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Morocco



Capital: Rabat

Time Zone: is local time. GMT +1 hour daylight savings time.
Tel. Country Code: 212
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plugs D, F.


Travel Advisory - Morocco

There is a low risk of malaria in North Africa and the Middle East, but other insect-transmitted diseases, such as leishmaniasis and viral infections, are potential threats. Safe water precautions, safe needle, and insect-bite prevention measures are important.

Dr. Rose Recommends for Travel to Morocco


Resource Links

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

Embassies

The U.S. Embassy is located at 2 Avenue de Marrakech in the capital city of Rabat, telephone [212] (37) 76-22-65. The workweek is Monday to Friday; however, the Consulate is closed to the public on Fridays for all consular services with the exception of emergency services for American citizens.

The American Consulate General in Casablanca is located at 8 Boulevard Moulay Youssef, telephone [212] (22) 26-45-50. Please note that all consular matters are handled at the U.S. Consulate General in Casablanca.
Please visit http://www.usembassy.ma for information on services offered by the U.S. Embassy in Rabat and http://casablanca.usconsulate.gov for information on all consular services and other assistance offered at the U.S. Consulate General in Casablanca.

• Embassy of Canada
13 bis, Jaafar As-Sadik Street
Agdal-Rabat
Tel: [212] (37) 68 74 00
Fax: [212] (37) 68 74 30
E-Mail: rabat@international.gc.ca
Internet: http://www.rabat.gc.ca

• British Embassy
28 rue Prince Sidi Mohamed
Souissi 10105 (BP 45)
Rabat
Tel: (212) (37) 63 33 33
Web: http://www.britain.org.ma

Entry Requirements

HIV Test: Not required.


Required Vaccinations: None required.

Passport Information

Passport/Visa: Morocco is a constitutional monarchy with a Parliament and an independent judiciary; however, ultimate authority rests with the king. The population is estimated at 32 million. While Morocco has a developing economy, modern tourist facilities and means of transportation are widely available, but may vary in quality depending on price and location. 

ENTRY/EXIT REQUIREMENTS: Travelers to Morocco must have a valid passport. Visas are not required for American tourists traveling to Morocco for fewer than 90 days. For visits of more than 90 days, Americans are required to apply for an extension (with a valid reason for the extension of stay). There are no required vaccines to enter Morocco. Travelers who plan to reside in Morocco must obtain a residence permit. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.

For further information on entry/exit requirements for Morocco, please contact the Embassy of Morocco at 1601 21st Street, NW, Washington, DC 20009, telephone (202) 462-7979 to 82, fax 202-462-7643, or the Moroccan Consulate General in New York at 10 E. 40th Street, New York, NY 10016, telephone (212) 758-2625, fax 212-779-7441. See our Foreign Entry Requirements brochure for more information on Morocco and other countries. Visit the Embassy of Morocco web site at http://www.usembassy.ma/ for the most current visa information.

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 infected blood or body fluids from unprotected sex; from injecting drug use with shared/re-used needles and syringes; from medical treatment with non-sterile (re-used) needles and syringes; from contact with open skin sores. 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.

Meningococcal (Meningitis): Quadrivalent meningitis vaccine is recommended for those travelers anticipating close contact with the indigenous population.

Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received received an additional dose of polio vaccine as an adult. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).

Rabies: Recommended for travelers spending time outdoors in rural areas where there is an increased the risk of animal bites. 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 in the event of a high-risk animal bite, but does not eliminate the need for treatment with the vaccine.

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

While the standard of medical facilities in Rabat and major cities is generally good, medical services in smaller cities and rural and remote areas can be extremely limited, and the medical staff seldom able to communicate in English. If driving in the mountains & remote areas, carry a medical kit & Moroccan phone card for emergencies. In event of car accidents involving injuries, immediate ambulance service not guaranteed or provided. Doctors & hospitals often expect immediate cash payment. Supplemental medical insurance with specific overseas coverage, including medical evacuation, is recommended.
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 or may be of unreliable quality.
• 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. Serious illness or injury may require evacuation to Europe.

A listing of doctors and hospitals is maintained by the U.S. Embassy at:
http://casablanca.usconsulate.gov/list_of_physicians.html

Medical facilities used by travelers include:

Marrakech
• Polyclinique du Sud
Dr. Taarji Bel Abbass
(Fair to Good English)
2 Rue Yougoslavie, Gueliz
Tel: [212] (44) 44-79-99/044-44-83-72

Casablanca
• Val d'Anfa Clinic: [212] (22) 39 14 39
• Ghandi Clinic: [212] (22) 36 05 34
• Maroc Assistance : [212] (22) 30 30 30
Website: http://www.isas.co.ma/

Tangiers
• Red Crescent Clinic: [212] (39) 94 25 17
• Timgis Clinic: [212] (39) 94 09 90 / 91 / 92
• Italian hospital: [212] (39) 93 12 88

Rabat
• Avicenne Hospital
Rabat (850 beds); general medical/surgical facility; blood bank
• Clinique Beausejour, Rabat
• Clinique California, Tangier

Destination Health Info for Travelers

AIDS/HIV: The prevalence of HIV in the Middler East and North Africa is estimated at 0.4%. As in other regions, known high-risk groups in the Middle East and North Africa include men who have sex with men, female sex workers and their clients, injecting drug users and prisoners.
• 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 body fluids or blood of another person. 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.

