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Norway



Capital: Oslo

Time Zone: +1 hour. GMT +2 hours between the last Sunday in March and the Saturday before the last Sunday in October.
Tel. Country Code: 47
USADirect Tel.: 800
Electrical Standards: Electrical current is 230/50 (volts/hz). Round two-pin plugs are in use. Grounding Adaptor Plug D.


Travel Advisory - Norway

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 Norway


Resource Links

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

Embassies

• U.S. Embassy
Drammensveien 18
Oslo
Tel: [47] (22) 44-85-50
Website: www.usa.no

• Canadian Embassy
Wergelandsveien 7
Tel: [47] (22) 99-53-00
E-mail: oslo@dfait-maeci.gc.ca

• British Embassy
Thomas Heftyesgate 8
Oslo
Tel: [47] (23) 13 27 00
Email: britemb@online.no
Website: http://www.britain.no

Entry Requirements

HIV Test: Not required.

Required Vaccinations: None required.

Passport Information

Passport/Visa: Norway is a highly developed stable democracy with a modern economy. The cost of living in Norway is high and tourist facilities are well developed and widely available. Read the Department of State Background Notes on Norway for additional information.

ENTRY REQUIREMENTS: A valid passport is required. Norwegian entry visas are governed by the rules of the Schengen Agreement. U.S. citizens may enter Norway for tourist or general business purposes without a visa for up to 90 days. That period begins when you enter any of the Schengen countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden. 
Contact the Royal Norwegian Embassy at 2720 34th Street, NW, Washington, DC 20008-2714, tel:1-202-333-6000, website: http://www.norway.org or the nearest Norwegian Consulate. Consulates are located in Houston, Minneapolis, New York City, and San Francisco. Information can also be obtained from the Norwegian Directorate of Immigration at http://www.udi.no.

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 travelers who might be exposed to blood or bodily fluids from unprotected sex with a high-risk partner; 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 virus.

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.

NOTE: There has been a significant number of cases of measles reported in travelers from England and the outbreak in Norway is linked to the ongoing UK outbreak.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3217
Measles is a potentially serious infectious disease, particularly for children, and the Department of Health and Ageing advises that travellers to Switzerland should ensure they are protected against measles prior to travel and should consult their doctor.

Who should receive the MMR vaccine?
• All infants 12 months of age or older
• Susceptible adults who do not have documented evidence of measles immunity, such as a physician-diagnosed case of measles, a blood test showing the presence of measles antibody, or proof of receiving measles vaccine.

Immunity against measles is particularly important for adults at high risk for measles exposure, including college students and health care workers. People born before 1957 who are not in one of these high-risk categories are generally considered immune to measles through environmental exposure. 

Hospitals / Doctors

Medical facilities are widely available and of high quality, but may be limited outside the larger urban areas. The remote and sparse populations in northern Norway, and the dependency on ferries to cross fjords of western Norway, may affect transportation and ready access to medical facilities.
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 also provides for medical evacuation in the event of serious illness or injury, especially if traveling in a remote location in this country.

• Aker University Hospital
Tel: [47] (22) 89 40 00
Aker University Hospital was founded in 1895 in Oslo, Norway and is currently one of the largest hospitals in Norway. It also serves as a regional hospital for Norway’s Health Region East, which includes Oslo, Hedmark, Oppland, Akershus and Ostfold counties.
http://www.answers.com/topic/aker-university-hospital

• The University Hospital of North Norway
Tromsø
Website: http://www.answers.com/topic/universitetssykehuset-nord-norge-hf
UNN is the regional hospital of the northern health region, which includes the counties of Nordland, Troms and Finnmark

• Rikshospitalet University Hospital
Oslo
Sognsvannsveien 20
Oslo
Tel: [47] (23) 07 00 00
Website: http://www.rikshospitalet.no/portal/page/portal/no/forsiden/globale/english
National referral hospital with all specialties.

• Ullevål University Hospital
Oslo
Tel: [47 (22) 93 22 93
The largest hospital in Norway, and one of the largest in Northern Europe. It has more than 8,600 employees. 940 of them are doctors and 2,400 nurses. With a total of 1,200 beds Ullevål admits some 45,000 patients per year and its polyclinics have about 400,000 consultations per year. The main hospital is located near the centre of the Norwegian capital Oslo, and was opened in 1887.

