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. Data prior to 1970 is not included.
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 if the necessary transmission factors are present.present Examples(for ofexample, first-everknown reportsvectors include:
EbolaorinpotentialGuinea(reported2014)Crimean-Congohaemorrhagicfever(CCHF)inSpain(reported2017)severefeverwiththrombocytopaeniasyndrome(SFTS)inVietnamandTaiwan(reported2019)
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) guidance (for which links are provided in the tables below).
Table Keykey
a) casesCommunity transmission or serologicaltransmission datafrom reporteda priorreservoir to(for 1990example, zoonotic)
b) evenLimited thoughlocal theretransmission isassociated awith lackan ofimported availableor data,laboratory Balkanacquired countriescase are(for presumedexample, toan beimported endemiccase forwith CCHFsubsequent household transmission)
c) unknownImported dateor laboratory acquired case with no onward transmission
d) Human serology (for example, from serological studies). To note: Whilst serological evidence indicates previous exposure to a pathogen, the exposure may not necessarily have occurred in the reporting country
e) Unknown
Countries A to D
Country or territory |
HCID |
Evidence | Year |
---|---|---|---|
Afghanistan | CCHF | 2024 | |
Plague | 2007 | ||
Albania | CCHF | 2001 | |
Algeria | 2014 | ||
(a) |
|||
Andorra | No known HCIDs | ||
Angola | Marburg | 2004 | |
Plague | 1981 | ||
Anguilla | No known HCIDs | ||
Antigua |
No known HCIDs | ||
Argentina | Junin virus | 2024 | |
Andes virus | 2019 (with isolated case(s) in 2024) | ||
Armenia | CCHF | 1974 | |
Australia | No known HCIDs |
||
Avian influenza A(H5N1) | (c) Imported case(s) only | 2024 | |
SARS | (c) Imported case(s) only | 2003 | |
Austria | No known HCIDs |
||
MERS | (c) Imported case(s) only | 2016 | |
Azerbaijan | Avian influenza A(H5N1) | 2006 | |
No known HCIDs |
|||
MERS | 2016 | ||
SARS | (c) Imported case(s) only | 2003 | |
Bangladesh | Avian influenza A(H5N1) | 2008 | |
2024 | |||
1994 | |||
Barbados | No known HCIDs | ||
Belarus | No known HCIDs | ||
Belgium | No known HCIDs |
||
Junin virus | (c) Imported case(s) only | 2020 | |
Belize | No known HCIDs | ||
Benin | Ebola | (d) Human serology | 1983 |
CCHF | (d) Human serology | 1983 | |
Lassa fever | 2023 | ||
Bermuda | No known HCIDs | ||
Bhutan | No known HCIDs | ||
Bolivia | Plague | 2018 | |
Machupo virus | 2013 | ||
Bosnia |
|||
Botswana | 1990 | ||
Plague | 2005 | ||
Brunei | No known HCIDs | ||
Bulgaria | CCHF | 2020 | |
Burkina Faso | |||
2017 | |||
Burundi | No known HCIDs | ||
Cambodia | Avian influenza |
2024 | |
Cameroon | CCHF | 2008 | |
Ebola | (d) Human serology |
2012 | |
Mpox |
2024 | ||
Canada | (c) Imported case(s) only | 2014 | |
Avian influenza A(H7N9) | (c) Imported case(s) only | 2015 | |
SARS | (a) |
2003 | |
Cape Verde | No known HCIDs | ||
No known HCIDs | |||
Central African Republic | CCHF | (d) Human serology | 2012 |
