vaccine uk travel

Travel vaccinations

Advice about getting vaccinated before travelling abroad and information about common travel vaccines.

• Travel vaccination advice
• Available travel vaccines

Country-by-country advice

• Travel Health Pro: country information travelhealthpro.org.uk
• GOV.UK: foreign travel advice www.gov.uk

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United Kingdom, including England, Scotland, Wales, and Northern Ireland Traveler View

Travel health notices, vaccines and medicines, non-vaccine-preventable diseases, stay healthy and safe.

• Packing List

After Your Trip

There are no notices currently in effect for United Kingdom, including England, Scotland, Wales, and Northern Ireland.

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Check the vaccines and medicines list and visit your doctor at least a month before your trip to get vaccines or medicines you may need. If you or your doctor need help finding a location that provides certain vaccines or medicines, visit the Find a Clinic page.

Routine vaccines

Recommendations.

Make sure you are up-to-date on all routine vaccines before every trip. Some of these vaccines include

• Chickenpox (Varicella)
• Diphtheria-Tetanus-Pertussis
• Flu (influenza)
• Measles-Mumps-Rubella (MMR)

Immunization schedules

All eligible travelers should be up to date with their COVID-19 vaccines. Please see  Your COVID-19 Vaccination  for more information. 

COVID-19 vaccine

Hepatitis A

Consider hepatitis A vaccination for most travelers. It is recommended for travelers who will be doing higher risk activities, such as visiting smaller cities, villages, or rural areas where a traveler might get infected through food or water. It is recommended for travelers who plan on eating street food.

Hepatitis A - CDC Yellow Book

Dosing info - Hep A

Hepatitis B

Recommended for unvaccinated travelers younger than 60 years old traveling to the United Kingdom. Unvaccinated travelers 60 years and older may get vaccinated before traveling to the United Kingdom.

Hepatitis B - CDC Yellow Book

Dosing info - Hep B

Cases of measles are on the rise worldwide. Travelers are at risk of measles if they have not been fully vaccinated at least two weeks prior to departure, or have not had measles in the past, and travel internationally to areas where measles is spreading.

All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6–11 months, according to  CDC’s measles vaccination recommendations for international travel .

Measles (Rubeola) - CDC Yellow Book

Dogs infected with rabies are not commonly found in the United Kingdom.

If rabies exposures occur while in the United Kingdom, rabies vaccines are typically available throughout most of the country.

Rabies pre-exposure vaccination considerations include whether travelers 1) will be performing occupational or recreational activities that increase risk for exposure to potentially rabid animals and 2) might have difficulty getting prompt access to safe post-exposure prophylaxis.

Please consult with a healthcare provider to determine whether you should receive pre-exposure vaccination before travel.

For more information, see country rabies status assessments .

Rabies - CDC Yellow Book

Tick-borne Encephalitis

Avoid bug bites

Learn more about tick-borne encephalitis at your destination .

Tick-borne Encephalitis - CDC Yellow Book

Avoid contaminated water

Leptospirosis

How most people get sick (most common modes of transmission)

• Touching urine or other body fluids from an animal infected with leptospirosis
• Swimming or wading in urine-contaminated fresh water, or contact with urine-contaminated mud
• Drinking water or eating food contaminated with animal urine
• Avoid contaminated water and soil
• Avoid floodwater

Clinical Guidance

Airborne & droplet.

• Breathing in air or accidentally eating food contaminated with the urine, droppings, or saliva of infected rodents
• Bite from an infected rodent
• Less commonly, being around someone sick with hantavirus (only occurs with Andes virus)
• Avoid rodents and areas where they live
• Avoid sick people

Tuberculosis (TB)

• Breathe in TB bacteria that is in the air from an infected and contagious person coughing, speaking, or singing.

Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in the United Kingdom, so your behaviors are important.

Eat and drink safely

Food and water standards around the world vary based on the destination. Standards may also differ within a country and risk may change depending on activity type (e.g., hiking versus business trip). You can learn more about safe food and drink choices when traveling by accessing the resources below.

• Choose Safe Food and Drinks When Traveling
• Water Treatment Options When Hiking, Camping or Traveling
• Global Water, Sanitation and Hygiene | Healthy Water
• Avoid Contaminated Water During Travel

You can also visit the  Department of State Country Information Pages  for additional information about food and water safety.

Prevent bug bites

Although the United Kingdom is an industrialized country, bug bites here can still spread diseases. Just as you would in the United States, try to avoid bug bites while spending time outside or in wooded areas.

What can I do to prevent bug bites?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Consider using permethrin-treated clothing and gear if spending a lot of time outside. Do not use permethrin directly on skin.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
• Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
• 2-undecanone
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?

Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs .

For more detailed information on avoiding bug bites, see Avoid Bug Bites .

Stay safe outdoors

If your travel plans in the United Kingdom include outdoor activities, take these steps to stay safe and healthy during your trip:

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• If you are outside for many hours in the heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation : use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Do not dive into shallow water.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if you are driving a boat, and always wear a life jacket.

Keep away from animals

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately.  Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Reduce your exposure to germs

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Avoid sharing body fluids

Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Know how to get medical care while traveling

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance for things your regular insurance will not cover.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medicines you take.
• Bring copies of your prescriptions for medicine and for eye glasses and contact lenses.
• Some prescription drugs may be illegal in other countries. Call the United Kingdom’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website ( www.jointcommissioninternational.org ).

Select safe transportation

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

Be smart when you are traveling on foot.

• Use sidewalks and marked crosswalks.
• Pay attention to the traffic around you, especially in crowded areas.
• Remember, people on foot do not always have the right of way in other countries.

Riding/Driving

Choose a safe vehicle.

• Choose official taxis or public transportation, such as trains and buses.
• Make sure there are seatbelts.
• Avoid overcrowded, overloaded, top-heavy buses and minivans.
• Avoid riding on motorcycles or motorbikes, especially motorbike taxis. (Many crashes are caused by inexperienced motorbike drivers.)
• Choose newer vehicles—they may have more safety features, such as airbags, and be more reliable.
• Choose larger vehicles, which may provide more protection in crashes.

Think about the driver.

• Do not drive after drinking alcohol or ride with someone who has been drinking.
• Consider hiring a licensed, trained driver familiar with the area.
• Arrange payment before departing.

Follow basic safety tips.

• Wear a seatbelt at all times.
• Sit in the back seat of cars and taxis.
• When on motorbikes or bicycles, always wear a helmet. (Bring a helmet from home, if needed.)
• Do not use a cell phone or text while driving (illegal in many countries).
• Travel during daylight hours only, especially in rural areas.
• If you choose to drive a vehicle in the United Kingdom, learn the local traffic laws and have the proper paperwork.
• Get any driving permits and insurance you may need. Get an International Driving Permit (IDP). Carry the IDP and a US-issued driver's license at all times.
• Check with your auto insurance policy's international coverage, and get more coverage if needed. Make sure you have liability insurance.
• Avoid using local, unscheduled aircraft.
• If possible, fly on larger planes (more than 30 seats); larger airplanes are more likely to have regular safety inspections.
• Try to schedule flights during daylight hours and in good weather.

Helpful Resources

Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, auto insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

Traffic flows on the left side of the road in the United Kingdom.

• Always pay close attention to the flow of traffic, especially when crossing the street.
• LOOK RIGHT for approaching traffic.

Maintain personal security

Use the same common sense traveling overseas that you would at home, and always stay alert and aware of your surroundings.

Before you leave

• Research your destination(s), including local laws, customs, and culture.
• Monitor travel advisories and alerts and read travel tips from the US Department of State.
• Enroll in the Smart Traveler Enrollment Program (STEP) .
• Leave a copy of your itinerary, contact information, credit cards, and passport with someone at home.
• Pack as light as possible, and leave at home any item you could not replace.

While at your destination(s)

• Carry contact information for the nearest US embassy or consulate .
• Carry a photocopy of your passport and entry stamp; leave the actual passport securely in your hotel.
• Follow all local laws and social customs.
• Do not wear expensive clothing or jewelry.
• Always keep hotel doors locked, and store valuables in secure areas.
• If possible, choose hotel rooms between the 2nd and 6th floors.

Healthy Travel Packing List

Use the Healthy Travel Packing List for United Kingdom for a list of health-related items to consider packing for your trip. Talk to your doctor about which items are most important for you.

Why does CDC recommend packing these health-related items?

It’s best to be prepared to prevent and treat common illnesses and injuries. Some supplies and medicines may be difficult to find at your destination, may have different names, or may have different ingredients than what you normally use.

If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic . Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.

For more information on what to do if you are sick after your trip, see Getting Sick after Travel .

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Travel Advice and Vaccines

If you’re planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as  yellow fever ,  typhoid  and  hepatitis A .

In the UK, the  NHS routine immunisation (vaccination) schedule protects you against a number of diseases, but does not cover all of the infectious diseases found overseas.

