High consequence infectious disease: country specific risk
Listing of countries with a known occurrence of high consequence infectious disease (HCID).
How to use this guidance
The information presented below is provided for health professionals wishing to determine if there is a known HCID risk in any particular country. It will be updated as new information arises.
The information is intended as a guide only. For any HCID, the risk will be greatest in countries that have reported laboratory-confirmed, locally acquired human cases, particularly recent cases. For countries where the only supporting evidence of an HCID is human serology data (which is often generated by studies of asymptomatic populations), the true risk may be lower and the data should be interpreted with caution.
HCID risk assessments should also consider other factors, including exposure histories, activities undertaken whilst travelling, and the areas visited within a country.
For any particular country, the absence of previously reported HCID cases does not mean that locally acquired HCIDs cannot occur in that country in the future, if the necessary transmission factors are present; recent examples of first-ever reports include Ebola in Guinea (reported 2014), CCHF in Spain (reported 2017), and SFTS in Vietnam and Taiwan (reported 2019).
Healthcare professionals wishing to discuss a possible HCID case should contact a local infection specialist (such as a consultant in infectious diseases, microbiology or virology) in the first instance.
Infection specialists should contact the Imported Fever Service about suspected HCID cases, as appropriate, and refer to the relevant Public Health England (PHE) guidance (for which links are provided in the tables below).
Table Key
a) cases or serological data reported prior to 1990
b) even though there is a lack of available data, Balkan countries are presumed to be endemic for CCHF
c) unknown date
d) countries with locally acquired human cases AND considered endemic for H5N1 in birds
Countries A to D
| Country | HCID Pathogen/Disease | Evidence |
|---|---|---|
| Afghanistan | CCHF | Human cases |
| Plague | Human cases | |
| Albania | CCHF | Human cases |
| Algeria | Plague | Human cases |
| American Samoa | No known HCIDs | |
| Andorra | No known HCIDs | |
| Angola | Marburg | Human cases |
| Plague | Human cases | |
| Anguilla | No known HCIDs | |
| Antigua & Barbuda | No known HCIDs | |
| Argentina | Junin virus | Human cases |
| Andes virus | Human cases | |
| Armenia | CCHF | Human serology (a) |
| Australia | No known HCIDs | |
| Austria | No known HCIDs | |
| Azerbaijan | No known HCIDs | |
| Bahamas, The | No known HCIDs | |
| Bahrain | No known HCIDs | |
| Bangladesh | Avian influenza H5N1 | Human cases |
| CCHF | Human cases | |
| Nipah virus | Human cases | |
| Barbados | No known HCIDs | |
| Belarus | No known HCIDs | |
| Belgium | No known HCIDs | |
| Belize | No known HCIDs | |
| Benin | CCHF | Human serology |
| Lassa fever | Human cases | |
| Bermuda | No known HCIDs | |
| Bhutan | No known HCIDs | |
| Bolivia | Plague | Human cases |
| Machupo virus | Human cases | |
| Bosnia & Herzegovina (b) | CCHF | Human serology (c) |
| Botswana | CCHF | Human serology |
| Plague | Human cases | |
| Brazil | Plague | Human cases |
| Brunei | No known HCIDs | |
| Bulgaria | CCHF | Human cases |
| Burkina Faso | Lassa fever | Human cases |
| Burma (Myanmar) | Plague | Human cases |
| Burundi | No known HCIDs | |
| Cambodia | Avian influenza H5N1 | Human cases |
| Cameroon | CCHF | Human serology |
| Ebola | Human serology (a) | |
| Monkeypox | Human cases | |
| Canada | No known HCIDs | |
| Canary Islands | No known HCIDs | |
| Cape Verde | No known HCIDs | |
| Central African Rep. | Ebola | Human serology (a) |
| Lassa fever | Human serology (a) | |
| Monkeypox | Human cases | |
| Chad | Ebola | Human serology (a) |
| Chile | Andes virus | Human cases |
| China | Avian influenza H5N1 | Human cases (d) |
| Avian influenza H7N9 | Human cases | |
| Avian influenza H5N6 | Human cases | |
| CCHF | Human cases | |
| Plague | Human cases | |
| SARS | Human cases | |
| SFTS | Human cases | |
| Colombia | No known HCIDs | |
| Comoros | No known HCIDs | |
| Congo, Republic of the | CCHF | Human serology |
| Ebola | Human cases | |
| Lassa fever | Human serology | |
| Monkeypox | Human cases | |
| Cook Islands | No known HCIDs | |
