Antigua and Barbuda
Time Zone: -4 hours. No daylight saving time in 2008.
Tel. Country Code: 1
USADirect Tel.: 1
Electrical Standards: Electrical current is 230/50 and 110/60 (volts/hz). North American Sytle Adaptor Plug and United Kingdom Adaptor Plugs. Grounding Adaptor Plugs A and C.
Travel Advisory - Antigua and Barbuda
Travelers to Central and South America and the Caribbean need to protect themselves against mosquito-transmitted viruses, such as dengue and Zika, as well as nighttime biting mosquitoes in countries where there is the threat of malaria. 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 Antigua and Barbuda
• U.S. Embassy
Wildey Business Park
Tel:   431-0225
The American Citizens Services (ACS) office of the U.S. Embassy in Bridgetown serves U.S. citizens living in and visiting Anguilla, Antigua and Barbuda, Barbados, the British Virgin Islands, Dominica, Guadeloupe, Martinique, Montserrat, St. Barthelemy, St. Kitts and Nevis, St. Lucia, French St. Martin, and St. Vincent and the Grenadines. (U.S. citizens in Dutch St. Maarten, Saba and St. Eustatius are served by the U.S. Consulate General in Curacao.)
• The Canadian High Commission
Bishop’s Court Hill
Tel:  (246) 429-3550
• British High Commission
Price Waterhouse Coopers Centre
11 Old Parham Rd
Tel:  (268) 462 0008/9
Fax: (268) 562 2124
HIV Test: HIV testing required of foreign university students and travelers suspected of being HIV infected.
Required Vaccinations: Required of all travelers >1 year of age if arriving from any yellow fever endemic zone country in Africa or Latin America.
Passport/Visa: Antigua and Barbuda is a dual island nation known for its beaches, and is a favorite destination for yachtsmen. Tourist facilities are widely available. English is the primary language. Banking facilities and ATMs are available throughout the island.
ENTRY/EXIT REQUIREMENTS: For information on entry requirements, travelers can contact the Embassy of Antigua and Barbuda, 3216 New Mexico Avenue, N.W., Washington, D.C. 20016, telephone (202) 362-5122, or consulates in Miami. Additional information may be found on the Internet on the home page of the Antigua and Barbuda Department of Tourism at http://www.antigua-barbuda.org
Vaccinations: Recommended and Routine
Hepatitis A: Recommended for all travelers >1 year of age not previously immunized against hepatitis A.
Hepatitis B: Recommended for all unvaccinated travelers who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment, such as for an accident, and for all adults requesting protection from HBV infection.
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, such as business travelers and cruise passengers.
Yellow Fever: A yellow fever vaccination certificate is required for all travelers >1 year of age arriving from any country in the yellow fever endemic zones, but is not recommended or required otherwise.
Hospitals / Doctors
Adequate, but limited, medical care by English-speaking physicians is available in this country. 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.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage. Policies should cover: ground and air ambulance transport, including evacuation to home country; payment of hospital bills; 24-hour telephone assistance. In the event of a serious illness or injury that can't be treated adequately in this country, the traveler should be flown by air ambulance to San Juan, Puerto Rico, Miami or other U.S. destination.
There is no hyperbaric chamber on the islands; divers requiring treatment of decompression illness must be evacuated to Saba or Guadeloupe.
The U.S. Embassy in Bridgetown, Barbados maintains a list of doctors and hospitals at: http://bridgetown.usembassy.gov/emergency-antigua_barbuda.html
• Holberton Hospital
Tel:  (268) 462-0251
This 141-bed acute care public facility has medical/surgical, pediatric, and ob/gyn services, as well as a 24-hour casualty (emergency) department, ICU, and renal dialysis unit. There are 13 consultant doctors and 22 resident doctors, physicians and surgeons on the staff.
• Adelin Clinic
Tel:  (268) 462-0866
Adelin Clinic is an 18-bed private facility located on Fort Road in St. John’s. The clinic offers 24-hour emergency care. There are two operating theatres. This facility handles moderate to severe surgery and gynecological care. There is no ambulance service.
This clinic will not accept medical travel insurance in payment for treatment. Patients must pay a deposit (US$4,000) via a credit card before treatment will be given. If funds deposited exceed the cost of the treatment, a refund will be given.
