Guidance

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 (for example, known vectors or potential reservoirs).

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 key

a) Community transmission or transmission from a reservoir (for example, zoonotic)

b) Limited local transmission associated with an imported or laboratory acquired case (for example, an imported case with subsequent household transmission)

c) Imported or 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 or limited information

Countries A to D

Country or territory HCID pathogen or disease Evidence Year
Afghanistan CCHF (a) Community transmission 2024
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 2007
Albania CCHF (a) Community transmission 2001
Algeria MERS (c) Imported case(s) only 2014
  Plague (a) Community transmission (pneumonic) 2008
Andorra No known HCIDs    
Angola Marburg (a) Community transmission 2004
  Plague (a) Community transmission (bubonic) 1981
Anguilla No known HCIDs    
Antigua and Barbuda No known HCIDs    
Argentina Junin virus (a) Community transmission 2024
  Andes virus (a) Community transmission 2019 (with isolated case(s) in 2024)
Armenia CCHF (a) Community transmission 1974
Australia No known HCIDs; travel associated case(s) as below    
  Avian influenza A(H5N1) (c) Imported case(s) only 2024
  SARS (c) Imported case(s) only 2003
Austria No known HCIDs; travel associated case(s) as below    
  MERS (c) Imported case(s) only 2016
Azerbaijan Avian influenza A(H5N1) (a) Community or zoonotic transmission 2006
Bahrain No known HCIDs; travel associated case(s) as below    
  MERS (c) Imported case(s) only 2016
  SARS (c) Imported case(s) only 2003
Bangladesh Avian influenza A(H5N1) (a) Community or zoonotic transmission 2008
  Nipah virus (a) Community transmission 2024
  Plague (e) Unknown (not reported whether bubonic or pneumonic) 1994
Barbados No known HCIDs    
Belarus No known HCIDs    
Belgium No known HCIDs; travel associated case(s) as below    
  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 (a) Community transmission 2023
Bermuda No known HCIDs    
Bhutan No known HCIDs    
Bolivia Plague (a) Community transmission (bubonic) 2018
  Machupo virus (a) Community transmission 2013
Bosnia and Herzegovina No known HCIDs    
Botswana Plague (a) Community transmission (bubonic) 1990
Brazil Plague (a) Community transmission (not reported whether bubonic or pneumonic) 2005
British Virgin Islands No known HCIDs    
Brunei No known HCIDs    
Bulgaria CCHF (a) Community transmission 2020
Burkina Faso CCHF (a) Community transmission 1983
  Lassa fever (a) Community transmission 2017
Burundi No known HCIDsMpox  (Clade I)  (a) Community transmission  2024
Cambodia Avian influenza A(H5N1) (a) Community or zoonotic transmission 2024
Cameroon CCHF (a) Community transmission 2008
  Ebola (d) Human serology 2012
  Mpox (Clade I) (a) Community transmission 2024
Canada Avian influenza A(H5N1) (c) Imported case(s) only 2014
  Avian influenza A(H7N9) (c) Imported case(s) only 2015
  SARS (a) Community transmission 2003
Cape Verde No known HCIDs    
Canary Islands No known HCIDs    
Central African Republic CCHF (d) Human serology 2012
  Mpox (Clade I)(a) Community transmission2024
 Ebola (d) Human serology 1995
  Lassa fever (d) Human serology 1993
  Mpox (Clade I) (a) Community transmission 2024
Chad Ebola (d) Human serology 1987
Chile Andes virus (a) Community transmission 2024
  Avian influenza A(H5N1) (a) Community or zoonotic transmission 2023
China Avian influenza A(H5N1) (a) Community or zoonotic transmission 2024
  Avian influenza A(H7N9) (a) Community or zoonotic transmission 2019
  Avian influenza A(H5N6) (a) Community or zoonotic transmission 2024
  CCHF (a) Community transmission 2023
  MERS (c) Imported case(s) only 2015
  Plague (a) Community transmission (pneumonic) 2022
  SARS (a) Community transmission 2004
  SFTS (a) Community transmission 2023
Colombia No known HCIDs    
Comoros No known HCIDs    
Congo CCHF (d) Human serology 1976
  Ebola (a) Community transmission 2003
  Lassa fever (e) Unknown -
  Mpox (Clade I) (a) Community transmission 2024
Congo (Democratic Republic) CCHF (a) Community transmission 2008
  Ebola (a) Community transmission 2023
  Lassa fever (e) Unknown -
  Marburg (a) Community transmission 1998
  Mpox (Clade I) (a) Community transmission 2024
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 2024
Costa Rica No known HCIDs    
Croatia No known HCIDs    
Cuba No known HCIDs    
Cyprus No known HCIDs    
Czechia No known HCIDs    
Denmark No known HCIDs    
Djibouti Avian influenza A(H5N1) (a) Community or zoonotic transmission 2023
Dominica No known HCIDs    
Dominican Republic No known HCIDs    

