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Health Advisory
Health Information for Travelers to Afghanistan
Food and waterborne diseases are the number one cause of illness in travelers. Travelers' diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout the region and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking water are safe. (See below.)
Malaria is a preventable infection that can be fatal if left untreated. Prevent infection by taking prescription antimalarial drugs and protecting yourself against mosquito bites (see below). Malaria risk in this region exists in some urban and many rural areas, depending on elevation.
Most travelers to the Indian Subcontinent at risk for malaria should take mefloquine to prevent malaria.
A certificate of yellow fever vaccination may be required for entry into certain of these countries if you are coming from countries in tropical South America or sub-Saharan Africa. (There is no risk for yellow fever in the Indian Subcontinent.)
Dengue, filariasis, Japanese encephalitis, leishmaniasis, and plague are diseases carried by insects that also occur in this region. Protecting yourself against insect bites (see below) will help to prevent these diseases.
If you visit the Himalayan Mountains, ascend gradually to allow time for your body to adjust to the high altitude, which can cause insomnia, headaches, nausea, and altitude sickness. In addition, use sunblock rated at least 15 SPF, because the risk of sunburn is greater at high altitudes.
Because motor vehicle crashes are a leading cause of injury among travelers, walk and drive defensively. Avoid travel at night if possible and always use seat belts.
CDC Recommends the Following Vaccines (as Appropriate for Age):
See your doctor at least 4-6 weeks before your trip to allow time for shots to take effect.
• Hepatitis A or immune globulin (IG).
• Hepatitis B, if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay longer than 6 months, or be exposed through medical treatment.
• Japanese encephalitis, only if you plan to visit rural areas for 4 weeks or more, except under special circumstances, such as a known outbreak of Japanese encephalitis.
• Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
• Typhoid vaccination is particularly important because of the presence of S. typhi strains resistant to multiple antibiotics in this region.
• As needed, booster doses for tetanus-diphtheria and measles, and a one-time dose of polio for adults. Hepatitis B vaccine is now recommended for all infants and for children ages 11-12 years who did not receive the series as infants.
To Stay Healthy, Do:
• Wash hands often with soap and water.
• Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an "absolute 1-micron or less" filter AND adding iodine tablets to the filtered water. "Absolute 1-micron filters" are found in camping/outdoor supply stores.
• Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
• If you are going to visit areas where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
• Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4-hour intervals) and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and long pants from dusk through dawn.
• To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
• Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
To Avoid Getting Sick:
• Don't eat food purchased from street vendors.
• Don't drink beverages with ice.
• Don't eat dairy products unless you know they have been pasteurized.
• Don't share needles with anyone.
• Don't handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague). (For more information, please see the Animal-Associated Hazards on the Making Travel Safe page.)
• Don't swim in fresh water. Salt water is usually safer.
What You Need To Bring with You:
• Long-sleeved shirt and long pants to wear while outside whenever possible, to prevent illnesses carried by insects (e.g., malaria, dengue, filariasis, leishmaniasis, and onchocerciasis).
• Insect repellent containing DEET (diethylmethyltoluamide), in 30%-35% strength for adults and 6%-10% for children. Travelers who are not in air-conditioned or well-screened housing should purchase a bed net impregnated with the insecticide permethrin. (Bed nets can be purchased in camping or military supply stores.)
• Over-the-counter antidiarrheal medicine to take if you have diarrhea.
• Iodine tablets and water filters to purify water if bottled water is not available. See Do's above for more detailed information about water filters.
• Sunblock, sunglasses, hat.
• Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).
After You Return Home:
If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for four weeks after you leave the area.
If you become ill after travel-even as long as a year after your trip-tell your doctor the areas you have visited.
For More Information:
Ask your doctor or check the CDC web sites for more information about how to protect yourself against diseases that occur in the Indian Subcontinent, such as:
For information about diseases-
Carried by Insects
Dengue, Japanese encephalitis, Malaria
Carried in Food or Water
Cholera, Escherichia coli, diarrhea, Hepatitis A, Typhoid Fever
Person-to-Person Contact
Hepatitis B, HIV/AIDS
Note:
Afghanistan is located in the Indian subcontinent health region.
Sources: https://wwwnc.cdc.gov/travel/ *** CDC uses Travel Health Notices (THNs) to inform travelers about global health risks during outbreaks, special events or gatherings, and natural disasters, and to provide advice about protective actions travelers can take to prevent infection or adverse health effects. A THN can be posted for: 1) a disease outbreak (higher number of expected cases) in a country or region, 2) sporadic cases of a disease in an unusual or new geographic location, 3) natural and human-made disasters with severe environmental health risks, or infrastructure damage that would limit healthcare services availability and 4) mass gathering events that can lead to disease outbreaks. Types of Notices Level 4 – Avoid All Travel
Avoid travel to this destination unless traveling for humanitarian aid or emergency response; there is an extreme health risk for travelers and no available precautions. Level 3 – Reconsider Nonessential Travel
Reconsider nonessential travel to this destination. The outbreak or event poses risk to travelers because limited precautions are available. Level 2 – Practice Enhanced Precautions
Practice enhanced precautions for this destination. The Travel Health Notice describes additional precautions or defines a specific population at risk. Level 1 – Practice Usual Precautions
Practice usual precautions for this destination, as described in the Travel Health Notice as described on the CDC Traveler Health Notice page, found at URL: https://wwwnc.cdc.gov/travel/notices
Level 4 - Avoid All Travel
Ebola Bundibugyo Virus Disease in Ituri and Nord-Kivu Provinces of the Democratic Republic of the Congo?CDC recommends avoiding all travel to Ituri and Nord-Kivu (North-Kivu) provinces in the Democratic Republic of the Congo (DRC) due to the current Bundibugyo virus disease (BVD) outbreak unless traveling for humanitarian aid or emergency response.? Level 3 - Reconsider Nonessential Travel Ebola Bundibugyo Virus Disease in Haut-Uélé and Tshopo Provinces of the Democratic Republic of the Congo?CDC recommends avoiding nonessential travel to Haut-Uélé and Tshopo provinces in the Democratic Republic of the Congo (DRC) due to the current Bundibugyo virus disease (BVD) outbreak.? Level 2 - Practice Enhanced Precautions Chikungunya in Nicaragua?There is an outbreak of chikungunya in Nicaragua. You can protect yourself by preventing mosquito bites.?
