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Belgium



Capital: Brussels

Time Zone: +1 (GMT +2 from the last Sunday in March to the last Sunday in October).
Tel. Country Code: 32
USADirect Tel.: 0
Electrical Standards: Electrical current: 220/50 (volts/hz). European-style two-pin plugs. Grounding Adaptor Plug D.


Travel Advisory - Belgium

Europe, Russia and former the Soviet Union countries vary widely in travel risks and adequacy of health care delivery. Water- and food-borne illnesses such as travelers' diarrhea, typhoid and Giardia are threats outside of Western Europe. Insect-transmitted diseases, such as Lyme disease and tick-borne encephalitis are common in wooded, rural areas in most countries, including Western Europe.

Dr. Rose Recommends for Travel to Belgium


Resource Links

NaTHNaC
World Health Organization
CDC
Travel Health Services
Country Insights
Travel Warnings
Consular Information
Foreign Commonweatlh Office

Embassies

• Embassy of the United States of America
American Citizens Unit
Boulevard du Regent/Regentlaan 25
Brussels
Tel: [32] (2) 508-2878
Fax: [32] (2) 513-0409
E-mail address: uscitizenbrussels@state.gov
Website: http://belgium.usembassy.gov/index.html
The American Citizen Services (ACS) Unit of the Consular Section assists American citizens in Belgium. Among other things, the unit provides passport services, registers the birth of children, assists with Federal benefits, offers notarial services, gives information on voting, and provides advice and information to Americans visiting and residing in Belgium. The ACS Unit also provides emergency assistance to American citizens in distress: when an American is destitute, arrested, separated from minor children, or sick. In an emergency, the Embassy Duty Officer can be reached at any time.

• Canadian Embassy
2, Avenue de Tervuren
Brussels
Tel: [32] (2) 741-0611
E-mail: bru@dfait-maeci.gc.ca
Website: www.dfait-maeci.gc.ca/brussels

• British Embassy
Rue d'Arlon 85 Aarlenstraat
Brussels
Tel: [32] (2) 287 6211
Email: visasection.brussels@fco.gov.uk
consularsection.Brussels@fco.gov.uk
Website: www.britishembassy.gov.uk/belgium

Entry Requirements



HIV Test: Not required.

Required Vaccinations: None required.

Passport Information

Passport/Visa: A passport is required that does not expire before the intended duration of the visit to Belgium, as well as proof of sufficient funds and a return airline ticket, are required. American citizens do not need a visa to travel to Belgium for business or pleasure for up to 90 days. That 90-day period begins with entry to any of the "Schengen group" countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden. Multiple visits to Schengen countries may not exceed 90 days in any 6 month period. For further information concerning entry requirements, contact the Embassy of Belgium at 3330 Garfield St. NW, Washington, DC 20008, telephone (202) 333-6900; or one of the Belgian Consulates General in Atlanta, Los Angeles, or New York. Visit the Belgian Embassy web site at http://www.diplobel.org/usa for the most current visa infomation.

Vaccinations: Recommended and Routine

Hepatitis A: Recommended for all travelers not previously immunized against hepatitis A who want maximum protection.

Hepatitis B: Recommended for all non-immune travelers at potential risk for acquiring this infection. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from acupuncture, tattooing or body piercing; when receiving non-sterile medical or dental injections, or unscreened blood transfusions; by direct contact with open skin sores on an infected person. Recommended for long-term travelers, expatriates, and any traveler requesting protection against hepatitis B infection.

Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.

Routine Immunizations: Immunizations against tetanus-diphtheria, measles, mumps, rubella (MMR vaccine) and varicella (chickenpox) should be updated, if necessary, before departure. MMR protection is especially important for any female of childbearing age who may become pregnant.
• The new Tdap vaccine, ADACEL, which also boosts immunity against pertussis (whooping cough) should be considered when a tetanus-diphtheria booster is indicated.

Hospitals / Doctors

Medical care in Belgium is of a high standard. The large university hospitals can handle almost every medical problem. Hospitals in Brussels and Flemish-speaking Flanders will probably have English-speaking staff. Hospitals in French-speaking Wallonia, however, may not have staff members who are fluent in English.
All travelers to Belgium should be up-to-date on their immunizations and are advised to carry a medical kit as well as antibiotics to treat travelers diarrhea or other infections. Travelers who are taking regular medications should carry them properly labeled and in sufficient quantity to last for the duration of their trip; they should not expect to obtain prescription or over-the-counter drugs in local stores or pharmacies in this country - the equivalent drugs may not be available.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage. Policies should cover: ground and air ambulance transport, including evacuation to home country; payment of hospital bills; 24-hour telephone assistance.

To reach a doctor in an emergency, telephone the emergency medical and ambulance service at number 100 or 112. The 100 or 112 numbers may be used for all emergencies. Ambulance services are provided at any time of the day or night and will transport the patient to the nearest hospital.

