Cambodia

Destination overview

Millions of tourists annually visit Cambodia to visit the Angkor temple complex (which includes Angkor Wat), a collection of approximately 1,000 ancient temples and other structures covering 400 km² (250 mi²) in the northwestern Cambodia jungle. Increasingly, tourists are also visiting other areas of Cambodia, including the capital Phnom Penh, the southern beaches, and the islands in the Gulf of Thailand. Adventure tourism in the rural and forested areas bordering Vietnam and Laos has also become popular.

The Angkor temple complex, located 6 km (4 mi) north of Siem Reap, is considered one of the architectural wonders of the world and was designated a World Heritage site in 1992. The temples were built between the 9th and 14th centuries at the height of the Khmer Empire and were part of the empire's capital (Angkor means "capital city" in Khmer). These historical structures were decorated with intricately carved Khmer artwork depicting Hindu and Buddhist themes, providing an archaeological portrayal of the empire that ruled much of Southeast Asia for 5 centuries. After the decline of the Khmer Empire, the site was largely abandoned to the surrounding jungle and remained virtually untouched until descriptions of the ruined temples of Cambodia were published in a journal in the late 19th century.

Restorations commenced as international visitors began to arrive, but the emergence of the Khmer Rouge regime and the ensuing decades of civil war halted most tourist travel to the site until the late 1990s. As Cambodia emerged from >20 years of political and economic turmoil, the Angkor temples have become one of the most popular tourist destinations in Southeast Asia.

Cambodia is one of the poorest countries in Southeast Asia but is currently experiencing a period of rapid economic development. As a result, business-related travel, in addition to tourism, is increasing. Visitors can fly directly to Phnom Penh, Siem Reap, or Sihanoukville from several international cities. Overland travel from surrounding countries is also possible via direct bus service to Siem Reap and Phnom Penh from Bangkok and Ho Chi Minh City. A network of interprovincial bus services connects Phnom Penh with Siem Reap and other Cambodian cities. Passenger train service connects Phnom Penh, Kampot, and Sihanoukville. Intercity transport usually involves taxis, tuk-tuks (motorbike taxis), bicycles, or buses (in Phnom Penh).

Infectious disease risks

All travelers to Cambodia should be up to date with their routine immunizations, including seasonal influenza and COVID-19, and, at the very least, should be protected against hepatitis A and typhoid fever. Although yellow fever is not a disease risk in Cambodia, the government requires travelers arriving from countries with a risk of yellow fever virus transmission to present proof of yellow fever vaccination.

Enteric infections and diseases

Travelers' diarrhea

Diarrhea and food-borne infections in travelers are common in Cambodia. Advise travelers to avoid water that is not bottled, ice, and food from street vendors. Safe, bottled water is readily available, and it is wise to verify that the seal is unbroken. Travelers should practice safe food and water precautions and consider carrying an antibiotic and antidiarrheal for self-treatment (see Food and Water Precautions for Travelers and Travelers' Diarrhea chapters). Because fluoroquinolone resistance is widespread in Cambodia and other areas of Southeast Asia, empiric azithromycin treatment for bacterial gastroenteritis is preferred.

Typhoid and paratyphoid fever

Typhoid and paratyphoid fever are endemic to Cambodia, and travelers are at risk. Antimicrobial resistance is common. Travelers should be vaccinated against typhoid fever, especially those planning extended stays or visiting remote regions (see Typhoid and Paratyphoid Fever chapter).

Respiratory infections and diseases

Coronavirus disease 2019

All travelers going to Cambodia should be up to date with their COVID-19 vaccines.

Tuberculosis

Cambodia has one of the region's highest rates of active tuberculosis (TB), with an estimated 54,000 cases and 4,500 deaths in 2022. Although Cambodia was removed from WHO's list of top 30 high TB burden countries in 2021, its TB burden remains substantial and WHO has placed the country on its new global TB watchlist. Travelers who plan to work in high-risk settings (e.g., medical facilities, prisons, or homeless shelter populations) are at risk for TB exposure (see Tuberculosis chapter). Travelers working in these settings in Cambodia should have a test for tuberculosis, either a tuberculin skin test or a blood test (interferon-gamma release assay or IGRA), to screen for TB infection before leaving and upon returning to the United States. The tuberculin skin test (TST) for TB testing is readily available in Cambodia. IGRA is more challenging and expensive to access but is available locally in Phnom Penh.