African Tick Bite Fever: This is a rickettsial disease caused by Rickettsia africae. (It is sometimes called South African spotted fever.) Symptoms: fever and a rash occur 3-7 days following a tick bite. Unlike Mediterranean spotted fever (see below): 1) multiple eschars may be present; and 2) the rash is vesicular, and present in only 30% of patients. Treatment: Doxycycline 100 mg twice daily for 3 to 5 days or chloramphenicol 500 mg four times daily for 3 to 5 days.

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 but levels are unclear. Sporadic cases and outbreaks of hepatitis E may go undiagnosed. 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 6%. 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 1.1% 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.

Leishmaniasis: Cutaneous leishmaniasis (CL) is widespread in semiarid rural areas, with increased vector activity June through September, particularly in Er Rachidia, Ouarzazate, and Tata Provinces. CL due to L. tropica apparently is distributed countrywide in rural areas, including the High Atlas mountain region (Azilal and Essaouira Provinces), Marrakech Province, and Agadir and Tiznit Provinces. L. infantum is focally distributed in urban areas throughout the country. Visceral leishmaniasis (kala-azar) is focally distributed throughout Morocco, including Fes, Marrakech, and the southwest Atlas region.
• The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite mostly in the evening and at night. They breed in ubiquitous places: in organically rich, moist soils (such as found in the floors of rain forests), animal burrows, termite hills, and the cracks and crevices in stone or mud walls, and earthen floors, of human dwellings.
• All travelers should take measures to prevent sandfly bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, permethrin (spray or solution) to clothing and gear, and sleeping under a permethrin-treated bednet.

Malaria: Year-round, but very limited risk, in rural areas of Khouribga Province. There is no malaria risk in Tangier, Rabat, Casablanca, and Fes. The risk of malaria (exclusively P. vivax) is highest from May to October. Chemoprophylaxis is not routinely recommended.

A malaria map is located on the Fit for Travel website (www.fitfortravel.nhs.uk), 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 Morocco page on the Destinations menu.

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 a malaria endemic region of this country.

Mediterranean Spotted Fever: This is a spotted fever disease caused by Rickettsia conorii organisms, which are transmitted by ticks. It is widely distributed in rural and suburban coastal areas of Morocco. Travelers to rural areas should take measures to avoid tick bites. Dogs and rodents are reservoirs of infection. It is also called boutonneuse fever, Indian tick typhu, Kenya tick typhus.
Symptoms: Headache, myalgia, maculopapular rash; an eschar (black ulcerative lesion at site of tick bite) may be identifiable; patient may recall tick bite or dog contact during the preceding 1 to 3 weeks; untreated disease resolves within two weeks; case-fatality rates of 2% to 3% are reported. Treat with doxycycline for 3 to 5 days.
• Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.

See also African Tick Bite Fever (above)

Note: Rickettsia conorii organisms include 4 different subspecies:
Boutonneuse fever and Mediterranean tick fever in Southern Europe and Africa (R. conorii subsp. conorii).
Indian tick typhus in South Asia (R. conorii subsp. indica).
Israeli tick typhus in Southern Europe and Middle East (R. conorii subsp. israelensis).
Astrakhan spotted fever in the North Caspian region of Russia (R. conorii subsp. caspiae).
More: http://wwwn.cdc.gov/travel/yellowBookCh4-Rickettsial.aspx and http://www.emedicine.com/med/TOPIC1412.HTM

Meningitis (Meningococcal): Cases of meningococcal disease associated with international travel were reported in 2000, with confirmed cases of Neisseria meningitidis serogroups C and W135. Travelers who anticpiate close, prolonged contact with the indigenous population should consider immunization with the quadrivalent conjugate vaccine Menactra.

Other Diseases/Hazards: Brucellosis (risk from unpasteurized goat/sheep milk and cheese)
• Echinococcosis (highly prevalent countrywide), leprosy
• Filariasis
• Tick-bore relapsing fever
• Sand fly fever (primarily in northern one-half of country)
• Toxoplasmosis (infection rates as high as 50%)
• Typhus (epidemic typhus; rickettsial disease, spread by body lice; rarely reported)
• West Nile virus (transmitted by night-biting Culex mosquitoes)

Rabies: A german tourist died of rabies in 2007 after being bitten on the hand by a stray dog. A 4-week-old dog, imported to Belgium from Morocco in 2007, developed rabies, as reported by PRO-MED. Sporadic cases of human rabies, usually transmitted by dogs, are reported, primarily from the populated northern urban and rural areas.
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: Year-round risk, with highest incidence in the summer. Urinary schistosomiasis is widespread, particularly along the wadis and slopes of the Anti- and Haut Atlas Mountains, the Atlantic and Mediterranean coast, in oases, and irrigated agricultural areas. Recognized foci occur in central and southern areas, including Agadir, Beni Mellal, El Kelaa des Srarhna, Er Rachidia, Marrakech, Ouarzazate, Taroudannt, Tata, and Tiznit Provinces. Activity also reported in northern areas, including Kenitra, Nador, and Tanger 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: Water sources in Morocco should be considered potentially contaminated. In urban and resort areas, the first-class hotels and restaurants generally serve reliable food and potable water. 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, 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.

Tuberculosis (TB): Tuberculosis is a major public health problem in Morocco. 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 fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people (with the exception of short-term visitors who restrict their meals to hotels or resorts) traveling to or working in Morocco, 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.

Typhus: no data