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New Caledonia



Capital: Noumea

Time Zone: +11 hours. No daylight saving time in 2008.
Tel. Country Code: 687
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Groudning Adaptor Plug D.

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• New Caledonia is a French Overseas Territory. It is an island group approximately 1500km (930 miles) off the northeast coast of Australia. It consists of the island of New Caledonia along with a number of other smaller islands. The Loyalty Group lies to the east of New Caledonia, the main islands being Ouvéa, Lifou and Maré. The remaining islands are the Chesterfield Group, Hinter, Huon Group, Matthew and Walpole.

• There is no U.S. Embassy or Consulate in New Caledonia. The U.S. Embassy in Fiji provides assistance for U.S. citizens in New Caledonia.
The U.S. Embassy in Fiji is located at 31 Loftus Street in the capital city of Suva, telephone (679) 331-4466; fax (679) 330-2267.
Information may also be obtained by visiting the Embassy�s home page at http://suva.usembassy.gov/.

• Canadian/Australian Embassy
Immeuble Foch, 7th Floor
19 rue du Marechal Foch
Noumea
Tel: 687-272-414
Fax: 687-278-001

There is no resident British Diplomatic Mission in New Caledonia. Routine consular matters are covered by the British Embassy in Paris.
• British Embassy (Paris)
Tel: [33] (1) 44 51 31 00
[33] (1) 49 55 73 00 (British Council)

Fax: [33] (1) 44 51 31 27 (Consular)
Email: webmaster.paris@fco.gov.uk

In case of emergency, contact the Honorary British Consul in New Caledonia, Nouméa
Tel: [687] 282153
Fax: [687] 285144)
or at 14 Rue Sarrail, Mont Coffyn, Nouméa.

Entry Requirements

HIV Test: Not Required.

Required Vaccinations: A yellow fever vaccination certificate is required from travelers over one year of age arriving from infected areas.

Passport Information

Passport/Visa: New Caledonia is a French overseas territory located in the Southwest Pacific near Australia. It consists of the large island of New Caledonia, the Loyalty Islands, the Isle of Pines, and several smaller island groups. The capital is Noumea. The moderately developed economy is based on mining and, to a lesser degree, tourism. Tourist facilities can be found throughout New Caledonia, the Loyalty Islands, and the Isle of Pines. The French Government Tourism Office, which has a wide range of information available to travelers, can be contacted by telephone at (212) 838-7800.

ENTRY/EXIT REQUIREMENTS: A passport valid for six months beyond duration of stay is required. Visas are not required for stays of up to one month. Extensions for up to three months may be granted locally by applying to the Haut Commissionaire (The French High Commissioner). For longer stays, you must apply for a visa at your nearest French Embassy or Consulate well beforehand, as the processing time is quite long. For further information about entry requirements, travelers, particularly those planning to enter by sea, may contact the French Embassy at 4101 Reservoir Road NW, Washington, DC 20007, telephone 202 944-6200, fax 202-944-6212, or visit the Embassy of France web site at http://www.info-france-usa.org.

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.

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 with the exception of short-term visitors who restrict their meals to hotels or resorts.

Hospitals / Doctors

The standard of medical facilities in New Caledonia is good for uncomplicated conditions and treatment. Nouméa's central hospital can handle routine and emergency matters but complicated conditions require evacuation to Australia. Medical care is substandard in the rest of the country.

Medical and hospital costs in New Caledonia are extremely high. For example, an intensive care bed in Noumea could cost up to $4,000 per day. Ambulance transfers, even for short distances, can cost $1,250 or more. A helicopter evacuation from one of the islands to Noumea will cost in excess of $6,500. An aeromedical evacuation from Noumea to Australia can exceed $40,000. Passengers on cruise ships are routinely evacuated to Nouméa for hospitalization.

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 uncertain 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 aeromedical evacuation to Australia.

There is only one hyperbaric (decompression) chamber in New Caledonia, located in Nouméa. Many of the popular dive sites are located on other islands and it may take several hours to reach facilities in the event of an accident. All registered dive companies carry basic treatment equipment to meet PADI standards and many require participants to have insurance cover for diving.

• Nouméa has one public hospital, three private clinics and an adequate selection of pharmacists. The smaller islands have community clinics providing basic medical care. The main medical facility in New Caledonia is the Hôpital Gaston Bourret:

• Hôpital Gaston Bourret
Centre Hospitalier Territorial
Rue Paul Doumer
Noumea
Tel: 25-66-66
Website http://www.cht.nc/
General medical/surgical facility; 24-hour ER; outpatient clinics.

• Polyclinique de l'Anse Vata
180 Route de l'Anse
Vata
Noumea
Tel: 26-14-22
Private clinic.

