Health Information for Travelers to Western Europe

• To find out about current U.S. Department of State travel warnings and public announcements, see http://travel.state.gov

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. (See below.)

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 (see below).

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. For detailed information, see Comprehensive Yellow Fever Vaccination Requirements. Also, find the nearest authorized U.S. yellow fever vaccine center.

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.
• 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 to Western Europe should also see the information on Bovine Spongiform Encephalopathy ["Mad Cow Disease"] and New Variant Creutzfeldt-Jakob Disease [nvCJD].)

Travelers to rural or 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.
• Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
• Protect yourself from mosquito bites:
  • Pay special attention to mosquito protection between dusk and dawn.
  • Wear long-sleeved shirts, long pants, and hats.
  • Use insect repellents that contain DEET (diethylmethyltoluamide).
  • Read and follow the directions and precautions on the product label.
  • Apply insect repellent to exposed skin.
  • Do not put repellent on wounds or broken skin.
  • Do not breathe in, swallow, or get into the eyes (DEET is toxic if swallowed). If using a spray product, apply DEET to your face by spraying your hands and rubbing the product carefully over the face, avoiding eyes and mouth.
  • Unless you are staying in air-conditioned or well-screened housing, purchase a bed net impregnated with the insecticide permethrin or deltamethrin. Or, spray the bed net with one of these insecticides if you are unable to find a pretreated bed net.
  • DEET may be used on adults, children, and infants older than 2 months of age. Protect infants by using a carrier draped with mosquito netting with an elastic edge for a tight fit.
  • Children under 10 years old should not apply insect repellent themselves. Do not apply to young children’s hands or around eyes and mouth.
  • For details on how to protect yourself from insects and how to use repellents, see Protection against Mosquitoes and Other Arthropods.
• 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. Do not drink beverages with ice.
• 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:

• Insect repellent containing DEET.
• Bed nets impregnated with permethrin. (Can be purchased in camping or military supply stores. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.)
• Flying-insect spray or mosquito coils to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
• Over-the-counter antidiarrheal medicine to take if you have diarrhea.
• Iodine tablets and water filters to purify water if bottled water is not available. See Food and Water Precautions and Travelers’ Diarrhea Prevention and Risks from Food and Drink for more detailed information about water filters.
• 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 become ill after your trip—even as long as a year after you return—tell your doctor where you have traveled.

For more information:

Ask your doctor or check the CDC web sites for more information about how to protect yourself against diseases that occur in Western Europe, including the following:

For more information about these and other diseases, please check the Diseases page and CDC Health Topics A–Z.

This document is not a complete medical guide for travelers to this region. Consult with your doctor for specific information related to your needs and your medical history; recommendations may differ for pregnant women, young children, and persons who have chronic medical conditions. In addition, you may also check the following CDC sites:

• Vaccine Recommendations for Infants and Children
• Food and Water Precautions and Travelers' Diarrhea Prevention

Be sure to read the information about all the regions you are planning to visit.