Time Zone: +12 hours. No daylight saving time in 2008
Tel. Country Code: 679
USADirect Tel.: 4
Electrical Standards: Electrical current is 240/50 (volts/hz). South Pacific Style Adaptor Plug. Grounding Adaptor Plug E.
• U.S. Embassy
31 Loftus Street
Tel:  314-466
• Embassy/Consulate of Canada
Tel:  721-936 or 722-400
Honorary Consul: Ms. Jana Vyas
Fax:  721-936
• British High Commission
47 Gladstone Road
Tel:  3229100 (switchboard)
FaX:  322 9132
HIV Test: Not required.
Required Vaccinations: Yellow fever vaccine is required for all travelers >1 year of age arriving from countries with risk of yellow fever transmission including transit through such countries. The international yellow fever vaccination certificate becomes valid 10 days after vaccination and remains valid for a period of 10 years. Yellow fever vaccination is not recommended or required otherwise.
Passport/Visa: Fiji is a South Pacific island nation consisting of over 350 islands and islets, of which approximately 100 are inhabited. The capital is Suva. On December 5, 2006, in the fourth coup since 1987, the Commander of the Fiji military force deposed the lawfully elected government of Fiji. There is currently an unelected interim government in place established by the military. The coup has had a negative effect on the economy. Tourist facilities are available. . The Fiji Visitors Bureau, which has a wide range of information of interest to travelers, can be contacted via the Internet at http://www.bulafiji.com/.
ENTRY/EXIT REQUIREMENTS: A passport valid for at least three months beyond the intended date of departure from Fiji, proof of sufficient funds and an onward/return ticket are required for entry to Fiji. A visa is not required for tourist stays up to four months. Yachts wishing to call at the Lau group of islands need special permission granted at the first port of entry into Fiji. For further information on entry/exit requirements, travelers may contact the Embassy of the Republic of Fiji, 2233 Wisconsin Avenue, NW, No. 240, Washington, DC 20007; telephone (202) 337-8320, or the Fiji Mission to the United Nations in New York. This is particularly important for travelers planning to enter Fiji by sailing vessel.
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.
• In addition to tetanus, all travelers, including adults, should be fully immunized against diphtheria. A booster dose of a diphtheria-containing vaccine (Td or Tdap vaccine) should be given to those who have not received a dose within the previous 10 years.
Note: ADACEL and Boostrix are new tetanus-diphtheria-pertussis (Tdap) vaccines that not only boost immunity against diphtheria and tetanus, but have the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children. The Tdap vaccines can be administered in place of the Td vaccine when a booster is indicated.
Yellow Fever: Yellow fever vaccine is required for all travelers >1 year of age arriving from countries with risk of yellow fever transmission including transit through such countries. The international yellow fever vaccination certificate becomes valid 10 days after vaccination and remains valid for a period of 10 years. Yellow fever vaccination is not recommended or required otherwise.
Hospitals / Doctors
Two major hospitals, Lautoka Hospital in city of Lautoka, and the Colonial War Memorial Hospital in Suva, provide emergency & outpatient services. Other hospitals & clinics provide only limited range of health services.
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 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. Medical facilities are adequate for uncomplicated treatment, but travel insurance with air ambulance coverage for medical evacuation to Australia or New Zealand is advised.
There are two operational decompression chambers in Fiji and both are located in the capital, Suva. They are at Suva Private Hospital and the Colonial War Memorial Hospital. Many of the popular dive sites are located away from Suva and divers needing emergency treatment are medically evacuated to the chambers.
• Colonial War Memorial Hospital
Tel:  31-3444
This is the main teaching hospital for the Fiji Schol of Medicine (FSM) and the main medical facility in Fiji. Recompression Chamber for scuba divers is on-site.
• Suva Private Hospital
120 Amy Street
Tel:  330 3404
Fax:  330 3456
Western-style medical care. Forty-bed hospital including ICU, two operating theatres, day surgery unit, two delivery rooms, 24-hour Emergency Room and recompression chamber.
• Gordon Street Medical Center
Tel:  313-131 or 313-355
• Lautoka Hospital
Tel:  666 0399
Lautoka or Sugar City is Fiji's second-largest city after Suva with a core population of around 50,000. Lautoka is situated in the western side of Viti Levu, the largest island in Fiji.
• Labasa Hospital
Tel:  81-1444
Most specialties; 24-hour emergency care available.
