Read below for travel health advice on Sweden from the MDtravelhealth channel on Red Planet Travel.
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Summary of recommendations
No special health immunizations or medications are necessary for most trips to Sweden. Tick precautions are advised, as below.
|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 Sweden:
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.
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.
Tick-borne encephalitis vaccine may be considered for long-term travelers who expect to be visiting rural or forested areas in the spring or summer. In Sweden, risk is greatest along the southern coastline from Uppsala to Karlshamm, though the disease has recently spread to new areas. Most cases occur in the counties of Stockholm, Södermanland, and Uppsala, with a small number also occurring each year in the county of Västra Götaland, south of Lake Vänern. More than 200 cases were reported for the first nine months of 2011. The incidence has been rising steadily since the mid-1980s, probably related to milder winters and earlier arrival of spring. Other factors, such as an increase in the population of host animals and greater travel to tick-endemic areas, may also play a role (see Eurosurveillance and ProMED-mail; July 7, 2001).
Two vaccines have been developed: TicoVac, also known as FSME Immun (Baxter AG), which is manufactured in Austria, and Encepur (Chiron Behring), which is made in Germany. The vaccines are approved for use in a number of European countries, but not the United States. A full series consists of three doses over a one-year period, which is not practical for most travelers, though limited data indicate that Encepur may be given in an accelerated schedule for faster immunity. Tick precautions, as discussed below, are strongly advised.
An increased number of cases of psittacosis was reported in March 2013 from Skane and Kronoberg counties in southernmost Sweden. A case-control study showed that those infected were more likely to have cleaned wild bird feeders or been exposed to wild bird droppings in other ways (see Eurosurveillance and ProMED-mail). Psittacosis is a potentially fatal respiratory infection caused by inhalation of aerosols containing the causative bacteria, which are shed in the feces and secretions of infected birds. Most travelers are at low risk.
A measles outbreak was reported from the canton of Geneva in March-April 2007, resulting in 11 cases (see Eurosurveillance). In January 2006, a measles outbreak was described in the Scandinavian region of Øresund, resulting in 18 cases as of late March (nine in Denmark and nine in Sweden). All the Swedish patients resided in the western part of Skane (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. Measles vaccine should not be given to pregnant or severely immunocompromised individuals.
An outbreak of tularemia was reported in the summer of 2006 from the county of Värmland in central Sweden (bordering Norway), resulting in 90 cases as of September. Most of the cases occurred in areas near the northern shores of Lake Vänern, where a river delta, beaches and golf courses are located. See Eurosurveillance for further information. In Sweden, tularemia is usually transmitted by mosquito bites and less often by tick bites. Most of those affected develop the ulceroglandular form of the disease, characterized by an infected ulcer, enlarged lymph nodes, and fever. Some cases are also acquired by inhalation, leading to pneumonia (especially common among farmers after working with hay). Tularemia responds well to antibiotics when started early in the course of the illness. In Sweden, no deaths have been reported from tularemia in recent years. There is no vaccine for tularemia. Insect protection measures are recommended, as below.
Outbreaks of tularemia occur periodically in Sweden, usually in summer and early autumn, typically in the central part of the country, though an increasing number of cases are being reported from border areas. A particularly large outbreak, numbering almost 700 cases, was reported in 2003. See Emerging Infectious Diseases and Eurosurveillance for further information. A large outbreak also occurred in 2000, when more than 400 cases were reported, chiefly from the counties of Stockholm, Sodermanland, Vastmanland, Varmland, and Orebro. See Eurosurveillance and Emerging Infectious Diseases for details.
Wound infections caused by Vibrio cholerae were reported in August 2006 among three people in Blekinge County in southeast Sweden after swimming in the Baltic Sea. The strains were non-agglutinating and non-toxin-producing (i.e. distinct from the strains which cause severe diarrheal illness). The Swedish Institute for Infectious Disease Control has advised people with any skin breakages not to bathe or swim outdoors. For further information, go to Eurosurveillance.
An outbreak of Legionnaires' disease was reported from the city of the city of Lidköping in August-September, 2004. The source of the outbreak has not been identified. For further information, go to Eurosurveillance.
For updates on recent outbreaks, go to the Smittskyddsinstitutet website (in Swedish). For detailed statistics regarding many infectious diseases, go to EpiNorth (click on EpiData from the menu on the left).
Insect and Tick Protection
When visiting rural or forested areas or the southern coast, travelers should wear long sleeves, long pants, and boots with pants tucked in. Insect repellents containing 25-35% DEET (N,Ndiethylmetatoluamide) should be applied to clothing and exposed skin (but not to the eyes, mouth, or open wounds). For children between 2 and 12 years of age, use preparations containing no more than 10% DEET and apply sparingly. DEET-containing compounds should not be used on children less than two years of age. For further protection, apply permethrin-containing repellents to clothing and shoes. After a day outdoors, travelers should perform a thorough tick check 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.
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.
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.
Ambulance and Emergency Services
For emergency services anywhere in Sweden, call 112. For a guide to hospitals, clinics and dentists in Sweden, go to the U.S. Embassy website at http://www.usemb.se/consulate/acs_hospital.html.
(reproduced from the U.S. State Dept. Consular Information Sheet)
Medical care comparable to that found in the United States is widely available. The Swedish medical system is a state run system, so instead of visiting a local private general practitioner, travelers can visit a local medical center or clinic, called an "Akutmottagning" or "Vardcentral." Patients should be prepared to present their passport. Non-European citizens should consult with their travel agents about the need for insurance before they travel. In case of a medical emergency, the emergency telephone number "112" (equivalent of U.S. "911") can be used to contact the appropriate emergency service.
Travelers with special medical needs should consult with their personal physician and take appropriate precautions, including bringing adequate supplies of necessary medication. Medicines may be brought into the country as long as they are intended for the traveler's personal use. Medications classified as narcotics may only be brought into the country to cover the traveler's personal use for a maximum of five days, and they must be accompanied by a medical certificate that states why the traveler needs them. Forwarding drugs to Sweden after a traveler has arrived is prohibited by stringent Swedish customs regulations. Travelers may also find local physicians reluctant to prescribe equivalent quantities or dosages. Prescriptions are dispensed at state-run pharmacies called "Apotek" in Swedish. Most pharmacies are open during normal shopping hours, but major cities have a 24-hour pharmacy.
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 Sweden for any extended period of time are encouraged to register at the Consular Section of the U.S. Embassy in Stockholm and obtain updated information on travel and security within Sweden. Americans living or traveling in Sweden are encouraged to register with the nearest U.S. Embassy or Consulate throu gh the State Department's travel registration website, https://travelregistration.state.gov, and to obtain updated information on travel and security within Sweden. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, you'l American citizens l make it easier for the Embassy or Consulate to contact you them in case of emergency. The U.S. E mbassy is located at Dag Hammarskjoldsvag 31, telephone: (46)(8) 783-5300, fax: (46)(8)783-5480, and after-hours telephone: (46)(8) 783-5310. The Embassy's Internet website is www.usemb.se. and U.S. citizens may also use the website to register on-line Normal hours for public visitors are Monday-Friday, 9:00 a.m.–11:00 a.m., except for Swedish and American holidays. Routine passport and citizen service inquiries are handled at telephone by calling: (46)(8)783-5375 Monday-Thursday between 1:00 and 3:00 p.m.
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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