world travel health pro

Protecting the health of the British traveller

• About NaTHNaC

Choose from our websites and some key resources below to learn more.

TravelHealthPro

Travel health information aimed at healthcare professionals advising travellers, and people travelling overseas from the UK including news, factsheets, outbreak reports and country information.

Yellow Fever Zone

Clinical and administrative resources for healthcare professionals and other staff running or managing a Yellow Fever Vaccination Centre (YFVC). Also find out how to apply to become a YFVC.

Telephone advice line for health professionals

Health professionals advising travellers with complex itineraries or specialist health needs can call weekdays to speak to one of NaTHNaC’s specialist travel health nurses. Find opening hours, contact number and more details.

NaTHNaC Training Portal

Health professionals can access booking information for online and classroom training in yellow fever vaccination, get guidance on how to gain experience in travel medicine and view a listing of forthcoming travel health courses.

Yellow fever vaccination centre search

Search by location or postcode to find a centre offering yellow fever vaccination in England, Wales or Northern Ireland. YFVCs generally also offer a wider travel health service. Search also Scotland, Isle of Man and the Channel Islands.

Outbreak Surveillance

Information on disease outbreaks and incidents worldwide from a wide variety of sources, and can be used along with the Country Information section of TravelHealthPro.

We were set up by the Department of Health in 2002 with the broad aim of Protecting the Health of British Travellers . We seek to improve the quality of travel health advice given by GP practices, travel clinics, pharmacies and other healthcare providers, and provide up to date and reliable information for the international traveller, travel industry and national government.

We are commissioned by UK Health Security Agency and hosted by University College London Hospitals NHS Foundation Trust (UCLH) ; we also work in partnership with our other network founders Liverpool School of Tropical Medicine (LSTM) , London School of Hygiene and Tropical Medicine (LSHTM) and the Hospital for Tropical Diseases (HTD) .

Health professionals and travellers seeking health information ahead of travel should visit our website: travelhealthpro.org.uk .

Our main goals

• To develop national guidance on travel health for health professionals advising the public.
• To advise on specific situations and circumstances that could affect the health of British travellers.
• To identify and report on disease outbreaks and other health hazards worldwide.
• To share our information and expertise widely.
• To keep a register of, monitor and train Yellow Fever Vaccination Centres (YFVCs) in England, Wales and Northern Ireland.
• To collaborate with organisations, particularly in the travel and insurance industries, and in the NHS and government, which share our aim of Protecting the Health of British Travellers.
• To train health professionals to provide best quality, evidence-based trave health advice and services.
• To initiate research, collect and analyse data to enable us to achieve our goals.

Annual reports

• NaTHNaC Annual report 2022-2023
• NaTHNaC Annual report 2021-2022
• NaTHNaC Annual report 2020-2021
• NaTHNaC Annual report 2019-2020
• NaTHNaC Annual report 2018-2019

Dr Dipti Patel OBE Director

Dr Vanessa Field Deputy Director

Administration Team

Masum Miah Operations Manager

Linda Pang YFVC Support

Sheena Ryan Business Support

Terence Corrigan Online Communications

Information

Sanch Kanagarajah Senior Information Analyst

Samia Richards-Zoubir Analyst for Travel Health

Dr Yasvita Gupta Intern Analyst for Travel Health

Clinical Team

Dr Lisa Ford (Liverpool) Clinical Advisor

Dr Catherine Smith Consultant

Dr Natalia Rodriguez-Valero Honorary Clinical Fellow

Dr Kirsten MacGregor Speciality Registrar

Hilary Simons (Liverpool) Senior Specialist Nurse (Travel Health)

Lynda Bramham Specialist Nurse (Travel Health)

Mary Gawthrop Specialist Nurse (Travel Health)

Alexandra Stillwell Specialist Nurse (Travel Health)

Rose Tucker Specialist Nurse (Travel Health)

Rachael Fletcher Specialist Nurse (Travel Health)

NaTHNaC has offices in London and Liverpool.

Membership of the Technical Advisory Group

Dr Nick Beeching Clinical Director, Tropical & Infectious Disease Unit, Royal Liverpool Hospitals; Senior Lecturer in Infectious Diseases, Liverpool School of Tropical Medicine Dr Mike Brown Infection Division Clinical Director, University College London Hospitals (UCLH); Senior Lecturer in Infectious Diseases and Tropical Medicine, London School of Hygiene and Tropical Medicine Kevin Dyer Senior Business Development Manager, UK Health Security Agency Dr Vanessa Field Deputy Director, NaTHNaC Prof James G. Logan Head of Department of Disease Control, London School of Hygiene and Tropical Medicine Dr Nicky Longley Consultant Physician and Clinical Lead in Travel Medicine, Hospital for Tropical Diseases, University College London Hospitals Prof Dilys Morgan MBE Chair of NaTHNaC Technical Advisory Group Dr Dipti Patel OBE Director, NaTHNaC Prof Bertie Squire Professor of Tropical Medicine and Dean of Clinical Sciences and International Public Health at the Liverpool School of Tropical Medicine Dr Fiona Yung Divisional Manager Clinical Support Services, Pathology, Infection , Camden MSK, University College London Hospitals

Our partners

NaTHNaC was founded in 2002 by the Department of Health and is now commissioned by UK Health Security Agency. We work in partnership with our network founders.

UK HEALTH SECURITY AGENCY

THE HOSPITAL FOR TROPICAL DISEASES

LIVERPOOL SCHOOL OF TROPICAL MEDICINE

LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE

UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST

• COUNTRY INFORMATION
• LATEST NEWS
• OUTBREAK SURVEILLANCE
• TOPICS IN BRIEF
• FACTSHEETS & RESOURCES
• WORLD OVERVIEW

Welcome to TravelHealthPro

Find travel health advice for destinations worldwide and a wealth of useful resources for travellers and health professionals providing travel health services in the UK. See our introduction to TravelHealthPro video here.

Latest News

Icc men's t20 cricket world cup 2024.

Tournament in June 2024 will be co-hosted in the West Indies and the USA

Travelling to Germany for Euro 2024?

