Health services for travelers to St

Health and Insurance

In theory, most foreigners are entitled to free emergency care in Russian hospitals, and some countries have reciprocal agreements with Russia for free healthcare for their citizens. Russians are extremely proud of the quality of their doctors, but few can deny the chronic under-funding of the public healthcare system, and free treatment is almost unheard of even for Russian citizens — even if you are admitted to hospital free, you will almost certainly have to pay for medication, and for reasonable treatment by nurses.

Before you travel
For the reasons stated above, it is well worth taking out effective travel insurance for your trip to St. Petersburg, or ensuring that your current travel insurance covers the city (you may want to know exactly what services they cover, as well).

Booster-shots for diphtheria, polio and tetanus are recommended for travelers.

While in St. Petersburg
If you do have health problems in St. Petersburg, there are a large number of private clinics in the city, many of them with English-speaking staff and many with their own ambulances. In fact, Russia is becoming an increasingly popular destination for medical tourism, as many procedures are available here at much lower prices than in the US or some parts of Europe. You can find a list of recommended clinics here. In a real emergency, you should be able to organize a medical evacuation to Finland.

The emergency services number for the ambulance service is 03. For an ambulance, say: «skoraya pomosh», literally meaning quick help.

Health tips
A few factors to be aware of during your stay.

Water
The situation with tap water in St. Petersburg has recently improved, with a new purifying plant in the city bringing the water supply up to international standards of safety, at least at source. Unfortunately, the pipe system in many districts and buildings is very old and neglected, and by the time the water comes out of the tap it often has quite high levels of heavy metals — and may be a rather unpleasant yellow color. Therefore it’s still probably safer to drink bottled water, unless there’s a filter system installed where you’re staying.

Ice
Every winter when there is a reasonable level of snowfall followed by a freeze, large quantities of ice form on the roofs of the city’s buildings. When temperatures rise above freezing, this has to be cleared quickly or it is likely to break off in large chunks and fall to the street. Unfortunately, the municipal authorities seem unable to organize this process effectively, and there are regular casualties among pedestrians. There is not that much that can be done to avoid randomly falling blocks of ice, but it’s worth keeping your wits about you during sudden thaws, and keeping your time on the street to a minimum.

Mosquitoes
This is more of an irritation than a real health risk, but by Western European standards the number of mosquitoes during the summer in St. Petersburg can be very high, particularly anywhere near bodies of water (which covers most of the city). If your accommodation does not have netted windows, you will probably want to invest in a chemical anti-mosquito plug-in.

Available in all supermarkets, pharmacies, and many kiosks (Raid and Raptor are popular brands), these simple devices will only cost a few dollars with refills (either tablets or screw-in bottles of liquid). Plug the unit in a couple of hours before you go to bed and you should be able to sleep peacefully. If you are planning a trip into the countryside, you will definitely need to buy some kind of repellent cream or gel, also widely available in supermarkets and pharmacies.

Ticks
In recent years, the risk of tick-borne encephalitis has spread from its nexus in Western Siberia all across Russia and most of Europe. There have been (very few) incidences of infection in the countryside around St. Petersburg, and local ticks are also known to be carriers of Lyme disease. There is no risk in urban areas, and this should only ever be an issue if you are involved in outdoor activities (camping, hiking, fishing, etc.) in forest areas. If you are, it is worth keeping as much of your body covered as possible (this will also help against mosquitoes).

Should you have the misfortune to be bitten by a tick, the most important thing is to have it removed quickly, usually by rubbing the area around the bite with alcohol or cooking oil and then using tweezers to grasp the tick as close to the skin as possible and pull gently but steadily until the tick becomes disengaged from the skin. It is vital that you keep the tick that bit you for analysis, and this is best done by placing it in a sealed container with some moisture — a recently emptied water-bottle is ideal. Provided the tick is promptly removed, the risk of infection is very low, but you should still contact a medical professional as soon as you get back to the city.

