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Health & safety

Before you go

Make sure you're healthy before you start travelling. If you require a particular medication take an adequate supply, as it may not be available locally. Take part of the packaging showing the generic name rather than the brand, which will make getting replacements easier. It's a good idea to have a legible prescription or letter from your doctor to show that you legally use the medication, to avoid any problems.

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Make sure that you have adequate health insurance. There is no free state health service in Switzerland (Swiss citizens and residents are all obliged to take out some form of private health insurance) and all treatment must generally be paid for. The EU and Switzerland have a reciprocal agreement on basic health-care provisions.

Although there is a public system in Switzerland, it is not really free as all residents in Switzerland have to pay for health insurance. EU members are covered to an extent, but should take out private travel/health cover. Treatment in a public ward of a public hospital is covered by the European Health Insurance Card (EHIC, which replaced the old E111 form in 2005), the card European citizens use to obtain reciprocal health care in other EU member states. There is a nonrefundable excess charge for every 30-day period in hospital. EU citizens with the EHIC pay half of the full cost of ambulances (road and air). Go to any doctor registered with the Swiss health system. Dental care, except emergency accident treatment, is not covered at all. You will generally have to pay up front and claim a refund from Gemeinsame Einrichtung KVG (+41 32 625 48 20; Gibelinstrasse 25, Postfach CH-4503 Solothurn).

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Recommended vaccinations

No immunisations are required to enter Switzerland, but generally it's a good idea to make sure your tetanus, diphtheria and polio vaccinations are up to date before travelling. You may also like to consider immunisation against tick-borne encephalitis if you are going to be in rural areas. Check with your doctor and leave plenty of time for shots - ideally six weeks before travel. The US-based Centers for Disease Control & Prevention (www.cdc.gov) also has information.

Although there is no risk of yellow fever in Switzerland, if you are arriving from a yellow fever-infected area (ie most of sub- Saharan Africa and parts of South America) you'll need proof of yellow fever vaccination before you will be allowed to enter the country.

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Internet resources

EU citizens should see the website of their national health system for travel advice and what the European Health Insurance Card (EHIC) entitles them to in Switzerland. In the case of the UK, check the NHS website (www.dh.gov.uk).

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Further reading

Lonely Planet's Travel with Children includes helpful advice on travel health for younger children. There are also excellent travel-health sites on the Internet. Try the World Health Organization and the US Centers for Disease Control & Prevention.

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Dangers & annoyances

The Swiss are relatively rule-oriented, and street crime is fairly uncommon. However, you should still always watch your belongings; pickpockets thrive in city crowds. The Swiss police aren't very visible, but when they do appear, they have a poor reputation for their treatment of people of non-European descent or appearance, with some suggesting that they perform random street searches of questionable necessity and so on.

Several cities, such as Zürich and Bern, have a heroin problem, but these days you generally have to be way off the main thoroughfares to notice it.

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In transit

Deep Vein Thrombosis (DVT)

Blood clots may form in the legs 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 of 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 immediately seek medical attention. 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 try drinking plenty of nonalcoholic fluids and eating light meals. Upon arrival, get exposure to natural sunlight and readjust your schedule (for meals, sleep etc) as soon as possible.

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While you're there

Self-diagnosis and treatment can be risky, so you should always seek medical help. An embassy, consulate or five-star hotel can usually recommend a local doctor or clinic. The quality of health care in Switzerland is generally very high, whether in public or private hospitals.

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Infection with the human immunodeficiency virus (HIV) may lead to acquired immune deficiency syndrome (AIDS), which is a fatal disease. Any exposure to blood, blood products or body fluids may put the individual at risk. The disease is often transmitted through sexual contact or dirty needles - vaccinations, acupuncture, tattooing and body piercing can be potentially as dangerous as intravenous drug use. HIV/AIDS can also be spread through infected blood transfusions; blood used for transfusions in European hospitals is screened for HIV and should be safe.

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Traveller's diarrhoea

Simple things like a change of water, food or climate can all cause a mild bout of diarrhoea, but a few rushed toilet trips with no other symptoms is not indicative of a major problem.

Dehydration is the main danger with any diarrhoea, particularly in children or the elderly as dehydration can occur quite quickly. Under all circumstances fluid replacement (at least equal to the volume being lost) is the most important thing to remember. Weak black tea with a little sugar, soda water, or soft drinks allowed to go flat and diluted 50% with clean water, are all good. Stick to a bland diet as you recover.

Swiss restaurants generally have very high standards of hygiene, and food poisoning is rare - although, naturally, always possible. Some of the country's dairy products have very high levels of fat, however.

