Israel

Country fact file

The information on these pages should be used to research health risks and to inform the pre-travel consultation.

Travellers should check the Foreign, Commonwealth & Development Office (FCDO) country-specific travel advice page (where available) which provides information on travel entry requirements in addition to safety and security advice.

Travellers should ideally arrange an appointment with their health professional at least four to six weeks before travel. However, even if time is short, an appointment is still worthwhile. This appointment provides an opportunity to assess health risks taking into account a number of factors including destination, medical history, and planned activities. For those with pre-existing health problems, an earlier appointment is recommended.

All travellers should ensure they have adequate travel health insurance.

A list of useful resources including advice on how to reduce the risk of certain health problems is available below

Resources

• Food and water hygiene

• Insect and tick bite avoidance

• Personal safety

• Sun protection

Details of vaccination recommendations and requirements are provided below.

All travellers

Travellers should be up to date with routine vaccination courses and boosters as recommended in the UK according to their age, medical history and individual risks.

Current routine UK vaccination schedule

The travel health consultation provides an opportunity to check whether routine immunisations are up to date such as MMR/MMRV and diphtheria-tetanus-polio vaccines. The following link provides information on the current recommended immunisation schedule recommended in the UK.

Country-specific diphtheria recommendations are not provided here. Diphtheria, tetanus and polio are combined in a single vaccine in the UK. Therefore, when a tetanus booster is recommended for travellers, diphtheria vaccine is also given. In the event of a diphtheria outbreak in a country, specific diphtheria vaccination guidance will be provided.

Vaccination of individuals with uncertain or incomplete immunisation

For individuals with an uncertain or incomplete immunisation history please find guidance for health professionals here Vaccination of individuals with uncertain or incomplete immunisation.

UKHSA provide an immunisation comparison tool for individuals who may have been vaccinated overseas UK and international immunisation schedules comparison tool.

Selective immunisation programmes

Those who may be at increased risk of an infectious disease due to their work, lifestyle choice, or certain underlying health problems should be up to date with additional recommended vaccines. See vaccine recommendations for these groups at the bottom of the 'Complete routine immunisation schedule' document. The individual disease chapters of the 'Green Book' Immunisation against infectious disease provides further details.

Certificate requirements

Please read the information below carefully, as certificate requirements may be relevant to certain travellers only. For travellers further details, if required, should be sought from their healthcare professional.

• Travellers who intend to visit Israel for four weeks or more should be that proof of polio vaccination recorded on an International Certificate of Vaccination or Prophylaxis (ICVP) given 4 weeks to 12 months before departure from Israel, may be required on exit. Failure to produce an ICVP may result in vaccination on departure. See 'Some travellers' section below for further details.

• There are no other certificate requirements under International Health Regulations.

Most travellers

The vaccines in this section are recommended for most travellers visiting this country. Information on these vaccines can be found by clicking on the blue arrow. Vaccines are listed alphabetically.

Tetanus

Tetanus is caused by a toxin released from *Clostridium tetani* bacteria and occurs worldwide. Tetanus bacteria are present in soil and manure and may be introduced through open wounds such as a puncture wound, burn or scratch.

Prevention

Travellers should thoroughly clean all wounds and seek medical attention for injuries such as animal bites/scratches, burns or wounds contaminated with soil.

Tetanus vaccination

• Travellers should have completed a tetanus vaccination course according to the UK schedule.

• If travelling to a country or area where medical facilities may be limited, a booster dose of a tetanus-containing vaccine is recommended if the last dose was more than ten years ago even if five doses of vaccine have been given previously.

Country-specific information on medical facilities may be found in the 'health' section of the FCDO foreign travel advice pages.

Tetanus in brief

Some travellers

The vaccines in this section are recommended for some travellers visiting this country. Vaccines are listed alphabetically.

Measles

Measles is a highly infectious viral illness, spread by airborne or droplet (coughing, sneezing, drops from mouth/nose) transmission. Measles usually starts with cold-like symptoms e.g. fever, cough, runny nose and conjunctivitis (sore, red eyes). This is followed by a blotchy rash starting on the face/head and spreading to the rest of the body.

