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Angola



Capital: Luanda

Time Zone: +1 hour. No daylight saving time in 2008.
Tel. Country Code: 244
USADirect Tel.: 808
Electrical Standards: Electrical current 220/50 (volts/hz). European Style Adaptor Plug. Grounding Plug Adaptor D.


Travel Advisory - Angola

Sub-Saharan Africa has the highest incidence of insect-transmitted diseases, such as malaria, and all travelers need products to prevent mosquito and tick bites. I recommend all travelers use a combination of DEET or Picaridin repellent on their skin and Permethrin fabric insecticide on their clothing for greater than 99% protection against mosquito and tick bites.

Dr. Rose Recommends for Travel to Angola


Resource Links

NaTHNaC
World Health Organization
CDC
Travel Health Services
Country Insights
Travel Warnings
Consular Information
Foreign Commonweatlh Office

Embassies


• U.S. Embassy
Rua Houari Boumedienne #32
Luanda, Angola
Tel: [244] (222) 445-481
Tel: (244) (222) 641-000 (Consular Section)
Fax: [244] (222) 446-924
Email: econusembassyluanda@yahoo.com
Website: http://angola.usembassy.gov/

The Canadian Embassy in Harare, Zimbabwe represents Canadian interests in Angola, Botswana, and Zimbabwe.

• Canadian Embassy
45 Baines Ave
Harare, Zimbabwe
Tel: [263] (4) 252181-5
Fax: [263] 4() 252186
Email: hrare-cs@international.gc.ca
Website: http://www.dfait-maeci.gc.ca/cairo/menu.asp

• British Embassy
Rua Diogo Cao 4
Luanda
Tel: [244] (222) 334582
Email: postmaster.Luand@fco.gov.uk
Website: http://www.britishembassy.gov.uk/angola

Entry Requirements

HIV Test: Not required.

Required Vaccinations: Yellow fever vaccination is required for all travelers >9 months of age arriving from all countries. The certificate of vaccination must be validated at least 10 days prior to arrival.

Passport Information

Passport/Visa: Passport and visa (must be obtained in advance), along with an International Certificate of Vaccination, are required. Persons arriving without visas are subject to arrest or exclusion. Travelers may also encounter delays if they do not have at least one completely blank visa page in their passports for entry and exit stamps. Travelers whose international immunization cards do not show inoculations against yellow fever within the past ten years may be subject to exclusion, on-the-spot vaccination, and heavy fines. Visitors remaining in Angola beyond their authorized visa duration are subject to fines and arrest. It is illegal to attempt to carry local currency out of Angola and persons found attempting to carry local currency out of Angola are subject to having this currency confiscated by customs officers. Current information on entry requirements may be obtained from the Embassy of Angola at 2100-2108 16th Street NW, Washington, DC, tel. (202) 785-1156, fax (202) 785-1258. 

Vaccinations: Recommended and Routine

Yellow fever vaccination is required for all travelers >9 months of age arriving from all countries. The certificate of vaccination must be validated at least 10 days prior to arrival.

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 unprotected sex; from acupuncture, tattooing or body piercing; 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.

Meningococcal (Meningitis): Quadrivalent conjugate meningitis vaccine is recommended for those travelers anticipating living or working closely with local people. The risk is greatest in the dry season, from November to May/June. Vaccination should be considered for all travelers venturing into epidemic regions at any time of year.

Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).

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.
• In addition to tetanus, all travelers, including adults, should be fully immunized against diphtheria. A booster dose of a diphtheria-containing vaccine (Td or Tdap vaccine) should be given to those who have not received a dose within the previous 10 years.
Note: ADACEL and Boostrix are new tetanus-diphtheria-pertussis (Tdap) vaccines that not only boost immunity against diphtheria and tetanus, but have the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children. The Tdap vaccines can be administered in place of the Td vaccine when a booster is indicated.

Typhoid: Recommended for all travelers.

Yellow Fever: Yellow fever vaccination is required for all travelers >1 year of age arriving from ALL COUNTRIES. Vaccination should be administered at least 10 days prior to arrival in order for the certificate of vaccination to be valid. Vaccination is recommended for all travelers >9 months of age.