Ebola | (d) Human serology |
1995 | |
Lassa fever | (d) Human serology |
1993 | |
Mpox (Clade I) | 2024 | ||
Chad | Ebola | (d) Human serology |
1987 |
Chile | Andes virus | 2024 | |
Avian influenza A(H5N1) | (a) Community or zoonotic transmission | 2023 | |
China | Avian influenza A(H5N1) | 2024 | |
Avian influenza A(H7N9) | 2019 | ||
Avian influenza A(H5N6) | 2024 | ||
CCHF | 2023 | ||
MERS | (c) Imported case(s) only | 2015 | |
Plague | 2022 | ||
SARS | 2004 | ||
SFTS | 2023 | ||
Colombia | No known HCIDs | ||
Comoros | No known HCIDs | ||
CCHF | (d) Human serology | 1976 | |
Ebola | 2003 | ||
Lassa fever | - | ||
Mpox (Clade I) | 2024 | ||
(a) |
|||
(a) |
|||
- | |||
1998 | |||
2024 | |||
2024 | |||
No known HCIDs | |||
No known HCIDs | |||
No known HCIDs | |||
No known HCIDs | |||
Denmark | No known HCIDs | ||
Djibouti | 2023 | ||
Dominica | No known HCIDs | ||
Dominican Republic | No known HCIDs |
Countries E to H
Country or territory |
HCID |
Evidence | Year |
---|---|---|---|
East Timor | No known HCIDs | ||
Ecuador | Avian influenza A(H5N1) | (a) Community or zoonotic transmission | 2023 |
Plague | 1998 | ||
Egypt | Avian influenza A(H5N1) | 2017 | |
CCHF | 2012 | ||
2014 | |||
El Salvador | No known HCIDs | ||
Equatorial Guinea | CCHF | (d) Human serology |
1985 |
Ebola | (d) Human serology |
1987 | |
Marburg | (a) Community transmission | 2023 | |
Eritrea | No known HCIDs | ||
Estonia | No known HCIDs | ||
Eswatini | No known HCIDs | ||
Ethiopia | Ebola | (d) Human serology |
1983 |
No known HCIDs | |||
No known HCIDs | |||
No known HCIDs | |||
No |
|||
SARS | (c) Imported case(s) only | 2003 | |
France | No known HCIDs |
||
Lassa fever | (c) Imported case(s) only | 2024 | |
MERS | (b) Limited local transmission (associated with a case import) | 2013 | |
SARS | (c) Imported case(s) only | 2003 | |
French |
No known HCIDs | ||
Gabon | Ebola | 2001 | |
Mpox (Clade I) | 1991 | ||
CCHF | 2023 | ||
No known HCIDs; travel associated case(s) as below | |||
CCHF | 2009 | ||
(b) |
2016 | ||
MERS |
(c) Imported case(s) only | 2015 | |
SARS | (c) Imported case(s) only | 2003 | |
Ghana | CCHF | (d) Human serology | 2011 |
Lassa fever | 2023 | ||
Marburg | 2022 | ||
Gibraltar | No known HCIDs | ||
Greece | CCHF | 2008 (with serology in 2012) | |
MERS | (c) Imported case(s) only | 2014 | |
Greenland | No known HCIDs | ||
Grenada | No known HCIDs | ||
Guadeloupe | No known HCIDs | ||
Guam | No known HCIDs | ||
Guatemala | No known HCIDs | ||
Guinea | Ebola | 2021 | |
Marburg | 2021 | ||
Lassa fever | 2024 | ||
Guinea-Bissau | |||
Guyana | No known HCIDs | ||
Haiti | No known HCIDs | ||
Honduras | No known HCIDs | ||
Hong Kong | Avian influenza A(H5N1) | (a) Community or zoonotic transmission | 1997 |
Avian influenza A(H7N9) | (c) Imported case(s) only | 2019 | |
SARS | 2003 | ||
Hungary | No known HCIDs |
Countries I to L
Country or territory |
HCID |
Evidence | Year |
---|---|---|---|
Iceland | No known HCIDs | ||
India | Avian influenza A(H5N1) | 2021 | |
