Time Zone: -4 hours. No daylight savings time in 2008.
Tel. Country Code: 592
USADirect Tel.: 159
Electrical Standards: Electrical current 110/60 (voltz/hz). North American Style Adaptor Plug. Grounding Adaptor Plug A, C, F.
TRAVEL ADVISORY - GUYANA
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.
• U.S. Embassy
100 Young and Duke Streets
Tel:  225-4900 through 225-4909
Hours of operation are Monday-Friday, 7:30 am to 4:00 pm, except local and U.S. holidays. For emergencies after hours, on weekends and on holidays, U.S. citizens are requested to call the U.S. Embassy duty officer at 011-592-623-1992.
• Canadian Embassy
High Commission of Canada
High and Young Streets
Tel: [592) 227-2081; 227-2082
• British High Commission
44 Main Street
 226 5881
 226 5882
HIV Test: Not required.
Required Vaccinations: A yellow fever vaccination certificate is required of all travelers >9 months of age arriving from yellow fever infected area. Required also for travelers arriving from:
• Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Gabon, Gambia, Ghana, Guinea, Guinea- Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, São Tomé and Principe, Senegal, Sierra Leone, Somalia, Tanzania, Togo, and Uganda.
• Americas: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guatemala, Honduras, Nicaragua, Panama, Peru, Suriname, and Venezuela.
Passport/Visa: Guyana is a developing nation on the north coast of South America. Tourist facilities are not developed, except for hotels in the capital city of Georgetown and a limited number of eco-resorts. The vast majority of the Guyanese live along the coast, leaving the interior largely unpopulated and undeveloped. Travel in the interior of Guyana can be difficult; many interior regions can only be reached by plane or boat.
ENTRY/EXIT REQUIREMENTS: A valid U.S. passport is required for U.S. citizens to enter and depart Guyana. On arrival, Guyanese Immigration normally grants U.S. visitors a stay of up to 3 months. U.S.-Guyanese dual nationals may be granted an indefinite stay. Extensions of stay may be obtained from the Ministry of Home Affairs at 60 Brickdam Street, Georgetown. The Central Office of Immigration located on Camp Street, Georgetown, must note the extension in the visitor's passport. Travelers for purposes other than tourism should check with the Ministry of Home Affairs for information about requirements for work permits and extended stays. U.S.-Guyanese dual nationals departing Guyana for the U.S. using a Guyanese passport must present to Guyanese authorities a U.S. Certificate of Naturalization or other document establishing that they may legally enter the United States. For further information about entry, exit and customs requirements, travelers may consult the Embassy of Guyana at 2490 Tracy Place NW, Washington, DC 20008, telephone (202) 265-6900, the Consulate General in New York, or honorary consuls in California, Florida, Ohio and Texas.
Visit the Embassy of Guyana web site at www.guyana.org for the most current visa information.
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; when receiving medical or dental injections, or unscreened blood transfusions; by direct contact between open skin lesions. 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.
Yellow Fever: Yellow fever vaccination is required for travelers arriving from a yellow-fever-infected area in Africa or the Americas. Vaccination is recommended for all travelers >9 months of age.
HOSPITALS / DOCTORS
Medical care is available for minor medical conditions. Emergency care and hospitalization for major medical illnesses or surgery is limited, due to a lack of appropriately trained specialists, below standard in-hospital care, and poor sanitation.
Most hospitals provide a 24-hour Emergency Room service. The standard of care varies widely, due to lack of trained and qualified nursing and maintenance staff. There are very few qualified and experienced nurses at the hospitals. Specialist doctors are very few and soemtimes there is no qualified specialists are available. CAT scan facilities are available but time is lost waiting for the interpretations to come back from a U.S facility.
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 be of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance transport. In the event of a serious illness or injury that can't be treated locally, every effort should be made to arrange medical evacuation to Miami or other United States location.
Medical facilities used by travelers include:
• St. Joseph Mercy Hospital
130-132 Parade Street
Tel:  227-2073,4,5
This hospital is located virtually next door to the Embassy at 130 Parade St., Kingston. It has one hundred and twenty-four beds (124) beds. There is a 24-hour emergency room (ER) staffed by a physician and RN. Specialists are available on call from their homes. The 4-bed Intensive Care Unit (ICU) has has very basic equipment. The hospital offers Medical, Surgical and Obstetric care including diagnostic Ultrasound. This facility is used by Embassy personnel.
• Georgetown Public Hospital
Tel:  227-8232/8204-9
Main referral hospital (600 beds) in Guyana.
• Davis Memorial Hospital
121 Durban Street Lodge
Tel:  227-2041-3
Used by Embassy personnel.
DESTINATION HEALTH INFO FOR TRAVELERS
AIDS/HIV: Due largely to their close geographic locations, the Caribbean is usually grouped with Latin America in discussions about HIV and AIDS, but the epidemics in these regions are very different. Even within the Caribbean, each country faces a unique situation. The diversity of the region – which is apparent in terms of politics, languages spoken, geographic location and wealth – is reflected in the significantly different ways that countries are affected.
At one extreme, Haiti has the highest HIV prevalence in the entire western hemisphere (3.8%); at the other, Cuba has one of the lowest (0.1%). The Bahamas (3.3%), Trinidad and Tobago (2.6%) and Guyana (2.4%) are all heavily affected, while Puerto Rico is the only Caribbean country apart from Cuba where it is thought that less than 1% of the population is living with HIV.
