Before travel, be sure you and your children are up to date on all routine immunizations according to schedules approved by the Advisory Committee on Immunization Practice (ACIP). See the schedule for adults and the schedule for infants and children. Some schedules can be accelerated for travel.
See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect. If it is less than 4 weeks before you leave, you should still see your doctor. It might not be too late to get your shots or medications as well as other information about how to protect yourself from illness and injury while traveling.
The following vaccines may be recommended
for your travel to the Middle East. Discuss
your travel plans and personal health with
a health-care provider to determine which vaccines
you will need.
A or immune globulin (IG). Transmission
of hepatitis A virus can occur through
direct person-to-person contact; through
exposure to contaminated water, ice, or
shellfish harvested in contaminated water;
or from fruits, vegetables, or other foods
that are eaten uncooked and that were contaminated
during harvesting or subsequent handling.
- Hepatitis B, especially if you might be exposed to blood or body fluids (for example, health-care workers), have sexual contact with the local population, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not receive the series as infants.
- Rabies, pre-exposure vaccination, if you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities.
- Typhoid vaccine. Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages that have been handled by a person who is infected. Large outbreaks are most often related to fecal contamination of water supplies or foods sold by street vendors Risk is greater if you are visiting developing countries in this region.
- As needed, booster doses for tetanus-diphtheria, measles, and a one-time dose of polio vaccine for adults.
- Meningococcal vaccine
is required for pilgrims to Mecca for the
annual Hajj. However, CDC currently recommends
the vaccine for all travelers
to Mecca, including those traveling for the
Umra. (For more information, please see Saudi
Arabia Hajj Requirements.)
Diseases found in the Middle East (risk can vary by country and region within a country; quality of in-country surveillance also varies)
The preventive measures you need to take while traveling in the Middle East depend on the areas you visit and the length of time you stay. You should observe the precautions listed in this document in most areas of this region. However, in highly developed areas of Israel, you should observe health precautions similar to those that would apply while traveling in the United States.
Malaria is always a serious disease and may be a deadly illness.
Humans get malaria from the bite of a mosquito infected with the parasite. Prevent this serious disease by seeing your health care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites.Your risk of malaria may be high in these countries, including some cities. Travelers to malaria-risk areas, including infants, children, and former residents of the Middle East, should take an antimalarial drug. Travelers to some areas of Iran, Iraq, Oman, Saudi Arabia, the Syrian Arab Republic, Turkey, and Yemen may be at risk for malaria.
For additional information on malaria risk and prevention, see Malaria Information for Travelers to the Middle East.
- Chloroquine is the recommended antimalarial drug for Iraq, Syria, and Turkey.
- Travelers to Iran, Saudi Arabia, and Yemen should take one of the following antimalarial drugs: (listed alphabetically): atovaquone/proguanil, doxycycline, mefloquine, or primaquine (in special circumstances).
- In Oman, the risk of malaria is in the Musandam Province only; because the risk is very limited, no antimalarial drug is needed in this area.
There is no risk of malariain Bahrain, Cyprus, Israel, Jordan, Kuwait, Lebanon, Qatar, and the United Arab Emirates.
There is no risk for yellow fever in the Middle East. A certificate of yellow fever vaccination may be required for entry into certain of these countries if you are coming from countries in South America or sub-Saharan Africa. For detailed information, see Comprehensive Yellow Fever Vaccination Requirements. Also, find the nearest authorized U.S. yellow fever vaccine center.
Food and Waterborne Diseases
Make sure your food and drinking water are safe. Food and waterborne diseases are the primary cause of illness in travelers. Travelers’ diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout the Middle East 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).
Additional information: see the Safe Food and Water page for a list of links.
Other Disease Risks
Cutaneous leishmaniasis is reported throughout the area;
visceral leishmaniasis, although rare throughout most of the area, is common in central Iraq, in the southwest of Saudi Arabia, in the northwest of Syria, in Turkey (southeast Anatolia only), and in the west of Yemen. Many cases of leishmaniasis have been reported in the US military in Iraq. A rise in West Nile fever has been seen recently in Israel. Outbreaks of dengue occurred in Saudi Arabia and Yemen in 2002. Protecting yourself against insect bites (see below) will help to prevent these diseases.