CCHF | 2023 | ||
Nipah virus | 2023 | ||
Plague | 2002 | ||
SARS | (a) Imported case(s) only | 2003 | |
Indonesia | Avian influenza A(H5N1) | 2017 | |
Plague | (a) Community transmission (not reported whether bubonic or pneumonic) | 2007 | |
SARS | (c) Imported case(s) only | 2003 | |
Iran | CCHF | 2024 | |
MERS | 2015 | ||
Iraq | Avian influenza A(H5N1) | 2006 | |
CCHF | 2024 | ||
Ireland | No known HCIDs; travel associated case(s) as below | ||
SARS | 2003 | ||
No known HCIDs; travel associated case(s) as below | |||
Lassa fever | (c) Imported case(s) only | 1988 | |
Italy | Avian influenza A(H7N7) | 2013 | |
No other known HCIDs |
|||
(c) |
2015 | ||
MERS | (c) Imported case(s) only | 2003 | |
SARS | (c) Imported case(s) only | 2013 | |
Ivory Coast | Ebola | (a) Community transmission | 1994 |
Lassa fever | (d) Human |
2008 | |
Jamaica | No known HCIDs | ||
Japan | SFTS | 2023 | |
Jordan | MERS | 2023 | |
Plague | 1997 | ||
Kazakhstan | CCHF | 2024 | |
Plague | 2003 | ||
Kenya | CCHF | 2020 | |
Ebola | (d) Human serology |
1983 | |
Marburg | 1987 | ||
MERS | 2019 | ||
Plague | |||
No known HCIDs | |||
2016 | |||
CCHF | (d) Human |
1982 | |
2015 | |||
2003 | |||
Kyrgyzstan | CCHF | 2021 | |
Plague | 2013 | ||
Laos | 2020 | ||
Avian influenza A(H5N6) | 2021 | ||
Plague | (a) Community transmission (not reported whether bubonic or pneumonic) | 1996 | |
Latvia | No known HCIDs | ||
Lebanon | |||
2017 | |||
Liberia | Ebola | 2014 | |
Lassa fever | 2024 | ||
Libya | Plague | 2009 | |
Liechtenstein | No known HCIDs | ||
Lithuania | No known HCIDs | ||
Luxembourg | No known HCIDs |
Countries M to P
Country or territory |
HCID |
Evidence | Year |
---|---|---|---|
Macau | No known HCIDs |
||
SARS | (c) Imported case(s) only | 2003 | |
Madagascar | CCHF | (d) Human |
2008 |
Ebola | (d) Human serology |
1989 | |
Plague | 2024 | ||
Malawi | Plague | 2002 | |
Malaysia | Avian influenza A(H7N9) | (c) Imported case(s) only | 2014 |
MERS | (c) Imported case(s) only | 2018 | |
Nipah virus | 1999 | ||
SARS | (c) Imported case(s) only | 2003 | |
Maldives | No known HCIDs | ||
Mali | CCHF | 2020 | |
Ebola | (b) Limited local transmission (associated with a case import) | 2014 | |
Lassa fever | 2019 | ||
Malta | No known HCIDs | ||
No known HCIDs | |||
Mauritania | CCHF | 2023 | |
No known HCIDs | |||
No known HCIDs | |||
No known HCIDs | |||
CCHF | (d) Human |
2018 | |
Plague | (a) Community transmission (bubonic) | 2023 | |
SARS | (b) Limited local transmission (associated with a case import) | 2003 | |
Montserrat | No known HCIDs | ||
Plague | 1977 | ||
CCHF | 2016 | ||
Plague | 1997 | ||
2007 | |||
Plague | 2010 | ||
SFTS | Community transmission | 2019 | |
Namibia | CCHF | 2023 | |
Plague | 1999 | ||
Nauru | No known HCIDs | ||
Nepal | Avian influenza A(H5N1) | 2019 | |
Netherlands | Avian influenza A(H7N7) | (a) Community or zoonotic transmission | 2003 |
Lassa fever | 2019 | ||
(c) |
2008 | ||
MERS | 2014 | ||
New |
No known HCIDs | ||