Avian influenza

The first human cases of influenza A(H5N1) in Cambodia were detected in 2005. After outbreaks in 2009 and 2014, no additional cases were seen until 2023. From February 2023 through March 2025, 19 cases had been reported from 7 provinces, with no evidence of human-to-human transmission. Risk to the general public is considered low; however, individuals planning travel to rural provinces should be cautioned to avoid contact with poultry and to seek medical care and laboratory testing for respiratory symptoms with high fever. Early treatment with oseltamivir (Tamiflu) is recommended.

Sexually transmitted infections and HIV

Expanded HIV testing and treatment programs, along with strong prevention messaging, have reduced the number of newly diagnosed HIV infections in Cambodia to approximately 1,200 cases annually. Antiretroviral and pre-exposure prophylaxis (PrEP) medications are available locally. HIV prevalence remains high in certain key populations, however, including men who have sex with men (MSM) and female sex workers. In addition, syphilis prevalence is high and antimicrobial-resistant gonorrhea is widespread throughout the region. Because of high hepatitis B prevalence, hepatitis B vaccine is recommended. The first cases of mpox in Cambodia were diagnosed in 2023; so far, all cases have been among MSM. The mpox-specific antiviral (tecovirimat) is available in Cambodia and mpox vaccine is available for use during outbreaks.

Cambodia is a destination for tourists seeking sex, and, although illegal, commercial sex work is practiced across the country (see Sex and Travel chapter). Travelers should be aware of these risks and always use condoms during transactional sex. Although not a sexual risk, travelers should avoid injecting drugs or sharing needles or syringes. Travelers whose practices put them at high risk for HIV infection should discuss pre-exposure prophylaxis with their primary care or travel medicine specialist. High-quality condoms are readily available at a reasonable price.

Soil- and waterborne infections

Leptospirosis and melioidosis

Leptospirosis and melioidosis are endemic causes of illness in Cambodia (see Leptospirosis chapter). For both diseases, most cases occur during the rainy season, from May–October, when flooding is common. Adventure travelers are at increased risk for these diseases because their activities expose them to soil (melioidosis) and freshwater (leptospirosis). The risk of leptospirosis can be reduced by not swimming or wading in water that might be contaminated with animal urine, by not participating in activities involving mud, and by eliminating contact with animal urine.

People with open skin wounds and those with chronic conditions (e.g., diabetes, kidney disease, heavy alcohol use) are at increased risk for melioidosis and should avoid contact with soil and surface water. People who engage in agricultural work should wear boots, which can prevent infection through the feet and lower legs. Travelers should immediately and thoroughly clean abrasions, burns, or lacerations contaminated with soil or surface water.

Schistosomiasis

Liver flukes (e.g., Schistosoma mekongi) are found in the Mekong River basin from the border of Laos to Kratie Province in Cambodia, where the freshwater dolphins attract tourists. Swimming in natural freshwater settings such as lakes, rivers, and ponds should be avoided. Travelers developing a rash within hours or up to a week after freshwater exposure should be evaluated for acute schistosomiasis (see Schistosomiasis chapter).

Vector-borne diseases

Chikungunya, dengue, and Zika

Chikungunya was reintroduced into Cambodia in 2011, and 2 large outbreaks have occurred since then, in 2012 and 2020 (see Chikungunya chapter). The risk of chikungunya occurs throughout Cambodia, including in Phnom Penh. A vaccine is now available that is recommended for certain travelers. Please see CDC's Chikungunya website for information on groups for whom vaccination is recommended and information on recent chikungunya virus transmission.

Dengue is endemic throughout Cambodia, and large epidemics occur every several years (see Dengue chapter). Peak transmission occurs during the rainy season, although cases occur year-round, even in nonepidemic years. A dengue vaccine, Dengvaxia, was FDA approved in 2019 for children aged 9–16 years with laboratory-confirmed evidence of prior dengue virus infection and living in areas where dengue is common. However, the vaccine is not recommended for residents in other age groups, including adults or travelers. Dengvaxia will be discontinued in September 2025, with the final doses expiring in September 2026. Other dengue vaccines are available in limited supply in Cambodia including Takeda's QDENGA (TAK-003) dengue vaccine, but this vaccine is not FDA-approved and data on efficacy and safety are incomplete. Dengue is by far the mosquito-borne virus most likely to infect travelers and the most dangerous due to the risk of dengue hemorrhagic fever. Travelers with a high fever in Cambodia, or within a few weeks of leaving, should seek medical care, including lab testing.