• Clinique de Baie de Citrons
5 Rue Fernand Legras
Nouméa
Tel: 26-18-66
Private clinic.

• Centre Hôpitalier Nord
Koumac
Tel: 35-62-16
Emergency and outpatient services.

• Centre Hôpitalier Est
Poindimie
Tel: 42-71-44

Destination Health Info for Travelers

AIDS/HIV: It is estimated that 0.4% of the adult population of Oceania is living with HIV/AIDS, but no statistics are currently available for New Caledonia.
• 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.

Cholera: Sporadic cases of cholera occur in Oceania but the threat to tourists is very low. Cholera is an extremely rare disease in travelers from developed countries. 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: A large outbreak of dengue fever was reported in January 2009. Most of the cases are occurring in the Greater Noumea area, especially the suburban town of Dumbea. Outbreaks of the mosquito-borne disease dengue fever are frequent, especially during the warm wet months of February to May. Dengue fever is a mosquito-transmitted, flu-like viral illness occurring in many parts of Oceania. 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

Filariasis: Malayan filariasis is widespread in the rest of Oceania, including the Solomon Islands and Vanuatu. Up to 16% prevalence has been reported in French Polynesia. Hyperendemic foci reported in the Cook Islands. Travelers should take personal protection measures against mosquito bites.

Hepatitis: Hepatitis A is endemic at moderate to high level. 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 may be endemic but levels are unclear. A very small percentage of the population is seropositive for this disease. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. 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 11.7%. 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 at a very low level 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.

Influenza: Influenza is transmitted year-round in the tropics. The flu vaccine is recommended for all travelers over age 6 months.

Leptospirosis: There has been a higher than usual number of cases of leptospirosis in 2008. A leptospirosis epidemic affected New Caledonia during the first semester of 2008 and a total of 135 cases were diagnosed with a fatality rate of 3.7%. Heavy rainfalls, related to La Niña, favoured this epidemic. Local authorities recommend wearing shoes when walking, avoiding swimming in rivers, not playing in muddy water, storing food in enclosed containers and removing rubbish from around homes. For information on leptospirosis from the World Health Organization, go to: http://www.who.int/water_sanitation_health/diseases/leptospirosis/en/

Leptospirosis (also known as Weils disease) is a bacterial (spirochetal) illness commonly transmitted to humans by allowing fresh water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, eyes or with mucous membranes. The chief animal hosts are dogs, rats and mice. An important risk is walking through ponds or stagnant water in rural areas, especially during the rainy season. Leptospirosis is also contracted by those engaged in water sports, such as rafting, especially after flooding has resulted in contamination of rivers and streams.

Malaria: No malaria is reported in New Caledonia.

Marine Hazards: Ciguatera poisoning is prevalent and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
Swimming-related hazards include sharks, jellyfish, including the Indo-Pacific man-of-war, stonefish, scorpion fish, stingrays, sea snakes, spiny sea urchins, sharp coral and poisonous cone shells. Swimmers should take sensible precautions to avoid these hazards. Stonefish, scorpion fish and stingrays congregate in shallow water along the ocean floor and can be difficult to see. Wearing booties may help protect you, but should not be relied upon as complete protection, as many of the spines are sufficiently rigid and long to penetrate wetsuits, booties, and gloves.
•The jellyfish population appears to be increasing, due in part to overfishing of jellyfish predators, rising water temperatures, and pollution. Jellyfish travel in groups, so looking before you leap into water may be protective.
Treatment guidelines for jellyfish stings: http://www.emedicine.com/derm/topic199.htm
•To avoid a shark attack, swim or dive with a group. Avoid swimming during hours of darkness or twilight, in fog, or in murky waters. Avoid swimming in the vicinity of sea lions, harbor seals or elephant seals. Avoid swimming near the mouths of rivers where sharks hunt for fish. When diving, minimize time spent at the surface. Wearing a wetsuit and fins or lying on a surfboard creates the silhouette of a seal to a shark below you. Shallow water is not a deterrent to sharks; attacks have occurred in less than 5 ft/1.5 m of water.