Destination Health Info for Travelers
AIDS/HIV: It is estimated that 0.4% of the adult population of Oceania is living with HIV/AIDS, but no statistics are currently available for Fiji. The risk factors for a fast growing HIV epidemic in Fiji include the high incidence of other sexually transmitted infections, a high incidence of teenage pregnancies, a high incidence of drug and substance abuse, a mobile population, a large tourism industry, and cultural behavior that includes a considerable degree of extramarital sex, particularly by men.
• 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.
Health insurance is essential.
Cholera: Low risk, but sporadic cases may occur. Cholera is an uncommon disease in travelers from developed countries. 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)
Crime/Security/Civil Unrest: We advise you to exercise caution when travelling in Fiji and Suva due to the unresolved political situation and deterioration in the rule of law following the military coup in December 2006.
Actions taken by the military and other government organisations since the coup have undermined the protections ordinarily afforded by the rule of law and have affected the interests and welfare of travelers in some instances.
Crime: Robbery, theft and violent assault occur in Fiji, including against tourists and expatriate residents. There have been reports of increases in violent crime in Fiji. Although most crime is opportunistic, there have been recent incidents of assault and robbery in which expatriates and tourists have been targeted. You should maintain a high degree of personal security awareness. Incidents occur more frequently in urban areas and at night. Home invasions also occur, affecting both locals and expatriates.
Local Travel: Take care when driving, particularly at night, because of insufficient street lighting, stray animals and the poor quality of roads. The safety standards you might expect of tour operators are not always met, especially for adventure sports or on boats in coastal waters and between islands. There are sometimes insufficient life jackets for boats, rafts and kayaks.
Dengue Fever: There is increased risk during the rainy seasons, December–January and May–June. An increase in incidence has been reported in 2008. Dengue fever is a mosquito-transmitted, flu-like viral illness occurring in many parts of Oceania. 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
Filariasis: Malayan filariasis occurs year-round but particularly in the summer months (November to April). Travelers should take precautions 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 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. 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 >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 with a prevalence of 1.0% to 2.4% 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 applied to clothing and gear, and use of a permthrin-treated bednet at night while sleeping.
Leptospirosis: Low risk for most travelers. There is occupational risk for farmers in paddy rice and sugar cane production. Visitors to rural areas and in contact with water in canals, lakes and rivers may be exposed to infection. There is increased risk after recent floods. The risk may be greater for those who practice canoeing, kayaking or other activities in water. Prophylaxis (protective treatment): Doxycycline may be effective.
• Travelers should avoid swimming or wading in potentially contaminated waters including canals, ponds, rivers, streams and swamps. Avoid all direct or indirect contact with rodents.
Malaria: There is no risk of malaria in Fiji.
Marine Hazards: Ciguatera poisoning is prevalent and results from eating reef fish such as grouper, snapper, amberjack, and barracuda. Cooking does not destroy the toxin.
Swimming-related hazards include sharks, jellyfish, including the Indo-Pacific man-of-war, stonefish, scorpion fish, stingrays, sea snakes, spiny sea urchins, sharp coral and poisonous cone shells. Swimmers should take sensible precautions to avoid these hazards. Stonefish, scorpion fish and stingrays congregate in shallow water along the ocean floor and can be difficult to see. Wearing booties may help protect you, but should not be relied upon as complete protection, as many of the spines are sufficiently rigid and long to penetrate wetsuits, booties, and gloves.
• The jellyfish population appears to be increasing, due in part to overfishing of jellyfish predators, rising water temperatures, and pollution. Jellyfish travel in groups, so looking before you leap into water may be protective.
Treatment guidelines for jellyfish stings: http://www.emedicine.com/derm/topic199.htm
• To avoid a shark attack, swim or dive with a group. Avoid swimming during hours of darkness or twilight, in fog, or in murky waters. Avoid swimming in the vicinity of sea lions, harbor seals or elephant seals. Avoid swimming near the mouths of rivers where sharks hunt for fish. When diving, minimize time spent at the surface. Wearing a wetsuit and fins or lying on a surfboard creates the silhouette of a seal to a shark below you. Shallow water is not a deterrent to sharks; attacks have occurred in less than 5 ft/1.5 m of water.
The most serious hazards:
Sea snake venom is highly toxic and the mortality has been reported to be 25% in untreated cases. In severe envenomations, symptoms can occur within 5 minutes, but typically evolve over 8 hours. It is possible that the victim may not have been aware of the bite, since there is little or no pain on envenomation.