See also:  Plants That Repel Mice, Hunker

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Vaccinations in Russia

On paper, the vaccination system in Russia is similar to other European countries. It’s not always easy to navigate the local requirements in Russian, though. How can you keep your vaccinations in Russia up-to-date?

If you are moving to Russia, you might want to know more about the vaccination recommendations prior to your travel. However, finding information about vaccinations in Russia might be nerve-wracking, especially if you can’t read Russian. This guide explains everything you need to know about getting your shots in Russia – or those required before you move.

Russian vaccination system

The Russian Ministry of Health (министерство здравоохранения in Russian) oversees the Russian healthcare system. There is a wide range of clinics and hospitals in Moscow. The situation is different in rural areas, as many towns and villages across the country have no medical infrastructure to speak of.

According to The Moscow Times, Russia struggles to maintain “the threshold percentage of the population that must be immunized for a disease to be kept at bay, generally considered to be between 92 and 95% — for diseases like diphtheria and measles, among others.” The lack of trust in vaccinations is stronger than ever. Local health situations can change quickly; follow local and international news and always ask for the medical opinion of a health specialist.

Insurance for vaccinations in Russia

Health insurance in Russia is free for citizens and residents under the government-run Russian health insurance system. Those who don’t qualify will need to consider private health insurance. Russia’s Obligatory Medical Insurance (OMI) covers most basic treatments, although the Russian healthcare system may not have the best reputation in the world. The quality of care you’ll receive varies drastically across the country, with major cities such as Moscow and Saint Petersburg boasting some of the best hospitals; however, many rural areas have few or no medical facilities at all.

In addition to this service gap, public healthcare and medical insurance in Russia are suffering from budget cuts resulting in longer waiting times for patients. With this in mind, many expats moving to Russia take out private health insurance or use international insurance to ensure the quality of their healthcare.

A wide variety of health insurance providers offer comprehensive plans that include vaccinations, such as:

Foreigners from the European Union who carry a European Health Insurance Card (EHIC) should check with their home government whether or not they can access healthcare in Russia before traveling or relocating to Moscow. Non-EU citizens need to check if their home country has a reciprocal healthcare agreement with Russia and what they could be entitled to.

Vaccinations for children in Russia

According to the UNICEF, the vaccination schedule for children in Russia is the following:

  • Bacillus Calmette-Guerin: three days, seven years, 14 years
  • Dip: every 10 years
  • DT (diphtheria, tetanus): three months, 4.5 months, 12 months
  • DTwPHep: six months
  • HepB: one day, one month, six months
  • HIP: six months, seven months
  • Influenza: seasonal
  • IPV (polio vaccine): three months, 4.5 months
  • MMR (mumps, measles, and rubella): one year, six years
  • Mumps: one year, six years
  • OPV (oral polio vaccine): six months, 18 months, 20 months, 14 years
  • Rubella: one year, six years
  • Td: 6–7 years, 14 years

Vaccinations are organized through your designated physician. Seek their advice for when and how to vaccinate your child.

An accurate vaccination schedule for your children might be tricky to find online in English or other languages than Russian. We strongly recommend that you seek advice from a health specialist before taking any health-related decision.

Travel vaccinations in Russia

Before going to Russia, make sure that you are up-to-date with your vaccination schedule. These vaccines include measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis, varicella (chickenpox), polio, and, of course, your yearly flu shot. Find more information on the Centers for Disease Control and Prevention.

Vaccinations against hepatitis A, typhoid and immunoglobulin are also recommended. If you’re planning on visiting Siberia, check the precautions for tick-borne encephalitis and Lyme disease.

Useful resources

Looking for more information about vaccinations in Russia? Check out the following websites:

www.expatica.com

What does TBE stand for?

TBE stands for Tick-Borne Encephalitis

This definition appears very frequently and is found in the following Acronym Finder categories:

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Coronavirus (COVID-19)

What is encephalitis?