| Costa Rica | No known HCIDs | |
| Cote d’Ivoire | CCHF | Human serology (c) |
| Ebola | Human cases | |
| Lassa fever | Human cases | |
| Monkeypox | Human cases (a) | |
| Croatia | CCHF | Human cases (a) |
| Cuba | No known HCIDs | |
| Curacao | No known HCIDs | |
| Cyprus | No known HCIDs | |
| Czech Republic | No known HCIDs | |
| Dem Rep of Congo | CCHF | Human cases |
| Ebola | Human cases | |
| Marburg | Human cases | |
| Monkeypox | Human cases | |
| Plague | Human cases | |
| Denmark | No known HCIDs | |
| Djibouti | No known HCIDs | |
| Dominica | No known HCIDs | |
| Dominican Republic | No known HCIDs |
Countries E to H
| Country | HCID Pathogen/Disease | Evidence |
|---|---|---|
| Ecuador | Plague | Human cases |
| Egypt | Avian influenza H5N1 | Human cases (d) |
| CCHF | Human cases | |
| Plague | Human cases (a) | |
| El Salvador | No known HCIDs | |
| Equatorial Guinea | CCHF | Human serology (a) |
| Ebola | Human serology (a) | |
| Eritrea | No known HCIDs | |
| Estonia | No known HCIDs | |
| Ethiopia | Ebola | Human serology (a) |
| Fiji | No known HCIDs | |
| Finland | No known HCIDs | |
| France | No known HCIDs | |
| French Guiana | No known HCIDs | |
| French Polynesia | No known HCIDs | |
| Gabon | Ebola | Human cases |
| Monkeypox | Human cases | |
| Gambia, The | CCHF | Human serology (c) |
| Georgia | CCHF | Human cases |
| Germany | No known HCIDs | |
| Ghana | CCHF | Human serology |
| Lassa fever | Human cases | |
| Greece | CCHF | Human cases |
| Greenland | No known HCIDs | |
| Grenada | No known HCIDs | |
| Guadeloupe | No known HCIDs | |
| Guam | No known HCIDs | |
| Guatemala | No known HCIDs | |
| Guinea | Ebola | Human cases |
| Lassa fever | Human cases | |
| Guinea-Bissau | CCHF | Human serology (c) |
| Guyana | No known HCIDs | |
| Haiti | No known HCIDs | |
| Honduras | No known HCIDs | |
| Hong Kong | SARS | Human cases |
| Hungary | No known HCIDs |
Countries I to L
| Country | HCID Pathogen/Disease | Evidence |
|---|---|---|
| Iceland | No known HCIDs | |
| India | CCHF | Human cases |
| Nipah virus | Human cases | |
| Plague | Human cases | |
| Indonesia | Avian influenza H5N1 | Human cases (d) |
| Iran | CCHF | Human cases |
| MERS | Human cases | |
| Iraq | CCHF | Human cases |
| Plague | Human cases | |
| Ireland | No known HCIDs | |
| Israel | No known HCIDs | |
| Italy | Avian influenza H7N7 | Human cases |
| Jamaica | No known HCIDs | |
| Japan | SFTS | Human cases |
| Jordan | MERS | Human cases |
| Plague | Human cases | |
| Kazakhstan | CCHF | Human cases |
| Plague | Human cases | |
| Kenya | CCHF | Human cases |
| Ebola | Human serology (a) | |
| Marburg | Human cases (a) | |
| MERS | Human serology | |
| Plague | Human cases | |
| Kiribati | No known HCIDs | |
| Korea, North | No known HCIDs | |
| Korea, South | SFTS | Human cases |
| Kosovo | CCHF | Human cases |
| Kuwait | CCHF | Human cases |
| MERS | Human cases | |
| Kyrgyzstan | CCHF | Human cases |
| Plague | Human cases | |
| Laos | Plague | Human cases |
| Latvia | No known HCIDs | |
| Lebanon | Plague | Human cases (a) |
| Lesotho | CCHF | Human serology (c) |
| Plague | Human cases (a) | |
| Liberia | Ebola | Human cases |
| Lassa fever | Human cases | |
| Monkeypox | Human cases | |
| Libya | Plague | Human cases |
| Liechtenstein | No known HCIDs | |
| Lithuania | No known HCIDs | |
| Luxembourg | No known HCIDs |
Countries M to P
| Country | HCID Pathogen/Disease | Evidence |
|---|---|---|
| Macau | No known HCIDs | |
| Macedonia | CCHF | Human cases (a) |
| Madagascar | Ebola | Human serology (a) |
| Plague | Human cases | |
| Malawi | Plague | Human cases |
| Malaysia | Nipah virus | Human cases |
| Maldives | No known HCIDs | |
| Mali | CCHF | Human cases |
| Lassa fever | Human cases | |
| Malta | No known HCIDs | |
| Marshall Islands | No known HCIDs | |
| Mauritania | CCHF | Human cases |
| Plague | Human cases (a) | |
| Mauritius | No known HCIDs | |
| Mexico | No known HCIDs | |
| Micronesia | No known HCIDs | |
| Moldova | CCHF | Human cases (a) |
| Monaco | No known HCIDs | |
| Mongolia | CCHF | Human serology |
| Plague | Human cases | |
| Montenegro (b) | CCHF | Presumed endemic |
| Morocco | Plague | Human cases (a) |
| Mozambique | CCHF | Human serology |
| Plague | Human cases | |
| Namibia | CCHF | Human cases |
| Plague | Human cases | |
| Nauru | No known HCIDs | |
| Nepal | Avian influenza H5N1 | Human cases |
