Travel Vaccines and Advice for Cambodia

• Typhoid – Typhoid, caused by Salmonella Typhi, is primarily transmitted through tainted food and water. Protection against this disease involves vaccination combined with good hygiene and careful food consumption.
• Hepatitis A – Hepatitis A is a contagious liver infection caused by the hepatitis A virus, typically spread through ingestion of contaminated food or water, or close contact with an infected person. Symptoms include fatigue, stomach pain, and jaundice. The hepatitis A vaccine provides effective prevention against the virus. It is administered in a series of shots, usually starting in childhood, and is recommended for travel to areas with high infection rates.
• Japanese Encephalitis – Japanese encephalitis is transmitted by mosquitoes and causes neurological issues. It can be prevented through mosquito management, protective attire, and vaccination. Vaccination is key to prevention for travelers to effected regions.
• Chikungunya – Chikungunya, carried by Aedes mosquitoes, can be prevented through use of repellents, netting and vaccination.
• Rabies – Rabies is a life-threatening viral infection transmitted primarily through bites and scratches from infected animals. Vaccination is the key to prevention, offering pre-exposure protection to high-risk individuals and post-exposure treatment for those exposed to rabies.
• Hepatitis B – The hepatitis B virus causes liver infection, spreading through contact with infected bodily fluids. Prevention measures include safe practices and, notably, hepatitis B vaccination. This vaccine effectively triggers the immune system to produce antibodies, offering reliable, long-term protection against the virus.
• Measles, Mumps, Rubella (MMR) – Measles, mumps, and rubella are viral infections that can spread through close contact and respiratory droplets. Vaccination is the most effective way to halt their transmission. The MMR vaccine, given in two doses, strengthens immunity, reducing the chances of contracting and spreading these diseases.

Malaria is present in all regions of Cambodia. Travelers are advised to take antimalarials to protect themselves from infection. Atovaquone, doxycycline and tafenoquine are recommended for travelers to the region. Malaria parasites in Cambodia are resistant to chloroquine and mefloquine. Speak with your travel health specialist to identify which antimalarial is best for your trip and medical history.

Mosquito-borne diseases are the biggest health risk for travelers to Cambodia. The country has dengue, chikungunya, Zika, Japanese encephalitis and malaria in certain regions.

Follow these precautions:

• Apply an EPA-registered insect repellent to exposed skin throughout the day.
• Reapply repellent every few hours.
• Treat items with permethrin before you leave home.
• Sleep under a mosquito net if your accommodations lack air conditioning or window screens.

Repellent and protective clothing lower your risk, but they don’t replace malaria medication or vaccinations. Travelers heading into rural regions or staying for more than a month should ask a Passport Health specialist which protections fit their itinerary.

Travelers’ diarrhea and foodborne illness are the most common health complaints among travelers.

While in Cambodia, stick to bottled, sealed water for drinking and brushing your teeth. Check that the seal is intact before you buy. Skip ice unless you know it was made from purified water. Tap water in Phnom Penh and Siem Reap may be treated, but standards vary elsewhere. Bottled water is the safer default everywhere in the country.

A meal at an established restaurant carries far less risk than the same dish from a street cart, even if they look identical. Choose food that’s served hot and freshly cooked. Be cautious with raw fruits and vegetables you haven’t washed or peeled yourself.

Typhoid fever is endemic in Cambodia, and antibiotic-resistant strains are common. The above actions can lower your risk, but they don’t replace vaccination. The CDC recommends the typhoid vaccine for most travelers, and hepatitis A for all travelers.

Bottled water and packaged snacks are easy to find in Phnom Penh and Siem Reap. Pack a water purification method as backup if your itinerary heads off the main tourist route.

• Dengue – Dengue is the mosquito-borne disease most likely to affect travelers to Cambodia. It spreads year-round with cases rising during the rainy season from May through October. Watch for high fever, and seek care quickly as dengue can be severe.
• Hantavirus – The CDC lists hantavirus as a risk in Cambodia. It spreads by breathing in air or eating food contaminated with the urine, droppings, or saliva of infected rodents, or through a rodent bite. Person-to-person spread is rare. Keep food sealed and avoid contact with rodent droppings, especially in enclosed spaces.
• Leptospirosis – This bacterial infection spreads through water or soil contaminated with infected animal urine, and cases in Cambodia climb during the rainy season from May through October. Avoid wading or swimming in flooded areas, and cover open cuts before you’re near freshwater or mud.
• Melioidosis – This bacteria lives in Cambodia’s soil and water, and infections rise during the same rainy-season floods that drive leptospirosis. People with diabetes or open wounds face higher risk. Wear boots around wet soil, and clean any cuts right away if they contact water or mud.
• Schistosomiasis – This parasite lives in freshwater snails, and the CDC identifies the Mekong River basin near Kratie province as a risk area, popular with travelers hoping to see freshwater dolphins. Skip swimming or wading in rivers, lakes, and ponds, and see a doctor if a rash develops after freshwater contact.
• Tuberculosis – Cambodia has one of the region’s highest rates of active tuberculosis. It spreads through the air when someone with the disease coughs or speaks nearby. Short trips carry little risk, but long stays or work in hospitals, prisons or crowded shelters raise the risk of infection. See a doctor about testing before and after this kind of trip.
• Zika – Zika has circulated in Cambodia at low levels since 2010. The virus spread mainly through mosquito bites and, less often, through sex. Infection during pregnancy can cause serious birth defects. Pregnant travelers or those trying to conceive should talk to a travel health specialist before the trip and use mosquito repellent throughout.