Cholera is an intestinal infection that can cause severe diarrhoea which may lead to dehydration and ultimately death. It is caught from the consumption of contaminated food and water. An increasing problem in areas of poor sanitation in South America, the Middle East, Africa and Asia, it is relatively uncommon among travellers. It can be avoided by scrupulous attention to food and personal hygiene. No vaccine against cholera is currently available (the old one was not effective) and no country now requires cholera immunisation as an official condition of entry.

Dengue - and its more severe form, dengue haemorrhagic fever ¨C occur throughout the tropics where they are increasing in many countries. They are transmitted by the bite of an infected mosquito. There are no vaccines against the diseases. Prevention is by avoiding mosquito bites by day as well as after dusk (Click here for details).

Diphtheria remains a serious disease throughout much of the world, especially in tropical countries where there is overcrowding and poor hygiene. It is caught by close contact with an infected person. Until the 1930s, it was one of the most important causes of childhood death worldwide but the mass immunisation of children since the 1940s has effectively eradicated the disease in developed countries. However, immunisation programmes have to be continued if the disease is to be kept at bay. For unimmunised adults, a special low-dose vaccine is available.

Viral hepatitis is an infection of the liver which can cause jaundice. There are several forms of the disease; including hepatitis A, sometimes called infectious hepatitis; hepatitis B and hepatitis C.

Hepatitis C

This is being increasingly recognised worldwide and is spread in the same way as HIV/AIDS and hepatitis B. There is no vaccine. The best way to avoid infection is to take the precautions recommended against HIV/AIDS and hepatitis B.

A viral inflammation of the brain which, in some cases, can be life-threatening, this occurs throughout Southeast Asia, mainly in rural areas and during the monsoon season. A vaccine is available and is recommended for travellers who are staying in risk areas for a month or more. However, the vaccine is not normally supplied under the NHS and you will have to pay a fee.

Rabies is an acute viral infection of the nervous system. Its symptoms include delirium and painful muscle spasms in the throat. Once symptoms develop in human beings, the disease is usually fatal.

Rabies occurs in animals in Europe and North America as well as in the less developed countries. You can contract the disease if you are bitten by any infected animal. So be careful not to touch any animals, whether wild, stray or apparently 'tame'. If you are bitten, 'post-exposure' treatment - if given early enough - usually prevents the disease developing.

If you are bitten by an animal while away from the United Kingdom:

• Wash the wound immediately, using soap or detergent; or flush with clean water. Apply alcohol if possible.
• Get medical attention - FAST. Go to the nearest doctor or hospital. You may need a rabies vaccination and the course of injections must be started immediately. Ask for 'human diploid cell vaccine', if possible. In case of any difficulty, contact the nearest British Consular official.
• Note the date and place of the incident, the animal's description and whether it was wild or stray.
• If the animal was not wild or a stray, try to identify its owner as soon as possible to ascertain if it is already - or if it becomes - sick. If the animal can be kept under observation for two weeks following the incident, exchange names, addresses and telephone numbers with the person responsible for it, and arrange to keep in contact to find out whether the animal becomes sick or dies. Find out whether it has had rabies vaccine and ask to see the certificate. But even if one is produced, do not assume there is no risk.
• Inform the local police.
• Whether or not you receive treatment outside the UK, consult your doctor as soon as you return.

Rabies vaccine before travel is only recommended for those who may be exposed to an unusual risk of infection or who are undertaking long journeys in remote areas where medical treatment maynot be immediately available. This vaccine is not normally provided free for travellers under the NHS. Even if you are immunised, however, this does not remove the need for urgent treatment if you are bitten by an infected animal.

Remember that the UK is still rabies free. Keep it that way. Do not bring any animals into the country without a licence. This is not only illegal and involves severe penalties, it could endanger lives. click here for more information

Tetanus is a dangerous disease, which causes severe and painful muscle spasms, and is caught by the introduction of bacterial spores into the body through even a slight wound. The spores are found worldwide, mainly in soil and manure. Tetanus is particularly dangerous where medical facilities are not available for immediate treatment. Everyone should be protected by immunisation, especially those who travel to remote areas. If you were immunised as a child, ask your doctor about a booster. If you were not, you will need a course of three injections.

Tuberculosis is increasing worldwide. If you or your family have not been immunised against the disease, and you are going to stay for more than a month in Eastern Europe, Asia, Africa, Central or South America, you should discuss the need for BCG immunisation with your doctor - preferably at least two months before departure. You will need a skin test first.

Immunisation is particularly advisable for those who will be travelling, living or working closely alongside the indigenous population, and for members of ethnic groups visiting their country of origin. It is not necessary for short visits if you are staying in international-style hotels. Once immunised, reimmunisation is unnecessary.

Yellow fever is caught from the bite of an infected mosquito and occurs in parts of Africa and South America. Some countries require a vaccination certificate for entry (Please Click here for details). The vaccine can only be given at a designated Yellow Fever Vaccination Centre - your doctor will be able to advise you. It is not available free of charge on the NHS. The certificate itself is valid from ten days after vaccination for a period of ten years.