Time Zone: +2 hours. No daylight saving time in 2008.
Tel. Country Code: 257
USADirect Tel.: 0
Electrical Standards: Electrical current 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
Travel Advisory - Burundi
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 Burundi
• U.S. Embassy
1720 Avenue Des Etats-Unis
Tel:  22-34-54/  21-48-53
Fax:  22-29-26
• Consulate of Canada
4708 Boulevard de l'UPRONA
Tel:  24-58-98
Fax:  24-58-99
Travelers from the UK should be aware that Burundi is covered by the British Embassy in Kigali, Rwanda. British representation in Burundi is limited to a Liaison Office (tel:  22 24 64 78. Address: Building Old East, Place de L'Independence, Bujumbura), who can provide advice.
If you intend to travel to, or are resident in, Burundi you should register your presence with the Belgian Embassy. Their contact details are:
Boulevard de la Liberté, 9
Tel:  22 22 32 66 or  22 22 61 76
Contact details of the British Embassy:
• British Embassy
Parcelle No 1131
Boulevard de l'Umuganda
Tel:  584098/ 586072
Fax:  582044
Email: firstname.lastname@example.org General
HIV Test: Not required.
Required Vaccinations: A yellow fever vaccination certificate is required for all travelers >1 year of age arriving from ALL COUNTRIES.
Passport/Visa: A passport, visa, and evidence of immunization against yellow fever are required for entry. Only those travelers resident in countries where there is no Burundian embassy are eligible for a visa upon arrival at the airport. Travelers without a visa are not permitted to leave the country. The latest information about visas may be obtained from the Embassy of the Republic of Burundi, Suite 212, 2233 Wisconsin Avenue, NW, Washington, DC 20007, telephone (202) 342-2574, or from the Permanent Mission of Burundi to the United Nations in New York at telephone (212) 499-0001 thru 0006.
Vaccinations: Recommended and Routine
Hepatitis A: Recommended for all travelers >1 year of age not previously immunized.
Hepatitis B: Recommended for all non-immune travelers who might be exposed to blood or body fluids from unprotected sexual contact; from injecting drug use; from medical treatment with non-sterile (re-used) needles and syringes. Recommended for any traveler requesting protection from HBV 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): Recommended for all travelers, especially those who anticipate close, extended contact with the indigenous population.
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.
Yellow Fever: Yellow fever vaccination is required for all travelers >1 year of age arriving from ALL COUNTRIES. Recommended for all travelers >9 months of age.
Hospitals / Doctors
Medical facilities are extremely limited. There are frequent shortages of essential supplies and medications. Equipment may not be properly sterilized. Most doctors and hospitals will expect payment in cash, regardless of whether you have travel health insurance.
All travelers should be up-to-date on their immunizations and are advised to carry a medical kit and a sterile needle/syringe 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 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 a serious illness or injury that can't be treated adequately in this country, the traveler should be flown by air ambulance to Nairobi, Kenya for further treatment and evaluation.
Travelers should contact the U.S. Embassy for physician referrals.
• Hospital Prince Regent Charles
Faculte de Medecine de Bujumbura
Universite du Burundi
Ibarabara Rya 28 Munyonyo
Tel:  232-074
Fax:  232-267
Medical school. General medical/surgical capability; ICU.
• Seventh Day Adventists Clinic
(Association des Services de Sante Adventistes au Burundi)
Tel:  223-130).
• Clinique Prince Louis Rwagasore (13 beds).
Destination Health Info for Travelers
A Summary of Risk: Burundi is a geographically small (smaller than Maryland) and mountainous nation located in central Africa. Subsistence agriculture and coffee production are the mainstays of the Burundian economy.
Measures of public health in the country are declining; life expectancy is decreasing, while maternal mortality and infant mortality are increasing. Over 8 percent of the adult population are estimated to be infected with HIV/AIDS (with higher rates in urban settings). The HIV/AIDS epidemic has also orphaned thousands of children. Malaria and tuberculosis incidence rates are on the rise. The malaria death rate for children ages 0-4 is 714 per 100,000, and fewer than 1 percent of children are sleeping under insecticide treated bednets. WHO estimated the 2000 TB prevalence rate in Burundi at 249 per 100,000, and the death rate at 65 per 100,000.
AIDS/HIV: At the end of 2007, UNAIDS/WHO estimates that 3.3% of the population of Burundi aged 15-49 years old were living with HIV or AIDS. Heterosexual contact is the predominate mode of transmission. HIV prevalence is estimated at up to >20% of the high-risk urban population. Soucre: http://www.avert.org/subaadults.htm
• 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.