Travel health advice for fans going to the 2024 Euros

Dengue reminder

Dengue is a viral infection transmitted by mosquitoes found in tropical and sub-tropical climates, including parts of Europe

Global risk of measles: travel reminder

All travellers are advised to be up to date with measles vaccination

Travelling for Carnival

Follow our advice for a safe and healthy trip

Japanese encephalitis vaccine out of stock: advice for travellers and health professionals

Important advice on Japanese encephalitis vaccine shortage for health professionals

Cholera: worldwide risk reminder

A reminder of the risks of cholera worldwide and the importance of good food, water and personal hygiene for all travellers

Management and reporting of adverse events

Information on management and reporting of suspected adverse events or inadvertent administration following YF vaccination

Check the recommendations for your destination

• Featured  News and Factsheets
• Latest Outbreaks

‘Getting to grips with tick-borne encephalitis’ webinar video available

The recording of the tick-borne encephalitis webinar on 28 March 2024 now added to TravelHealthPro

Polio: Public Health Emergency of International Concern

An update on the polio Public Health Emergency of International Concern (PHEIC)

Yellow fever update

Yellow fever cases continue to be reported in Africa and South America

Qdenga® dengue vaccine guidance

Joint Committee on Vaccination and Immunisation (JCVI) deliberations on Qdenga® vaccine now available

Yellow fever pre-vaccination checklist updated

Updates to the pre-vaccination checklist have been made in line with the new 'green book' yellow fever chapter

Nipah virus; information for travellers and health professionals

Information on risks and prevention for travellers and health professionals

Cholera vaccine shortage: advice for health professionals

Cholera cases increase worldwide, with shortages of cholera vaccine reported

Further update to 'green book' yellow fever chapter

Information about reinforcing doses of yellow fever vaccine has been updated in Immunisation against infectious disease

Shigellosis in Belgium, Germany, Ireland & Netherlands

On 9 April 2024, 31 cases of extensively drug-resistant (XDR) Shigella sonnei infections were reported in Belgium since January 2024. On 12 April 2024, cases were also reported from Germany (2), Ireland (2), and the Netherlands (1). All of the cases had links to a music festival in Belgium.

Botox reaction in USA

As of 12 April 2024, a total of 19 people from nine states have reported harmful reactions after receiving botulinum toxin injections from unlicensed or untrained individuals or in non-healthcare settings, such as homes and spas. Nine people have been admitted to hospital.

Cholera in Comoros

As of 14 April 2024, a total of 1,484 cholera cases, with 38 deaths (representing a 2.5% case mortality rate) have been reported since this cholera outbreak was declared on 2 February 2024. The three islands have reported cases, with most from Anjouan island.

Rabies in Timor-Leste

As of 22 March 2024, one fatal human case of rabies was confirmed in Pasabe Subregion, Oecusse. This is the first confirmed human case of rabies in Timor-Leste.

cVDPV2 in Liberia

As of 8 April 2024, circulating vaccine-derived poliovirus type 2 (cVDPV2) has been detected in an environmental sample in this country.

cVDPV2 in Senegal

Cvdpv2 in sierra leone, influenza a(h9n2) in vietnam.

As of 7 April 2024, the Vietnam Department of Information and Communications reported a confirmed human case of avian influenza A(H9N2) infection. This is the first confirmed human case of avian influenza A(H9N2) reported in Vietnam. To date, no further cases have been detected among close contacts.

Dengue in Argentina

Between 1 January and 25 March 2024, a total of 163,419 confirmed cases of dengue have been reported from Argentina. This reflects a six times greater number of cases compared to the previous season.

cVDPV2 in Angola

As of 13 March 2024, two circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental samples were reported in Huambo and Luanda.

Advice Line for health professionals

020 7383 7474.

Monday to Friday 09:00 – 11:00

Monday 13:00 – 14:00 Tuesday 13:00 – 15:30 Wednesday 14:30 – 17:00 Thursday 13:00 – 15:30 Friday 13:00 – 14:00

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London School of Hygiene and Tropical Medicine

University College London Hospitals NHS Foundation Trust

Travel vaccination advice

If you're planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as yellow fever , typhoid and hepatitis A .

In the UK, the  NHS routine immunisation (vaccination) schedule protects you against a number of diseases, but does not cover all of the infectious diseases found overseas.

When should I start thinking about the vaccines I need?

If possible, see the GP or a private travel clinic at least 6 to 8 weeks before you're due to travel.

Some vaccines need to be given well in advance to allow your body to develop immunity.

And some vaccines involve a number of doses spread over several weeks or months.

You may be more at risk of some diseases, for example, if you're:

• travelling in rural areas
• backpacking
• staying in hostels or camping
• on a long trip rather than a package holiday

If you have a pre-existing health problem, this may make you more at risk of infection or complications from a travel-related illness.

Which travel vaccines do I need?

You can find out which vaccinations are necessary or recommended for the areas you'll be visiting on these websites:

• Travel Health Pro
• NHS Fit for Travel

Some countries require proof of vaccination (for example, for polio or yellow fever vaccination), which must be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country.

Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages.

Even if an ICVP is not required, it's still a good idea to take a record of the vaccinations you have had with you.

Find out more about the vaccines available for travellers abroad

Where do I get my travel vaccines?

First, phone or visit the GP practice or practice nurse to find out whether your existing UK vaccinations are up-to-date.

If you have any records of your vaccinations, let the GP know what you have had previously.

The GP or practice nurse may be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

They can give you any missing doses of your UK vaccines if you need them.

Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area.

If the GP practice can give you the travel vaccines you need but they are not available on the NHS, ask for:

• written information on what vaccines are needed
• the cost of each dose or course
• any other charges you may have to pay, such as for some certificates of vaccination

You can also get travel vaccines from:

• private travel vaccination clinics
• pharmacies offering travel healthcare services

Which travel vaccines are free?

The following travel vaccines are available free on the NHS from your GP surgery:

• polio (given as a combined diphtheria/tetanus/polio jab )
• hepatitis A

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Which travel vaccines will I have to pay for?

You'll have to pay for travel vaccinations against:

• hepatitis B
• Japanese encephalitis
• tick-borne encephalitis
• tuberculosis (TB)
• yellow fever

Yellow fever vaccines are only available from designated centres .

The cost of travel vaccines that are not available on the NHS will vary, depending on the vaccine and number of doses you need.

It's worth considering this when budgeting for your trip.

Other things to consider

There are other things to consider when planning your travel vaccinations, including:

• your age and health – you may be more vulnerable to infection than others; some vaccines cannot be given to people with certain medical conditions
• working as an aid worker – you may come into contact with more diseases in a refugee camp or helping after a natural disaster
• working in a medical setting – a doctor, nurse or another healthcare worker may require additional vaccinations
• contact with animals – you may be more at risk of getting diseases spread by animals, such as rabies

If you're only travelling to countries in northern and central Europe, North America or Australia, you're unlikely to need any vaccinations.

But it's important to check that you're up-to-date with routine vaccinations available on the NHS.

Pregnancy and breastfeeding

Speak to a GP before having any vaccinations if:

• you're pregnant
• you think you might be pregnant
• you're breastfeeding

In many cases, it's unlikely a vaccine given while you're pregnant or breastfeeding will cause problems for the baby.

