Slovakia Health Overview
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There are no vaccinations required for travel to Slovakia. No special precautions are necessary, except for visitors intending to spend time in the forests, in which case a vaccination for tick-borne encephalitis is recommended. Bird flu was first detected in February 2006, and although there is little risk to travellers, close contact with live birds should be avoided and all poultry products well cooked as a precaution. No human deaths or infections have been reported. Slovakia has a reciprocal health agreement with most EU countries providing emergency health care on the same terms as Slovak nationals. EU travellers should carry a European Health Insurance Card (EHIC) with them. It is still recommended that visitors take out comprehensive medical insurance, including mountain evacuation. Hospitals are available in all major towns, and pharmacies and clinics exist in the tourist areas and smaller towns, but little English is spoken.
View information on diseases: Tick-borne encephalitis, Hepatitis A, Typhoid fever, Tetanus, Rabies, Hepatitis B, Diphtheria
Tick-borne encephalitis
Cause: The tick-borne encephalitis (TBE) virus, which is a flavivirus. Other closely related viruses cause similar diseases. Transmission: Infection is transmitted by the bite of infected ticks. There is no direct person-to-person transmission. Some related viruses, also tick-borne, infect animals such as birds, deer (louping-ill), rodents and sheep. Nature of the disease: Infection with tick-borne encephalitis may induce an influenza-like illness, with a second phase of fever occurring in 10% of cases. Encephalitis develops during the second phase and may result in paralysis, permanent sequelae or death. Severity of illness increases with age. Geographical distribution: Tick-borne encephalitis is present in large parts of Europe, particularly Austria, the Baltic States (Estonia, Latvia, Lithuania), the Czech Republic, Hungary and the Russian Federation. The disease is seasonal, occurring mainly during the summer months in rural and forest areas at altitudes up to 1,000 metres. Risk for travellers: In endemic areas during the summer months, travellers are at risk when hiking or camping in rural or forest areas. Prophylaxis (protective treatment): A vaccine against TBE is available. Precautions: Avoid bites by ticks by wearing long trousers and closed footwear when hiking or camping in endemic areas. If a bite occurs, the tick should be removed as soon as possible. Source: WHO.
Back to TopHepatitis A
Cause: Hepatitis A virus, a member of the picornavirus family. Transmission: The virus is acquired directly from infected persons by the faecal-oral route or by close contact, or by consumption of contaminated food or drinking water. There is no insect vector or animal reservoir (although some non-human primates are sometimes infected). Nature of the disease: An acute viral hepatitis with abrupt onset of fever, malaise, nausea and abdominal discomfort, followed by the development of jaundice a few days later. Infection in very young children is usually mild or asymptomatic (e.g. causes no symptoms); older children are at risk of symptomatic disease. The disease is more severe in adults, with illness lasting several weeks and recovery taking several months; case-fatality is greater than 2% for those over 40 years of age and 4% for those over 60. Geographical distribution: Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled. Risk for travellers: Non-immune travellers to developing countries are at significant risk of infection. The risk is particularly high for travellers exposed to poor conditions of hygiene, sanitation and drinking water control. Prophylaxis (protective treatment): Vaccination. Precautions: Travellers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Source: WHO.
Back to TopTyphoid fever
Cause: Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans. Transmission: Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water. Nature of the disease: Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved. Geographical distribution: Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking. Risk for travellers: Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal. Prophylaxis (protective treatment): Vaccination. Precautions: Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.
Back to TopTetanus
Disease: Tetanus is acquired through environmental exposure to the spores of Clostridium tetani, which are present in soil worldwide. The disease is caused by the action of a potent neurotoxin produced by the bacterium in dead tissue (e.g. dirty wounds). Clinical symptoms of tetanus are muscle spasms, initially muscles of mastication causing trismus or "lockjaw", which results in a characteristic facial expression-risus sardonicus. Trismus can be followed by sustained spasm of the back muscles (opisthotonus) and by spasms of other muscles. Finally, mild external stimuli may trigger generalized, tetanic seizures, which contribute to the serious complications of tetanus (dysphagia, aspiration pneumonia) and lead to death unless intense supportive treatment is rapidly initiated. Occurrence: Dirty wounds can become infected with the tetanus spores anywhere in the world. Risk for travellers: Every traveller should be fully protected against tetanus. Almost any form of injury, from a simple laceration to a motor-vehicle accident, can expose the individual to the spores. Vaccine: All travellers should be up to date with the vaccine. The primary immunizing course of three doses of DTP is given in the first months of life. Booster doses are most easily given as Td, but certainly all doses given to individuals aged 7 years and above should be Td. A booster dose of Td should generally be used in preference to tetanus toxoid (TT) immediately following trauma. However, no such booster is needed if the last dose was given less than 5 (for dirty wounds) to 10 years (for clean wounds) previously. Precautions and contraindications: Mild local reactions occur in up to 95% of vaccine recipients. Reactions increase in frequency and severity as the number of doses increases. After booster doses of TT, 50-80% of people experience some pain or tenderness at the injection site. True hypersensitivity reactions to TT occur very rarely. Source: WHO.
