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

1
A yellow fever vaccination certificate is required from travellers arriving within six days from infected areas (children under one year are exempt).

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is no longer a condition of entry to Kazakhstan. However, cholera is a serious risk in this country and precautions are essential. 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.

Food & drink
All water should be regarded as being a potential health risk. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is pasteurised and dairy products are safe for consumption. 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
Hepatitis A, B, C and E occur. Diphtheria outbreaks have been reported in the area. Giardiasis, echinococcosis, typhus (tick-borne), Crimean-Congo haemorrhagic fever, trechinellosis, leishmaniasis and brucellosis can also occur. Although rare, foci of plague exist. Tuberculosis and typhoid are increasing throughout. Increased cases of meningitis and encephalitis have also been reported in Almaty.
There was a seasonal outbreak of haemorrhagic fever with renal syndrome in western Kazakhstan in December 2005. There have been reports of avian influenza (bird flu) around northern Kazakhstan, but no human infections or deaths. Visitors should avoid visiting live animal markets, poultry farms and any other situations involving close contact with poultry.
Tick-borne encephalitis is a problem in mountains and forests, particularly during April, May and June.
There is some presence of rabies. 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.

Note
Foreign visitors (except nationals of CIS countries) staying in Kazakhstan for longer than three months may be required to take an AIDS test.

There is a large network of hospitals, emergency centres and pharmacies. The largest include the Central Hospital, the Maternity and Childhood Institute Clinic and the Medical Teaching Institute Clinic in Almaty, and the Spinal Centre and Hospital of Rehabilitation Treatment in Karaganda. However, standards within the public healthcare system have declined significantly since the Soviet era. It is hard to ascertain the level of expertise of the doctors, and visitors cannot rely on the availability of western medicines. Medical insurance is strongly recommended and should include Medevac insurance.