But the GP will be able to give you further advice about this.

People with immune deficiencies

For some people travelling overseas, vaccination against certain diseases may not be advised.

This may be the case if:

• you have a condition that affects your body's immune system, such as HIV or AIDS
• you're receiving treatment that affects your immune system, such as chemotherapy
• you have recently had a bone marrow or organ transplant

A GP can give you further advice about this.

Non-travel vaccines

As well as getting any travel vaccinations you need, it's also a good opportunity to make sure your other vaccinations are up-to-date and have booster vaccines if necessary.

Although many routine NHS vaccinations are given during childhood, you can have some of them (such as the MMR vaccine ) as an adult if you missed getting vaccinated as a child.

There are also some extra NHS vaccinations for people at higher risk of certain illnesses, such as the flu vaccine , the hepatitis B vaccine and the BCG vaccine for tuberculosis (TB) .

Your GP can advise you about any NHS vaccinations you might need.

Find out about NHS vaccinations and when to have them

Page last reviewed: 16 March 2023 Next review due: 16 March 2026

• COUNTRY INFORMATION
• LATEST NEWS
• OUTBREAK SURVEILLANCE
• TOPICS IN BRIEF
• FACTSHEETS & RESOURCES
• WORLD OVERVIEW

Welcome to TravelHealthPro

Find travel health advice for destinations worldwide and a wealth of useful resources for travellers and health professionals providing travel health services in the UK. See our introduction to TravelHealthPro video here.

Latest News

Icc men's t20 cricket world cup 2024.

Tournament in June 2024 will be co-hosted in the West Indies and the USA

Travelling to Germany for Euro 2024?

Travel health advice for fans going to the 2024 Euros

Dengue reminder

Dengue is a viral infection transmitted by mosquitoes found in tropical and sub-tropical climates, including parts of Europe

Global risk of measles: travel reminder

All travellers are advised to be up to date with measles vaccination

Travelling for Carnival

Follow our advice for a safe and healthy trip

Japanese encephalitis vaccine out of stock: advice for travellers and health professionals

Important advice on Japanese encephalitis vaccine shortage for health professionals

Cholera: worldwide risk reminder

A reminder of the risks of cholera worldwide and the importance of good food, water and personal hygiene for all travellers

Management and reporting of adverse events

Information on management and reporting of suspected adverse events or inadvertent administration following YF vaccination

Check the recommendations for your destination

• Featured  News and Factsheets
• Latest Outbreaks

‘Getting to grips with tick-borne encephalitis’ webinar video available

The recording of the tick-borne encephalitis webinar on 28 March 2024 now added to TravelHealthPro

Polio: Public Health Emergency of International Concern

An update on the polio Public Health Emergency of International Concern (PHEIC)

Yellow fever update

Yellow fever cases continue to be reported in Africa and South America

Qdenga® dengue vaccine guidance

Joint Committee on Vaccination and Immunisation (JCVI) deliberations on Qdenga® vaccine now available

Yellow fever pre-vaccination checklist updated

Updates to the pre-vaccination checklist have been made in line with the new 'green book' yellow fever chapter

Nipah virus; information for travellers and health professionals

Information on risks and prevention for travellers and health professionals

Cholera vaccine shortage: advice for health professionals

Cholera cases increase worldwide, with shortages of cholera vaccine reported

Further update to 'green book' yellow fever chapter

Information about reinforcing doses of yellow fever vaccine has been updated in Immunisation against infectious disease

Shigellosis in Belgium, Germany, Ireland & Netherlands

On 9 April 2024, 31 cases of extensively drug-resistant (XDR) Shigella sonnei infections were reported in Belgium since January 2024. On 12 April 2024, cases were also reported from Germany (2), Ireland (2), and the Netherlands (1). All of the cases had links to a music festival in Belgium.

Botox reaction in USA

As of 12 April 2024, a total of 19 people from nine states have reported harmful reactions after receiving botulinum toxin injections from unlicensed or untrained individuals or in non-healthcare settings, such as homes and spas. Nine people have been admitted to hospital.

Cholera in Comoros

As of 14 April 2024, a total of 1,484 cholera cases, with 38 deaths (representing a 2.5% case mortality rate) have been reported since this cholera outbreak was declared on 2 February 2024. The three islands have reported cases, with most from Anjouan island.

Rabies in Timor-Leste

As of 22 March 2024, one fatal human case of rabies was confirmed in Pasabe Subregion, Oecusse. This is the first confirmed human case of rabies in Timor-Leste.

cVDPV2 in Liberia

As of 8 April 2024, circulating vaccine-derived poliovirus type 2 (cVDPV2) has been detected in an environmental sample in this country.

cVDPV2 in Senegal

Cvdpv2 in sierra leone, influenza a(h9n2) in vietnam.

As of 7 April 2024, the Vietnam Department of Information and Communications reported a confirmed human case of avian influenza A(H9N2) infection. This is the first confirmed human case of avian influenza A(H9N2) reported in Vietnam. To date, no further cases have been detected among close contacts.

Dengue in Argentina

Between 1 January and 25 March 2024, a total of 163,419 confirmed cases of dengue have been reported from Argentina. This reflects a six times greater number of cases compared to the previous season.

cVDPV2 in Angola

As of 13 March 2024, two circulating vaccine-derived poliovirus type 2 (cVDPV2) positive environmental samples were reported in Huambo and Luanda.

Advice Line for health professionals

020 7383 7474.

Monday to Friday 09:00 – 11:00

Monday 13:00 – 14:00 Tuesday 13:00 – 15:30 Wednesday 14:30 – 17:00 Thursday 13:00 – 15:30 Friday 13:00 – 14:00

Subscribe to our News Alerts and Newsletter

Enter your email address to subscribe and manage the news you receive from us.

Preferences

The Yellow Fever Zone

Get TravelHealthPro on your site

A short introduction to using the TravelHealthPro website for travellers and health professionals .

FEEDBACK SURVEY

Personal information:, successfully submitted .

UK Health Security Agency

Hospital for Tropical Diseases

Liverpool School of Tropical Medicine

London School of Hygiene and Tropical Medicine

University College London Hospitals NHS Foundation Trust

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TRAVEL ADVISORY; New Clinic Serves Visitors to Moscow

A new private clinic has opened in Moscow to serve travelers as well as residents. The service is provided by U.S. Global Health, a members-only joint venture of Columbia-Presbyterian Health Services; the Fund for Large Enterprises in Russia, a private investment company, and Pepsico World Trading, which helps develop businesses for its parent company, Pepsico.

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News & features, winter center, news / recreation, ‘magical’ moment as surfer shares wave with pod of dolphins as she wins first world championship tour event.