African Sleeping Sickness (Trypanosomiasis): There is the potential risk of disease in scattered areas countrywide. Travelers at most risk are those on safari and game-viewing holiday. Travelers to urban areas are at very low risk. The tsetse fly comes out in the early morning and the late afternoon. Insect repellent applied to the skin does not prevent tsetse fly bites, so travelers should wear protective clothing and sleep under a bed net.
Initial symptoms: The bite of tsetse fly can be painful and may develop into a raised red sore, called a chancre. The initial sore may subside or develop into an expanding red, tender, swollen area, followed by a generalized illness with fever, myalgia, abdominal discomfort, diarrhea, vomiting, headache, rigors, and sweats.
Read more: http://www.phac-aspc.gc.ca/tmp-pmv/info/af_trypan-eng.php
Animal Hazards: Animal hazards include snakes (vipers, cobras), centipedes, scorpions, and black widow spiders.
Cholera: This disease is active in this country with cholera outbreaks reported in 2007 and current activity reported in 2008 in the Cibitoke (Rugombo commune), Makamba and Bururi Regions. Although this disease is reported active, the threat to tourists is low. 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)
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 in sub-Saharan Africa. Sporadic cases and outbreaks occur in this country. 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.
• 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 hyperendemic with a prevalence of 11.i% 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. The flu vaccine is recommended for all travelers over age 6 months who have not received a flu shot in the past 6 months.
Malaria: Risk is present year-round throughout this country, including urban areas. Transmission is highest during and immediately after the rainy seasons, September through December and March through May. Peak transmission in the Rusizi Valley occurs during the drier months of May through September. Risk may be lower in locations above 1,800 meters elevation. Falciparum malaria accounts for approximately 80% of cases, followed by P. malariae in up to 20% of cases. Chloroquine-resistant falciparum malaria is reported.
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline, or primaquine (G6-PD test required0 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 Burundi 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.
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.
• Long-term travelers who may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours.
Meningitis: Outbreaks of meningococcal meningitis, Group A and group W-135, regularly occur in this country. Vaccination with a quadrivalent conjugate vaccine is advised for those travelers anticipating close contact with the indigenous population.
• Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at: http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx#651
Other Diseases/Hazards: African tick typhus
• Ebola-Marburg disease (virus widespread in region but no cases reported in Burundi)
• Leishmaniasis (probably endemic; data not available)trypanosomiasis (undetermined incidence; may be present in Bururi and Ngozi Provinces),
• Typhus (louse-borne; reported from the highlands)
Poliomyelitis (Polio): Polio remains persistent in sub-Saharan Africa. At the end of September 2009 of two cases of wild polio were reported from the northwestern province of Cibitoke, on the border with the Democratic Republic of Congo and Rwanda. Health authorities said the virus was imported from the east of the neighbouring Democratic Republic of Congo where cases were discovered around two months ago.
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: Stray and sometimes viscous dogs, dogs may be encountered throughout this country. Pre-exposure rabies vaccine is recommended for travel longer than 3 months, for shorter stays in rural when travelers plan to venture off the usual tourist routes and where they may be more exposed to the stray dog population; when travelers desire extra protection; or when they will not be able to get immediate medical care.
• 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.
Rift Valley Fever: An outbreak of Rift Valley fever was reported in May 2007 near the Tanzanian border, apparently caused by consumption of contaminated meat from animals which had come from Tanzania, which was experiencing a major outbreak of Rift Valley fever at that time.
• Rift Valley fever is a viral infection that affects both cattle and people. It is usually transmitted by mosquitoes, but may also be acquired by direct exposure to infected animals or by consumption of unpasteurized milk. Most cases occur in livestock workers. Symptoms include chills, fever, headache, muscle aches, nausea and vomiting. Most people recover uneventfully in about a week. Approximately 1% of patients die of the disease.
Further information: http://en.wikipedia.org/wiki/Rift_Valley_fever
• All travelers should take measures to avoid mosquito 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 at night.
Schistosomiasis: Risk is present mainly in three areas: the western Imbo lowlands extending across the Rusizi River and Plain and along the shores of Lake Tanganyika, including Bujumbura, the northeast around Lake Cohoha, and the eastern Moso lowlands.
• 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. 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: Tuberculosis is highly endemic in Burundi 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: The yellow fever vaccine is required for travelers coming from ALL countries. The vaccine is recommended for all travelers >9 months of age.