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Greece



Capital: Athens

Time Zone: +2 hours. GMT +3 hours daylight savings time.
Tel. Country Code: 30
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.


Travel Advisory - Greece

Europe, Russia and former the Soviet Union countries vary widely in travel risks and adequacy of health care delivery. Water- and food-borne illnesses such as travelers' diarrhea, typhoid and Giardia are threats outside of Western Europe. Insect-transmitted diseases, such as Lyme disease and tick-borne encephalitis are common in wooded, rural areas in most countries, including Western Europe.

Dr. Rose Recommends for Travel to Greece


Resource Links

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

Embassies

U.S. Embassy 91 Vasilissis Sophias Boulevard Athens Tel: [30] (210) 721-2951 Website: http://www.usembassy.gr/ The website for the U.S. Consulate General, Thessaloniki is: http://www.usconsulate.gr/ • Embassy of Canada 4, Ioannou Ghennadiou Street Athens Tel: [30] (210) 727-3400 E-Mail: athns-cs@international.gc.ca Website: http://www.athens.gc.ca • British Embassy 1 Ploutarchou Street Athens Tel: [30] (210) 727-2600 Website: http://www.british-embassy.gr/

Entry Requirements

• U.S. Embassy
91 Vasilissis Sophias Boulevard
Athens
Tel: [30] (210) 721-2951
Website: http://www.usembassy.gr/
The website for the U.S. Consulate General, Thessaloniki is: http://www.usconsulate.gr/

• Embassy of Canada
4, Ioannou Ghennadiou Street
Athens
Tel: [30] (210) 727-3400
E-Mail: athns-cs@international.gc.ca
Website: http://www.athens.gc.ca

• British Embassy
1 Ploutarchou Street
Athens
Tel: [30] (210) 727-2600
Website: http://www.british-embassy.gr/

Passport Information

HIV Test: Testing required for prostitutes (as defined by Greek law).

Required Vaccinations: None required.

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; from unscreened blood transfusions; from contact with open skin sores of another person. 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.

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.

Hospitals / Doctors

Medical facilities are adequate, and some, particularly the private clinics and hospitals in Athens and Thessaloniki, are quite good. Some private hospitals have affiliations with U.S. facilities, and generally their staff doctors have been trained in U.S. or other international teaching institutions. However, English is not as widely spoken as might be expected. Public medical clinics, especially on the islands, may lack resources; care there can be inadequate by American standards, and often, little English is spoken. Many patients, Greeks and visitors alike, are transferred from the provinces and islands to Athens hospitals for more sophisticated care. Others may choose to transfer from a public to a private hospital within Athens.
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.
• Travelers are advised to obtain travel insurance that provides for medical evacuation to more advanced medical facility in Europe in the event of serious illness or injury that cannot be treated locally.
Medical facilities used by travelers include;

• HYGEIA
Kifissias Ave. & 4 Erythou Stavrou Str.
Maroussi
Athens
Tel: [30] 210 68 67 000 (Main)
Tel: [30] 210 68 67 780 (Emergency line)
Website: http://www.hmi.hms.harvard.edu/hmi_partners/partners/hygeia.php
The Diagnostic and Therapeutic Center of Athens Hygeia, S.A., Athens, Greece is a 369-bed facility providing general hospital services to the people of Athens. Harvard medical International is supporting the development and implementation of a Quality Management Program through regular site visits and conference calls, a series of educational symposia with visiting HMS faculty in 2004 and a medical conference on advances in preventive health care issues in 2005. HMI also supports a one-month surgical rotation for HMS students at Hygeia hospital.

• Onassis Cardiac Surgery Center
356 Sygrou Avenue
Kallithea
Athens
Tel: [30] (1) 94 93000
Website: http://www.onasseio.gr/english/Onaseio/default.asp
The Department of Cardiothoracic Surgery is organized into four separate divisions, three dedicated to the treatment of acquired and one to congenital heart diseases. All divisions are managed by a senior surgeon and staffed with highly specialized medical personnel. State-of-the-art surgical procedures, such as the use of arterial grafts, coronary grafting in acute ischemia, valvular repairs, use of stentless valves, minimally invasive procedures and the repair of thoracic as well as of thoraco-abdominal aneurysms, are routinely performed.