Complications of measles infection can include ear infections, diarrhoea, pneumonia and convulsions (fits). Life-threatening complications such as encephalitis (brain inflammation) can occur on rare occasions. Measles can have serious consequences especially in children under 1 year of age, immunosuppressed individuals (those with a weakened immune system) and during pregnancy.

Measles is either 'endemic' (continuous transmission in a 12-month period) and/or the measles risk is assessed to be greater than in the UK due to current outbreaks, conflict, damaged infrastructure, travel-related cases or poor vaccine coverage.

Prevention

All travellers should follow good respiratory hygiene rules and avoid contact with individuals with measles infection.

Measles vaccination

All travellers should make sure they are up to date with the measles, mumps and rubella (MMR) or measles, mumps, rubella and chickenpox (MMRV) vaccines, according to current UK recommendations.

Guidance on vaccinating adults can be found in Measles: the green book chapter – GOV.UK.

Consider early Measles Mumps Rubella (MMR)/Measles Mumps Rubella Varicella (MMRV) vaccination for infants and children.

• Infants from six months of age who are likely to be mixing with local people, should receive a MMR vaccine. The MMRV vaccine can be given from nine months of age if MMR is not available at the time of the appointment.

• Not all children will respond to MMR/MMRV given in the first year of life. When the vaccine has been given before one year of age this dose should be discounted and two further doses of MMR/MMRV should be given at the recommended ages.

• Children who are travelling and have already received one dose of MMR/MMRV at the routine age should have the second dose brought forward to at least one month after the first.

• If a child is given the second dose less than three months after the first dose and is less than 18 months of age, then the routine 18-month dose (which would constitute a third dose) should be given in order to provide optimum protection.

Measles in brief

Polio

Polio is caused by one of three types of polio virus and is transmitted by contaminated food and water. Previous infection with one type of polio virus does not protect against other types of the virus.

Those at increased risk include travellers who are unvaccinated or under-vaccinated visiting friends and relatives, those in direct contact with an infected person, long-stay travellers, and those visiting areas of poor sanitation.

This country is infected with circulating vaccine-derived poliovirus type 1 (cVDPV1) with the potential risk of international spread. This country is also infected with circulating vaccine-derived poliovirus type 2 (cVDPV2).

Prevention

All travellers should take care with personal and food and water hygiene.

Polio vaccination

• All travellers should have completed a polio vaccination course according to the UK schedule.

• A booster dose of inactivated polio vaccine (IPV) is recommended for the following travellers if they have not had a polio containing vaccine within a year of their planned departure from this country:

  • Immunosuppressed individuals and their household contacts, pregnant women, or others for whom live oral polio vaccine is contraindicated, who plan to travel to this country for 4 weeks or more.

  • Travellers to settings with extremely poor hygiene (e.g. refugee camps), or likely to be in close proximity with cases (e.g. healthcare workers).

• A booster dose of IPV containing vaccine should also be considered for immunosuppressed individuals travelling for less than 4 weeks to an area with circulating wild or vaccine-derived virus if they have not received a dose within the previous 10 years.

• Polio vaccination should be recorded on an International Certificate of Vaccination or Prophylaxis (ICVP).

• For other travellers who are up to date with their UK schedule, further vaccination is not routinely recommended. Proof of polio vaccination recorded on an ICVP given 4 weeks to 12 months before departure from this country, may be required on exit.

• Failure to produce an ICVP may result in vaccination with live oral polio vaccine on departure. For most individuals, this should cause no problems but those with weakened immune systems (and others for whom live oral vaccine is contraindicated; see above) should NOT receive live oral polio vaccine.

• Supply of International Certificate of Vaccination or Prophylaxis (polio vaccination).

Polio in brief

Rabies

Rabies is a viral infection which is usually transmitted following contact with the saliva of an infected animal most often via a bite, scratch or lick to an open wound or mucous membrane (such as on the eye, nose or mouth). Although many different animals can transmit the virus, most cases follow a bite or scratch from an infected dog. In some parts of the world, bats are an important source of infection.