Other infections that tend to occur more often in longer-term travelers (or immigrants from this region) include tuberculosis (Yemen), lymphatic filariasis and onchocerciasis (Yemen), hepatitis B, and schistosomiasis (Saudi Arabia, Yemen, Iraq, and Syria) To prevent schistosomiasis, do not swim in fresh water (except in well-chlorinated swimming pools) in these countries. (For more information, please see Swimming and Recreational Water Precautions.) Polio has resurfaced in Yemen. Pilgrims to the Hajj in Saudi Arabia have acquired meningococcal infections caused by serotypes A and W-135, as well as influenza.
Other Health Risks
Motor vehicle crashes are a leading cause of injury among travelers. Protect yourself from motor vehicle injuries: avoid drinking and driving; wear your safety belt and place children in age-appropriate restraints in the back seat; follow the local customs and laws regarding pedestrian safety and vehicle speed; obey the rules of the road; and use helmets on bikes, motorcycles, and motor bikes. Avoid boarding an overloaded bus or mini-bus. Where possible, hire a local driver.
What You Need To Bring With You
- Long-sleeved shirt, long pants, and a hat to wear whenever possible while outside, to prevent illnesses carried by insects (e.g., malaria, Dengue, filariasis, leishmaniasis, and onchocerciasis).
- Insect repellent containing DEET.
- Bed nets treated with permethrin. For use and purchasing information, see Insecticide Treated Bednets on the CDC malaria site. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.
- Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
- Iodine tablets and portable water filters to purify water if bottled water is not available. See Preventing Cryptosporidiosis: A Guide to Water Filters and Bottled Water for more detailed information.
- Sunblock, sunglasses, and a hat for protection from harmful effects of UV sun rays. See Skin Cancer Questions and Answers for more information.
- Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s) or letter from your health-care provider on office stationery explaining that the medication has been prescribed for you.
- Always carry medications in their original containers, in your carry-on luggage.
- Be sure to bring along over-the-counter antidiarrheal medication (e.g., bismuth subsalicylate, loperamide) and an antibiotic prescribed by your doctor to self-treat moderate to severe diarrhea. See suggested over-the-counter medications and first aid items for a travel kit.
Staying Healthy During Your Trip
Travelers should take the following precautions
To stay healthy, do...
Wash your hands often with soap and water or, if hands are not visibly
soiled, use a waterless, alcohol-based hand rub to remove potentially
infectious materials from your skin and help prevent disease
- In developing countries, 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,
learn how to make water safer to drink.
- Take your malaria prevention medication before, during, and after travel, as directed. (See your health care provider for a prescription.)
- To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot, even on beaches.
- Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
- Protect yourself from mosquito insect bites:
- Do not eat food purchased from street vendors or food that is not well cooked to reduce risk of infection (i.e., hepatitis A and typhoid fever).
- Do not drink beverages with ice.
- Avoid dairy products, unless you know they have been pasteurized.
- Do not swim in fresh water to avoid exposure to certain water-borne diseases such as schistosomiasis. (For more information, please see Swimming and Recreational Water Precautions.)
- Do not handle animals, especially monkeys, dogs, and cats, to avoid bites and serious diseases (including rabies and plague). Consider pre-exposure rabies vaccination if you might have extensive unprotected outdoor exposure in rural areas. For more information, please see Animal-Associated Hazards.
- Do not share needles for tattoos, body piercing or injections to prevent infections such as HIV and hepatitis B.
After You Return Home
If you have visited a malaria-risk area, continue taking your antimalarial drug for 4 weeks (chloroquine, doxycycline, or mefloquine) or seven days (atovaquone/proguanil) after leaving the risk area.
Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the physician your travel history.
Important: This document is not a complete medical guide for travelers to this region. Consult with your doctor for specific information related to your needs and your medical history; recommendations may differ for pregnant women, young children, and persons who have chronic medical conditions.
National Center for Infectious Diseases, Division of Global Migration and Quarantine