Time Zone: +1 hour. +2 hours during Central European Summer Time from March 30 to October 26.
Tel. Country Code: 355
USADirect Tel.: 0
Electrical Standards: Electrical current 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
TRAVEL ADVISORY - ALBANIA
Europe, Russia and former the Soviet Union countries vary widely in travel risks and adequacy of health care delivery. Water- and food-borne illnesses such as travelers' diarrhea, typhoid and Giardia are threats outside of Western Europe. Insect-transmitted diseases, such as Lyme disease and tick-borne encephalitis are common in wooded, rural areas in most countries, including Western Europe.
• U.S. Embassy
Rruga Elbasanit 103
Tel: (355) (4) 247285
• Consulate of Canada
Rruga -Dervish Hima- Kulla, No. 2, Apt. 22
Tel:  (4) 257 274 or 25 7275
Fax:  (4) 257 273
• British Embassy
Rruga Skenderbeg 12
Tel:  (4) 234 973/4/5
HIV Test: Not Required.
Required Vaccinations: Proof of yellow fever vaccination is required of all travelers >1 year of age arriving from any country in the yellow fever endemic zones.
Passport/Visa: Albania is a parliamentary democracy that is transforming its economy into a market-oriented system. Albania's per capita income is among the lowest in Europe, but economic conditions in the country are steadily improving. Tourist facilities are not highly developed in much of the country, and though Albania’s economic integration into European Union markets is slowly underway, many of the goods and services taken for granted in other European countries are not yet available. Hotel accommodations are limited outside of major cities.
ENTRY AND EXIT REQUIREMENTS: A passport is required. All travelers entering or exiting Albania must have six months or more validity on their passport. Customs officers strictly enforce this law. A traveler does not have to obtain a visa prior to entering Albania . An entry stamp will be issued at the point of entry that is valid for a stay of up to 90 days for a fee of ten Euros, or the equivalent in any easily convertible currency, including U.S. dollars. For stays exceeding 90 days, those interested must apply for a Residency Permit at the police station with jurisdiction over the city of residence.
Information on how to apply for a residency permit is available on the Embassy of Albania’s website at www.albaniaembassy.org. There is also a departure fee of ten Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Visit the Embassy of Albania’s website at www.albaniaembassy.org for the most current visa information.
VACCINATIONS: RECOMMENDED AND ROUTINE
Proof of yellow fever vaccination is required of all travelers >1 year of age arriving from any country in the yellow fever endemic zones.
Hepatitis A: Recommended for all travelers >1 year of age not previously immunized against hepatitis A.
Hepatitis B: Recommended for all non-immune travelers at potential risk for acquiring this infection. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and uånprotected sex; when receiving non-sterile medical or dental injections, or unscreened blood transfusions; by direct contact with open skin sores on an infected person. Recommended for long-term travelers, expatriates, and any traveler requesting protection against hepatitis B infection.
Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.
Rabies: Rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection.
Routine Immunizations: Immunizations against tetanus-diphtheria, measles, mumps, rubella (MMR vaccine) and varicella (chickenpox) should be updated, if necessary, before departure. MMR protection is especially important for any female of childbearing age who may become pregnant.
• The new Tdap vaccine, ADACEL, which also boosts immunity against pertussis (whooping cough) should be considered when a tetanus-diphtheria booster is indicated.
Typhoid: Recommended for all travelers with the exception of short-term visitors who restrict their meals to major restaurants and hotels.
Yellow Fever: Travelers >1 year of age entering the country from an endemic area are required to present a certificate of immunization against yellow fever.
HOSPITALS / DOCTORS
Medical facilities and capabilities in Albania are limited beyond rudimentary first-aid treatment. Emergency and major medical care requiring surgery and hospital care is inadequate due to lack of specialists, diagnostic aids, medical supplies, and prescription drugs.
All travelers should be up-to-date on their immunizations and are advised to carry a medical kit as well as antibiotics to treat travelers’ diarrhea or other infections. Travelers who are taking regular medications should carry them properly labeled and in sufficient quantity to last for the duration of their trip; they should not expect to obtain prescription or over-the-counter drugs in local stores or pharmacies in this country—the equivalent drugs may not be available; may be of dubious origin; or be of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance medevac. In the event of a serious illness or injury every effort should be made to arrange medical evacuation to a more advanced medical facility in Western Europe for treatment and on-going care.
A list of doctors is maintained by the U.S. Embassy at: http://tirana.usembassy.gov/list_of_doctors.html
Health care facilities include:
• Mother Teresa Hospital Centre
Tel:  (4) 349 523/362 630
General medical/surgical facility.
• ABC Health Center
Qemal Stafa #260
Tel:  (4) 234 105
This clinic serves the foreign and local communities of Tirana.
