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Chile



Capital: Santiago

Time Zone: -4 hours. No daylight saving time in 2008.
Tel. Country Code: 56
USADirect Tel.: 800
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug I.


Travel Advisory - Chile

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 Chile


Resource Links

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

Embassies


• U.S. Embassy
Avenida Andres Bello 2800
Santiago
Tel: [56] (2) 232-2600
Fax: [56] (2) 330-3005
E-mail: SantiagoAMCIT@state.gov
Website: http://santiago.usembassy.gov/

• Canadian Embassy
Nueva Tajamar 481
Torre Norte
12th Floor
Las Condes
Santiago
Tel: [56] (2) 362-9660
Fax: [56] (2) 362-9393
E-mail: stago@dfait-maeci.gc.ca
Website: http://geo.international.gc.ca/latin-america/chile/menu-en.asp

• British Embassy
Avda. El Bosque Norte 0125
Las Condes
Santiago
Tel: [56] (2) 370 4100
Fax: [56] (2) 370 4170 Consulate
Email: consular.santiago@fco.gov.uk
Website: www.britishembassy.gov.uk/chile

Entry Requirements

HIV Test: Not required.

Required Vaccinations: None required.

Passport Information

Passport/Visa: Chile is a rapidly developing country with a large, educated middle class and a robust free-market economy. Tourist facilities are generally good and are continuously improving. 
ENTRY/EXIT REQUIREMENTS: United States citizens entering Chile for business or pleasure must have a valid passport and visa. Visas may be obtained at the port of entry upon payment of a fee. The visa is valid for multiple entries to Chile and remains valid until the expiration of the passport. U.S. citizens are admitted to Chile for up to 90 days. An extension of stay for an additional 90 days is possible, but requires payment of another fee. Visitors will be issued a Tourist Card upon entry that must be surrendered upon departure. . Visit the Embassy of Chile web site at www.chile-usa.org for the most current visa information. 

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 who might be exposed to blood or body fluids from unsafe/unprotected sexual contact; from injecting drug use; from medical treatment with non-sterile (re-used) needles and syringes. Recommended for any traveler requesting protection against hepatitis B.

Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.

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 with the exception of short-term visitors who restrict their meals to major restaurants and hotels, such as business travelers and cruise passengers.

Hospitals / Doctors

Medical care, though generally good in Santiago, is not up to Western standards in other areas, especially in remote areas.
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 or may be of unreliable quality.
• Travelers, including skiers and mountain climbers, are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance transport. 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 an appropriate medical facility.

There are two modern facilities in Santiago that offer 24-hour walk-in service for urgent problems, as well as specialty care (by appointment) and inpatient services:

• Clinica Las Condes
Lo Fontecilla 441
Las Condes, Santiago
Tel: [56] (2) 210-4000
Website: http://www.clinicalascondes.cl/

• Clinica Alemana
Av. Vitacura 5951
Vitacura, Santiago
Tel: [56] (2) 210 1111, [56] (2) 212 9700
Website: http://en.alemana.cl/reader/alemanaingles/pub/v02/index.html

A listing of healthcare providers in Santiago is posted on the US Embassy website. Go to http://santiago.usembassy.gov
Click on US Citizens, then General Information.

Destination Health Info for Travelers

AIDS/HIV: Relatively low rates of HIV infection are reported, but the incidence is increasing, especially in urban areas. In Chile, even though HIV prevalence remains less than 1%, the epidemic is concentrated among populations at particular risk, such as sex workers, drug users, and men who have sex with men.
• 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.
• 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.

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. Important safety rules to follow are 1) Do not drive at night, 2) Do not rent a motorcycle, moped, bicycle, or motorbike, even if you are experienced, and 3) Don't swim alone, at night, or if intoxicated.
• 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.

