High consequence infectious disease: country specific risk
Listing of countries with a known occurrence of high consequence infectious disease (HCID).
How to use this guidance
The information presented below is provided for health professionals wishing to determine if there is a known HCID risk in any particular country. It will be updated as new information arises.
The information is intended as a guide only. For any HCID, the risk will be greatest in countries that have reported laboratory-confirmed, locally acquired human cases, particularly recent cases. For countries where the only supporting evidence of an HCID is human serology data (which is often generated by studies of asymptomatic populations), the true risk may be lower and the data should be interpreted with caution.
HCID risk assessments should also consider other factors, including exposure histories, activities undertaken whilst travelling, and the areas visited within a country.
For any particular country, the absence of previously reported HCID cases does not mean that locally acquired HCIDs cannot occur in that country in the future,future if the necessary transmission factors are present;present. examplesExamples of first-ever reports include include:
-
Ebola in Guinea (reported
2014),2014) -
Crimean-Congo haemorrhagic fever (CCHF) in Spain (reported
2017),2017) -
severe
andfever with thrombocytopaenia syndrome (SFTS) in Vietnam and Taiwan (reported2019).2019)
Healthcare professionals wishing to discuss a possible HCID case should contact a local infection specialist (such as a consultant in infectious diseases, microbiology or virology) in the first instance.
Infection specialists should contact the Imported Fever Service about suspected HCID cases, as appropriate, and refer to the relevant UK Health Security Agency (UKHSA)(UKHSA) guidance (for which links are provided in the tables below).
Table Key
a) cases or serological data reported prior to 1990
b) even though there is a lack of available data, Balkan countries are presumed to be endemic for CCHF
c) unknown date
Countries A to D
Country | HCID Pathogen/Disease | Evidence |
---|---|---|
Afghanistan | CCHF | Human cases |
Plague | Human cases | |
Albania | CCHF | Human cases |
Algeria | Plague | Human cases |
American Samoa | No known HCIDs | |
Andorra | No known HCIDs | |
Angola | Marburg | Human cases |
Plague | Human cases | |
Anguilla | No known HCIDs | |
Antigua & Barbuda | No known HCIDs | |
Argentina | Junin virus | Human cases |
Andes virus | Human cases | |
Armenia | CCHF | Human serology (a) |
Australia | No known HCIDs | |
Austria | No known HCIDs | |
Azerbaijan | Avian influenza A(H5N1) | Human cases |
Bahamas, The | No known HCIDs | |
Bahrain | MERS | Human cases |
Bangladesh | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Nipah virus | Human cases | |
Barbados | No known HCIDs | |
Belarus | No known HCIDs | |
Belgium | No known HCIDs | |
Belize | No known HCIDs | |
Benin | CCHF | Human serology |
Lassa fever | Human cases | |
Bermuda | No known HCIDs | |
Bhutan | No known HCIDs | |
Bolivia | Plague | Human cases |
Machupo virus | Human cases | |
Bosnia & Herzegovina (b) | CCHF | Human serology (c) |
Botswana | CCHF | Human serology |
Plague | Human cases | |
Brazil | Plague | Human cases |
Brunei | No known HCIDs | |
Bulgaria | CCHF | Human cases |
Burkina Faso | Lassa fever | Human cases |
Burma (Myanmar) | Plague | Human cases |
SFTS | Human cases | |
Burundi | No known HCIDs | |
Cambodia | Avian influenza A (H5N1) | Human cases |
Cameroon | CCHF | Human serology |
Ebola | Human serology (a) | |
