† Certain vaccines should not be given to pregnant women, young children, or immunocompromised individuals. Ask your physician or go to MD Travel Health for details.

Malaria prophylaxis is not necessary for those travelling only to major urban areas or to rural areas only during the daytime, which includes most tourists. Prophylaxis with Lariam, Malarone, or doxycycline is recommended for the southern provinces of Hainan, Yunnan, and Guangxi. Prophylaxis with chloroquine is recommended for rural areas in most other provinces, including Anhui, Fujian, Guangdong, Guizhou, Hubei, Hunan, Jiangsu, Jiangxi, Shandong, Shanghai, Sichuan, Xinjiang (only along the valley of the Yili river), Xizang (only along the valley of the Zangbo river in the extreme southeast) and Zhejiang. Prophylaxis is not necessary for the northern provinces bordering Mongolia and for the western provinces of Heilungkiang, Kirin, Ningsia Hui Tibet, and Tsinghai.

Mosquito protection:

To prevent mosquito bites, travelers should wear long sleeves, long pants, hats, and shoes instead of sandals. Insect repellents containing 25-35% DEET (N,Ndiethylmetatoluamide) should be applied to clothing and exposed skin (but not to the eyes, mouth, or open wounds). For children between 2 and 12 years of age, use preparations containing no more than 10% DEET and apply sparingly. DEET-containing compounds should not be used on children less than two years of age. For further protection, apply permethrin-containing repellents to clothing, shoes, and bed nets. Don’t sleep with the window open unless there is a screen. If sleeping outdoors or in an accomodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress.

Food and water:

The safest course is not to drink tap water unless it has been boiled, filtered, or chemically disinfected, and not to drink any unbottled beverages or drinks with ice. Fruits and vegetables should not be eaten unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish. Some types of fish may contain poisonous biotoxins even when cooked, including barracuda, red snapper, grouper, amberjack, sea bass, and many tropical reef fish.

Altitude sickness:

Altitude sickness may occur in travelers who ascend rapidly to altitudes greater than 2500 meters. Most roads and towns in Tibet, Qinghai, parts of Xinjiang, and western Sichuan are at altitudes over 3000 meters. Acetazolamide is the drug of choice to prevent altitude sickness, starting 24 hours before ascent and continuing for 48 hours after arrival at altitude. Travel to high altitudes is not generally recommended for those with a history of heart disease, lung disease, or sickle cell disease. Travel to high altitudes is not generally recommended for those with a history of heart disease, lung disease, or sickle cell disease.

General advice:

Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from your physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician’s letter documenting their medical necessity. If you wear glasses or contacts, bring an extra pair. Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars.

Pack a personal medical kit, customized for your trip. The kit should include an antibiotic and an antidiarrheal drug, to be started promptly if significant diarrhea occurs (defined as five or more loose stools in a 24-hour period). On long flights, consider isometric muscle contractions, walking, drinking plenty of fluids, and wearing elastic compression stockings to prevent blood clots in the legs.

Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Do not swim in lakes, ponds, or other bodies of unchlorinated fresh water. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.