Portugal

Health & safety

Before you go

Prevention is the key to staying healthy while abroad. A little planning before departure, particularly for pre-existing illnesses, will save trouble later. 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 your medical conditions and medications, 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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Insurance

If you’re an EU citizen, be sure to get the EHIC (European Health Insurance Card), which replaces the no-longer valid E111 certificate. You can apply for this card online (www.ehic.org.uk) or pick up an application at any British post office. The EHIC 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 Portugal. If you do need health insurance, strongly consider 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. 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

The WHO recommends that all travellers should 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 at least six weeks before departure.

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Internet resources

The WHO’s publication International Travel and Health is revised annually and is available on line at www.who.int/ith. Other useful websites include www.mdtravelhealth.com (travel health recommendations for every country; updated daily), www.fitfortravel.scot.nhs.uk (general travel advice for the layperson), www.ageconcern.org.uk (advice on travel for the elderly) and www.mariestopes.org.uk (information on women’s health and contraception).

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Dangers & annoyances

Crime

Compared to other European countries, Portugal’s crime rate is low, but it is rising. Crime against foreigners is of the usual rush-hour-pickpocketing, bag-snatching and theft-from-rental-cars variety. Take the usual precautions: don’t flash your cash; keep valuables in a safe place; and, if you are challenged, hand it over – it’s not worth taking the risk.

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While you're there

Availability & cost of health care

Good health care is readily available and for minor illnesses pharmacists can give valuable advice and sell over-the-counter medication. Most pharmacists speak some English. They can also advise when more specialised help is required and point you in the right direction. The standard of dental care is usually good, but it is sensible to have a dental check-up before a long trip.

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Traveller’s diarrhoea

If you develop diarrhoea, be sure to drink plenty of fluids, preferably an oral rehydration solution (eg Dioralyte). A few loose stools don’t require treatment, but if you start having more than four or five stools a day, you should start taking an antibiotic (usually a quinolone drug) and an antidiarrhoeal agent (such as loperamide). If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain you should seek medical attention.

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Heat exhaustion & heat stroke

Heat exhaustion occurs following excessive fluid loss with inadequate replacement of fluids and salt. Symptoms include headache, dizziness and tiredness. Dehydration is already happening by the time you feel thirsty – aim to drink sufficient water to produce pale, diluted urine. To treat heat exhaustion, replace lost fluids by drinking water and/or fruit juice or an oral rehydration solution, such as Dioralyte, and cool the body with cold water and fans. Treat salt loss with salty fluids such as soup or Bovril, or add a little more table salt to foods than usual.

Heat stroke is much more serious, resulting in irrational and hyperactive behaviour and eventually loss of consciousness and death. Rapid cooling by spraying the body with water and fanning is ideal. Emergency fluid and electrolyte replacement by intravenous drip is recommended.

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Insect bites & stings

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

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

Sand flies are found around Mediterranean beaches. They usually cause only a nasty itchy bite but can carry a rare skin disorder called cutaneous leishmaniasis.

Bed bugs lead to very itchy, lumpy bites. Spraying the mattress with crawling insect killer after changing the 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.

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Snakes & scorpions

Avoid getting bitten by snakes – don’t walk barefoot or stick your hand into holes or cracks. Half of those bitten by venomous snakes are not injected with poison (envenomed). If bitten by a snake, don’t panic. Immobilise the bitten limb with a splint (eg a stick) and apply a bandage over the site firmly, similar to a bandage over a sprain. Do not apply a tourniquet, or cut or suck the bite. Get medical help as soon as possible so that antivenin can be administered if necessary.

Scorpions are found in Portugal and their sting can be extremely painful but is not considered fatal.

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Jellyfish, sea urchins & weever fish

Stings from jellyfish are painful but not dangerous. Douse the wound in vinegar to deactivate any stingers that haven’t ‘fired’. Applying calamine lotion, antihistamines or analgesics may reduce the reaction and relieve the pain.

Watch for sea urchins around rocky beaches. If you get their needles embedded in your skin, immerse the limb in hot water to relieve the pain. But to avoid infection visit a doctor and have the needles removed.

Thankfully, it is very rare to find the dangerous weever fish that inhabit shallow tidal zones along the Atlantic coast. They bury themselves in the sand with only their spines protruding and inject a powerful toxin if trodden upon. Soaking your foot in very hot water breaks down the poison, but you should seek medical advice in any event, since in rare cases this can cause permanent local paralysis.

Rabies, though rare in Portugal, is a risk, and transmittable via the bite of an infected animal. It can also be transmitted if the animal’s saliva comes in contact with an open wound. If you’ve been bitten by a wild animal, a treatment of shots must begin at once.

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Travelling with children

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

In hot moist climates any wound or break in the skin is likely to let in infection. The area should be cleaned and kept dry.

Remember to avoid contaminated food and water. If your child has vomiting or 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 immediately be thoroughly cleaned. If there is any possibility that the animal is infected with rabies, immediate medical assistance should be sought.

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Women’s health

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

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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 they have been rigorously tested, and then store them in a cool and dry place or they may crack and perish.

Abortion is still illegal in Portugal.

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