Back to TopRabies
Cause: The rabies virus, a rhabdovirus of the genus Lyssavirus. Transmission: Rabies is a zoonotic disease affecting a wide range of domestic and wild animals, including bats. Infection of humans usually occurs through the bite of an infected animal. The virus is present in the saliva. Any other contact involving penetration of the skin occurring in an area where rabies is present should be treated with caution. In developing countries transmission is usually from dogs. Person-to-person transmission has not been documented. Nature of the disease: An acute viral encephalomyelitis, which is almost invariably fatal. The initial signs include a sense of apprehension, headache, fever, malaise and sensory changes around the site of the animal bite. Excitability, hallucinations and aerophobia are common, followed in some cases by fear of water (hydrophobia) due to spasms of the swallowing muscles, progressing to delirium, convulsions and death a few days after onset. A less common form, paralytic rabies, is characterized by loss of sensation, weakness, pain and paralysis. Geographical distribution: Rabies is present in animals in many countries worldwide. Most cases of human infection occur in developing countries. Risk for travellers: In rabies-endemic areas, travellers may be at risk if there is contact with both wild and domestic animals, including dogs and cats. Prophylaxis (protective treatment): Vaccination for travellers with a foreseeable significant risk of exposure to rabies or travelling to a hyperendemic area where modern rabies vaccine may not be available. Precautions: Avoid contact with wild animals and stray domestic animals, particularly dogs and cats, in rabies-endemic areas. If bitten by an animal that is potentially infected with rabies, or after other suspect contact, immediately clean the wound thoroughly with disinfectant or with soap or detergent and water. Medical assistance should be sought immediately. The vaccination status of the animal involved should not be a criterion for withholding post-exposure treatment, unless the vaccination has been thoroughly documented and vaccine of known potency has been used. In the case of domestic animals, the suspect animal should be kept under observation for a period of 10 days. Rabies post-exposure treatment: In a rabies-endemic area, the circumstances of an animal bite, other contact with the animal, and the animal's behaviour and appearance may suggest that it is rabid. In such situations, medical advice should be obtained immediately. Post-exposure treatment to prevent the establishment of rabies infection involves first-aid treatment of the wound followed by administration of rabies vaccine and antirabies immunoglobulin in the case of a bite or exchange of saliva. The administration of vaccine, and immunoglobulin if required, must be carried out, or directly supervised, by a physician. Source: WHO.
Back to TopHepatitis B
Cause: Hepatitis B virus (HBV), belonging to the Hepadnaviridae. Transmission: Hepatitis B is transmitted from person to person by contact with infected body fluids. Sexual contact is an important mode of transmission, but infection is also transmitted by transfusion of contaminated blood or blood products, or by use of contaminated needles or syringes for injections. There is also a potential risk of Hepatitis B transmission through other skin-penetrating procedures including acupuncture, piercing and tattooing. Perinatal transmission may occur from mother to baby. There is no insect vector or animal reservoir. Nature of the disease: Many HBV infections are asymptomatic (e.g. causes no symptoms) or cause mild symptoms, which are often unrecognised in adults. When clinical hepatitis results from infection, it has a gradual onset, with anorexia, abdominal discomfort, nausea, vomiting, arthralgia and rash, followed by the development of jaundice in some cases. In adults, about 1% of cases are fatal. Chronic HBV infection persists in a proportion of adults, some of whom later develop cirrhosis and/or liver cancer. Geographical distribution: Worldwide, but with differing levels of endemicity. In north America, Australia, northern and western Europe and New Zealand, prevalence of chronic HBV infection is relatively low (less than 2% of the general population). Risk for travellers: Negligible for those vaccinated against hepatitis B. Unvaccinated travellers are at risk if they have unprotected sex or use contaminated needles or syringes for injection, acupuncture, piercing or tattooing. An accident or medical emergency requiring blood transfusion may result in infection if the blood has not been screened for HBV. Travellers engaged in humanitarian relief activities may be exposed to infected blood or other body fluids in health care settings. Prophylaxis (protective treatment): Vaccination. Precautions: Adopt safe sexual practices and avoid the use of any potentially contaminated instruments for injection or other skin-piercing activity. Source: WHO.
Back to TopDiphtheria
Disease: Diphtheria is a bacterial disease caused by Corynebacterium diphtheriae. The infection commonly affects the throat and may lead to obstruction of the airways, and death. Transmission is from person to person, through close physical contact, and is increased in overcrowded and poor socioeconomic conditions. Exotoxin-induced damage occurs to organs such as the heart. Nasal diphtheria may be mild, and chronic carriage of the organism frequently occurs; asymptomatic infections are common. A cutaneous form of diphtheria is common in tropical countries and may be important in transmission of the infection. Occurrence: Diphtheria is found worldwide, although it is not common in industrialized countries because of long-standing routine use of DTP vaccine. Recently, large epidemics have occurred in several east European countries. Risk for travellers: Potentially life-threatening illness and severe, lifelong complications are possible in incompletely immunized individuals. Vaccine: All travellers should be up to date with the vaccine, which is usually given as "triple vaccine"-DTP (diphtheria/tetanus/pertussis). After the initial course of three doses, additional doses may be given as DT until 7 years of age, after which a vaccine with reduced diphtheria content (Td) is given. Since both tetanus toxoid and diphtheria toxoid can reasonably be given on a booster basis about every 10 years, there is little reason to use monovalent diphtheria vaccine. Precautions and contraindications: Avoid diphtheria-containing vaccines if a severe or life-threatening reaction has occurred to a previous dose. Use a vaccine with reduced diphtheria content (Td) from age 7 years onwards. Source: WHO.
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