Encephalitis is an inflammation of the brain that is often caused by a viral infection. The arboviruses cause encephalitis and are passed on to people and animals by insects.

There have been outbreaks in recent years in the U.S. of several types of encephalitis, such as West Nile encephalitis and St. Louis encephalitis. Travelers abroad are most at risk for Japanese encephalitis and tick-borne encephalitis.

Japanese encephalitis is mosquito-borne and occurs mainly in:

  • China, Japan, and Korea
  • Eastern Russia

Japanese encephalitis also occurs less often in Republic of China (Taiwan), Singapore, and Hong Kong. In all of these areas, Japanese encephalitis is mainly a rural disease.

On average, among people who are infected by a mosquito bite, very few will develop an illness. Most people who are infected develop only mild or no symptoms. But among people who develop encephalitis, the results are serious.

Tick-borne encephalitis is a viral infection of the central nervous system passed on by bites of certain ticks. The disease occurs in:

  • Scandinavia
  • Western and Central Europe
  • The countries that made up the former Soviet Union

People can be infected by the bite of infected Ixodes ricinus ticks. This usually happens in people who visit or work in forests, fields, or pastures. You can also get the infection by consuming unpasteurized dairy products from infected cows, goats, or sheep.

The risk of getting the disease is greatest from April through August. This is when ticks are most active.

What causes arbovirus encephalitis?

The arboviruses that cause encephalitis are passed on to people and animals by insects. In rural areas, arboviruses that are carried by mosquitoes or ticks are the most common cause of arboviral infection. The infection is often mild, but it can progress to encephalitis.

What are the symptoms of arbovirus encephalitis?

The following are the most common symptoms of encephalitis caused by arboviruses:

  • Headache
  • Feeling unwell
  • Drowsiness
  • Fever
  • Vomiting
  • Stiff neck
  • Muscle soreness or trembling
  • Confusion
  • Convulsions
  • Sensitivity to light
  • Extreme weakness

The symptoms of arbovirus encephalitis may look like other health conditions or problems. Always see your doctor for a diagnosis.

How is arbovirus encephalitis diagnosed?

Healthcare providers will use blood tests and tests of cerebrospinal fluid to find the virus.

How is arbovirus encephalitis treated?

Because this is a viral disease, antibiotics will not help. There are no effective antiviral medicines at this time. There is no specific treatment for encephalitis. The main goal is to ease symptoms and keep the person’s breathing and circulation working well while the infection runs its course.
Your healthcare provider will determine the best treatment for you based on:

  • How old you are
  • Your overall health and past health
  • How sick you are
  • How well you can handle specific medicines, procedures, or therapies
  • How long your condition is expected to last
  • Your opinion or preference

Can arbovirus encephalitis be prevented?

A vaccine for Japanese encephalitis is currently available in the U.S. through most travelers’ clinics. The CDC generally recommends the vaccine only for people who will travel in rural areas for 4 weeks or more. It is also recommended where there is a known outbreak of Japanese encephalitis.

As a traveler, take steps to prevent insect bites, including the following:

  • Limit how much time you spend outdoors during the cooler hours at dusk and dawn. This is when mosquitoes that pass on the disease feed.
  • Wear mosquito repellents containing DEET as an active ingredient.
  • Stay in air-conditioned or well-screened rooms.

If you are traveling to rural areas, bring a portable bed net. Use permethrin, a mosquito repellent/insecticide, on both the bed net and clothing.

Another way to prevent encephalitis is with mosquito control. In many emergency cases, the best method is with aerial spraying. Many states may use aerial spraying to control mosquitoes. They can also spray in areas where the virus is active.

To protect yourself against tick-borne encephalitis, follow these recommendations:

  • Stay away from tick-infested areas.
  • Wear clothing that will help you avoid being bitten.
  • Use repellents containing DEET. These can be put directly on skin.
  • Use permethrin on clothing and camping gear.
  • Don’t drink or eat unpasteurized dairy products.

