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Health & safety

Before you go

Further reading

Health Advice for Travellers (currently called the ‘T6’ leaflet) is an annually updated leaflet by the Department of Health in the UK, avail­able free from post offices. It contains some general information, details of legally required and recommended vaccines for different countries, reciprocal health agreements and an E111 application form. Lonely Planet’s Travel with Children includes advice on travel health for younger children. Other recommended references include Traveller’s Health by Dr Richard Dawood (Oxford University Press) and The Traveller’s Good Health Guide by Ted Lankester (Sheldon Press).

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If you’re an EU citizen, an E111 form, available from health centres or, in the UK, post offices, covers you for most medical care. An E111 will not cover you for nonemergencies or emergency repatriation home. Citizens from other countries should find out if there is a reciprocal arrangement for free medical care between their country and Belgium and/or Luxembourg. If you do need health insurance, make sure you get a policy that covers you for the worst possible scenario, such as an accident requiring an emergency flight home. Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures.

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Online resources

The WHO’s publication International Travel and Health is revised annually and is available online at www.who.int/ith/. Other useful websites include:

Age Concern (www.ageconcern.org.uk) Advice on travel for the elderly.

Fit For Travel (www.fitfortravel.scot.nhs.uk) General travel advice for the layperson.

Marie Stopes International (www.mariestopes.org.uk) Information on women’s health and contraception.

MD Travel Health (www.mdtravelhealth.com) Travel-health recommendations for every country; updated daily.

It’s usually a good idea to consult your government’s travel health website before departure, if one is available:

Australia (www.dfat.gov.au/travel/)

Canada (www.travelhealth.gc.ca)

UK (www.doh.gov.uk/traveladvice/)

USA (www.cdc.gov/travel/)

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Prevention is the key to staying healthy while abroad. A little planning before you depart, particularly for preexisting illnesses, will save you trouble later. For instance, see your dentist before a long trip, carry a spare pair of contact lenses and glasses, and take your optical prescription with you. Bring medications in their original, clearly labelled, containers. A signed and dated letter from your physician describing any medical conditions you have and the medications you are using, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity.

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Recommended vaccinations

The World Health Organization (WHO) recommends that all travellers should be vaccinated against diphtheria, tetanus, measles, mumps, rubella and polio, as well as hepatitis B, regardless of their destination. Since most vaccines don’t produce immunity until at least two weeks after they’re given, visit a physician at least six weeks before departure.

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Dangers & annoyances

Both countries are, in general, very safe. The only danger you’re likely to confront is a big night out on Belgian beer. That said, Belgians were shocked in 2006 by two separate murders in broad daylight in busy public places in the country’s main cities. These events have put personal security back on the public agenda.

While the rate of violent crime is low compared with many European countries, petty theft does occur, more so in large cities. Favoured haunts for pickpockets in Brussels include the Grand Place, the narrow streets around Ilôt Sacré, Rue Neuve, and the markets at Gare du Midi and Place du Jeu-de-Balle. In Luxembourg, keep your hands on your valuables around the train station area.

In January 2007, restaurants in Belgium – but not Luxembourg – became smoke-free. But unlike in a growing number of European countries, the new law didn’t extend to cafés and pubs. Although cafés are required by law to have adequate ventilation, in reality few do. Even fewer have sections for niet rokers/non-fumeurs (nonsmokers). If you’re used to socialising in a smoke-free environment, you’ll find both countries challenging.

And lastly there’s the subject of dog mess. Belgians’ love of dogs unfortunately manifests itself in footpaths dotted with doggie-doos. Pictograms stencilled onto pavements ordering dogs ‘not to squat here’ have made little difference, and rare is the Belgian who follows his or her hairy companion and faithfully scoops up after it. A few years back, Brussels introduced hefty fines for failing to do just that, but they seem to have made little difference. A poll in 2005 showed dog mess on the street was the one thing that most irritated most Belgians.

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In transit

Deep vein thrombosis (dvt)

Blood clots may form in the legs (deep vein thrombosis or DVT) during plane flights, chiefly because of prolonged immobility. The longer the flight, the greater the risk. The chief symptom of DVT is swelling or pain in the foot, ankle or calf – usually but not always – on just one side. When a blood clot travels to the lungs, it may cause chest pain and breathing difficulties. Travellers with any of these symptoms should seek medical attention immediately.

To prevent the development of DVT on long flights, you should walk about the cabin, contract the leg muscles while sitting, drink plenty of fluids, and avoid alcohol and tobacco.

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Jet lag & motion sickness

To avoid jet lag, which is common when crossing more than five time zones, try drinking plenty of nonalchoholic fluids and eating light meals. Upon arrival, get exposure to natural sunlight and readjust your schedule (for meals, sleep and so on) as soon as possible.

