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Maldives



Capital: Male

Time Zone: +5 hours.
Tel. Country Code: 960
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 D, F.


Travel Advisory - Maldives

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 Maldives


Resource Links

NaTHNaC
World Health Organization
CDC
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Travel Warnings
Consular Information
Foreign Commonweatlh Office

Embassies

There is no U.S. Embassy in Maldives. Travelers should contact the Consular Section of the American Embassy in Sri Lanka: Tel: [94] (1) 448-007

HIV Test: Not required.

Required Vaccinations: A yellow fever vaccination certificate is required from travellers coming from areas with a risk of yellow fever transmission.

Entry Requirements

Passport/Visa: The Republic of Maldives consists of 1,190 islands (fewer than 200 are inhabited) in the Indian Ocean, southwest of Sri Lanka. The Maldives has a population of almost 300,000, of which about 104,000 reside in Male, the capital city. Beautiful atolls, inhabited by over 1,100 species of fish and other sea life, attract thousands of visitors each year. Tourism facilities are well developed on the resort islands. The tsunami of December 26, 2004 caused some damage to several hotels and facilities on some of the islands. Most of the tourism infrastructure remains intact.

ENTRY/EXIT REQUIREMENTS: A valid passport, along with an onward/return ticket and sufficient funds, is required for entry. A no-cost visitor visa valid for thirty days is issued upon arrival. The Department of Immigration and Emigration routinely approves requests for extension of stays up to ninety days for travelers who present evidence of sufficient funds and who stay in a resort or hotel or present a letter from a local sponsor. Anyone staying over sixty days without proper authorization faces heavy fines and deportation. All visitors departing the Republic of the Maldives (except diplomats and certain exempted travelers) must pay an airport departure tax, which is usually included in the price of an airline ticket. Travelers need a yellow fever immunization if they are arriving from an infected area.

Arrival by private boat: Travelers arriving by private yacht or boat are granted no-cost visas, usually valid until the expected date of departure. Vessels anchoring in atolls other than Male must have prior clearance through agents in Male. Maldivian customs, police and/or representatives of Maldivian immigration will meet all vessels, regardless of where they anchor. Vessels arriving with a dog on board will be permitted anchorage, but the dog will not be allowed off the vessel.

Specific inquiries should be addressed to the Maldives High Commission in Colombo, Sri Lanka at No. 24, Melbourne Avenue, Colombo 4, telephone (94) (11) 2580076/2586762/2500943, or the Maldives Mission to the U.N. in New York, telephone (212) 599-6194.

Passport Information

Passport/Visa: The Republic of Maldives consists of 1,190 islands (fewer than 200 are inhabited) in the Indian Ocean, southwest of Sri Lanka. The Maldives has a population of almost 300,000, of which about 104,000 reside in Male, the capital city. Beautiful atolls, inhabited by over 1,100 species of fish and other sea life, attract thousands of visitors each year. Tourism facilities are well developed on the resort islands. The tsunami of December 26, 2004 caused some damage to several hotels and facilities on some of the islands. Most of the tourism infrastructure remains intact.

ENTRY/EXIT REQUIREMENTS: A valid passport, along with an onward/return ticket and sufficient funds, is required for entry. A no-cost visitor visa valid for thirty days is issued upon arrival. The Department of Immigration and Emigration routinely approves requests for extension of stays up to ninety days for travelers who present evidence of sufficient funds and who stay in a resort or hotel or present a letter from a local sponsor. Anyone staying over sixty days without proper authorization faces heavy fines and deportation. All visitors departing the Republic of the Maldives (except diplomats and certain exempted travelers) must pay an airport departure tax, which is usually included in the price of an airline ticket. Travelers need a yellow fever immunization if they are arriving from an infected area.

Arrival by private boat: Travelers arriving by private yacht or boat are granted no-cost visas, usually valid until the expected date of departure. Vessels anchoring in atolls other than Male must have prior clearance through agents in Male. Maldivian customs, police and/or representatives of Maldivian immigration will meet all vessels, regardless of where they anchor. Vessels arriving with a dog on board will be permitted anchorage, but the dog will not be allowed off the vessel.

Specific inquiries should be addressed to the Maldives High Commission in Colombo, Sri Lanka at No. 24, Melbourne Avenue, Colombo 4, telephone (94) (11) 2580076/2586762/2500943, or the Maldives Mission to the U.N. in New York, telephone (212) 599-6194.

HIV Test: Not required.

Required Vaccinations: A yellow fever vaccination certificate is required from travellers coming from areas with a risk of yellow fever transmission.

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.

Rabies: Rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection.

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.
• In addition to tetanus, all travelers, including adults, should be fully immunized against diphtheria. A booster dose of a diphtheria-containing vaccine (Td or Tdap vaccine) should be given to those who have not received a dose within the previous 10 years.
Note: ADACEL and Boostrix are new tetanus-diphtheria-pertussis (Tdap) vaccines that not only boost immunity against diphtheria and tetanus, but have the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children. The Tdap vaccines can be administered in place of the Td vaccine when a booster is indicated.

Typhoid: Recommended for all travelers except short-stay visitors and cruise ship passengers.

