Time Zone: -6 hours. No daylight saving time in 2008.
Tel. Country Code: 502
USADirect Tel.: 190
Electrical Standards: Electrical current is 120/60 (volts/hz). North American Style Adaptor Plug. Grounding Adaptor Plug A.
Travel Advisory - Guatemala
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 Guatemala
Provides emergency and other services for American travelers.
Embassy of Canada
HIV Test: Not required.
Required Vaccinations: A yellow fever vaccination certificate is required from travelers over 1 year of age coming from countries with infected or endemic areas.
ENTRY/EXIT REQUIREMENTS: A valid U.S. passport is required for all U.S. citizens, regardless of age, to enter Guatemala and to depart Guatemala for return to the U.S. Even if dual nationals are permitted to enter Guatemala on a second nationality passport, U.S. citizens returning to the United States from Guatemala are not allowed to board their flights without a valid U.S. passport. Certificates of Naturalization, birth certificates, driver's licenses, and photocopies are not accepted by Guatemalan authorities as alternative travel documents. While in Guatemala, U.S. citizens should carry their passports, or a photocopy of their passports, with them at all times.
For further information regarding entry, exit and customs requirements, you can also contact the Guatemalan Embassy at 2220 R Street NW, Washington, DC. Tel. (202) 745-4953.
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 with shared/re-used needles and syringes; from medical treatment with non-sterile (re-used) needles and syringes. Recommended for 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.
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
Guatemalan hospitals are reluctant to give medical treatment unless they can be satisfied that the patient has medical insurance. It is therefore essential that you carry evidence of your insurance cover at all times. State-funded hospitals are on the whole under-staffed, under-funded, ill equipped, and are often unhygienic. We advise the use of private clinics where possible.
A full range of is available in Guatemala City, but medical care outside the city is limited. Guatemala‘s public hospitals frequently experience serious shortages of basic medicines and equipment. Care in private hospitals is generally adequate for most common illnesses and injuries, and many of the medical specialists working in them are U.S. trained and certified.
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; they should bring drugs for malaria prophylaxis, if needed according to their itinerary. 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 aeromedical evacuation to the United States.
The US Embassy maintains a listing of doctors & hospitals
Hospitals used by travelers include:
Hospital Herrera Llerandi
6a. Avenida 8-71
Hospital Centro Médico
6a, Avenida 3-47
CEDROS DE LIBANO
8a. Avenida 2-48
Destination Health Info for Travelers
AIDS/HIV: Although HIV prevalence (the percentage of a population living with HIV) in Latin American countries is relatively low compared to the rates found in many parts of Africa, the number of people affected is still substantial. What is more, the situation is likely to get worse in many Latin American countries. No country in the region has experienced a significant drop in HIV prevalence, and it is projected that the total number of people living with HIV in Latin America will increase in coming years.
The most severe epidemics are found in smaller countries such as Honduras and Belize, which have HIV prevalence rates of 1.5% and 2.5% respectively. The majority of countries in the region have prevalence rates of less than 1%, but the prevalence among specific groups, such as men who have sex with men and sex workers, is often very high. In Guatemala, 0.9% of the adult population is living with HIV/AIDS. (Source: www.Avert.org)
• 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 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.
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.
Angiostrongyliasis: This infection is caused by larvae of the roundworm A. costaricensis contaminating raw or unwashed vegetables, salads, mint, or fruits. Contamination is from the mucous secretions of infected slugs, the intermediate host. After ingestion, the larvae penetrate through the intestinal wall and migrate to the arteries and arterioles of the ileocecal region, causing a severe eosinophilic entercolitis, mimicking acute appendicitis. Human infection occurs predominantly in Central and South America, from southern Mexico to Argentina.The incidence of disease is highest from September through November, during the rainy season when the slug population is at its peak.
Chagas’ Disease: This disease is endemic with about 5% of the population seropositive for exposure to the disease. The risk of transmission occurs primarily in those rural-agricultural areas where there are adobe-style huts and houses that often harbor the night-biting triatomid (assassin) bugs. Travelers sleeping in such structures should take precautions against nighttime bites, which typically occur on the face of the sleeping victim.
• Other methods of transmission are possible, from; consumption of food or juice (especially sugar cane juice and acai palm juice) contaminated with crushed triatome insects; from blood transfusions; from fetal transmission.
Cholera: This disease is sporadicslly active in this country, but the threat to tourists is low. Only 13 cases were reported for the year 2001 and only one for 2002. Cholera is a rare disease in travelers from developed countries. Cholera vaccine is usually recommended only for people, such as 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 don’t 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.
Crime/Security/Civil Unrest: Guatemala has one of the highest crime rates in Central America. Violent crime, often involving the use of firearms, including murder, kidnapping, assault, rape and robbery continues to increase, including in the Tikal National Park, Antigua, Cerro de la Crus (outside Antigua), Volcan de Pacaya, at Biotopo Cerro Cahui and in Izabal Department. Victims have been injured when resisting perpetrators. Gangs are a growing concern throughout Guatemala. To minimise risks, you should avoid public transport or walking alone, especially after dark. Use of a reputable tour company or tour organiser may reduce risks associated with travel in remote areas.
We advise you to be particularly cautious and check with local authorities if considering travel to tourist destinations Rio Dulce and Livingstone in Izabal Department in the central west of Guatemala. Tensions remain in the long running dispute between the indigenous people and the Guatemalan authorities. Kidnapping of foreigners has been used, as recently as March 2008, as a way to draw attention to the indigenous cause.