If possible, see the GP or a private travel clinic at least 6 to 8 weeks before you’re due to travel.

Some vaccines need to be given well in advance to allow your body to develop immunity.

And some vaccines involve a number of doses spread over several weeks or months.

You may be more at risk of some diseases, for example, if you’re:

– travelling in rural areas – backpacking – staying in hostels or camping – on a long trip rather than a package holiday

If you have a pre-existing health problem, this may make you more at risk of infection or complications from a travel-related illness.

You can find out which vaccinations are necessary or recommended for the areas you’ll be visiting on these websites:

Travel Health Pro

NHS Fit for Travel

Some countries require proof of vaccination (for example, for polio or yellow fever vaccination), which must be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country.

Saudi Arabia requires proof of vaccination against certain types of  meningitis  for visitors arriving for the Hajj and Umrah pilgrimages.

Even if an ICVP is not required, it’s still a good idea to take a record of the vaccinations you have had with you.

Find out more about the vaccines available for travellers abroad

Coronavirus (COVID-19) vaccination

You may need COVID-19 vaccinations to travel abroad.

Check the  foreign travel advice on GOV.UK  to find out the entry requirements of the country you’re visiting.

Find out more about the NHS COVID Pass for travel.

First, phone or visit the GP practice or practice nurse to find out whether your existing UK vaccinations are up-to-date.

If you have any records of your vaccinations, let the GP know what you have had previously.

The GP or practice nurse may be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

They can give you any missing doses of your UK vaccines if you need them.

Not all travel vaccinations are available free on the NHS, even if they’re recommended for travel to a certain area.

If the GP practice can give you the travel vaccines you need but they are not available on the NHS, ask for:

– written information on what vaccines are needed – the cost of each dose or course – any other charges you may have to pay, such as for some certificates of vaccination

You can also get travel vaccines from:

– private travel vaccination clinics – pharmacies offering travel healthcare services

The following travel vaccines are available free on the NHS from your GP surgery:

polio (given as a  combined diphtheria/tetanus/polio jab )

hepatitis A

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

United Kingdom Travel Restrictions

Traveler's COVID-19 vaccination status

Traveling from the United States to the United Kingdom

Open for vaccinated visitors

COVID-19 testing

Not required

Not required for vaccinated visitors

Restaurants

Not required in enclosed environments and public transportation.

United Kingdom entry details and exceptions

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Can I travel to the United Kingdom from the United States?

Most visitors from the United States, regardless of vaccination status, can enter the United Kingdom.

Can I travel to the United Kingdom if I am vaccinated?

Fully vaccinated visitors from the United States can enter the United Kingdom without restrictions.

Can I travel to the United Kingdom without being vaccinated?

Unvaccinated visitors from the United States can enter the United Kingdom without restrictions.

Do I need a COVID test to enter the United Kingdom?

Visitors from the United States are not required to present a negative COVID-19 PCR test or antigen result upon entering the United Kingdom.

Can I travel to the United Kingdom without quarantine?

Travelers from the United States are not required to quarantine.

Do I need to wear a mask in the United Kingdom?

Mask usage in the United Kingdom is not required in enclosed environments and public transportation.

Are the restaurants and bars open in the United Kingdom?

Restaurants in the United Kingdom are open. Bars in the United Kingdom are .

Travel health advice and travel vaccinations

You should make an appointment for a travel health risk assessment if you’re travelling abroad and think you need:

• a malaria risk assessment
• further advice

A travel health professional will take you through your travel health risk assessment.

Your GP is no longer your point of contact for a travel health risk assessment, including travel vaccines.

NHS travel health service

NHS Scotland provides a travel health service that includes some free vaccines.

To find information on how to make an appointment for a travel health risk assessment in Scotland, contact the NHS health board where you live.

Private travel clinics

You can also visit an independent (private) travel clinic for:

• a travel health risk assessment
• travel advice
• other travel vaccines

You should arrange a travel health risk assessment 6 to 8 weeks before you travel. This gives time for any vaccines you need to become fully effective.

If your trip is sooner, remember it’s never too late to get advice.

Travel health risk assessment

If you’re planning to travel outside the UK, your travel health needs will depend on your individual situation. This includes:

• your destination
• how long you’ll stay
• what you’ll be doing
• your general health

The fitfortravel website provides country-specific advice on:

• recommended vaccines
• other risk prevention advice

If you think you need vaccines and/or a malaria risk assessment, you should make an appointment with a travel health professional.

A travel health risk assessment is also recommended for some people, even when vaccines or malaria tablets aren’t required. This includes:

• older people
• those with a weakened immune system
• those with long-term conditions that need medications
• pregnant women

Travel vaccines

The following travel vaccines are free on the NHS in Scotland:

• diphtheria, polio and tetanus (combined booster)
• hepatitis A

It’s likely that you’ll have to pay for vaccines against:

• yellow fever
• Japanese encephalitis
• tick-borne encephalitis

You may also have to pay for the following vaccines if they’re only needed for travel purposes:

• hepatitis B
• tuberculosis (TB)

Proof of vaccination

To enter some countries you may need proof that you have had particular vaccines. This includes the yellow fever vaccine.

Yellow fever vaccines are only available from designated centres. To find out if you need a yellow fever vaccine or proof of the vaccine, you should contact a yellow fever clinic.

To request a list of any other vaccines held on your GP record, contact your GP practice. GP practices cannot provide proof of COVID vaccine.

Preventing risk while travelling

Vaccines or anti-malarial tablets will not protect against all travel health risks. This means you’ll need to take extra steps to protect your health whilst travelling abroad.

The fitfortravel website has further advice on preventing health risks whilst travelling. This includes information on:

• general travel advice
• disease prevention

Travelling abroad to visit friends and relatives

If you’re travelling abroad to visit friends or relatives, you may be at higher risk of developing travel-related illnesses. For example, malaria or typhoid. This could be because:

• you may be living with the local community
• your trip might be longer than the average holiday
• you might be visiting more rural areas where it’s difficult to take precautions that reduce your risk

The fitfortravel website provides information and advice on visiting friends and family abroad .

Travel safety advice

You can find country-specific safety and security advice through the UK government website .

Travel insurance advice

Many countries don’t have the same access to medical treatments as the UK and can be expensive.

It’s recommended that all travellers get comprehensive travel insurance before travelling.

When you return home

If you become unwell and/or develop a fever when you return home, it’s important to get medical advice as soon as possible. You should seek medical help even if it’s up to 1 month after you’ve been travelling.

Always make sure you tell the health professional that you’ve recently travelled abroad. This is especially important if you have been to a country where malaria is a risk.

Donating blood after travelling abroad

Travel outside the UK can affect whether you can give blood donations. This is because some infections may be caught abroad. This is usually through mosquito or other insect bites.

There are conditions for donating blood if you’ve been to certain countries. This can depend on your length of stay and some other factors.

Further information on donating blood after travelling abroad

Source: Public Health Scotland - Opens in new browser window

Last updated: 01 March 2024

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Everything you need to know about traveling to the U.K.

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In London , it’s not immediately obvious that the world is still dealing with the coronavirus pandemic. In the halls of Borough Market, you’ll see maskless, smiling faces of patrons and shopkeepers back to business as usual. On the Tube, few masks, if any, make an appearance. At the airport, travelers can now enter the country without testing, quarantines or proof of vaccination.

“The city is full of life. The city is full of people,” says Jim Strong, president of Strong Travel Services , who recently returned from a trip to London.

A local's guide to London

The United Kingdom lifted all remaining travel restrictions in March, after two years of complicated rules. In the wake of that change, here’s everything you need to know to get prepared for a trip to the U.K.

What to know about restrictions

Britain has removed all of its coronavirus travel restrictions. Visitors from any country are welcome, regardless of vaccination status, and no longer need to test before their trip or complete a U.K. passenger locator form before arriving.

Travelers are not required to mask on flights and public transportation, although the government does encourage doing so in crowded, enclosed spaces.

How to dine and explore

Travel experts, including Strong, say London is one of the most popular European destinations for travelers this year, so plan ahead in anticipation of competition.

“Now that the testing requirement to return to the U.S. has been removed, I think we’re going to see much more intense interest in traveling, not only to London, but to all of Europe,” Strong says.

If there are certain attractions you’d like to visit or restaurants you’d like to eat at, be sure to make reservations.

“If you are going to the London, you must — in our opinion — do everything possible to have things prearranged, such as cars and drivers, restaurant reservations, entrance into certain sites,” Strong says.

Many attractions have ended limited-entry policies, making it more convenient to visit, but some remain.

“Everything is operating as it was pre-covid, however, sometimes at a diminished level,” Strong says, noting that he has seen London hotels and restaurants not operating at full capacity or limiting reservations because of staffing issues.