Yellow Fever: Yellow fever vaccination is required for all travelers >1 year of age arriving from any infected country in the yellow fever endemic zones in Africa or the Americas, but is not recommended or required otherwise.

Hospitals / Doctors

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. 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.
• 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 Singapore or Bangkok.

Medical care is limited. Facilities include:

• Indira Ghandi Memorial Hospital-IGMH
Kanbaa Aisaa Rani Hingun
Maafannu
Male
Tel: [960] 333 5335 or 331 6647
Website: http://www.igmh.gov.mv
Government-run hospital offering a wide range of specialty services, including neurosurgery and orthopedics. There is no trauma unit but there is a 24-hour Emergency Department. The IGMH (200 beds) operates as the central referral hospital for the whole country. The hospital delivers tertiary care to six regional hospitals and 10 atoll hospitals.

• Abduarahman Don Kaleyfan Hospital-ADK
Private hospital which accepts some insurance plans, which the IGMH doesn't. General, orthopedic and neurosurgery are available at these facilities, but there are no trauma units and they do not offer spinal surgery. Visitors requiring treatments not offered in the Maldives are evacuated to the nearest adequate medical facility in South East Asia.

Outside Male, there are six regional hospitals, located at Haa Dhaal Kulhuduffushi, Raa Ugoofaaru, Meemu Muli, Laamu Gan, Gaaf Dhaal Thinadhoo and Seenu Hithadhoo.

There are two decompression facilities in the Maldives Islands, one on Bandos Island (fifteen minutes by speedboat from Male) and the other on Kuramathi (one hour by speed boat and about twenty minutes by air taxi from Male.

Destination Health Info for Travelers

AIDS/HIV: The number of reported people living with HIV/ AIDS in the Maldives is currently very small (no statistics are currently available), but a number of factors make the country vulnerable to the spread of HIV. The factors under consideration include:
• The high mobility rate, including migrant workers, students, small businessmen, seamen, and tourists
• High rates of divorce and remarriage in the Maldives create exposure to large sexual networks capable of transmitting HIV and other sexually transmitted diseases.
• The high percentage of population under 15 years of age (approx. 50%). An estimated 26,000 young people will enter the labour force in the next five years, with anticipated high rates of unemployment;
• The rise in drug use amongst young people;
• Maldivians are dispersed over as many as 190 islands. This dispersed population creates barriers to educating people on HIV/AIDS, distributing condoms, and treating people for STDs that increase transmission of HIV.
• Although sex tourism is not present in the Maldives, the great influx of people from all over the world represents a potential route of introduction of HIV and high-risk behaviour such as injecting drug use and unsafe sex. (Source: youandaids.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.

Animal/Marine Hazards: Marine hazards include poisonous sea snakes, corals, jellyfish, sharks, stingrays, starfish, shellfish, anemones, and sea nettles/urchins.
• Prevention: Swim at approved beaches; do not handle; seek medical attention if stung/bitten.

Chikungunya Fever: An outbreak of chikungunya fever, a mosquito-borne illness characterized by fever and incapacitating joint pains, was reported from the Maldives in December 2006. More cases were reported in 2008, chiefly on the islands of Alif Dhaal Maamigili and Alif Dhaal Fenfushi. In 2009, ProMED reports that chikungunya fever occurred in a 35-yeqr-old German tourist and his 7-year-old son four days after they returned from a 10-day trip on the island.
Chikungunya is an arboviral infection, transmitted by mosquitoes, and usually self-limiting. Travelers are advised to practice daytime and nighttime insect precautions.This disease has become widespread in the Indian sub-Continent and the islands of the Indian Ocean. Symptoms include fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain. Acute Chikungunya fever typically lasts a few days to several weeks, but as with dengue, West Nile fever, and other arboviral fevers, some patients have prolonged fatigue lasting several weeks. No deaths related to chikungunya infection have been conclusively documented in the scientific literature.
• To prevent this disease, and other arboviral illnesses, travelers should take measures to prevent 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 at night.

Dengue Fever: Dengue fever is a mosquito-transmitted, flu-like viral illness occurring in throughout Asia. An outbreak of dengue fever in the Maldives was reported in January 2006 with sporadic cases since. 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

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 may be endemic, 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. Farm animals (primarily pigs) 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 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 with a prevalence of 1.8% 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.

Insect-Bite Prevention: All travelers should exercise insect-bite prevention measures. These 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 (30%) provide the protection protection under circumstances in which it is crucial to be protected against mosquito bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
• DEET-based repellents have long been the gold standard to prevent mosquito and tick bites. The CDC and the World Health Organization now recommend 20% picaridin repellents as an effective DEET alternative.

Malaria: There is no risk of malaria in this country.

Other Diseases/Outbreaks: An outbreak of scrub typhus was reported in 2002. Most cases were reported from the Gaafu Dhaalu Atoll and Gadhdhoo Island. Scrub typhus is transmitted by some species of mites (chiggers) which are found in areas of heavy scrub vegetation. The bite of this mite leaves a characteristic black eschar that is useful in making the diagnosis.
• Lymphatic filariasis, transmitted by mosquitoes, is present in this country. Short-term travelers are at little risk, but should take measures to prevent insect bites.

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 and fish. 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 the Maldives 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 traveling to or working in 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, 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.