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Health Information for Travelers to FranceClinician View

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Vaccines and Medicines

Prepare travelers to France with recommendations for vaccines and medications.

 

  Recommendations Transmission Guidance
Routine vaccines

Recommended for all travelers

varied

Immunization schedules

Hepatitis A

Consider for most travelers; recommended for travelers at higher risk (e.g. visiting smaller cities, villages, or rural areas where exposure might occur through food or water; or prone to "adventurous eating")

Fecal-oral route (contaminated food and water)

Person-to-person contact

Hepatitis A (Yellow Book)

Dosing info

Hepatitis B

Consider for most travelers; recommended for those who might be exposed to blood or other body fluids, have sexual contact with the local population, or be exposed through medical treatment (e.g., for an accident).

Contact with blood and other body fluids:

  • Unprotected sex
  • Injection drug use
  • Contaminated transfusions
  • Exposure to human blood
  • Contaminated tattoo and piercing equipment

Hepatitis B (Yellow Book)

Dosing info (Twinrix)

Rabies

Recommended for the following groups:

  • Travelers involved in outdoor and other activities in remote areas that might bring them into direct contact with bats (such as adventure travelers and cavers).
  • Those with occupational risks (such as wildlife professionals and researchers).

Bites from bats (rabies is not present in canines or other mammals)

Rabies (Yellow Book)

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Non-Vaccine-Preventable Diseases

The following diseases are possible risks your patients may face when traveling in France. This list is based on our best available surveillance data and risk assessment information at the time of posting. It is not a complete list of diseases that may be present in a destination. Risks may vary within different areas of a destination.

 

  Guidance Patient Eduction Notes

Vectorborne

Tickborne Encephalitis
  • Spread by tick bites, occasionally by unpasteurized dairy products
  • Risk present only in small areas in many countries
  • Most cases occur
    • in forested areas
    • in areas with <2,500 ft (750 m) elevation
    • from April through November; peaks in early and late summer
  • Higher risk: outdoor activities (such as camping, hiking, fishing, bicycling) and outdoor occupations (such as forestry, military training)
  • No vaccine available in the US. Travelers with high-risk exposures or expatriates may consider vaccination in Canada or Europe.

Airborne & Droplet

H5N1 Avian Influenza
  • No human cases have been reported
  • Cases reported in poultry in France

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Patient Counseling

Counsel your patients on actions they can take on their trip to stay healthy and safe.

Eat and drink safely

Industrialized country—no special precautions.

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Prevent bug bites

Counsel travelers to take standard precautions against bug bites, including use of an appropriate insect repellent.

More Information on Insect Repellents

DEET (concentration of 20% or more) is the only insect repellent shown to be effective against ticks. However, several EPA-registered active ingredients provide reasonably long-lasting protection against mosquitoes:

  • DEET (chemical name: N,N-diethyl-m-toluamide or N,N-diethyl-3-methyl-benzamide): Concentrations above 50% show no additional protective benefit.
  • Picaridin (KBR 3023 [Bayrepel] and icaridin outside the United States; chemical name: 2-(2-hydroxyethyl)-1-piperidinecarboxylic acid 1-methylpropyl ester): Must be reapplied more often than DEET.
  • Oil of lemon eucalyptus (OLE) or PMD (chemical name: para-menthane-3,8-diol), the synthesized version of OLE. “Pure” oil of lemon eucalyptus (essential oil) is not the same product; it has not undergone similar testing for safety and efficacy, is not registered with EPA as an insect repellent, and is not covered by this recommendation.
  • IR3535 (chemical name: 3-[N-butyl-N-acetyl]-aminopropionic acid, ethyl ester).

Products with <10% active ingredient may offer only limited protection (1–2 hours).

Encourage patients to use repellents and reapply only as instructed. If sunscreen is also needed, they should apply sunscreen first and repellent second. Encourage them to follow package directions for using repellent on children and avoid applying to their hands, eyes, and mouth.

For more detailed information, visit the Yellow Book: Protection against Mosquitoes, Ticks, & Other Insects & Arthropods

Additional Resources
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Stay safe outdoors

Advise travelers to exercise caution during outdoor activities. Important tips include dressing appropriately for the climate (such as loose, lightweight clothing in hot climates and warm layers in cold climates), staying hydrated, avoiding overexposure to the sun, and practicing safe swimming habits.

Encourage travelers to learn basic first aid and CPR before travel, especially if they will be traveling to remote areas where medical assistance may not be accessible. Help them assemble a travel health kit.

