Food and water-borne diseases are considered a high risk on the sub-Continent, where standards of sanitation and hygiene can vary widely, particularly during or just after the monsoon season (July to September). Hepatitis A, Typhoid and Traveller’s diarrhoea (TD) are common in India. TD even has its own local name – Delhi Belly. Insect-borne diseases such as dengue fever, chikungunya fever and malaria are also present (see below).
Other health and safety issues include traffic accidents, animal bites, and personal security.

While there are no mandatory vaccinations for travel to India, several should be considered, including:
Hepatitis A is common in India. Vaccination is recommended, even a short stay of two weeks – more strongly for longer stays. The disease is a moderate to high risk to travellers of any age, regardless of their itinerary or standard of accommodation.
Hepatitis B is also common. The vaccine can be administered singly or combined with Hep A vaccine. (At least two shots a month apart are necessary before travel, so act early!) The risk of Hep B lies in transmission through contaminated needles or syringes, unprotected sex, tattooing, piercing, pedicures etc. as well as adventurous physical activities involving a risk of injury.
Typhoid is a low to moderate risk and vaccination is recommended, particularly as drug-resistant typhoid is present in India. Like Hep A, typhoid is transmitted by contaminated food and water.
Influenza vaccination is recommended. Flu poses a seasonal travel risk through close contact with other fans and local people. There has been a resurgence of swine flu in southern India during the current monsoon (see alert). This year’s seasonal flu vaccine contains the strain for H1N1 (Swine flu). Minimise the risk of respiratory illnesses by avoiding people with a persistent cough, and through sound sanitation and hygiene practices. Wash your hands regularly before and after eating, particularly after visiting rest rooms, and after touching bus/train seats and stadium railings, door handles, ATMs etc.
Rabies vaccination is not recommended for short stays. However, the disease is present throughout India and travellers should avoid contact with animals. Urgent medical assistance is essential if you are bitten or scratched.
Measles, mumps, whooping cough and polio make up the list of so-called childhood vaccinations and all travellers should update their protection through first-time vaccinations or boosters.

Other travel health issues for India
Malaria: There is risk in all areas under 2000 metres. The disease is present in Dehli so travellers to the region should discuss their itinerary, the need (or not) for preventative malaria medication, with their healthcare provider or with a travel health professional at a Travelvax clinic.
STDs: There are high rates of sexually transmitted diseases, including HIV-AIDS, and Hep B and C, in India and unprotected sex carries a high risk of transmission.
Travellers’ diarrhoea (TD): TD-causing gastro bugs are the main risk for Commonwealth Games visitors. Travellers should carry self-treatment medication and those prone to TD should consider the oral cholera vaccine, which also offers good protection against a common cause of TD.
Taking simple precautions with food, beverages and personal hygiene is important. Here are the golden rules:
• Avoid buying food and beverages from street vendors and places where you suspect hygiene is lacking. Tap water, ice, unpasteurised milk, and dairy products are especially risky, while bottled carbonated beverages, hot tea or coffee, beer, wine, and water that has been boiled or treated are much safer.
• Do not eat raw or undercooked meat and seafood (purchased anywhere).
• Avoid raw fruit and vegetables unless you buy them whole and peel them yourself.
• If handled hygienically, well-cooked and packaged foods are safe.
Health care: There is no reciprocal health care agreement between India and Australia and travellers are strongly advised to obtain comprehensive medical insurance that includes cover for medical evacuation.
In urban areas, medical facilities usually meet international standards, but may be costly. In rural and remote areas, healthcare services may be basic.
Carry an advanced travel first-aid kit if you are planning extensive travel throughout India, including needles and syringes, as the standard of medical services can vary widely.

CHECKLIST
Before you go and while you are there …
The Australian Government warns of high levels of violent crime in India and advises Australians to ensure their personal safety at all times (smartraveller).

Smartraveller also recommends visitors:
• Register their travel and contact details before departure, so they can be contacted in an emergency https://www.orao.dfat.gov.au/orao/weborao.nsf/homepage?Openpage.
• Subscribe to emailed travel safety and security advisories for details of changing conditions.
• Take out comprehensive travel insurance.
• Know embassy contact details for assistance.