Travel vaccinations for Japan

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.

Dengue is a viral infection spread by mosquitoes which mainly feed during daytime hours. It causes a flu-like illness, which can occasionally develop into a more serious life-threatening illness. Severe dengue is rare in travellers. The mosquitoes that spread dengue are more common in towns, cities and surrounding areas. There is a risk of dengue in this country.Information on current outbreaks, where available, will be reported on our outbreak surveillance database. Travellers should avoid mosquito bites, particularly during daytime hours. Vaccination can be considered for individuals aged 4 years of age and older who have had dengue infection in the past and who are: travelling to areas where there is a risk of dengue infection or areas with an ongoing outbreak of dengue, or are exposed to dengue virus through their work, such as laboratory staff working with the virus Exceptionally, vaccination can be considered in those who have not had dengue in the past. In these situations, further expert advice should be considered. Detailed guidance on how to ascertain previous infection is available in the UK Health Security Agency Immunisation against infectious disease the 'Green book'. The final decision on vaccination rests with the health professional and the traveller after a detailed risk assessment has been performed and the potential risks of vaccination explained.

Hepatitis B is a viral infection spread through blood, semen and vaginal fluids. This mostly occurs during sexual contact or as a result of blood-to-blood contact (for example from contaminated equipment during medical and dental procedures, tattooing or body piercing procedures, and sharing of intravenous needles). Mothers with the virus can also pass on the infection to their baby during childbirth. This country is considered to have an intermediate or high prevalence of hepatitis B. Travellers should avoid contact with blood or body fluids. This includes: Avoiding unprotected sexual intercourse. Avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile equipment is used). Not sharing needles or other injection equipment. Following universal precautions if working in a healthcare or other higher risk setting. A sterile medical equipment kit may be helpful when travelling to resource poor areas. Vaccination could be considered for all travellers and is recommended for those whose activities or medical history put them at increased risk. This includes: Those who may have unprotected sex. Those who may be exposed to contaminated needles through injecting drug use. Those who may be exposed to blood or body fluids through their work (e.g. health and aid workers). Those at high risk of requiring medical or dental procedures or hospitalisation e.g. those with pre-existing medical conditions, those who may require travelling for medical care abroad, or those travelling to visit families or relatives. Long-stay travellers. Those who are participating in contact sports. Families adopting children from this country.

Japanese encephalitis (JE) is a viral infection transmitted to humans by the bite of an infected mosquito. These mosquitoes usually bite between dusk and dawn, mainly in rural areas – especially where there are rice fields, swamps and marshes. Mosquitoes become infected by biting JE-infected animals, particularly pigs or birds. Travellers are at increased risk of infection when visiting rural areas. Short trips (usually less than a month), especially if only travelling to urban areas, are considered lower risk. JE occurs countrywide, apart from Hokkaido where only animal cases have been reported. The risk season is June to October, although cases may be reported outside these months. Vaccine is not routinely recommended for short trips to Tokyo or major cities. All travellers should avoid mosquito bites particularly between dusk and dawn. Vaccination can be considered for the following groups: Those residing in an area where JE is endemic (is present) Those staying in JE-endemic area for one month or more during transmission season Those frequently travelling to JE-affected areas Those who are uncertain about their itinerary, location, activities and duration of stay Those who are exposed to JE virus through their work, such as laboratory staff working with the virus Vaccination can also be considered for those with shorter exposure periods but increased risk of JE due to their planned itinerary, location and activities e.g. visiting rice field or pig farms.

Although rare, bat lyssaviruses (bat rabies) can be transmitted to humans or other animals following contact with the saliva of an infected bat most often by a bite. The disease can also be transmitted if the saliva of an infected bat gets into open wounds or mucous membranes (such as on the eye, nose or mouth). Bat lyssaviruses can cause disease in humans that is indistinguishable from rabies. Symptoms can take some time to develop, but when they do the condition is almost always fatal. The risk to most travellers is low. However, it is increased for certain occupations for example bat handlers and veterinarians, or certain activities such as caving. Rabies has not been reported in this country; therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies). Travellers should avoid contact with bats. Bites from bats are frequently unrecognised. Rabies-like disease caused by bat lyssaviruses is preventable with prompt post-exposure rabies management. Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial. Although rabies has not been reported in other animals in this country, it is sensible to seek prompt medical advice if bitten or scratched. It is possible, although very rare for bats to pass rabies like viruses to other animals including pets. 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 rabies vaccinations are recommended for those who are at increased risk due to their work (e.g. laboratory staff working with the virus and those working with bats). Pre-exposure vaccines could be considered for those whose activities put them at increased risk of exposure to bats.

Tick-borne encephalitis (TBE) is a viral infection spread by the bite of infected ticks. Occasionally cases of TBE occur after consumption of raw (unpasteurised) milk or dairy products from infected animals (e.g. cows, goats and sheep). Travellers are at increased risk of exposure during outdoor activities in areas of vegetation such as gardens, parks, meadows, woods, forest fringes and glades. This includes urban parks and woodland areas in cities. Ticks are usually most active between early spring and late autumn. There is a risk of TBE in some areas of this country. The transmission season varies, however, ticks are most active during early spring to late autumn.Cases have been reported in Hokkaido, Honshu and Kyushu. All travellers should avoid tick bites during outdoor activities, apply insect repellent frequently and follow tick bite avoidance advice. Travellers should check their skin and clothes regularly for ticks and remove them as soon as possible with a recommended technique. Wearing light coloured clothes makes it easier to spot ticks. Travellers should not eat or drink any unpasteurised milk products. Vaccination is recommended for those visiting affected areas whose activities put them at increased risk including: Living in TBE risk areas. Working in forestry, woodcutting, farming and the military. Visiting forested areas and urban parks, e.g. camping, fieldwork, hiking and hunting. Laboratory workers who may be exposed to TBE.