Time Zone: +3.5 hours. GMT +1 hour daylight savings time.
Tel. Country Code: 98
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
Travel Advisory - Iran
There is a low risk of malaria in North Africa and the Middle East, but other insect-transmitted diseases, such as leishmaniasis and viral infections, are potential threats. Safe water precautions, safe needle, and insect-bite prevention measures are important.
Dr. Rose Recommends for Travel to Iran
The U.S. government does not maintain diplomatic relations with Iran. American interests are represented by the Swedish Embassy; Tel:  675-011 or 675-020.
• Embassy of Canada
57 Shahid Sarfaraz Street
Ostad Motahari Avenue
Tel:  (21) 8152-0000
• British Embassy
198 Ferdowsi Avenue
Tel:  (21) 66705011/7
HIV Test: HIV Test: Not required.
Required Vaccinations: A yellow fever vaccination certificate is required from travelers if traveling from an endemic zone country.
Passport/Visa: Iran is a constitutional Islamic republic with a theocratic system of government where ultimate political authority is vested in a learned religious scholar, the Supreme Leader. Shia Islam is the official religion of Iran, and Islamic law is the basis of the authority of the state. The Iranian Constitution guarantees freedom of worship to Jews, Christians and Zoroastrians, though they are sometimes the subject of discrimination and repression. The workweek in Iran is Saturday through Thursday; however, many government offices and private companies are closed on Thursdays. Friday is the day of rest when all establishments are closed. Offices in Iran are generally open to the public during the morning hours only. Read the Department of State Background Notes on Iran for additional information.
ENTRY/EXIT REQUIREMENTS: Should you decide to travel to Iran despite the current Travel Warning, a passport and visa are required. To obtain a visa, contact the Iranian Interests Section of the Embassy of Pakistan located at 2209 Wisconsin Ave. NW, Washington, DC. 20007; tel 202-965-4990, 91, 92, 93, 94, 99, fax 202-965-1073, 202-965-4990 (Automated Fax-On-Demand after office hours). Their Internet website is http://www.daftar.org/Eng/default.asp?lang=eng. U.S. citizens do not have to obtain a visa for travel from Dubai to Kish Island.
The Iranian press has reported that foreign tourists may obtain seven-day tourist visas at the airport in Tehran. However, U.S. citizens are strongly encouraged to obtain valid visas in advance to avoid delays and/or interrogation, as well as to reduce the prospect of denial of entry at the airport. Note: possession of a valid Iranian visa will not guarantee entry into the country. Some American travelers with valid visas have been refused entry at the border without explanation.
U.S. passports are valid for travel to Iran.
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; from acupuncture, tattooing or body piercing; when receiving non-sterile medical or dental injections, or unscreened blood transfusions; by direct contact with open skin sores on an infected person. Recommended for long-term travelers, expatriates, and 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.
Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).
Rabies: Recommended for travelers spending time in remote locations, or 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 additional treatment with rabies 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: A yellow fever vaccination certificate is required from travelers coming from areas with risk of yellow fever transmission. Not required or recommended otherwise.
Hospitals / Doctors
Medical facilities are reasonable in the major cities in Iran but poor in remote areas. Local medical facilities are substantially below Western standards and should be used by U.S. citizens only in the case of emergency.
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 of dubious origin; 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.
• Tehran University of Medical Siences
Tel:  (21) 889 53001
• Day General Hospital
Vali Asr Avenue
Tel:  (21) 879 7111
• Behzad Djazaeri, M.B., B.Ch
M.Ch. University of Wales
Consultant general and vascular surgeon
Day Medical Center
1225 Valiasr Avenue
Tel:  (21) 8888-6197
• Iamat Center
Tel:  (21) 655 128
Hospitals outside Tehran:
• Alzahra Hospital
Hezar Jarib Avenue
Tel:  31 169 2180
• Chamran Hosptial (cardiology)
2nd Moshtagh Avenue
Tel:  31 160 0961/5
• Dena Hospital
Tel:  71 162 8041/2
Destination Health Info for Travelers
AIDS/HIV: It is feared that the situation regarding HIV/AIDS in Iran may be more serious than generally realized. The main concern of the government is the potential spread of infection from injecting drug users to the general population. The strategic geographic situation of Iran and its long common borders with the countries of the Golden Crescent (Afghanistan and Pakistan), which produce a substantial proportion of the world’s heroin, have confronted Iran with the problems of drug trafficking and concomitant drug addiction within the country. Drug addiction is affecting not only the drug users, but also their families, especially women and children. According to the latest observations, many drug-using men return home from prison with HIV/AIDS and the wives of such men are at very high risk of contracting HIV. The prevalence in adults (15 to 49) living with HIV/AIDS is currently 0.3% or less of the population. (Source: Medical Women’s International Association.)
• 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.
• 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.
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.
Avian Influenza (Bird Flu): In November 2005 the Iranian authorities have confirmed outbreaks of Avian Influenza (Bird Flu) in wild swans in Anzali Wetlands and in domestic poultry in the northern Iranian provinces of Azarbaiyan and Gilan. The World Health Organisation (WHO) have also confirmed cases elsewhere in the region, although there have been no human infections or deaths reported.
