Inoculation regulations can change at short notice. Please take medical advice in the case of doubt.

1
A yellow fever vaccination certificate is required if arriving within six days of leaving or transiting countries with endemic or infected areas. Travellers arriving from non-endemic zones should note that vaccination is strongly recommended for travel outside urban areas, even if an outbreak of the disease has not been reported and they would normally not require a vaccination certificate to enter the country.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is no longer a condition of entry to Afghanistan. However, cholera is considered a risk in this country and precautions are advised. Up-to-date advice should be sought before deciding whether these precautions should include vaccination, as medical opinion is divided over its effectiveness; see the Health appendix for further information.

3
Typhoid fever occurs and vaccination is advised. Polio eradication measures were being taken but will have been disrupted by the fighting. Polio should still, therefore, be assumed to be a threat.

4
Malarial risk, primarily in the benign vivax form, exists from May to November below 2000m (6562ft). The falciparum strain occurs in the south of the country. Chloroquine- and sulfadoxine-pyrimethamine-resistant falciparum has been reported. The recommended prophylaxis is mefloquine, doxycycline or atovaquore/proguanil.

Food & drink
All water should be regarded as being potentially contaminated. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks
Cutaneous leishmaniasis and tick-borne relapsing fever occur in Afghanistan. Hepatitis A and E are both present. Hepatitis B is endemic. Typhus occurs and trachoma is common. Giardiasis and other waterborne diseases are common. Respiratory tuberculosis is common. Diarrhoeal disease and other gastrointestinal infections are common causes of ill health, especially in hotter months. Outbreaks of meningococcal disease have been reported.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Medical care was very limited before the 2001 conflict but now medicines are in even shorter supply and many hospitals have been damaged or destroyed. Doctors and hospitals demand immediate cash payment for most services. Medical insurance, covering emergency evacuation, is essential. International aid groups operate in some cities and villages.