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Brunei Darussalam



Capital: Bandar Seri Begawan

Time Zone: +8 hours.
Tel. Country Code: 673
USADirect Tel.: 800
Electrical Standards: Electrical current: 220/50 (volts/hz). United Kingdom Style Adaptor Plugs.


Travel Advisory - Brunei Darussalam

Malaria, Japanese encephalitis, and dengue fever occur throughout SE Asia and the Indian sub-Continent. Insect-bite protection is essential. Hepatitis E, spread by contaminated water, is also a threat. There is no vaccine. Pregnant women are at special risk. Take measures, as needed, to purify your water outside of first-class hotels.

Dr. Rose Recommends for Travel to Brunei Darussalam


Resource Links

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

Embassies


• U.S. Embassy
3rd floor, Teck Guan Plaza
Bandar Seri Begawan
Tel: [673] (2) 229-670
E-mail: USEmbassy_BSB@state.gov
Consular section: ConsularBrunei@state.gov
Website: http://bandar.usembassy.gov/
Note: U.S. citizens residing in or traveling through Malaysia - including the states of Sarawak and Sabah - should seek asssistance from the U.S. Embassy in Kuala Lumpur in the event of an emergency.

• Canadian Embassy
5th Floor, Jalan McArthur Building, No. 1
Jalan McArthur, Bandar Seri Begawan
Tel: [673] (2) 22-00-43
E-mail: bsbgn@dfait-maeci.gc.ca
Website: www.dfait-maeci.gc.ca/Brunei

• British High Commission
2nd Floor, Block D
Kompleks Yayasan Sultan Haji Hassanal Bolkiah
Bandar Seri Begawan
Brunei Darussalam
Bandar Seri Begawan
Tel: [673] (2) 222231/223121 Switchboard
[673] (2) 226001 Consular/Visa
Email: brithc@brunet.bn
Website: http://www.britishhighcommission.gov.uk/brunei

Entry Requirements

HIV Test: Not required for tourists.

Required Vaccinations: A yellow fever vaccination certificate is required from travellers aged one year and over who have visited infected or endemic areas within the previous six days.

Passport Information

Passport/Visa: Brunei Darussalam is a small Islamic Sultanate on the northwest coast of the Island of Borneo. It is divided into four districts, namely Brunei/Muara, Tutong, Belait and Temburong. The capital, Bandar Seri Begawan, is its only major city. 
U.S. passport-holders must have at least six months validity remaining on their passport before entering or visiting Brunei for business or pleasure may obtain visas upon arrival for up to 90 days at no charge. There is an airport departure tax. For further information about entry requirements, travelers may consult the Consular Section of the Embassy of Brunei, 3520 International Court, N.W., Washington, D.C. 20008 , tel. (202) 237-1838, or visit the Embassy of Brunei website at http://www.bruneiembassy.orgfor the most current visa information. 

Vaccinations: Recommended and Routine

A yellow fever vaccination certificate is required from travellers aged one year and over who have visited infected or endemic areas within the previous six days.

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; from acupuncture; from 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.

Japanese Encephalitis: Travelers staying in rural areas (especially where there is pig rearing and rice farming) should consider vaccination if the duration of their trip exceeds 3 to 4 weeks.
• Vaccination is advised for expatriates living in this country.
• All travelers should take measures to prevent mosquito bites, especially in the evening and during the night.

Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received 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: Recommended for travelers spending time outdoors in rural areas where there is an increased the risk of animal bites. 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 in the event of a high-risk animal bite, but does not eliminate the need for treatment with the vaccine.

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.

Hospitals / Doctors

The standards of health care in Brunei are generally better than in many countries in the region, though basic hospital supplies can run low from time to time. Many physicians in Brunei have been trained in the UK, Australia, and New Zealand.
• 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 of dubious origin or 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 that can't be treated locally, every effort should be made to arrange medical evacuation to Singapore.

• The main facility is the government-run Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital
Bandar Seri Begawan
Tel: [673] (02) 242 424
Broad range of specialty services, as well as outpatient emergency care.

• Jerudong Park Medical Centre
Jerudong Park
Tel: [673] (02) 611 433
Website: http://www.jpmc.com.bn/
The leading private hospital; offers comprehensive outpatient care as well as extensive inpatient services.