There are signs that the epidemic is receding in parts of Jamaica, Barbados and the Bahamas. In Trinidad and Tobago, Suriname and Guyana, however, there are no signs that the spread of HIV is slowing. Furthermore, HIV surveillance in the Caribbean is generally considered inadequate, so these reported trends are only vague indicators. Both HIV prevalence and AIDS cases are thought to be widely underestimated in the region.
Reflecting global patterns, heterosexual sex is now the main route of transmission throughout the region, and it has been established that women and young people are particularly vulnerable. Little is known about the role that sex between men plays in the region’s epidemics – it has been estimated that men who have sex with men account for 12% of infections, but it is thought that the actual proportion is higher than this, since the rampant homophobia that exists throughout the region has led to denial and under-reporting.
Despite differences between countries, the spread of HIV in the Caribbean has taken place against a common background of poverty, gender inequalities and a high degree of HIV-related stigma. Migration between islands and countries is common, contributing to the spread of HIV and blurring the boundaries between different national epidemics. Additionally, poor availability of HIV and AIDS data makes it difficult to gain a clear picture of each country’s situation. Source: 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 the body fluids 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.
Cholera: This disease is reported active in this country, but the threat to tourists is very low. Cholera is a rare 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)
Dengue Fever: Outbreaks of dengue fever occurs sporadically throughout Guyana. In 2007 there was a marked increase in the number of reported cases of dengue across the region. There have been numerous cases of dengue in recent months in Georgetown and the interior. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in the Caribbean and is the most common cause of fever in travelers returned from this region. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash.
• Dengue is transmitted via the bite of an infected Aedes aegypti mosquito. Aedes mosquitoes feed predominantly during daylight hours. All travelers 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 dengue.
Filariasis: Bancroftian filariasis is endemic in Georgetown and other cities in the coastal plain, with up to 10% of the population infected. Travelers should take standard precautions to prevent 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 is endemic, but levels are unclear. Sporadic cases probably 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.
• Hepatitis B is hyperendemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 2% to 7%. 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 the levels are 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.
Leishmaniasis: Outbreaks of cutaneous leishmaniasis have occurred in military personnel. Most cases are acquired in the interior forests and savanna areas in the northeast. Visceral leishmaniasis not reported. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite in the evening and at night and are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• 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.
Leptospirosis: An outbreak of leptospirosis was reported from Guyana in February 2005, following widespread flooding. Leptospirosis is transmitted to humans by exposure to water contaminated by the urine of infected animals. Outbreaks often occur at times of flooding, when sewage overflow may contaminate water sources. Doxycycline is an effective prophylactic drug.
• Leptospirosis is a bacterial disease caused by contact with urine excreted by infected mammals primarily through skin abrasions, open wounds or mucous membranes. Patients commonly present with a flu-like illness with high fever, headache, muscle pains, red eye, sore throat and rash.
Malaria: Malaria occurs year-round in all regions below 900 meters elevation. There is a high risk of malaria in all interior regions of Guyana, and a low risk in Georgetown and the coastal region. Increased transmission occurs during and just after the rainy seasons (May through mid-August and November through January). Falciparum malaria accounts for 60% of cases, vivax 40%.
• Failure of combined chloroquine and high-dose primaquine therapy for Plasmodium vivax malaria acquired in this country is reported. Read more: http://www.ajtmh.org/cgi/content/abstract/56/2/231
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine (G6PD test rquired) is recommended in malarious areas.
A malaria map is located on the Fit for Travel website, which is compiled and maintained by experts from the Travel Health division at Health Protection Scotland (HPS). Go to www.fitfortravel.nhs.uk and select Malaria Map from the Guyana page on the Destinations menu or A-Z Index.
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.
Other Diseases/Hazards: Chagas’ disease (very low prevalence in the northwest district)
• Mansonellosis (black-fly borne)
• Onchocerciasis (river blindness; regionally endemic)
• Schistosomiasis (not reported, but occurs in neighboring Suriname)
• Strongyloidiasis and other helminthic infections are reported.
Animal hazards include snakes (vipers), centipedes, scorpions, black widow spiders, brown recluse spiders, banana spiders, pruning spiders, and wolf spiders. Electric eels and various carnivorous fish (including piranha) may be found in this country’s fresh waters. Portuguese man-of-war, sea wasps, and stingrays are found in the coastal waters and could be a hazard to swimmers.
Rabies: 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 outside of first-class hotels and resorts. 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 milk and dairy products. Do not eat raw or undercooked food.
Peel all fruits.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
• A quinolone antibiotic, azithromycin, or rifaximin (Xifaxin), 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.
Tuberculosis (TB): Tuberculosis is highly endemic in Guyana with 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 fever is the most serious of the Salmonella infections and is present throughout Guyana. Typhoid vaccine is recommended by the CDC for all unvaccinated people traveling to or working in South 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, 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.
Yellow Fever: No recent cases have been reported. The CDC recommends yellow fever vaccination for all travelers >9 months of age. Guyana requires travelers arriving from countries where yellow fever is present to present proof of yellow fever vaccination.