Japan: migrant health guide

Advice and guidance on the health needs of migrant patients from Japan for healthcare practitioners.

Main messages

If the patient is new to the UK:

Due to a low prevalence, ascertain any risk factors for hepatitis B infection that may indicate the need for screening.

The prevalence of HTLV is high.

There is a risk of typhoid infection.

Be alert for possible cases of Chagas disease, and refer as appropriate, because there is a risk of chronic Chagas disease in migrants.

Consider nutritional and metabolic concerns.

Infectious diseases


Ensure that all patients, especially children, are up-to-date with the UK immunisation schedule. See Immunisation collection with complete schedules.


There is a low incidence of TB in Japan (< 40 cases per 100,000), so:

  • routine screening is not required
  • consider testing in patients (including children) who show signs and symptoms
  • be aware that TB is a notifiable disease

Sexually transmitted infections and HIV

Take a sexual history, and:

  • screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
  • test all sexually active patients under the age of 25 for chlamydia

Japan has a low rate of HIV (≤1%), so offer and recommend an HIV test if the patient:

  • falls into a high risk group
  • is newly registering in a high prevalence area


The prevalence of Human T-cell lymphotropic virus (HTLV) is high. Refer to further HTLV guidance about testing and treatment.

Hepatitis B

Japan has a low prevalence of hepatitis B, so:

  • offer screening for hepatitis B to all pregnant women during each pregnancy
  • immunise appropriately babies born to mothers who are hepatitis B positive, and follow up accordingly
  • be aware that the UK has a universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups

Hepatitis C

The prevalence of hepatitis C is higher than the UK, so consider screening for hepatitis C if other risk factors apply.


There is a risk of typhoid infection, so:

  • ensure that travellers are offered typhoid immunisation and advice on prevention of enteric fever
  • remember enteric fever in the differential diagnosis of illness in patients with a recent history of travel to or from this country


There is a risk of chronic Chagas disease in migrants, so:

  • be alert for possible cases
  • refer as appropriate

Travel plans and advice

Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin. People who travel to visit friends and relatives (VFR travellers) should visit the Foreign and Commonwealth Office for overseas travel advice and National Travel Health Network and Centre (NaTHNaC) for country specific travel advice prior to leaving the UK.

Nutritional and metabolic concerns


There is a moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20% to 40%) and low risk in pre-school children (estimated prevalence is 5% to 20%), so:

  • be alert to the possibility of anaemia in recently arrived migrants, particularly women and pre-school children
  • test as clinically indicated

Vitamin D

Consider the possibility of vitamin D deficiency in people who may be at risk due to:

  • darker skin
  • those who are not often outdoors
  • those who cover up most of their skin when outdoors

Women’s health

Reproductive health indicators

Reproductive health indicator UK Japan
Number of children per woman¹ 1.7 1.4
Use of contraception² 71.7% 39.8%

¹lifetime average; ²by woman of reproductive age or partner

Country profile

Health indicators and health care

WHO Global Health Observatory has a summary of health indicators and health care in Japan.

Culture, politics and history

BBC News and The World Factbook provide background information on the culture, politics and history of Japan.


The main language used in Japan is Japanese (official).

Source: The World Factbook.


Religion Population (%)¹
Shintoism 69
Buddhism 66.7
Christianity 1.5
Other 6.2

¹Total exceeds 100% because many people practice both Shintoism and Buddhism

Source: The World Factbook.

Migration to the UK

There were almost 36,000 people from Japan living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics

Published 31 July 2014
Last updated 20 September 2021 + show all updates
  1. Updated country guidance on prevalence of communicable diseases and other health topics.

  2. First published.