• Borneo Clinic
Simpang 27, 1 Bang PIF
Jln Gadong
Bandar Seri Begawan
Tel: [673] (02) 224 301

• Hart Medical Clinic
47 Jalan Pemancha
Wisma Setta
Tel: [673] (02) 225 531
Bandar Seri Begawan

Destination Health Info for Travelers

AIDS/HIV: Malaysia’s (and probably Brunei’s) HIV epidemic is largely driven by injecting drug use. Other than injecting drug users (IDUs,) HIV is spreading amongst women, fishermen, lorry drivers and factory workers. A senior health official in Malaysia has warned that the number of people living with HIV in the country - currently around 73,000 - could rise to 300,000 by 2015 if nothing is done. The government launched a five-year strategic plan to tackle HIV in 2006, which includes drug substitution therapy and needle exchange programs for drug users. The proportion of adults aged 15-49 who were living with HIV/AIDS in Malaysia is estimated at 0.1%. (Source: www.Avert.org). There are no country-specific data for Brunei.
• 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 fluid 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.
• 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.

Cholera: Sporadic cases of cholera possibly occur, but the threat to tourists is very low. Cholera is an extremely rare disease in travelers from developed countries. Cholera vaccine is usually recommended only for people, such as 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 don’t 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: Dengue fever is endemic in Brunei. There is risk of both dengue fever and dengue hemorrhagic fever in both urban and rural areas. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in the Asia. 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. 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 imay be endemic but levels are unclear. Sporadic cases may be underdiagnosed or underreported. 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 elevated at 10% to 12%. 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 levels are unclear. 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.

Influenza: Influenza is transmitted from November through March. The flu vaccine is recommended for all travelers over age 6 months who have not had a flu shot in the past 12 months.

Japanese Encephalitis (JE): Risk of transmission occurs year-round. The Centers for Disease Control and Prevention (CDC) recommends JE vaccination for travelers spending more than 30 days in an endemic environment, or less than 30 days in areas with epidemic transmission. However, the use of an arbitrary cutoff cannot protect all travelers. Advance knowledge of trip details, accommodation and purpose, as well as local geography, is warranted to give adequate advice. Is travel occurring during the peak transmission season? In general, travelers to rural areas (especially where there is pig rearing and rice farming) should be vaccinated if the duration of their trip exceeds 3 to 4 weeks. They may consider vaccination for trips of shorter duration if more intense exposure is anticipated, especially during unprotected outdoor activities in the evening. Vaccination is advised for expatriates living in this country.
• Japanese encephalitis is transmitted by night-biting Culex mosquitoes. All travelers should take measures to prevent mosquito bites, especially in the evening and overnight. 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.

Malaria: There is a very low risk of malaria in Brunei, according to published sources (NaTHNaC, CDC). Malaria is present in neighboring Malaysia, however. The CDC does not recommend malaria prophylaxis for Brunei, but neither does it state that there is no risk of disease.

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.
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.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country. Dengue fever should also be considered as a cause of fever.

Marine Hazards: Corals, jelly fish, poisonous fish, sharks, and sea snakes are a potential hazard to bathers and divers. Others hazards include stonefish, lionfish, and box jelly fish. The box jellyfish is the most dangerous, and lethal jellyfish in the world; antivenom is required for treatment, but may not be available locally.
• When red algae reaches certain levels, Bruneian authorities may issue Red Tide warnings which may advise against swimming in certain areas and eating certain types of seafood. The warnings, which vary from time to time depending on climatic conditions, are published in the English language newspaper, the Borneo Bulletin.

Other Diseases/Hazards: Fasciolopsiasis (giant intestinal fluke)
• Helminthic infections (e.g., hookworm, roundworm)
• Filariasis (transmitted by mosquitoes),
• Scrub typhus (mite-borne)
• Melioidosis

Brunei has periodic problems with air quality reaching hazardous levels because of smoke haze. There is smoke haze across some parts of Brunei usually during the July to October period. This haze can cause health problems for some people. Keep up-to-date with the advice of local authorities and seek medical advice on appropriate precautions.


Rabies: Rabies occurs in this country but the incidence is unclear. 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.
• All animal bite wounds, especially from a dog, should be thoroughly cleansed with soap and water and then medically evaluated for possible post-exposure treatment, regardless of your vaccination status. Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine.
• Even if rabies vaccine was administered before travel, a 2-dose booster series of vaccine is needed after the bite of a rabid animal.

Travelers' Diarrhea: The food and drink in first-class restaurants and hotels are considered generally safe. Outside of 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.
• Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
• 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.

Tuberculosis (TB): Tuberculosis is highly endemic in Brunei, 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 vaccine is recommended by the CDC for all people traveling to or working in South East 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.