• IASO Hospital
37-39 Kifisias Avenue
Marousi
Athens
Tel: [30] (1) 618 4000
Website: http://www.iaso.gr/en/Group/?BC=1,1,43

• St. Luke Hospital
Panorama
Thessaloniki
Tel: [30] 31 342 102

Travel Medicine specialists in Greece:
• Petroula Chatzipantazi, M.D.
Medical Office
Ministry of Foreign Affairs
V. Sofias 1
Athens
Tel: [30] (210) 368 5072
E-mail: doctor@mfa.gr
Pre-Travel Vaccination, Post-Travel Medical Consultation.

• Antonis Vassiloyanakopouls, MD, PHD
Henry Dunant Hospital
107, Mesogion Str.
Athens
Tel: [30] (10) 866 3354
E-mail: avassilo@network.gr
Pre-Travel Vaccination, Post-Travel Medical Consultation, On-Site Diagnostic Laboratory.

Destination Health Info for Travelers

AIDS/HIV: HIV prevalence is relatively low in Greece, estimated at 0.2% 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 development of 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.


Air Pollution: Travelers with respiratory diseases should be aware that severe air-quality problems occur in Athens and other urban areas.

Avian Influenza (Bird Flu): There are no reports of avian influenza A H5N1 in this country.

Brucellosis: In May 2008 an outbreak of 55 cases of brucellosis was reported in Thassos and Kavala. Most patients had consumed unpasteurized milk and/or dairy products. Eight had a high-risk profession (six herd owners and two butchers), and nine had had systematic contact with sheep and/or goats. A total of 50 cases and five cases were permanent residents of Thassos and Kavala. The data indicate that the disease mainly affects rural areas of the mainland and all cases were either engaged in a high-risk occupation (shepherds, workers in animal husbandry, vets) or sharing unpasteurized milk or dairy products with friends and relatives. No cases in tourists were reported.

Crime/Security/Civil Unrest: Groups opposed to the Greek Government, Greek institutions, Western commercial and diplomatic interests have firebombed government and commercial buildings in Greece.
Violent rioting has taken place in Athens and other Greek cities, including Thessaloniki, since 6 December 2008. The situation remains volatile and further protests could occur. travelers should exercise particular care in central Athens, including the tourist areas of Monastiraki and Plaka.
• Crime: Crime, including pickpocketing and bag snatching, can take place in tourist areas and on public transport. You should exercise caution when walking alone and avoid, where possible, secluded areas after dark.
• A valid driver licence and an international driver licence are both required to legally operate a vehicle in Greece. Driving in Greece can be hazardous due to aggressive driving practices and poorly maintained roads and vehicles.
When travelling by motorcycle or motor scooter, it is a legal requirement that both the operator and any passengers wear a helmet. Failure to do so could invalidate your travel insurance if you are involved in an accident.
• You are legally required to carry identification documents with you at all times. Your passport will meet this requirement.
Source: www.smartraveller.gov.au

Crimean-Congo Hemorrhagic Fever (CCHF): Crimean-Congo hemorrhagic fever is reported. CCHF is caused by a virus and is transmitted by tick bite or by exposure to blood or secretions from infected animals or humans. Anyone who has visited this country and is suffering from a fever, headache, chills, muscle aches, vomiting, red rash (which does not fade when pressed under glass), bleeding on the roof of the mouth, or any other unexplained symptoms should seek medical advice immediately. Risk is seasonal, associated with periods of high tick activity (usually March through September, but seasonal patterns may occur) and increases in tick and rodent host populations.
• All travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions of endemic areas should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.

