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Honduras



Capital: Tegucigalpa

Time Zone: -6 hours. No daylight savings time in 2008.
Tel. Country Code: 504
USADirect Tel.: 800
Electrical Standards: Electrical current is 110/60 (volts/hz). North American Style Adaptor Plug. Grounding Adaptor Plug A.

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Embassies


U.S. Embassy and Consulate location:
Avenida La Paz in Tegucigalpa
Honduras
Tel: [504] 236-9320 or 011-504-238-5114
Website: http://honduras.usembassy.gov/
For information on services for U.S. citizens, please ask for ext. 4400.
American Citizens Services Unit
Fax: [504] 238-4357
Consular Agency in San Pedro Sula location:
Banco Atlantida Building – 11th Floor
San Pedro Sula, Honduras
Tel: [504] 558-1580

For more details about all U.S. Embassy and consular services in Honduras, please see the Embassy website at http://honduras.usembassy.gov/ or visit the Bureau of Consular Affairs website at http://travel.state.gov/

• Canadian Embassy: There is no local representation. Travelers should contact the Canadian Embassy in Costa Rica.

La Sabana Executive Business Centre
Building No. 5, 3rd Floor
Centro Colón
San José
Costa Rica
Tel: [506] 242-4400
Fax: [506] 242-4410
Website: http://geo.international.gc.ca/latin-america/sanjose/menu-en.aspx

• There is no British Embassy in Honduras. For emergency consular assistance, contact the Honorary Consuls in Tegucigalpa, San Pedro Sula, Roatan or the British Embassy in Guatemala City.

• British Embassy
Edificio Torre Internacional
16 Calle 0-55, Zona 10
Guatemala City
Tel: [502] 2367 5425,6,7,8,9
Email: embassy@intelnett.com (General enquiries)
consular.guatemala@fco.gov.uk (Consular enquiries)
Website: www.britishembassy.gov.uk/guatemala

Entry Requirements

HIV Test: Not required.

Required Vaccinations: Yellow fever vaccination certificate is required for all travelers arriving from any country in the yellow fever endemic zones in Africa or the Americas.

Passport Information

Passport/Visa: ENTRY/EXIT REQUIREMENTS: A U.S. passport valid for at least three months from the date of entry is required to enter Honduras. Though not required by law, some travelers have reported difficulty departing Honduras using a passport with less than three months of validity beyond the date of departure. A visa is not required, but tourists must provide evidence of return or onward travel. Parents should not rely on birth certificates for their childrens travel; rather, prior to travel they should obtain U.S. passports for infants and minors born in the U.S. U.S. citizens are encouraged to carry a photocopy of their U.S. passports with them at all times, so that if questioned by local officials proof of identity and U.S. citizenship are readily available.
For more information concerning entry and exit requirements, travelers may contact the Embassy of Honduras at 3007 Tilden Street N.W., Washington, D.C. 20008, telephone (202) 966-7702, or a Honduran consulate in Atlanta, Boston, Chicago, Houston, Jacksonville, Los Angeles, Miami, New Orleans, New York, Phoenix, San Francisco, San Juan or Tampa. The Honduran Embassy e-mail address is embhondu@aol.com
Interested individuals may visit the Honduran Embassy website for additional contact information through http://www.hondurasemb.org/. 

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.
• 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.

Yellow Fever: Yellow fever vaccine is required for all travelers arriving from any country in the yellow fever endemic zones in Africa or the Americas. Not recommended or required otherwise.

Hospitals / Doctors

Medical care in Honduras varies greatly in quality and availability. Outside Tegucigalpa and San Pedro Sula, medical care is inadequate to address complex situations. Support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in Honduras. Facilities for advanced surgical procedures are not available. Wide areas of the country, including the popular tourist areas of the Bay Islands, do not have a general surgery hospital.
• 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; may be counterfeit; 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. In the event of a serious illness or injury that can't be treated adequately in this country, the traveler should be flown by air ambulance to Miami or Houston for emergency care.

The U.S. Embassy maintains a list of hospitals at: http://honduras.usembassy.gov/english/mission/sections/hospitals.pdf

There is a fully operable hyperbaric decompression chamber on Roatan (http://www.scuba-doc.com/divhond.htm) and there are decompression facilitates on the Bay Island of Utila (http://www.utilalodge.com/html/hyperbaric_chamber.html). However, you should be aware that medical facilities on the Bay Islands are extremely limited in the event of an emergency.

Medical facilities used by travelers include:

• Hospital Viera Barrio La Ronda
5 Calle, 11-12 Ave.
Tegucigalpa
Tel: [504] 238-0736, 238-0697

• Hospital Centro Medico Hondureño
3ra Avenida Nro 202
Barrio La Granja
Tegucigalpa
Tel: [504] 225-0028

• Hospital La Policlinica
3a Ave. Entre 7 y 8 Calles
Tegucigalpa
Tel: [504] 237-3211/12/13
24-hour service.

• Hospital Leonardo Martinez
Tegucigalpa
Tel: [504] 554-3410
General medical/surgical facility; most specialties.

• Hospital Escuela
Tel: [504] 232-2322
Tegucigalpa
Most specialties; ER, ICU.

• Centro Medico Cemesa
Col. Altmira Blvd. del Sur
San Pedro Sula
Tel: [504] 556-7401
Modern treatment and diagnostic facility; CT scanning and MRI capability; new outpatient building located on the hospital grounds.

