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Azerbaijan



Capital: Baku

Time Zone: +2 hours. GMT +3 from the last Sunday in March to October.
Tel. Country Code: 994
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Styel Adaptor Plug. Grounding Adaptor Plugs D, F.


Travel Advisory - Azerbaijan

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.

Dr. Rose Recommends for Travel to Azerbaijan


Resource Links

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

Embassies


• U.S. Embassy
Prospect Azadlig 83
Tel: [9] 9412) 498-03-35, 36, or 37
E-mail: ConsularBaku@state.gov
website: http://www.usembassybaku.org
Travelers are encouraged to notify the embassy before their permanent departure from the country.

The Canadian Embassy in Ankara handles diplomatic and consular duties for Canada in Azerbaijan.

• Embassy of Canada
Cinnah Caddesi No. 58
Ankara
Turkey
Tel: [90] (312) 409-2700
E-Mail: ankra@international.gc.ca
Website: http://www.dfait-maeci.gc.ca/canada-europa/turkey

• British Embassy
45 Khagani Street
Baku
Tel: [994] (12) 4975188/89/90
Email: generalenquiries.baku@fco.gov.uk
Website: http://www.britishembassy.gov.uk/azerbaijan

Entry Requirements

HIV Test: Not required.

Required Vaccinations: None required.

Passport Information

Passport/Visa: A passport and visa are required. Travelers may obtain single-entry visas for USD 40 by mail or in person from either the Azerbaijani Embassy in Washington, D.C. or any other Azerbaijani embassy offering consular services. Travelers may also obtain single-entry, 30-day visas at the airport upon arrival. Visas are not available at the land border with Georgia. Double-entry, 90-day visas (cost $80 U.S.) and one-year multiple-entry visas (cost $250 U.S.) are only available through an Azerbaijani embassy or through the Ministry of Foreign Affairs. A letter of invitation from a contact in Azerbaijan is required, and travelers who expect to travel in the region should request a one-year, multiple-entry visa. According to Azerbaijani law, foreign nationals intending to remain in Azerbaijan for more than 30 days must register with local police within three days of their arrival.
For further information, contact:
Embassy of The Republic of Azerbaijan
2741 34th Street, NW, Washington DC 20008
Telephone: (202) 337-3500; Fax: (202) 337-5911
E-mail: azerbaijan@azembassy.com
Website: http://www.azembassy.com/new/

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 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.

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 with the exception of short-term visitors who restrict their meals to hotels or resorts.


Hospitals / Doctors

Medical care in Azerbaijan is well below Western standards and medical facilities outside Baku are very limited. 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 or may 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 home country; payment of hospital bills; 24-hour telephone assistance. In the event of serious illness or injury, medical evacuation to a more advanced medical facility in Turkey or Western Europe may be required.

• The health service provides free medical treatment for all citizens, but quality has deteriorated since independence from the Soviet Union. State-run services in Azerbaijan are limited and there is a lack of basic supplies and modern equipment.

• A listing of medical facilities in Azerbaijabn can be found on the U.S. Embassy website at: http://azerbaijan.usembassy.gov/medical_services.html

Most expatriates and tourists now receive care from a growing number of private-run clinics operated by international companies.

• Central Clinical Hospital
Parliament Prospect 76
Tel: 4921092
Fax: 4934131
Website: www.mkx.mednet.az

• German Medical Center
30 Rashid Behbutov Street
Baku
Monday to Friday 9.00 to 18.00
Saturday 9.00 to 13.00
Tel: [994] 12 4937 354
Fax: [994] 12 4939 644
Website: http://www.internationalsos.com/en/ourresources_clinics_azerbaijan_34.htm
The International SOS clinic/German Medical Center in Baku provides integrated support for medical and non-medical assistance cases throughout Azerbaijan. International SOS,which works in close co-operation with their Moscow emergency center, is able to manage referrals within the region, to Europe and beyond, and secure prompt medical evacuation through their dedicated air ambulance in Moscow. Services include: 24-hour emergency service including two emergency room beds; family practice consultations provided by our two expatriate physicians; well baby and antenatal clinic; house calls; diagnostic and in-house laboratory services; comprehensive vaccination programs; medical referrals and advice; coordination of medical evacuations and repatriation.

• MediClub
Uzeir Hajibayov str. 45
Tel: 4970911, 4970912
Fax: 4987096
Website: http://www.mcg.com.ge/mcg.html

Destination Health Info for Travelers

AIDS/HIV: The incidence of HIV/AIDS is increasing. The reasons include 1) an increase in IV drug abuse, 2) an increase in commercial sex, 3) an increase in sexually transmitted diseases, 4) decreased availability of sterile needles and syringes, and 5) little or no public health education or AIDS prevention programs.
Results from a WHO-supported survey conducted in late 2005 showed an HIV prevalence of 16.5% among injecting drug users (IDUs) in Baku and 19.5% in Lenkoran. These figures are much higher than the routinely collected surveillance data. The most affected group is the so-called street IDUs, a group that remains outside the focus of national HIV prevention and care efforts. Prevalence in this group is 12 times higher than among IDUs registered at narcology centres in Baku. The number of opiate users is very high in Azerbaijan, and is estimated by the United Nations Office on Drugs and Crime (UNODC) to be around 0.2% of the adult population, of which 50-60% inject heroin.
• 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 (Bird Flu): Outbreaks of Avian Influenza (Bird Flu) occurred in various regions of Azerbaijan in early 2006, resulting in five human fatalities in the Salyan and Tartar Region.
• H5N1 avian influenza 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 H5N1 avian influenza in birds, including those countries which have reported associated cases of human infection.