Hemorrhagic Fever with Renal Syndrome (HFRS): Most cases of this viral illness are reported in the rural mountain regions of northern and northwestern Greece. HFRS is also reported on Crete and the Ionian Islands, including Corfu. Transmission is primarily via aerosolized dried rodent excreta.

Hepatitis: There is a higher risk of hepatitis A in Greece than in western European countries. 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; up to 5% of adults are seropositive for the hepatitis E virus (HEV), but outbreaks have not been reported. Sporadic cases may be 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.
• The hepatitis B (HBsAg) carrier rate in the general population varies from 1% in the northwest to more than 3% in the southeast Mediterranean areas. 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 a low level with a prevalence anti-C antibody of 1.5% 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 November through March. The flu vaccine is recommended for all travelers over age 6 months.

Leishmaniasis: Risk of transmission is highest between May and October. Cutaneous leishmaniasis occurs sporadically, with the highest prevalence on the Ionian Islands and Crete. Visceral leishmaniasis occurs focally on the mainland, including the Athens area, and on the islands, especially Crete. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite mostly in the evening and at night. They breed in ubiquitous places: in organically rich, moist soils (such as found in the floors of rain forests), animal burrows, termite hills, and the cracks and crevices in stone or mud walls, and earthen floors, of human dwellings.
• All travelers should take measures to prevent sandfly 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.

Malaria: There is no risk of malaria in this country. Greece was declared malaria-free in 1986.

Other Diseases/Hazards: Brucellosis (An outbreak of brucellosis was reported from the island of Thassos in June 2008; sheep and goats are the most common sources of infection; also from contaminated dairy products)
• Echinococcosis (Infection with E. granulosus is common in Mediterranean countries, especially in farming areas)
• Legionellosis (reported sporadically, usually in summer tourists)
• Measles
• Q fever (tick-borne)
• Sand fly fever (viral illness, transmitted by mosquitoes; endemic)
• Tick-borne encephalitis (see below)
• Tick-borne relapsing fever (risk in rocky, rural livestock areas)
• Trichinosis
• Worms (helminthic infections - roundworm, hookworm, and whipworm infections reported occasionally from rural areas)

Other tick-borne infections include:
• Mediterranean spotted fever. Also called boutonneuse fever; highest incidence found in farmers in the prefecture of Trikala in northern Greece who have seropositivity rates up to 20%.
• Human granulocytic ehrlichiosis (HGE). This is another tick-borne rickettsial infection. The overall prevalence of antibodies to the HGE agent is about 8% countrywide. HGE is now called human granulocytic anaplasmosis. (http://www.cdc.gov/Ncidod/EID/vol11no12/05-0898.htm)

Rabies: Greece is now officially “rabies-free” for cases of human rabies, as well as rabies in animals. All animal bites, however, should be medically evaluated for post-exposure treatment.

Tick-Borne Encephalitis (TBE): There is a risk of TBE, April through September, in northern Greece, where sporadic cases are reported. The TBE vaccine (available in Canada and Europe), is recommended only for people at significant risk of exposure to tick-bites, for example campers and hikers on extended trips, or forestry workers. The risk to the average tourist is very low.
• Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A map showing the distribution of TBE is here: http://www.nathnac.org/includes/contents/documents/TBEmap.gif
More information on TBE at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/TBE.htm

Travelers' Diarrhea: Low- to medium-risk for acute diarrheal disease. 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: 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 Greece, 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.



West Nile Virus: Between early July and 22 August 2010, 81 cases of West Nile Virus disease were reported in the region of Central Macedonia, northern Greece. The median age of cases was 70 years. Encephalitis, meningoencephalitis or aseptic meningitis occurred mainly in patients aged 50 years or older. This is the first time that West Nile virus (WNV) infection has been documented in humans in Greece. Travelers are urged to take measures to prevent mosquito bites.
Note: WNV is transmitted by night-biting Culex mosquitoes. Culex species also spread filariasis, Japanese encephalitis, St. Louis encephalitis and avian malaria.