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see also Australian consular advice: www.smartraveller.gov.au/zw-cgi/view/Advice/

DEVELOPED COUNTRIES

The preventive measures you need to take while travelling in Developed Countries including Western Europe, North America, Australia and New Zealand, depend on the areas you visit and the length of time you stay. For most areas of these countries, you should observe health precautions similar to those that would apply while travelling in Australia.

Travellers' diarrhoea, the number one illness in Travellers, can be caused by viruses, bacteria, or parasites, which can contaminate food or water. Infections may cause diarrhoea 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. 

A certificate of yellow fever vaccination may be required for entry into certain of these countries if you are coming from countries in tropical South America or subSaharan Africa. (There is no risk for yellow fever in any of these countries.) 

Tick borne encephalitis, a viral infection of the central nervous system, occurs chiefly in Central and Western Europe and parts of America. Travellers are at risk who visit or work in forested areas during the summer months and who consume unpasteurized dairy products. To prevent tick borne encephalitis, as well as Lyme disease, Travellers should take precautions to prevent tick bites.

See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect.

• Influenza vaccine - Always worthwhile 
• Hepatitis A or immune globulin (IG). You are not at increased risk in Northern and Western Europe, but there is some risk in Southern Europe and the countries bordering the Mediterranean, as well as Portugal.
• 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.
• Update your routine vaccinations - (ADT & Sabin* , Measles** )Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not complete the series as infants.
• Consider Rabies vaccination if cycling around Europe or other at risk activity (cave explorers, animal handling - ( details )

All Travellers 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 Travellers, 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.
• 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.
• To reduce any risk of acquiring Mad Cow Disease (BSE - vCJD) from food, travellers to Europe may consider either avoiding beef and beef products altogether or selecting beef or beef products, such as solid pieces of muscle meat (rather than brains or beef products such as burgers and sausages), that might have a reduced opportunity for contamination with tissues that may harbour the BSE agent. Milk and milk products from cows are not believed to pose any risk for transmitting the BSE agent. - Lawrence Schonberger, Ermias Belay  CDC last reviewed June 30, 2003

see also - Travel medical kit

Management of diarrhoea:

Bottled or canned beverages (eg carbonated mineral water), tea, broth & foods such as rice, bananas, papaya (pawpaw), potatoes and dry biscuits are tolerated best. Take gastrolyte sacchets for children. When diarrhoea is prolonged and with fever seek medical attention

• Antimotility drugs ('stoppers'): eg. Imodium (loperamide) - helpful in relieving diarrhoea and cramps. Do not use if high fever or blood in motions. Do not use in children under 6, and be cautious in children under 12.

• Antibiotics. Diarrhoea with high fever, distressing symptoms or blood in motions: eg (single dose Norfloxacin 800mg or Azithromycin 1 Gm ). Nb Safe for children >12 months and in pregnancy.

Prolonged diarrhoea greater than 10 days and without fever: A bowel parasite "giardiasis" is the commonest cause. Usually treated with tinidasole (Fasigyn) - 4 x 500mg tablets (2g) in a single dose

Medical Examination after travel: It is advisable (if not essential) to visit your local doctor promptly if you

• suffer from a chronic disease, such as cardiovascular disease, diabetes mellitus, chronic respiratory disease;
• experience illness in the weeks following their return home, particularly if fever, persistent diarrhoea, vomiting, jaundice, urinary disorders, skin disease or genital infection occurs;
• consider that you may have been exposed to a serious infectious disease while travelling;
• have spent more than 3 months in a developing country.

Source: WHO - http://whqlibdoc.who.int/publications/2005/9241580364_chap1.pdf  (page 8)

Last edit: May 6, 2007