Time Zone: +1 in the west (Kinshasa) and GMT +2 in the east.
Tel. Country Code: 242
USADirect Tel.: 0
Electrical Standards: Electrical current 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
Travel Health Services
Foreign Commonweatlh Office
The Embassy in Brazzaville has interim offices located in the B.D.E.A.C Building, 4 th Floor, Place du Gouvernement, Plateau de Centre Ville, Brazzaville. The telephone number during regular business hours (7:30 am until 4:30 pm, Monday through Friday) is 242-81-14-81; email CongoB.ACS@state.gov . The Embassy in Kinshasa is located at 310 Avenue des Aviateurs, Gombe; tel. 243-(0)81-225-5872 (do not dial the zero when calling from abroad into the Congo), and the mailing address from the U.S. is Brazzaville Embassy Office, American Embassy Kinshasa, Unite 31550, APO AE, 09828-1550. Entrance to the Consular Section of the U.S. Embassy in Kinshasa is on Avenue Dumi, opposite Ste. Anne residence. The Consular Section of the Embassy in Kinshasa may be reached at cellular tel. 243-(0)81-884-4609, 243-(0)81-884-6859 or 243-(0)81-225-5872; fax 243-(0)81-301-0560. For after-hours emergencies, use 243-81-225-5872. (Cellular phones are the norm, as other telephone service is often unreliable); website: http://kinshasa.usembassy.gov/.
• Canadian Embassy (Zaire); Tel.  (12) 27551
HIV Test: Not required.
Passport/Visa: The Republic of the Congo (Congo-Brazzaville) is a developing nation in central Africa. The official language is French. The largest cities are the capital, Brazzaville, on the Congo River, and Pointe Noire on the coast. Civil conflict in 1997 and again in 1998-99 damaged parts of the capital and large areas in the south of the country. The last rebel group still engaged in armed struggle signed a cease-fire accord with the government in March 2003. Facilities for tourism are very limited.
ENTRY/EXIT REQUIREMENTS: A passport, visa and evidence of yellow fever vaccination are required for entry. Additional information on entry requirements may be obtained from the Embassy of the Republic of Congo, 4891 Colorado Ave., N.W., Washington, D.C. 20011, telephone (202) 726-5500, or from the Permanent Mission of the Republic of Congo to the United Nations, 14 E. 65th St., New York, NY, 10021, telephone (212) 744-7840. Overseas, inquiries should be made at the nearest Congolese embassy or consulate.
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.
Meningococcal (Meningitis): Quadrivalent meningitis vaccine is recommended for those travelers anticipating close 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 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: Yellow fever vaccination is required for all travelers >1 year of age arriving from ALL COUNTRIES. Vaccination is recommended for all travelers >9 months of age.
HOSPITALS / DOCTORS
In the Republic of the Congo, medical facilities are severely limited. The public hospitals are dilapidated, their equipment is obsolete and they usually do not have medications and necessary supplies. 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, and bring drugs for malaria prophylaxis. Travelers who are taking regular medications should carry them properly labelled 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. Travelers are also advised to obtain travel insurance that provides for medical evacuation to more advanced medical facility in another country in the event of serious illness or injury.
In Brazzaville and Pointe-Noire the facilities listed below are used by expatriates.
• Centre Privé d’Urgences (CPU)
Avenue de Commerce/Avenue Bas-Congo
Tel:  20-875/876
• French Embassy medico-social center
Tel:  81-54-73
• C.S.S.I.E., 22 Avenue N’Goued
Tel:  943-432/943
• Guenin Private Hospital (Clinique Guenin)
Tel:  94-17-51
Private medical/surgiacal facility; emergency care
• BP CLINIQUE MÉDICALE SAINT-RAPHAEL
291 Pointe-noire, République du Congo
Emergency cellphone: 529-46-04
DESTINATION HEALTH INFO FOR TRAVELERS
A Country Profile: As a result of past conflicts, there is extensive damage to the infrastructure in Brazzaville and in the southern part of the country, and the government is working to reconstruct roads and buildings. Fighting broke out in March and June of 2002 when rebel groups launched attacks first in the Pool region, and later, at the Brazzaville airport. The fighting in Brazzaville was quickly contained and the rebels were repulsed. In March 2003, the rebels and the government signed a cease-fire accord, which remains in effect, although there was some violence in Brazzaville in December 2003.