• A listing of clinics and hospitals is maintained by the U.S. Embassy at:
http://belgium.usembassy.gov/clinics_and_hospitals.html
and English-speaking doctors at:
http://belgium.usembassy.gov/medical_doctors.html

• University Clinic St. Luc
Avenue Hippocrate 10
Brussels
Tel: [32] (02) 764-1111
Website: www.saintluc.be
Provides services to the English-speaking communitiy. The facilty has 23 operating rooms as well as cardiac catheterization and angioplasty capability.

• Hôpital Brugmann
Place Van Gehuchten 4
Brussels
Tel: [32] (2) 477-2111
Website: www.chu-brugmann.be

• Regionaal Ziekenhuis Lier
Kolveniersevest
Leuven
Belgium
Tel: [32] (3) 491-2345
All specialties, including neurosurgery; Emergency Department is open 24/7.

Travel Medicine & Infectious Disease Specialists

• van Gompel, Alfons, MD, DTMH
Associate Professor of Tropical Medicine
Chief of the Polyclinic and Travel Clinic
Institute of Tropical Medicine
Kronenburgstraat 42/3
Antwerp
Tel: [32] (3) 247-6405
E-mail: fvgompel@itg.be
Website: http://www.itg.be/itg/
Pre-Travel Vaccination, Official Yellow Fever Vaccine Center, Post-Travel Medical Consultation, On-Site Diagnostic Laboratory.

• Jacobs, Frederique, MD
Erasme Hospital
Route de Lennik 808
Brussels
Tel: [32] (2) 555-6746
E-mail: fjacobs@ulb.ac.be
Pre-Travel Vaccination, Post-Travel Medical Consultation, On-Site Diagnostic Laboratory.

• Legrand, Jean Claude, MD
CHU Charleroi
Bd Janson, 92
Charleroi
Tel: [32] (71) 23 21 33
E-mail: jean-claude.legrand@chu-charleroi
Pre-Travel Vaccination, Official Yellow Fever Vaccine Center, Post-Travel Medical Consultation, On-Site Diagnostic Laboratory.

• Cartuyvels, Reinoud, MD
Vaccinatiecentrum
Virga Jesseziekenhuis
Stadsomvaart 11
Hasselt
Tel: [32] (11) 309740
Website: http://www.virgajesse.be
Pre-Travel Vaccination, Official Yellow Fever Vaccine Center, On-Site Diagnostic Laboratory.

• Peetermans, Willy E., MD
Dept. Internal Medicine
University Hospital
Herestraat 49
Leuven
Telephone: [32] (16) 344775
Pre-Travel Vaccination, Official Yellow Fever Vaccine Center, Post-Travel Medical Consultation, On-Site Diagnostic Laboratory.

Destination Health Info for Travelers

AIDS/HIV: Belgium is currently experiencing an upward trend in the number of new HIV diagnoses characterised by a continuous increase in the number of cases among men who have sex with men (MSM). Based on surveillance data, in the past decade the yearly number of newly diagnosed HIV cases in MSM increased more than threefold, from 101 cases diagnosed in 1999 to 332 cases.
The steady increase in the number of newly diagnosed HIV cases among MSM, and the high proportion of MSM among HIV-positive patients co-infected with other sexually transmitted infections (STI) (95.6% in 2008) indicate increases in unsafe sex practices in this group.
Read more: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19420

Primary risk groups include men having sex with men (MSM) and intravenous drug users. According to UNAIDS estimates, the largest numbers of people living with HIV in Western Europe in 2006 were in France and Italy. The adult HIV prevalence in France is 0.4% and in Italy 0.5%. The HIV prevalence in Belgium is 0.3%. This also compares to the prevalence rate in adults in the UK of around 0.2% (See: www.Avert.org)
• Transmission of HIV can be prevented by avoiding: sexual contact with a high-risk partner; injecting drug use with shared needles; non-sterile medical injections; unscreened blood transfusions.
• The threat of HIV/AIDS should not be a primary concern for the traveler. However, there may be a concern for a subset of travelers who may be exposed to HIV, the virus that causes AIDS, through contact with the body fluids of another person or their blood. Although travel has contributed in a general way to the global spread of AIDS, fear of traveling because of this disease is not warranted.

Accidents & Medical Insurance: Accidents and injuries are the leading cause of death among travelers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drownings, aircraft crashes, homicides, and burns are lesser causes.
• Heart attacks cause most fatalities in older travelers.
• Infections cause only 1% of fatalities in overseas travelers, but, overall, infections are the most common cause of travel-related illness.
• MEDICAL INSURANCE: Travelers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance center that can help arrange and monitor delivery of medical care and determine if medevac or air ambulance services are required.

