Time Zone: +2 hours. GMT +1 hour daylight savings time.
Tel. Country Code: 373
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
Travel Advisory - Moldova
Europe, Russia and former the Soviet Union countries vary widely in travel risks and adequacy of health care delivery. Water- and food-borne illnesses such as travelers' diarrhea, typhoid and Giardia are threats outside of Western Europe. Insect-transmitted diseases, such as Lyme disease and tick-borne encephalitis are common in wooded, rural areas in most countries, including Western Europe.
Dr. Rose Recommends for Travel to Moldova
• U.S. Embassy
Strada Alexei Mateevici 103
Tel:  (22) 23-37-72
After-hours telephone:  (22) 23-73-45
Fax:  (22) 22-63-61
The nearest Canadian Embassy is in Bucharest, Romania.
• Embassy of Canada
1-3 Tuberozelor Street
Tel:  (21) 307-5000
Fax:  (21) 307-5010
• British Embassy
18 Nicolae Iorga str.
Republic of Moldova
Tel:  (22) 22 59 02
Fax:  (22) 25 18 59
HIV Test: Not required.
Required Vaccinations: None required.
Passport/Visa: Moldova is a Republic with a freely elected government. It has been an independent nation since 1991. Its capital, Chisinau, offers adequate hotels and restaurants, but tourist facilities in other parts of the country are not highly developed, and many of the goods and services taken for granted in other countries are not yet available.
ENTRY/EXIT REQUIREMENTS: Since January 1, 2007, citizens of the United States, EU member states, Canada, Switzerland, and Japan do not require visas to enter Moldova. For more information on entry requirements, please contact the Moldovan Embassy, 2101 S Street NW, Washington, DC; telephone: (202) 667-1130, (202) 667-1131, or (202) 667-1137, fax: (202) 667-1204; E-mail: firstname.lastname@example.org. Travelers may also wish to consult the Moldovan Ministry of External Affairs and European Integration website at http://www.mfa.md/En/ConsularInf/VisasInfo.htm for general information on Moldovan visas and for application forms.
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. It is important that 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 is a new tetanus-diphtheria-pertussis (Tdap) vaccine that not only boosts immunity against diphtheria and tetanus, but has the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children. The Tdap vaccine can be administered in place of the Td vaccine if a booster is indicated.
• An outbreak of mumps began in October 2007 and as of March 2008 >20,000 cases have been reported.
Typhoid: Recommended for all travelers except short-stay visitors staying in first-class hotels.
Hospitals / Doctors
The standard of medical care in Moldova is below that available in Western countries. Non-Russian/Romanian speakers may encounter difficulties in a medical emergency. Essential medications and supplies may not be available. Most doctors and hospitals will expect payment in cash, regardless of whether you have travel health insurance.
All travelers should be up-to-date on their immunizations and are advised to carry a medical kit as well as antibiotics to treat travelersâ€™ 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 or may be of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance medevac. In the event of a serious illness or injury that can't be treated locally, every effort should be made to arrange medical evacuation to a hospital in Western Europe.
For a guide to physicians in Moldova, go to the U.S. Embassy website (http://chisinau.usembassy.gov/local_doctors.html) or contact the Embassy directly if in-country.
For an ambulance in Moldova, call 903.
• Municipal Clinical Emergency Hospital
1 Toma Ciorba Street
Tel:  (2) 24 84 35
• Dalila Medical Clinic
bd. Dacia 5A
Tel:  (22) 534 190
• National Institute of Health Care for Mother & Child
str. Burebista 93
Tel:  (22) 523 207
Destination Health Info for Travelers
AIDS/HIV: HIV/AIDS, sexually transmitted infections (STIs) and tuberculosis (TB) are among the most urgent public health problems in Moldova. Early actions to fight HIV/AIDS and tuberculosis have slowed the growth of these two epidemics in the country. Although the number of HIV infections continues to rise, the spread of the disease among injecting drug users (IDUs) has slowed. A major restructuring of the health system is underway to improve efficiency and equity, albeit with limited funding.
UNAIDS estimates that HIV prevalence among adults exceeds 1% in Moldova and Ukraine. Injecting drug use has become widespread amongst young people, especially young men. Other factors causing an increase in HIV transmission include needle sharing, commercial sex, lack of adequate public health programs, the high levels of sexually transmitted infections in the wider population, and the decreased availability of sterile needles and syringes for medical injections. (Sources: www.avert.org/ecstatee.htm and the World Bank)
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: 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.
Health insurance is essential.
Avian Influenza A (Bird Flu): There have been no reported cases of Avian Influenza (Bird Flu) in Moldova during the current series of outbreaks.
Crimean-Congo Hemorrhagic Fever: Crimean-Congo hemorrhagic fever is found in Eastern and Central Europe, particularly in the former Soviet Union. It is also distributed throughout the Mediterranean, in northwestern China, central Asia, southern Europe, Africa, the Middle East, and the Indian subcontinent.