Richard Cooke, general manager of the Balmoral hotel in Edinburgh, Scotland, recommends that travelers talk to the concierge at their hotel and get a few reservations on the books, whether you’re hoping to tour the Macallan Distillery in Speyside or go to a football match.

“We have a bar with over 500 single malts,” Cooke says. “It’s been busier than ever with guests trying things they’ve never tried before or seeking to understand differing nuances. It’s a thirst for knowledge.”

Where to get a coronavirus test

It is no longer required to test before returning to the United States. If you’d still like to test, you can pack a self-test or find them for purchase from U.K. shops and pharmacies. You may be able to have one arranged at your hotel, but if that’s not the case, you can make an appointment at a pharmacy near you. The U.S. Embassy in the U.K. has a list of local labs to find tests . Testing is also available at Heathrow Airport .

More travel tips

Vacation planning: Start with a strategy to maximize days off by taking PTO around holidays. Experts recommend taking multiple short trips for peak happiness . Want to take an ambitious trip? Here are 12 destinations to try this year — without crowds.

Cheap flights: Follow our best advice for scoring low airfare , including setting flight price alerts and subscribing to deal newsletters. If you’re set on an expensive getaway, here’s a plan to save up without straining your credit limit.

Airport chaos: We’ve got advice for every scenario , from canceled flights to lost luggage . Stuck at the rental car counter? These tips can speed up the process. And following these 52 rules of flying should make the experience better for everyone.

Expert advice: Our By The Way Concierge solves readers’ dilemmas , including whether it’s okay to ditch a partner at security, or what happens if you get caught flying with weed . Submit your question here . Or you could look to the gurus: Lonely Planet and Rick Steves .

Security Alert May 17, 2024

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United Kingdom

Travel Advisory July 26, 2023

United kingdom - level 2: exercise increased caution.

Reissued with obsolete COVID-19 page links removed.

Exercise increased caution in the United Kingdom due to terrorism.

Country Summary:  Terrorist groups continue plotting possible attacks in the United Kingdom. Terrorists may attack with little or no warning, targeting tourist locations, transportation hubs, markets/shopping malls, local government facilities, hotels, clubs, restaurants, places of worship, parks, major sporting and cultural events, educational institutions, airports, and other public areas.

There is also a risk of isolated violence by dissident groups in Northern Ireland, focused primarily on police and military targets.

Read the  country information page  for additional information on travel to the United Kingdom.

If you decide to travel to the United Kingdom:

• Be aware of your surroundings when traveling to tourist locations and crowded public venues.
• Follow the instructions of local authorities.
• Monitor local media for breaking events and adjust your plans based on new information.
• Enroll in the  Smart Traveler Enrollment Program  ( STEP ) to receive Alerts and make it easier to locate you in an emergency.
• Follow the Department of State on  Facebook  and Twitter.com/Travelgov
• Review the  Country Security Report  for the United Kingdom.
• Visit the CDC page for the latest  Travel Health Information  related to your travel and return to the United States.
• Prepare a contingency plan for emergency situations. Review the  Traveler’s Checklist .

Embassy Messages

View Alerts and Messages Archive

Quick Facts

Must be valid for the duration of your stay in the United Kingdom   (If you have onward travel to countries outside the United Kingdom, you should check the passport validity requirements for each additional country on their respective information pages.)

Must have at least one page

Not required for stays less than six months.

Embassies and Consulates

U.s. embassy london.

33 Nine Elms Lane London, SW11 7US United Kingdom Telephone: +(44)(20) 7499-9000 Emergency After-Hours Telephone: +(44)(20) 7499-9000 Fax: +(44) (20) 7891-3845 Email:   [email protected]

U.S. Consulate General Edinburgh, Scotland 3 Regent Terrace, Edinburgh EH7 5BW Scotland Telephone: 013-1556-8315 / from the United States: 011 (44)(13) 1556-8315 Emergency After-Hours Telephone:  020-7499-9000 / from the United States: 011 (44)(20) 7499-9000 Fax: 0131-557-6023 /from the United States: 011 (44) 131-557-6023 Email:   [email protected]

U.S. Consulate General Belfast, Northern Ireland Danesfort House, 223 Stranmillis Road, Belfast BT9 5GR Northern Ireland, United Kingdom Telephone: 028-9038-6100 / from the United States: 011 (44)(28) 9038-6100 Emergency After-Hours Telephone: 01253-501106 / from the United States: 011 (44) 1253-501106 Fax: 028-9068-1301 / from the United States: 011 (44)(28) 9068-1301 Email: [email protected]

Destination Description

Learn about the U.S. relationship to countries around the world.

Entry, Exit and Visa Requirements

• To enter the United Kingdom, your passport must be valid for the entire duration of your planned stay.
• Starting June 2019, U.S. passport holders will be able to use the ePassport Gates upon arrival in the United Kingdom. U.S. citizens who had previously registered for the UK’s Registered Traveller Service (RTS) should now also use the ePassport Gates on arrival in the UK.
• If you are planning onward travel after departing the UK, note that many other countries require at least six months’ remaining validity on your passport to enter. If you are bound for Continental Europe, please see our  U.S. travelers in Europe page for additional details.
• Visas for specific categories of visitors must be obtained prior to travel. Visit the  UK Visas and Immigration (UKVI) website to determine if you need a visa to enter the United Kingdom. We cannot intervene on your behalf when you apply for a UK visa, nor can we advocate for your admission into the UK if you are denied entry.
• Students and prospective students should visit the  UKVI website  to determine if they need a visa.
• For some U.S. travelers, especially students, an entry stamp is required.  Please consult this website  for more information.
• Unpaid and paid workers, interns, volunteers, charity workers, and temporary workers can find information about obtaining a visa on the  UKVI website .
• Visitors traveling to the United Kingdom to get married, even if they do not plan to reside there, must obtain a visa in advance. See the  UKVI website  for visa information.
• Surcharges apply to certain categories of visas, generally those involving work, study, or residency for more than six months. More information is available on the  UKVI website  and in our Health section below.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the United Kingdom.

Find information on  dual nationality ,  prevention of international child abduction  and  customs regulations  on our websites.

Safety and Security

Terrorist groups continue plotting possible near-term attacks in Europe. The UK Security Service publishes specific reasons for any changes in the threat level and recommended actions for the public via its  UK threat levels website .

There is the potential for  isolated violence  related to the political situation in Northern Ireland. The Police Service of Northern Ireland assesses there is a continued threat of violence from dissident groups in Northern Ireland, focused primarily on police and military targets, and may involve the use of  firearms  and  explosives . Tensions may be heightened during the summer marching season (April to August), particularly on and around the July 12 public holiday.

Avoid areas of demonstrations  if possible, and be careful within the vicinity of demonstrations. Demonstrations occur frequently in and around city centers and areas where tourists frequent. Even demonstrations intended to be peaceful can turn confrontational and possibly escalate to violence.

The phone number for  police/fire/ambulance emergency services  is  999  in the United Kingdom and  112  in Gibraltar. You should also use these numbers to report security threats or suspicious packages. Also see information for  contacting police from abroad .

• Be cautious and aware of your surroundings.
• Be vigilant, as  pickpocketing ,  mugging,  and “snatch and grab” theft of mobile phones, watches and jewelry can occur.
• Do not leave bags unattended in restaurants, pubs, hotel lobbies, and parked cars.
• Be alert to other criminal schemes, such as  impostors  posing as undercover police officers and “fining” tourists for bogus minor offenses. A legitimate Metropolitan Police Services officer will never demand an immediate cash payment.
• Use only licensed Black Cabs or pre-ordered car services (minicabs) . Unlicensed taxis or private cars posing as taxis may offer low fares, but in some instances, travelers have been  robbed  or  sexually assaulted  while using these cars. See Transport for London for additional information on cabs and car services .
• Avoid using ATMs that look temporary in structure or location  or are located in isolated areas – they may not be legitimate. Use ATMs located inside a bank branch.

Scams : Before sending any money to individuals you have never met in person, visit the  Embassy London website  for more information about  internet financial scams  and how to protect yourself.

See the  Department of State  and the  FBI  pages for information on scams.

Victims of Crime : Report crimes to the local police at 999 (United Kingdom) or 112 (Gibraltar) and contact the U.S. Embassy at +(44) (20) 7499-9000.

• Local authorities are responsible for investigating and prosecuting crimes.

See our webpage on  help for U.S. victims of crime overseas .

• help you find appropriate medical care
• assist you in reporting a crime to the police
• contact relatives or friends with your written consent
• explain the local criminal justice process in general terms
• provide a list of local attorneys
• provide our information on  victim compensation programs in the United States
• The Victim Support website  is maintained by an independent UK charity to help people cope with the effects of crime
• A Northern Ireland-based independent charity maintains a similar  victim support website
• In Scotland, victims of crime should contact  Victim Support Scotland
• provide an emergency loan for repatriation to the United States and/or limited medical support if you are destitute
• help you find accommodation and arrange flights home
• replace a stolen or lost passport

Domestic Violence:  U.S. citizen victims of domestic violence may contact the Embassy for assistance.

