Travel vaccinations for Israel

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

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

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

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

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 fever is known or presumed to occur in this country. All travellers should take care with personal, food and water hygiene. Vaccination could be considered for those whose activities put them at increased risk (see above). Oral and injectable typhoid vaccinations are available.