All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics, prior to international travel. The following are the recommended vaccinations for Ireland:

Measles-mumps-rubella vaccine: two doses are recommended (if not previously given) for all travelers born after 1956, unless blood tests show immunity. Many adults born after 1956 and before 1970 received only one vaccination against measles, mumps, and rubella as children and should be given a second dose before travel. MMR vaccine should not be given to pregnant or severely immunocompromised individuals.

Tetanus-diphtheria vaccine is recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.

Influenza vaccine is recommended for all travelers during flu season, which runs from November through April. Influenza vaccine may cause soreness at the injection site, low-grade fevers, malaise, and muscle aches. Severe reactions are rare. Influenza vaccine should not be given to pregnant women during the first trimester or those allergic to eggs.

A mumps outbreak was reported in April 2008 from the Mid-West area, with over half of the cases occurring among students at the University of Limerick. In late 2004, a number of mumps outbreaks were reported from higher education colleges, apparently related to the fact that, in Ireland, many in this age group never received measles-mumps rubella (MMR) vaccine as children but were never exposed to natural mumps infection due to the extensive use of MMR in others (see Eurosurveillance). The outbreaks continued into 2005, but appeared to subside in late 2006 and 2007. However, the number of cases began to rise again in 2008, reaching a total of 153 cases in the first four months of 2008, chiefly in those between the ages of 15 and 24 (see Eurosurveillance). All travelers born after 1956 should make sure they have had either two documented mumps or MMR immunizations or a blood test showing mumps immunity. This does not apply to people born before 1957, who are presumed to be immune. Children greater than 12 months of age should be given two doses of MMR vaccine, separated by one month, before travel to Ireland.

An outbreak of cryptosporidiosis was reported from Galway in March 2007, due to contamination of the municipal water supply. As of April 14, the number of laboratory confirmed cases was 182. Cryptosporidiosis is caused by an intestinal parasite which produces diarrhea and crampy abdominal pain, usually lasting 1-2 weeks. The disease may be especially severe in those with compromised immune systems, such as those infected with HIV. The infection is usually acquired by ingestion of contaminated water, but may also be transmitted by contaminated food and from person-to-person. Local health authorities advise that all water intended for drinking or food preparation should be boiled before use. Water can be used for personal hygiene, such as bathing, but only boiled water should be used for brushing teeth. For further information, go to Eurosurveillance, NATHNAC, the Health Service Executive West, and ProMED-mail (April 9, 2007).

An increase in measles activity was reported between May and September 2004, and before that between November 2002 and February 2003. A major measles outbreak involving more than 1000 people, including two deaths, was reported in the first half of 2000, chiefly in the north Dublin area. The increase in measles cases is thought to be due to reduced vaccination of young children owing to negative publicity surrounding measles vaccine. All travelers to Ireland should make sure they are fully immunized against measles. See the National Disease Surveillance Centre for details.

Four cases of variant Creutzfeldt-Jakob disease (CJD) have been identified in the Republic of Ireland. The disease is acquired by eating beef from cows with a related infection known as bovine spongiform encephalopathy (mad cow disease). At present, the risk of acquiring variant CJD from European beef appears to be extraordinarily low, at most about one in 10 billion servings. The Centers for Disease Control does not advise against eating European beef, but suggests that travelers who wish to reduce their risk may either abstain from beef while in Europe or eat only solid pieces of muscle meat, such as steak, rather than products like sausage or chopped meat that might be contaminated. There is no evidence of any risk from pork, lamb, milk or milk products. For recent updates, go to ProMED-mail.

Clusters of cases of leptospirosis have been associated with canoeing on the River Liffey, especially in the autumn following heavy rainfall. A small number of cases developed in November 2004 among those who had been canoeing on the river over the national holiday weekend of October 23-25 (see Eurosurveillance for details). In November 2001, six cases were reported in association with canoeing on a particular stretch of the river in October 2001 (see EPI-Insight for further information). Leptospirosis is transmitted to humans by exposure to water contaminated by the urine of infected animals. Symptoms may include fever, chills, headache, muscle aches, conjunctivitis (pink eye), photophobia (light sensitivity), and rash. Most cases resolve uneventfully, but a small number may be complicated by meningitis, kidney failure, liver failure, or hemorrhage. Those engaging in high-risk activities may consider taking a prophylactic 200 mg dose of doxycycline, either once weekly or as a one-time dose.

Liver infection caused by Fasciola hepaticum (liver fluke) has been reported in travelers to Ireland. A recent study indicates that the prevalence is increasing. Sheep, cattle, and dairy cows are chiefly affected, but humans may acquire the disease by eating fresh watercress. For further information, go to ProMED-mail (November 17, 2002).

Brucellosis is occasionally reported. Cattle are the most common source of infection.

HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.

For disease statistics and updates on recent outbreaks, go to the National Disease Surveillance Centre.

Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from your personal physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity. Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.

Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.

Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.

Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.

For an ambulance in Ireland, call 999.

High quality medical care is generally available, though the waiting time for certain specialists and procedures may be long. For a guide to physicians and hospitals, go to the U.S. Embassy website. The Embassy website also includes information as to eligibility for health services.

Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed.

All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).

Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, and appropriate antibiotics for common childhood infections, such as middle ear infections.

Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.

Americans living or traveling in Ireland are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, https://travelregistration.state.gov, and to obtain updated information on travel and security within Ireland. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The Embassy is located at 42 Elgin Road, Ballsbridge, Dublin 4, telephone (353)-(1)-668-8777, after hours number: (353) (1) 668-9612, fax: (353) (1) 668-8056. Travelers to Northern Ireland should also consult the Consular Information Sheet for the United Kingdom. Further information and answers to many frequently asked questions are available on the Embassy Dublin's Internet homepage at http://dublin.usembassy.gov/.

For information on safety and security, go to the U.S. Department of State, United Kingdom Foreign and Commonwealth Office, Foreign Affairs Canada, and the Australian Department of Foreign Affairs and Trade.