Criminals have targeted tourists traveling from the international airport to hotels in Guatemala City. If possible, you should schedule arrival at La Aurora Airport (Guatemala City) during the day or early evening. Avoid displaying valuable items such as cameras and mobile phones. Laptops are frequently targeted, so carry them inconspicuously in a backpack or other carry-on luggage.
• Violent carjackings continue to occur, particularly on poorly maintained roads and on parts of the Pan-American Highway. Inter-city buses, including luxury coaches, have been forced to stop by criminal gangs who then rob and/or sexually assault passengers. Highway robberies occur frequently, particularly in the Peten region of northern Guatemala and areas near the El Salvador and Honduras borders. Robberies may be accompanied by violence.
Sexual assault, extortion and robbery have been committed by persons posing as police officers, sometimes driving automobiles resembling police vehicles.
• Petty crime including pick-pocketing and bag-snatching is common in major cities and tourist areas, including airports and bus terminals. You should take particular care in and around the Central Markets and in Zone 1 in Guatemala City and in the city of Antigua. You should avoid traveling in Zone 1 in Guatemala City after dark. Scams target tourists to steal money and other possessions. You should be vigilant at all times.
• Cross land borders to Guatemala with care. Violent armed robberies have occurred when travelers entering Guatemala have changed large amounts of cash at a land border crossing. Allow time for border crossing formalities in order to arrive in a major town before dark. Many border posts close for lunch and at dusk.
• Using ATMs on the street puts you at high risk of robbery. Changing money at hotels or using ATMs in shopping centres or department stores may reduce this risk. Do not withdraw too much at any one time and avoid withdrawing money at night.
Dengue Fever: Risk occurs year-round countrywide in urban areas at lower elevations; outbreaks occur annually. More than 1400 cases were reported during the first half of 2007, 20% more than during the same period in 2006. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in Latin America. 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.
Dengue fever map of risk areas worldwide
Hepatitis: All travelers not previously immunized against hepatitis A should receive the vaccine. Hepatitis A is transmitted through 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 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 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 at a low level with a prevalence of 0.7% 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.
Leishmaniasis: Cutaneous leishmaniasis is reported occurring in northern departments, especially in the forested areas in Peten Department. Limited risk of visceral leishmaniasis occurs in the semiarid valleys and the foothills of east-central Guatemala in the Department of El Progresso.
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: Risk exists year-round countrywide below 1,500 meters elevation. There is a higher risk in the northern and western regions of Alta Verapaz, Baja Verapaz, Peten and San Marcos. P. vivax accounts for 97% of cases.
A malaria outbreak was reported from Chiquimula District in December 200`4, chiefly affecting the villages of Santa Barbara and Colonia El Maestro, the hamlet of El Jurgallon, and the colonias Lomas.
• Chloroquine prophylaxis is recommended for travel to all rural areas below altitude 1500 m (4900 feet), except Antigua and Lake Atitian. Take chloroquine, once weekly, in a dosage of 500 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after your departure.
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.
Onchocerciasis: Risk occurs near fast-flowing rivers between 300 and 1,600 meters elevation in the Pacific coast foothills and along the border with Mexico in the south. Travelers to these areas should take measures to prevent insect (blackfly) bites.
Other Diseases/Hazards: Angiostrongyliasis (Angiostrongylus costaricensis, a nematode that infects several species of rodents, e.g., cotton rats, causes human abdominal angiostrongyliasis in Guatemala and other Latin America and Caribbean countries. Infective nematode larvae are transmitted by consumption of raw or undercooked intermediate hosts - snails, slugs, prawns, and vegetables contaminated by their secretions; symptoms may mimic acute appendicitis with abdominal pain and fever; marked eosinophilia is a feature of this disease)
• Anthrax, brucellosis (from unpasteurized dairy products and infected slaughtered animals)
• Chagas’ disease (endemic in many rural areas)
• Cyclosporiasis (seven confirmed cases in Spanish tourists reported in 2006; contaminated raspberry juice was suspected)
• Paralytic shellfish poisoning (an outbreak of paralytic shellfish poisoning occurred in Champerico, on the Pacific coast of Guatemala, in 1987)
• Tick-borne relapsing fever
• Hookworm and other helminthic infections
• Murine typhus (low incidence)
• Venezuelan equine encephalitis and Eastern equine encephalitis (both mosquito-transmitted)
Rabies: Sporadic cases of human rabies are reported countrywide. Pre-exposure rabies vaccine is recommended for: travel longer than 3 months; for shorter stays in rural when travelers plan to venture off the usual tourist routes and where they may be more exposed to the stray dog population; when travelers desire extra protection; or when they will not be able to get immediate medical care.
• All animal bite wounds, especially from a dog, should be thoroughly cleansed with soap and water and then medically evaluated for possible post-exposure treatment, regardless of your vaccination status. Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Even if rabies vaccine was administered before travel, you will need a 2-dose booster series of vaccine after the bite of a rabid animal.
Travelers' Diarrhea: High risk. 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.
Cryptosporidiosis is reported. See Other Diseases/Hazards (above)
Tuberculosis: Tuberculosis is highly endemic in Guatemalwith 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 vaccine is recommended for all people traveling to or working in Central 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. Travelers should practice strict food, water and personal hygiene precautions even if vaccinated.
Yellow Fever: Not active at this time. Yellow fever vaccine is required for all travelers over one year of age arriving from a yellow-fever-infected country in Africa or the Americas, but is not recommended or required otherwise.