Countries E to H

Country or territory HCID pathogen or disease Evidence Year
East Timor No known HCIDs    
Ecuador Avian influenza A(H5N1) (a) Community or zoonotic transmission 2023
  Plague (a) Community transmission (pneumonic) 1998
Egypt Avian influenza A(H5N1) (a) Community or zoonotic transmission 2017
  CCHF (a) Community transmission 2012
  MERS (c) Imported case(s) only 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
Falkland Islands No known HCIDs    
Faroe Islands No known HCIDs    
Fiji No known HCIDs    
Finland No known HCIDs; travel associated case(s) as below    
  SARS (c) Imported case(s) only 2003
France No known HCIDs; travel associated case(s) as below    
  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 Guiana No known HCIDs    
Gabon Ebola (a) Community transmission 2001
  Mpox (Clade I) (a) Community transmission 1991
Georgia CCHF (a) Community transmission 2023
Germany No known HCIDs; travel associated case(s) as below    
  CCHF (c) Imported case(s) only 2009
  Lassa fever (b) Limited local transmission (associated with a case import) 2016
  MERS (c) Imported case(s) only 2015
  SARS (c) Imported case(s) only 2003
Ghana CCHF (d) Human serology 2011
  Lassa fever (a) Community transmission 2023
  Marburg (a) Community transmission 2022
Gibraltar No known HCIDs    
Greece CCHF (a) Community transmission 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 (a) Community transmission 2021
  Marburg (a) Community transmission 2021
  Lassa fever (a) Community transmission 2024
Guinea-Bissau No known HCIDs    
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 (a) Community transmission 2003
Hungary No known HCIDs    

Countries I to L

Country or territory HCID pathogen or disease Evidence Year
Iceland No known HCIDs    
India Avian influenza A(H5N1) (e) Unknown 2021
  CCHF (a) Community transmission 2023
  Nipah virus (a) Community transmission 20232024
  Plague (a) Community transmission (pneumonic) 2002
  SARS (a) Imported case(s) only 2003
Indonesia Avian influenza A(H5N1) (a) Community or zoonotic transmission 2017
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 2007
  SARS (c) Imported case(s) only 2003
Iran CCHF (a) Community transmission 2024
  MERS (b) Limited local transmission (associated with a case import) 2015
Iraq Avian influenza A(H5N1) (a) Community or zoonotic transmission 2006
  CCHF (a) Community transmission 2024
Ireland No known HCIDs; travel associated case(s) as below    
  SARS (c) Imported case(s) only 2003
Israel No known HCIDs; travel associated case(s) as below    
  Lassa fever (c) Imported case(s) only 1988
Italy Avian influenza A(H7N7) (a) Community or zoonotic transmission 2013
  No other known HCIDs; travel associated case(s) as below    
  Ebola (c) Imported case(s) only 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 serology 2008
Jamaica No known HCIDs    
Japan SFTS (a) Community transmission 2023
Jordan MERS (a) Community transmission 2023
  Plague (a) Community transmission (pneumonic) 1997
Kazakhstan CCHF (a) Community transmission 2024
  Plague (a) Community transmission (bubonic) 2003
Kenya CCHF (a) Community transmission 2020
  Mpox (Clade I)(e) Limited information2024
 Ebola (d) Human serology 1983
  Marburg (a) Community transmission 1987
  MERS (a) Community transmission 2019
  Plague (a) Community transmission (bubonic) 1990
Kiribati No known HCIDs    
Kosovo CCHF (a) Community transmission 2016
Kuwait CCHF (d) Human serology 1982
  MERS (a) Community transmission 2015
  SARS (c) Imported case(s) only 2003
Kyrgyzstan CCHF (a) Community transmission 2021
  Plague (a) Community transmission (bubonic) 2013
Laos Avian influenza A(H5N1) (a) Community or zoonotic transmission 2020
  Avian influenza A(H5N6) (a) Community or zoonotic transmission 2021
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 1996
Latvia No known HCIDs    
Lebanon No known HCIDs; travel associated case(s) as below    
  MERS (c) Imported case(s) only 2017
Lesotho No known HCIDs    
Liberia Ebola (a) Community transmission 2014
  Lassa fever (a) Community transmission 2024
Libya Plague (a) Community transmission (pneumonic) 2009
Liechtenstein No known HCIDs    
Lithuania No known HCIDs    
Luxembourg No known HCIDs    