| Plague | Human cases | |
| Netherlands | Avian influenza H7N7 | Human cases |
| New Zealand | No known HCIDs | |
| Nicaragua | No known HCIDs | |
| Niger | No known HCIDs | |
| Nigeria | CCHF | Human cases |
| Ebola | Human serology (a) | |
| Lassa fever | Human cases | |
| Monkeypox | Human cases | |
| Norway | No known HCIDs | |
| Oman | CCHF | Human cases |
| MERS | Human cases | |
| Pakistan | CCHF | Human cases |
| Plague | Human cases | |
| Palau | No known HCIDs | |
| Panama | No known HCIDs | |
| Papua New Guinea | No known HCIDs | |
| Paraguay | No known HCIDs | |
| Peru | Plague | Human cases |
| Andes virus | Human serology | |
| Philippines | No known HCIDs | |
| Poland | No known HCIDs | |
| Portugal | CCHF | Human serology (a) |
| Puerto Rico | No known HCIDs |
Countries Q to T
| Country | HCID Pathogen/Disease | Evidence |
|---|---|---|
| Qatar | MERS | Human cases |
| Romania | No known HCIDs | |
| Russia | CCHF | Human cases |
| Plague | Human cases | |
| Rwanda | No known HCIDs | |
| Saint Kitts & Nevis | No known HCIDs | |
| Saint Lucia | No known HCIDs | |
| Saint Vincent and the Grenadines | No known HCIDs | |
| Samoa | No known HCIDs | |
| San Marino | No known HCIDs | |
| Sao Tome & Principe | No known HCIDs | |
| Saudi Arabia | CCHF | Human cases |
| MERS | Human cases | |
| Plague | Human cases | |
| Senegal | CCHF | Human cases |
| Plague | Human cases (a) | |
| Serbia | CCHF | Human cases |
| Seychelles | No known HCIDs | |
| Sierra Leone | Ebola | Human cases |
| Lassa fever | Human cases | |
| Monkeypox | Human cases | |
| Singapore | No known HCIDs | |
| Sint Maarten | No known HCIDs | |
| Slovakia | No known HCIDs | |
| Slovenia (b) | CCHF | Presumed endemic |
| Solomon Islands | No known HCIDs | |
| Somalia | No known HCIDs | |
| South Africa | CCHF | Human cases |
| Plague | Human cases (a) | |
| South Sudan | CCHF | Human serology (c) |
| Ebola | Human cases | |
| Spain | CCHF | Human cases |
| Sri Lanka | No known HCIDs | |
| State of Palestine | No known HCIDs | |
| Sudan | CCHF | Human cases |
| Monkeypox | Human cases | |
| Suriname | No known HCIDs | |
| Swaziland | CCHF | Human serology (c) |
| Sweden | No known HCIDs | |
| Switzerland | No known HCIDs | |
| Syria | Plague | Human cases (a) |
| Taiwan | SARS | Human cases |
| SFTS | Human cases | |
| Tajikistan | CCHF | Human cases |
| Tanzania | CCHF | Human serology (a) |
| Ebola | October 2019: probable human case | |
| Plague | Human cases | |
| Thailand | No known HCIDs | |
| Timor Leste | No known HCIDs | |
| Togo | Lassa fever | Human cases |
| Tonga | No known HCIDs | |
| Trinidad & Tobago | No known HCIDs | |
| Tunisia | CCHF | Human serology |
| Plague | Human cases (a) | |
| Turkey | CCHF | Human cases |
| Turkmenistan | Plague | Human cases |
| Tuvalu | No known HCIDs |
Countries U to Z
| Country | HCID Pathogen/Disease | Evidence |
|---|---|---|
| Uganda | CCHF | Human cases |
| Ebola | Human cases | |
| Lassa fever | Human serology (a) | |
| Marburg | Human cases | |
| Plague | Human cases | |
| Ukraine | CCHF | Human cases |
| United Arab Emirates | CCHF | Human cases |
| MERS | Human cases | |
| United Kingdom | No known HCIDs | |
| United States | Plague | Human cases |
| Uruguay | No known HCIDs | |
| Uzbekistan | CCHF | Human cases |
| Plague | Human cases | |
| Vanuatu | No known HCIDs | |
| Venezuela | No known HCIDs | |
| Vietnam | Avian influenza H5N1 | Human cases (d) |
| Plague | Human cases | |
| SFTS | Human cases | |
| Western Sahara | No known HCIDs | |
| Yemen | MERS | Human cases |
| Plague | Human cases (a) | |
| Zambia | Plague | Human cases |
| Lujo virus | Human cases | |
| Zimbabwe | CCHF | Human serology (a) |
| Ebola | Human serology (a) | |
| Marburg | Human cases (a) | |
| Plague | Human cases |
Last updated 21 March 2020 + show all updates
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Removed COVID-19 from the listing.
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Added Wuhan novel coronavirus to China, and SFTS to Taiwan.
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Added Ebola to Tanzania listing.
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Added avian influenza H5N1 to Nepal.
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Sources of evidence for each country reviewed and updated.
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First published.