• H5N1 avian influenza is predominantly a disease of birds. The virus does not pass easily from birds to people and does not to pass from person to person (except in very rare cases of close contact with an infected blood relative).
• The risk to humans from avian influenza is believed to be very low and no travel restrictions are advised, except travelers should avoid visiting animal markets, poultry farms and other places where they may come into close contact with live or dead poultry, or domestic, caged or wild birds and their excretions. In addition, travelers are advised to:
1. Cook poultry and egg dishes thoroughly. (Well-cooked poultry is safe to eat.)
2. Wash hands frequently with soap and water if around poultry.
• The World Health Organization (WHO) does not recommend travel restrictions to countries experiencing outbreaks of H5N1 avian influenza in birds, including those countries which have reported associated cases of human infection.
The usual vaccines against influenza are not protective against “bird flu.”
Oseltamivir (Tamiflu) is somewhat effective in the treatment of H5N1 avian influenza. It seems to be effective in some cases, but may fail in others. Recently, resistant strains have been reported. In addition, the dosage and duration of treatment appear to be different in severe H5N1 cases.
Cholera: An outbreak of cholera affecting 96 people including 4 deaths was reported in September 2008 by ProMED. Tehran and Qom Provinces were most seriously affected. Although this disease occurs sporadically in this country, most travelers are at low risk. 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)
Crimean-Congo Hemorrhagic Fever (CCHF): Cases of Crimean-Congo hemorrhagic fever are reported each year from Iran. According to a posting on ProMED, at least 63 cases of Crimean-Congo hemorrhagic fever (CCHF) have been reported in Iran so far this year. A total of 120 cases were recorded for the year 2008, of which 19 were fatal. The largest number of cases are reported from the southeastern province of Sistan and Baluchistan, which borders on Afghanistan and Pakistan, where the disease is endemic. Most cases of Crimean-Congo hemorrhagic fever in Iran are acquired by exposure to infected meat, though the disease may also be transmitted by tick bites.
• Tick-bite prevention measures are recommended for all travelers to northeast Turkey. These measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear. There is no vaccine against Lyme disease.
Geographic Distribution of Crimean-Congo Hemorrhagic Fever
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 >5% of healthy blood donors seropositive for antibodies to the hepatitis E virus (HEV). Sporadic cases and occasional outbreaks occur, but may go unrecognized. Transmission of the 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 5% in healthy people and 38% to 47% among intravenous drug users (IDUs). 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 occurs throughout Iran in the rural and semirural areas at the margins of deserts throughout the country. Visceral leishmaniasis (kala-azar) is widespread (except for the arid zones in the southeast and deserts), particularly in Fars, Azarbbayjan-e Khavari, and the northeastern Khorasan provinces. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sand fly. Sand flies bite in the evening and at night. They are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• All travelers should take measures to prevent sand fly 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: Malaria risk is present in various areas at elevations up to 1,500 meters. There is a risk of malaria in the rural south eastern provinces of Iran from March to November. There is a low risk of malaria near the northern border with Azerbaijan from May to October. Transmission may occur in urban areas in the south and southwest. Other urban areas (including Tehran) are risk-free. Chloroquine-resistant falciparum malaria is reported. Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine (G6PD test required) is currently recommended when traveling to 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 Iran page on the Destinations menu or A-Z Index.
• Malaria is transmitted via the bite of an infected 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. You should suspect malaria if you develop an unexplained fever during or after travel to an endemic region.
Other Diseases/Hazards: Brucellosis (acquired by ingestion of unpasteurized dairy products or, less commonly, ingestion of poorly cooked meat from infected animals, by direct or indirect exposure to the organism through mucous membranes or broken skin, or by inhalation of infectious material)
• Crimean-Congo hemorrhagic fever
• Filariasis (reported in the southeastern province of Baluchistan-Sistan, where the mosquito vector is present)
• Leptospirosis (animal reservoir includes cattle, buffalo, sheep, sheep, rats and camels)
• North Asian tick typhus
• Flea-borne typhus
• Tick-borne relapsing fever
• Tularemia (reported from Sistan-Baluchestan province in 2007)
Poliomyelitis (Polio): Polio continues to be reported from the southeastern provinces near the Afghanistan and Pakistan borders, and rare cases occur elsewhere. A recent polio outbreak in neighboring Iraq raises the threat of polio in the western provinces. All travelers should be fully immunized. A one-time dose of IPV (Inactivated Polio Vaccine) is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult.
Rabies: Animal rabies is common in the wolf and stray dog population. Twenty to 50 human rabies cases occur annually, usually in rural villages.
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: Transmission of urinary schistosomiasis occurs year-round and increases in the spring rainy seasons, March to May. Distribution is focal along a branch of the Rud-e Karun River, between Ahvaz and Dezful, in the western province of Khuzestan.
• Schistosomiasis is transmitted through exposure to freshwater streams, rivers or lakes during activities such as 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: 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.
Tuberculosis (TB): Tuberculosis is highly endemic in Iran 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 is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people traveling to or working in the Middle East, 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.