Altitude Sickness (AMS): Extreme variations in altitude occur in this country. Ojos del Salado, elevation 22,539 ft (6,870 meters), on the border between Argentina and Chile, is the highest mountain in Chile. Many ski resorts are over 9,800 feet (3,000 meters) elevation. There is risk for altitude sickness for tourists arriving in Quito (altitude 2,800 meters; 9,350 feet) and for those going to higher-altitude destinations. Arriving travelers should spend several days acclimatizing and avoiding strenuous activity.
Acute mountain sickness (AMS), also known as altitude illness, is a common malady above 2,400 m (8,000 ft), especially if you have not had a chance to acclimatize by ascending gradually. The prevalence of AMS varies between 15% and 75%, depending on your speed of ascent, altitude gained, sleeping altitude, and individual susceptibility. Acute mountain sickness can progress to high altitude cerebral edema (HACE) or be associated with high altitude pulmonary edema (HAPE). You should intersperse your ascent with rest days and avoid, if possible, increasing your sleeping altitude by more than 1,000 - 1,500 feet each night. To reduce further your risk of AMS, take acetazolamide (Diamox), starting the day prior to beginning your ascent. Acetazolamide is a respiratory stimulant that speeds acclimatization and is about 75% effective. It may also reduce the risk of HAPE.
• Symptoms of AMS include mild to moderate headache, loss of appetite, nausea, fatigue, dizziness and insomnia. Mild AMS usually resolves with rest plus medication for headache and nausea. You can also take acetazolamide to treat mild AMS.
• Under no circumstances should you continue to ascend (especially to a higher sleeping altitude) if you have any persistent symptoms of altitude illness. In the absence of improvement or with progression of symptoms you should descend (at least 500 m) to a lower altitude.
• Dexamethasone (Decadron) is a steroid drug used for treating AMS and HACE. You should carry stand-by treatment doses. You can take dexamethasone together with acetazolamide to treat mild- to moderate-AMS.
• More severe AMS (increasing headache, vomiting, increasing fatigue or lethargy) may indicate the incipient onset of high-altitude cerebral edema (HACE)—recognized by confusion, difficulty with balance and coordination, staggering gait. Start treatment with dexamethasone and descend immediately.
• Increasing dry cough and breathlessness at rest may indicate high altitude pulmonary edema (HAPE). Nifedipine, sildenafil (Viagra), or tadalafil (Cialis) can be used for both the prevention and treatment of HAPE. Dexamethasone and the asthma drug salmeterol (Serevent) also will prevent HAPE.
• Descent, combined with medication (and oxygen, if available) is the best treatment for more severe AMS, HACE or HAPE. Consider helicopter evacuation if the situation is urgent.

Caution: Prior to departing for a high-altitude trip, consult with a physician about the use of medications for preventing/treating altitude illness.
Further advice:
http://www.basecampmd.com/expguide/highalt.shtml
http://wwwn.cdc.gov/travel/yellowBookCh6-AltitudeIllness.aspx
http://www.altitudemedicine.org
http://www.ismmed.org

Animal Hazards: Animal hazards include black widow and brown widow spiders. There are no venomous land snakes on the mainland of Chile. Portuguese man-of-war, sea wasps, and several species of stingrays are found in the country’s coastal waters and are potential hazards to swimmers.

Chagas’ Disease: No cases have been reported since 1999. Nonetheless, travelers to rural areas should sleep under a mosquito net (well tucked in), sleep away from walls if in an adobe-style house, and spray sleeping quarters with an insecticide (such as RAID Flying Insect Spray) prior to retiring. Unscreened blood transfusions are also a potential source of infection. The rate of contaminated blood reported by Chilean blood banks is in the 1.9%–6.5% range.

Cholera: This disease is occasionally active in this country but the threat to tourists is very low. The last outbreak occurred in January 1998. No cases of cholera have been officially reported since 1999.
An outbreak of Vibrio parahemolyticus infections was reported from Chile in December 2008, primarily affecting the southern regions of Maule and Biobio. (Vibrio parahaemolyticus is a bacterium in the same family as those that cause cholera. It lives in brackish saltwater and causes gastrointestinal illness in humans.) This infection is usually acquired by eating contaminated shellfish. Since Region X is the source of most of the shellfish consumed in Chile, the outbreak spread rapidly to other parts of the country. Note: The cholera vaccine is not effective against other Vibrio bacteria.

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)

Climate-Related Illness: Santiago has one of the highest pollution levels in South America. Heavy smog can pose serious health hazards from May through August. The most severe pollution occurs from May to October. Air pollution occurs to a lesser extent in the Chilean countryside. Travelers with emphysema, asthma, and bronchitis should expect an increase in respiratory symptoms.