New Zealand | No known HCIDs; travel associated case(s) as below | ||
SARS | (c) Imported case(s) only | 2003 | |
Nicaragua | No known HCIDs | ||
Niger | No known HCIDs | ||
Nigeria | Avian influenza A(H5N1) | 2007 | |
CCHF | 2014 (human serology 2019) | ||
Ebola | 2014 | ||
Lassa fever | 2024 | ||
North Korea | No known HCIDs | ||
North Macedonia | CCHF | (a) Community transmission | 2024 |
Norway | No known HCIDs | ||
Occupied Palestinian Territories | No known HCIDs | ||
Oman | CCHF | 2017 | |
MERS | 2023 | ||
Pakistan | Avian influenza A(H5N1) | 2007 | |
CCHF | 2024 | ||
Plague | 1994 | ||
(d) |
|||
Panama | No known HCIDs | ||
Papua New Guinea | No known HCIDs | ||
Paraguay | No known HCIDs | ||
Peru | Andes virus | (d) Human serology | 2012 |
Plague | 2018 | ||
Philippines | No known HCIDs; travel associated case(s) as below | ||
MERS | (c) |
2015 | |
SARS | 2003 | ||
No known HCIDs | |||
Poland | No known HCIDs | ||
Portugal | CCHF | (d) Human serology |
1980 |
Puerto Rico | 2003 |
Countries Q to T
Country or territory |
HCID |
Evidence | Year |
---|---|---|---|
Qatar | MERS | 2022 | |
Réunion | No known HCIDs | ||
Romania | No known HCIDs | ||
Russia | CCHF | 2024 | |
Ebola | (c) Laboratory acquired case(s) | 2004 | |
Marburg | (c) Laboratory acquired case(s) | 1990 | |
Plague | 2016 | ||
SARS | (e) Unknown | 2003 | |
Rwanda | Plague | (a) Community transmission (bubonic) | 1994 |
St Helena, Ascension and Tristan da Cunha | No known HCIDs | ||
No known HCIDs | |||
No known HCIDs | |||
No |
|||
St Vincent | No known HCIDs | ||
Samoa | No known HCIDs | ||
San Marino | No known HCIDs | ||
Sao Tome |
No known HCIDs | ||
Saudi Arabia | CCHF | 1990 | |
MERS | 2024 | ||
Plague | 1994 | ||
Senegal | CCHF | 2024 | |
2014 | |||
Lassa fever | (e) Unknown | - | |
Serbia | No known HCIDs; travel associated case(s) as below | ||
CCHF | 1999 | ||
Seychelles | No known HCIDs |
||
Plague | (b) Limited local transmission (pneumonic) (associated with a case import) | 2017 | |
Sierra Leone | Ebola | 2014 | |
Lassa fever | 2023 | ||
Singapore | Nipah virus | (a) Community transmission | 1999 |
SARS | (a) Community transmission | 2003 | |
Slovakia | No known HCIDs | ||
No |
|||
Solomon Islands | No known HCIDs | ||
No known HCIDs | |||
CCHF | 2019 | ||
Ebola | (b) |
||
Lassa |
(c) |
2002 | |
Lujo virus | (b) Limited local transmission (associated with a case import) | 2008 | |
Marburg | (b) Limited local transmission (associated with a case import) | 1975 | |
Plague | (a) Community transmission (not reported whether bubonic or pneumonic) | 1982 | |
SARS | (c) Imported case(s) only | 2003 | |
South Georgia and South Sandwich Islands | No known HCIDs | ||
South |
2018 | ||
2003 | |||
SFTS | (a) Community transmission | 2024 | |
South Sudan | CCHF | 2013 | |
Ebola | 2004 | ||
Mpox (Clade I) | (a) Community transmission | 2005 | |
Spain | Avian influenza A(H5N1) | 2022 | |
CCHF | 2024 | ||
(c) |
2014 | ||
MERS | (c) Imported case(s) only | 2013 | |
SARS | (c) |
2003 | |
Sri Lanka | No known HCIDs | ||