• Dr. Joseph John
Tel:  (268) 562-1169
Dr. John is a leading surgical practitioner.
• Hannah Thomas Hospital
Facilities: 8-bed mainly outpatient facility.
• Spring View Hospital
Tel:  (268) 460-0409
This small hospital has a full time resident doctor and hosts visiting American doctors. This facility handles minor to moderate surgeries. Major medical emergencies are transferred to Antigua.
Destination Health Info for Travelers
AIDS/HIV: The Caribbean has a well-established HIV epidemic and the incidence of HIV/AIDS in the region is now second only to sub-Saharan Africa, making the region the second most affected in the world. The predominant route of HIV transmission in the Caribbean is heterosexual contact. Much of this transmission is associated with commercial sex, but the virus is also spreading in the general population. The contribution by men having sex with men is significant but not well documented, due to a general atmosphere of homophobia making data gathering difficult. At one extreme, Haiti has the highest HIV prevalence in the entire western hemisphere (3.8%); at the other, Cuba has one of the lowest (0.1%). The Bahamas (3.3%), Trinidad and Tobago (2.6%) and Guyana (2.4%) are all heavily affected, while Puerto Rico is the only Caribbean country apart from Cuba where it is thought that less than 1% of the population is living with HIV. The overall prevalence of HIV in the Caribbean is estimated to be between 1.1% and 2.2%. (Source: www.Avert.org)
The United Nations does not currently publish HIV/AIDS epidemiological fact sheets for Antigua & Barbuda and thus specific HIV/AIDS data are not available for this country.
• 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.
Dengue Fever: Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in the Caribbean and is the most common cause of fever in travelers returned from this region. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash. It is sometimes complicated by hemorrhage or shock.
• 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
Helminthic Diseases: Roundworms, hookworms and whipworms (soil-transmitted helminths) may be present on these islands. Travelers should not walk barefoot on moist ground.
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 may be endemic, but levels are unclear. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. Farm animals may serve as a viral reservoir. 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.
• The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 2% to 7%. 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 but the prevalence is not determined. 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.
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.
Marine Hazards: Swimming related hazards include jellyfish, Portuguese Man-o-War, sharp coral, fire coral, poisonous sponges (the red fire sponge and the touch-me-not), bristle worm, sea urchins, scorpionfish, puffer fish, Moray eel, stingrays, barracudas and sharks. There are no sea snakes in the Caribbean Sea.
• Ciguatera poisoning is prevalent and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
• Scuba Diving-Hyperbaric Chamber Referral: Divers Alert Network (DAN) maintains an up-to-date list of all functioning hyperbaric chambers in North America and the Caribbean. DAN does not publish this list, since at any one time a given chamber may be non-functioning, or its operator(s) may be away or otherwise unavailable. Through Duke University, DAN operates a 24-hour emergency phone line for anyone (members and non-members) to call and ask for diving accident assistance. Dive medicine physicians at Duke University Medical Center carry beepers, so someone is always on call to answer questions and, if necessary, make referral to the closest functioning hyperbaric chamber. In a diving emergency, or for the location of the nearest decompression chamber, call 919-684-8111 (collect).
Rabies: Antigua and Barbuda is considered rabies-free, but stray and sometimes viscous dogs may be encountered. All unprovoked animal bites should be medically evaluated for possible post-exposure treatment.
Schistosomiasis: Schistosoma mansoni (intestinal) is present on Antigua, but travelers are at very low risk. Schistosomiasis is a parasitic flatworm infection of the intestinal or urinary system caused by one of several species of Schistosoma, and 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: Low to moderate risk. In urban and resort areas, the hotels and restaurants serve reliable food and potable water. Elsewhere, travelers should observe safety precautions. A quinolone antibiotic, azithromycin, or rifaximin (Xifaxan), combined with loperamide (Imodium) is recommended for the treatment of acute diarrhea.
Typhoid Fever: Typhoid is the most serious of the Salmonella infections. Typhoid vaccine is recommended for all people (except short-stay visitors and cruise ship passengers) traveling to or working in the Caribbean, 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. Travelers should practice strict food, water and personal hygiene precautions even if vaccinated.
Yellow Fever: There is no risk of yellow fever in this country, however, there is a certificate of vaccination requirement for travelers arriving from endemic zone countries.