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Diseases potentially acquired by travel to South Asia

David Murdoch, MD, MSc, DTM&H, FRACP, FRCPA, FFSc(RCPA)
Section Editor
Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
Deputy Editor
Elinor L Baron, MD, DTMH


Countries within this region are Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. This is a region of diverse geography, including high mountains, deserts, flood plains, forests, tropical beaches, and large urban/peri-urban areas. Many areas in South Asia are popular destinations for travelers.


Malaria — Malaria-endemic areas exist in all countries in this region except the Maldives and Sri Lanka. The transmission risk varies considerably within endemic areas, and transmission occurs in many cities within the Indian subcontinent. Country-specific risk areas are as follows:

Afghanistan – Risk from May through November at altitudes below 2000 meters.

Bangladesh – Risk throughout the year in 13 of 64 districts, but transmission occurs only in rural areas. The risk is high in Chittagong Hill Tract districts (Bandarban, Rangamati, and Khagrachari), Chittagong district, and Cox Bazaar district, and the risk is low in Hobigonj, Kurigram, Moulvibazar, Mymensingh, Netrakona, Sherpur, Sunamgonj, and Sylhet. There is no risk in Dhaka City.

Bhutan – Risk exists in the southern belt of seven districts: Chukha, Dagana, Pemagatshel, Samdrup Jongkhar, Samtse, Sarpang, and Zhemgang. No transmission occurs in Bumthang, Gasa, Paro, and Thimphu.

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Literature review current through: Nov 2017. | This topic last updated: Nov 30, 2017.
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  1. Inactivated Japanese encephalitis virus vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 1993; 42:1.
  2. Murdoch DR, Woods CW, Zimmerman MD, et al. The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal. Am J Trop Med Hyg 2004; 70:670.
  3. Mathai E, Rolain JM, Verghese GM, et al. Outbreak of scrub typhus in southern India during the cooler months. Ann N Y Acad Sci 2003; 990:359.
  4. Lewis MD, Yousuf AA, Lerdthusnee K, et al. Scrub typhus reemergence in the Maldives. Emerg Infect Dis 2003; 9:1638.
  5. International Travel and Health. Geneva, World Health Organization, 2005.
  6. Steffen R. Epidemiology of traveler's diarrhea. Clin Infect Dis 2005; 41 Suppl 8:S536.
  7. Jain D, Sinha S, Prasad KN, Pandey CM. Campylobacter species and drug resistance in a north Indian rural community. Trans R Soc Trop Med Hyg 2005; 99:207.
  8. Maskey AP, Day JN, Phung QT, et al. Salmonella enterica serovar Paratyphi A and S. enterica serovar Typhi cause indistinguishable clinical syndromes in Kathmandu, Nepal. Clin Infect Dis 2006; 42:1247.
  9. Woods CW, Murdoch DR, Zimmerman MD, et al. Emergence of Salmonella enterica serotype Paratyphi A as a major cause of enteric fever in Kathmandu, Nepal. Trans R Soc Trop Med Hyg 2006; 100:1063.
  10. Rubach MP, Halliday JE, Cleaveland S, Crump JA. Brucellosis in low-income and middle-income countries. Curr Opin Infect Dis 2013; 26:404.
  11. Emerson SU, Purcell RH. Hepatitis E virus. Rev Med Virol 2003; 13:145.
  12. Antony SJ. Leptospirosis - An Emerging Pathogen in Travel Medicine: A Review of its Clinical Manifestations and Management. J Travel Med 1996; 3:113.
  13. Epidemiological fact sheets on HIV/AIDS and sexually transmitted infections. Geneva, UNAIDS/WHO, 2004.
  14. Global distribution of hepatitis A, B and C, 2001. Wkly Epidemiol Rec 2002; 77:45.
  15. Human plague in 2002 and 2003. Wkly Epidemiol Rec 2004; 79:301.
  16. Rabies vaccines. WHO position paper. Wkly Epidemiol Rec 2007; 82:425.
  17. Smith A, Petrovic M, Solomon T, Fooks A. Death from rabies in a UK traveller returning from India. Euro Surveill 2005; 10:E050728.5.
  18. Fenner PJ. Dangers in the ocean: the traveler and marine envenomation. I. jellyfish. J Travel Med 1998; 5:135.
  19. Fenner PJ. Dangers in the ocean: the traveler and marine envenomation. II. Marine vertebrates. J Travel Med 1998; 5:213.
  20. Basnyat B, Murdoch DR. High-altitude illness. Lancet 2003; 361:1967.