CCHF is caused by a virus and is transmitted by a tick bite or by exposure to blood or secretions from infected animals or humans. Anyone who has visited Moldova and is suffering from a fever, headache, chills, muscle aches, vomiting, red rash (which does not fade when pressed under glass), bleeding on the roof of the mouth, or any other unexplained symptoms should seek medical advice immediately.
• Risk is seasonal, associated with periods of high tick activity (usually March through September, but seasonal patterns may occur) and increases in tick and rodent host populations. Travelers, especially those engaging in outdoor activities in rural areas, such as campers and hikers, are advised to take measures to prevent tick bites during the peak transmission season. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
Diphtheria: An epidemic of diphtheria began in the 1990s in the Russian Federation has spread extensively, involving many countries of the former Soviet Union. Seventy percent of cases have occurred in persons older than 15 years. All travelers to Moldova, including adults, should be fully immunized against diphtheria. (The CDC estimates that 20% to 60% of Americans older than 20 years of age lack sufficient immunity to diphtheria.) Diphtheria vaccine in the United States is widely available and is administered in combination with the tetanus toxoid vaccine (Td vaccine).
Note: The ADACEL (Tdap) vaccine also provides protection against pertussis (whooping cough-a serious disease in adults) and should be considered in place of the Td vaccine.
Hepatitis: All travelers not previously immunized against hepatitis A should be vaccinated against this disease. Hepatitis A is transmitted through 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 but levels are unclear. (A study in Moldova found 51.1% of swine farmers and 24.7% of persons without occupational exposure to swine had anti-HEV antibodies.) Sporadic cases may be 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.
• The overall hepatitis B (HBsAg) carrier rate in the general population is moderately elevated 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
• Hepatitis C is endemic at high level with a prevalence of 4.7% 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.
Lyme Disease: Lyme disease occurs focally endemic in this country. Lyme disease is transmitted by Ixodes ticks that in found in wooded, brushy areas, although transmission can also occur in backyards. Travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions of endemic areas should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A single 200-mg dose of doxycycline is effective in preventing Lyme disease if taken within 72 hours of being bitten by an infected tick. (Reference: http://content.nejm.org/cgi/content/abstract/345/2/79).
Malaria: There is no risk of malaria in Moldova.
Other Diseases/Hazards: Anthrax (sporadic human cases occur, related to exposure to livestock in rural areas, especially southern areas), brucellosis, mumps (more than 2000 cases have been recorded since the beginning 2008 in Kishinev, the Gagauzsky autonomic district, Ungensky, Orgeevsky, and other districts of the Republic), rabies, tick-borne relapsing fever, trichinosis, and tularemia.
Rabies: Rabies is problem with reports of attacks by rabid dogs as well as wild carnivores, including foxes, wolves and lynx. Pre-exposure 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. Children are considered at higher risk because they tend to play with animals and may not report bites.
• Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Prompt medical evaluation and treatment of any animal bite is essential, regardless of vaccination status. Note: If adequate rabies treatment is not available locally, medical evacuation is advised to a facility that can provide treatment.
Tick-Borne Encephalitis (TBE): Tick-borne encephalitis (TBE) is a viral disease that occurs in forested areas of the former Soviet Union, eastern and central Europe, and Scandinavia. TBE is transmitted by Ixodid ticks (the same ticks that transmit Lyme disease) and presents a risk primarily to campers and hikers engaging in prolonged outdoor activities in endemic areas. The disease can also be transmitted by the consumption of unpasteurized dairy products from infected cows, goats, or sheep.
The greatest risk of disease occurs during periods of high tick activity, usually March through September. Infective ticks are found in mixed coniferous-deciduous forests, extending into the shrubby forest edge and meadows, as well as along river and stream valleys (including forests bordering large cities).
• Travelers, especially those engaging in outdoor activities in rural areas, such as campers and hikers, should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A map showing the distribution of TBE is here: http://www.nathnac.org/includes/contents/documents/TBEmap.gif
More information on TBE at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/TBE.htm
Travelers' Diarrhea: High risk outside of first-class hotels. All water supplies in Moldova are suspect, including municipal tap water, which may be untreated and grossly contaminated. Travelers should consume only bottled water, or boiled or chemically treated water and observe food safety precautions. A quinolone antibiotic, or azithromycin, is recommended for the treatment of acute diarrhea. Diarrhea not responding to treatment with an antibiotic may be due to a parasitic disease, especially giardiasis.
• Outbreaks of giardiasis and cryptosporidiosis are reported from many urban areas throughout Central Europe and Russia. Amebiasis may occur focally countrywide.
Tuberculosis (TB): Tuberculosis is an increasingly serious health concern in Moldova. This disease is highly endemic in Moldova 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 vaccine is recommended by the CDC for all people traveling to or working in Eastern Europe, 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.