Pakistan

Medical Summary

General Information

Pakistan is a developing nation classified as lower middle income. Located in southern Asia (west of India and east of Iran), the climate is classified as dry (arid) to dry (semi arid), with cooler temperatures in some high-altitude areas.

Vaccinations

Routine vaccinations are essential due to a persistent rise of vaccine-preventable diseases (especially markedly high rates of diphtheria, pertussis, and measles) globally. Prior to travel, travelers should be up-to-date with the age-appropriate routine vaccinations recommended by their home country, which may include: COVID-19; H. influenzae type B (Hib); hepatitis A; hepatitis B; herpes zoster; human papillomavirus; influenza; measles, mumps, rubella; meningococcal; pneumococcal; polio; rotavirus; tetanus, diphtheria, pertussis (Tdap preferred; consider an early pertussis booster for high-risk travelers); varicella.

Yellow Fever

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 certificate proving yellow fever vaccination 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 chikungunya, cholera, Japanese encephalitis, rabies, typhoid fever, or a one time polio booster if you haven't previously received one for travel.

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) Malaria risk due to P. vivax and P. falciparum exists throughout the year in the entire country below 2000 m, especially in rural areas from July through December.

• 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
  a}Alternatively, 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).

• Drug resistance³ : Chloroquine.
• Malaria species: P. vivax 70%, P. falciparum 30%.
• 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.

Other Concerns

Travelers' Diarrhea

See also: Library article for Travelers' Diarrhea

High risk exists throughout the country, including in deluxe accommodations. Community sanitation and food safety measures are generally 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

Dengue, leishmaniasis, West Nile virus, Zika may pose a risk. Personal protective measures are important.

Other Disease and Health Risks

Additional concerns include air pollution, anthrax disease, Crimean-Congo hemorrhagic fever, helminths, hepatitis C, leptospirosis, marine hazards, plague, sexually transmitted infections, snakebites, tuberculosis.

Safety and Security

See also: Library article for Safety and Security

Key Safety Risks

• Road conditions and traffic collisions
• Public transportation
• Domestic and/or international air travel
• Petty crime
• Heightened crime risk for women
• Heightened crime risk for LGBTQ+ travelers
• Theft of vehicles
• Scams
• Celebratory gunfire
• Natural disasters

Key Security Threats

• Terrorist attacks by domestic and/or transnational groups, which may target foreign nationals or airports
• Risk of violent civil unrest
• Risk of violent protests
• Potential spillover of armed conflict
• Cross-border threats in areas bordering Afghanistan, India, the Line of Control in Kashmir, and Iran
• Explosions in public places
• Violent crime
• Kidnapping, which may target foreign nationals
• Random acts of armed violence

Emergency Phone Number

The police emergency number is 15.