Crime/Security/Civil Unrest: Large demonstrations and protests occur occasionally. You should avoid all demonstrations and protests as they may turn violent. The anniversary of the 11 September 1973 coup, Workers Day (1 May) and Day of the Young Combatant (29 March) may be accompanied by large protests and demonstrations.
Anti-tank mines and landmines are a danger in remote sections of several popular national reserves and parks near northern borders, including Lauca and Llullaillaco National Parks, Salar de Surire National Monument, and Los Flamencos National Reserve. There are also unexploded munitions outside of military zones in the desert areas bordering Chile and Peru. You should seek advice from local authorities before travelling to these areas and observe all warning signs and follow clearly identified roads. There are also clearly marked landmine fields in the Magallanes region of southern Chile, between Punta Arenas and the Torres del Paine National Park and on Tierra del Fuego.
• Crime: Muggings and robberies are common in urban areas, especially at night. People walking alone are often targeted. Daylight muggings have been reported in the Cerro San Cristobal Park and in and around the Plaza de Armas in the capital, Santiago. Petty crime including pickpocketing and bag snatching is increasingly common in crowded areas, such as on public transport, outdoor cafes and markets and in resort areas. There has been an increase in incidents of thieves slashing backpacks. You should remain vigilant at all times.
Foreigners have been robbed after accepting spiked drinks in bars and places of entertainment.
• Local Travel: Driving in Chile can be dangerous due to aggressive driving practices. Secondary and rural roads are often poorly maintained and lack sufficient street lighting. Roads in mountainous areas often lack guardrails. Chains are often required on mountain roads during the winter.
For further advice, see the bulletin on Overseas Road Safety from Smartraveller:
(http://www.smartraveller.gov.au/zw-cgi/view/TravelBulletins/Overseas_Road_Safety)
Major highways are mostly toll roads. Drivers should ensure they carry sufficient local currency to pay the tolls.
If you are planning scientific, technical or mountaineering activities in areas classified as frontier areas, you are required to obtain authorisation from the Chilean government at least 90 days prior to the expedition.

Source: http://www.smartraveller.gov.au/zw-cgi/view/Advice/Chile

Hantavirus Infections: See Other Diseases/Hazards (below)

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 endemic but levels are unclear. Sporadic cases may occur. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. Farm animals (primarily pigs) 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%. 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 0.9% 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 from April through September in the Southern Hemisphere and travelers during this time are at potential risk. The flu vaccine is recommended for all people over age 6 months.

Malaria: There is no risk of malaria in Chile.

Natural Disasters, Severe Weather & Climate: In 2008, eruptions from the Chaiten volcano located 1220 kms south of Santiago have resulted in considerable ash fall and evacuation of residents in the areas of Chaiten and Futaleufu located in the tenth region of Chile and neighbouring areas in Southern Argentina.

Other Diseases/Hazards: Brucellosis (rare cases are associated with contact with cattle; unpasteurized dairy products).
• Echinococcosis (risk is highest in rural southern areas. Echinococcosis is a parasitic zoonotic disease, endemic in cattle-raising regions).
• Hantavirus pulmonary syndrome (present in rural farming areas throughout the country except in areas north of Santiago; occasional cases occur; this diseases is transmitted by the infected urine of rodents. So far in 2010, there have been 35 cases of hantavirus infection, a significant increase over the average incidence. The highest number of cases is reported from the central and southern regions of Bio Bio (11 cases) and De los Lagos (8 cases). Although risk to the typical traveler is minimal, you should avoid contact with rodent droppings and rodent urine.
• Meningitis (outbreaks of serogroup B meningococcal meningitis are reported; the quadrivalent meningitis vaccine does not protect against serogroup B meningitis).
• Taeniasis (pork and beef tapeworm disease).
• Tuberculosis (a serious public health problem).
• Fascioliasis (reported from Curico, Talca, and Linares Provinces).
• Strongyloidiasis and other helminthic infections.
• Insect-borne diseases are relatively unimportant in Chile.

Rabies: No human cases have been reported in this country since 1972. In 2007, one dog and one cat from a village in Maule region were diagnosed to have rabies. The possible source of the infection was from bat.
• Any animal bite wound, especially from a dog, should be thoroughly cleansed with soap and water and then medically evaluated for possible post-exposure rabies treatment.

Travelers' Diarrhea: Water supplies in Santiago are considered potable but breakdowns in the system can occur. All water outside Santiago should be considered contaminated. 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.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene helps prevent travelers’ diarrhea.
• A quinolone antibiotic, rifaximin (Xifaxin), 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.

Note: An outbreak of Vibrio parahemolyticus infections was reported from Chile in December 2008, particularly affecting the southern regions of Maule and Biobio. More than 200 cases were described. Vibrio parahemolyticus gastroenteritis from contaminated shellfish was reported in January 2005 from Puerto Montt, a major city in Region X of Chile. More cases reported in 2006. See the section on Cholera (above).

Typhoid Fever: There is a higher than average incidence of typhoid fever in this country. Typhoid fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people (except short-stay visitors and cruise ship passengers) traveling to or working in South America, 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: There is no risk of yellow fever in Chile. Yellow fever vaccination is neither required nor recommended unless there is planned on-going travel to a yellow fever Endemic Zone country in South America.