Mpox (monkeypox) | Human cases | |
Canada | No known HCIDs | |
Canary Islands | No known HCIDs | |
Cape Verde | No known HCIDs | |
Central African Republic | Ebola | Human serology (a) |
Lassa fever | Human serology (a) | |
Mpox | Human cases | |
Chad | Ebola | Human serology (a) |
Chile | Andes virus | Human cases |
China | Avian influenza A(H5N1) | Human cases |
Avian influenza A(H7N9) | Human cases | |
Avian influenza A(H5N6) | Human cases | |
CCHF | Human cases | |
Plague | Human cases | |
SARS | Human cases | |
SFTS | Human cases | |
Colombia | No known HCIDs | |
Comoros | No known HCIDs | |
Congo, Republic of the | CCHF | Human serology |
Ebola | Human cases | |
Lassa fever | Human serology | |
Mpox | Human cases | |
Cook Islands | No known HCIDs | |
Costa Rica | No known HCIDs | |
Cote d’Ivoire | CCHF | Human serology (c) |
Ebola | Human cases | |
Lassa fever | Human cases | |
Croatia | CCHF | Human cases (a) |
Cuba | No known HCIDs | |
Curacao | No known HCIDs | |
Cyprus | No known HCIDs | |
Czech Republic | No known HCIDs | |
Democratic Republic of the Congo | CCHF | Human cases |
Ebola | Human cases | |
Marburg | Human cases | |
Mpox | Human cases | |
Plague | Human cases | |
Denmark | No known HCIDs | |
Djibouti | No known HCIDs | |
Dominica | No known HCIDs | |
Dominican Republic | No known HCIDs |
Countries E to H
Country | HCID Pathogen/Disease | Evidence |
---|---|---|
Ecuador | Plague | Human cases |
Egypt | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Plague | Human cases (a) | |
El Salvador | No known HCIDs | |
Equatorial Guinea | CCHF | Human serology (a) |
Ebola | Human serology (a) | |
Eritrea | No known HCIDs | |
Estonia | No known HCIDs | |
Ethiopia | Ebola | Human serology (a) |
Fiji | No known HCIDs | |
Finland | No known HCIDs | |
France | No known HCIDs | |
French Guiana | No known HCIDs | |
French Polynesia | No known HCIDs | |
Gabon | Ebola | Human cases |
Mpox | Human cases | |
Gambia, The | CCHF | Human serology (c) |
Georgia | CCHF | Human cases |
Germany | No known HCIDs | |
Ghana | CCHF | Human serology |
Lassa fever | Human cases | |
Marburg | Human cases | |
Greece | CCHF | Human cases |
Greenland | No known HCIDs | |
Grenada | No known HCIDs | |
Guadeloupe | No known HCIDs | |
Guam | No known HCIDs | |
Guatemala | No known HCIDs | |
Guinea | Ebola | Human cases |
Marburg | Human case | |
Lassa fever | Human cases | |
Guinea-Bissau | CCHF | Human serology (c) |
Guyana | No known HCIDs | |
Haiti | No known HCIDs | |
Honduras | No known HCIDs | |
Hong Kong | SARS | Human cases |
Hungary | No known HCIDs |
Countries I to L
Country | HCID Pathogen/Disease | Evidence |
---|---|---|
Iceland | No known HCIDs | |
India | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Nipah virus | Human cases | |
Plague | Human cases | |
Indonesia | Avian influenza A(H5N1) | Human cases |
Iran | CCHF | Human cases |
MERS | Human cases | |
Iraq | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Plague | Human cases | |
Ireland | Avian influenza A(H7N7) | Human case |
Israel | No known HCIDs | |
Italy | Avian influenza A(H7N7) | Human cases |
Jamaica | No known HCIDs | |
Japan | SFTS | Human cases |
Jordan | MERS | Human cases |
Plague | Human cases | |
Kazakhstan | CCHF | Human cases |
Plague | Human cases | |
Kenya | CCHF | Human cases |
Ebola | Human serology (a) | |
Marburg | Human cases (a) | |
MERS | Human serology | |
Plague | Human cases | |
Kiribati | No known HCIDs | |
Korea, North | No known HCIDs | |
Korea, South | SFTS | Human cases |
Kosovo | CCHF | Human cases |
Kuwait | CCHF | Human cases |
MERS | Human cases | |
Kyrgyzstan | CCHF | Human cases |
