Includes health and sanitation standards within the country, as well as any potential health risks that businesspeople should be aware of. Includes any mandatory or highly recommended vaccinations.
Last Published: 8/2/2017

One of the major challenges for all travelers to India is staying healthy.  While adequate to excellent medical care is available in the major population centers, it is usually very limited or unavailable in rural areas, so it is important to take precaution to avoid getting sick in the first place.  Most important is to wash your hands at every opportunity with warm soapy water for at least 20 seconds.  Dry them with a paper towel and use the towel to turn off faucet handles.

Wash your hands particularly before you handle food, after you handle food, before you eat, and also before you touch your face.

Use an alcohol hand sanitizer when you cannot get to a faucet.

Water and Ice:  Do not drink hotel or restaurant water.  Only bottled water, soft drinks, beer, wine, hot tea and coffee are considered safe.  Order all drinks without ice.

Meat and Fish:  All meat and fish should always be cooked well done, ordered well done in restaurants, and eaten hot to prevent illness.

Salads, unpeeled fruit and vegetables:  Generally, it is not safe to eat unpeeled fruit and vegetables.  But if you are so inclined, you can prepare them properly in your hotel room (see below).  As beautiful as some of the salad bars look, they should be totally avoided in restaurants and in homes where you are not certain about the kitchen practices. People get sick from salad bars, even those in 5 star hotel restaurants.

Buy only fruits and vegetables without holes or broken skin.

Wash all fruits and vegetables with soap and warm water. Clean each with a vegetable brush to remove dirt. Rinse in cold tap water.  Soak all fruits and vegetables for 20 minutes in a 5% bleach solution. Prepare 5% bleach by adding one tablespoon of Clorox (household bleach, U.S. or foreign) to one gallon of water. Rinse the fruits and vegetables with potable bottled water.  Drain and allow to dry before refrigerating.

Local milk: The medical staff of the U.S. Embassy does not recommend drinking local milk. In restaurants milk added to tea or coffee is boiled and therefore considered safe.  To be sure, ask if the milk has been boiled.

Diarrhea is  usually  caused  by  ingesting  food  or  water  containing  viruses,  parasites, bacteria, or bacterial toxins.   Hands (yours or someone else's), non-potable water and contaminated raw fruits and vegetables are the usual vehicles that carry the offending agent(s) into your mouth and then into the intestinal tract.  Diarrhea can be treated with supportive measures.  Pepto-Bismol is quite effective in most cases.  The routine use of Lomotil, Imodium, or antibiotics is discouraged.  If diarrhea persists for longer than 24 hours or any of the symptoms of dysentery develop, you should seek medical care.

As  the  treatment  for  diarrhea  varies  depending  on  its  etiology  (bacteria,  giardia,  amoeba,  etc.),  it  is preferable to identify the cause and take only those medications truly necessary.   Most diarrhea is self- limited and will resolve in 3–5 days.
In addition to any medications used for diarrhea, it is important to replace the fluid lost in the stool in order to maintain adequate hydration.  Many  of  the  symptoms  are  due  to  fluid  and  electrolyte  (salts)  loss.  If adequate fluids cannot be taken, medical advice should be sought.

To replace lost fluids and electrolytes, you should consume large amounts of liquids, especially Oral Rehydration Solution (ORS).  ORS packets are available in most upscale hotels.  Other helpful fluids include soft drinks and clear soup.  Eat a bland diet (bananas, rice, apple sauce, and toast).  Avoid dairy products until recovery occurs.

Seek medical care in the following cases:
• Diarrhea is accompanied by blood
• Diarrhea persists for more than 48 hours
• Vomiting persists
• Cramps are severe and/or are accompanied with persistent abdominal pain
• Persistent fever over 101 degrees F
• Noticeably reduced urinary output or loss of weight

Most individuals rely on their thirst mechanism to "tell" them when to drink.  In temperate climates this is adequate, but the thirst mechanism can become inadequate in tropical climates and individuals can become chronically dehydrated.  You should drink at least 2 quarts (8 glasses) of non-alcoholic beverages daily to assist your body in maintaining a good fluid balance.  Remember that alcohol is a dehydrating agent and can actually increase risk.

Parasitic Diarrheal Infections are quite common throughout most of India.  The two most common types are amoebiasis and giardiasis.  Diagnosis and treatment require stool examinations.

Many amoebic infections are without symptoms.   Symptomatic cases may present with mild abdominal discomfort and diarrhea alternating with periods of constipation or acute dysentery with fever, chills, and bloody or mucoid diarrhea.

Giardiasis, while often asymptomatic, may also be associated with a variety of symptoms such as abdominal discomfort, bloating, vomiting, loose malodorous stools, fatigue, and weight loss.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection and malaria information, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s Internet site at http://wwwnc.cdc.gov/travel/destinations/india.htm. For information about outbreaks of infectious diseases abroad consult the World Health Organizations (WHO) website at Further health information for travelers is available online.

Indian health regulations require all travelers arriving from Sub-Saharan Africa or other yellow-fever areas to have evidence of vaccination against yellow fever.  Travelers who do not have such proof are subject to immediate deportation or a six-day detention in the yellow-fever quarantine center.  U.S. citizens, who transit through any part of sub-Saharan Africa, even for one day, are advised to carry proof of yellow fever immunization.

Medical insurance: Americans should consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.  Please see information on medical insurance overseas.

We strongly recommend supplemental insurance to cover medical evacuation.
 

Prepared by our U.S. Embassies abroad. With its network of 108 offices across the United States and in more than 75 countries, the U.S. Commercial Service of the U.S. Department of Commerce utilizes its global presence and international marketing expertise to help U.S. companies sell their products and services worldwide. Locate the U.S. Commercial Service trade specialist in the U.S. nearest you by visiting http://export.gov/usoffices.



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