By Aimee Lewis, CNN

Published Apr 22, 2024 11:54 AM PDT | Updated Apr 22, 2024 11:54 AM PDT

Gabriela Bryan surfs in the final at the Western Australia Margaret River Pro. (Photo credit: Aaron Hughes/World Surf League/Getty Images via CNN Newsource)

(CNN) —  Gabriela Bryan won her first  world championship tour event  at the Western Australia Margaret River Pro on Sunday and in a “magical” moment in the final, the Hawaiian surfer shared a  wave  with a pod of dolphins.

Bryan, 22, a former rookie of the year, beat 18-year-old Sawyer Lindbald to the title, an 8.10 score on one wave making sure of victory for a 15.93 total, which was nearly two points better than Linblad’s cumulative mark.

But it was on the 7.83-scoring run beforehand where she was joined by the dolphins.

“I’m just so happy we got good waves today and all the girls put on a really good show. It’s insane, I just won,” Bryan said on the World Surf League (WSL) broadcast.

“When I kicked out, I was just wow! That wave was sent to me by someone, the dolphins in it. It was magical.”

Bryan also makes the WSL’s mid-season cut and moves to No. 5 in the world rankings.

Gabriela Bryan celebrates her first world championship tour win. (Beatriz Ryder/World Surf League/Getty Images via CNN Newsource)

In the men’s event, Australia’s Jack Robinson won, beating two-time world champion John John Florence, who had scored a perfect 10 in the semifinals.

On the biggest wave of the day, Robinson all but sealed the win with a 9.10 score, finishing with a 17.27 total in the final – 1.23 points ahead of Florence.

“That was the final I wanted, I wanted to throw everything at it. It’s always fun surfing against John - we’re going to have many more heats together,” said Robinson, per Reuters.

The-CNN-Wire™ & © 2024 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.

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15 men brought to military enlistment office after mass brawl in Moscow Oblast

Local security forces brought 15 men to a military enlistment office after a mass brawl at a warehouse of the Russian Wildberries company in Elektrostal, Moscow Oblast on Feb. 8, Russian Telegram channel Shot reported .

29 people were also taken to police stations. Among the arrested were citizens of Kyrgyzstan.

A mass brawl involving over 100 employees and security personnel broke out at the Wildberries warehouse in Elektrostal on Dec. 8.

Read also: Moscow recruits ‘construction brigades’ from Russian students, Ukraine says

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• WORLD OVERVIEW

Antigua and Barbuda

Capital City: Saint John’s

Official Languages: English

Monetary Unit: Eastern Caribbean dollar (EC$)

• General Information
• Vaccine Recommendations
• Other Risks

TRAVEL RESTRICTIONS ARE IN PLACE FOR THIS COUNTRY

There are entry requirements for anyone who plans to travel to England from this country. Please check here for further information. Advice may vary in Scotland, Wales, and Northern Ireland.

The information on these pages should be used to research health risks and to inform the pre-travel consultation.

Due to COVID-19, travel advice is subject to rapid change. Countries may change entry requirements and close their borders at very short notice. Travellers must ensure they check current Foreign, Commonwealth & Development Office (FCDO) travel advice in addition to the FCDO specific country page (where available) which provides additional information on travel restrictions and entry requirements in addition to safety and security advice.

Travellers should ideally arrange an appointment with their health professional at least four to six weeks before travel. However, even if time is short, an appointment is still worthwhile. This appointment provides an opportunity to assess health risks taking into account a number of factors including destination, medical history, and planned activities. For those with pre-existing health problems, an earlier appointment is recommended.

All travellers should ensure they have adequate travel health insurance .

A list of useful resources including advice on how to reduce the risk of certain health problems is available below.

• Food and water hygiene
• Insect and tick bite avoidance
• Personal safety
• Sexually transmitted infections
• Sun protection

Details of vaccination recommendations and requirements are provided below.

All travellers

Travellers should be up to date with routine vaccination courses and boosters as recommended in the UK . These vaccinations include for example measles-mumps-rubella (MMR) vaccine and diphtheria-tetanus-polio vaccine.

Country-specific diphtheria recommendations are not provided here. Diphtheria tetanus and polio are combined in a single vaccine in the UK. Therefore, when a tetanus booster is recommended for travellers, diphtheria vaccine is also given. Should there be an outbreak of diphtheria in a country, diphtheria vaccination guidance will be provided.

Those who may be at increased risk of an infectious disease due to their work, lifestyle choice, or certain underlying health problems should be up to date with additional recommended vaccines. See the individual chapters of the 'Green Book' Immunisation against infectious disease for further details.

Certificate requirements

Please read the information below carefully, as certificate requirements may be relevant to certain travellers only. For travellers further details, if required, should be sought from their healthcare professional.

• There is no risk of yellow fever in Antigua and Barbuda, however, there is a certificate requirement.
• Under International Health Regulations, proof of vaccination against yellow fever is required for travellers aged 1 year or over arriving from countries with risk of yellow fever transmission and for travellers having transited for more than 12 hours through an airport of a country with risk of yellow fever transmission.
• According to World Health Organization (WHO), from 11 July 2016 (for all countries), the yellow fever certificate will be valid for the duration of the life of the person vaccinated. As a consequence, a valid certificate, presented by arriving travellers, cannot be rejected on the grounds that more than ten years have passed since the date vaccination became effective as stated on the certificate; and that boosters or revaccination cannot be required. 
• View the WHO list of countries with risk of yellow fever transmission.

Most travellers

The vaccines in this section are recommended for most travellers visiting this country. Information on these vaccines can be found by clicking on the blue arrow. Vaccines are listed alphabetically.

Tetanus is caused by a toxin released from Clostridium tetani bacteria and occurs worldwide. Tetanus bacteria are present in soil and manure and may be introduced through open wounds such as a puncture wound, burn or scratch.

Travellers should thoroughly clean all wounds and seek medical attention for injuries such as animal bites/scratches, burns or wounds contaminated with soil.

Tetanus vaccination

• Travellers should have completed a tetanus vaccination course according to the UK schedule.
• If travelling to a country or area where medical facilities may be limited, a booster dose of a tetanus-containing vaccine is recommended if the last dose was more than ten years ago even if five doses of vaccine have been given previously.

Country-specific information on medical facilities may be found in the 'health' section of the FCDO foreign travel advice pages.

Tetanus in brief

Some travellers.

The vaccines in this section are recommended for some travellers visiting this country. Information on when these vaccines should be considered can be found by clicking on the arrow. Vaccines are listed alphabetically.

Hepatitis A

Hepatitis A is a viral infection transmitted through contaminated food and water or by direct contact with an infectious person. Symptoms are often mild or absent in young children, but the disease can be more serious with advancing age. Recovery can vary from weeks to months. Following hepatitis A infection immunity is lifelong.