Countries M to P

Country or territory HCID pathogen or disease Evidence Year
Macau No known HCIDs; travel associated case(s) as below    
  SARS (c) Imported case(s) only 2003
Madagascar CCHF (d) Human serology 2008
  Ebola (d) Human serology 1989
  Plague (a) Community transmission (pneumonic and bubonic) 2024
Malawi Plague (a) Community transmission (bubonic) 2002
Malaysia Avian influenza A(H7N9) (c) Imported case(s) only 2014
  MERS (c) Imported case(s) only 2018
  Nipah virus (a) Community transmission 1999
  SARS (c) Imported case(s) only 2003
Maldives No known HCIDs    
Mali CCHF (a) Community transmission 2020
  Ebola (b) Limited local transmission (associated with a case import) 2014
  Lassa fever (a) Community transmission 2019
Malta No known HCIDs    
Martinique No known HCIDs    
Mauritania CCHF (a) Community transmission 2023
Mauritius No known HCIDs    
Mexico No known HCIDs    
Moldova No known HCIDs    
Monaco No known HCIDs    
Mongolia CCHF (d) Human serology 2018
  Plague (a) Community transmission (bubonic) 2023
  SARS (b) Limited local transmission (associated with a case import) 2003
Montserrat No known HCIDs    
Montenegro No known HCIDs    
Morocco Plague (a) Community transmission (not reported whether bubonic or pneumonic) 1977
Mozambique CCHF (d) Human serology 2016
  Plague (a) Community transmission (bubonic) 1997
Myanmar (Burma) Avian influenza A(H5N1) (a) Community or zoonotic transmission 2007
  Plague (a) Community transmission 2010
  SFTS Community transmission 2019
Namibia CCHF (a) Community transmission 2023
  Plague (a) Community transmission (bubonic) 1999
Nauru No known HCIDs    
Nepal Avian influenza A(H5N1) (a) Community or zoonotic transmission 2019
Netherlands Avian influenza A(H7N7) (a) Community or zoonotic transmission 2003
  No other known HCIDs; travel associated case(s) as below    
  Lassa fever (c) Imported case(s) only 2019
  Marburg (c) Imported case(s) only 2008
  MERS (c) Imported case(s) only 2014
New Caledonia 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) (a) Community or zoonotic transmission 2007
  CCHF (a) Community transmission 2014 (human serology 2019)
  Ebola (b) Limited local transmission (associated with a case import) 2014
  Lassa fever (a) Community transmission 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 (a) Community transmission 2017
  MERS (a) Community transmission 2023
Pakistan Avian influenza A(H5N1) (a) Community or zoonotic transmission 2007
  CCHF (a) Community transmission 2024
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 1994
  SFTS (d) Human serology 2020
Panama No known HCIDs    
Papua New Guinea No known HCIDs    
Paraguay No known HCIDs    
Peru Andes virus (d) Human serology 2012
  Plague (a) Community transmission 2018
Philippines No known HCIDs; travel associated case(s) as below    
  MERS (c) Imported case(s) only 2015
  SARS (b) Limited local transmission (associated with a case import) 2003
Pitcairn, Henderson, Ducie and Oeno Islands No known HCIDs    
Poland No known HCIDs    
Portugal CCHF (d) Human serology 1980
Puerto Rico SARS (e) Unknown 2003