Tourism:  The tourism industry is generally regulated and rules are regularly enforced. Hazardous areas/activities are identified with appropriate signage and professional staff is typically on hand in support of organized activities. In the event of an injury, appropriate medical treatment is widely available throughout the country. Outside of a major metropolitan center, it may take more time for first responders and medical professionals to stabilize a patient and provide life-saving assistance. U.S. citizens are encouraged to purchase medical evacuation insurance . 

Local Laws & Special Circumstances

Criminal Penalties:  You are subject to local laws. If you violate local laws, even unknowingly, you may be expelled, arrested, or imprisoned. 

Furthermore, some laws are also prosecutable in the United States, regardless of local law. For examples, see our website on  crimes against minors abroad  and the  Department of Justice  website.

• You will be arrested if you bring pocket knives, blades, mace or pepper spray canisters, or any part of a gun into the United Kingdom . Please refer to the UK government publication  Travelling to the UK , which details the items visitors are prohibited from bringing into the United Kingdom.
• Penalties against  alcohol-related  and other  in-flight  crimes committed aboard aircraft to and from the United Kingdom are stiff and are enforced with  prison sentences . Please also see  our information on U.S. customs regulations  covering your return to the United States.
• Controlled Substances: UK law prohibits possession and trafficking of controlled substances and narcotics, including some substances that may be legal to possess under the law of certain U.S. states. More information on controlled substances is available here . Individuals who violate UK drug laws may face penalties including fines or prison sentences.

Arrest Notification:  If you are arrested or detained in the United Kingdom, ask police or prison officials to notify the U.S. Embassy immediately. See our  webpage  for further information.

Special Circumstances:

• The legal drinking age in the United Kingdom is 18. Parents and organizers of school trips should read our  Students Abroad website  to help plan a safe and enjoyable experience.
• Scotland’s “drink drive limit” law was amended to a lower level (roughly .05 BAC) and is stricter than the rest of the United Kingdom (roughly .08 BAC). This means that  driving after even one drink  can result in a charge of driving under the influence.
• The United Kingdom has very strict gun control laws, and importing firearms is extremely complicated.  Information on applying for a firearm and/or shotgun certificate can be found on the  London Metropolitan Police Firearms licensing webpage .  Licenses from England or Wales may not be valid in Scotland; please check with the appropriate authorities.  For firearms certificates for Scotland, please check with  Police Scotland .

Faith-Based Travelers:  See our following webpages for details:

• International Religious Freedom Report  – see country reports
• Human Rights Report  – see country reports
• Hajj Fact Sheet for Travelers
• Best Practices for Volunteering Abroad

LGBTI Travelers:  There are no legal restrictions on same-sex sexual relations or the organization of LGBTI events in the United Kingdom.

See our  LGBTI Travel Information  page and section 6 of our  Human Rights report  for further details.

Travelers Who Require Accessibility Assistance:

• UK law requires that all public service providers (except in the transportation sector) make “reasonable adjustments” to ensure their services are available to persons with disabilities.  Nevertheless, code exemptions permit many older buildings to have steps up from the street.
• Getting around in cities may be difficult at times because sidewalks can be narrow and uneven.
• Most London Underground and UK National Rail System stations are not readily accessible for people with disabilities.  Many stations do not have elevators, and have stairways and long corridors for changing trains or exiting to the street. Many UK buses are equipped with lowering platforms for limited-mobility or sight- or hearing-disabled travelers.
• Many taxis have swivel-entry seats or retractable ramps to ease entry.
• Disabled parking permits (known as “blue badges”) are issued by local government councils throughout the country. Visit the  UK government website  for contact information. Some councils may not offer permits to temporary visitors.

The  Transport for London  and  National Rail  websites provide information for passengers with disabilities.

Students:  See our  Students Abroad  page and  FBI travel tips .

Women Travelers:  See our travel tips for  women travelers .

While medical services are widely available,  free medical care  under the National Health System (NHS) is allowed only for UK residents, certain EU nationals, and some visa holders.

An NHS surcharge is assessed on certain visa applicants at the time of application.  Tourists and short-term visitors will not be assessed the surcharge, but will be charged 150 percent of the cost of any medical treatment they receive from the NHS. Unpaid balances of £1,000 or more can result in being barred from return to the United Kingdom.

• The U.S. government does not pay medical bills, and U.S. Medicare is not valid overseas.

Medical Insurance:  Make sure your health insurance plan provides  coverage overseas . Most care providers overseas only accept  cash payments . See our webpage for more information on insurance coverage overseas.

• We strongly recommend  supplemental insurance  to cover medical evacuation.

Carry  prescription medication  in original packaging, along with your doctor’s prescription. Traveling with sufficient supplies to last the duration of your trip is recommended. Mailing prescriptions is prohibitive and may be delayed or rejected by British customs.

Certain prescriptions available in the United States are classified as a "controlled drug"  in the United Kingdom and cannot be brought into the country without applying for and obtaining a prior license. This includes prescriptions for medical marijuana or products containing CBD and THC.  Please visit the https://www.gov.uk/travelling-controlled-drugs for additional information. 

Vaccinations:  Be up-to-date on all  vaccinations  recommended for international travel by the U.S. Centers for Disease Control and Prevention.

Further health information:

• World Health Organization
• U.S. Centers for Disease Control and Prevention  (CDC)

Travel and Transportation

Road Conditions and Safety:  Road conditions in the United Kingdom can differ significantly from those in the United States.

• In contrast to the United States, UK traffic drives on the left.  Read the  Highway Code  before driving.
• Emergency call boxes  (orange telephone booths with “SOS” printed on them) are found at half-mile intervals along motorways. White and blue poles point in the direction of the nearest call box. Call boxes dial directly to a motorway center. Use these phones rather than a personal cell phone, because motorway center personnel will immediately know your exact location.
• Generally,  pedestrians do not have the right of way  and should not expect vehicles to stop for them.

Many U.S. citizen pedestrians are injured, some fatally, every year in the United Kingdom, because they forget that oncoming  traffic approaches from the opposite direction  than in the United States.  Exercise extra care when crossing streets; remain alert and look both ways before stepping into the street.

Traffic Laws: 

• UK penalties for driving under the influence of  alcohol  or  drugs  are strict and often  result in prison sentences .
• Using a  hand-held cell phone  or similar device while driving is  illegal  in the United Kingdom. Only hands-free phones may be used. You will be  fined , or in the case of an accident,  arrested  and serve time in  prison .
• The speed limit on highways/motorways in the United Kingdom is 70 mph, or lower when posted.
• You will be  detained  and  arrested  if you cannot provide a UK address to receive a subpoena or are about to depart the United Kingdom and have to be brought to court quickly for a motoring offense.
• In Central London, a congestion charge is levied on all drivers who pass through the congestion zone. You will be  fined  or  arrested  if you do not pay the charge. See  Transport for London  for more information about driving in London.

Public Transportation:  Public transport in the United Kingdom is extensive.

• Information on disruptions to London transportation services can be found on the  Transport for London  website.
• Information about the status of National Rail Services can be found on the  National Rail Enquiries  website.
• Bus and train service information in Northern Ireland can be found on the  Translink  website.
• Bus and train service information in Scotland can be found on the  Traveline Scotland  website.

See our  Road Safety page  for more information. For specific information concerning UK driving permits, vehicle inspection, road tax, and mandatory insurance, refer to the  UK Department for Transport  website or the  Driver and Vehicle Standards Agency  website.

Aviation Safety Oversight:  The U.S. Federal Aviation Administration (FAA) has assessed the government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of United Kingdom’s air carrier operations. Further information may be found on the  FAA’s safety assessment page .

Maritime Travel: Mariners planning travel to the United Kingdom should also check for U.S. maritime advisories and alerts at  www.marad.dot.gov/msci . Information may also be posted to the U.S. Coast Guard homeport website and the NGA broadcast warnings website (select “broadcast warnings”).

For additional travel information

• Enroll in the  Smart Traveler Enrollment Program (STEP)  to receive security messages and make it easier to locate you in an emergency.
• Call us in Washington, D.C. at 1-888-407-4747 (toll-free in the United States and Canada) or 1-202-501-4444 (from all other countries) from 8:00 a.m. to 8:00 p.m., Eastern Standard Time, Monday through Friday (except U.S. federal holidays).
• See the  State Department’s travel website  for the  Worldwide Caution  and  Travel Advisories .
• Follow us on  Twitter  and  Facebook .
• See  traveling safely abroad  for useful travel tips.

Review information about International Parental Child Abduction in the United Kingdom . For additional IPCA-related information, please see the International Child Abduction Prevention and Return Act ( ICAPRA ) report.

