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Health & safety

Before you go

A little planning before departure, particularly for pre-existing illnesses or conditions, will save trouble later. See your dentist before a long trip, carry a spare pair of contact lenses or 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 your medical conditions and medications, including their 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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If you're an EU citizen, a European Health Insurance Card (EHIC), available from health centres or, in the UK, post offices, covers you for most medical care. It will not cover you for nonemergencies or emergency repatriation. Citizens from other countries should find out if there is a reciprocal arrangement for free medical care between their country and Hungary.

In Hungary, foreigners are entitled to first-aid and ambulance services only when they have suffered an accident and require immediate medical attention; follow-up treatment and medicine must be paid for.

If you do need health insurance while travelling, consider a policy that covers you for the worst possible scenario, such as an accident requiring an ambulance or 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. The former option is generally preferable, as it doesn't require you to pay out of pocket in a foreign country.

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Recommended vaccinations

Hungary doesn't require any vaccination of international travellers, but the World Health Organisation (WHO) recommends travellers be covered for diphtheria, tetanus, measles, mumps, rubella and polio, regardless of their destination. Since most vaccines don't produce immunity until at least two weeks after they're given, visit a physician or clinic at least six weeks before departure.

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Internet resources

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

www.ageconcern.org.uk Advice on travel for the elderly.

www.fitfortravel.scot.nhs.uk General travel advice for the lay person.

www.mariestopes.org.uk Information on women's health and contraception.

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.dh.gov.uk/home/fs/en)

USA (www.cdc.gov/travel/)

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Dangers & annoyances

As a traveller, you are most vulnerable to pickpockets, dishonest waiters, car thieves and the scams of the capital's so-called konzumlányok, attractive 'consume girls' in collusion with rip-off bars and clubs who will see you relieved of a serious chunk of money.

Pick pocketing is most common at popular tourist sights, near major hotels, in flea markets and on certain forms of public transport in Budapest. The usual method on the street is for someone to distract you by running into you and then apologising profusely - as an accomplice takes off with the goods.

It is not unknown for waiters to try to rip you off once they see/hear that you are a foreigner. They may try to bring you an unordered dish or make a 'mistake' when tallying the bill. If you think there's a discrepancy, ask for the menu and check the bill carefully. If you've been taken for more than 15% or 20% of the bill, call for the manager. Otherwise just don't leave a tip.

Most Hungarian car thieves are not after fancy Western models because of the difficulty in getting rid of them. But Volkswagens, Audis and the like are very popular, and are easy to dismantle and ship abroad. Don't leave anything of value, including luggage, inside the car.

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In transit

Deep vein thrombosis

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-haul flights, you should walk about the cabin, contract the leg muscles while sitting, drink plenty of fluids and avoid alcohol.

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Jet lag & motion sickness

To avoid jet lag, which is common when crossing more than five time zones, you should drink plenty of nonalchoholic fluids and eat 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

Availability & cost of health care

Medical care in Hungary is generally adequate and good for routine problems but not complicated conditions. Treatment at a rendelő intézet (public outpatient clinic) costs little, but doctors working privately will charge much more. Very roughly, a consultation in an orvosi rendelő (doctor's surgery) costs from 5000Ft while a home visit is from 10, 000Ft.

Most large towns and all of Budapest's 23 districts have a gyógyszertár or patika (rotating 24-hour pharmacy). A sign on the door of any pharmacy will help you locate the closest one.

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Infectious diseases

Tickborne encephalitis is spread by kullancs (ticks), which burrow under the skin; in recent years, it has become a common problem in parts of Central and Eastern Europe, especially eastern Austria, Germany, Hungary and the Czech Republic. Encephalitis is a serious infection of the brain, and vaccination is advised for campers and hikers, particularly in Transdanubia and the Northern Uplands between May and September. For up-to-date information log on to www.masta.org/tickalert.

Lyme disease is another tick-transmitted infection not unknown in Central and Eastern Europe. The illness usually begins with a spreading rash at the site of the tick bite and is accompanied by fever, headaches, extreme fatigue, aching joints and muscles and mild neck stiffness. If untreated, these symptoms usually resolve over several weeks, but over subsequent weeks or months disorders of the nervous system, heart and joints might develop.

Poliomyelitis is spread through contam- inated food and water. It's one of the vaccines given in childhood and should be boosted every 10 years, either orally or by injection.

Typhoid and hepatitis A are spread through contaminated food (particularly shellfish) and water. Typhoid can cause septicaemia; hepatitis A causes liver inflammation and jaundice. Neither is usually fatal, but recovery can be prolonged. Typhoid vaccine (typhim Vi, typherix) will give protection for three years. In some countries, the oral vaccine Vivotif is also available. Hepatitis A vaccine (Avaxim, VAQTA, Havrix) is given as an injection; a single dose will give protection for up to a year, a booster after a year gives 10 years' protection. Hepatitis A and typhoid vaccines can also be given as a single dose vaccine, hepatyrix or viatim.

Rabies is spread through bites or licks on broken skin from an infected animal and is always fatal unless treated. Three injections are needed over a month. If you have not been vaccinated, you will need a course of five injections starting 24 hours or as soon as possible after the injury.

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Insect bites & stings

Mosquitoes are a real scourge around Hungary's lakes and rivers in summer; the blood- thirsty beasties might not carry malaria but can still cause irritation and infection. Just make sure you're armed with a DEET-based insect repellent, or rovarírtó, and wear long-sleeved shirts and long trousers around sundown

Bees and wasps cause real problems only to those with a severe allergy (anaphylaxis). They should carry an 'epipen' or similar adrenaline injection.

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The WHO reports that arsenic in Hungary's drinking water has been detected at concentrations higher than the guideline level of 0.01 mg/L. Avoid drinking tap water in favour of the bottle stuff, which is available everywhere.

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Women's health

If using oral contraceptives, remember that some antibiotics, diarrhoea and vomiting can stop the pill from working and lead to the risk of pregnancy. Time zones, gastro- intestinal upsets and antibiotics do not affect injectable contraception.

Travelling during pregnancy is usually possible but always consult your doctor before planning your trip. The riskiest times for travel are during the first 12 weeks of pregnancy and after 30 weeks.

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Sexual health

The numbers of registered AIDS cases in Hungary and those who are HIV-positive are relatively low (just over 1100), though Hungarian epidemiologists estimate the actual number of those infected with HIV to be around 3000 or more. That number could multiply substantially as Budapest claims its less-than-distinctive title of 'sex industry capital of Eastern and Central Europe'. Two AIDS lines to contact in Budapest are the Anonymous AIDS Association(1-466-9283; 5-8pm Mon, Wed & Thu, 9am-noon Tue & Fri) and the AIDS helpline (1-338 2419, 266 0465; 8am-3pm Mon-Thu, 8am-1pm Fri), with some English spoken.

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