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Destination
Health Precautions for
Western Europe
Andorra,
Austria, Azores, Belgium, Denmark,
Faroe Island, Finland, France, Germany,
Gibraltar, Greece, Greenland, Iceland,
Ireland, Italy, Liechtenstein, Luxembourg,
Madeira, Malta, Monaco, Netherlands,
Norway, Portugal, San Marino, Spain,
Sweden, Switzerland, United Kingdom
Currently, there is an outbreak of
foot-and-mouth disease (FMD) among
animals in the United Kingdom and
several other European countries.
For more information about the outbreak
and recommendations, see Foot-and-Mouth
Disease—Information for Travelers.
On July 11, the Spanish National Centre
for Epidemiology reported an outbreak
of legionellosis (Legionnaires' disease)
in Murcia, Spain. Since July 14, no
new cases have been reported.
The preventive measures you need to
take while traveling in Western Europe
depend on the areas you visit and
the length of time you stay. For most
areas of this region, you should observe
health precautions similar to those
that would apply while traveling in
the United States.
Travelers’ diarrhea, the number one
illness in travelers, can be caused
by viruses, bacteria, or parasites,
which can contaminate food or water.
Infections may cause diarrhea and
vomiting (E. coli, Salmonella, cholera,
and parasites), fever (typhoid fever
and toxoplasmosis), or liver damage
(hepatitis). Make sure your food and
drinking water are safe.
Tickborne encephalitis, a viral infection
of the central nervous system, occurs
chiefly in Central and Western Europe.
Travelers are at risk who visit or
work in forested areas during the
summer months and who consume unpasteurized
dairy products. The vaccine for this
disease is not available in the United
States at this time. To prevent tickborne
encephalitis, as well as Lyme disease,
travelers should take precautions
to prevent tick bites.
There is no risk for yellow fever
in Western Europe. A certificate of
yellow fever vaccination may be required
for entry into certain of these countries
if you are coming from countries in
South America or sub-Saharan Africa.
CDC recommends the following vaccines
(as appropriate for age):
See your doctor at least 4–6 weeks
before your trip to allow time for
shots to take effect.
- Hepatitis
A or immune globulin (IG). You are
not at increased risk in Northern,
Western, and Southern Europe, including
the Mediterranean regions of Italy
and Greece.
- Hepatitis
B, if you might be exposed to blood
(for example, health-care workers),
have sexual contact with the local
population, stay longer than 6 months
in Southern Europe, or be exposed
through medical treatment.
- As
needed, booster doses for tetanus-diphtheria.
Hepatitis B vaccine is now recommended
for all infants and for children
ages 11–12 years who did not complete
the series as infants.
All travelers should take the following
precautions, no matter the destination:
- Wash
hands often with soap and water.
- Because
motor vehicle crashes are a leading
cause of injury among travelers,
walk and drive defensively. Avoid
travel at night if possible and
always use seat belts.
- Always
use latex condoms to reduce the
risk of HIV and other sexually transmitted
diseases.
- Don’t
eat or drink dairy products unless
you know they have been pasteurized.
- Don’t
share needles with anyone.
- Eat
only thoroughly cooked food or fruits
and vegetables you have peeled yourself.
Remember: boil it, cook it, peel
it, or forget it. Never eat undercooked
ground beef and poultry, raw eggs,
and unpasteurized dairy products.
Raw shellfish is particularly dangerous
to persons who have liver disease
or compromised immune systems.
Travelers visiting undeveloped
areas should take the following precautions:
To stay healthy, do...
- Drink
only bottled or boiled water, or
carbonated (bubbly) drinks in cans
or bottles. Avoid tap water, fountain
drinks, and ice cubes. If this is
not possible, make water safer by
BOTH filtering through an “absolute
1-micron or less” filter AND adding
iodine tablets to the filtered water.
“Absolute 1-micron filters” are
found in camping/outdoor supply
stores.
- If
you visit an area where there is
risk for malaria, take your malaria
prevention medication before, during,
and after travel, as directed. (See
your doctor for a prescription.)
- Protect
yourself from insects by remaining
in well-screened areas, using repellents
(applied sparingly at 4-hour intervals),
and wearing long-sleeved shirts
and long pants from dusk through
dawn.
- To
prevent fungal and parasitic infections,
keep feet clean and dry, and do
not go barefoot. To avoid getting
sick...
- Don’t
eat food purchased from street vendors.
- Don’t
drink beverages with ice.
- Don’t
share needles with anyone.
- Don’t
handle animals (especially monkeys,
dogs, and cats), to avoid bites
and serious diseases (including
rabies and plague).
What you need to bring with you:
- Long-sleeved
shirt and long pants to wear while
outside whenever possible, to prevent
illnesses carried by insects.
- Insect
repellent containing DEET (diethylmethyltoluamide),
in 30%–35% strength for adults and
6%–10% for children, as well as
a bed net impregnated with the insecticide
permethrin. (Bed nets can be purchased
in camping or military supply stores.)
- Over-the-counter
antidiarrheal medicine to take if
you have diarrhea.
- Iodine
tablets and portable water filters
to purify water if bottled water
is not available.
- Sunblock,
sunglasses, hat.
- Prescription
medications: make sure you have
enough to last during your trip,
as well as a copy of the prescription(s).
After you return home:
If you have visited a malaria-risk
area, continue taking your antimalarial
drug for 4 weeks (Lariam®, doxycycline)
or seven days (Malarone™) after leaving
the risk area. Travelers who become
ill with a fever or flu-like illness
while traveling in a malaria-risk
area and up to one year after returning
home should seek prompt medical attention
and should tell the physician their
travel history.
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