Health and safety

Dengue and malaria in India: where the risk is and how to avoid bites

Dengue is the mosquito-borne disease most travellers to India actually meet: it lives in cities, bites in daytime and peaks in and after the monsoon. Malaria risk is real but uneven, concentrated in forested, tribal and hilly districts and in a few eastern and north-eastern states. For both, not getting bitten is the core of prevention, and a fever during or after the trip means seeing a doctor the same day.

Not medical advice

This page summarises official travel health advice. It does not diagnose or treat anything. Whether you need antimalarial tablets, and which ones, is decided by a doctor or travel clinic; if you have a fever in India or after returning, see a doctor.

Two mosquitoes, two schedules

It helps to know who is biting. Dengue, chikungunya and Zika are carried by Aedes, a small black mosquito with white stripes. India's National Center for Vector Borne Diseases Control (NCVBDC) describes it as a daytime biter that lives around houses and does not fly far, about 400 metres. That is why dengue is a city disease, and why a hotel room with a net is not enough on its own: the bites happen at cafés, in parks and on the train platform in broad daylight.

Malaria is carried by Anopheles. NaTHNaC notes that dawn and dusk are the riskier hours, though bites can happen at other times, for example in forests or on overcast days.

Repellent and covered skin work against both. The schedule only tells you when not to relax.

Where and when the risk is higher

Official sources describe risk by disease. The short version:

Dengue	Across the country, including big cities. NCVBDC notes that transmission is higher in the rainy season, when mosquitoes live longer, and that cases surge every year from July to November, peaking after the monsoon.
Malaria: where	The CDC lists transmission throughout India, including Mumbai and New Delhi, but none above 2,000 m in the hills of Himachal Pradesh, Ladakh, Jammu and Kashmir, Sikkim, Uttarakhand, Arunachal Pradesh, Kerala and Tamil Nadu. NaTHNaC marks Mizoram, Odisha and Tripura as high risk and Lakshadweep as risk-free.
Malaria: how much	NCVBDC says about 80% of India's malaria comes from tribal, hilly and hard-to-reach areas home to about 20% of the population. Cases fell from 3.29 per 1,000 people in 1995 to 0.18 in 2024.
Japanese encephalitis	Countrywide and year-round, with peaks during and just after the monsoon, especially in the north. A vaccine exists; see the [vaccinations guide](/en/guide/vaccinations/).
Chikungunya and Zika	Both present in India and spread by the same daytime Aedes mosquito. NaTHNaC advises pregnant travellers to discuss Zika and the trip with a health professional.

✅ How not to get bitten

No vaccine covers dengue or malaria for an ordinary traveller, so these habits are the main protection. The advice follows NaTHNaC's bite avoidance guidance.

Use a proven repellent — DEET at 50% is the first choice; higher concentrations add nothing. Alternatives: icaridin (at least 20%), oil of lemon eucalyptus (PMD) or IR3535, reapplied more often.
Sunscreen first, repellent second — DEET weakens sunscreen a little, so NaTHNaC suggests SPF 30–50 underneath.
Daytime counts too — Dengue mosquitoes bite in daylight. Repellent goes on in the morning, not only at dusk.
Cover up and sleep protected — Long sleeves and trousers, especially at dawn and dusk. At night, air-conditioning or a net, ideally one treated with insecticide.
Skip what doesn't work — Electronic buzzers, phone apps, garlic, vitamin B, tea tree oil, tonic water and citronella products: NaTHNaC finds no evidence they work.
Children and pregnancy — UK guidance allows DEET up to 50% for babies over two months, and in pregnancy and breastfeeding. Check products for small children with a doctor or pharmacist.

Antimalarial tablets: a question for the clinic

Whether you need tablets depends on the area, the season and how long you stay, not simply on the state. Official sources also differ: NaTHNaC recommends tablets for Mizoram, Odisha and Tripura and "awareness and bite avoidance" for the rest of India, Goa and the Andamans included, while the CDC recommends prescription antimalarials for travellers to areas with malaria, which it draws much more widely.

That is exactly why this decision belongs to a travel clinic. Bring your route (states, districts, villages or cities, trekking or forest stays) and the clinic will choose whether you need tablets, which ones and how to take them. Some courses start before the trip and continue after it.

Fever: see a doctor the same day

Any fever in India, or within a year of coming back, needs a doctor and a malaria test that day. NaTHNaC notes that falciparum malaria usually shows up 7–14 days after exposure, but it can appear months later, and it can turn serious fast.

Dengue typically starts 4–10 days after the bite with high fever, a severe headache, pain behind the eyes, muscle and joint pain, nausea or a rash. The dangerous phase can come after the fever drops. WHO lists warning signs that need emergency care: severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums or nose, blood in vomit or stool, great thirst, pale cold skin, restlessness or weakness.

Until a doctor has ruled out dengue, WHO advises avoiding aspirin, ibuprofen and other anti-inflammatory painkillers, because they raise the risk of bleeding. In an emergency call 112 (see [emergency numbers](/en/guide/emergency-numbers/)).

👣 If you get a fever

Don't wait for it to pass
In dengue season or after time in a malaria area, a fever is a reason to see a doctor today, not in three days.
Go to a hospital or clinic with a lab
Private hospital chains in big cities have international desks. Call your insurer's assistance line first if you can; they often point you to a partner clinic.
Tell the doctor where you have been
States, dates, rural or forest stays. The right test for dengue depends on the day of illness, and the doctor will also rule out malaria and typhoid.
Drink and rest
Fluids matter in dengue. Bring a fever down only with what the doctor approves, and skip aspirin and ibuprofen.
After the trip, mention India
If a fever starts back home, tell the doctor you were in India and when. Malaria can appear up to a year later.

❓ Questions people ask

Is there malaria in Goa or Delhi?

The CDC includes Mumbai and New Delhi in its malaria area. NaTHNaC classes Goa and most of India as lower risk, where bite avoidance is advised rather than tablets.

Do I need malaria tablets for Rajasthan or Kerala?

Official sources disagree, and the answer depends on your exact route and season. A travel clinic decides.

Is there a dengue vaccine I can get?

NaTHNaC suggests a dengue vaccine mainly for people who have already had dengue, and only exceptionally for others. For everyone else, bite prevention is the protection.

Is a second dengue infection worse?

WHO says people infected a second time are at greater risk of severe dengue. If you have had dengue before, tell your doctor and be extra careful about bites.

Is Ladakh or Spiti free of malaria?

The CDC reports no malaria transmission above 2,000 m in the listed Himalayan regions, which covers most of Ladakh and Spiti. The lowland stops on your route still count.

Does a mosquito net in the room solve it?

For malaria at night, it helps a lot. For dengue, no: those mosquitoes bite during the day, so repellent matters more.

Sources (8)

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