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

1
Poliomyelitis occurs. Immunisation is advisable.

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. Contaminated tap water contains a high prevalence of gastrointestinal infections. The water supply in St Petersburg especially has been linked to giardiasis. Bottled water is widely available. 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
Dysentery is common throughout the country. Hepatitis A occurs. Widespread outbreaks of diphtheria have been reported. Consult a doctor regarding inoculation before travelling to the Russian Federation. Tick-borne typhus has been reported from east and central Siberia. Tick-borne encephalitis and Lyme disease occur in forested areas throughout the Russian Federation. Vaccination is advisable. Outbreaks of Japanese encephalitis have been reported from the southeast. Leishmaniasis can occur in the south. Outbreaks of meningitis have been reported from Volgograd.
Rabies is present and increasing. 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
Visitors staying for more than three months must produce a certificate proving they are HIV-negative. The certification requirements are exacting and detailed; a medical examination may also be required. Foreign tests may be acceptable under certain conditions. Check details with the Embassy.

Note
There have been reports of outbreaks of Avian Influenza (bird flu) in a number of regions of Russia, including Tula, Tambov, Kurgan, Chelyabinsk and Novosibirsk. As a precaution, the European Union has banned the import of live birds and feathers from Russia.
No human infections or deaths have been reported but travellers to the Russian Federation should consult their healthcare provider for travel medical advice before departure.
The risk from Avian Influenza is believed to be very low provided visitors avoid live animal markets, poultry farms and other places with close contact with domestic, caged or whild birds. Ensure poultry and egg dishes are throughly cooked.

The highly developed health service provides free medical treatment for all citizens. If a traveller becomes ill during a booked tour, emergency treatment is free, with small sums to be paid for medicines and hospital treatment. If a longer stay than originally planned becomes necessary because of the illness, the visitor has to pay for all further treatment. This can be very expensive; air evacuation can cost up to £80,000. All visitors are strongly advised to have full medical cover that includes medical evacuation. It is advisable to take a supply of medicines that are likely to be required (check first that they may be imported legally). A reciprocal health care agreement is in operation between the UK and the Russian Federation, allowing citizens to receive free treatment. Private medical care can be expensive.