Estonia

Disease Risks and Prevention

Diseases of concern in Estonia include hepatitis A and B, drug-resistant tuberculosis and, in forested areas in summer, tickborne encephalitis. Vaccination can protect you against hepatitis (and rabies, if you are at risk); for other conditions, protective measures appear below under Precautions.

See a Doctor Before You Travel

Visit a travel medicine specialist, or a doctor familiar with travel medicine, at least a month before your trip.

Recommendations of the Centers for Disease Control are below, but appropriate vaccines and medicines depend on many factors that are specific to each person. Inform your doctor:

Where you are traveling within a country,

The length of your trip,
What types of activities you might do,
Other personal matters such as your age, medical and vaccine history, and current medical state.

Many hospitals and many county health departments have a Travel Medicine office. A directory of private travel clinics is available at the International Society of Travel Medicine, www.istm.org.

Immunizations

Required: none
Recommended
Hepatitis A or immune globulin (IG)	Recommended for all unvaccinated people traveling to or working in countries with an intermediate or high level of hepatitis A virus infection where exposure might occur through food or water. Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors.
Hepatitis B	Recommended for all unvaccinated persons who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment (e.g., for an accident).
Rabies	Vaccination recommended only for: Travelers with high occupational risks, such as veterinarians Long-term travelers and expatriates living in areas with a high risk of exposure Travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals, such as wildlife professionals, researchers, veterinarians, or adventure travelers visiting areas where bats, carnivores, and other mammals are commonly found
Routine	Before traveling, update any vaccinations you would normally receive, such as measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine, poliovirus vaccine.

Precautions

Tickborne encephalitis
When you visit areas with ticks and fleas, wear shoes, not sandals, and tuck pants into socks. After a hike, check for attached ticks, especially in skin creases such as the back of the knee or behind the ear.
Tuberculosis
Avoid exposure to known TB patients in crowded environments such as hospitals, prisons, or homeless shelters. Avoid unpasteurized dairy products.
Food- and water-borne illness
Observe food safety practices: Wash your hands often with soap and water, especially before eating. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol). Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, learn how to make water safer to drink. Do not eat food purchased from street vendors. Make sure food is fully cooked. Avoid dairy products unless you know they have been pasteurized.
HIV and other infections
To avoid infections such as HIV and viral hepatitis, do not share needles for tattoos, body piercing, or injections. To reduce the risk of HIV and other sexually transmitted diseases, always use latex condoms.

Pack a travel health kit

Your kit serves three purposes: to manage any pre-existing conditions, to prevent illnesses related to traveling, and to take care of minor health matters.

When packing medications for travel, remember the following considerations.

Original containers: All medications should be carried in their original containers with clear labels, so the contents are easily identified. Although many travelers like placing medications into small containers or packing them in the daily-dose containers, officials at ports of entry may require proper identification of medications.
Prescriptions: Travelers should carry copies of all prescriptions, including their generic names.
Physician notes: For controlled substances and injectable medications, travelers are advised to carry a note from the prescribing physician on letterhead stationery.
Restricted medications: Travelers should be aware that certain medications are not permitted in certain countries. If there is a question about these restrictions, particularly with controlled substances, travelers are recommended to contact the embassy or consulate of the destination country.
Availability: A travel health kit is useful only when it is available. It should be carried with the traveler at all times (e.g., in a carry-on bag). Due to airline security rules, sharp objects and some liquids and gels must remain in checked luggage.

Source: U.S. CDC (Centers for Disease Control), Atlanta, Georgia, USA

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