Tensions in the neighboring Democratic Republic of the Congo have led to insecurity in border areas in the north of the Republic of the Congo along the Ubangui River. Travel to these regions is not recommended. Night travel outside of town and cities should be avoided.
• U.S. citizens should avoid political rallies and street demonstrations and maintain security awareness at all times.
The Department of State suspended operations at the U.S. Embassy in Brazzaville in 1997. The Brazzaville U.S. Embassy interim offices are located in the B.D.E.A.C (Central African Development Bank) building in Brazzaville. While Brazzaville is still not fully open for normal operations, Embassy staff is present in Brazzaville to provide information and guidance to American citizens. Staff can be contacted through the Embassy’s interim offices (see Registration/Embassy Location section below). The reduced staff in Brazzaville has limited ability to provide emergency services and non-emergency services generally take a few days to coordinate through Embassy Kinshasa. Please see the below section on Registration/Embassy Location for more information.
• Doctors Without Borders/ Médecins Sans Frontières (MSF) has been in the neighboring DRC since 1985.
AIDS/HIV: Heterosexual contact is the predominate mode of transmission. Prevalence of HIV estimated at 17.5% of the high-risk urban population. Rate in prostitutes estimated as high as 64%. All travelers are cautioned against unsafe/unprotected sex, medical or dental injections (with re-used equipment), and 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.
African Sleeping Sickness (Trypanosomiasis): This disease is currently active. Major risk areas include the southern savanna of Niari and Bouenza Regions, along the Congo River north of Brazzaville to north of Betou, and in the northwest (Etoumbi vicinity) and the extreme southwest of Cuvette Region (Okoyo vicinity); risk also occurs along the Lefini River. 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: hthttp://www.phac-aspc.gc.ca/tmp-pmv/info/af_trypan-eng.php
Animal Hazards: Animal hazards include snakes (mambas, adders, vipers, cobras), centipedes, scorpions, and black widow spiders.
Cholera: Cholera outbreaks were reported in 2008 from Kinkakassa village in the southern Congolese Pool District and in the Loudima district in the Bouenza division. A cholera outbreak was reported in January 2007 from the Republic of Congo’s economic capital, Pointe-Noire, causing more then 4000 cases and resulting in at least 82 deaths. Although this disease is active in this country, the threat to tourists is very 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)
Dengue Fever: Not reported, although the mosquito vector, Aedes aegypti, is present in this country.
Ebola Virus Hemorrhagic Fever: Sporadic outbreaks occur, the last being reported in May 2005 from Etoumbi and Mbomo, Cuvette Ouest region. At least three other Ebola outbreaks have occurred in the Cuvette Ouest region.
• Travelers should be advised that the Ebola virus is acquired by direct contact with the body fluids or secretions of infected patients. Travelers to the Congo should refrain from visiting households possibly affected by Ebola. Those who care for Ebola patients should wear protective gowns, gloves, and masks, as well as a face shield. Travelers should also avoid eating meat from primates, which may be infective. The Ebola viru is not transmitted by insect bites.
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 but the levels are unclear. Sporadic cases may occur but go 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.
• 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 endemic at high level, with a prevalence of 6.4% 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.
Insects: All travelers should take measures to prevent both daytime and nighttime insect bites. Insect-bite prevention measures include a DEET-containing repellent applied to exposed skin, insecticide (permethrin) spray or solution applied to clothing and gear, and use of a permthrin-treated bednet at night while sleeping.
Leishmaniasis: Sporadic cases have been reported. Travelers should take personal protection measures against insect (sandfly) bites.
Loiasis: Areas in the rain forest and villages in the Chaillu mountains are highly endemic. Travelers should take personal protection measures against biting deer flies.
