Time Zone: -5 hours. No daylight savings time in 2008.
Tel. Country Code: 876
USADirect Tel.: 1
Electrical Standards: Electrical current is 110/50 (volts/hz). North American Style Adaptor Plug. Grounding Adaptor Plug A.
Travel Advisory - Jamaica
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 Jamaica
• U.S. Embassy
142 Old Hope Road
Tel:  702-6000; (After-Hours Emergency)
Fax:  702-6018
The Consular Section of the U.S. Embassy is located at 142 Old Hope Road in the Liguanea area of Kingston, Tel:  702-6000.
For emergencies after hours, on weekends, and holidays, U.S. citizens are requested to call the U.S. Embassy duty officer through the main switchboard at  702-6000.
The Consular Agency in Montego Bay is located at St. James Place, 2nd Floor, Gloucester Avenue,
Tel:  952-0160.
The U.S. Embassy also has consular responsibility for the Cayman Islands, a British dependent territory.
Tel:  945-8173.
• Canadian Embassy:
3 West Kings House Road
Tel:  926-1500
Fax:  511-3493
IMPORTANT NEW INFORMATION: As early as January 1, 2008, U.S. citizens traveling between the United States and Jamaica by sea (including ferries) may be required to present a valid U.S. passport or other documents as determined by the Department of Homeland Security. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on applying for a passport.
Visitors must have a return ticket and be able to show sufficient funds for their visit. U.S. citizens traveling to Jamaica for work or extended stays are required to have a current U.S. passport and visa issued by the Jamaican Embassy or a Jamaican Consulate. There is a departure tax for travelers, which is regularly included in airfare. For further information, travelers may contact the Embassy of Jamaica at 1520 New Hampshire Avenue NW, Washington, DC 20036, telephone (202) 452-0660; the Jamaican Consulate in Miami or New York; honorary consuls in Atlanta, Boston, Chicago, Houston, Seattle or Los Angeles. Visit the Embassy of Jamaica's web site at http://www.congenjamaica-ny.orgfor the most current visa information.
HIV Test: Not required.
Required Vaccinations: Yellow fever vaccine is required for all travelers >1 year of age arriving from any country in the yellow fever endemic zones in Africa or the Americas. Not recommended or required otherwise.
U.S. citizens traveling by air to and from Jamaica must present a valid passport when entering or re-entering the United States. Sea travelers must have a valid U.S. passport (or other original proof of U.S. citizenship, such as a certified U.S. birth certificate with a government-issued photo ID). Persons traveling with U.S. passports tend to encounter fewer difficulties upon departure than those who choose to use other documents.
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 unprotected or high-risk sexual contact; from injecting drug use; from medical treatment with non-sterile (re-used) needles and syringes. Recommended for any traveler requesting protection from 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.
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
All travelers should be up-to-date on their immunizations and are advised to carry a medical kit as well as stand-by antibiotics. Travelers are also advised to obtain travel insurance that provides for medical evacuation to the United States in the event of serious illness or injury. Most medical emergencies are evacuated to Miami for urgent care.
There are 16 public and six private hospitals in Jamaica, but medical service is limited, especially outside Kingston and Montego Bay.
The U.S. Embassy maintains a list of doctors and hospitals at:
The Jamaican Ministry of Health maintains a list of hospitals at:
• University of the West Indies Hospital
Tel:  927-1620-9, 876-977-2607
This is the leading medical facility in Jamaica, and is publicly financed, but has a private wing (the Tony Thwaites Wing) which serves more affluent patients.
• Medical Associates Hospital
18 Tangerine Place, Kingston
Tel:  926-1400-1, 926-8624, 926-9013
This is a smaller, private facility, and preferred by some travelers.
Destination Health Info for Travelers
AIDS/HIV: The Caribbean has a well-established HIV epidemic and the incidence of HIV/AIDS in the region is now second only to sub-Saharan Africa, making the region the second most affected in the world. The predominant route of HIV transmission in the Caribbean is heterosexual contact. Much of this transmission is associated with commercial sex, but the virus is also spreading in the general population. The contribution by men having sex with men is significant but not well documented, due to a general atmosphere of homophobia making data gathering difficult. 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. The overall prevalence of HIV in the Caribbean is estimated to be between 1.1% and 2.2%.
The prevalence of HIV/AIDS in adults (15-49) in Jamaica is estimated at 1.5%. (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 the body fluid 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.
• 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.
Cholera: This disease may occur sporadically in this country but the threat to tourists is very low. Cholera is an extremely 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)
Cutaneous Larva Migrans: Most cases contracted from walking barefoot on, or sunbathing, on beaches that have been contaminated by dog or cat hookworm larvae. The migrating larvae cause an erythematous rash with serpiginous tracks. Cases of CLM are often misdiagnosed as ant bites or scabies. The disease is self-limiting, with 80% of cases resolving in 4 weeks. Treatment with thiabendazole, 50 mg/kg/day for 3 days, is recommended.
