NORTH AMERICA - CANADA - EUROPE - FORMER USSR
	PREVENTION OF MALARIA  |   DIARRHOEA  |   VACCINATIONS
	NORTH AMERICA - CANADA - EUROPE - FORMER USSR There is no risk of malaria in the tourist areas. There is a limited malaria risk in remote areas from June to October, exclusively due to the mild P.vivax-form in: Armenia: possibly present in certain villages of the Masis district in the Ararat valley on the western border with Turkey (no cases have been reported since 2006). The measures against mosquito bites from dusk till dawn suffice. Azerbeidjan: in the lower rural areas in the region between the Kura- and the Arax rivers. Georgia: only in a few villages in the southeast of the country. The measures against mosquito bites from dusk till dawn suffice. Kyrgyzstan: in some of the southern and the western parts of the country, mainly in the Batken, Osh and Jalal-Abad regions (in the border area with Tadjikistan and Oezbekistan) and in the suburbs of Bishkek. The measures against mosquito bites from dusk till dawn suffice. Oezbekistan: sporadic autochthonous cases are reported in some places in the southern and eastern parts of the country (Surkhanda-rinskaya region: Uzunskiy, Sariassiskiy and Shurchinskiy districts). The measures against mosquito bites from dusk till dawn suffice. Russian Federation: because of the intense migration streams from the southern regions of the "Commonwealth of Independent States", there may be a very limited risk of malaria in some regions. No preventive measures are recommended. Tadjikistan (*): southern border areas, (Khatlon region), in some central (Dushanbe), western (Gorno-Badakhshan), and northern areas (Leninabad region). For the preventive measures, see below (*).  Turkmenistan:  in a number of villages in the southeast of the country, near the Afghan border, mainly in the Mary district. No autochthonous cases have been reported since 2006. Measures for protection against moquito bites are sufficient here.
	PREVENTION OF MALARIA IN THE RISK AREAS: Measures for protection against mosquito bites in the evenings and at night are always essential for protection against malaria if you are staying overnight outside large towns (see information on "malaria"). In case of fever malaria should always be considered, how small the risk might be. People visiting a malaria area during the daytime and staying in good hotels in the evenings and overnight run no risk and do not need to take antimalaria tablets. Although they should always have a mosquito repellent with them in case they are not able to get back to the hotel in time in the evening, for example due to illness, car breakdown, etc. You should also generously apply the mosquito repellent when on a trip or a safari in the early morning, in the evening or at night. On trips of the adventure type in the countryside with overnight stays in primitive conditions in small villages, the following additional measures are indispensable: - impregnating the mosquito net with permethrine or deltamethrine, a chemical substance that provides an extra mosquito-repellent and mosquitocidal effect. - (*) taking medication in Tadjikistan in the above mentioned risk regions: NIVAQUINE®, 3 tablets per week, taken all in one dose. Start this regimen from 1 week before departure, and continue until 4 weeks upon return; P. falciparum malaria has been reported in the southern areas: the intake of Malarone® every day or Doxycycline 100 mg per day or Lariam®, 1 tablet per week, is recommended.
	DIARRHOEA DIARRHOEA is a frequent problem when travelling. Even when travelling in good conditions, it is not always possible to avoid it.  Some advice and the correct medication from the travel pharmacy are very useful. Please consult the text on "travellers' diarrhoea", where the measures for prevention and the correct treatment of diarrhoea are discussed.
	VACCINATIONS No vaccination is actually required. YELLOW FEVER vaccination is not required for any of these countries. When visiting the Russian Federation, the vaccination against yellow fever is required when you are coming from a region where yellow fever might occur, the vaccine is not required when you are leaving from Belgium. Going on a trip is an ideal opportunity to bring your TETANUS, DIPHTHERIA, PERTUSSIS and MEASLES VACCINATIONS up to date. BOTH DIPHTHERIA and POLIOMYELITIS VACCINATIONS are advisable for a trip to the former USSR. Vaccination against HEPATITIS A is systematically recommended for people who are travelling in poor hygienic conditions. In a lot of cases, vaccination against HEPATITIS B is recommended. For more details, please consult the text about "VACCINATIONS". In exceptional cases, vaccination against TYPHOID, TICK-BORNE ENCEPHALITIS & RABIES is also recommended.