Travel Advisory Levels

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Your Health To-Do List When Traveling to the UK

Last Updated on January 6, 2024

Health and fitness holidays in the UK have gained immense popularity in 2023. With The Guardian’s  extensive catalog  of wellness travel featuring everything from invigorating running breaks in Scotland to serene mindful walking weekends in Wales, the spotlight on traveling for your well-being has never been stronger. However, as tourists increasingly seek vacations that align with their health goals, prioritizing well-being beyond simple wellness retreats is equally important.

A proactive approach to health ensures you can enjoy the mainland and different islands of the UK without worrying about getting sick along the way. To maximize your health outcomes, preparation must begin long before the first boarding call. Below, we take a closer look at four health to-dos before traveling to the UK in 2024.

Update your vaccines

Traveling increases your chances of spreading diseases that are rare in your home country. Hence,  updating your vaccines  is not only a preventive measure for your well-being but also a responsible action to protect the communities you visit.

For example, there are routine vaccines that are recommended for anyone going to the UK, such as chickenpox, shingles, or the flu. You can always have additional vaccines for certain conditions if you think you’re more likely to be exposed to them. For instance, hepatitis A vaccination is recommended for travelers who plan to visit smaller villages and rural areas. Otherwise, it’s crucial to check for any travel health notice regarding current health issues in your destination. As of September 2023, the UK was placed under Level 2 Practice Enhanced Precautions for poliovirus, so it would be wise to be up to date on your polio vaccines.

Check your eye health

Vision health can significantly impact your adventures. Yet, the process of safeguarding your eye health can vary across different locations. For one, eyeglass wearers who lost their glasses may struggle to find a new pair in rural areas, leading to blurry and uncomfortable vision for the rest of the trip. In that case, it’s best to have spare eyeglasses on hand.

However, there are various accessible options for vision care. If you need to immediately replace your eyewear, then you can find affordable options for different types of  glasses  at eyewear retailer Glasses Direct, with deals such as 2-for-1 designer frames from £69 (approximately $88). This can be ordered online and delivered directly to your accommodations. If you need a new prescription, then you can easily book an eye test at the multiple branches of Asda Opticians or Vision Express. You might also qualify for a free eye test from the NHS in Scotland as an overseas visitor, so try to register with a general medical practice as soon as you arrive at your destination.

Check your oral health

Maintaining good oral health is vital on international journeys, especially longer trips. Similar to eye health maintenance, however, this process can be a little difficult in a new location. This can be particularly challenging in the UK, which has had a  shortage of dentists  since 2021, with dental tourism at record highs. In fact, UK-based consultancy Medical Travel Market received over 1,500 inquiries in 2023, up more than 450% from 2022.

Thus, consulting with a dentist before any extended trip is crucial, especially for those with ongoing treatments, such as braces or retainers. Your dentist may need to adjust your braces to a safer setting before your travels or equip you with an extra retainer. These will help you avoid the inconvenience of seeking orthodontic treatment during your travels. If it comes down to it, then you may have to find a private clinic in the UK or line up for NHS dental services if eligible.

Secure travel insurance

As you embark on the journey of a lifetime, it’s crucial to have a safety net in place. Factors such as trip duration or destinations should be taken into account when securing  travel insurance . For instance, annual contracts normally cover up to 30 days maximum, whereas backpacking insurance can range from three months to a year. A helpful tip: most travel insurance comes with a deductible that you must pay beforehand. Clarify this policy when making any purchase.

That being said, take your time to compare several insurance companies, then, upon your selection, inform your provider about your travel plans. Understanding your coverage for medical emergencies, trip cancellations, and unexpected events will provide peace of mind throughout your journey.

By prepping in advance, you lay the foundation for a journey to the UK filled with memorable moments and peace of mind. Remember, taking care of your health is not only a personal responsibility but also a commitment to fostering a healthier global travel community.

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• How to Travel Through India on a Budget
• Why You Should Mess With Texas and Visit Marfa
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• Get to Know a Different Side of Bhutan For Every Season

Blog UK Health Security Agency

https://ukhsa.blog.gov.uk/2024/06/28/from-measles-to-malaria-how-to-keep-you-and-your-family-healthy-on-holiday/

From measles to malaria, how to keep you and your family healthy on holiday

With lots of people preparing for their holidays, I’ve written this blog post as a handy guide to travelling safely and minimising risks to your health.

Risks vary depending on the type of trip you’re going on – but whether you’re off for a week of sunbathing, watching the Euros, visiting family based overseas or taking a lengthier backpacking trip, it’s worth being prepared. It’s important to research your trip and  check your destination  before you travel and stay up to date with the latest outbreaks and events.

Before you travel

Routine vaccinations.

It is vital to ensure you are up to date with your vaccinations before you travel, both for your protection and for the benefit of the health of those around you.

Many countries have different diseases circulating and some of these could potentially be dangerous. It’s possible to pick up an illness that we don’t routinely see in the UK, and important to remember that some can have serious consequences for vulnerable people.

Measles is a highly infectious viral illness that can be very unpleasant and sometimes leads to serious complications. The measles, mumps and rubella (MMR) vaccine is normally given in childhood, but if you or anyone in your family has not had the MMR, you can catch up at any time. The MMR is available to all adults and children who are not up to date with their 2 doses. It is essential that you take both doses - finishing the full course offers life-time protection from measles for most people. If you are not sure if you are protected, you can check with your GP practice or arrange a travel clinic appointment to discuss.

The measles virus is currently circulating in the UK and it is even more common in some parts of Africa, Asia and mainland Europe, so please check that you and your family are up to date with your MMR vaccines.

Additional vaccinations/pre-medications

You may need additional vaccinations and preventative medications for the countries you are visiting. For example, if you’re visiting parts of rural Asia and the Far East  Japanese encephalitis  may be a risk, and the vaccination could be recommended.

For  malaria  risk areas - you may need to take malaria prevention tablets. It’s important to bear in mind that some countries require proof of  yellow fever  vaccination even if there is no risk of infection. There are also places where the  rabies vaccination  may be needed.

Always  check your country of travel for recommended vaccinations , review the  NHS Advice on travel vaccinations  and keep a close eye on  outbreaks in your country of travel .

For advice on vaccinations and preventative medicines, you can contact your local travel health clinic or GP practice. With most vaccines it is advised you arrange your vaccination 4 to 6 weeks before you arrive at your destination.

During travel

General health measures.

While abroad, especially in more remote/rural places, be conscious of hand hygiene, your water supply, food safety and  sun exposure .

During a heatwave, keep out of the heat if you can. If you have to go outside, stay in the shade especially between 11am and 3pm and stay hydrated. You should wear sunscreen, a hat and light clothes, and avoid exercise or activity that makes you hotter.

Be sure to pack hand sanitiser and where possible and appropriate drink bottled water. Always wash your hands with soap and water after using the toilet and before eating. For general advice, this  helpful blog post covers top tips for each of these.

It’s more common in some countries but traveller's diarrhoea, which results from eating and drinking unsafe food/water, is something to be aware of. You can have quite significant fluid loss from this, so if you experience these symptoms while travelling, it is a good idea to take lots of rest, drink plenty of bottled fluids - if possible, topped up with rehydration salts. If you feel particularly unwell or your symptoms don’t improve, seek medical attention while abroad as you may require medical treatment for dehydration.

Particular diseases to be aware of

Mosquito bites are always an annoyance but also pose a particular risk in other parts of the world, where they can cause diseases including malaria, dengue , zika , West Nile virus or chikungunya . This applies to large parts of Europe as well as long-haul destinations.  Mosquito bite avoidance advice  includes wearing long-sleeved clothing to cover exposed skin, using repellents (at least 50% DEET), and mosquito nets.

Suspected malaria is a medical emergency and must be quickly diagnosed and treated. If you visit a malaria risk country, which include countries in large areas of Africa, Asia, and Central and South America, and have a fever, flu-like symptoms or any unusual symptoms during or after travelling you must get urgent medical attention. Don’t wait until you return to the UK if you are unwell.

Rabies is transmitted by a bite or scratch from an infected animal, usually a dog, and can be fatal if not recognised, or because post-exposure treatment is not available.

Avoid animal bites, and check if you would benefit from a pre-exposure vaccine. All travellers who have a possible exposure to the rabies virus, whether by bites, scratches, or other means, should seek medical advice without delay. You can  find full rabies advice here .

Getting help

You should also seek medical care if you experience any of the following:

- a fever of 38°C or more

- blood and/or mucus in your poo

- confusion or an altered mental status

- severe abdominal pain

- jaundice or rash

If your symptoms do not improve in 3 days you should seek help.

Young children, infants, older travellers and other groups where dehydration may have more serious consequences, must seek early medical advice if they are not tolerating fluids or are showing signs of dehydration.

Sexual health

Practising safer sex while abroad will reduce the risk of STIs and HIV, as well as infections that spread through close personal contact.