Rabies symptoms can take some time to develop, but when they do, the condition is almost always fatal.

The risk of exposure is increased by certain activities and length of stay (see below). Children are at increased risk as they are less likely to avoid contact with animals and to report a bite, scratch or lick.

Rabies in Israel

Rabies is considered a risk and has been reported in domestic animals in this country. Bats may also carry rabies-like viruses.

Prevention

• Travellers should avoid contact with all animals. Rabies is preventable with prompt post-exposure treatment.

• Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial.

• Post-exposure treatment and advice should be in accordance with national guidelines.

Rabies vaccination

A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure treatment and removes the need for rabies immunoglobulin which is in short supply world-wide.

Pre-exposure vaccinations are recommended for travellers whose activities put them at increased risk including:

• those at risk due to their work (e.g. laboratory staff working with the virus, those working with animals or health workers who may be caring for infected patients).

• those travelling to areas where access to post-exposure treatment and medical care is limited.

• those planning higher risk activities such as running or cycling.

• long-stay travellers (more than one month).

Rabies in brief

Typhoid

Typhoid is a bacterial infection transmitted through contaminated food and water. Previous typhoid illness may only partially protect against re-infection.

Travellers who will have access to safe food and water are likely to be at low risk. Those at increased risk include travellers visiting friends and relatives, frequent or long-stay travellers to areas where sanitation and food hygiene are likely to be poor, and laboratory personnel who may handle the bacteria for their work.

Typhoid in Israel

Typhoid fever is known or presumed to occur in this country.

Prevention

All travellers should take care with personal, food and water hygiene.

Typhoid vaccination

• Vaccination could be considered for those whose activities put them at increased risk (see above).

• Oral and injectable typhoid vaccinations are available.

Typhoid in brief

There are some risks that are relevant to all travellers regardless of destination. These may for example include road traffic and other accidents, diseases transmitted by insects or ticks, diseases transmitted by contaminated food and water, or health issues related to the heat or cold.

Some additional risks (which may be present in all or part of this country) are mentioned below and are presented alphabetically.

Biting insects or ticks

Insect or tick bites can cause irritation and infections of the skin at the site of a bite. They can also spread certain diseases.

Diseases in Western Asia

There is a risk of insect or tick-borne diseases in some areas of Western Asia. This includes diseases such as Crimean-Congo haemorrhagic fever, leishmaniasis, Rift Valley fever and West Nile virus.

Prevention

• All travellers should avoid insect and tick bites day and night.

• There are no vaccinations (or medications) to prevent these diseases.

Further information about specific insect or tick-borne diseases for this country can be found, if appropriate on this page, in other sections of the country information pages and the insect and tick bite avoidance factsheet.

Influenza

Seasonal influenza is a viral infection of the respiratory tract and spreads easily from person to person via respiratory droplets when coughing and sneezing. Symptoms appear rapidly and include fever, muscle aches, headache, malaise (feeling unwell), cough, sore throat and a runny nose. In healthy individuals, symptoms improve without treatment within two to seven days. Severe illness is more common in those aged 65 years or over, those under 2 years of age, or those who have underlying medical conditions that increase their risk for complications of influenza.

Seasonal influenza in Israel

Seasonal influenza occurs throughout the world. In the northern hemisphere (including the UK), most influenza occurs from as early as October through to March. In the southern hemisphere, influenza mostly occurs between April and September. In the tropics, influenza can occur throughout the year.

Prevention

All travellers should:

• Avoid close contact with symptomatic individuals

• Avoid crowded conditions where possible

• Wash their hands frequently

• Practise ‘cough hygiene’: sneezing or coughing into a tissue and promptly discarding it safely, and washing their hands

• Avoid travel if unwell with influenza-like symptoms

• A vaccine is available in certain circumstances (see below)*

*In the UK, seasonal influenza vaccine is offered routinely each year to those at higher risk of developing of severe disease following influenza infection, and certain additional groups such as healthcare workers and children as part of the UK national schedule (see information on vaccination). For those who do not fall into these groups, vaccination may be available privately.

