Country Focus: India - increase in insect, mosquito and tick spread infections reminder

Visiting India? Be aware there’s been an increase in insect spread infections such as dengue in this country - make sure you know how to protect yourself

India is reporting an increase in insect and mosquito spread illnesses including dengue [1]. Outbreaks of Zika virus are also being reported in some regions of India [2, 3] and the mosquito (Aedes aegypti) that carries this virus is found all areas of India [4].

Malaria is a risk throughout India, as are other insect, mosquito and tick spread infections such as Chandipura virus [1, 5], Chikungunya, Crimean-Congo haemorrhagic fever, Japanese encephalitis, leishmaniasis, Kyasanur Forest Disease, scrub typhus and West Nile virus.

Advice for travellers

Before you travel

Research your trip; see our general advice for travellers to help you plan ahead.

Check our India Country Information page for current health news, vaccine recommendations and travel advice, including information about insect and tick spread infections and your malaria risk.

Arrange an appointment with your GP, practice nurse, pharmacist or a travel clinic to discuss your trip and to get travel vaccine recommendations and malaria/insect spread infection advice as soon as you decide to travel.

As malaria is a risk in the whole country, tell your travel health adviser about all the places in India you are visiting, as antimalarials are recommended for certain higher risk areas and for some travellers at increased risk of severe illness.

See our India malaria recommendations map and advice for more information.

Vaccines are available for some diseases spread by mosquitoes and may be recommended:

• a live, attenuated (weakened) dengue vaccine called Qdenga® licensed in the United Kingdom (UK), but it is not suitable for all travellers; Please see our news item: Qdenga® dengue vaccine guidance for more information
• a Japanese encephalitis vaccine course may be recommended for some travellers to India

Check the Foreign, Commonwealth and Development Office (FCDO) India country advice for up to date safety and security information and guidance about driving/transport risks. You can also sign up for FCDO email updates about India.

Pregnant or planning a pregnancy?

India is a country with a risk of Zika and infection in pregnancy has been associated with birth defects. If you are pregnant or planning a pregnancy, discuss the suitability of your trip, and the potential risk that Zika virus may present to you, with your doctor or (if appropriate) your midwife, and a travel health professional.

The UK Health Security Agency has specific Zika advice for pregnant travellers and those planning a pregnancy: Zika virus (ZIKV): clinical and travel guidance.

This includes recommendations about preventing sexual transmission of Zika if you are travelling with a male partner.

You should also discuss your malaria risk in India with a health professional, as this infection is more dangerous in pregnancy. Certain prescription antimalarial tablets are safe in pregnancy [6] and your health professional can advise you about this.

Insect repellents containing DEET 50 percent have good safety record in pregnancy and are recommended by the UK Health Security Agency [6] for pregnant women at risk of insect spread infections like malaria and Zika.

In India

Reduce your risk of insect and tick spread infections by following insect and tick bite avoidance advice carefully day and night.

Mosquitoes that spread dengue and Zika mainly bite during the day, but mosquitoes that carry malaria bite mostly at night.

Always use suitable insect repellents such as DEET (or an effective alternative like Icaridin if you can't tolerate DEET) directly onto exposed skin and apply this regularly.

Covering up with clothes, including wearing long sleeves/trousers, helps reduce bites. Clothing can also be sprayed or impregnated with an insecticide like permethrin, although insecticides should not be used directly on skin.

DEET repellents can also be applied to natural fibres like cotton, but can damage synthetic fabrics.

Sleep under an insecticide treated mosquito net to avoid being bitten, unless your accommodation has working, switched on air-conditioning.

Insecticide vaporisers can be used to help prevent mosquito bites and mosquito coils can be used outdoors, but are not suitable for use inside.

If you are staying long-term in India, it is possible to reduce mosquito breeding sites around your accommodation by removing any pools of water in ditches, plant pots, gutters, drains and clearing rubbish collected in the area.

If you have been prescribed antimalarial tablets, remember to take them as advised.

If you have a fever, headache, tiredness, muscle ache, a persistent cough, a rash or any unusual symptoms, you must get urgent local medical advice.

When you return

If you were prescribed antimalarial tablets, remember to finish the course when you get home, even if you feel fine.

If you are ill within weeks or even months of your trip, particularly if you have fever or flu-like symptoms and/or diarrhoea, you must get urgent (same day) medical help.

Remember to tell your doctor you visited India, a malaria risk country.

Pregnancy

If you are pregnant, contact your GP or midwife when you return from India, even if you have remained fit and well, with no Zika symptoms. They will advise if you need any assessments after your trip. You can find more information here: Health advice for women returning from countries or areas with risk for Zika virus transmission.