There is a risk of malaria in the south-eastern part of the country, but not in the main tourist areas in the west and south-west of the country, although mosquitoes can still be an irritation in summer. There are no vaccination requirements. An outbreak of bird flu on a farm in north west Turkey was reported in October 2005, but measures have been taken to contain the outbreak. No human cases have been reported and visitors are unlikely to be at risk, but are advised to avoid exposure to caged, domestic or wild birds. Most tap water in the larger towns and cities has been chlorinated, but bottled water is still recommended for drinking. Food from street vendors should be treated with caution. Medical facilities and standard of health care are not high in state hospitals and private health insurance is recommended.