Read below for travel health advice on Norway from the MDtravelhealth channel on Red Planet Travel.
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Summary of recommendations
In general, no special medications or immunizations are necessary for travel to Norway.
|Measles, mumps, rubella (MMR)||Two doses recommended for all travelers born after 1956, if not previously given|
|Tetanus-diphtheria||Revaccination recommended every 10 years|
|Influenza||Recommended for all travelers from November through April|
All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics, prior to international travel. The following are the recommended vaccinations for Norway:
Measles-mumps-rubella vaccine: two doses are recommended (if not previously given) for all travelers born after 1956, unless blood tests show immunity. Many adults born after 1956 and before 1970 received only one vaccination against measles, mumps, and rubella as children and should be given a second dose before travel. MMR vaccine should not be given to pregnant or severely immunocompromised individuals. Only eight cases of measles were reported from Norway between 1998 and 2001, six of which were acquired outside the country.
Influenza vaccine is recommended for all travelers during flu season, which runs from November through April. Influenza vaccine may cause soreness at the injection site, low-grade fevers, malaise, and muscle aches. Severe reactions are rare. Influenza vaccine should not be given to pregnant women during the first trimester or those allergic to eggs.
A tularemia outbreak was reported in January 2011 from five communities in More og Romsdal and Sor-Trondelag in central Norway, causing 39 cases by March: 21 cases of oropharyngeal type, 10 cases of glandular/ulceroglandular type, two of respiratory and two of typhoid type. Three cases were asymptomatic and clinical information was unavailable for one case. Most had reported use of drinking water from private wells. The outbreak might have been related to an increased rodent population and snow melting, leading to contamination of the wells with infected rodents or rodent excreta (see Eurosurveillance).
Tularemia is caused by a bacteria called Francisella tularensis, which is carried by rodents and hares. In Norway, most cases of tularemia are caused by direct contact with infected rodents or hares or by ingesting contaminated water or snow. In March 2007, a tularemia outbreak occurred in three adjacent municipalities in northern Norway, resulting in nine cases, almost all of them oropharyngeal, i.e. chiefly involving the mouth and throat, with enlargement of the lymph nodes in the neck. The outbreak appeared to be related to a large surge in the rodent population in the fall of 2006, followed by the appearance of large numbers of dead rodents in the affected areas. In 2002, an outbreak of water-borne tularemia, affecting 11 people, was reported from the municipality of Midtre Gauldal in central Norway. For further information, go to Eurosurveillance.
A measles outbreak was reported from Oslo in Janaury-February 2011, causing 10 cases (see Eurosurveillance). All travelers born after 1956 should make sure they have had either two documented measles immunizations or a blood test showing measles immunity. This does not apply to people born before 1957, who are presumed to be immune to measles. Although measles immunization is usually begun at age 12 months, children between the ages of 6 and 11 months should be given an initial dose of measles or MMR vaccine before traveling to Norway.
An outbreak of Legionnaires' disease was reported in June-July 2008 from the industrial twin cities of Sarpsborg and Fredrikstad in southeast Norway. Five cases were identified, two of them fatal. The same strain of Legionella that caused the cases was found in the aeration ponds and air scrubbers at a local chemical production plant, which was thought to be the source of the outbreak (see Eurosurveillance). The same facility was the cause of a Legionnaires' outbreak in May 2005, resulting in 56 cases and 10 deaths (see Eurosurveillance). A Legionnaires' outbreak was reported from Stavanger, on the western coast of the country, between July and September 2001. A total of 26 confirmed and two probable cases were identified, including seven deaths. The outbreak was traced to a cooling tower near the center of the city, which was disinfected. For details, go to Eurosurveillance and the World Health Organization.
Legionnaires' disease is a bacterial infection which typically causes pneumonia but may also involve other organ systems. The disease is usually transmitted by airborne droplets from contaminated water sources, such as cooling towers, air conditioners, whirlpools, and showers. Legionnaires' disease is not transmitted from person-to-person.
An outbreak of Giardia infections was reported from Bergen between September and November 2004, resulting in more than 300 cases. The chief symptoms were diarrhea and abdominal cramps. A preliminary investigation has pointed to a public water supply which provides water to central areas of the city as the source of the outbreak. For further information, go to Eurosurveillance.
An outbreak of human Salmonella infections in the summer of 2000 was traced to hedgehogs. A previous Salmonella outbreak in 1996 was also associated with hedgehogs. See Eurosurveillance for details.
For detailed statistics regarding many infectious diseases, go to EpiNorth (click on EpiData from the menu on the left). For an overview of public health in Norway, go to the National Institute of Public Health (Folkehelsa) website.
Insect and Tick Protection
Wear long sleeves, long pants, and boots, with pants tucked in when traveling to rural or forested areas. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing and shoes. Permethrin-treated clothing appears to have little toxicity. Perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.
Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from your personal physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity. Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.
Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.
Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.
Many health care facilities will expect payment in cash. Bring your insurance card, claim forms, and any other relevant insurance documents. Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.
Physicians and hospitals
For an online list of physicians, dentists, and hospitals in Norway, go to the U.S. Embassy website.
(reproduced from the U.S. State Dept. Consular Information Sheet)
Medical facilities are widely available and of high quality, but they may be limited outside the larger urban areas. The remote and sparse populations in northern Norway, and the dependency on ferries to cross fjords of western Norway, may affect transportation and ready access to medical facilities. The U.S. Embassy in Oslo maintains a list of emergency clinics in major cities.
Traveling with children
Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed.
All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).
Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, and appropriate antibiotics for common childhood infections, such as middle ear infections.
Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.
(reproduced from the U.S. State Dept. Consular Information Sheet)
Americans living in or visiting Norway are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, https://travelregistration.state.gov, and to obtain updated information on travel and security within Norway, Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Oslo near the Royal Palace at Drammensveien 18; tel. (47) 22-44-85-50, consular fax (47) 22-56-27-51. Information about consular services can be found in the Consular Section of the Embassy's home page at http://www.usa.no. Normal hours for public visitors are 9:00 a.m. to 12:00 p.m. on Monday, Tuesday, Thursday and Friday, except for Norwegian and American holidays. Wednesdays are reserved for special appointments or emergencies.
For information on safety and security, go to the U.S. Department of State, United Kingdom Foreign and Commonwealth Office, Foreign Affairs Canada, and the Australian Department of Foreign Affairs and Trade.
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