UKHSA urges travellers to take steps to avoid infection abroad
Typhoid and paratyphoid cases reach record high while Malaria cases remain high despite small dip in cases.
The latest UK Health Security Agency (UKHSA) provisional data shows an increase in travel-associated enteric fever cases (typhoid fever and paratyphoid fever cases) in England, Wales and Northern Ireland, with 702 cases in 2024, an 8% rise from 2023 (645 cases). This represents the highest number of cases recorded annually to date.
Typhoid and paratyphoid fever are serious preventable illnesses caused by Salmonella bacteria, usually spread through contaminated food or water. In the UK, most cases of enteric fever are acquired abroad, commonly in regions with poor hygiene and sanitation. Previous surveillance has also highlighted a concerning rise in antibiotic-resistant typhoid in Pakistan, which reduces the effectiveness of commonly used antibiotics, impacting the response to treatment, and increasing the risk of complications. A free typhoid vaccination is available from GP surgeries for some travellers, though no vaccine exists for paratyphoid.
Meanwhile, provisional data shows that imported malaria cases remain at concerning levels in the UK despite a slight decrease in diagnoses to 1,812 in 2024 from 2,106 in 2023. These figures significantly exceed the levels seen in recent years. Most cases were reported during peak summer travel months between July and October. Malaria is potentially fatal but almost entirely preventable when antimalarial tablets are taken correctly.
There were fewer imported dengue cases reported in the first quarter of 2025 compared to last year in England, Wales and Northern Ireland, with 65 cases in the first 3 months of 2025 compared to 254 cases in 2024, mostly linked to travel to Thailand, Brazil and Indonesia. Dengue cases have increased substantially globally over the past five years, with exceptionally high levels in 2023 and 2024, and the sustained transmission of dengue is an ongoing global health challenge.
Dr Philip Veal, Consultant in Public Health at UKHSA, said:
We are seeing high levels of infections such as malaria and typhoid in returning travellers. It is important that travellers remain alert and plan ahead of going abroad – even if you’re visiting friends and relatives abroad or it’s somewhere you visit often. The Travel Health Pro website has information on how to keep yourself and family healthy, including what vaccines to get, any important medication such as anti-malaria tablets, and how to avoid gastrointestinal infections such as typhoid and hepatitis A. If you are pregnant or trying to conceive there are special precautions you should take, so please speak to a healthcare professional before planning your trip.
Dr Diana Ayoola Mabayoje, co-founder of African Diaspora Malaria Initiative (ADMI), said:
Most UK malaria cases occur in Black African people returning from travel to Africa. Community engagement of the African Diaspora in malaria prevention is crucial to reduce imported malaria in the UK. The African Diaspora Malaria Initiative (ADMI) is leading this charge with our upcoming ‘Africans Against Malaria’ campaign. It will directly address the perceptions, beliefs, and behaviours that hinder malaria prevention uptake amongst the UK African diaspora and signpost where to obtain malaria chemoprophylaxis. Our focus is on community engagement and outreach, and we will be targeting African communities in London ahead of summer travel.
The Travel Health Pro website, supported by UKHSA, has information on health risks in countries across the world. It is a one-stop-shop for information to help people plan their trip abroad.
Ideally travellers should consult their GP, practice nurse, pharmacist, or travel clinic at least 4 to 6 weeks before their trip for individual advice, travel vaccines and malaria prevention tablets, if relevant for their destination. Travellers who may be eligible for dengue vaccine should consult 3 to 4 months before travel.
In countries with insects that spread diseases like dengue, malaria or Zika virus infection, travellers can protect themselves by using insect repellent, covering exposed skin, and sleeping under an insecticide-treated bed net where air conditioning is not available.
It is also important for travellers to:
- ensure your routine childhood vaccines are up to date
- have any recommended travel related vaccines
- stock up on necessary medications including malaria prevention tablets
- get valid travel insurance to cover your entire trip and planned activities
Along with typhoid, hepatitis A is another gastrointestinal infection that is spread through viral infection that affects the liver. The virus spreads through contaminated food or water, and through close contact with infected individuals. A hepatitis A vaccine is available from GPs and travel health clinics and is recommended for those visiting high-risk areas.
To prevent the spread of hepatitis A, UKHSA recommends:
- thorough handwashing – especially after using the toilet, changing nappies, helping children with toileting, and before preparing or eating food
- regular cleaning of toilet seats and handles using standard household cleaning products