Food and waterborne
diseases are the number one cause of illness in
diarrhea can be caused by viruses, bacteria,
or parasites, which are found throughout Eastern
Europe and can contaminate food or water. Infections
may cause diarrhea and vomiting (E. coli, Salmonella,
and parasites), fever (typhoid
fever and toxoplasmosis), or liver damage
(hepatitis). Make sure your food and drinking water
are safe. (See
is a preventable infection that can be fatal if left
untreated. Prevent infection by taking prescription
antimalarial drugs and protecting yourself against
mosquito bites (see
below). Risk for malaria exists in parts of
Armenia, Azerbaijan, Georgia, Tajikistan,
Turkmenistan, and Uzbekistan. Travelers to
malaria-risk areas in Armenia, Azerbaijan, Georgia,
Tajikistan, Turkmenistan, and Uzbekistan should take
chloroquine to prevent malaria. In Uzbekistan, the
risk of malaria is low and varies along its border
with Tajikistan; travelers to Uzbekistan or their
health care provider should contact CDC
(Malaria Hotline, 770-488-7788) for risk and
prevention advice. For additional information on
malaria risk and prevention, see
Malaria Information for Travelers to Eastern Europe
and the Newly Independent States of the Former Soviet
of diphtheria is occurring in all the states of
the former Soviet Union. Travelers to these areas
should be sure that their diphtheria
immunization is up to date.
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. 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
Because motor vehicle
crashes are a leading cause of injury among travelers,
walk and drive defensively. Avoid nighttime travel if
possible and always use seat belts.
There is no risk
for yellow fever in Eastern Europe and the Newly
Independent States of the Former Soviet Union (NIS). 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.
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.
or immune globulin
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, or be exposed through medical treatment.
if you might be exposed to wild or domestic
animals through your work or recreation.
particularly if you are visiting developing
countries in this region.
- As needed, booster
doses for tetanus-diphtheria,
and a one-time dose of polio vaccine for adults. Hepatitis
B vaccine is now recommended for all infants
and for 11� to 12-year-olds who did not receive
the series as infants.
stay healthy, do...
- Wash hands often
with soap and water.
- 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
- Eat only
thoroughly cooked food or fruits and vegetables
you have peeled yourself. Remember: boil it,
cook it, peel it, or forget it.
- If you are going
to visit risk areas for malaria,
take your malaria
prevention medication before, during, and
after travel, as directed. (See your doctor for a
yourself from mosquito bites:
mosquito bites by wearing long-sleeved shirts
and long pants.
- Use insect
repellents that contain DEET
- Apply insect
repellent to exposed skin. Mosquitoes that
transmit malaria bite between dusk and dawn.
- Unless you are
staying in air-conditioned or well-screened
housing, purchase a bed net impregnated with
the insecticide permethrin.
- For more
information on protecting yourself from insect
bites and DEET see Protection
against Mosquitoes and Other Arthropods.
- To prevent fungal
and parasitic infections, keep feet clean and dry,
and do not go barefoot.
- Always use latex
condoms to reduce the risk of HIV and other
sexually transmitted diseases.
To avoid getting
- Don�t eat food
purchased from street vendors.
- Don�t drink
beverages with ice.
- Don�t eat dairy
products unless you know they have been
- Don�t share
needles with anyone.
- Don�t handle
animals (especially monkeys, dogs, and cats), to
avoid bites and serious diseases (including rabies
What you need to bring
- Long-sleeved shirt
and long pants to wear while outside whenever
possible, to prevent illnesses carried by insects.
- Insect repellent
- Bed nets
impregnated with permethrin (can be purchased in
camping or military supply stores).
antidiarrheal medicine to take if you have
- Iodine tablets and
water filters to purify water if bottled water is
not available. See
above for more information about water
medications: make sure you have enough to last
during your trip, as well as a copy of the
After you return
If you have visited a
malaria-risk area in Eastern Europe, continue taking
your chloroquine for 4 weeks 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.
Ask your doctor or
check the CDC web sites for more information about how
to protect yourself against diseases that occur in
Eastern Europe and the NIS, including the following:
For more information
about these and other diseases, please check the Diseases