indianembassy.org
- In Canada: www.hciottawa.ca
- In the U.K.: www.hcilondon.in
- In Australia: www.hcindia-au.org
HIV testing is not required to obtain a tourist, work, or residence visa.