Additional Resources:

Sunburn
Problems with Heat & Cold

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Keep away from animals

Counsel travelers to be cautious around all animals.

  • Travelers could be at risk for injuries from domestic animals such as dogs or cats, even in industrialized countries.
  • The best course of action is to avoid touching, petting, handling, or feeding animals, including pets.
  • Arthropods such as spiders and scorpions can pose a stinging risk, and travelers should exercise care in environments where these creatures are likely to be present.
  • Stress the urgency of treating suspected and probable rabies infection by:
    • Washing the wound immediately with soap and clean water.
    • Seeking medical attention as soon as possible.
Additional Resources

Animal-Associated Hazards (YB)
Rabies (YB)
Criteria for Preexposure Immunization for Rabies (YB)
Protection against Mosquitoes, Ticks, & Other Insects & Arthropods (YB)

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Reduce your exposure to germs

People who are ill should not travel. Urge travelers to practice hand hygiene and sneeze into a tissue or their sleeve.

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Avoid sharing body fluids

Counsel travelers on the risks of diseases associated with the exchange of saliva, blood, vomit, semen, urine, and feces.

Travelers should:

  • Use a latex condom correctly every time they engage in sex (vaginal, anal, and oral-genital).
  • Not inject drugs.
  • Limit alcohol consumption.
  • Not have tattoos, piercings, or other procedures that use needles (acupuncture) unless the needles are packaged new or sterilized.
  • Ensure that medical and dental equipment is sterile or disinfected if seeking care.
Additional Resources:
HIV & AIDS (YB)
Hepatitis B (YB)
Hepatitis C (YB)
Medical Tourism (YB)

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Know how to get medical care while traveling

Travelers should plan for how to obtain health care during their trip, should the need arise.

Discuss supplemental travel health insurance and medical evacuation insurance, and consider helping the traveler obtain an extra month of prescriptions for any needed medications.

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Select safe transportation

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

Most recommendations for safe transportation are basic and could be considered common sense. However, travelers often do not think about the importance of being aware and careful when walking, riding, driving, or flying. Counsel travelers to think about transportation options before they arrive, especially if they will be driving in France.

Some basic reminders to review with your patients:

  • Choose safe vehicles and avoid motorbikes when possible.
  • Wear a seatbelt or a helmet at all times.
  • Do not drive after drinking alcohol or ride with someone who has been drinking.
  • If they will be driving, remind them to get any driving permits and insurance they may need. It is recommended to get an International Driving Permit (IDP).
  • Avoid using local, unscheduled aircraft, and fly on larger planes (more than 30 seats) when possible.

Helpful Resources
Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, Auto Insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

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Maintain personal security

Travelers should be reminded on how to protect their personal safety during travel, regardless of their destination. 

The US Department of State has an extensive website with safety information for international travelers, travel alerts and warnings, and country-specific information. Travelers should be directed to the Department of State resources for information and tips on safe travel.

Stay abreast of current events, particularly those that could pose a safety or health problem for travelers. You can also receive updates on new travel alerts and warnings from the US Department of State by subscribing to their RSS feeds.

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Healthy Travel Packing List

Remind your patients to pack health and safety items. Use the Healthy Travel Packing List for France for a list of health-related items they should consider packing.

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Travel Health Notices

Stay aware of current health issues in France in order to advise your patients on additional steps they may need to take to protect themselves.

Alert Level 2, Practice Enhanced Precautions

  • Schistosomiasis in Corsica (France) Updated August 04, 2014 According to the European Centre for Disease Control, 6 people were infected with schistosomiasis on the island of Corsica (France). All of the travelers were exposed to the freshwater in the Cavu River and had not traveled to other areas where schistosomiasis is known to occur. CDC recommends that travelers to the island of Corsica avoid exposure to freshwater to prevent schistosomiasis. Read More >>

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Advising Returning Travelers

Although some illnesses may begin during travel, others may occur weeks, months, or even years after return. A history of travel, particularly within the previous 6 months, should be part of the routine medical history for every ill patient. A newly returned, ill international traveler should be preferentially evaluated by a physician versed in travel-related illness.

Here are two professional medical organizations that provide directories of travel clinics throughout the United States:

For more information on advising patients after international travel, see Yellow Book Chapter 5: Post-Travel Evaluation.

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Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Centers for Disease Control and Prevention concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked.

 
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