Antihistamines, such as dimenhydrinate (Dramamine) and meclizine (Antivert, Bonine), are usually the first choice for treating motion sickness. A herbal alternative is ginger.

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While you're there

Insect bites & stings

Mosquitoes are found in most parts of Europe, and while they may not carry malaria, they can cause irritation and infected bites. Use a DEET-based insect repellent.

Bees and wasps only cause real problems to those with a severe allergy (anaphylaxis.) If you have a severe allergy to bee or wasp stings, carry an ‘epipen’ or similar adrenaline injection.

Bed bugs lead to very itchy, lumpy bites. Spraying the mattress with crawling-insect killer after changing bedding will get rid of them.

Scabies are tiny mites that live in the skin, particularly between the fingers. They cause an intensely itchy rash. Scabies is easily treated with lotion from a pharmacy; other members of the household also need treating to avoid spreading scabies between asymptomatic carriers.

Tickborne encephalitis is spread by tick bites and it’s possible to contract it in the Ardennes. It is a serious infection of the brain and vaccination is advised for those in risk areas who are unable to avoid tick bites (such as campers, forestry workers and hikers/ramblers). Two doses of vaccine will give a year’s protection, three doses up to three years.

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Snake bites

Avoid getting bitten in the first place: do not walk barefoot or stick your hand into holes or cracks. Half of those bitten by venomous snakes are not actually injected with poison (envenomed). If bitten by a snake, do not panic. Immobilise the bitten limb with a splint (eg a stick) and apply a bandage over the site. Make sure you apply firm pressure, similar to a bandage over a sprain. Do not apply a tourniquet, or cut or suck the bite. Get the victim to the nearest medical facility as soon as possible.

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Travelling with children

All travellers with children should know how to treat minor ailments and when to seek medical treatment. Make sure children are up to date with routine vaccinations, and discuss possible travel vaccines well before departure as some vaccines are not suitable for children under one year old.

Remember to avoid contaminated food and water. If your child is vomiting or has diarrhoea, lost fluid and salts must be replaced. It may be helpful to take rehydration powders for reconstituting with boiled water.

Children should be encouraged to avoid and mistrust any dogs or other mammals because of the risk of rabies and other diseases. Any bite, scratch or lick from a warm-blooded, furry animal should be thoroughly cleaned immediately. If there is any possibility that the animal is infected with rabies, immediate medical assistance should be sought.

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Availability & cost of health care

Good health care is readily available. For minor self-limiting illnesses pharmacists can give valuable advice and sell over-the-counter medication. They can also advise when more specialised help is required and point you in the right direction. The standard of dental care in both countries is usually good; however, it is sensible to have a dental check-up before a long trip.

Hotels and tourist offices will be able to assist you in finding a hospital ziekenhuis/hôpital in Flemish/French with an English-speaking doctor.

Apotheek/pharmacie (pharmacies) in both countries usually sport a green cross or the symbol of Aesculapius (the Roman god of medicine or healing) and are open from about 8.30am to 7pm Monday to Friday, as well as Saturday mornings. In cities and major towns, pharmacies work on a weekend and late-night roster: in Belgium look for the notice displayed in the pharmacy windows listing which are on duty that weekend or night; in Luxembourg on-duty pharmacies are listed in local newspapers.

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Sexual health

Emergency contraception is most effective if taken within 24 hours after unprotected sex. The International Planned Parent Federation (www.ippf.org) can advise about the availability of contraception in different countries.

When buying condoms, look for a Euro­pean CE mark, which means it has been rigorously tested. Keep condoms in a cool, dry place or they may crack and perish.

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Women’s health

Emotional stress, exhaustion and travelling through different time zones can all contribute to an upset in the menstrual pattern. If using oral contraceptives, remember diarrhoea, vomiting and some antibiotics can stop the pill from working and lead to the risk of pregnancy – remember to take condoms with you just in case. Time zones, gastrointestinal upsets and antibiotics do not affect injectable contraception.

Travelling during pregnancy is usually possible but there are important things to consider. Always seek a medical check-up before planning your trip. The most risky times for travel are during the first 12 weeks of pregnancy and after 30 weeks. Antenatal facilities vary greatly between countries and you should think carefully before travelling to a country with poor medical facilities, or where there are major cultural and language differences from home. Illness during pregnancy can be more severe, so take special care to avoid contaminated food and water, and insect and animal bites. A general rule is to only use vaccines, as with other medications, if the risk of infection is substantial. Remember that the baby could be at serious risk if you were to contract infections such as typhoid or hepatitis. Some vaccines are best avoided, for example those that contain live organisms; however, there is very little evidence that damage has been caused to an unborn child when vaccines have been given to a woman very early in pregnancy, or before the pregnancy was suspected. Take written records of your pregnancy with you. Ensure your insurance policy covers pregnancy delivery and postnatal care, but remember insurance policies are only as good as the facilities available. Always consult your doctor before you travel.

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