• Orthodox Clinic
Rr. Dibres, Nr. 159
Tel:  (4) 360 925
DESTINATION HEALTH INFO FOR TRAVELERS
AIDS/HIV: In most countries the HIV epidemic is driven by behaviours (e.g., multiple sexual partners, commercial sex, injecting drug use) that expose individuals to the risk of infection. In Albania, the epidemic is predominantly urban, young, male, injecting drug users and their sexual partners and other transmission groups account primarily for the rise in HIV/AIDS in this country. Central Europe, however, has been relatively spared by the HIV epidemic, with the incidence of both AIDS cases and newly diagnosed HIV infections remaining low. The prevalence of adults living with HIV in Albania is estimated at 0.2%. (Source: Avert.org)
• Transmission of HIV can be prevented by avoiding: sexual contact with a high-risk partner; injecting drug use with shared needles; non-sterile medical injections; unscreened blood transfusions.
• The threat of HIV/AIDS should not be a primary concern for the traveler. However, there may be a concern for a subset of travelers who may be exposed to HIV, the virus that causes AIDS, through contact with another person’s body fluids or blood. Although travel has contributed in a general way to the global spread of AIDS, fear of traveling because of this disease is not warranted.
Accidents & Medical Insurance: Accidents and injuries are the leading cause of death among travelers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drownings, aircraft crashes, homicides, and burns are lesser causes.
• Heart attacks cause most fatalities in older travelers.
• Infections cause only 1% of fatalities in overseas travelers, but, overall, infections are the most common cause of travel-related illness.
• MEDICAL INSURANCE: Travelers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance center that can help arrange and monitor delivery of medical care and determine if medevac or air ambulance services are required.
Avian Influenza A (Bird Flu): In March 2006, the Albanian authorities confirmed outbreaks of avian influenza in domestic poultry in the village of Cuka near the Butrint Lagoon in south west Albania and in the village of Peze-Helmes, 14km from the capital Tirana. No human infections or deaths have been reported.
• Avian influenza A (H5N1) is predominantly a disease of birds. The virus does not pass easily from birds to people and does not to pass from person to person (except in very rare cases of close contact with an infected blood relative).
• The risk to humans from avian influenza is believed to be very low and no travel restrictions are advised, except travelers should avoid visiting animal markets, poultry farms and other places where they may come into close contact with live or dead poultry, or domestic, caged or wild birds and their excretions. In addition, travelers are advised to: 1. Cook poultry and egg dishes thoroughly. (Well-cooked poultry is safe to eat.) 2. Wash hands frequently with soap and water if around poultry.
• The World Health Organization (WHO) does not recommend travel restrictions to countries experiencing outbreaks of influenza A (H5N1) in birds, including those countries which have reported associated cases of human infection. To date, no cases of avian influenza A (H5N1) illness have been identified among short-term travelers visiting countries affected by outbreaks among poultry or wild birds.
The usual vaccines against influenza are not protective against “bird flu.” Oseltamivir (Tamiflu) is somewhat effective in the treatment of avian influenza A (H5N1). It seems to be effective in some cases, but may fail in others. Recently, resistant strains have been reported. In addition, the dosage and duration of treatment appear to be different in severe cases.
Crimean-Congo Hemorrhagic Fever: This is a viral illness transmitted by ticks. Sporadic cases occur throughout the summer. Travelers should take measures to prevent tick bites.
Hemorrhagic Fever with Renal Syndrome (HFRS): Presumed transmission is via airborne spread of Hantaan virus found in dried rodent excreta. Most cases reported in rural mountainous regions. Shepherds and outdoorsmen are at greatest risk.
Hepatitis: All travelers not previously immunized against hepatitis A should be vaccinated against this disease. Hepatitis A is transmitted through contaminated food and water. Travelers who will have access to safe food and water are at lower risk. Those at higher risk include travelers visiting friends and relatives, long-term travelers, and those visiting areas of poor sanitation.
• Hepatitis E is endemic, but levels are unclear. Transmission of HEV occurs primarily through contaminated drinking water. There is no vaccine.
• Hepatitis B is moderately endemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 7.0%. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from non-sterile medical or dental injections, and acupuncture; from unscreened blood transfusions; by direct contact with open skin lesions of an infected person. The average traveler is at low risk for acquiring this infection. Vaccination against hepatitis B is recommended for: persons having casual/unprotected sex with new partners; sexual tourists; injecting drug users; long-term visitors; expatriates, and anybody wanting increased protection against the hepatitis B virus.
