Travel vaccinations for Belgium

Tetanus is caused by a toxin released from Clostridium tetani bacteria and occurs worldwide. Tetanus bacteria are present in soil and manure and may be introduced through open wounds such as a puncture wound, burn or scratch. Travellers should thoroughly clean all wounds and seek medical attention for injuries such as animal bites/scratches, burns or wounds contaminated with soil. Travellers should have completed a tetanus vaccination course according to the UK schedule. If travelling to a country or area where medical facilities may be limited, a booster dose of a tetanus-containing vaccine is recommended if the last dose was more than ten years ago even if five doses of vaccine have been given previously. Country-specific information on medical facilities may be found in the 'health' section of the FCDO foreign travel advice pages.

Although rare, bat lyssaviruses (bat rabies) can be transmitted to humans or other animals following contact with the saliva of an infected bat most often by a bite. The disease can also be transmitted if the saliva of an infected bat gets into open wounds or mucous membranes (such as on the eye, nose or mouth). Bat lyssaviruses can cause disease in humans that is indistinguishable from rabies. Symptoms can take some time to develop, but when they do the condition is almost always fatal. The risk to most travellers is low. However, it is increased for certain occupations for example bat handlers and veterinarians, or certain activities such as caving. Rabies has not been reported in this country; therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies). Travellers should avoid contact with bats. Bites from bats are frequently unrecognised. Rabies like disease caused by bat lyssaviruses is preventable with prompt post-exposure rabies treatment. Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial. Although rabies has not been reported in other animals in this country, it is sensible to seek prompt medical advice if bitten or scratched. It is possible, although very rare for bats to pass rabies like viruses to other animals including pets. Post-exposure treatment and advice should be in accordance with national guidelines. A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure treatment and removes the need for rabies immunoglobulin which is in short supply world-wide. Pre-exposure rabies vaccinations are recommended for those who are at increased risk due to their work (e.g. laboratory staff working with the virus and those working with bats). Pre exposure vaccines could be considered for those whose activities put them at increased risk of exposure to bats.

Tick-borne encephalitis (TBE) is a viral infection spread by the bite of infected ticks. Occasionally cases of TBE occur after consumption of raw (unpasteurised) milk or dairy products from infected animals (e.g. cows, goats and sheep). Travellers are at increased risk of exposure during outdoor activities in areas of vegetation such as gardens, parks, meadows, woods, forest fringes and glades. This includes urban parks and woodland areas in cities. Ticks are usually most active between early spring and late autumn. There is a risk of TBE in some areas of this country. The transmission season varies, however, ticks are most active during early spring to late autumn. All travellers should avoid tick bites during outdoor activities, apply insect repellent frequently and follow tick bite avoidance advice. Travellers should check their skin and clothes regularly for ticks and remove them as soon as possible with a recommended technique. Wearing light coloured clothes makes it easier to spot ticks. Travellers should not eat or drink any unpasteurised milk products. Vaccination is recommended for those visiting affected areas whose activities put them at increased risk including: Living in TBE risk areas. Working in forestry, woodcutting, farming and the military. Visiting forested areas and urban parks, e.g. camping, fieldwork, hiking and hunting. Laboratory workers who may be exposed to TBE.