Health and Safety Tips

I. Vaccinations for Russia/CIS

Please use this adult vaccine schedule as a GUIDELINE ONLY. Before receiving any vaccine, always discuss with your doctor the indications, precautions, contra-indications, and ways to avoid exposure to these and other diseases.

Hepatitis B Vaccine - for those at risk, primary series of 3 injections.
Hemophilus Influenze (B) - for those younger than 5 years.
Influenza Vaccine - for those 50 years and older and others at risk.
Measles, Mumps, Rubella - primary series & single booster for anyone born after 1956.
Pneumococcal Vaccine - for those 65 years and older and others at risk.
Polio Vaccine - primary series; one time adult booster for international travel.
Tetanus, Diphtheria, Pertussis (DPT/Td) - primary series; booster every 5-10 years.

Special Immunizations

Hepatitis A Vaccine - one dose for those at risk. Booster in 6 to 12 months.
Rabies Vaccine - for those at risk, pre-exposure prophylaxis in 3 doses.
Typhoid Vaccine - one injection at least 2 weeks before expected exposure, may repeat every 2 years. Oral vaccine is currently unavailable in the US.

*IMPORTANT NOCICE: This summary is based on the traveler's itinerary in order of travel and based on information provided by the CDC and US State Department available at the time of update publication. Further explanation of the risk, recommendations and requirements are available in the CDC publication "Health Information for International Travel" and the associated "Blue Sheets" published biweekly. These sheets should always be consulted to confirm current infected areas. Final recommendations will take into account specific travel within each country and special patient situations that may or may not be provided at time summary was generated. This printout is provided as a patient educational aid and should not be used as the sole source for medical judgement and treatment. Recommendations for vaccinations may vary for short-term visitors. Always consult your personal physician to discuss immunizations and your particular requirements.

II. Other Health Related Issues

WATER
Generally, the tap water in St. Petersburg does not contain parasites. Reports have shown quantities of chlorine and metals in the water, probably from older pipes. In St. Petersburg and other areas around the CIS, giardia has been found in some water samples. Avoid tap water, fountain drinks and ice cubes in restaurants. It is recommended to use boiled (at least for 20 minutes at a rolling boil) and filtered water.

Precautions should be taken when swimming in lakes, streams or ponds. Risks can be associated not only to water quality, but to dangerous submerged objects (such as glass) which can cause injury. It's best to swim only in adequately chlorinated pools or in salt water.

Giardia has been found in St. Petersburg tap water samples, so special precautions should be taken when visiting the city. Cholera outbreaks have also occurred in several areas in the southern regions of Russia and the Ukraine.

III. Food Safety

'Food poisoning' is the name given to illness caused by eating food that has harmful micro-organisms in it. It may include vomiting and/or diarrhea, stomach pains, fever and headaches.

Micro-organisms that cause the disease (sometimes called bacteria, bugs or germs) are everywhere. Most bacteria grow best in warm temperatures. They like moist conditions and need time to grow. Bacteria especially like meats, seafood, poultry, eggs, milk, cream, sauces, gravies, cooked meats and reheated foods. Parasites such as amoebae and giardia organisms are also a significant source of disease. They usually inhabit contaminated water sources and so-called "fresh" vegetables, which may need to be specifically disinfected.

IV. Good Rules to remember are:

Be particular about where and what you eat.
Avoid tap water and ice.
Eat hot foods hot - and make sure they're too hot to eat when they arrive on your plate, otherwise send them back.
Eat cold foods while cold.
Avoid raw leafy vegetables, meats and raw fish or shellfish. These foods are associated with a diarrhea attack rate of 6 - 10%.
Avoid non-carbonated beverages.
Avoid room-temperature meat and sausages.
Be cautious of non-refrigerated cakes and desserts containing milk or egg products.
Avoid milk and all milk byproducts (such as cheese), unless they have been cooked (or pasteurized).
Avoid buying damaged meat packs or vacuum packages with broken seals and do not buy food from chilled or frozen food cabinets which are overfilled, messy or warm.
Make sure fresh pork, other meat, seafood and poultry are well wrapped and cannot drip onto other food.
Buy food from reliable outlets and ALWAYS check the "use by" date.
Avoid eating wild mushrooms or mushrooms bought off the street.
Always cook meat, fish and poultry well.
Fruits and vegetables should be washed and peeled before eating.
Drink adequate amounts of safe liquid when under heat stress or suffering from diarrhea.