Time Zone: +7 hours. No daylight savings time in 2008.
Tel. Country Code: 856
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). North American Style Adaptor Plug and European Style Adaptor Plug. Grounding Adaptor Plugs A, D.
Travel Advisory - Laos
Malaria, Japanese encephalitis, and dengue fever occur throughout SE Asia and the Indian sub-Continent. Insect-bite protection is essential. Hepatitis E, spread by contaminated water, is also a threat. There is no vaccine. Pregnant women are at special risk. Take measures, as needed, to purify your water outside of first-class hotels.
Dr. Rose Recommends for Travel to Laos
• U.S. Embassy
(aka Rue Bartholonie, near Tat Dam)
Tel: 856-21-212-581, 212-582, 212-585
• Canadian Embassy
There is no Canadian Embassy in Laos
All diplomatic and Consular activities are handled by the Canadian Embassy in Thailand.
• British Embassy
14 Wireless Road
 (2) 305 8229 Consular information
HIV Test: Not required.
Required Vaccinations: A yellow fever vaccination certificate is required from all travelers arriving from infected areas or Endemic Zones.
Passport/Visa: The Lao People’s Democratic Republic (Laos) is a poor, developing country ruled by an authoritarian, Communist, one-party government. Political power is centralized in the Lao People’s Revolutionary Party. Services and facilities for tourists are adequate in the capital, Vientiane, and the UNESCO World Heritage town of Luang Prabang, but are extremely limited in other parts of the country. ENTRY/EXIT REQUIREMENTS: A passport and visa are required. The Lao Ministry of Foreign Affairs states that visas can be issued upon arrival in Laos to U.S. citizen tourists with two passport-size photographs and $35 at the following ports of entry: Wattay Airport, Vientiane; Friendship Bridge, Vientiane, and Luang Prabang Airport. Persons who obtain entry visas prior to their arrival in Laos may also enter at the following international entry points: Boten-Bohan, Huaixay, Khammouane-Nakhonphanom, Savannakhet-Mukdahan, Vangtao-Chong Mek, Pakse Airport, Daensayanh-Laobao, Namphao-Kaopae, and Namkan. Foreign tourists are generally admitted to Laos for 30 days.
Foreign tourists who wish to obtain a visa in advance may contact a Lao embassy or consulate. In the United States, visas and further information about Lao entry requirements can be obtained directly from the Embassy of the Lao People’s Democratic Republic, 2222 S St. NW, Washington DC 20008, tel: 202-332-6416, fax: 202-332-4923.
Vaccinations: Recommended and Routine
Please check back here for updates. Thank you.
Hospitals / Doctors
Medical facilities and services in Laos are limited and do not meet Western standards. Pharmaceuticals are in short supply. There are no reliable facilities to deal with medical emergencies. Medical evacuation is difficult to arrange and very expensive.
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 of unreliable quality.
• Travelers are advised to obtain travel insurance that provides for medical evacuation to more advanced medical facility in Thailand, Singapore or another country in the event of serious illness or injury.
Just across the border in Nong Kai, Thailand there is:
1. Nong Kai Wattana Hospital
Tel:  42 465201 or 42 465202
2. Nong Kai Public Hospital
Tel:  42 461088
At Udon Thani in northeast Thailand (approx 1.5 hours drive) there is:
1. AEk Udon Hospital
Tel:  42 342555
2. Udon Wattana Hospital
Tel: 42 241031
AEK International Hospital and North Eastern Wattana General Hospital, both in Udorn, Thailand have English-speaking staff accustomed to dealing with foreign patients.
Nong Khai Wattana Hospital in Nong Khai, Thailand can handle most simple medical procedures.
Ambulances for both AEK International Hospital and Nong Khai Wattana Hospital have permission to cross the Friendship Bridge to collect patients from Vientiane. In Vientiane, the Setthatirat Hospital ambulance (tel: 21-413-720) can take patients to Thailand.
Common sources of medical care for travelers in Laos include:
• Mahosot Hospital
International Medical Clinic
Fa Ngum Road
Tel:  21 21-4022
open 24 hours
• Swedish Clinic
near Swedish Embassy
Sok Pa Louang Road
Tel: 21 31-5015
• Australian Clinic
Tel: 21 41-3603
Destination Health Info for Travelers
AIDS/HIV: Laos has a relatively low HIV prevalence (estimated adult sero-prevalence of 0.08%). The government has an active public health education program warning people of the risks of HIV; Laos has not seen the same level of large-scale migration that has occurred in other parts of Asia; there are relatively high rates of condom use among sex workers and their clients; and it’s thought that very few people in the country inject drugs.
• The development of 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.
Animal Hazards: Animal hazards include snakes (cobras, vipers), spiders (black and brown widow), tigers, leopards, and large leeches.
Avian Influenza (Bird Flu): Bird flu has been detected in poultry and wild birds, and the first case of human infection was confirmed in February 2007.
• 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: Cholera is reported in Xekong Province and two other southern provinces, Champassak and Saravan, in 2008. Although this disease is reported active in this country, 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)
Dengue Fever: More than 1,900 cases of dengue fever, including 18 deaths, were reported through August 2008. The risk of dengue is countrywide, year-round, but may be elevated in urban areas, especially during the warmer and wetter months, usually May through October. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in Asia. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash. 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.
Filariasis: Both the Bancroftian and Malayan varieties are highly endemic in rural and urban areas. Travelers should take personal protection measures against mosquito bites.
Helminthic Infections: Soil-transmitted infections (caused by hookworms, roundworms, whipworms, strongyloides) are highly prevalent in most rural areas. Travelers should wear shoes (to prevent the hookworm and strongyloides larvae from penetrating the skin) and food should be thoroughly washed/cooked (to destroy roundworm and whipworm eggs).
