What vaccines do I need for India? And 15 health and safety concerns in India

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 Paddy fields are a hotspot for the Japanese Encephalitis carrying mosquito

Paddy fields are a hotspot for the Japanese Encephalitis carrying mosquito

India has been growing in popularity as a vacation destination for many years now. It is a magnificently colourful and diverse country with incredible history, architecture and nature spots. To this end, it is no wonder that there were 8.80 million foreign tourist arrivals in 2016 and 10.18 million from January until November in 2017 (Indian government statistics, 2017).  

India is, however, considered a developing country in many regions, and there are numerous healthcare risks you should be aware of before heading off on your holiday. To begin with, you should immediately be thinking about shots and medications (Typhoid, Hepatitis and Tetanus among others) to avoid contracting any diseases while in India. General health and safety preparation are also necessary in order to get the most out of your trip in this beautiful country. 

In this article, we will present all the recommended vaccines for travel to India as well as 15 health and safety matters to be aware of for before heading to India. 

What to prepare before you travel to India?

It is imperative to remember that travel to India needs some planning in order to enjoy a fantastic holiday without any health or safety concerns. Number one on our list of health concerns to plan in advance is vaccines. 

1. What vaccinations are needed for travel to India?

Vaccines in general

Before you begin your travels in India, start by checking your general vaccine record with a medical professional in case you are missing any booster shots. 

As a child in Canada you will routinely be given the following shots: 

As an adult in Canada booster shots are offered especially for those planning travels to countries such as India. These adult shots may include:

  • Td-IPV, Td, Hepatitis A, Hepatitis B, HPV, Meningococcal, Pneumococcal and Shingles.

Boosters for Td (Tetanus and Diphtheria), Hepatitis A and Typhoid are the most important booster shots to worry about pre-travel to India. 

For travel to India

The CDC recommends the following two vaccines before any kind of travel to India:

  • Hepatitis A. Although included in many general vaccine programs, if you are missing this booster, it is highly recommended as you are able to contract Hepatitis A through drink and food in India. 
  • Typhoid. Also contracted through contaminated food or water; typhoid is another highly recommended vaccine for any kind of traveller in India. 

For specific travels in India

Other vaccinations and medications that are recommended for travel to India are:

  • Cholera. Recommended for people travelling to regions where Cholera is active. 
  • Hepatitis B. Recommended for people having sexual relations or, getting tattoos and/or piercings in India.
  • Japanese encephalitis. Recommended for long terms travellers (over 1 month) and those going to rural regions and areas with dense forestation.
  • Malaria. Although no vaccine exists against Malaria, there are antimalarial medications available to take before, during and once returned to Canada from your travels from India.
  • Rabies. Anyone coming into contact with animals such as through caving, outdoor activities or animal charity work is highly recommended to have this vaccine. It is also recommended for children as they are more likely to get bitten through playful behaviour with animals. 
  • Yellow fever. You will not be at risk of contracting Yellow fever in India; rather it is an obligatory vaccine to enter India (proof on arrival is demanded) if you are coming from any yellow fever infected country. This does not include Canada. 

The Public Health Agency of Canada recommends that you visit a travel clinic or your health care provider six weeks before you travel. You can book a travel health appointment at our Toronto Travel Clinic, Etobicoke Travel Clinic, or Oakville Travel Clinic

2. What health insurance do I need for India?

As with any other travel destination, a trip to India can present you with unforeseen circumstances. Your domestic insurance plan will most certainly not cover incidents or accidents overseas. You should carefully research and select a travel insurance plan that covers death, disability, healthcare, car (if you’re planning to drive) and other activities and risks related to your plan.

You can purchase travel insurance from your travel agent, online, through your financial institution or credit card company, and sometimes via your employer. 

When selecting the best travel insurance plan, make sure you read the terms and conditions thoroughly. If something is not clear, you should ask for a clarification in writing. These are some considerations when selecting travel insurance:

  • Does the plan cover flight delays and lost baggage?
  • Can you renew or extend coverage from abroad?
  • Will the plan cover pre-existing medical conditions?
  • Is there a 24-hour emergency contact number in English?
  • Will the plan cover medical evacuation?
  • Does the plan provide cashless hospitalization

The considerations are lengthy and complex, but as with every other aspect surrounding your trip, proper planning will make a successful trip. The government of Canadian has a comprehensive guide on how to select the appropriate travel insurance for your trip. We encourage you to consult it. 

3. Where is medical care in India?

India has a vast array of medical centres that will treat you in case of illness. Nonetheless, be aware that much of the better quality medical care can be found in centres in and around cities and large towns. In rural areas you may find little to no medical care available. 

You should always check with your insurer prior to using a medical centre or hospital as they often have specific centres you are covered in. 

You should also try to bring your own medicines and check that your prescription medication is legal to bring into India by consulting with the Indian Embassy. If you must buy medicine in India, verify packaging to make sure it is not damaged, that you are taking the correct medicine and dosage, and that the sell-by-date is correct.   

 Indian culture differs greatly from western cultures.