Hospitals / Doctors

Medical care in Angola, except for Luanda, is well below Western standards. 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; they should bring drugs for malaria prophylaxis, if needed according to their itinerary. 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 counterfeit; or be of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage. Policies should cover: Ground and air ambulance transport, including evacuation to your home country; payment of doctor and hospital bills; 24-hour telephone assistance.
In the event of a serious illness or injury that can't be treated locally, every effort should be made to arrange medical evacuation to South Africa or Europe.

For a guide to other physicians, hospitals, clinics, and pharmacies in Luanda, go to the U.S. Embassy website:
http://angola.usembassy.gov/medical_information.html

• Clinica Sagrada Esperanza
Avenida Mortella Mohamed
Ilha de Luanda
Tel: [244] (309) 360 or 309 034
This clinic is favored by expatriates.

• Medigroup/Clinica da Mutamba
Rua Pedro Felix Machado, 10-12
Luanda
Tel: [244] (393) 783/395 283
Provides 24-hour emergency services as well as routine medical care.

• South African Medical Clinic
Stuartmill Angola
Rua Helder Neto #42
Alvalade
Tel: [244] (2) 322 048

• TotalFina Elf Aquitane Clinic
Rua Dr. Tome Agostinho das Neves
Luanda
Tel: [244] (2) 352 633

• Americo Boavida Hospital
Av. Hoji Ya Henda
Luanda
Tel: [244] (222) 380-117/118/119
General medical/surgical facility. This is the main hospital in Luanda.

• Medical Rescue International (MRI)
Rua Eduardo Mondlaine #41
Tel: 336-555/391-946/337-939
Provides emergency response for many expatriate organizations in Luanda.

Destination Health Info for Travelers

AIDS/HIV: Limited information on HIV seroprevalence in Angola is available. There has been little surveillance among women attending antenatal care clinics (ANC) during the past decade. The latest available ANC surveillance data are from 2002. HIV prevalence in Luanda was 4.6%, ranging from 2.6% to 8.0% in the different sites. The HIV prevalence among women attending ANC was 0.8% in Malange, 1.4% in Huila, 1.5% in Lunda-Sul, 3.2% in Benguela, and 3.3% in Cabinda province. Among 864 sex workers aged 15-45 years, HIV prevalence was 32.8% in 2001. Among the 1000 military personnel tested in Luanda in 2001, HIV prevalence was 3.2%.
Heterosexual transmission is the predominate means of transmission. Current infection rates of high-risk groups is presently not available.
• 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 the body fluids of another person or their 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.
• 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.

African Sleeping Sickness (Trypanosomiasis): African trypanosomiasis is epidemic in focal areas throughout the country. Cases of the Rhodesian form of trypanosomiasis have been reported in the southeast. The Gambian form of trypanosomiasis occurs primarily in the northwestern provinces of Zaire, Uige, Luanda, and Cuanza Norte, and as far south as Bengo Province. Travelers should take measures to prevent insect (tsetse fly) bites.

Animal Hazards: Animal hazards include snakes (vipers, cobras, mambas), centipedes, scorpions, and black widow spiders.

Chikungunya Fever: Mosquito-borne viral illness, similar to dengue fever; human outbreaks in the region have occurred primarily in rural populations, but explosive urban outbreaks can also occur. Human outbreaks have been reported in the Luanda area. There is no vaccine. Daytime mosquito bite protection measures are advised.

Cholera: There is currently an outbreak of cholera in Cacuaco, north of Luanda, with nearly 200 cases reported since January 2008. Cases are still being reported. Although this disease is reported to be active, the threat to tourists is relatively low. Cholera is an rare disease in travelers from developed countries. Cholera vaccine is usually recommended only for relief workers or health care personnel who are working in a high-risk endemic area under less than adequate sanitary conditions, or travelers who work or live in remote, endemic or epidemic areas and who do not have ready access to medical care. Canada, Australia, and countries in the European Union license an oral cholera vaccine. The cholera vaccine is not available in the United States.
• The main symptom of more severe cholera is copious watery diarrhea.
• Antibiotic therapy is a useful adjunct to fluid replacement in the treatment of cholera by substantially reducing the duration and volume of diarrhea and thereby lessening fluid requirements and shortening the duration of hospitalization.
• A single 1-gm oral dose of azithromycin is effective treatment for severe cholera in adults. This drug is also effective for treating cholera in children. (NEJM:http://content.nejm.org/cgi/content/short/354/23/2452)