Hantavirus Infections: Between January and April 2007, 61 cases of Puumala virus were detected. It is estimated that 175 cases will be reported in 2007, which would make it the 3rd consecutive epidemic year in a row. Hantaviruses (including the Puumala virus serotype) are human pathogens that are prevalent worldwide. In western and central Europe, the predominant serotype is Puumala, which causes hemorrhagic fever with renal syndrome (HFRS). Puumala virus is spread by rodents and is transmitted to humans by inhalation or ingestion of food contaminated with rodent excreta. Most cases in Belgium are reported from southeastern areas of the country. Travelers are at low risk for infection.
• The most common symptoms are fever, nausea, vomiting, headache, stomachache, back pain, tenderness in the kidney area, diarrhea or constipation, and sore throat. HFRS infection may also lead to neurologic symptoms including encephalitis, radiculitis, seizures, and cerebral hemorrhage. Renal failure may require dialysis.


Hepatitis: There is a low risk of hepatitis A in Western Europe, but the hepatitis A vaccine should be considered for maximum protection. Sporadic outbreaks have occurred in developed countries. In July 2004, 80 cases of hepatitis A were reported in the Grimbergen area (Vlaams-Brabant province) of Belgium and 172 cases in Antwerp province. (Eurosurveillance Weekly). Travelers 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. Travelers who will have access to safe food and water are at lower risk. Those at higher risk include travelers visiting friends and relatives, long-term travelers, and those visiting areas of poor sanitation.
• Hepatitis E may be endemic at low levels. Sporadic cases may be underdiagnosed or underreported. Most cases of documented hepatitis E in Belgium occur in younger travelers who have visited endemic areas, especially the Indian subcontinent. (http://www.journals.uchicago.edu/doi/abs/10.1086/313430) Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. Farm animals, such as swine, and also deer and wild boar, may serve as a viral reservoirs. (HEV is one of the few viruses which has been shown to be transmitted directly from animals through food.) In developing countries, prevention of hepatitis E relies primarily on the provision of clean water supplies and overall improved sanitation and hygiene. There is no vaccine.
• The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at <1%. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from non-sterile medical or dental injections, and acupuncture; from unscreened blood transfusions; by direct contact with open skin lesions of an infected person. The average traveler is at low risk for acquiring this infection. Vaccination against hepatitis B is recommended for: persons having casual/unprotected sex with new partners; sexual tourists; injecting drug users; long-term visitors; expatriates, and anybody wanting increased protection against the hepatitis B virus.
• Hepatitis C is endemic at a low level with a prevalence of <0.9% in the general population. Most hepatitis C virus (HCV) is spread either through intravenous drug use or, in lesser-developed countries, through blood contamination during medical procedures. Over 200 million people around the world are infected with hepatitis C, an overall incidence of around 3.3% of the population of the world. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.

Lyme Disease: Lyme disease occurs in wooded regions of this country, especially in the Ardennes and in the northeast. Peak transmission occurs from April to September. All travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions of endemic areas should take measures to prevent tick bites (The tick vector in Europe is Ixodes ricinus). Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A single 200-mg dose of doxycycline is effective in preventing Lyme disease if taken within 72 hours of being bitten by an infected tick. (Reference: http://content.nejm.org/cgi/content/abstract/345/2/79).

Other tick-borne diseases transmitted in Europe by I.ricinus include:
Tick-borne encephalitis
Ehrlichiosis (now called human granulocytic anaplasmosis)
Babesiosis: The majority of babesia infections in Europe are life-threatening and caused by Babesia divergens and B. bovis
Mediterranean spotted fever (southern Europe; caused by Rickettsia conorii)
Tularemia (also transmitted to humans by direct handling of infectious carcasses, ingestion of contaminated food or water, and inhalation of infectious dusts or aerosols)

Rabies: Belgium is reported to be free of canine rabies. All wild animal bites, however, especially from a racoon dog or fox, should be vigorously cleansed with soap and water and medically evaluated for possible post-exposure treatment.

Rabies is still present in Europe. Its incidence in humans remains limited (fewer than 5 human cases per year) through the application of strict prophylactic measures (anti-rabies treatment) and by means of veterinary rabies control measures in the domesticated and wild animal populations. The main indigenous animal reservoirs are: the dog in eastern European countries and on the borders with the Middle East; the fox in central and eastern Europe; the racoon dog in northeastern Europe; and the insectivorous bat throughout the entire territory.
Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=575

Travelers' Diarrhea: Low risk. Tap water in this country is potable. Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
• A quinolone antibiotic, or azithromycin, combined with loperamide (Imodium), is recommended for the treatment of diarrhea. Diarrhea not responding to antibiotic treatment may be due to a parasitic disease such as giardiasis, amebiasis, or cryptosporidiosis.
• Seek qualified medical care if you have bloody diarrhea and fever, severe abdominal pain, uncontrolled vomiting, or dehydration.