Zika virus was first detected in Cambodia in 2010. Since then, sporadic cases have been identified retrospectively (see Zika chapter). Because Zika virus infection in pregnant women can cause serious congenital disabilities, CDC encourages a pre-travel discussion of risks with anyone who is pregnant or trying to become pregnant. See Zika Travel Information on the CDC Travelers' Health website.

All travelers to Cambodia should take measures to protect themselves from mosquito bites through multiple means, including sleeping with mosquito nets in malarious areas and using high-quality mosquito repellent during the day (see Mosquitoes, Ticks, and Other Arthropods chapter).

Japanese encephalitis

Japanese encephalitis (JE) is considered endemic throughout Cambodia; transmission occurs year-round but peaks during the rainy season from May–October (see Japanese Encephalitis chapter). The vaccine is recommended for travelers who are moving to an area with JE to live or plan to spend ≥1 month in rural areas. The vaccine should be considered for short-term travelers who may be at increased risk for JE virus exposure (e.g., those who will spend substantial time outdoors in rural or agricultural areas, especially during the rainy season). Travelers on a typical 2- to 4-day visit to the main (nonremote) Angkor temples and staying in air-conditioned hotels in Siem Reap are at minimal risk, but mosquito prevention measures should be employed (see Mosquitoes, Ticks, and Other Arthropods chapter).

Malaria

Greater than 95% of reported malaria cases in Cambodia are Plasmodium vivax species, with the remainder consisting of Plasmodium falciparum, Plasmodium malariae, and Plasmodium knowlesi. The highest risk of malaria infection for the traveler in Cambodia is in forested areas (see Map 1.5.19, Malaria prevention in Cambodia). There is little to no malaria transmission around the main temples of Angkor Wat, Phnom Penh, Siem Reap city, and Tonle Sap Lake. Malaria risk is minimal on a typical visit that involves exploring the main temples of the Angkor temple complex during the day and staying in an air-conditioned hotel in Siem Reap at night. Risk can be further minimized by following mosquito prevention measures (see Mosquitoes, Ticks, and Other Arthropods chapter). Eco-travelers planning to visit and sleep in deeply forested areas should receive malaria chemoprophylaxis. Recommended chemoprophylaxis regimens include atovaquone-proguanil, doxycycline, primaquine, or tafenoquine (see Yellow Fever Vaccine & Malaria Prevention Information, by Country and Malaria chapters).

Map 1.5.19

This map of Cambodia outlines malaria prevention recommendations across the country. Areas shaded in brown show regions where chemoprophylaxis (preventive medication) and mosquito avoidance are recommended for rural, forested areas. This includes most of Cambodia except Phnom Penh, Siem Reap, and Sihanoukville, which are shaded in beige indicating that there is no known malaria transmission.

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Environmental hazards and risks

Air quality

Monitoring of air quality in Cambodia is limited. Like other countries in the region, fine particulate matter levels exceed both the World Health Organization annual standard, with an annual mean estimated to be 25–35 μg/m³, and the U.S. government daily standard for fine particulate matter (PM2.5) during parts of the year. For additional information on real-time monitoring, see World's Air Pollution: Real-time Air Quality Index, Air Pollution in the World, and Air Quality and Ionizing Radiation During Travel chapter. When the Air Quality Index is over 100, people with heart or lung disease, older adults, children, and teenagers should reduce prolonged outdoor exertion and follow their healthcare professional's advice.

Animal bites

Rabies

Rabies is endemic throughout Cambodia, where infection results in over 400 human deaths from canine rabies annually (see Rabies chapter). The chief risk to humans is from dog bites; there are over 200,000 dog bites annually in Cambodia. For most travelers on a short tour of the Angkor temple complex, the risk is minimal. Travelers planning more extensive travel in Cambodia, particularly to rural areas or extended stays, are strongly advised to receive rabies pre-exposure prophylaxis vaccination before arrival. The Institut Pasteur du Cambodge (IPC) in Phnom Penh and many private clinics can provide rabies vaccine and consultation after an exposure. In addition, rabies immune globulin is available to the public at IPC and the Royal Phnom Penh Hospital. However, rabies immune globulin is expensive, and supply can be sporadic in Cambodia.

Snakebites

At least 17 known venomous snake species are found in Cambodia; therefore, travelers should use precautions to avoid snakebites (see Poisonings, Envenomations, and Toxic Exposures During Travel chapter). A snakebite is a medical emergency, and a bitten traveler needs to proceed as quickly as possible to a hospital for antivenom. Antivenom is available at Royal Angkor International Hospital in Siem Reap and the Calmette Hospital in Phnom Penh. Traditional medicine (thnam boran) is popular in rural Cambodia but should not be used to treat snakebites because it often causes increased harm and delays effective treatment.