If individuals at higher risk of severe disease following influenza infection are travelling to a country when influenza is likely to be circulating they should ensure they received a flu vaccination in the previous 12 months.

The vaccine used in the UK protects against the strains predicted to occur during the winter months of the northern hemisphere. It is not possible to obtain vaccine for the southern hemisphere in the UK, but the vaccine used during the UK influenza season should still provide important protection against strains likely to occur during the southern hemisphere influenza season, and in the tropics.

Avian influenza

Avian influenza viruses can rarely infect and cause disease in humans. Such cases are usually associated with close exposure to infected bird or animal populations. Where appropriate, information on these will be available in the outbreaks and news sections of the relevant country pages. Seasonal influenza vaccines will not provide protection against avian influenza.

Avian influenza in brief

Outdoor air quality

Poor air quality is a significant public health problem in many parts of the world. Exposure to high levels of air pollution over short time periods (e.g. minutes/hours/days) and longer time periods (e.g. years) is linked to many different acute and chronic health problems. These effects are mainly on the respiratory (lungs and airways) and cardiovascular (heart function and blood circulation) systems.

Current information on world air quality is available from the world air quality index project.

Prevention

Travellers with health problems that might make them more vulnerable to the effects of air pollution who are travelling to areas of high pollution should:

• discuss their travel plans with their doctor, and carry adequate supplies of their regular medication.

• take sensible precautions to minimise their exposure to high levels of air pollution.

• check local air quality data and amend their activities accordingly.

• take notice of any health advisories published by the local Ministry of Health and Department for Environment, and follow the guidance provided.

It is unclear if face masks are beneficial at reducing exposure and may make breathing more difficult for those with pre-existing lung conditions. Those who choose to use one should make sure that the mask fits well and know how to wear it properly.

Outdoor air quality in brief

Sexually transmitted infections

Sexually transmitted infections (STIs) are a group of viral, bacterial and parasitic infections spread during sexual intercourse or by intimate contact. Certain STIs can be more difficult to treat due to higher levels of antibiotic resistance and some STIs that are rare in the UK may be more common in other world regions.

Anyone who is sexually active is at risk of getting an STI wherever they are in the world.

Risk is higher for travellers who:

• have sex without a condom

• have sex with new or casual partners

• engage in sex tourism

• have sex under the influence of drugs or alcohol

Symptoms of STIs vary depending on the type of infection; some may only cause mild or unnoticeable symptoms. If symptoms do occur, they can include a rash, discharge, itching, blisters, sores or warts in genital and/or anal areas, pain when peeing and flu like symptoms.

If left untreated, STIs can cause serious long term health issues such as fertility problems, pelvic inflammatory disease and pregnancy complications.

Prevention

Using condoms consistently and correctly with new or casual partners is the most effective way to reduce risk of STIs.

Travellers can also reduce their risk of STIs by:

• ensuring they are up to date for all UK recommended vaccines, including if appropriate gonorrhoea, hepatitis B, mpox and human papillomavirus (HPV) vaccines

• considering HIV Pre-Exposure Prophylaxis (PrEP) if appropriate

Travellers should seek medical advice and give their travel history if they think they may have an STI, even if they have no symptoms. They should also have a test for STIs if they have had sex without condoms with a new or casual partner while abroad.

In the UK STI testing is free and confidential.

Source and disclaimer

This travel health information is based on data supplied by NaTHNaC (the National Travel Health Network and Centre). All intellectual property rights in the data are owned by NaTHNaC. It must not be copied, reproduced, distributed, amended or offered for sale without NaTHNaC’s prior written consent.

Patient.info ensures that this information is reviewed and updated on at least a weekly basis. However, NaTHNaC’s data is accurate only as at the date it was prepared, and Patient.info is solely responsible for maintaining its accuracy and completeness after that date. NaTHNaC accepts no liability for the use of this data by Patient.info or its users.