Health Information for Travelers to the Middle East
  
Bahrain, Cyprus, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syrian Arab Republic, Turkey, United Arab Emirates, Yemen
  
  

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.

Travelers diarrhea, the number one illness in travelers, can be caused by viruses, bacteria, or parasites, which 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). Make sure your food and drinking water are safe. (See below.)

Malaria is a serious, but preventable infection that can be fatal. Your risk of malaria may be high in these countries, including some cities. Prevent this deadly disease by seeing your health care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites (see below).

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. There is no risk of malaria in Bahrain, Cyprus, Israel, Jordan, Kuwait, Lebanon, Qatar, and the United Arab Emirates. See also Preventing Malaria in the Pregnant Woman (Information for the Public) and Preventing Malaria in Infants and Children (Information for the Public).

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.

Dengue, filariasis, leishmaniasis, onchocerciasis, and plague are diseases carried by insects that also occur in this region. Protecting yourself against insect bites (see below) will help to prevent these diseases.

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.
  

CDC recommends the following vaccines (as appropriate for age)
 

See your doctor at least 46 weeks before your trip to allow time for shots to take effect.

  • Hepatitis A or immune globulin (IG).
  • Hepatitis B, if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay longer than 6 months, or be exposed through medical treatment.
  • Meningococcal 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 Meningococcal Disease Among Travelers to Saudi Arabia.)
  • Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
  • Typhoid, particularly 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. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not receive the series as infants.

  
All travelers should take the following precautions, no matter the destination:
  
  • Wash hands often with soap and water.
  • Because motor vehicle crashes are a leading cause of injury among travelers, walk and drive defensively. Avoid travel at night if possible and always use seat belts.
  • Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
  • Don’t eat or drink dairy products unless you know they have been pasteurized.
  • Don’t share needles with anyone.
  • Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
  • Never eat undercooked ground beef and poultry, raw eggs, and unpasteurized dairy products. Raw shellfish is particularly dangerous to persons who have liver disease or compromised immune systems.
  
To stay healthy, follow these guidelines:
  
  • 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, make water safer by BOTH filtering through an "absolute 1-micron or less" filter AND adding iodine tablets to the filtered water. "Absolute 1-micron filters" are found in camping/outdoor supply stores.
  • If you visit an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
  
Protect yourself from mosquito bites:
  
  • Pay special attention to mosquito protection between dusk and dawn. This is when the type of mosquito whose bite transmits malaria is active.
  • Wear long-sleeved shirts, long pants, and hats.
  • Use insect repellents that contain DEET (diethylmethyltoluamide).
  • Read and follow the directions and precautions on the product label.
  • Apply insect repellent to exposed skin.
  • Do not put repellent on wounds or broken skin.
  • Do not breathe in, swallow, or get into the eyes (DEET is toxic if swallowed). If using a spray product, apply DEET to your face by spraying your hands and rubbing the product carefully over the face, avoiding eyes and mouth.
  • Unless you are staying in air-conditioned or well-screened housing, purchase a bed net impregnated with the insecticide permethrin or deltamethrin. Or, spray the bed net with one of these insecticides if you are unable to find a pretreated bed net.
  • DEET may be used on adults, children, and infants older than 2 months of age. Protect infants by using a carrier draped with mosquito netting with an elastic edge for a tight fit.
  • Children under 10 years old should not apply insect repellent themselves. Do not apply to young children’s hands or around eyes and mouth.
  • For details on how to protect yourself from insects and how to use repellents, see Protection against Mosquitoes and Other Arthropods.
  • If you are visiting friends and relatives in your home country in areas where malaria occurs, please read the malaria prevention recommendations for recent immigrants on the CDC malaria site.
  • To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
  
To avoid getting sick, follow these healthy guidelines:
  
  • Don’t eat food purchased from street vendors.
  • Don’t drink beverages with ice.
  • Don’t handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague). (For more information, please see Animal-Associated Hazards.)
  • Don’t swim in fresh water. Salt water is usually safer. (For more information, please see Swimming and Recreational Water Precautions.)
  
What you need to bring with you:
  
  • Long-sleeved shirt, long pants, and a hat to wear while outside whenever possible, to prevent illnesses carried by insects (e.g., malaria, dengue, filariasis, leishmaniasis, and onchocerciasis).
  • Insect repellent containing DEET.
  • Bed nets impregnated with permethrin. (Can be purchased in camping or military supply stores. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.)
  • Flying-insect spray or mosquito coils to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
  • Over-the-counter antidiarrheal medicine to take if you have diarrhea.
  • Iodine tablets and water filters to purify water if bottled water is not available. See Do’s above for more details about water filters.
  • Sunblock, sunglasses, hat.
  • Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).
  
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.
  
For more information:
  
Ask your doctor or check the CDC web sites for more information about protecting yourself against diseases that occur in the Middle East, including the following:
  
Diseases carried by insects
  
  • Dengue
  • Malaria
    - Frequently asked questions
    - Prescription drugs
  • Plague
  
Diseases carried in food or water
  
  • Cholera
  • Escherichia coli diarrhea
  • Hepatitis A
  • Schistosomiasis
  • Typhoid fever
  
Diseases from person-to-person contact
  
  • Hepatitis B
  • HIV/AIDS
    - Prevention
     - HIV-infected travelers
Please 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. In addition, you may also check the following CDC sites:  
  

Additional Helpful Related Topics For Your Travel

 Emergency Planning

 Food & Beverage Precautions

 Insect Precautions

 Safety and Security
 
Be sure to read the information about all the regions you are planning to visit.
 
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