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Altitude sickness

This disorder can occur above 3000m, but very few treks or ski runs in the Austrian, French, Italian or Swiss Alps reach heights of 3000m or more - Mont Blanc is one exception - so altitude sickness is unlikely. Headache, vomiting, dizziness, extreme faintness, and difficulty in breathing and sleeping are all signs to heed. Treat mild symptoms with rest and simple painkillers. If mild symptoms persist or get worse, descend to a lower altitude and seek medical advice.

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Switzerland is one of the few European countries to be have been declared free of rabies.

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Switzerland is home to several types of snakes, a couple of which can deliver a nasty, although not fatal, bite. They are more prevalent in the mountains. To minimise your chances of being bitten always wear boots, socks and long trousers when walking through undergrowth where snakes may be present. Don't put your hands into holes and crevices, and be careful when collecting firewood.

If bitten by a snake that could be venomous, immediately wrap the bitten limb tightly, as you would for a sprained ankle, and then attach a splint to immobilise it. Keep the victim still and seek medical help. Tourniquets and sucking out the poison are now comprehensively discredited.

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These small creatures can be found throughout Switzerland up to an altitude of 1200m, and typically live in underbrush at the forest edge or beside walking tracks. A tiny proportion carry viral encephalitis, which may become serious if not detected early.

You should always check all over your body if you have been walking through a potentially tick-infested area, as ticks can cause skin infections and other more serious diseases. If a tick is found attached, press down around the tick's head with tweezers, grab the head and gently pull upwards. Avoid pulling the rear of the body as this may squeeze the tick's gut contents through the attached mouth-parts into the skin, increasing the risk of infection and disease. Smearing chemicals on the tick will not make it let go and is not recommended.

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Lyme disease

This is an infection transmitted by ticks that may be acquired in Europe. The illness usually begins with a spreading rash at the site of the tick bite and is accompanied by fever, headache, 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 may develop. Treatment works best early in the illness. Medical help should be sought.

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Tick-borne encephalitis

This disease is a cerebral inflammation carried by a virus. Tick-borne encephalitis can occur in most forest and rural areas of Switzerland. If you have been bitten, even having removed the tick, you should keep an eye out for symptoms, including blotches around the bite, which is sometimes pale in the middle. Headache, stiffness and other flu-like symptoms, as well as extreme tiredness, appearing a week or two after the bite, can progress to more serious problems. Medical help must be sought. A vaccination is available and is the best protection.

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The weather in Europe's mountains can be extremely changeable at any time of the year. Skiers and hikers should always be prepared for very cold and wet weather.

Hypothermia will occur when the body loses heat faster than it can produce it and the core temperature of the body falls. It is surprisingly easy to progress from very cold to dangerously cold due to a combination of wind, wet clothing, fatigue and hunger, even if the air temperature is above freezing. It is best to dress in layers; silk, wool and some of the new artificial fibres are all good insulating materials. A hat is important, as a lot of heat is lost through the head. A strong, waterproof outer layer (and a 'space' blanket for emergencies) is essential. Carry basic supplies, including food containing simple sugars to generate heat quickly and fluid to drink.

Symptoms of hypothermia are exhaustion, numb skin (particularly toes and fingers), shivering, slurred speech, irrational or violent behaviour, lethargy, stumbling, dizzy spells, muscle cramps and violent bursts of energy. Irrationality may take the form of sufferers claiming they are warm and trying to take off their clothes.

To treat mild hypothermia, first get the person out of the wind and/or rain, remove their clothing if it's wet and replace it with dry, warm clothing. Give them hot liquids - not alcohol - and high-kilojoule, easily digestible food. Do not rub victims; instead, allow them to slowly warm themselves. This should be enough to treat the early stages of hypothermia. The early recognition and treatment of mild hypothermia is the only way to prevent severe hypothermia, which is a critical condition.

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You can get sunburnt surprisingly quickly, even through cloud, and particularly at high altitude. Use a sunscreen, a hat and a barrier cream for your nose and lips. Calamine lotion or a commercial after-sun preparation are good for mild sunburn. Protect your eyes with good-quality sunglasses, particularly if you will be near water, sand or snow.

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Not only can you rely on tap water in Switzerland, but the water from most of the country's tens of thousands of fountains is also drinkable. Occasionally you will come across a tap or fountain labelled Kein Trinkwasser or eau non potable, and that means it's not drinking quality.

If you will be drinking water from rivers, lakes or streams - even crystal-clear Alpine streams - you should take steps to purify it. The simplest way of purifying water is to boil it thoroughly. Vigorous boiling should be satisfactory; however, at high altitude water boils at a lower temperature, so germs are less likely to be killed. Boil it for longer in these environments. Consider purchasing a water filter for a long trip. Alternatively, iodine is effective in purifying water and is available in tablet form. Follow the directions carefully and remember that too much iodine can be harmful.

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