While it’s never nice to be injured or become sick while you’re travelling, you can at least take some comfort in the knowledge that Israel has world-class medical facilities.
While standards of health are high in Israel, there are several location-specific conditions for travellers to be aware of, particularly dehydration, heat exhaustion and sunburn.
The vast majority of the snakes are not poisonous – but some, such as the Palestine viper (tzefa; Vipera palaestinae), are. Do not walk barefoot or stick your hand into holes or cracks.
If bitten by a snake, do not panic. Half the number of people bitten by venomous snakes are not actually injected with poison (envenomed). Immobilise the bitten limb with a splint (eg a stick) and apply a bandage over the site with firm pressure, similar to a bandage over a sprain. Do not apply a tourniquet, or cut or suck the bite. Get the victim to medical help as soon as possible so that antivenene can be given if necessary.
Heat exhaustion is one of the most common ailments among travellers. This occurs following heavy sweating and excessive fluid loss with inadequate replacement of fluids and salt. It is particularly common in hot climates when taking unaccustomed exercise before full acclimatisation. Symptoms include headache, dizziness and tiredness. Dehydration is already happening by the time you feel thirsty – aim to drink enough water that you produce pale, diluted urine. The treatment for heat exhaustion consists of replacing fluid with water or fruit juice or both, and cooling by cold water and fans. The treatment of the salt-loss component consists of salty fluids as in soup or broth, and adding a little more table salt to foods than usual.
Heat stroke is much more serious. This occurs when the body’s heat-regulating mechanism breaks down. An excessive rise in body temperature leads to the cessation of sweating, to irrational and hyperactive behaviour, and eventually to loss of consciousness and death. Rapid cooling by spraying the body with water and fanning is an ideal treatment. Emergency fluid and electrolyte replacement by intravenous drip is usually also required.
Mosquitoes may not carry malaria but can cause irritation and infected bites. Using DEET-based insect repellents will prevent bites. Mosquitoes also spread dengue fever.
Bees and wasps cause real problems only to those with a severe allergy (anaphylaxis). If you have a severe allergy to bee or wasp stings you should carry an adrenaline injection or similar.
Sandflies are located around the Mediterranean beaches. They usually cause only a nasty itchy bite, but can carry a rare skin disorder called cutaneous leishmaniasis. Bites may be prevented by using DEET-based repellents.
The number of jellyfish has been increasing over the years, thanks to overfishing in the Mediterranean (fish eat jellyfish, and in the absence of predators the jellyfish have boomed). A jellyfish sting is irritating, but in most cases it wears off in about 10 or 15 minutes. A particularly strong sting (or a sting to the face or genitals) requires an evaluation by a physician.
Scorpions are frequently found in arid or dry climates. They can cause a painful bite that is rarely life threatening.
Bedbugs are occasionally found in hostels and cheap hotels. They lead to very itchy, lumpy bites. Spraying the mattress with an appropriate insect killer will do a good job of getting rid of them.
Scabies are also sometimes found in cheap accommodation. These tiny mites live in the skin, particularly between the fingers. They cause an intensely itchy rash. Scabies are easily treated with lotion available from pharmacies; people who you come into contact with also need treating as they may become asymptomatic carriers.
Tap water is safe to drink but sometimes has an unpleasant taste (in some areas it is slightly saline) so many locals use filters or spring water dispensers at home. Bottled water is available everywhere. Do not drink water from rivers or lakes as it may contain bacteria or viruses that can cause diarrhoea or vomiting.
Israel has first-rate state-funded hospitals across the country, plus a number of private hospitals and clinics. For a list of hospitals, see www.science.co.il/hospitals.asp.
Pharmacies (beit merkachat) are a common sight on city streets; pharmacists speak English and can give advice about what medicine to take if you describe your problem. In cities, at least one pharmacy is always on call (beit merkachat toran) – phone 106 (the local municipal hotline) for details, or check out the links at www.onlineisrael.info/search-internet/health/city (in Hebrew). Some branches of Super Pharm are open 24 hours. In the Palestinian Territories, medicine may be expired so check the date.
If you require any prescribed medication, take enough from home to get you through your trip and bring a copy of the prescription details in case you need a refill. Note: Israeli pharmacies can accept only prescriptions issued by Israeli doctors.
Private dental clinics are found everywhere from suburban streets to shopping malls. Standards of dental care are high, but keep in mind that your travel insurance will not usually cover you for anything other than emergency dental treatment.
Since 2012, cases of MERS (Middle East Respiratory Syndrome) have been confirmed in the Arabian Peninsula, Jordan and Lebanon but not here at this stage. Symptoms of MERS include fever, coughing and shortness of breath; the illness is spread through close contact, meaning most people are not at risk. Almost one-third of those with confirmed cases of MERS have died, though most of those people had an underlying medical condition. For more details, see www.cdc.gov/coronavirus/mers.
Rabies is rare but present so avoid contact with stray dogs and wild animals such as foxes.
Spread through bites or licks on broken skin from an infected animal, rabies is fatal. Animal handlers should be vaccinated, as should those travelling to remote areas where a reliable source of post-bite vaccine is not available within 24 hours. Three injections are needed over a month. If you have not been vaccinated, you will need a course of five injections starting within 24 hours or as soon as possible after the injury. Vaccination does not provide you with immunity; it merely buys you more time to seek appropriate medical help.
Spread through the bite of an infected sandfly, leishmaniasis – endemic to this region – can cause a slowly growing skin lump or ulcer. It may develop into a serious life-threatening fever, usually accompanied by anaemia and weight loss. Infected dogs and animals such as rock rabbits (hyraxes or dassies) are also carriers of the infection. Sandfly bites should be avoided whenever possible.
Traveller’s diarrhoea can occur with a simple change of diet, so even though food and water are generally healthy you may get an upset stomach simply because your body is not accustomed to the new foods – it may take a few days to adjust. Keep in mind that in summer outdoor food spoils quickly, so this is a good time to avoid hole-in-the-wall shawarma and falafel joints because hummus goes bad quickly. (Eating hummus in an indoor restaurant is likely to be safer.)
If you develop diarrhoea, be sure to drink plenty of fluids, preferably an oral rehydration solution containing salt and sugar. 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.
For emergency first aid or evacuation by ambulance to a hospital in Israel, call the country’s national emergency medical service, Magen David Adom, on any phone by dialling 101. Magen David Adom stations also provide after-hours first aid.
For less urgent matters, you can do one of the following:
If you become seriously ill, you may want to contact your embassy or consulate.
Recommended references include Traveller’s Health, edited by Dr Richard Dawood (Oxford University Press), and The Travellers’ Good Health Guide, by Ted Lankester (Sheldon Press), an especially useful guide for volunteers and long-term expatriates working in the Middle East.
Israel does not require any vaccinations before arrival.
Health insurance policies may not cover visits to the border regions with Gaza and Lebanon (although the Golan Heights is usually included).
It’s usually a good idea to consult a government travel health website before departure.
USA (wwwnc.cdc.gov/travel) Search for the booklet Health Information for International Travel ('Yellow Book').
World Health Organization (www.who.int/ith/en) You can download the book International Travel & Health.
MD Travel Health (www.mdtravelhealth.com) Provides country-by-country travel health recommendations.