All travellers should take care with personal, food and water hygiene.

Hepatitis A vaccination

Vaccination is recommended for those whose activities put them at increased risk. This includes:

• those who are staying with or visiting the local population.
• frequent and/or long-stay travellers to areas where sanitation and food hygiene are likely to be poor.
• adventure travellers visiting rural areas and staying in basic accommodation such as backpackers.
• those with existing medical conditions such as liver disease or haemophilia.
• men who have sex with men.
• people who inject drugs.
• those who may be exposed to the virus through their work.
• those going to areas of hepatitis A outbreaks who have limited access to safe water and medical care.

Hepatitis A in brief

Hepatitis b.

Hepatitis B is a viral infection; it is transmitted by exposure to infected blood or body fluids. This mostly occurs during sexual contact or as a result of blood-to-blood contact (for example from contaminated equipment during medical and dental procedures, tattooing or body piercing procedures, and sharing of intravenous needles). Mothers with the virus can also transmit the infection to their baby during childbirth.

Hepatitis B in Antigua and Barbuda

2% or more of the population are known or thought to be persistently infected with the hepatitis B virus (intermediate/high prevalence).

Travellers should avoid contact with blood or body fluids. This includes:

• avoiding unprotected sexual intercourse.
• avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile equipment is used).
• not sharing needles or other injection equipment.
• following universal precautions if working in a medical/dental/high risk setting.

A sterile medical equipment kit may be helpful when travelling to resource poor areas.

Hepatitis B vaccination

Vaccination could be considered for all travellers, and is recommended for those whose activities or medical history put them at increased risk including:

• those who may have unprotected sex.
• those who may be exposed to contaminated needles through injecting drug use.
• those who may be exposed to blood or body fluids through their work (e.g. health workers).
• those who may be exposed to contaminated needles as a result of having medical or dental care e.g. those with pre-existing medical conditions and those travelling for medical care abroad including those intending to receive renal dialysis overseas.
• long-stay travellers.
• those who are participating in contact sports.
• families adopting children from this country.

Hepatitis B in brief

Rabies (bat lyssavirus).

Although rare, bat lyssaviruses (bat rabies) can be transmitted to humans or other animals following contact with the saliva of an infected bat most often by a bite. The disease can also be transmitted if the saliva of an infected bat gets into open wounds or mucous membranes (such as on the eye, nose or mouth). Bat lyssaviruses can cause disease in humans that is indistinguishable from rabies.

Symptoms can take some time to develop, but when they do the condition is almost always fatal.

The risk to most travellers is low. However, it is increased for certain occupations for example bat handlers and veterinarians, or certain activities such as caving.

Bat lyssavirus in Antigua and Barbuda

Rabies has not been reported in this country; therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies).

• Travellers should avoid contact with bats. Bites from bats are frequently unrecognised. Rabies-like disease caused by bat lyssaviruses is preventable with prompt post-exposure rabies treatment.
• Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial. Although rabies has not been reported in other animals in this country, it is sensible to seek prompt medical advice if bitten or scratched. It is possible, although very rare for bats to pass rabies-like viruses to other animals including pets.
• Post-exposure treatment and advice should be in accordance with national guidelines .

Rabies vaccination

A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure treatment and removes the need for rabies immunoglobulin which is in short supply world-wide.

• Pre-exposure rabies vaccinations are recommended for those who are at increased risk due to their work (e.g. laboratory staff working with the virus and those working with bats).
• Pre exposure vaccines could be considered for those whose activities put them at increased risk of exposure to bats.

Rabies in brief

There are some risks that are relevant to all travellers regardless of destination. These may for example include road traffic and other accidents, diseases transmitted by insects or ticks, diseases transmitted by contaminated food and water, sexually transmitted infections, or health issues related to the heat or cold.

Some additional risks (which may be present in all or part of this country) are mentioned below and are presented alphabetically. Select risk to expand information.

Biting insects or ticks

Insect or tick bites can cause irritation and infections of the skin at the site of a bite. They can also spread certain diseases.

Diseases in Caribbean

There is a risk of insect or tick-borne diseases in some areas of the Caribbean. This includes diseases such as  chikungunya  and  West Nile virus .

Prevention 

• All travellers should avoid insect and tick bites day and night.
• There are no vaccinations (or medications) to prevent these diseases.

Further information about specific insect or tick-borne diseases for this country can be found, if appropriate on this page, in other sections of the country information pages and the  insect and tick bite avoidance factsheet .

Dengue is a viral infection spread by mosquitoes which mainly feed during daytime hours. It causes a flu-like illness, which can occasionally develop into a more serious life-threatening illness. Severe dengue is rare in travellers.

The mosquitoes that spread dengue are more common in towns, cities and surrounding areas.

Dengue in Antigua and Barbuda

There is a risk of dengue in this country.

• Travellers should avoid mosquito bites particularly during daytime hours.
• A dengue vaccine is licensed in the UK for the prevention of dengue disease in individuals from 4 years of age. The Joint Committee on Vaccination and Immunisation (JCVI) and World Health Organization are in the process of reviewing the product information. Recommendations on the use of this vaccine will be published in due course.

Dengue in brief

Seasonal influenza is a viral infection of the respiratory tract and spreads easily from person to person via respiratory droplets when coughing and sneezing. Symptoms appear rapidly and include fever, muscle aches, headache, malaise (feeling unwell), cough, sore throat and a runny nose. In healthy individuals, symptoms improve without treatment within two to seven days. Severe illness is more common in those aged 65 years or over, those under 2 years of age, or those who have underlying medical conditions that increase their risk for complications of influenza.

Seasonal influenza in Antigua and Barbuda

Seasonal influenza occurs throughout the world. In the northern hemisphere (including the UK), most influenza occurs from as early as October through to March. In the southern hemisphere, influenza mostly occurs between April and September. In the tropics, influenza can occur throughout the year.

All travellers should:

• Avoid close contact with symptomatic individuals
• Avoid crowded conditions where possible
• Wash their hands frequently
• Practise ‘cough hygiene’: sneezing or coughing into a tissue and promptly discarding it safely, and washing their hands
• Avoid travel if unwell with influenza-like symptoms
• A vaccine is available in certain circumstances (see below)*

*In the UK, seasonal influenza vaccine is offered routinely each year to those at higher risk of developing of severe disease following influenza infection, and certain additional groups such as healthcare workers and children as part of the UK national schedule (see information on vaccination ). For those who do not fall into these groups, vaccination may be available privately.

If individuals at higher risk of severe disease following influenza infection are travelling to a country when influenza is likely to be circulating they should ensure they received a flu vaccination in the previous 12 months.

