Cook Islands (New Zealand)
Time Zone: +12 hours. (GMT +13 from the last Sunday in October to the last Sunday in March).
Tel. Country Code: 682
USADirect Tel.: 9
Electrical Standards: Electrical current is 240/50 (volts/hz). South Pacific Style Adaptor Plug. Grounding Adaptor Plug E.
There are no local embassies. The U.S. Embassy in New Zealand, has jurisdiction.
• U.S. Consul General
23 Customs St. East
Tel:  (9) 303-2724
Fax:  (9) 303-1069
After hours number for American citizen emergencies only: Dial  (4) 462 6000 and leave a message for duty officer to return your call; or phone  (9) 303 2724 ext. 2900.
• Canadian High Commission
125 The Terrace
Telephone:  (4) 473 9577
Fax:  (4) 471 2082
The nearest British diplomatic contact is in New Zealand.
• British High Commission
44 Hill Street
Tel:  (4) 924 2888
Fax: [64} (4) 473 4982
HIV Test: Not required.
Required Vaccinations: None required.
Passport/Visa: U.S. citizens eligible for a visa waiver do not need a visa for tourist stays of three months or less. For more information about visa waivers and entry requirements, contact the Embassy of New Zealand, 37 Observatory Circle, N.W., Washington, D.C. 20008, telephone (202) 328-4800, http://www.nzemb.org or the Consulate General of New Zealand in Los Angeles, 2425 Olympic Blvd Suite 600E, Santa Monica, CA 90404, telephone (310) 566 6555, http://www.nzcgla.com.
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.
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-stay visitors who restrict their meals to hotels or resorts.
Hospitals / Doctors
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 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. Serious illness or injury may require medical evacuation to New Zealand.
Information of health facilities and services in Cook Islands is here: http://www.health.gov.ck/clinical.asp
• Rarotonga Hospital
The Rarotonga hospital is the largest in the country. It has 80 beds, X-Ray facilities, Laboratory Facilities, a surgery ward, and other modern amenities. There are always doctors on call to tend to emergencies. The Rarotonga Hospital is located on the top of Hospital Hill Road.
• Aitutaki Hospital
Small facility with 20 beds and a dental clinic.
• Tupapa Outpatient Clinic
Destination Health Info for Travelers
AIDS/HIV: It is estimated that 0.4% of the adult population of Oceania is living with HIV/AIDS whereas the prevalence rate in Cook Islands is estimated at around 0.1% of the adult population.
• 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.
Dengue Fever: This disease is active. An outbreak of dengue fever was reported from the Cook Islands in May 2006. As of June 2007, almost 1400 cases had been identified, mostly on the island of Rarotonga. The number of dengue fever cases has increased steadily since the beginning of January 1997. 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
Filariasis: The Malayan variety of filariasis is reported. Travelers should take protective measures against mosquito 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 may be 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 >8%. 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 not well documented. 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.
Malaria: There is no risk of malaria in Cook Islands.
Marine Hazards: Swimming related hazards include jellyfish, spiny sea urchins, and coral.
• Ciguatera poisoning is prevalent and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
Ross River Fever: This mosquito-transmitted viral illness occurs in periodic epidemics. Travelers should take protective measures against insect bites.
Travelers' Diarrhea: Low to medium risk. Tap water on Rarotonga is generally safe to drink. (Most hotels have filtration systems.) Tap water on Aitutaki is not considered 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 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.
Typhoid Fever: Recommended for all people traveling to or working in Southern and Western Pacific, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water. Because the typhoid vaccines are only 60% to 70% effective, safe food and drink guidelines should continue to be observed.