Western Europe
Travel To Western Europe
* Andorra * Austria * Azores * Belgium * Denmark * Faroe Island * Finland * France * Germany * Gibraltar * Greece * Greenland * Holy See * Iceland * Ireland * Italy * Liechtenstein * Luxembourg * Madeira * Malta * Monaco * Netherlands * Norway * Portugal * San Marino * Spain * Sweden * Switzerland * United Kingdom
The area is characterised by a low risk for most infectious diseases.
Vector-borne infections: The only malaria cases are "airport" malaria and imported cases. Lyme disease is found in broad areas of Europe in temperate forested areas. Tick-borne encephalitis is found in Austria, Germany, Finland, Sweden, Switzerland, and Denmark (only on island of Bornholm); a few cases have also been reported from Italy, Norway, and France. Leishmaniasis (cutaneous and visceral) is found, especially in countries bordering the Mediterranean, with the highest numbers of cases from Spain, where it is an important opportunistic infection in HIV-infected persons. Relapsing fever (tick-borne) is found in focal areas in Greece, Italy, Portugal, and Spain; sporadic cases may occur elsewhere in region. Murine typhus is more common in warmer areas, especially Mediterranean port cities. Sandfly fever occurs in warmer months in southern Europe, especially in Italy, Spain, Portugal, and Greece. Small numbers of cases of babesiosis have been reported from the region.
Food- and water-borne infections: Risk of hepatitis A is low (except for Greenland). Outbreaks of salmonellosis, campylobacteriosis, and other food- and water-borne infections occur, but the risk of diarrhoea in travellers is low. Brucellosis is found, especially in southern countries on the Mediterranean. Variant Creutzfeldt-Jacob cases have been reported primarily from the United Kingdom, although a small number of cases have been reported from other countries. Large outbreaks of trichinosis have occurred; outbreaks in France have been linked to horse meat.
Airborne and person-to-person transmission: Measles transmission has been slowed by vaccination programs. The annual incidence rate of tuberculosis per 100,000 population is estimated to be 10-50 for most of the region and <10 in Norway and Sweden.
Sexually transmitted and blood-borne infections: The prevalence of HIV in adults is estimated to be 0.3% in this region.
Zoonotic infections: Large outbreaks of tularemia* have occurred in rural areas in several of these countries, including Sweden, Finland, and Spain. Hantaviruses causing haemorrhagic fever with renal syndrome are widespread; Puumala virus, the cause of mild nephropathia epidemica, is found in Scandinavian and western European countries. Rabies is present in many countries in western Europe; human cases are rare. Echinococcosis* due to Echinococcus granulosus is found, especially in Spain and the Mediterranean countries; areas with alveolar echinococcosis (caused by E. multilocularis) have expanded in recent years, with the largest number of cases found in focal areas of France, Germany, and Switzerland. Q fever* (airborne spread) is a common cause of febrile illness (both sporadic cases and outbreaks), especially in rural areas of Spain, southern France, and other Mediterranean countries.
Soil- and water-associated infections: Legionnaires' disease is sporadic; some outbreaks have involved tourists at resort hotels.