Countries Q to T

Country or territory HCID pathogen or disease Evidence Year
Qatar MERS (a) Community transmission 2022
Réunion No known HCIDs    
Romania No known HCIDs    
Russia CCHF (a) Community transmission 2024
  Ebola (c) Laboratory acquired case(s) 2004
  Marburg (c) Laboratory acquired case(s) 1990
  Plague (a) Community transmission (bubonic) 2016
  SARS (e) Unknown 2003
Rwanda Mpox (Clade I)(e) Limited information2024
 Plague (a) Community transmission (bubonic) 1994
St Helena, Ascension and Tristan da Cunha No known HCIDs    
St Kitts and Nevis No known HCIDs    
St Lucia No known HCIDs    
St Pierre and Miquelon No known HCIDs    
St Vincent No known HCIDs    
Samoa No known HCIDs    
San Marino No known HCIDs    
Sao Tome and Principe No known HCIDs    
Saudi Arabia CCHF (a) Community transmission 1990
  MERS (a) Community transmission 2024
  Plague (a) Community transmission (bubonic) 1994
Senegal CCHF (a) Community transmission 2024
  Ebola (c) Imported case(s) only 2014
  Lassa fever (e) Unknown -
Serbia No known HCIDs; travel associated case(s) as below    
  CCHF (c) Imported case(s) only 1999
Seychelles No known HCIDs; travel associated cases(s) as below    
  Plague (b) Limited local transmission (pneumonic) (associated with a case import) 2017
Sierra Leone Ebola (a) Community transmission 2014
  Lassa fever (a) Community transmission 20232024
Singapore Nipah virus (a) Community transmission 1999
  SARS (a) Community transmission 2003
Slovakia No known HCIDs    
Slovenia No known HCIDs    
Solomon Islands No known HCIDs    
Somalia No known HCIDs    
South Africa CCHF (a) Community transmission 2019
  Ebola (b) Limited local transmission (associated with a case import) 1996
  Lassa fever (c) Imported case(s) only 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 Korea MERS (a) Community transmission 2018
  SARS (c) Imported case(s) only 2003
  SFTS (a) Community transmission 2024
South Sudan CCHF (a) Community transmission 2013
  Ebola (a) Community transmission 2004
  Mpox (Clade I) (a) Community transmission 2005
Spain Avian influenza A(H5N1) (a) Community or zoonotic transmission 2022
  CCHF (a) Community transmission 2024
  Ebola (c) Imported case(s) only 2014
  MERS (c) Imported case(s) only 2013
  SARS (c) Imported case(s) only 2003
Sri Lanka No known HCIDs    
Sudan CCHF (a) Community transmission 2020
  Mpox (Clade I) (a) Community transmission 2022
Suriname No known HCIDs    
Sweden No known HCIDs; travel associated case(s) as below    
  Lassa fever (c) Imported case(s) only 2016
  SARS (c) Imported case(s) only 2003
Switzerland No known HCIDs; travel associated case(s) as below    
  SARS (c) Imported case(s) only 2003
Syria No known HCIDs    
Taiwan Avian influenza A(H7N9) (c) Imported case(s) only 2019
  SARS (a) Community transmission 2003
  SFTS (a) Community transmission 2022
Tajikistan CCHF (a) Community transmission 2009
Tanzania CCHF (a) Community transmission 1986 (human serology in 2016)
  Marburg (a) Community transmission 2023
  Plague (a) Community transmission (bubonic) 2007
  SARS (c) Imported case(s) only 2003
Thailand Avian influenza A(H5N1) (a) Community or zoonotic transmission 2006
  MERS (c) Imported case(s) only 2016
  SARS (c) Imported case(s) only 2003
  SFTS (a) Community transmission 2020
The Bahamas No known HCIDs    
The Gambia No known HCIDs    
Togo Lassa fever (a) Community transmission 2022
Tonga No known HCIDs    
Trinidad and Tobago No known HCIDs    
Tunisia CCHF (d) Human serology 2016
  MERS ‘(b) Limited local transmission (associated with a case import) 2013
Turkey Avian influenza A(H5N1) (a) Community or zoonotic transmission 2006
  CCHF (a) Community transmission 2024
  MERS (c) Imported case(s) only 2014
Turkmenistan Plague (a) Community transmission (not reported whether bubonic or pneumonic) 2004
Turks and Caicos Islands No known HCIDs    
Tuvalu No known HCIDs    

Countries U to Z

Country or territory HCID pathogen or disease Evidence Year
Uganda CCHF (a) Community transmission 2024
  Ebola (a) Community transmission 2022
  Lassa fever (d) Human serology 1984
  Marburg (a) Community transmission 2017
  Mpox (Clade I)(c) Imported case(s) only2024
 Plague (b) Limited local transmission (pneumonic) (associated with a case import) 2019
Ukraine CCHF (d) Human serology 2020
United Arab Emirates CCHF (a) Community transmission 2010
  MERS (a) Community transmission 2023
United Kingdom Avian influenza A(H5N1) (a) Community or zoonotic transmission 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) (a) Community or zoonotic transmission 2024
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 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 (a) Community transmission 2017
Vanuatu No known HCIDs    
Vatican City No known HCIDs    
Venezuela No known HCIDs    
Vietnam Avian influenza A(H5N1) (a) Community or zoonotic transmission 2024
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 2002
  SARS (a) Community transmission 2003
  SFTS (a) Community transmission 2017
Wallis and Futuna Islands No known HCIDs    
Yemen MERS (a) Community transmission 2014
  Plague (a) Community transmission (pneumonic) 2020
Zambia Lujo virus (a) Community transmission 2008
  Plague (a) Community transmission (bubonic) 2015
Zimbabwe CCHF (d) Human serology 1980
  Ebola (d) Human serology 1980
  Marburg (d) Human serology 1980
  Plague (a) Community transmission (not reported whether bubonic or pneumonic) 2012

Updates to this page

Published 30 January 2019
Last updated 115 August 2024 + show all updates
  1. 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, Uganda India: Nipah (year) updated Sierra Leone: Lassa fever (year) updated

  2. All HCIDs in countries listed have been reviewed to ensure they reflect the latest information available

  3. Updated list of HCIDs.

  4. Updated list of HCIDs.

  5. Updated list of HCIDs.

  6. Removed COVID-19 from the listing.

  7. Added Wuhan novel coronavirus to China, and SFTS to Taiwan.

  8. Added Ebola to Tanzania listing.

  9. Added avian influenza H5N1 to Nepal.

  10. Sources of evidence for each country reviewed and updated.

  11. First published.

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