The vaccine used in the UK protects against the strains predicted to occur during the winter months of the northern hemisphere. It is not possible to obtain vaccine for the southern hemisphere in the UK, but the vaccine used during the UK influenza season should still provide important protection against strains likely to occur during the southern hemisphere influenza season, and in the tropics.

Avian influenza

Avian influenza viruses can rarely infect and cause disease in humans. Such cases are usually associated with close exposure to infected bird or animal populations. Where appropriate, information on these will be available in the outbreaks and news sections of the relevant country pages. Seasonal influenza vaccines will not provide protection against avian influenza.

Avian influenza in brief

Outdoor air quality.

Poor air quality is a significant public health problem in many parts of the world. Exposure to high levels of air pollution over short time periods (e.g. minutes/hours/days) and longer time periods (e.g. years) is linked to many different acute and chronic health problems. These effects are mainly on the respiratory (lungs and airways) and cardiovascular (heart function and blood circulation) systems.

Current information on world air quality is available from the world air quality index project .

Travellers with health problems that might make them more vulnerable to the effects of air pollution who are travelling to areas of high pollution should:

• discuss their travel plans with their doctor, and carry adequate supplies of their regular medication.
• take sensible precautions to minimise their exposure to high levels of air pollution.
• check local air quality data and amend their activities accordingly.
• take notice of any health advisories published by the local Ministry of Health and Department for Environment, and follow the guidance provided.

It is unclear if face masks are beneficial at reducing exposure and may make breathing more difficult for those with pre-existing lung conditions. Those who choose to use one should make sure that the mask fits well and know how to wear it properly.

Outdoor air quality in brief

Schistosomiasis.

Schistosomiasis is a parasitic infection. Schistosoma larvae are released from infected freshwater snails and can penetrate intact human skin following contact with contaminated freshwater. Travellers may be exposed during activities such as wading, swimming, bathing or washing clothes in freshwater streams, rivers or lakes.

Schistosomiasis infection may cause no symptoms, but early symptoms can include a rash and itchy skin ('swimmer's itch'), fever, chills, cough, or muscle aches. If not treated, it can cause serious long term health problems such as intestinal or bladder disease.

Schistosomiasis in Antigua and Barbuda

Cases of schistosomiasis have previously been reported from this country. There is a very low risk of schistosomiasis in this country.

• There is no vaccine or tablets to prevent schistosomiasis.
• All travellers should avoid wading, swimming, or bathing in fresh water. Swimming in adequately chlorinated water or sea water is not a risk for schistosomiasis.
• Drink water that is boiled, filtered or bottled.
• Application of insect repellent before exposure to fresh water, or towel drying after possible exposure to schistosomiasis are not reliable in preventing infection.
• If you have concerns about your risk discuss with your health care provider.

Schistosomiasis in brief

Zika virus (ZIKV) is a viral infection spread by mosquitoes which predominantly feed during daytime hours. A small number of cases of sexual transmission of ZIKV have also been reported. Most people infected with ZIKV have no symptoms. When symptoms do occur, they are usually mild and short-lived. Serious complications and deaths are not common. However, ZIKV is a cause of Congenital Zika Syndrome (microcephaly and other congenital anomalies) and neurological complications such as Guillain-Barré syndrome.

Zika virus in Antigua and Barbuda

There is a risk of Zika virus in this country. Details of specific affected areas within this country are not available, but information on current outbreaks where available will be reported on our outbreak surveillance database.

Pregnant women should discuss the suitability of travel and the potential risk that Zika virus may present with their health care provider.

• All travellers should avoid mosquito bites particularly during daytime hours.
• There is no vaccination or medication to prevent Zika virus infection.
• Women should avoid becoming pregnant while travelling in this country, and for 2 months (8 weeks) after their last possible Zika virus exposure* (see below if male partner has travelled).
• If a woman develops symptoms compatible with Zika virus infection, it is recommended she avoids becoming pregnant for a further 2 months following recovery.
• Women who visited this country while pregnant, or who become pregnant within 2 months after their last possible Zika virus exposure*, should contact their GP, obstetrician or midwife for further advice, even if they have not been unwell.

Please note screening of returning travellers without Zika virus symptoms is not available on the NHS. Couples planning pregnancy in the very near future should consider whether they should avoid travel to a country or area with risk of Zika virus, rather than delay conception for the recommended period (see below) after travel. This particularly includes couples in assisted fertility programmes.

Prevention of sexual transmission

Couples should follow guidance on prevention of sexual transmission of Zika virus and avoid conception as follows:

• If both partners travelled, for 3 months after last possible Zika virus exposure*
• Male traveller only, for 3 months after last possible Zika virus exposure*
• Female traveller only, for 2 months after last possible Zika virus exposure*

See further information for pregnant women, their partners and couples planning pregnancy .

*Last possible Zika virus exposure is defined as the later of either the date of leaving a country or area with risk for Zika virus transmission, or the date on which unprotected sexual contact with a potentially infectious partner took place.

See detailed guidance on factors to consider when assessing the risk of Zika virus.

Zika virus in brief

COVID-19 disease is caused by the coronavirus SARS-CoV2. The main symptoms of COVID-19 are a new continuous cough, a high temperature, and a loss of, or change in, normal sense of taste or smell. Symptoms range from mild to life-threatening. Older people and  those with underlying health problems  are more likely to develop severe disease.

COVID-19 is spread through close contact with people who have the virus. It is mainly transmitted from person to person by breathing in droplets produced when someone infected with the virus breathes, speaks, coughs or sneezes. It is also spread by touching the infected droplets on surfaces, then touching the eyes, nose or mouth.

COVID-19 vaccines provide high levels of protection against severe illness, hospitalisation, or dying from the virus. Vaccination against COVID-19 reduces, but does not eliminate the risk of infection, so social distancing and personal and respiratory hygiene remain important interventions, particularly during overseas travel.

Travellers should always check the UK Foreign, Commonwealth & Development Office (FCDO) travel advice and their  country-specific pages  for the latest COVID-19 travel advisories which may include information on travel restrictions, quarantine, COVID-19 testing or vaccination requirements. This includes considering the recommendations and requirements for any transit countries.

Travellers should be aware that COVID-19 case numbers in individual countries/areas can increase rapidly, and healthcare capacity and country requirements can change at short notice.

COVID-19 in Antigua and Barbuda

Most countries worldwide present a risk of exposure to COVID-19. The risk of COVID-19, public health policy, and travel advice or restrictions may change quickly, therefore travellers should ensure they have access to up to date information on COVID-19 and be prepared for rapid changes in guidance both before and during travel.