Plague | Human cases | |
Laos | Plague | Human cases |
Avian influenza A(H5N6) | Human cases | |
Latvia | No known HCIDs | |
Lebanon | Plague | Human cases (a) |
Lesotho | CCHF | Human serology (c) |
Plague | Human cases (a) | |
Liberia | Ebola | Human cases |
Lassa fever | Human cases | |
Libya | Plague | Human cases |
Liechtenstein | No known HCIDs | |
Lithuania | No known HCIDs | |
Luxembourg | No known HCIDs |
Countries M to P
Country | HCID Pathogen/Disease | Evidence |
---|---|---|
Macau | No known HCIDs | |
Macedonia | CCHF | Human cases (a) |
Madagascar | Ebola | Human serology (a) |
Plague | Human cases | |
Malawi | Plague | Human cases |
Malaysia | Nipah virus | Human cases |
Maldives | No known HCIDs | |
Mali | CCHF | Human cases |
Lassa fever | Human cases | |
Malta | No known HCIDs | |
Marshall Islands | No known HCIDs | |
Mauritania | CCHF | Human cases |
Plague | Human cases (a) | |
Mauritius | No known HCIDs | |
Mexico | No known HCIDs | |
Micronesia | No known HCIDs | |
Moldova | CCHF | Human cases (a) |
Monaco | No known HCIDs | |
Mongolia | CCHF | Human serology |
Plague | Human cases | |
Montenegro (b) | CCHF | Presumed endemic |
Morocco | Plague | Human cases (a) |
Mozambique | CCHF | Human serology |
Plague | Human cases | |
Namibia | CCHF | Human cases |
Plague | Human cases | |
Nauru | No known HCIDs | |
Nepal | Avian influenza A(H5N1) | Human cases |
Plague | Human cases | |
Netherlands | Avian influenza A(H7N7) | Human cases |
New Zealand | No known HCIDs | |
Nicaragua | No known HCIDs | |
Niger | No known HCIDs | |
Nigeria | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Ebola | Human serology (a) | |
Lassa fever | Human cases | |
Norway | No known HCIDs | |
Oman | CCHF | Human cases |
MERS | Human cases | |
Pakistan | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Plague | Human cases | |
Palau | No known HCIDs | |
Panama | No known HCIDs | |
Papua New Guinea | No known HCIDs | |
Paraguay | No known HCIDs | |
Peru | Plague | Human cases |
Andes virus | Human serology | |
Philippines | No known HCIDs | |
Poland | No known HCIDs | |
Portugal | CCHF | Human serology (a) |
Puerto Rico | No known HCIDs |
Countries Q to T
Country | HCID Pathogen/Disease | Evidence |
---|---|---|
Qatar | MERS | Human cases |
Romania | No known HCIDs | |
Russia | CCHF | Human cases |
Plague | Human cases | |
Rwanda | No known HCIDs | |
Saint Kitts & Nevis | No known HCIDs | |
Saint Lucia | No known HCIDs | |
Saint Vincent and the Grenadines | No known HCIDs | |
Samoa | No known HCIDs | |
San Marino | No known HCIDs | |
Sao Tome & Principe | No known HCIDs | |
Saudi Arabia | CCHF | Human cases |
MERS | Human cases | |
Plague | Human cases | |
Senegal | CCHF | Human cases |
Plague | Human cases (a) | |
Serbia | CCHF | Human cases |
Seychelles | No known HCIDs | |
Sierra Leone | Ebola | Human cases |
Lassa fever | Human cases | |
Singapore | No known HCIDs | |
Sint Maarten | No known HCIDs | |
Slovakia | No known HCIDs | |
Slovenia (b) | CCHF | Presumed endemic |
Solomon Islands | No known HCIDs | |
Somalia | No known HCIDs | |
South Africa | CCHF | Human cases |
Plague | Human cases (a) | |
South Sudan | CCHF | Human serology (c) |
Ebola | Human cases | |
Spain | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Sri Lanka | No known HCIDs | |
State of Palestine | No known HCIDs | |
Sudan | CCHF | Human cases |
Suriname | No known HCIDs | |
Swaziland | CCHF | Human serology (c) |
Sweden | No known HCIDs | |
Switzerland | No known HCIDs | |
Syria | Plague | Human cases (a) |
Taiwan | SARS | Human cases |
SFTS | Human cases | |