Symptoms often include anxiety, muscle aching, salivation and a sensation of tongue swelling, followed by nausea, vomiting, muscle spasms, ascending paralysis, ocular palsy and sometimes loss of vision. Respiratory collapse may ensue, and the need for endotracheal intubation and mechanical ventilation should be anticipated. Sea snake antivenom (older name: antivenin) should be administered in all actual and suspected cases.
• A sea snake bite is always a medical emergency, even if the victim does not appear ill.
• You must get the victim to an emergency department, as fast as possible.
• En route, attempt to keep the bite site in a resting position, while keeping the victim as still as possible.
• Apply a broad pressure bandage over the bite about as tight as an elastic wrap to a sprained ankle. This is intended to slow the spread of the venom through the lymphatic system. Apply a splint to the limb. Make sure that arterial circulation is not cut off, by making sure fingers or toes stay pink and warm.
• Never cut open a sea snake bite and try to suck venom from the victim.
• Sea snake toxin is not inactivated by changes in temperature or pH. Application of ice, hot packs, or vinegar only wastes time.
Read more: http://emedicine.medscape.com/article/771804-overview
The box jellyfish is the most dangerous jellyfish in the world. Box jellyfish belong to the class Cubozoa, and are not a true jellyfish (Scyphozoa), although they show many similar characteristics. When people talk about the extremely dangerous Australian box jellyfish they refer to the species Chironex fleckeri. Chironex fleckeri (sometimes simply called “the box Jellyfish”), is the best-known species of box jellyfish, and is only one of a category which actually contains about 19 different species. The name sea wasp is also applied to some species of Cubozoans, including the aforementioned Chironex fleckeri.
The other species that is known to have caused deaths is Carukia barnesi, commonly called Irukandji. This tiny jellyfish is only about thumbnail size.
Chironex fleckeri is present in the waters of Australia, the Indo-Pacific region, including Vietnam, Papua New Guinea, the Phillipines, and Hawaii. Their exact distribution has not been fully determined and they may be present in the waters around Fiji.
• Box jellyfish stings are extremely painful, potentially lethal and require treatment with antivenom. Cardio-respiratory arrest may occur within 20 minutes of envenomation. Four other varieties of jellyfish (jimble, Carukia, mauve stinger, and hairy stinger) should also be avoided.
Box jellyfish treatment and antivenom information:
The stonefish is a rather unattractive squat fish with a mostly rough “skin” that assists its superb camouflage as it sits on old coral or debris. There is a series of erectile dorsal spines, which, with the associated venom glands, provides the creature means of envenoming potential predators. Stonefish are mostly encountered in shallow water, where they may be stepped on by accident, or picked up by the unwary. Instant and severe pain is a constant feature of stings, followed by local swelling, which may be marked, tenderness and a blue discoloration of skin surrounding the sting site. Dizziness, nausea, hypotension, collapse, cyanosis and pulmonary edema have been described, though are by no means common. Tissue ischemia at the sting site is possible.
• Antivenom: Stonefish antivenom should only be given if there is clear evidence of envenomation. It should be given only IM, not IV.
• The use of stonefish antivenom in stings by other species of scorpionfish is not clearly recommended, but there is limited evidence that it may be beneficial (e.g. possibly bullrout stings, Notesthes robusta). The potential risks of immediate and delayed adverse reactions to antivenom should be carefully considered before using this antivenom for other than stonefish stings.
Emergency treatment guidelines for marine stings are here:
Clinical Toxicology Resources
University of Adelaide
Wilderness Medicine and Field Guide to Wilderness Medicine
Rabies: Fiji is considered rabies-free, but stray and free-roaming dogs may be encountered. All unprovoked animal bites should be thoroughly cleansed with soap and water medically evaluated for possible post-exposure treatment.
Ross River Fever: This mosquito-borne, debilitating viral illness, also called epidemic polyarthritis, occurs sporadically and also in periodic epidemics. (Infection was reported in two Canadian tourists who visited Fiji in late 2003 and early 2004.) Symptoms include fever, headache, chills, and muscle pains; the polyarthritis is characterized by swollen and aching joints, especially at the knees, ankles and fingers.
• Ross River fever is transmitted via the bite of an infected Aedes vigilax 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 this illness.
Travelers' Diarrhea: Urban areas of Fiji have some water treatment facilities, but most water should be considered potentially 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, 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: Multiple cases of typhoid fever occurred in 2007 and are still being reported in 2008. Most cases were in Northern Bua Province, but in February 2008 more cases were reported from the village of Nailou, Northern Division. Typhoid vaccine is recommended by the CDC for all people traveling to or working in Oceania, 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.