Indian culture differs greatly from western cultures.

4. How to prepare for an Indian cultural shock?

Despite cultural shocks not being considered of medical concern, it is a subject we should always take into account before travelling to very much foreign lands as is India. 

In travel blogs we can find information concerning poverty, smog, traffic, unwanted stares, customs and rip-offs as the main topics that create an uncomfortable sense of culture shock in India.

India, as well as having a highly dense population is also in development. For this reason, you should expect to feel overwhelmed by the sheer quantity of people and the traffic and trash they produce. The country has high levels of poverty that affect all ages in the population so do not be surprised by the number of street sleepers or homeless animals roaming the streets.

The general customs of the Indian population may vary greatly depending on the region you choose to travel in; however, at no times should you expect to feel like at home. They have grown up with different traditions and will treat foreigners with curiosity in many circumstances. You will likely be stared at, offered high prices and generally harassed to buy products and services. 

All this being said, do not let it sway you from planning a trip to this magical country. Embrace the culture shock and appreciate everything India has to offer; the bad and the good. 

What health concerns are there in India?

Once you have arrived in India you should concern yourself with some general and very important health concerns that could affect your travel including common diseases and illnesses such as malaria and traveller’s diarrhea.

5. What mosquito-borne diseases are there in India? 

The first health concern to think about is mosquito-borne diseases in this area of the world. Here we include the top 4 mosquito-borne diseases in India.

Malaria is definitely a top concern given it is a worldwide killer and prevalence in India is fairly high. You may be asking yourself when is malaria season in India? The answer is, it varies between regions; however, the malaria carrying mosquito will be more prevalent generally around the start of monsoon season until the start of the dry season so around end of May to December to give you an idea (Berger, 2018). As we have already seen, antimalarial medication is on the CDC’s list of recommended drugs for a trip to India. According to UNICEF malaria kills a child every 30 seconds so it is definitely a good idea to prevent spreading by means of antimalarial medicine. 

Another disease becoming more prevalent in India is Dengue fever, also contracted through mosquito bites. Your main defence will be to avoid mosquito bites. Avoiding sources of stagnant water, covering up with light colored clothes and mosquito spray are just some of the ways to avoid these sometimes dangerous bugs. The fatality rates are low from Dengue fever therefore if you contract it, after seeking medical advice, you will likely recover quickly after rest, paracetamol and fluids. 

According to the British National Health Service (2017), India has a moderate risk of Zika virus transmission.  Although no vaccine exists, Zika is not of great concern for the general population unless you are pregnant. Please follow travel advice that suggests postponing non-essential travel to India for pregnant women. Avoid being bitten during daylight in densely populated areas as this is where the Zika carrying mosquito is often found.

Japanese encephalitis is another mosquito-borne disease that can be contracted in rural areas. We highly recommend long-term travellers to India to have this vaccine done in order to protect themselves from this possibly fatal virus. The mosquito is often active around stagnant water during the evening and night. 

6. What illnesses are spread through body fluids in India?

Another way viruses enter our body is through the sharing of body fluids (saliva, semen and blood). Be wary when travelling to India with the following activities: 

⦁    Having sexual relations with non-stable partners
⦁    Having a tattoo done
⦁    Getting a piercing
⦁    Sharing needles
⦁    Receiving medical treatment (all equipment should be thoroughly sterilized)

Through the sharing of body fluids, you put yourself at risk of contracting Hepatitis B as well as many other sexually transmitted infections. To this end, it is even more important to keep your vaccines up-to-date, always use a condom and do not use injectable drugs or any other for that matter.  

7. How to eat and drink safely in India

Unfortunately, there are many illnesses that can be spread through contaminated drink and food in India.  Some of these viruses include: Hepatitis A, Cholera and Typhoid. In order to stay safe please follow the medical advice about recommended vaccines when travelling to India. To avoid infection or a bad stomach please take into account the following advice: 

The CDC recommends for drink: Only drink bottled well-sealed water, soda, hot coffee and tea and pasteurised milk. Do not drink tap water and be wary of ice in drinks and reconstituted juices.

The CDC recommends for food: Only eat cooked hot food and hard-cooked eggs. Avoid eating pre-peeled fruit and vegetables, raw or rare eggs, meat and fish. Also, try and avoid street vendor food and unpasteurised dairy products. 

8. How to avoid traveller’s diarrhea in India

Traveller’s diarrhea is an unfortunate fact of many people’s holidays to India and Asia in general. Contaminated food is the main cause of diarrhea, therefore, it is vital to follow food and drink guidelines when dining in India. Also, remember to wash your hands before and after eating and using the toilet; and carry an antibacterial gel with you at all times. 

The most important treatment for traveller’s diarrhea is re-hydration. When passing liquid stools you will lose a lot of fluids. It is necessary to drink plenty of water in order to not dehydrate.  

If there is blood or mucous present in your stools or if you are passing more than 6 stools in 24 hours, you should seek out medical attention.

