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 over 1 year of age arriving within six days from infected areas. Those countries formerly classified as endemic by the WHO are considered by the Malaysian authorities to be infected areas.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not a condition of entry to Malaysia, although it may be required if travelling on to a cholera-infected country. However, outbreaks have been reported in Semphorna and Pulau Gaya, Sabah, in May 2005; see the Health appendix.

3
Typhoid risk exists, especially in rural areas. Vaccination again poliomyelitis and typhoid is recommended. There was an outbreak of typhoid in Kelantan in April 2005.

4
Malaria risk exists only in certain isolated inland regions. Urban and coastal areas are safe. The falciparum strain is reported to be highly resistant to chloroquine and resistant to sulfadoxine/pyrimethamine. The recommended prophylaxis is mefloquine.

Food & drink
All water should be regarded as being potentially contaminated. Water used for drinking or making ice should have first been boiled or otherwise sterilised. 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 that 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.

Note
It is generally considered safe to drink water straight from the tap; however, as no authority is absolutely clear on this matter, the above advice is included as it reflects the necessity for caution for visitors who are unused to the Malaysian way of life.

Other risks
Hepatitis A, C and E occur and hepatitis B is hyperendemic. Epidemics of dengue fever and Japanese encephalitis can occur in both urban and rural areas. Immunisation against tetanus, TB, diphtheria, hepatitis A and E is recommended. Outbreaks of meningococcal meningitis can occur.
There may be some risk of rabies in certain areas. 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.
Malaysia has periodic problems with air quality reaching hazardous levels because of smoke haze. For more information on the air quality in Malaysia please visit the Malaysian Department for the Environment’s website at: www.jas.sains.my/jas/Air+Pollutant+Index
In February 2006, local health authorities confirmed the presence of the virus in 40 chickens that died in villages on the outskirts of Kuala Lumpar. No human infections or deaths have been reported. The risk to humans from avian influenza is believed to be very low. As a precaution, visitors should avoid visiting live animal markets, poultry farms and other places where they may come into close contact with domestic, caged or wild birds; and ensure poultry and egg dishes are thoroughly cooked.
There have been large-scale outbreaks of Hand, Foot and Mouth Disease (HFMD) across Sarawak in early 2006. HFMD is a communicable disease, which affects all age groups, but children are particularly vulnerable. As a precaution, the Malaysian Government has ordered day care centres, kindergartens and some primary schools across Sarawak to close. The disease usually causes mild illness but may occasionally take a more serious form, sometimes resulting in death. For further information on HFMD, please visit the NaTHNac website: www.nathnac.org/pro/clinical_updates/HFMD_140306.htm

Health insurance is recommended. Hospitals are found in all the main cities and can deal with all major needs. Private hospitals, some managed and staffed by British-trained doctors and nurses, provide a high standard of medical care and include Gleneagles Intan Medical Centre in Kuala Lumpur and Ampang Puteri Specialist Hospital, Selangor. Smaller towns and rural areas have private clinics. In an emergency, dial 999.