Time Zone: -4 hours. No daylight savings time in 2008.
Tel. Country Code: 664
USADirect Tel.: 1
Electrical Standards: Electrical current is 230/60 (volts/hz). North American Style Adaptor Plug. Grounding Adaptor Plug A.
• The nearest U.S. diplomatic contact is with the U.S. Embassy in Barbados:
Wildey Business Park
Tel:  436-4950
• The nearest Canadian diplomatic contact is with the High Commission of Canada in Barbados:
High Commission of Canada
Bishop’s Court Hill
Tel:  429-3550
Emergency toll-free to Ottawa: 1-888-949-9993
Fax:  437-7436
• Montserrat is a British Overseas territory:
The Governor’s Office
Tel:  491 2688/9
HIV Test: Not required.
Required Vaccinations: Travelers >1 year of age entering the country from an endemic area are required to present a certificate of immunization against yellow fever.
Passport/Visa: Montserrat is a British overseas territory and part of the British West Indies. The island rises in a series of mountain slopes to a high point of over 3,000 feet at the Soufriere Volcano in the exclusion zone. Montserrat is a highly active volcanic island. The Government of Montserrat has issued several recent proclamations and warnings urging residents and visitors to be vigilant and to be prepared to move at short notice.
ENTRY/EXIT REQUIREMENTS: For information, travelers may contact the British Embassy, 19 Observatory Circle N.W., Washington, D.C. 20008; telephone (202) 588-7800; or the nearest consulate of the United Kingdom in Atlanta, Boston, Chicago, Dallas, Los Angeles, New York, Denver, Houston, Miami, Orlando, Seattle, or San Francisco. Visit the British Embassy’s web site at http://www.britainusa.com/ for the most current visa information. However, U.S. citizens are now required to present a valid passport to travel by air between the United States and the Caribbean.
Vaccinations: Recommended and Routine
Hepatitis A: Recommended for all travelers >1 year of age not previously immunized against hepatitis A.
Hepatitis B: ecommended 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; when receiving medical or dental injections, or unscreened transfusions; by direct contact between open skin lesions. Recommended for 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.
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.
Yellow Fever: Travelers >1 year of age entering the country from an endemic area are required to present a certificate of immunization against yellow fever. 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 that provides for medical evacuation to more advanced medical facility in the event of serious illness or injury that requires specialty care not available in this country. For more serious or complicated problems, medical evacuation to a neighbouring island (Antigua or Guadeloupe), San Juan, or Miami, may be required.
• St. John’s Hospital
Montserrat’s main hospital has a 24-hour emergency room and can handle most routine and surgical emergencies. However, there is no hyperbaric chamber in Montserrat. Doctors in private practice are available.
Destination Health Info for Travelers
AIDS/HIV: 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. Cultural and behavioural patterns (such as early initiation of sexual acts, and taboos related to sex and sexuality), gender inequalities, lack of confidentiality, stigmatization and economic need are some of the factors influencing vulnerability to HIV and AIDS in the Caribbean.
The prevalence of HIV in the Caribbean is estimated to be between 1.1% and 2.2%; among young people 15-24 years of age, HIV prevalence is approximately 1.6% for women and 0.7% for men. The Bahamas and Haiti are most affected countries, with incidence rates exceeding 3%. Trinidad and Tobago’s national adult incidence of HIV exceeds 2%. (Source: www.Avert.org)
• The United Nations does not currently publish HIV/AIDS epidemiological fact sheets for Montserrat and thus specific HIV/AIDS data are not available for this country.
• 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 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.
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.
• 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.
Dengue Fever: Risk is present year-round. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in the Caribbean. It 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
For more information on the disease, please consult the World Health Organization’s dengue fact sheet (under “health topics”) at the following website: http://www.who.int/topics/dengue/en/
Hepatitis: All travelers not previously immunized against hepatitis A should receive the vaccine. 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 may be endemic but the levels are unclear. 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..
• 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 but the levels are not well documented. Most hepatitis C virus 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 world’s population. 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.
Marine Hazards: Swimming related hazards include jellyfish, spiny sea urchins, and sharp coral.
• Ciguatera poisoning occurs and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
• Scuba Diving-Hyperbaric Chamber Referral: Divers' 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 919-684-8111 (collect).
Rabies: Montserrat is considered to be rabies-free but there is little surveillance information. All animal bite wounds, however, especially from a dog, should be thoroughly cleansed and then medically evaluated for possible post-exposure treatment.
Schistosomiasis: This disease has officially been eliminated and the risk is believed to be extremely low or nonexistent.
• Schistosomiasis is transmitted through exposure to contaminated water while 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, streams, cisterns, aqueducts, or irrigated areas. There is no risk in chlorinated swimming pools or in seawater.
Travelers' Diarrhea: Low to moderate risk. In urban and resort areas, the hotels and restaurants generally serve reliable food and potable water. 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 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.
Typhoid Fever: Typhoid vaccine is 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, 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. Travelers should practice strict food, water and personal hygiene precautions even if vaccinated.
Volcanic Activity: The Soufriere Hills Volcano remains active with a fluctuating level of activity. Scientists at the Montserrat Volcanic Observatory (MVO) continuously monitor the status of the volcano. The Volcano Alert Level System ranges from Level 0 to Level 5. In December 2006 it was increased to level 4, which is described as: increased eruptive activity or potential for serious activity that could affect inhabited areas. Evacuation of persons and/or restrictions on movement are very likely.
• Since April 2007, growth of the current volcanic dome has slowed and the latest scientific advice is that the volcano is in a state of “pause”, but with the danger of a large hot dome remaining.
• The Unsafe Zone covers all areas south of the Belham Valley. The Unsafe Area boundary was moved back to the January 2007 line on 21 July on the basis of further scientific advice. All residential properties inthe Old Towne area, north of the Belham Valley, became available fro re-occupation.
• An island-wide siren system is installed to warn of volcanic activity. If the sirens sound, please tune in immediately to Radio Montserrat (ZJB) for a related safety message on FM 88.3 or 95.5. ZJB also provides regular scientific updates and advice.
The latest version of the risk map, revised in July 2007, can be viewed at http://www.mvo.ms/riskmap