Dengue Fever: Over 4,000 cases were reported or suspected in 2007 and several deaths from dengue hemorrhagic fever were also reported. In Jamaica, as on all the other islands, risk is present in both urban and rural areas. 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. 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.
A dengue fever map is at:http://www.nathnac.org/ds/c_pages/documents/dengue_map.pdf
Summary of symptoms of dengue fever:
• Severe headache
• Pain behind the eyes (retro-orbital headache)
• Muscle and joint pains
• Skin rash
• Nausea, vomiting and/or abdominal pain
• Bleeding spots under the skin (pinpoint-sized hemorrhages called petechiae)
Food & Water Safety: Most water is chlorinated in major urban areas, and while relatively safe may cause mild abdominal upsets. Bottled water is available. Milk is pasteurized and dairy products are safe for consumption. Local meat, poultry, seafood, fruit and vegetables are generally considered safe to eat.
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 may occur but levels are unclear. 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 moderately endemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at up 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 0.3% 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.
Influenza: Influenza is transmitted year-round in the tropics. The flu vaccine is recommended for all travelers over age 6 months.
Leptospirosis: An outbreak of leptospirosis was occurred in 2007 after flooding caused by Hurricane Dean. Over 100 cases were reported. In January 2008, there have been 3 suspected cases of the disease in Granville (St. James) with one fatality.
• Leptospirosis is a bacterial disease transmitted to humans by exposure to water contaminated by the urine of infected animals. (Most commonly dogs, cattle, goats, and rodents, especially rats.) Symptoms include fever, chills, headache, muscle aches, conjunctivitis, and a rash. Most cases resolve uneventfully, but a small number may result in fatality. Travelers at risk include those who engage in water sports, such as rafting. Disease transmission is increased after periods of heavy rainfall and flooding which increase water contamination from animal excreta.
• A 200 mg dose of doxycycline, either once weekly or as a one-time dose, can prevent this disease.
Risk factors for contracting leptospirosis include:
• Eating foods or handling water contaminated by urine of infected animals.
• Tending infected animals - dogs, cows, goats, pigs.
• Bathing or wading in stagnant water frequented by animals, especially after heavy rains and flooding.
Symptoms of leptospirosis:
• Sudden onset of chills and high fever.
• Headache and or other body aches, especially in the calf muscles.
• Nausea and vomiting
• Flu-like symptoms
Malaria: There is not normally a risk of malaria in Jamaica; however an outbreak was reported between December 2006 and October 2007. A total of 370 cases were identified, largely from Kingston A small number of cases were also reported from St. Catherine, St. Thomas, and Clarendon. All cases were caused by Plasmodium falciparum. The outbreak appeared to have ended in June 2007, but two additional cases were reported from Kingston in October 2007.
The Centers for Disease Control and Prevention (CDC) has removed the temporary recommendation that travelers take preventive medication (chloroquine) for travel to Kingston, Jamaica. Travelers should instead take measures to prevent mosquito bites. Kingston continues to experience rare cases of malaria, but the risk to travelers appears to be minimal.
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 malaria endemic areas of this country.
Marine Hazards: Swimming related hazards include jellyfish, spiny sea urchins, and corals.
• Ciguatera poisoning is prevalent and can result from eating reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
• SCUBA DIVING-Hyperbaric Chamber Referral: Diver’s Alert Network (DAN) maintains an up-to-date list of all functioning hyperbaric chambers in North America and the Caribbean. DAN does not publish this list, since at any one time a given chamber may be non-functioning, or its operator(s) may be away or otherwise unavailable. Through Duke University, DAN operates a 24-hour emergency phone line for anyone (members and non-members) to call and ask for diving accident assistance. Dive medicine physicians at Duke University Medical Center carry beepers, so someone is always on call to answer questions and, if necessary, make referral to the closest functioning hyperbaric chamber. In a diving emergency, or for the location of the nearest decompression chamber, call the DAN Emergency Hotline:
 919-684-8111 or  919-684-4DAN (Collect).
• Jamaica has one hyperbaric chamber, the Discovery Bay Marine Lab, located in St Ann’s parish.
Rabies: Jamaica is presumed to be rabies-free. All animal bite wounds, however, especially from a dog, should be thoroughly cleansed and then medically evaluated for possible post-exposure treatment.
Travelers' Diarrhea: Outside of hotels and resorts, we recommend that you 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.
Typhoid Fever: Typhoid vaccine is recommended by the CDC for all unvaccinated people traveling to or working in the Caribbean, 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.