Dengue Fever: Low apparent risk, but dengue does occur in urban and rural areas. Dengue fever is a mosquito-transmitted, flu-like viral illness occurring in many parts of sub-Saharan Africa. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash. A syndrome of hemorrhagic shock can occur in severe cases.
• Dengue is transmitted via the bite of an infected Aedes aegypti mosquito. Aedes mosquitoes feed predominantly during daylight hours. All travelers are at risk and should take measures to prevent daytime mosquito bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin and applying permethrin spray or solution to clothing and gear.
• There is no vaccination or medication to prevent or treat dengue.

A dengue fever map is at: http://www.nathnac.org/ds/c_pages/documents/dengue_map.pdf



Hepatitis: All travelers not previously immunized against hepatitis A should be vaccinated against this disease. Travelers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially 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 at a high level. Sporadic cases and outbreaks occur. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. In developing countries, prevention of hepatitis E relies primarily on the provision of clean water supplies and overall improved sanitation and hygiene. There is no vaccine.
• Hepatitis B is hyperendemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at >10%. 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 1.0% 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 population of the world. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.

Influenza: Influenza is transmitted year-round in the tropics. Flu vaccine is recommended for all travelers over age 6 months.

Insect-Bite Prevention: There is the risk of insect-transmitted diseases in this country. You should take measures to prevent insect-bites. 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 recently, DEET-based repellents have been the gold standard against mosquito and tick bites. The CDC and the World Health Organization now recommend 20% picaridin as an effective DEET alternative. You can achieve nearly 100% bite protection by using a properly-applied DEET or picaridin skin repellent and wearing permethrin-treated clothing.

Malaria: Risk is present year-round throughout this country, including urban areas and the enclave of Cabinda. Falciparum malaria accounts for 90% of cases, followed by P. malariae. Chloroquine-resistant falciparum malaria is reported.
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine (G6PD test required) is recommended.

A malaria map is located on the Fit for Travel website, which is compiled and maintained by experts from the Travel Health division at Health Protection Scotland (HPS). Go to www.fitfortravel.nhs.uk and select Malaria Map from the Angola page on the Destinations menu or A-Z Index.

• Malaria is transmitted via the bite of an infected female Anopheles mosquito. Anopheles mosquitoes feed predominantly during the hours from dusk to dawn. All travelers should take measures to prevent evening and nighttime mosquito bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, applying permethrin spray or solution to clothing and gear, and sleeping under a permethrin-treated bednet. DEET-based repellents have been the gold standard of protection under circumstances in which it is crucial to be protected against insect bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.

NOTE: Picardin repellents (20% formulation, such as Sawyer GoReady or Natrapel 8-hour) are now recommended by the CDC and the World Health Organization as acceptable non-DEET alternatives to protect against malaria-transmitting mosquito bites. Picaridin is also effective and ticks and biting flies.


Marine Hazards: Sea wasps, Portuguese man-of-war, black sea urchins, weever fish, spiny dogfish are found in the coastal waters of Angola and could be a hazard to swimmers.

Meningitis: Angola lies well south of the sub-Saharan meningitis belt but has reported several outbreaks in recent years. Quadrivalent conjugate meningitis vaccine is recommended for those travelers anticipating living or working closely with local people. The risk is greatest in the dry season, from November to May/June. Vaccination should be considered for all travelers venturing into epidemic regions at any time of year.
• Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at: http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx#651

Onchocerciasis: Also known as river blindness. Onchocerciasis is transmitted by black flies near fast-flowing rivers. Risk areas lies particularly in the northern provinces of Cuanza Norte, Lunda, Malanje, Uige, and Zaire - and in the plateau region of the central province of Bie, and the Cabinda exclave. Travelers should take precautions against insect (black fly) bites.