• Hepatitis C is endemic with a prevalence of 3% in the general population. Most hepatitis C virus (HCV) is spread either through intravenous drug use or, in lesser-developed countries, through blood contamination during medical procedures. Over 200 million people around the world are infected with hepatitis C — an overall incidence of around 3.3% of the world’s population. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS. (Source: European Journal of Epidemiology, 2004 [Vol. 19] [No. 5] 467-469)
Insect-Bite Prevention: You should exercise insect-bite prevention measures. For maximum protection, apply a DEET-containing repellent to exposed skin (30% concentration recommended), apply permethrin spray or solution to your clothing and gear, and sleep under a permethrin-treated bednet (if available).
• Until now, DEET-based repellents have been the gold standard of protection against disease-transmitting mosquito and tick bites. The CDC and WHO now recommend 20% picaridin as an effective DEET alternative. You can achieve nearly 100% protection by using a properly-applied skin repellent and wearing permethrin-treated clothing.
Leishmaniasis: Cases of cutaneous and visceral leishmaniasis (VL) are reported in this country. There has been a recrudescence of VL in the past 10 year; the incidence of visceral leishmaniasis has doubled. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite in the evening and at night and are usually found in forests, the cracks of stone or mud walls, or animal burrows. Peak transmission is May to October.
• All travelers should take measures to prevent sandfly bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, permethrin (spray or solution) to clothing and gear, and sleeping under a permethrin-treated bednet.
(Source: Transactions of the Royal Society of Tropical Medicine and Hygiene, 2003 (Vol. 97) (No. 3) 288-290)
Lyme Disease: The highest risk of Lyme borreliosis in Europe is found in central Europe, with Slovenia and Austria having the highest incidence. Comparative risk in Albania is not established, but there is transmission of disease in rural brushy, wooded, and forested areas up to 1,500 meters elevation, especially April through September. All travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions of endemic areas should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A single 200-mg dose of doxycycline is effective in preventing Lyme disease if taken within 72 hours of being bitten by an infected tick. (Reference: http://content.nejm.org/cgi/content/abstract/345/2/79)
Other Diseases/Hazards: Anthrax (sporadic human cases)
• Brucellosis (humans acquire infection by ingestion of unpasteurized milk products or, less commonly, ingestion of poorly cooked meat from infected animals; infected sheep, goats, and pigs are the primary sources of infection in this country)
• Boutonneuse fever (Mediterranean spotted fever; transmitted by ticks; may occur along the coast in bushy or forested areas), echinococcosis
• Sand fly fever (transmitted by day-biting sand flies, the same insects that transmit leishmaniasis. Prevalent in cosatal areas)
• Tick-borne relapsing fever (risk in rocky, rural livestock areas)
Rabies: Rabies occurs most commonly in stray dogs and cats, jackals, foxes, and wolves; rarely but occasionallyr cases are reported in humans. Pre-exposure rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection. Children are considered at higher risk because they tend to play with animals and may not report bites.
• Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Prompt medical evaluation and treatment of any animal bite is essential, regardless of your vaccination status.
Tick-Borne Encephalitis (TBE): There is a risk of TBE in areas of the country below 1,400m elevation, especially in the northern, lowland forested areas. The ticks that transmit TBE are most active during early spring to late autumn (March to November). The TBE vaccine (available in Europe and Canada) is recommended only for people who expect to have extensive exposure to ticks in rural areas (e.g., hikers, campers).
• Travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A map showing the distribution of TBE is here: http://www.nathnac.org/includes/contents/documents/TBEmap.gif
More information on TBE at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/TBE.htm
Travelers' Diarrhea: Tirane has a fairly well-developed municipal water system for offices; urban homes, however, are not connected. There is a high risk of travelers’ diarrhea outside of first-class hotels and resorts. We recommend that you boil, filter or purify all drinking water or drink only bottled water or other bottled beverages and do not use ice cubes. Avoid unpasteurized milk and dairy products. Do not eat raw or undercooked food (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). Peel all fruits.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene helps prevent travelers’ diarrhea.
• A quinolone antibiotic, or azithromycin, combined with loperamide (Imodium), is recommended for the treatment of diarrhea. Diarrhea not responding to antibiotic treatment may be due to a parasitic disease such as giardiasis, amebiasis, or cryptosporidiosis.
• Seek qualified medical care if you have bloody diarrhea and fever, severe abdominal pain, uncontrolled vomiting, or dehydration.
Typhoid Fever: Typhoid vaccine is recommended by the CDC for all unvaccinated people traveling to or working in the Balkans, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water. Current vaccines against Salmonella typhi are only 50-80% protective and do not protect against Salmonella paratyphi, the cause of paratyphoid fever. (Paratyphoid fever bears similarities with typhoid fever, but the course is generally more benign.) Travelers should continue to practice strict food, water and personal hygiene precautions, even if vaccinated.