When should I call my healthcare provider?

Call your healthcare provider if you have the following symptoms:

  • Headache
  • Drowsiness
  • Fever of 100.4°F (38°C) or higher, or as advised by your healthcare provider
  • Vomiting
  • Stiff neck
  • Muscle trembling
  • Confusion
  • Convulsions
  • Light sensitivity

Key points on arbovirus encephalitis

  • Encephalitis is an inflammation of the brain that is often caused by a viral infection. Arboviruses can cause encephalitis.
  • Arboviruses are passed on to people and animals by insects. In rural areas, mosquitoes and ticks are the most common carriers.
  • The viral infection is usually mild. But it can progress to encephalitis.
  • There is no treatment for encephalitis. Treatment is usually to relieve symptoms while the virus runs its course.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
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Russia Selective Vaccinations:
Japanese Encephalitis

Outbreaks occur occasionally in the southeast of Russia between the border with China and the Sea of Japan, with prevalence in the area of Vladivostok. The period of transmission is from July to October.

Description

Japanese Encephalitis is a viral infection caused by RNA viruses belonging to the Flavivirus genus. It is a zoonosis – an animal disease that can spread to humans – primarily transmitted by evening biting Culex mosquitoes that feed on infected birds, pigs and other mammals passing the infection to humans living and working in rural areas around rice paddies and irrigation systems.

Japanese Encephalitis occurs in Southeast Asia. Long-term travellers, persons involved in outdoor recreational activities or on work assignments going to endemic areas are at risk, especially those visiting rural areas, farms, rice fields and irrigation areas. Children under 15 years of age seem to particularly susceptible to the infection. Outbreaks typically occur during or shortly after the rainy season in temperate regions and year-round in tropical regions (peak transmission during summer months).

Symptoms

The majority of cases are asymptomatic – persons do not exhibit symptoms. Those with symptoms usually get ill 5 to 15 days after exposure to the virus. Symptoms include fever, severe headache, vomiting, diarrhea, and general weakness. Some patients will develop neurological symptoms such as tremors, seizures (especially children), expressionless face, and sudden paralysis which can affect the respiratory system and cause bladder retention problems. Patients may also experience behavioural changes which can be misdiagnosed as psychiatric illness. Japanese Encephalitis can be fatal in 20% to 30% percent of cases and many survivors continue to have long-term neurologic, psychiatric, or cognitive problems. Treatment includes supportive care of symptoms.

Prevention
  • Use a repellent containing 20%-30% DEET or 20% Picaridin on exposed skin. Re-apply according to manufacturer’s directions.
  • Wear neutral-coloured (beige, light grey) clothing. If possible, wear long-sleeved, light-weight garments.
  • If available, pre-soak or spray outer layer clothing and gear with permethrin.
  • Get rid of water containers around dwellings and ensure that door and window screens work properly.
  • Apply sunscreen first followed by the repellent (preferably 20 minutes later).
  • More details on insect bite prevention.
Vaccination

Recommended for persons travelling extensively in rural areas, long-term travellers, and persons on work assignments in endemic areas.

The inactivated Vero cell vaccine is available in Canada, the USA and select countries. Booster vaccination is recommended 1-2 years if you are at continued risk of exposure. Live attenuated vaccines are available in Japanese Encephalitis endemic countries where they are given as part of the childhood routine immunization schedule. Discuss your options with a healthcare provider if you can’t finish the vaccination series before departure.

Information last updated: January 2020

  • Solomon T. Japanese Encephalitis. In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter’s Tropical Medicine and Emerging Infectious Diseases. 9 th ed. New York: Saunders Elsevier; 2013: 358-365.
  • Centres for Disease Control and Prevention: Yellow Book, Japanese Encephalitis
  • Public Health Agency of Canada: Canadian Immunization Guide, Japanese Encephalitis Vaccine
  • World Health Organization:International Travel and Health, Vaccine Preventable Diseases and Vaccines

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