Malaria: Malaria is present year-round countrywide, including urban areas. Risk is elevated during and just after the rainy season—April through October north of the equator, October through May south of the equator. Falciparum malaria accounts for 90% of cases, followed by P. malariae (6% of cases) and P. ovale (3% of cases, but P. vivax may occur. See below:
Plasmodium vivax is not thought to be transmitted in western and central Africa, because of the very high prevalence of the red blood cell Duffy-negative phenotype in local populations, a condition which is thought to confer complete resistance against blood infection with P. vivax. There are, however, persistent reports of travelers returning from this region with P. vivax infections.
Read more: http://www.ncbi.nlm.nih.gov/pubmed/19803728
Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline, or primaquine is recommended.
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.
Marburg Virus Hemorrhagic Fever: In 1998, an outbreak occurred in Durba, Democratic Republic of the Congo. Control measures are not available since the mechansism of spread has not been identified. Marburg virus is indigenous to Africa. While the geographic area to which it is native is unknown, this area appears to include at least parts of Uganda and Western Kenya, and perhaps Zimbabwe. As with Ebola virus, the actual animal host for Marburg virus also remains a mystery. Just how the animal host first transmits Marburg virus to humans is unknown. However, as with some other viruses which cause viral hemorrhagic fever, humans who become ill with Marburg hemorrhagic fever may spread the virus to other people. Spread of the virus between humans has occurred in a setting of close contact, often in a hospital. Droplets of body fluids, or direct contact with persons, equipment, or other objects contaminated with infectious blood or tissues are all highly suspect as sources of disease.
Meningitis: A large outbreak, due to Neisseria meningitidis serogroup A, occurred in January 2002 in Katana, Bukavu and Idjwi Health Zones, South-Kivu. The Republic of Congo lies just south of the sub-Saharan meningitis belt. Quadrivalent meningitis vaccine is recommended for travelers staying longer than 1 month during the dry season, December to June, and should be considered consider for shorter stays if close contact with the local populace is anticipated.
• Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at: http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx#651
Onchocerciasis: High prevalence in two southwestern areas: the Djoue River basin and the bank region of the Congo River. Travelers should take personal protection measures against insect (blackfly) bites.
Other Diseases/Hazards: Brucellosis (from consumption of raw dairy products or occupational exposure)
• Chikungunya fever (mosquito-transmitted; cyclic outbreaks occur regionally)
• Mansonellosis (mosquito-borne form of filariasis)
• Paragonimiasis (from eating raw crabs)
• Human monkeypox (most cases in Akungula and Ekanga)
• Toxoplasmosis, tuberculosis (a major health problem)
• Worms (intestinal helminths are very common)
Poliomyelitis (Polio): Polio outbreaks were reported in several previously polio-free countries in Central, Eastern, and Western Africa beginning in 2003. Immunization is recommended, due to the persistence of polio in sub-Saharan Africa. A one-time dose of IPV 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. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).
Schistosomiasis: Risk of urinary schistosomiasis is present in the southwestern regions of Bouenza, Niari, and Kouilou, as well as the Brazzaville vicinity. Less risk occurs in the northern areas of the country.
Schistosomiasis is a parasitic flatworm infection of the intestinal or urinary system caused by one of several species of Schistosoma. 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, or streams. There is no risk in chlorinated swimming pools or in seawater. Travelers should avoid swimming, bathing, or wading in freshwater lakes, ponds, or streams.
Travelers' Diarrhea: High risk. Rural villages and towns obtain water from untreated sources. Brazzaville, Point Noire, and some other major cities have modern filtration and purification plants, but the water is subject to recontamination. 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 dairy products. Do not eat raw or undercooked food, especially meat, fish, raw vegetables. 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 a major health problem in this country, with 2% of the population infected. Travelers planning an extended stay should have a predeparture TB skin test (PPD test) and be re-rested after leaving this country. Tuberculosis is highly endemic in Congo 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 (with the exception of short-term visitors who restrict their meals to hotels) traveling to or working in Congo, 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: According to WHO, 1 confirmed and 11 suspected human cases of yellow fever have been reported since March 2010 in the northern region of Titule, Orientale Province. These are the first reports of cases in the Democratic Republic of the Congo since 1971. Yellow fever vaccination is required for all travelers >1 year of age arriving from ALL COUNTRIES. Vaccination is recommended for all travelers >9 months of age.