Sudan | CCHF | 2020 | |
Mpox (Clade I) | (a) Community transmission | 2022 | |
Suriname | No known HCIDs | ||
Lassa fever | 2016 | ||
SARS | (c) Imported case(s) only | 2003 | |
No known HCIDs |
|||
SARS | (c) Imported case(s) only | 2003 | |
Syria | No known HCIDs | ||
2019 | |||
SARS | 2003 | ||
SFTS | 2022 | ||
Tajikistan | CCHF | 2009 | |
Tanzania | CCHF | 1986 (human serology in 2016) | |
Marburg | (a) Community transmission | 2023 | |
2007 | |||
SARS | (c) |
2003 | |
Thailand | Avian influenza A(H5N1) | (a) Community or zoonotic transmission | 2006 |
2016 | |||
SARS | (c) Imported case(s) only | 2003 | |
SFTS | 2020 | ||
No known HCIDs | |||
The Gambia | No known HCIDs | ||
Togo | Lassa fever | 2022 | |
Tonga | No known HCIDs | ||
Trinidad |
No known HCIDs | ||
Tunisia | CCHF | (d) Human serology | 2016 |
2013 | |||
Turkey | Avian influenza A(H5N1) | 2006 | |
CCHF | 2024 | ||
MERS | (c) Imported case(s) only | 2014 | |
Turkmenistan | Plague | 2004 | |
Turks and Caicos Islands | No known HCIDs | ||
Tuvalu | No known HCIDs |
Countries U to Z
Country or territory |
HCID |
Evidence | Year |
---|---|---|---|
Uganda | CCHF | 2024 | |
Ebola | 2022 | ||
Lassa fever | (d) Human serology |
1984 | |
Marburg | 2017 | ||
Plague | 2019 | ||
Ukraine | CCHF | (d) Human |
2020 |
United Arab Emirates | CCHF | 2010 | |
MERS | 2023 | ||
United Kingdom | Avian influenza A(H5N1) | 2023 | |
Avian influenza A(H7N7) | (a) Community or zoonotic transmission | 1996 | |
No other known HCIDs; travel associated case(s) as below | |||
CCHF | (c) Imported case(s) only | 2014 | |
Ebola | (c) Imported case(s) only | 2015 | |
Lassa fever | (b) Limited local transmission (associated with a case import) | 2022 | |
MERS | (c) Imported case(s) only | 2018 | |
SARS | (c) Imported case(s) only | 2003 | |
United States | Avian influenza A(H5N1) | 2024 | |
Plague | 2024 | ||
No other known HCIDs; travel associated case(s) as below | |||
Ebola | (b) Limited local transmission (associated with a case import) | 2014 | |
Lassa fever | (c) Imported case(s) only | 2015 | |
Marburg | (c) Imported case(s) only | 2008 | |
MERS | (b) Limited local transmission (associated with a case import) | 2014 | |
SARS | (b) Limited local transmission (associated with a case import) | 2003 | |
Uruguay | No known HCIDs | ||
Uzbekistan | CCHF | 2017 | |
No known HCIDs | |||
Venezuela | No known HCIDs | ||
Vietnam | Avian influenza A(H5N1) | 2024 | |
Plague | 2002 | ||
SARS | (a) Community transmission | 2003 | |
SFTS | 2017 | ||
No known HCIDs | |||
Yemen | MERS | 2014 | |
Plague | 2020 | ||
Zambia | 2008 | ||
2015 | |||
Zimbabwe | CCHF | (d) Human serology |
1980 |
Ebola | (d) Human serology |
1980 | |
Marburg | (d) Human |
1980 | |
Plague | 2012 |
Updates to this page
Last updated
-
All HCIDs in countries listed have been reviewed to ensure they reflect the latest information available
-
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.
Update history
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.