Destination Health Info for Travelers

AIDS/HIV: Honduras has the highest incidence of HIV/AIDS in Central America, outside of Belize. It is estimated that 1.5% of the adult population, age 15–29, is infected with HIV. More than half of Latin Americans living with HIV reside in the four largest countries of the region: Brazil, Columbia, Mexico and Argentina. 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 (MSM) and commercial sex workers, is often very high. In almost every Latin American country, the highest levels of HIV infection are found amongst MSM. This problem is largely hidden, since homophobia and a machismo culture are common throughout the region and sex between men is highly stigmatized. The extent of HIV infection amongst MSM is downplayed in many countries, and prevention campaigns often neglect this group. (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.

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.
• 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.

Chagas’ Disease: There is a very low risk to travelers, but slightly increased in the southern half of the country, especially in the Tegucigalpa area. 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, including; consumption of food or juice (especially sugar cane juice and acai palm juice) contaminated with crushed triatome insects; blood transfusions; in-utero transmission.

Cholera: This disease may be sporadically active in this country but the threat to tourists is low. 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: The highest number of cases is usually reported in the hot season from May to November. In 2008, there was a marked increase in the number of reported cases of dengue across the region. Multiple outbreaks occurred throughout 2007 with close to 30,000 cases reported. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in Central America and the Caribbean and is the most common cause of fever in travelers returned from this region. Most cases in Honduras have occurred in the Central District, which includes the capital city of Tegucigalpa, followed by the departments of Cortez, in the north along the Guatemalan border, and El Paraiso y Olancho, both in the eastern part of the country, along the Nicaraguan border.
• Dengue is transmitted via the bite of an infected Aedes aegypti mosquito. Aedes mosquitoes feed predominantly during daylight hours. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash.
• 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 permethrin spray or solution to clothing and gear. Sleeping under a permethrin-treated bednet at night is also recommended to reduce exposure to malaria.
A dengue fever map is at: http://www.nathnac.org/ds/c_pages/documents/dengue_map.pdf

Food & Water Safety: The diseases of greatest risk throughout the region, in both rural and urban areas, are bacterial diarrhea, hepatitis A, and typhoid fever associated with contaminated food, water, and/or ice. Do not consume any food, water, or beverages (to include bottled water) that may be contaminated. Assume all food, ice, and water outside of hotels and resorts is potentially contaminated. Water and food items available in this region, including dairy products, fish, fruits, and vegetables, may contain unsafe levels of pesticides, chemical fertilizers, bacteria, and viruses. Contamination with human or animal waste is widespread. Even a one-time consumption of these foods or water may cause severe illness.

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 with a 6% seroprevalence in the population. Sporadic cases and possibly outbreaks occur. (http://www.ncbi.nlm.nih.gov/pubmed/9660454) Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. Farm animals may serve as a viral reservoir. 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 3% 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 with a prevalence of 0.1% 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 and mucocutaneous leishmaniasis is widespread in rural areas, with elevated risk in the northern one-half and western one-third of the country. Visceral leishmaniasis has been reported on Tigre Island and in southern rural areas.
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 of malaria occurs year-round in rural areas below 1,000 meters elevation, including the municipalities of Tegucigalpa and San Pedro Sula. Most cases occur in the coastal lowlands along the border with Nicaragua. P. vivax accounts for 97% of reported cases. Falciparum malaria may occur along the Nicaraguan border and in the Caribbean coastal region, but chloroquine-resistant P. falciparum has not been reported. Chloroquine prophylaxis is recommended in malarious areas, including Ceiba, Tela, and Roatan and other Bay Islands.

A malaria map is located on the Fit for Travel website (www.fitfortravel.nhs.uk), 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 Honduras page on the Destinations menu.
Another malaria map is at: http://www.paho.org/Images/Hcp/HCT/malaria_13.gif

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.

Marine Hazards: Swimming related hazards include jellyfish, spiny sea urchins, and coral.
• Ciguatera poisoning is prevalent and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.

Other Diseases/Hazards: Brucellosis (limited risk in cattle raising areas; associateds with unpasteurized dairy products)
• Coccidiomycosis
• Cysticercosis
• Encephalitis (Venezuelan equine and Eastern equine)
• Leptospirosis
• Measlesmelioidosis
• Myiasis (caused by human bot fly)
• Paragonimiasis (oriental lung fluke)
• Tick-borne relapsing fever
• Strongyloidiasis and other helminthic infections.

Rabies: Update 2011: A vaccination campaign of animals is being advanced to prevent the risk of spreading rabies. Upon detection of a case of rabies in El Progreso, Yoro, authorities in the Health Region of the Department of Cortez number 5 have decided to advance the vaccination of dogs in the municipalities near the city to avoid the risk of spreading the disease. Travellers need to be careful to avoid contact with mammals in at risk countries.

Honduras has one of the highest incidences of animal (dog) rabies in Latin America. Sporadic cases of human rabies are reported countrywide. Pre-exposure rabies vaccination is recommended for extended travel to rural areas where there is an increased the risk of animal bites, or where travelers are far from a source of medical care. Transmission may occur following contact with the saliva from an infected wild or domestic animal, most often via a bite or lick to an open wound. Bats may also transmit rabies. Risk of exposure is increased by type of activity (e.g. running, cycling in rural areas), and longer duration of stay. All children should be warned to avoid contact with unknown animals. Children are at higher risk because they may not report a bite.
• 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.

Travelers' Diarrhea: High risk. Honduras is the least-developed country in Central America and has inadequate treatment and distribution systems for piped water. Tap water is not considered potable. 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: Tuberculosis is highly endemic in Honduras 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. Typhoid vaccine is recommended by the CDC for all people (except short-stay visitors and cruise ship passengers) 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, 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: Yellow fever is not active. Vaccination is required only for travelers coming from infected areas.