You can reduce your risk by using condoms and having an open conversation about HIV and other STIs before any sexual contact, and avoid sharing items such as towels, clothing or bedding with someone who has mpox or mpox symptoms.

Mpox is a virus which can be spread from an infected animal to a person, or by close personal contact with a person with mpox or materials where a person has shed the virus.

Symptoms include fever, headache, muscle ache, joint pain, and a rash with scabs which often begins on the face then spreads to other parts of the body which can include the mouth, genitals and anus (considered contagious until all scabs fall off and skin is intact).

Antibiotic-resistant gonorrhoea is on the rise in popular tourist destinations in the Asia-Pacific region – including countries such as China, Thailand, Cambodia and the Philippines. This type of gonorrhoea is not easy to treat and can affect fertility.

If you have had condomless sex while abroad, get yourself tested for STIs before having sex with anyone else – depending on where you live, you could get a  self-sampling kit  or simply attend  your local sexual health clinic .

Other factors to consider

• You should ensure that you are able to undertake the type of travel have planned. This includes ensuring that any underlying health conditions are stable prior to travel. For example if you have asthma or diabetes please ensure that you have sufficient medications for the duration of your trip.
• Carry common medicines or a small first aid kit you might need, as you do not know what medicines/provisions the country you are travelling to will have.
• It’s also important to check the rules around using and importing medication in your target country, what might be a common medication in the UK could be outlawed in another.

Returning to the UK

If you feel unwell on returning to the UK, seek medical attention and ensure you inform your healthcare provider that you have been travelling recently.

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Rabies Pre-exposure Prophylaxis

• Pre-exposure vaccination is recommended for persons who work directly with animals that could have rabies
• Also, those who travel to parts of the world where rabies is common and access to medical care is limited.

Pre-exposure vaccination (PrEV)

Most people in the United States have a low risk of encountering an animal with rabies. However, a small subset of people have a higher level of risk, like those who work directly with animals that could have rabies, or those who travel to parts of the world where rabies is common and access to medical care is limited. These people should receive rabies pre-exposure vaccination (PrEV), a series of rabies vaccine doses given before exposure to the rabies virus.

The Advisory Committee on Immunization Practices (ACIP) develops U.S. recommendations about how and when to use vaccines to prevent disease in the United States, including how to prevent rabies in people. ACIP updated rabies vaccine recommendations in May 2022, which are summarized below:

Updates to the ACIP recommendations to prevent human rabies, 2022

• A 2-dose PrEV schedule has replaced the 3-dose PrEV schedule to protect people from rabies for up to 3 years. Options for maintaining protection beyond 3 years are also described.
• Risk categories have been redefined into 5 risk groups.
• The minimum acceptable laboratory value (antibody titer) used to determine whether rabies vaccine booster doses are needed was revised and standardized.
• Many people for whom serial titers were recommended every 2 years now require only a one-time titer (and booster if below a certain level) OR a one-time booster.

Clinical guidance for administering PrEV to people with weakened immune systems has been outlined and includes recommendations to confirm that the vaccine was effective.

Risk category

Who this typically* affects

Recommendations

Risk category 1 Highest risk

People who work with live or concentrated rabies virus in laboratories

2 doses, days 0 and 7

• Check titer every 6 months

Risk category 2

People who frequently do at least one of the following: handle bats, have contact with bats, enter high-density bat environments like caves, or perform animal necropsies

• Check titer every 2 years

Risk category 3

People who interact with, or are at higher risk to interact, with mammals other than bats that could be rabid, for a period longer than three years after they receive PrEP.

This group includes:

• Most veterinarians, veterinary technicians, animal control officers, wildlife biologists, rehabilitators, trappers, and spelunkers (cave explorers)
• Certain travelers to regions outside of the United States where rabies in dogs is commonly found

2 doses, days 0 and 7, plus:

• Either a one-time titer check after 1 year and up to 3 years following the first 2-dose vaccination
• 1-dose booster between 3 weeks and 3 years following the first vaccine in the 2-dose vaccination

Risk category 4

Same population as risk category 3, but at a higher risk for ≤ three years after they receive PrEV

Risk category 5 Lowest risk

General U.S. population

* The typical characteristics described may not include the characteristics of all activities that fall within the described risk group.

For detailed information about these recommendations, please refer to the published MMWR .

Rabies is a preventable viral disease of mammals usually transmitted through the bite of an infected animal.

For Everyone

Health care providers, public health.

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Increased Risk of Dengue Virus Infections in the United States

Distributed via the CDC Health Alert Network June 25, 2024, 2:30 PM ET CDCHAN-00511

Summary The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify healthcare providers, public health authorities and the public of an increased risk of dengue virus (DENV) infections in the United States in 2024. Global incidence of dengue in 2024 has been the highest on record for this calendar year; many countries are reporting higher-than-usual dengue case numbers . In 2024, countries in the Americas have reported a record-breaking number of dengue cases, exceeding the highest number ever recorded in a single year. From January 1 – June 24, 2024, countries in the Americas reported more than 9.7 million dengue cases, twice as many as in all of 2023 (4.6 million cases). In the United States, Puerto Rico has declared a public health emergency (1,498 cases) and a higher-than-expected number of dengue cases have been identified among U.S. travelers (745 cases) from January 1 – June 24, 2024. In the setting of increased global and domestic incidence of dengue, healthcare providers should take steps including:

• Have increased suspicion of dengue among people with fever who have been in areas with frequent or continuous dengue transmission within 14 days before illness onset,
• Order appropriate diagnostic tests for acute DENV infection: reverse transcription polymerase chain reaction [RT-PCR] and IgM antibody tests, or non-structural protein 1 [NS1] antigen tests and IgM antibody tests,
• Ensure timely reporting of dengue cases to public health authorities, and
• Promote mosquito bite prevention measures among people living in or visiting areas with frequent or continuous dengue transmission.

Background Dengue is the most common arboviral disease globally. It is caused by four distinct but closely related dengue viruses (DENV-1, -2, -3, and -4). DENVs are transmitted through bites of infected Aedes species mosquito vectors. Infection with one DENV generally induces life-long protection against infection from that specific DENV but only protects against other DENVs for several months to years. Dengue is a nationally notifiable disease in the United States. Six U.S. territories and freely associated states are classified as areas with frequent or continuous dengue transmission : Puerto Rico, American Samoa, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau. In the rest of the United States, local transmission of DENV has been limited, with sporadic cases or small outbreaks in Florida, Hawaii, and Texas. However, confirmed local DENV transmission has also been reported by Arizona and California over the past two years.

Approximately one in four DENV infections are symptomatic and can be mild or severe. Symptoms begin after an incubation period of 5–7 days (range 3–10 days) and present as fever accompanied by non-specific signs and symptoms such as nausea, vomiting, rash, muscle aches, joint pain, bone pain, pain behind the eyes, headache, or low white blood cell counts. Warning signs are specific clinical findings that predict progression to severe disease. Warning signs include abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation (e.g., ascites, pleural effusion), mucosal bleeding, lethargy or restlessness, progressive increase of hematocrit, or liver enlargement >2cm. Severe disease, with associated severe bleeding, shock or respiratory distress caused by plasma leakage, or end-organ impairment, develops in 1 in 20 people with symptomatic dengue. Infants aged ≤1 year, pregnant people, adults aged ≥65 years, and people with certain medical conditions are at increased risk of severe dengue. Although a second DENV infection (i.e., with a different DENV from the first infection) carries a higher risk of severe disease than a first, third, or fourth infection, any infection can lead to severe disease.

Patients with symptoms compatible with dengue can be tested with both molecular and serologic diagnostic tests. All patients with suspected DENV infection should be tested with RT-PCR (i.e., a nucleic acid amplification test (NAAT)) or a NS1 antigen test, and also with IgM antibody test to confirm DENV infection. These tests can be considered regardless of the symptom onset date, although the test sensitivity of RT-PCR and NS1 antigen tests decrease after the first 7 days. IgG detection by enzyme-linked immunosorbent assay (ELISA) in a single serum sample should not be used to diagnose a patient with acute dengue because it does not distinguish between current and previous DENV infection. U.S. Food and Drug Administration (FDA)-approved testing is available at public health laboratories and some commercial laboratories. State, tribal, territorial, and local health departments, and CDC can offer additional testing guidance.

There are no antiviral medications approved to treat dengue. Treatment is supportive and requires careful volume management. Appropriate triage, management, and follow-up remain the most effective interventions to reduce dengue morbidity and mortality. Expectant management of patients at high risk for severe disease and rapid initiation of a standardized fluid replacement strategy recommended by the World Health Organization (WHO) can decrease mortality from 13% to <1%. In June 2021, the Advisory Committee of Immunization Practices recommended a dengue vaccine, Dengvaxia , for children aged 9–16 years with laboratory confirmation of previous DENV infection and living in areas with frequent or continuous dengue transmission such as Puerto Rico. While the vaccine is considered safe and effective, the manufacturer (Sanofi Pasteur, Inc., Paris France) has discontinued production citing a lack of demand. Vaccine administration will continue in Puerto Rico until available doses expire in 2026.There are no vaccines recommended for travelers, adults, or persons without a previous DENV infection.