9. How to stay safe outdoors in India

India is a big country with extremely varying climates and temperatures. You should always prepare for the climate found in the area you are visiting

Sunburn in India 
You are likely to get sunburnt in India if you are of light skin, red hair or are a child. To avoid sunburn always use a high 30 or more SPF sun cream that protects you from both UVA and UVB rays (this information is found on the sun cream bottles). 

Other important factors in the fight against sunburn include avoiding the midday sun from 12:00 pm – 4:00 pm, wearing loose-fitting clothing that covers your body and wearing a hat. 

Heatstroke in India
Heatstroke is another uncomfortable and sometimes deadly symptom of the tropics (or mountains) of India. Heatstroke can be fatal therefore it is vital you do not exert yourself under the midday sun, you drink lots of water and wear loose-fitting clothing. 

The cold in India 
Despite India being famous for its beaches, cities and tropical jungles, it also holds some of the highest mountains in the world in the Himalayas range. In the north of India you will find low temperatures and if hiking in the mountains you will need to go prepared. Dress appropriately in these regions with thick winter clothing that covers your head, hands and feet. 

10. Can I get altitude sickness in India?

High up in the Himalayas it is very probable you will suffer from Acute Mountain Sickness (AMS). At altitudes such as those found in the Himalayas (4000+ metres above sea-level), you are at risk of AMS deteriorating to High Altitude Pulmonary or Cerebral Edema. Both these can be fatal so it is of extreme importance to acclimatize your body and follow guidelines for safe mountain treks. You should not be ascending more than 500m per day; neither should you drink alcohol at these heights. You must drink lots of fluids and not exert yourself or persist if symptoms of AMS present themselves (lethargy, vomiting, dizziness and nausea, among others). 

What safety concerns are there in India?

Save viruses, infections and illnesses, it is important to consider other aspects of travel to India to make your trip as safe as possible such as safe transport and personal safety. 

 According to the WHO, India is the world’s most polluted country

According to the WHO, India is the world’s most polluted country

11. How to choose safe transport in India

When travelling in India you should be aware of the risks involved in taking transportation. 

Motorbike crashes are frequent, for that reason always wear a helmet and avoid driving on dark roads where potholes are common. You should never ride a motorbike while drinking and avoid taking motorbike taxis if other transport options are available.

You should always choose licensed taxis and note down the driver number and number plate in event of any difficulties. Always wear a seatbelt and try and find a newer vehicle with fitted airbags if possible.

It is advised to avoid heavily crowed transport options for both the safety aspects of the vehicle (seat belt access) and personal safety to avoid any unwanted harassment. This especially concerns sole female travellers.  

12. Contact with animals in India

Stray and wild animals can be found all over India. In certain circumstances you may be at risk of being attacked or bitten and at worst being infected with rabies in extreme situations. 

Always avoid touching and feeding animals. Be extra careful with dogs and bats as they are the main transmitters of rabies. But also be wary of snakes and jellyfish whose sting may also be fatal. If you have been bitten by an animal please consult medical attention immediately. 

It is also advisable to not have dogs or any such animal lick you; their saliva can transmit bacteria that could cause you a lot of harm. 

If you are worried about rabies, please follow our guidelines over the administration of the rabies vaccine.

13. How to keep safe in India

Everyone who goes to India will want to feel safe and without worries while exploring the great cities and landscapes. To that end, we have some advice concerning your personal safety. 

Firstly, always read up on government travel advice so you know which regions are safe to travel in and which to avoid:

  • https://travel.gc.ca/destinations/india  - Canadian Government advice
  • https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories/india-travel-advisory.html - USA Government advice

Secondly, let someone know where you are at all times; leaving your holiday itinerary with close family is always a good idea. 

You should not carry expensive or irreplaceable items around with you. Neither should you carry your passport (having a photocopy is always handy) or large amounts of money with you. Furthermore, try not to attract attention by wearing expensive clothing, carrying large bags around or having an expensive mobile on display. 

We recommend you carry your Embassy’s phone number with you, written on paper, as well as your hotel and any close contact’s number you may have in India. 

Lastly, follow your instincts. If you feel unsafe, go towards a more lit-up area or where you feel more comfortable.  

 However cute they look, avoid contact with street animals.

However cute they look, avoid contact with street animals.

What environmental concerns could affect my vacation in India?

India has a few environmental issues that their Government still have to work on. One of these issues is air pollution and the other carbon monoxide poisoning. 

14. What environmental hazard is there in India?

In India’s northern regions winter tends to get quite cold. To deal with the cold most households use coal-burning heaters. Unfortunately, these coal burners emit high levels of carbon monoxide which can cause poisoning and death. We recommend avoiding these heating systems and relying on thick clothing and blankets to keep warm in the mountain regions. 

15. How bad is air pollution in India?

According to the World Health Organization India is number one in the world for air pollution. Kanpur in the north is the world’s most polluted city and Delhi and Mumbai do not fall far behind. 

Before leaving your accommodation always check air pollution levels. If levels of 100 or above are recorded it is best to stay inside. Furthermore, consider having a face mask at hand to protect your respiratory system in urban centres.