Other Diseases/Hazards:
• African tick typhus (contracted from dog ticks; also called Mediterranean spotted fever)
• African tick-bite fever (Rickettsia africae is the agent of African tick bite fever, an emerging disease transmitted by Amblyomma ticks in sub-Saharan Africa; Read more: http://www.ncbi.nlm.nih.gov/pubmed/15462202)
• Brucellosis (from consumption of raw dairy products)
• Bancroftian filariasis (mosquito-borne; reported in the north, primarily Cabinda enclave and Zaire Province)
• Leishmaniasis (low apparent risk; sporadic cases may have previously occurred)
• Plague (flea-borne; human cases last reported from Benguela Province)
• Polio (cases of polio were reported in June-August 2005, representing the first cases of polio in Angola since 2001; all travelers should be fully immunized)
• Relapsing fever (tick-borne and louse-borne)
• Toxoplasmosis
• Syphilis
• Typhus (louse-borne and flea-borne)
• Worms (very common)

Poliomyelitis (Polio): According to WHO, wild poliovirus type 1 has become widespread and Angola. Poliomyelitis has been reported annually in this country since 2003. In 2007, over 10 cases were reported from Luanda and Benguela provinces alone. Polio is transmitted through contaminated food and water. Those at higher risk of exposure include travelers visiting friends and relatives, those in direct contact with an infected person, long-term travelers, and those visiting areas of poor sanitation.
• All travelers should be fully immunized. A one-time dose of IPV (Inactivated Polio Vaccine) is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult.

Rabies: Rabies is considered a public health problem in many rural and urban areas; stray dogs are the primary cause of human infection. Pre-exposure rabies vaccine should be considered for stays of over 3 months, or for shorter stays if traveling to locations more than 24 hours travel from a reliable source of rabies immune globulin and/or rabies vaccine. Pre-exposure vaccination eliminates the need for rabies immune globulin but not for rabies boosters (2 doses). All animal bites or scratches should be medically evaluated and post-exposure prophylaxis administered, as needed.

Rift Valley Fever: This viral illness is transmitted by mosquitoes and also by contact with flesh of infected domestic animals. Low risk to travelers, but human outbreaks have occurred.

Schistosomiasis: Infection rates for urinary schistosomiasis have been highest in the coastal provinces of Luanda, Bengo, and Benguela, decreasing in an eastward direction. An outbreak was reported in October 2008 from Kindeje, Nzeto district, in northern Ziare province. Intestinal schistosomiasis, presumably distributed countrywide, is most prevalent in the southeastern province of Cuando Cubango.
• Schistosomiasis is transmitted through exposure to contaminated water while wading, swimming, and bathing. Schistosoma larvae, released from infected freshwater snails, penetrate intact skin to establish infection. All travelers should avoid swimming, wading, or bathing in freshwater lakes, ponds, streams, cisterns, aqueducts, or irrigated areas. There is no risk in chlorinated swimming pools or in seawater.

Travelers' Diarrhea: High risk. Only major urban areas have access to public water systems, which serve primarily the former European sections. Water distribution systems may be damaged and contaminated. Water-borne and food-borne diseases are prevalent with more serious outbreaks occurring from time to time. Outbreaks of diarrheal diseases are more common during the rainy season.
We recommend that you boil all drinking water or drink bottled water, and avoid ice cubes and raw and undercooked food. Seek medical advice if you have a fever or are suffering from diarrhea. A quinolone antibiotic, azithromycin, or rifaximin, 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.

Tuberculosis: Tuberculosis is highly endemic in Angola with an annual occurrence was greater than or equal to 40 cases per 100,000 population. Tuberculosis (TB) is transmitted following inhalation of infectious respiratory droplets. Most travelers are at low risk. Travelers at higher risk include those who are visiting friends and relatives (particularly young children), long-term travelers, and those who have close contact, prolonged contact with the local population. There is no prophylactic drug to prevent TB. Travelers with significant exposure should have PPD skin testing done to evaluate their risk of infection.

Typhoid Fever: Typhoid fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people traveling to or working in sub-Saharan Africa, 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.

Yellow Fever: Yellow fever vaccination is required for all travelers arriving from all countries. Risk is reported from the northeastern forested areas (Luanda and Bengo Provinces).