Dengue cases resurged globally after the COVID-19 pandemic. In 2023, more than 4.6 million cases and 4000 deaths were reported in the Americas region. As of June 24, 2024, more than 9.7 million dengue cases have been reported in the Americas, twice as many as in all of 2023 (4.6 million cases). Dengue transmission peaks during the warmer and wetter months in many tropical and subtropical regions. Dengue cases are likely to increase as global temperatures increase. Higher temperatures can expand the range of the mosquitoes that spread dengue, as well as affect other factors that facilitate virus transmission like faster viral amplification in the mosquito, increased vector survival, and changes in reproduction and biting rates. U.S. summer travel often overlaps with the months of increased dengue activity in many countries. Epidemics in the Americas region increase travel-associated cases and limited local transmission in the continental United States. A higher-than-expected number of dengue cases (total of 2,241 cases, including 1,498 in Puerto Rico) were reported in the United States from January 1 – June 24, 2024. Public health authorities in Puerto Rico declared a public health emergency in March 2024 because of the high number of cases reported during the low dengue season. Healthcare providers should be prepared to recognize, diagnose, manage, and report dengue cases to public health authorities; public health partners should investigate cases and disseminate clear prevention messages to the public. The CDC is actively implementing several strategies to address the increase in cases of dengue in the United States, including:

• Launching a program-led emergency response, which was activated on April 8, 2024.
• Providing regularly scheduled monthly situational updates on dengue to partners, stakeholders, and jurisdictions.
• Expanding laboratory capacity to improve laboratory testing approaches.
• Collaborating with State, Tribal, Local, and Territorial Health Departments to strengthen dengue surveillance and recommend prevention strategies.
• Educating the public on dengue prevention.

Recommendations for Healthcare Providers

• Maintain a high suspicion for dengue among patients with fever and recent travel (within 14 days before illness onset) to areas with frequent or continuous dengue transmission .
• Consider locally acquired dengue among patients who have signs and symptoms highly compatible with dengue (e.g., fever, thrombocytopenia, leukopenia, aches, pains, rash) in areas with competent mosquito vectors .
• Order appropriate FDA-approved dengue tests (RT-PCR and IgM antibody tests, or NS1 and IgM antibody tests), and do not delay treatment waiting for test results to confirm dengue.
• Know the warning signs for progression to severe dengue, which include abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy or restlessness, and liver enlargement.
• For people with suspected dengue who do not have warning signs and are not part of a population at high risk for severe dengue, consider outpatient management with close follow-up.
• Teach patients about the warning signs that may appear as their fever starts to decline and instruct them to seek care urgently if they experience any warning signs.
• Recognize the critical phase of dengue. The critical phase begins when fever starts to decline and lasts for 24–48 hours. During this phase, some patients require close monitoring and may deteriorate within hours without appropriate intravenous (IV) fluid management.
• Hospitalize patients with severe dengue or any warning sign of progression to severe dengue and follow CDC/WHO protocols for IV fluid management .
• Follow local guidelines to report dengue cases to state, tribal, local, or territorial health departments.

Recommendations for State, Tribal, Local, and Territorial Health Departments

• Use FDA-approved dengue tests. Ensure access to dengue testing for all patients with suspected dengue.
• Remind clinicians of the high risk of dengue among patients with fever who have been in areas with frequent or continuous dengue transmission .
• Remind clinicians that local transmission can occur in areas with competent vectors and to test patients with compatible illnesses even without a history of having been in an area with dengue.
• Inform healthcare providers and the public when locally acquired and travel-associated dengue cases are detected in the area.
• Report dengue cases to CDC via ArboNET , the national arboviral surveillance system managed by CDC and state health departments.
• Take the lead in investigating dengue cases and outbreaks.
• Consider targeted outreach about increasing dengue risk to healthcare providers more likely to identify dengue cases (i.e., travel medicine clinics, infectious disease physicians, or healthcare systems serving highly mobile populations such as migrant and border health clinics, and clinics with frequent travelers to areas with frequent or continuous dengue transmission) and messaging to populations at higher risk for dengue.

Recommendations for the Public

• Use Environmental Protection Agency-approved repellents during travel to and after returning from areas with frequent or continuous dengue transmission.
• Wear loose-fitting, long-sleeved pants and shirts.
• Use air conditioning and window screens when possible, to lower risk for mosquito bites indoors.
• Dump and drain containers that hold water to reduce mosquito egg-laying sites in your home and neighborhood.
• Seek medical care if you have a fever or have dengue symptoms and live in or traveled to an area with dengue outbreaks .
• If you plan international travel to a an area with frequent or continuous dengue transmission , protect yourself from mosquito bites during and after your trip.

For More Information

Healthcare Providers

• Clinical Testing Guidance for Dengue | Dengue | CDC
• Guidelines for Classifying Dengue | Dengue | CDC
• Clinical Features of Dengue | Dengue | CDC
• Dengue Case Management Pocket Guide | CDC
• Dengue During Pregnancy | Dengue | CDC
• Dengue Vaccine | Dengue | CDC
• Dengvaxia: What Healthcare Professionals Need to Know | Dengue | CDC
• Dengue | CDC Yellow Book 2024
• Dengue Clinical Management Course | Dengue | CDC
• Webinar: What Clinicians Need to Know about Dengue in the United States | CDC

Health Departments and Public Health Professionals

• Data and Statistics on Dengue in the United States | Dengue | CDC
• What You Can Do to Control Mosquitoes During an Outbreak | Mosquitoes | CDC
• ArboNET | Mosquitoes | CDC
• Dengue case investigation report | CDC
• Dengue Print Resources | Dengue | CDC
• Communication Resources | Mosquitoes | CDC
• Submitting Specimens for Dengue Virus Tests | Vector-Borne Diseases | CDC
• Preventing Dengue | Dengue | CDC
• Caring for a Family Member with Dengue | CDC
• Mosquito Control at Home | Mosquitoes | CDC
• Get Rid of Mosquitos at Home | CDC
• Your Infant has Dengue | CDC
• Areas with Risk of Dengue | Dengue | CDC
• Travel Health Notices | Travelers’ Health | CDC
• Find a Clinic | Travelers’ Health | CDC
• Pan American Health Organization. Epidemiological Update Increase in dengue cases in the Region of the Americas. https://www.paho.org/en/documents/epidemiological-update-increase-dengue-cases-region-americas-18-june-2024
• Wong JM, Adams LE, Durbin AP, et al. Dengue: a growing problem with new interventions. Pediatrics . 2022;149(6):e2021055522. DOI: 10.1542/peds.2021-055522
• Paz-Bailey G, Adams L, Wong JM, et al. Dengue vaccine: recommendations of the Advisory Committee on Immunization Practices, United States, 2021. MMWR Recommendations and Reports . 2021;70(6):1–16. DOI: 10.15585/mmwr.rr7006a1 .
• World Health Organization. Disease Outbreak News; Dengue – Global situation. May 30, 2024.   https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON518

The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.

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• International travel, immigration and repatriation during COVID-19

New system for international travel

Eight countries will move from the red list on 22 September and the rules for international travel to England will change on 4 October 2021.

• new clearer travel system: red list and rest of world
• simpler, cheaper rules for fully vaccinated travellers coming from non-red list countries – fully vaccinated passengers will be able to replace day 2 PCR tests with cheaper lateral flow tests – from the end of October – and no longer need to take pre-departure tests (PDTs)
• 8 destinations removed from red list including Turkey and Pakistan
• government recognises full vaccinations from a further 17 countries and territories including Japan and Singapore

Read the rules for travel to England from 4 October 2021 .

The Transport Secretary, Grant Shapps, has today (17 September 2021) announced a simplified system for international travel in light of the success of the UK ’s domestic vaccine rollout, providing greater stability for industry and passengers.

The current traffic light system will be replaced by a single red list of countries and territories which will continue to be crucial in order to protect public health, and simplified travel measures for arrivals from the rest of the world from Monday 4 October at 4am.

Testing requirements will also be reduced for eligible fully vaccinated travellers, who will no longer need to take a PDT when travelling to England from Monday 4 October 4am.

From the end of October, eligible fully vaccinated passengers and those with an approved vaccine from a select group of non-red countries will be able to replace their day 2 test with a cheaper lateral flow test, reducing the cost of tests on arrival into England. The government wants to introduce this by the end of October, aiming to have it in place for when people return from half-term breaks.

Anyone testing positive will need to isolate and take a confirmatory PCR test, at no additional cost to the traveller, which would be genomically sequenced to help identify new variants.

