china edition



All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure.


Prophylaxis is recommended only for rural areas below 1500 m in the following provinces: Hainan, Yunnan, Fuijan, Guangdong, Guangxi, Guizhou, Sichuan, Tibet (Xizang) (in the Zangbo River valley only), Anhui, Hubei, Hunan, Jiangsu, Jiangxi, Shandong, and Shanghai. In provinces with risk, transmission occurs only during warm weather: north of latitude 33° N, July-November; between latitude 25° N and 33° N, May-December; south of latitude 25° N, transmission occurs year-round. For the provinces of Hainan and Yunnan, prophylaxis with Lariam, Malarone, or doxycycline is recommended. For all other risk areas, chloroquine is the drug of choice.

Hepatitis A Recommended for all travelers.
Typhoid For travelers who may eat or drink outside major restaurants and hotels.
Yellow Fever Required for all travelers arriving from a yellow-fever-infected area in Africa or the Americas. Not recommended otherwise.
Japanese Encephalitis For long-term (>1 month) travelers to rural areas or travelers who may engage in extensive unprotected outdoor activities in rural areas, especially after dusk.
Hepatitis B For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months.
Rabies For travelers who may have direct contact with animals and may not have access to medical care.
Routine immunizations All travelers should be up-to-date on tetanus-diphtheria, measles-mumps-rubella, polio, and varicella immunizations.

Insect and tick protection

Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-35% DEET 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. Do not use DEET-containing compounds on children less than two years of age. Preparations containing a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen.

If sleeping outdoors or in an accommodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.