Precautions are advised for Brits heading abroad
The UK’s health authority has issued a warning to Brits planning to travel abroad this summer and beyond, following a surge in cases of enteric fever – typhoid and paratyphoid fever – across England, Wales and Northern Ireland. In 2024, there were 702 reported cases, marking an 8% increase from the previous year (645 cases).
The data comes courtesy of the UK Health and Security Agency (UKHSA), which noted that these figures represent the highest number of annual cases recorded thus far. Typhoid and paratyphoid fever are serious illnesses caused by Salmonella bacteria, typically contracted through contaminated food or water.
The UKHSA explained that most cases of enteric fever in the UK are acquired overseas, particularly in areas with poor sanitation and hygiene standards. It also highlighted a worrying rise in antibiotic-resistant typhoid in Pakistan, which diminishes the effectiveness of commonly used antibiotics, thereby complicating treatment and increasing the risk of complications.
For some travellers, a free typhoid vaccination is available at GP surgeries, although no vaccine currently exists for paratyphoid. The UKHSA also shed light on the latest data concerning imported malaria cases, which it described as “remaining at concerning levels in the UK despite a slight decrease in diagnoses to 1,812 in 2024 from 2,106 in 2023”.
Malaria and dengue cases
It added that the figures “significantly exceed the levels seen in recent years”. Most cases were reported during peak summer travel months between July and October. Malaria is potentially fatal, but almost entirely preventable when antimalarial tablets are taken correctly.
There were fewer imported dengue cases reported in the first quarter of 2025 compared to last year in England, Wales and Northern Ireland, with 65 cases in the first three months of 2025 compared to 254 cases in 2024 – mostly linked to travel to Thailand, Brazil and Indonesia. Dengue cases have increased substantially globally over the past five years, with exceptionally high levels in 2023 and 2024, and the sustained transmission of dengue is an ongoing global health challenge, the UKHSA said.
Dr Philip Veal, consultant in public health at UKHSA, said: “We are seeing high levels of infections such as malaria and typhoid in returning travellers. It is important that travellers remain alert and plan ahead of going abroad – even if you’re visiting friends and relatives abroad or it’s somewhere you visit often.
“The Travel Health Pro website has information on how to keep yourself and family healthy, including what vaccines to get, any important medication such as anti-malaria tablets, and how to avoid gastrointestinal infections such as typhoid and hepatitis A. If you are pregnant or trying to conceive, there are special precautions you should take, so please speak to a healthcare professional before planning your trip.”
Dr Diana Ayoola Mabayoje, co-founder of African Diaspora Malaria Initiative (ADMI), said: “Most UK malaria cases occur in Black African people returning from travel to Africa. Community engagement of the African Diaspora in malaria prevention is crucial to reduce imported malaria in the UK.
“The African Diaspora Malaria Initiative (ADMI) is leading this charge with our upcoming ‘Africans Against Malaria’ campaign. It will directly address the perceptions, beliefs, and behaviours that hinder malaria prevention uptake amongst the UK African diaspora and signpost where to obtain malaria chemoprophylaxis. Our focus is on community engagement and outreach, and we will be targeting African communities in London ahead of summer travel.”
Where and when to get travel health advice before a trip abroad
The Travel Health Pro website, supported by UKHSA, has information on health risks in countries across the world. It is a one-stop shop for information to help people plan their trip abroad. Ideally travellers should consult their GP, practice nurse, pharmacist, or travel clinic at least four to six weeks before their trip for individual advice, travel vaccines and malaria prevention tablets, if relevant for their destination. Travellers who may be eligible for dengue vaccine should consult three to four months before travel.
In countries with insects that spread diseases like dengue, malaria or Zika virus infection, travellers can protect themselves by using insect repellent, covering exposed skin, and sleeping under an insecticide-treated bed net where air conditioning is not available.
It is also important for travellers to:
- ensure your routine childhood vaccines are up to date
- have any recommended travel-related vaccines
- stock up on necessary medications, including malaria prevention tablets
- get valid travel insurance to cover your entire trip and planned activities
Along with typhoid, hepatitis A is another gastrointestinal infection that is spread through viral infection that affects the liver. The virus spreads through contaminated food or water, and through close contact with infected individuals. A hepatitis A vaccine is available from GPs and travel health clinics and is recommended for those visiting high-risk areas.
To prevent the spread of hepatitis A, UKHSA recommends:
- Thorough handwashing – especially after using the toilet, changing nappies, helping children with toileting, and before preparing or eating food
- Regular cleaning of toilet seats and handles using standard household cleaning products
Symptoms of typhoid and paratyphoid
Common symptoms of enteric fever include high temperature (39C to 40C), abdominal pain, headache and either constipation or diarrhoea. If left untreated, typhoid fever can pose a significant risk of serious complications. Cases diagnosed early usually recover after a seven-to-14-day course of treatment.
Oropouche infections
There has been a global rise in Oropouche infections since 2024. Oropouche virus (OROV) is mainly spread through midge bites, not mosquito bites. OROV is not spread by midge bites in the UK. Due to the increase in cases and concerns about infection during pregnancy, pregnant travellers should take extra care.
There is also some evidence the virus might spread through sexual contact, as it has been found in the semen of an infected individual previously. To reduce the risk, travellers should consider using condoms or avoiding sexual contact during their trip and for six weeks after returning.
Chikungunya cases
The latest data show a rise in chikungunya cases in England, Wales and Northern Ireland. Twenty-three cases were reported in the first quarter of 2025, nearly triple the number during the same period last year (eight cases), with most cases reporting travel to Sri Lanka.
Zika virus
In England, one Zika virus case was reported in a traveller who returned from India in January 2025. Although Zika virus cases are rare, the infection poses a significant risk to pregnant women, as it can be passed to the fetus. There is currently no drug or vaccine to prevent Zika virus infection. The only way to prevent infection is by minimising mosquito bites or by avoiding visiting regions with a known or potential Zika virus risk.
Advice for pregnant women
With careful preparation, most pregnant women can travel without experiencing health problems. Pregnant women should see their travel health advisor six to eight weeks before travel, although for those with less time an appointment is still worthwhile.
Pregnant women have an increased risk of developing severe malaria and dying from malaria compared to non-pregnant women. If travel to a risk area is essential, careful insect bite avoidance is important, antimalarial tablets should be advised and prompt medical advice should be sought if symptoms of malaria occur.
For more advice, visit NaTHNaC – Pregnancy.