Tajikistan | CCHF | Human cases |
Tanzania | CCHF | Human serology (a) |
Ebola | October 2019: probable human case | |
Plague | Human cases | |
Thailand | ||
Timor-Leste | No known HCIDs | |
Togo | Lassa fever | Human cases |
Tonga | No known HCIDs | |
Trinidad & Tobago | No known HCIDs | |
Tunisia | CCHF | Human serology |
Plague | Human cases (a) | |
Turkey | Avian influenza A(H5N1) | Human cases |
CCHF | Human cases | |
Turkmenistan | Plague | Human cases |
Tuvalu | No known HCIDs |
Countries U to Z
Country | HCID Pathogen/Disease | Evidence |
---|---|---|
Uganda | CCHF | Human cases |
Ebola | Human cases | |
Lassa fever | Human serology (a) | |
Marburg | Human cases | |
Plague | Human cases | |
Ukraine | CCHF | Human cases |
United Arab Emirates | CCHF | Human cases |
MERS | Human cases | |
United Kingdom | Avian influenza A(H5N1) | Human case |
United States | Avian influenza A(H5N1) | Human case |
Plague | Human cases | |
Uruguay | No known HCIDs | |
Uzbekistan | CCHF | Human cases |
Plague | Human cases | |
Vanuatu | No known HCIDs | |
Venezuela | No known HCIDs | |
Vietnam | Avian influenza A(H5N1) | Human cases |
Plague | Human cases | |
SFTS | Human cases | |
Western Sahara | No known HCIDs | |
Yemen | MERS | Human cases |
Plague | Human cases (a) | |
Zambia | Plague | Human cases |
Lujo virus | Human cases | |
Zimbabwe | CCHF | Human serology (a) |
Ebola | Human serology (a) | |
Marburg | Human cases (a) | |
Plague | Human cases |
Last updated
-
Updated list of HCIDs.
-
Updated list of HCIDs.
-
Updated list of HCIDs.
-
Removed COVID-19 from the listing.
-
Added Wuhan novel coronavirus to China, and SFTS to Taiwan.
-
Added Ebola to Tanzania listing.
-
Added avian influenza H5N1 to Nepal.
-
Sources of evidence for each country reviewed and updated.
-
First published.
Update history
2025-03-20 09:30
Mpox (clade I) has been removed due to derogation as a HCID. Ebola (Sudan virus) in Uganda has been updated for the current 2025 outbreak.
2025-02-20 13:59
Updated the year to 2025 for several infections across several countries. Updated Mpox clade I transmission in Kenya, Rwanda and Zambia to community transmission. Added Ireland, South Sudan and United Arab Emirates to Mpox clade I imported cases.
2025-01-31 14:38
Updated Uganda ebola status.
2025-01-30 16:28
Updated mpox information.
2025-01-16 11:05
Mpox (Clade I) has been amended for Cameroon from 2024 to 2022 to align with the last confirmed reports of clade I mpox.
2025-01-16 09:30
Belgium, China, France, Oman and Pakistan updated to reflect detection of Mpox (clade I) over December 2024 and January 2025.
2024-12-19 14:06
Updated information for Canada, Germany, Philippines, Rwanda and Zambia.
2024-11-27 09:30
Updated HCID risks for November 2024.
2024-10-14 17:32
Addition of section on where to find the most up to date information on the clade I mpox affected countries.
2024-10-01 15:37
We have updated the Rwanda entry of the ## Countries Q to T section. The update now includes “Marburg – limited information – 2024”.Change is to provide an updated list following the ongoing Marburg virus disease incident in Rwanda
2024-08-15 17:08
Updated countries as per the latest monthly summary of HCIDs. Table key updated to (e) Unknown or limited information. Mpox Clade I countries updated: Burundi, Central African Republic, Kenya, Rwanda, UgandaIndia: Nipah (year) updatedSierra Leone: Lassa fever (year) updated
2024-08-01 09:30
All HCIDs in countries listed have been reviewed to ensure they reflect the latest information available
2023-01-24 16:09
Updated list of HCIDs.
2022-12-12 13:56
Updated list of HCIDs.