High consequence infectious disease: country specific risk

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)zoonotic).

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

c) Imported or laboratory acquired case with no onward transmissiontransmission.

d) Human serology (for example, from serological studies). To note: Whilst serological evidence indicatesmay indicate previous exposure to a pathogen, the exposure may not necessarily have occurred in the reporting country. Specificity limitations of serologic assays must also be considered, especially in the context of presence of related viruses. Historic record of human serology of a pathogen in a country should therefore be interpreted with caution.

e) Unknown or limited informationinformation.

Countries A to D

Countries E to H

Countries I to L

Countries M to P

Countries Q to T

Countries U to Z