The most serious hazards:
Sea snakes: Sea snake venom is highly toxic and the mortality has been reported to be 25% in untreated cases. In severe envenomations, symptoms can occur within 5 minutes, but typically evolve over 8 hours. It is possible that the victim may not have been aware of the bite, since there is little or no pain on envenomation.
Symptoms often include anxiety, muscle aching, salivation and a sensation of tongue swelling, followed by nausea, vomiting, muscle spasms, ascending paralysis, ocular palsy and sometimes loss of vision. Respiratory collapse may ensue, and the need for endotracheal intubation and mechanical ventilation should be anticipated. Sea snake antivenom (older name: antivenin) should be administered in all actual and suspected cases.
•A sea snake bite is always a medical emergency, even if the victim does not appear ill.
•You must get the victim to an emergency department, as fast as possible.
•En route, attempt to keep the bite site in a resting position, while keeping the victim as still as possible.
•Apply a broad pressure bandage over the bite about as tight as an elastic wrap to a sprained ankle. This is intended to slow the spread of the venom through the lymphatic system. Apply a splint to the limb. Make sure that arterial circulation is not cut off, by making sure fingers or toes stay pink and warm.
•Never cut open a sea snake bite and try to suck venom from the victim.
•Sea snake toxin is not inactivated by changes in temperature or pH. Application of ice, hot packs, or vinegar only wastes time.
Read more: http://emedicine.medscape.com/article/771804-overview

The box jellyfish is the most dangerous jellyfish in the world. Box jellyfish belong to the class Cubozoa, and are not a true jellyfish (Scyphozoa), although they show many similar characteristics. When people talk about the extremely dangerous Australian box jellyfish they refer to the species Chironex fleckeri. Chironex fleckeri (sometimes simply called “the box Jellyfish”), is the best-known species of box jellyfish, and is only one of a category which actually contains about 19 different species. The name sea wasp is also applied to some species of Cubozoans, including the aforementioned Chironex fleckeri. Chironex fleckeri is present in the waters of Australia, the Indo-Pacific region, including Vietnam, Papua New Guinea, the Phillipines, and Hawaii. It amy be present in New Caledonia. Their exact distribution has not been fully determined.
The other species that is known to have caused deaths is Carukia barnesi, commonly called Irukandji. This tiny jellyfish is only about thumbnail size.
•Box jellyfish stings are extremely painful, potentially lethal and require treatment with antivenom. Cardio-respiratory arrest may occur within 20 minutes of envenomation. Four other varieties of jellyfish (jimble, Carukia, mauve stinger, and hairy stinger) should also be avoided.
Box jellyfish treatment and antivenom information:
http://emedicine.medscape.com/article/1087794-overview
http://www.toxinology.com/generic_static_files/cslavh_antivenom_boxjelly.html

The stonefish is a rather unattractive squat fish with a mostly rough “skin” that assists its superb camouflage as it sits on old coral or debris. There is a series of erectile dorsal spines, which, with the associated venom glands, provides the creature means of envenoming potential predators. Stonefish are mostly encountered in shallow water, where they may be stepped on by accident, or picked up by the unwary. Instant and severe pain is a constant feature of stings, followed by local swelling, which may be marked, tenderness and a blue discoloration of skin surrounding the sting site. Dizziness, nausea, hypotension, collapse, cyanosis and pulmonary edema have been described, though are by no means common. Tissue ischemia at the sting site is possible.
•Antivenom: Stonefish antivenom should only be given if there is clear evidence of envenomation. It should be given only IM, not IV.
•The use of stonefish antivenom in stings by other species of scorpionfish is not clearly recommended, but there is limited evidence that it may be beneficial (e.g. possibly bullrout stings, Notesthes robusta). The potential risks of immediate and delayed adverse reactions to antivenom should be carefully considered before using this antivenom for other than stonefish stings.

Emergency treatment guidelines for marine stings are here:
http://www.jcu.edu.au/interest/stingers/first%20aid%201treatment.htm#firstaidtop

Sources:
Clinical Toxicology Resources
University of Adelaide
Website: http://www.toxinology.com/index.cfm

Wilderness Medicine and Field Guide to Wilderness Medicine
http://www.travmed.com/catalog/index.php?cPath=172

Other Diseases/Hazards: Angiostrongyliasis (human cases reported from New Calendonia)
•Anisikiasis (endemic region-wide)
•Brucellosis, (enzootic on the Solomon Islands; likely more widespread)crub typhus (reported in rurals areas of the Solomon Islands and Vanuatu).
•Hookworm disease, roundworm disease, strongyloidiasis, and other helminthic infections are reported throughout Oceania.
•Melioidosis
•Ross River fever (viral epidemic polyarthritis; mosquito-borne; endemic in northern and eastern Australia; now reported in Central and South Pacific).

Rabies: Rabies is not reported in New Caledonia, but there is little surveillance information. All unprovoked animal bites should be medically evaluated for possible post-exposure treatment.

Travelers' Diarrhea: Most risk occurs outside of first-class hotels and resorts. Town tap water is safe to drink. 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 highly endemic in New Caledonia 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 unvaccinated people traveling to or working in Oceania, 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.