All travellers should check the FCDO travel advice and carefully consider their personal situation and risks of COVID-19 before travel to this country. This is particularly important in those at higher risk from COVID-19 who may wish to seek medical advice before travel.

Individuals entering or returning to the UK may be required to follow additional  UK border measures .

If travelling to this country, travellers should:

• Consider the risk at all destinations including any transit countries, and the risk during travel itself.
• Check with the airline/tour operator about preventive measures in place to reduce risk during travel.
• Follow the latest guidance on social distancing and face coverings, including any local requirements and maintain good hand, respiratory, and personal hygiene at all times. This may be particularly important if staying with friends and family.
• Ensure they are up to date with their COVID-19 vaccination courses and boosters as recommended in the UK vaccination programme.

See  guidance on factors to consider when assessing the risk of COVID-19 for travellers .

If travellers develop COVID-19 symptoms while abroad, they should:

• Follow local guidelines on self-isolation, testing and avoiding travel.
• Contact their travel insurance provider.
• Seek medical advice if needed.

COVID-19 in brief

ICC Men's T20 Cricket World Cup 2024

Tournament in June 2024 will be co-hosted in the West Indies and the USA

Dengue: the Caribbean region

An increase in cases of dengue have been reported in the Caribbean region

Changes to the Country Information pages: Zika

UK Health Security Agency and NaTHNaC have reviewed and updated country-specific Zika information and prevention advice

Using information collated from a variety of sources, we regularly review and update information on overseas disease outbreaks and other health issues that may affect the UK traveller.

Please note that not all cases of disease or outbreaks are reported ; some diseases may only be reported if they occur outside of the usual recognised risk area or season, or they have been reported in greater than usual numbers.

Further information on the Outbreak Surveillance section.

Foreign travel advice

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Giottus, Veriscope join hands to augment crypto travel rule compliance

Bengaluru: Giottus, one of India's top crypto investment platforms, has announced its partnership with Shyft Veriscope to ensure FATF Travel Rule compliance. This strategic partnership underscores Giottus’ unwavering commitment to compliance, anti-money laundering, and combating financial terrorism (AML/CFT).

The move will help ensure a more transparent, secure, and safer environment for the investor community by making crypto transactions more traceable.

Giottus has already established itself as a reporting entity under the purview of the Financial Intelligence Unit (FIU-India) of the Union Ministry of Finance and is a member of the Alliance of Reporting Entities for AML/CFT (ARIFAC).

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Veriscope, the Shyft Network’s one-of-a-kind Travel Rule Solution, makes counterparty VASP discovery convenient and non-intrusive and allows VASP-to-VASP data transfer without the need for intermediate or third-party storage.

The FATF Travel Rule is a requirement for Virtual Digital Asset Service Providers (VDA-SPs). Under this rule, VDA-SPs must be able to identify and exchange data during crypto asset transfers. The entities also should be capable of assessing risks with counterparties, all the while ensuring that they transact with trusted parties. Giottus now becomes part of a global network of VASPs who can share data seamlessly and transact with confidence.

Vikram Subburaj, Giottus CEO, said since its inception in 2018, Giottus has been at the forefront of innovation and compliance in the Indian VDA space.

Zach Justein, Veriscope co-founder, shared similar enthusiasm: “This is a significant development for the entire crypto ecosystem, as with this integration, both Veriscope and Giottus are setting a new standard for unwavering commitment to safety, transparency, and user experience."

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Italy renews pro-Moscow push ahead of EU summit

Italy's Eurosceptic government is pushing for a reduction of tensions between the European Union and Russia but risks isolation in Brussels as EU partners seek instead stronger measures to deter Moscow from interfering in EU affairs.

Russia has been subjected to EU sanctions since the 2014 Ukraine crisis and Rome has long urged a relaxation of the penalties on the grounds that they have hit Italian firms trading with Moscow.In a new pro-Russia thrust, Italy is now calling on EU partners to back a plan to channel EU money to small Russian firms that operate in sectors not covered by existing EU sanctions on banking, defense and the energy industry, three diplomats told Reuters. That initiative preceded a two-day summit of EU leaders started yesterday in Brussels.

Rome is also resisting EU proposals to impose sanctions on countries that carry out cyber-attacks, in another move seen as being in favor of Moscow. Diplomats said the new EU sanctions regime would be aimed mostly at Russia, which has been in recent months at the center of allegations of elections meddling via social media in various Western states, as well as cyber warfare and security breaches conducted through electronic means.

Italy was the only EU member state that openly resisted the new sanctions regime, according to a confidential EU document seen by Reuters.

The diplomatic push in Brussels coincides with a visit of Italy's far right Deputy Prime Minister Matteo Salvini to Russia yesterday, the second since he was sworn in four months ago. Salvini, who leads Italy's co-ruling League party, is an admirer of Russian President Vladimir Putin and has rejected allegations of Russian meddling in Western elections. Polls show the League has multiplied its supporters in recent months also thanks to hardline slogans against the European Union. Italian Prime Minister Giuseppe Conte repeats calls for better relations with Russia. He is planning to fly to Moscow next week.

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Middle East latest: No concern expressed from Israel about UNRWA employees since 2011, review finds

An independent report commissioned after Israel alleged 12 UNRWA employees took part in the Hamas attacks has found Israel had not expressed concerns about anyone on the agency staff lists it gets annually for more than a decade.

Monday 22 April 2024 22:59, UK

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• No concerns expressed from Israel about UNRWA employees since 2011, report finds
• Rockets 'fired from Iraq towards US military base in Syria'
• Israeli intelligence head resigns over 7 October failings
• Dominic Waghorn: Reckoning in Israel after massive intelligence and military failure
• The big picture : What you need to know about the conflict in the Middle East right now
• Live reporting by Andy Hayes

We are pausing our coverage.

Thank you for reading - we will be back with more updates in the morning.

The prime minister of Pakistan has praised Iran's "strong stand on the issue of Palestine".

Shehbaz Sharif has welcomed Ebrahim Raisi, the president of Iran, to his country for a three-day visit.

"Pakistan is also with the Palestinians," Mr Sharif said.

In televised remarks, Mr Raisi said the deaths caused by the Israeli military in Gaza were being committed with the support of the United States and other Western countries.

Regarding international organisations - including the United Nations - he said: "They say they support human rights, but they proved that they are inefficient."

Iran recently launched an unprecedented missile and drone attack against Israel - after an alleged Israeli strike in Syria that killed two Iranian generals.

Pakistan is among countries that have no diplomatic relations with Israel because of the issue of Palestinian statehood.

By Alistair Bunkall , Middle East correspondent

It's taken 199 days for the first senior Israeli to resign over the Hamas attacks on 7 October.

Major General Aharon Haliva, Israel's military intelligence chief, said that under his command, the division "did not live up to the task we were entrusted with".

