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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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