Climate and sun exposure

Cambodia's tropical climate is generally hot and humid throughout the year. The hottest months are March–May, but heat precautions should be taken year-round when exploring the temples or visiting other tourist areas (see Heat and Cold Illness in Travelers chapter). Travelers should stay hydrated, especially during midday. Many travelers explore the temples in the early mornings and late afternoons, taking a midday break in the comfort of an air-conditioned restaurant. The rainy season is from late April or early May–October. During this time, the risk of vector-borne disease transmission increases.

Landmines

More than 65,000 people have been killed or injured from landmines and unexploded ordnance since the end of the Khmer Rouge in 1979. Although the areas around the Angkor temple complex and major towns have been cleared, landmines and unexploded ordnance from the decades of conflict are still found in rural areas in Cambodia, especially along the Cambodia-Thailand border. Travelers to those areas should exercise caution, especially when venturing out to the more remote temples and forests, by staying on roads and paths and using a guide with knowledge of local hazards. Travelers should not touch anything resembling a mine or unexploded ordnance. Alert travelers to notify the Cambodia Mine Action Centre should they observe these items.

Safety and security

Crime

Travelers should use common-sense measures such as not walking or traveling alone at night. Travelers are also advised to only carry what they are willing to lose. The most common type of theft is "snatch and grab" robbery. Travelers should keep belongings out of sight if traveling by tuk-tuk and carry items and bags away from the street side while walking. Educate travelers about the U.S. Department of State's Smart Traveler Enrollment Program (STEP), which sends electronic updates to enrolled travelers about safety conditions at their destination.

Traffic-related injuries

Road traffic incidents are one of the leading causes of death in Cambodia (see Injury and Death During Travel chapter). Deaths related to motor vehicle crashes increased by nearly 25% between 2009–2019. The National Police reported that in 2023, on average, at least four individuals were killed and 12 injured in crashes in Cambodia daily. The most common means of transport in Cambodia is motorbike, and although both drivers and passengers are required to wear helmets, this law is infrequently followed or enforced. Travelers should always wear a helmet when on a motorbike. In addition to the ever-growing number of cars and motorbikes, there is lax enforcement of traffic laws and a scant understanding of the rules of the road. Travelers should carefully look in every direction before crossing the street.

In cities and at the Angkor temple complex, most travelers use tuk-tuks, which are readily available, or hire cars with a driver guide. Advise travelers to negotiate the fare at the outset and avoid using tuk-tuks after dark, when limited street lighting and inadequate enforcement of impaired driving laws make this mode of transportation unsafe. Ride-hailing apps such as Grab, Pass App, and TADA are frequently used locally because prices are fixed to prevent being overcharged and navigation systems prevent drivers from getting lost. In addition, it is increasingly common to rent bicycles to get around the Angkor temple complex. Forewarn travelers planning to rent bicycles to yield to motorized traffic, wear helmets, and use extreme caution.

Six national highways link Cambodia's capital city, Phnom Penh, to other cities and beach resorts. During the rainy season, road conditions deteriorate rapidly; discourage travel after dark on the highways. Intoxicated drivers are common during the evening hours, and travelers should stay off the road at night whenever possible. In addition, counsel travelers to avoid traveling by boats, which often lack safety equipment and are overcrowded.

Availability and quality of medical care

Counterfeit drugs

Local pharmacies provide a variety of imported prescription and over-the-counter medications. Due to variable quality, improper storage, and lack of proper ingredients in some formulations, travelers should bring an adequate supply of their regular medications. In addition, counterfeit drugs are commonly found and often indiscernible from authentic medication.

Medical care

Most medical facilities in Cambodia do not meet international standards. A few internationally run clinics and hospitals in Siem Reap and Phnom Penh can provide basic medical care and stabilization. Some information on health facilities and pharmacies in Cambodia can be found on the U.S. Embassy Phnom Penh website. For anything other than basic care and stabilization, travelers should seek medical care in Bangkok or Singapore. For this reason, strongly encourage travelers to purchase travel health insurance that includes medical evacuation.

Acknowledgements

The following authors contributed to the previous version of this chapter: Michael C. Thigpen, Stacy L. Ali, Alyssa Finlay, Rachel Albalak