The usual vaccines against influenza are not protective against “bird flu.”
Oseltamivir (Tamiflu) is somewhat effective in the treatment of H5N1 avian influenza. 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 H5N1 cases.

Cholera: Sporadic cases of cholera may occur in this country, but most travelers are at low risk for infection. Cholera vaccine is 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)

Crimean-Congo Hemorrhagic Fever (CCHF): Crimean Congo hemorrhagic fever (CCHF) is endemic to Azerbaijan. Although, most cases of CCHF occur during the summer months. CCHF is caused by a virus and is transmitted by tick bite or by exposure to blood or secretions from infected animals or humans. Anyone who has visited Azerbaijan and is suffering from an unexplained fever, headache, chills, muscle aches, vomiting, red rash (which does not fade when pressed under glass), bleeding on the roof of the mouth, or any other unexplained symptoms should seek medical advice immediately.
Risk is seasonal, associated with periods of high tick activity (usually March through September, but seasonal patterns may occur) and increases in tick and rodent host populations.

Diphtheria: Epidemic diphtheria occurred in the 1990s and 70% of cases occurred in persons older than 15 years of age. All travelers to Azerbaijan, especially adults, should be fully immunized against this disease. (The CDC estimates that 20% to 60% of Americans older than 20 years lack sufficient immunity to diphtheria.) Diphtheria vaccine in the United States is usually administered in combination with the tetanus toxoid vaccine (Td vaccine).
• 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 is a new tetanus-diphtheria-pertussis (Tdap) vaccine that not only boosts immunity against diphtheria and tetanus, but has the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children.

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 and accounts for up to 18% of acute hepatitis in the south. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. Farm animals, such as swine, and also deer and wild boar, may serve as a viral reservoirs. (HEV is one of the few viruses which has been shown to be transmitted directly from animals through food.) 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 4%. 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 in the general population but levels are unclear. (There is prevalence rate of over 50% in injecting drug users.) 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 from November through March. The flu vaccine is recommended for all travelers over age 6 months.

Leishmaniasis: Scattered foci of cutaneous leishmaniasis are found below 1,300 meters elevation. Visceral leishmaniasis is confined to areas along the southeastern coast of the Black Sea, the southeastern and southwestern coasts of the Caspian Sea and the border areas of Georgia and Azerbaijan.
• The parasites that causes leishmaniasis are transmitted by the bite of female phlebotomine sand fly. Sand flies bite in the evening and at night. Contrary to what their name suggests, sand flies are not found on beaches. They are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• All travelers should take measures to prevent sand fly 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.

Lyme Disease: Lyme disease occurs focally in rural forested areas. 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).



Malaria: There is a low risk of malaria in the southern border area of Azerbaijan from May to October. Sporadic cases have also been reported in the Baku suburbs. A weekly dose of chloroquine is the recommended prophylaxis for risk areas only.

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 Azerbaijan page on the Destinations menu or A-Z Index.

• Malaria is transmitted via the bite of an infected 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 at night.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.

Mediterranean Spotted (Boutonneuse) Fever: Reported most commonly in the Black Sea coastal areas of the Caucasus, Transcaucasus, and the Crimea, and along the Caspian Sea coastline. Travelers should take measures to prevent tick bites.

Other Diseases/Hazards: Anthrax (sporadic human cases occur, related to exposure to livestock in rural areas, especially southern areas), brucellosis (from unpasteurized dairy products or infected meat from farm animals), echinococcosis (in southern and northeastern areas. Echinococcus multilocularis is associated with the reindeer culture in north), legionellosis, leptospirosis (extensive outbreaks have occurred in east central areas), North Asian tick typhus (also called Siberian tick typhus; occurs in the steppe areas; risk elevated May–June), plague (flea-borne; usually occurs as isolated cases or small outbreaks in semi-arid areas of the southern republics of Azerbaijan, Armenia, and Georgia), rabies, rickettsialpox, tick-borne relapsing fever (may occur south of 55 degrees north latitude), trichinosis (greatest risk in western Belarus and the Ukraine), tularemia (“rabbit fever”; risk may be elevated in the north), and helminthic infections (roundworm, hookworm, and whipworm infections and strongyloidiasis) reported, especially from the Transcaucasus.

Rabies: There have been outbreaks of rabies in the remote rural areas of Azerbaijan.
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 vaccination status.

Tick-Borne Encephalitis (TBE): Tick-borne encephalitis is transmitted from the Baltics to the Crimea. Peak transmission period is April through October. Risk is present primarily in rural brushy and forested areas below 1,500 meters elevation.
• Travelers to risk areas are advised to take measures to prevent tick bites, especially during the peak transmission season, March through September. The TBE vaccine (available in Canada and Europe), is recommended only for people at significant risk of exposure to tick-bites, for example, campers and hikers on extended trips, or forestry workers.
• 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: High risk outside of first-class hotels. All water supplies are suspect, including municipal tap water, which may be untreated and grossly contaminated. Travelers should consume only bottled water, or boiled or chemically treated water. Travelers should observe strict food and drink safety precautions. A quinolone antibiotic, or azithromycin, combined with loperamide (Imodium), is recommended for the treatment of acute diarrhea. Diarrhea not responding to treatment with an antibiotic may be due to a parasitic disease, especially giardiasis.

Tuberculosis: Tuberculosis is highly endemic in Azerbaijan with an annual occurrence was greater than or equal to 40 cases per 100,000 population. Multiple-drug-resistant tuberculosis cases are increasing: 22.3 percent of new TB cases are resistant to the standard anti-tuberculosis drug regimen. This is the highest incidence of any country of the former USSR.
Tuberculosis 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 is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people traveling to or working in Central Asia, 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.