• Oriental lung fluke disease (paragonimiasis) and liver fluke diseases (clonorchiasis, opisthorchiasis, fascioliasis) are prevalent. Prevention: Travelers should avoid eating raw freshwater fish; raw, salted, or wine-soaked crustacea (freshwater crabs or crayfish); or undercooked water vegetables and plants, especially watercress.
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. Up to 4% of acute hepatitis may be due to hepatitis E. 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% to 10%. 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 1% to 2% in the general population, but higher in injecting drug users. 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.
Insects: You should exercise insect-bite prevention measures in this country. For maximum protection, apply a DEET-containing repellent to exposed skin (30%–50% concentration recommended), apply permethrin spray or solution to your clothing and gear, and sleep under a permethrin-treated bednet (if available).
• Until recently, DEET-based repellents have been the gold standard of protection against mosquito and tick bites. The CDC and the World Health Organization now recommend 20% picaridin as an effective DEET alternative. You can achieve nearly 100% bite protection by using a properly-applied DEET or picaridin skin repellent and wearing permethrin-treated clothing.
Japanese Encephalitis (JE): Risk is elevated in rural and periurban areas, especially where mosquito-breeding sites and pig farming coexist. Sporadic cases occur throughout the year, but disease transmission is higher during the warmer and wetter months (usually May through October).
The Centers for Disease Control and Prevention (CDC) recommends JE vaccination for travelers spending more than 30 days in an endemic environment, or less than 30 days in areas with epidemic transmission. However, the use of an arbitrary cutoff cannot protect all travelers. Advance knowledge of trip details, accommodation and purpose, as well as local geography, is warranted to give adequate advice. Is travel occurring during the peak transmission season? In general, travelers to rural areas (especially where there is pig rearing and rice farming) should be vaccinated if the duration of their trip exceeds 3 to 4 weeks. They may consider vaccination for trips of shorter duration if more intense exposure is anticipated, especially during unprotected outdoor activities in the evening.
• Vaccination is advised for expatriates living in this country.
• All travelers should take measures to prevent mosquito bites, especially in the evening and during the night. 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 at night.
Malaria: Malaria is considered the leading cause of morbidity and mortality, with 70% of the population at risk. Malaria drug resistance is increasing and artemesinen-based combination treatment is being introduced.
Risk is present countrywide, but is more prevalent in mountainous and rural areas than in the lowland plains or urban areas. There is no risk of malaria in Vientiane. P. falciparum accounts for over 80% of cases. Vivax malaria may predominate in some areas. Multidrug-resistant falciparum malaria is reported, especially near the border with Thailand.
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 Laos page on the Destinations menu.
Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine is recommended.
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 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.
Other Diseases/Hazards: • Anthrax
• Brucellosis (often transmitted by the consumption of unpasteurized dairy products)
• Capillariasis (acquired by the consumption of raw freshwater fish)
• Giant intestinal fluke (fasciolopsiasis; this disease occurs in Asia and the Indian subcontinent, especially in areas where humans raise pigs and consume raw aquatic plants.)
• Gnathostomatiasis (this is a nematode infestation endemic in Southeast Asia, which can involve multiple organs including the liver, eyes, gastrointestinal tract and CNS. The most common manifestation is recurrent migratory subcutaneous swellings which can appear anywhere on the body and are accompanied by pruritus and systemic symptoms such as low-grade fever, loss of appetite and nausea. Avoid the consumption of raw or undercooked freshwater fish)
• Lung fluke disease (paragonimiasis)
• Melioidosis (caused by bacteria found in contaminated soil and water, especially in agricultural fields during the rainy season; causes wound infections or pneumonia, which may progress rapidly and be life-threatening)
• Oriental liver fluke (clonorchiasis; the reservoir for this disease is various freshwater snails, while the vector is usually uncooked freshwater fish. Clonorchis sinensis is the most common Oriental liver fluke infection.)
• Opisthorchiasis (liver flukes disease; humans are infected by ingesting raw fish containing the parasites; liver fluke infection caused by Opisthorchiidae is a major public health problem in many parts of the Far East)
• Plague (a small number of cases of human plague are reported from Laos. The plague is usually transmitted by the bite of rodent fleas.)
• Scrub typhus (transmitted by chiggers, the larval stage of mites). The term scrub is used because of the type of vegetation (terrain between woods and clearings) that harbors the vector; however, the name is not entirely correct because certain endemic areas can also be sandy and semiarid.
• Murine typhus (also called fleaborne or endemic typhus, is a rickettsial disease caused by the organism Rickettsia typhi)
Plant Hazards: Plant hazards: Bamboo, rattan, and large palm- or fern-like trees, which can cause serious puncture wounds and slow-healing lacerations, are widespread in the forested areas of the country. Regas are large forest trees whose black resinous sap can cause a potent poison ivy–type skin reaction. Stinging nettles, small thorny trees, and many species of euphorbs can also cause skin reactions.
Rabies: Sporadic cases of human rabies are reported countrywide. 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: Risk is present year-round. Focal distribution occurs along the Mekong River (including Vientiane), and in Louangphrabang and Champasak Provinces. 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: Piped water supplies countrywide are frequently untreated and may be grossly contaminated. 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 (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). Peel all fruits.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene helps prevent travelers’ diarrhea.
• 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: Tuberculosis a major health problem in this country. 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 with an infected individual. 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 for all unvaccinated people traveling to or working in Southeast Asia, 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. Travelers should practice strict food, water and personal hygiene precautions even if vaccinated.