Zika in Indonesia?Cases of Zika are being reported in returning travelers from Bali, Indonesia. All travelers to Bali should take steps to prevent mosquito bites and sexual transmission of Zika virus during and after travel. Ebola Bundibugyo Virus Disease in the Democratic Republic of the Congo and Uganda?CDC recommends practicing enhanced precautions for travel to Uganda or to provinces in the Democratic Republic of the Congo (DRC) not affected by the current Bundibugyo virus disease (BVD) outbreak.?
Chikungunya in Costa Rica?There is an outbreak of chikungunya in northwest Costa Rica. You can protect yourself by preventing mosquito bites.?
Malaria in Yemen?Increased cases of malaria have been reported in Yemen, including in areas that were previously considered low-risk.?
Chikungunya in French Guiana?There is an outbreak of chikungunya in French Guiana. You can protect yourself by preventing mosquito bites.?
Malaria in Mayotte?Increased cases of malaria have been reported in Mayotte. Malaria is spread by the bite of infected mosquitoes.?
Chikungunya in Mauritius?There is an outbreak of chikungunya in Mauritius. You can protect yourself by preventing mosquito bites.?
Meningococcal Disease in the Democratic Republic of the Congo?There is an outbreak of meningococcal disease in the Mangembo Health Zone of Kongo Central Province. The best way to protect yourself is to get meningococcal vaccination.?
Yellow Fever in Venezuela?An increased number of cases of yellow fever have been reported throughout Venezuela.?
Global Polio?Some international destinations have circulating poliovirus. Before any international travel, make sure you are up to date on your polio vaccines. Destination List: Afghanistan, Algeria, Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d'Ivoire (Ivory Coast), Democratic Republic of the Congo, Djibouti, Ethiopia, Germany, Guinea, Israel, the West Bank and Gaza, Laos, Namibia, Niger, Nigeria, Pakistan, Papua New Guinea, Poland, Republic of South Sudan, Senegal, Somalia, Sudan, Tanzania, including Zanzibar, United Kingdom, including England, Scotland, Wales, and Northern Ireland, Yemen?
Chikungunya in Suriname?There is an outbreak of chikungunya in Suriname. You can protect yourself by preventing mosquito bites.?
Chikungunya in Bolivia?There is an outbreak of chikungunya in Santa Cruz and Cochabamba Departments, Bolivia. You can protect yourself by preventing mosquito bites.?
Yellow Fever in Colombia?An increased number of cases of yellow fever have been reported in Colombia.? Level 1 - Practice Usual Precautions Global Dengue?Dengue is a year-round risk in many parts of the world, with outbreaks commonly occurring every 2–5 years. Travelers to risk areas should prevent mosquito bites.?
Paratyphoid Fever in Yemen?Cases of paratyphoid fever are being reported in returning travelers from Yemen. You can prevent paratyphoid fever by practicing safe eating and drinking habits. Diphtheria in Sub-Saharan Africa?There are outbreaks of diphtheria in several countries in Africa. Vaccination against diphtheria is essential to protect against the disease.?
Diphtheria in Haiti?There is an outbreak of diphtheria in Haiti. Vaccination against diphtheria is essential to protect against the disease. Hepatitis A in Canada?Manitoba, Canada is currently experiencing a hepatitis A virus (HAV) outbreak. HAV is contagious and spreads through close person-to-person contact and by eating contaminated food or drink.?
Rocky Mountain Spotted Fever in Mexico?Illness and death due to Rocky Mountain spotted fever (RMSF) have been reported in the northern region of Mexico along the U.S. border, particularly in Baja California, Sonora, Chihuahua, Coahuila, and Nuevo León.?
Global Measles?Measles cases are rising in many countries around the world. All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, according to CDC's measles vaccination recommendations for international travel. Additional Notoces:
Global Flooding
Due to changing seasonal patterns, several regions of the world are experiencing increased flooding. Floodwater may increase the risk of vector-borne, waterborne, and fungal diseases. Avoid contact with floodwater and follow all instructions from local authorities.
Global Wildfires
Several regions of the world are experiencing wildfires. Wildfire smoke can reach far away from where fires burn and can make anyone sick, but some people have a higher risk of getting sick. If traveling to an affected area, reduce exposure to smoke and follow all instructions from local authorities.
You can find more information that is country-specific at URL:
https://wwwnc.cdc.gov/travel/notices
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