Testing for unvaccinated passengers from non-red countries will include pre-departure tests, day 2 and day 8 PCR tests. Test to release remains an option to reduce self-isolation period.

From 4 October, England will welcome fully vaccinated travellers from a host of new countries – who will be treated like returning fully vaccinated UK travellers – including 17 countries and territories such as Japan and Singapore, following the success of an existing pilot with the US and Europe.

Grant Shapps Transport Secretary said:

Today’s changes mean a simpler, more straightforward system. One with less testing and lower costs, allowing more people to travel, see loved ones or conduct business around the world while providing a boost for the travel industry. Public health has always been at the heart of our international travel policy and with more than 8 in 10 adults vaccinated in the UK , we are now able to introduce a proportionate updated structure that reflects the new landscape.

Part of the third Global Travel Taskforce checkpoint review, today’s update reiterates the government’s focus on protecting its borders from the most dangerous variants and ensures continuity for industry and passengers the remainder of the year. We will look to set out a further review for the UK ’s international travel policy early in the new year to provide further certainty for the spring and summer 2022 seasons.

Conducting the final regular traffic light review before the switch to the new two-tiered system, several additional countries and territories will move off the red list – Turkey, Pakistan, the Maldives, Egypt, Sri Lanka, Oman, Bangladesh and Kenya. Changes will come into effect at 4am Wednesday 22 September.

Passengers who aren’t recognised as being fully vaccinated with authorised vaccines and certificates under England’s international travel rules, will still have to take a pre-departure test , a day 2 and day 8 PCR test and self-isolate for 10 days upon their return from a non-red list country under the new two-tiered travel programme. Test to Release will remain an option for unvaccinated passengers who wish to shorten their isolation period.

Sajid Javid Health and Social Care Secretary said:

Today we have simplified the travel rules to make them easier to understand and follow, opening up tourism and reducing the costs to go abroad. As global vaccination efforts continue to accelerate and more people gain protection from this dreadful disease, it is right that our rules and regulations keep pace.

From late October, we will also be making changes to allow passengers who change flights or international trains during their journey to follow the measures associated to their country of departure, rather than any countries they have transited through as part of their journey.

All passengers will still need to fill in a passenger locator form ahead of travel. Passengers should continue to check GOV. UK travel guidance including FCDO travel advice before, during and after travel to keep up to date in entry requirements and ensure compliance with the latest COVID-19 and non-COVID-19 regulations for the country being visited.

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Ukraine war latest: Belarus deploys extra air defence forces to border; 10 Ukrainian prisoners freed with Vatican's help

Ten Ukrainian civilians who had been imprisoned in Russia for years have been released after mediation from the Vatican. Overnight, five people were killed in a Ukrainian drone strike on a Russian village. Listen to a Sky News podcast on Putin and North Korea while you scroll.

Saturday 29 June 2024 18:05, UK

• Five killed, including two children, in Ukrainian strike on Russian village
• Ten Ukrainians imprisoned in Russia freed after Vatican mediation
• Belarus deploys additional air defence forces to Ukraine border
• Your questions answered : Has the West been honest about Ukraine's failures?
• Listen to the Daily above and tap here to follow wherever you get your podcasts
• Live updates by Jess Sharp and (earlier)  Niamh Lynch

Ask a question or make a comment

We're pausing our live coverage for now. 

You can scroll below to catch up on the latest developments, and we'll be back with our regular coverage tomorrow. 

Six people have been killed in a Russian attack on a small town in the southern Zaporizhzhia region, a Ukrainian official has said. 

A further eight people have been injured, regional governor Ivan Fedorov said. 

Infrastructure, a shop and residential buildings in Vilniansk have also been damaged, he added. 

The strike comes after five people were killed in the Kursk region of Russian due to a Ukrainian drone attack. 

Two young children were also injured in the strike on the village of Gorodishche, around 73 miles (118km) from the Ukrainian border, Kursk governor Alexey Smirnov said. 

Two other people were injured and were in a "serious condition" in hospital, he added. 

Volodymyr Zelenskyy has met one of the men released from Russian captivity earlier today. 

The Ukrainian president met Nariman Dzhelyal who was successfully returned home after three years in captivity. 

"We will bring security to all our people and peace to Ukraine. I thank everyone who is helping. I thank Nariman for this meeting and for his strength," Mr Zelenskyy said. 

Mr Dzhelyal was detained in Crimea in 2021 while serving as the first deputy chairman of the Mejlis of the Crimean Tatar People. 

During his imprisonment, he sent several letters, Mr Zelenskyy said. 

He added that in one of them he wrote: "We are fighting not only for the integrity of our territories but also for the unity of our society, our beautiful, strong nation." 

US officials told Reuters news agency late last night that the Biden administration would provide Ukraine with $150m (£118.6m) worth of weapons and ammunition, including HAWK air defence interceptors and 155 millimetre artillery munitions.

The weapons aid package is expected be unveiled on Monday, the officials said.

Ukraine has urgently requested air defence support as Russia has pounded its energy facilities in recent weeks via aerial attacks. 

The US began shipping HAWK interceptor missiles to Ukraine in 2022 as an upgrade to the shoulder-launched Stinger air defence missile systems - a smaller, shorter-range system. 

The support package will include other munitions and equipment to support Ukraine's defence needs, the officials added. 

The US has provided Ukraine with more than $50bn (£39.5bn) in military aid since 2022. 

We reported earlier on the 10 Ukrainian civilians who were released from Russian captivity earlier today after years of imprisonment (see 8.49am post). 

Watch them reunite with their loved ones in Kyiv's international airport in newly released footage.

A report by the Ukrainian military's centre for strategic communications has found that the country's forces have damaged or destroyed more than 30 Russian military aircraft in the first six months of 2024. 

Most of the strikes against the aircraft have taken place in occupied Ukraine except for a handful of strikes over the Sea of Azov and within Russia, the centre said, as reported by the Institute for the Study of War (ISW). 

The centre did not specify what portion of these Ukrainian strikes were air defence interceptions of Russian aircraft in flight and what percentage were strikes against Russian aircraft at airfields. 

The ISW said they were unable to verify the report.

But it said the downing of Russian aircraft, especially critical aircraft like the A-50 and Il-22, has temporarily constrained Russian aviation activities over occupied Ukraine, but added Ukrainian forces "have yet to be able to significantly attempt to contest the air domain".

President Volodymyr Zelenskyy has revealed that Russian strikes have resulted in Ukraine losing around 80% of its thermal power and one third of its hydroelectric power.

Discussing the attack in Dnipro, Mr Zelenskyy said it was a reminder to Ukraine's allies that the country needed more air defence systems. 

He said: "This is why we constantly remind all of our partners: only a sufficient amount of high quality of air defence systems, only a sufficient amount of determination from the world at large can stop Russian terror."

Kyiv has also struck back at Russia with its own attacks, which also often target energy infrastructure.

Belarus has deployed additional air defence forces to its border with Ukraine to protect "critical infrastructure facilities" due to increased Ukrainian drone activity, a Belarusian military commander has said.

Belarus, an ally of Russia, said earlier this week it had shot down a quadcopter that had illegally crossed the border from Ukraine "to collect information about the Belarusian border infrastructure". 

The situation in the airspace over the border remains tense, Andrei Severinchik, commander of the Belarusian Air Defence Forces, said. 

"We are ready to decisively use all available forces and means to protect our territory and the population of the Republic of Belarus from possible provocations in the airspace," he said. 

Belarus' defence ministry said earlier today it had information showing Ukraine had been moving more troops, weapons and military equipment to the northern Zhytomyr region, which borders Belarus. 

There was no immediate response from Ukraine. 

Russian elites and oligarchs have reportedly moved from criticising the country's war effort in Ukraine to supporting it, the Institute for the Study of War (ISW) has reported.

Mikhail Zygar, the founder of the Russian opposition television channel TV Rain, reported that many elites who were opposed to the war in 2022 started to support the war in 2023 because they "believe Russia is prevailing".

Mr Zygar said these people made this assessment due to Russia's slow but steady battlefield gains, a persisting Ukrainian munitions disadvantage, and perceived "waning" Western security assistance to Ukraine.

One anonymous Russian oligarch who previously criticised the war reportedly told Mr Zygar that Russia must win the war otherwise "they won't allow us to live... and Russia would collapse".

The ISW said it cannot independently verify Mr Zygar's reporting but it is consistent with the institute's assessment that this section of Russian society came to heel behind Vladimir Putin in support of the war after his government intensified crackdowns against elites in the wake of the 2022 invasion. 

As Russia announces it has captured a second village in 24 hours (see 12.26pm post), let's take a look at where Russia has advanced along the frontline with Ukraine. 

As well as pockets of advances on the border north of Kharkiv, Russia appears to have captured areas along the length of the front, from the Donetsk region right up to the western edge of Luhansk.

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