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Guinea-Bissau



Capital: Bissau

Time Zone: 0 hours. No daylight savings time 2008.
Tel. Country Code: 245
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.

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

Embassies

U.S. Embassy, Bissau. Avenida Domingos Ramos. Tel. 21-2816, 21-3674. Canadian Embassy (Senegal). Tel. [221] 21-0290.

Entry Requirements

• Passport/Visa: Valid passport and visa are required.

• HIV Test: Not required.

• Vaccinations: A yellow fever vaccination certificate is required from all travelers arriving from infected areas and from all countries in the Yellow Fever Endemic Zones, including Cape Verde, Djibouti, Madagascar, and Mozambique.

Passport Information

Simao Mendes National Hospital, Bissau (100 beds); general medical/surgical facility; orthopedics, emergency services. 

Hospitals / Doctors

Simao Mendes National Hospital, Bissau (100 beds); general medical/surgical facility; orthopedics, emergency services.

Destination Health Info for Travelers

AIDS/HIV: Heterosexual contact is the predominate mode of transmission. HIV-2 is currently the
predominate infection with up to 10% of the urban population being seropositive. Highest
seroprevalence rates are found in high-risk groups, such as female prostitutes. All travelers are cautioned against unsafe sex, or receiving unsterile medical or dental injections.

African Sleeping Sickness (Trypanosomiasis): Sporadic cases were reported in the 1980s. Low-level transmission probably occurs in the coastal and northcentral areas. 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

Cholera: This disease is active. A widespread cholera outbreak was reported from Guinea-Bissau in May 2008. Most travelers are at low risk for infection. 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)

Hepatitis: High risk. 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 >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 but prevalence is unclear. 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.

Malaria: Risk is present year-round throughout this country, including urban areas. Increased risk occurs during and immediately after the rainy season, June through October. P. falciparum accounts for 90% of cases, the remainder being due to P. malariae and P. ovale. Chloroquine-resistant falciparum malaria is reported. Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), or doxycycline is currently recommended when traveling to malarious areas.

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: Picaridin repellents (20% formulation, such as Sawyer Picaridin 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.
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.


Meningitis (Meningococcal): An outbreak of meningococcal meningitis that affected almost the entire country occurred from January to March 1999. Quadrivalent meningitis vaccine is recommended for those travelers anticipating living or working with local people, or if a current outbreak is reported. The risk is greatest in the dry season, but these may vary within a country and from year to year. The dry season in West Africa is usually between November-May/June. In East Africa, seasons are variable.

Onchocerciasis: Risk occurs near fast-flowing rivers, where black flies transmit this disease.

Other Diseases/Hazards: African tick typhus (transmitted by dog ticks, often in urban areas, and bush ticks)
• Brucellosis (from consumption of raw dairy products)
• Filariasis
• Lassa fever (risk undetermined)


Rabies: Human cases have been reported countrywide from both urban and rural areas, but exact incidence is not known. 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.

Schistosomiasis: Urinary schistosomiasis occurs in the northern half of Guinea Bissau, extending from the coastal region of Cacheau to the border with Guinea, including the valleys of the Cacheau and Geba River basins.
• 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' Diarrhea: High risk. All water sources should be considered potentially contaminated. Potable water is accessible to only 30%–40% of the population. 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 and fish. 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.

Yellow Fever: Vaccination is recommended. No cases are recently reported, but yellow fever is active in neighboring Guinea. Guinea-Bissau is in the Yellow Fever Endemic Zone. Yellow fever vaccine is recommended for all travelers greater than nine months of age. The vaccine is required for all travelers greater than one year of age arriving from a yellow-fever-infected country in Africa or the Americas.