The argument that has kept military heads in post - one made by generals, intelligence chiefs and even Prime Minister Benjamin Netanyahu - is that judgement should be suspended while the war against Hamas is being fought. 

There is cold logic in that, but almost seven months in, and with no conclusion in sight, judgement day is nearing and more Israelis are demanding accountability for the failure of their leaders.

General Haliva isn't the only IDF commander to express regret - he is the first to fall on his sword, though.

Others have hinted they will, when the time is right. 

If they conclude that standing down is the honourable thing to do, then pressure will grow on Mr Netanyahu. 

He remains the one leader yet to acknowledge blame. 

It is unsustainable - although the prime minister's position is reasonably stable for now.

Tonight, Israelis are sitting down to a Jewish festival - Passover - with 132 people still being held hostage in Gaza and the defeat of Hamas looking increasingly unlikely. 

Major General Haliva's resignation will not bring Mr Netanyahu down, but it might be the first brick to come out of the wall. 

EU foreign ministers have agreed in principle to increase sanctions against Iran, the bloc's foreign policy chief Josep Borrell has said.

It follows Iran's unprecedented missile and drone attack against Israel on 13 April. 

There are already multiple European Union sanctions programmes against Iran.

These are for proliferation of weapons of mass destruction, human rights abuses, and supplying drones to Russia.

Several EU countries, however, have been calling for more sanctions regarding drones to cover missiles and transfers to proxy forces such as Hamas and Hezbollah.

"We have reached a political agreement in order to enlarge and expand the existing drone (sanctions) regime in order to cover missiles and their potential ... transfer to Russia," Mr Borrell told reporters following a meeting of EU foreign ministers in Luxembourg. 

Israel said that 99% of the objects launched towards it were shot down. 

More resignations are possible after the head of Israeli military intelligence stood down earlier today, our  international affairs editor Dominic Waghorn  has said.

Major General Aharon Haliva admitted he failed to foresee and prevent the Hamas attacks in Israel on 7 October.

Asked whether there could be more resignations, Waghorn said: "I think so, potentially."

It is worth remembering that a "number of IDF commanders and intelligence chiefs have admitted responsibility and declared mea culpas in the wake of 7 October", he added.

Mr Haliva had written "quite a long resignation letter saying the burden of what he has to bear after 7 October is something that will live with him all his life".

Waghorn added that there is a "reckoning" as Israel tries to work out what happened on 7 October, which was a "massive intelligence and military failure".

"There will be a commission of inquiry and investigation," Waghorn said.  

"It's the beginning of what will be a long and I think very painful process for Israel as it comes to terms with the failures that led to the worst loss of Jewish life since World War Two."

Israel did not express concerns about anyone on the UNRWA staff lists it received annually since 2011, an independent review has found.

The report was commissioned after Israel alleged that a dozen employees of the United Nations agency helping Palestinian refugees took part in the Hamas attacks in Israel on 7 October.

A number of countries, including the UK, froze donations to UNRWA as a result.

Some of those nations - and the EU - have since restored funding, but the UK has not.

The 48-page report said UNRWA has "robust" procedures to uphold the UN's principle of neutrality.

However, it said there were serious gaps in implementation, including staff publicly expressing political views, textbooks with "problematic content", and staff unions disrupting operations.

The report, led by French former foreign minister Catherine Colonna, said that between 2017 and 2022, allegations of neutrality being breached at UNRWA ranged annually from 7 to 55. 

Between January 2022 and February 2024, UN investigators received 151 allegations - most of them related to social media posts "made public by external sources", the report added.

It said UNRWA shares lists of staff with host countries for its 32,000 staff, including about 13,000 in Gaza. 

It added that Israeli officials never expressed concerns and informed panel members they did not consider the list to be a "screening or vetting process", but rather a procedure to register diplomats. 

The Israeli foreign ministry told the panel that until March 2024, staff lists did not include Palestinian identification numbers, the report said. 

Apparently based on those numbers, "Israel made public claims that a significant number of UNRWA employees are members of terrorist organizations", the panel said. 

It added: "However, Israel has yet to provide supporting evidence of this."

Multiple countries supported Israel as it defended itself against Iran's unprecedented attack on 13 April. 

Our  Middle East correspondent Alistair Bunkall explains the "surprising, informal collaboration" that has emerged in the region in this video...

US forces in Iraq and Syria have been targeted in two separate rocket and drone attacks in less than 24 hours, Reuters news agency reports, citing security sources and US officials.

At least one armed drone was launched at the Ain al Asad air base hosting US troops in the western Iraqi province of Anbar, a US official said.

That attack followed five rockets fired from Iraq yesterday towards US forces at a base in Rumalyn, northeastern Syria, according to US and Iraqi officials.

Referring to the rocket attack, Iraqi armed faction Kata'ib Hezbollah earlier denied it had resumed attacks on US forces after a three-month pause.

No casualties have been reported from the drone attacks.

On Saturday, a huge explosion at a military base in Iraq killed a member of an Iraqi security force that includes Iran-backed groups.

The force’s commander said it was an attack, while the army said it is investigating and there were no warplanes in the sky at the time.

The US denied involvement.

Mental illness could manifest among Palestinians in Gaza years from now, a UN expert has warned.

Tlaleng Mofokeng, UN special rapporteur on the right to health, warned it is "really important" to start considering the conflict's impact on the long-term wellbeing of Palestinians in Gaza.

"Of course, we see the physical injury, and because it's physical, one can appreciate the severity of it," she said.

"But acute mental distress that will then turn into anxiety and other kinds of mental illnesses later on in life is really, really important to start thinking intentionally about."

Ms Mofokeng said she is concerned about the risk of water and airborne diseases, and the lack of medical supplies, reproductive and mental health services in the territory.

"The health system in Gaza has been completely obliterated, and the right to health has been decimated at every level," she added.

Israeli troops have launched a surprise raid in the eastern part of Khan Younis in southern Gaza, Reuters is reporting.

Israel pulled its troops out of southern Gaza earlier this month, but their apparent return has caused residents to flee once more, the news agency added.

"They were too frightened," 42-year-old Ahmed Rezik said from a school where he is sheltering in the western part of Khan Younis.

"This morning many families who had left here in the past two weeks to go back home to Abassan came back," he told Reuters via a messaging app. 

"They said tanks pushed in the eastern area of the town under heavy fire, and they had to run for their lives."  

Meanwhile, Palestinian authorities said more bodies had been recovered from mass graves on the site of the city's main hospital, abandoned by Israeli troops (11.33 post).

Further south, there are reports of fresh air strikes in Rafah, where more than half the enclave's 2.3 million people have sought shelter.

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