Travel Medicine & Infectious Diseases
• Linda H. Maeland, MD
Centrum Vaksiner a.s
Nordboegaten 6
Stavanger
Tel: [47] (51) 93 86 80
Fax: [47] (51) 93 86 81
E-mail: post@centrumvaksiner.no
Website: http://www.centrumvaksiner.no
Pre-Travel Vaccination, Official Yellow Fever Vaccine Center.

Destination Health Info for Travelers

AIDS/HIV: The prevalence of HIV adults in Norway is estimated at 0.1 percent. This is well below France (0.4%), Italy (0.5%) and Spain (0.6%). (Source: www.Avert.org)
• In 2007, 248 new cases of HIV infection were diagnosed, a moderate decrease from the previous year. The HIV epidemic shows the same spread pattern as before. In total, 3,787 people are diagnosed with HIV infection in Norway. Newly diagnosed cases of HIV in men who have sex with men group was 77, compared to 90 in the previous year. The majority claim to have been infected in Oslo where there has been a continuous outbreak of HIV infection in the MSM group. Most who are infected heterosexually were infected before arrival in Norway (99 cases). In total, 42 people were diagnosed after heterosexual contact whilst they were living in Norway. Most were infected outside the country (27) whilst 15 were infected in Norway. As before, most men are infected abroad. In 2007, 12 men were infected in Thailand. The number of injecting drug addicts with HIV remains at a stable, low level (13). There is still very little HIV transmission among young heterosexuals in Norway. (Eurosurveillance 30 April 2008)
• 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 (not a risk factor in Norway).
• 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.
• 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.

Food-Borne Disease: Around 150 cases of shigellosis are confirmed per year, the majority caused by Shigella sonnei. Only around 10 to 20 of the shigellosis cases reported each year are acquired in Norway, usually as secondary cases caused by faecal-oral transmission in households.
In May 2009, the Norwegian Institute of Public Health (NIPH) identified a possible outbreak of Shigella sonnei infection involving four cases. Additionally, five suspected cases in two separate households were reported. Sugar peas imported from Kenya appear to be the source of illness.

Food-Borne Disease: Salmonellosis: In November-December 2008, Norway and Denmark independently identified outbreaks of Salmonella typhimurium infections. Outbreak investigations led to the identification of pork in various forms as the source.
Read more: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19147

Hepatitis: Low risk, but hepatitis A is a preventable disease and all travelers, not previously immunized, should consider receiving hepatitis A vaccine. Sporadic outbreaks of this disease do occur in developed countries. Hepatitis A is transmitted through contaminated food and water. 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. 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 1s estimated at <2% in the general population. 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 low level with a prevalence of 0.1% 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.

Legionnaires' Disease: During June and July 2008, five cases of Legionnaires’ disease (LD) were reported in the industrial twin cities Sarpsborg and Fredrikstad in southeast Norway. In the same area, a large outbreak of LD with 56 cases and 10 deaths had occurred in 2005. The source at the time had been traced to an industrial air scrubber in a wood-based chemicals. During this outbreak patients were infected up to 10km away from the source. The risk to tourists is deemed low.
Source: Eurosurveillance Sept 2008: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18985

Lyme Disease: Lyme disease is transmitted April through September by ticks in brushy areas and forests in the southern coastal areas at elevations below 1,500 meters.
• 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. There is no vaccine against Lyme disease.
• A single 200-mg dose of doxycycline is effective in preventing Lyme disease in someone who has just been bitten by an infected tick. (Reference: http://content.nejm.org/cgi/content/abstract/345/2/79)

Rabies: Norway is reported to be rabies-free. All unprovoked dog or wild animal bites, however, should be medically evaluated for possible post-exposure treatment.

Seafood-Related Illness: Anisakiasis is a parasitic disease of fish transmitted by eating raw, smoked, undercooked, or lightly pickled saltwater fish, especially salmon, herring, mackerel, gefiltefish, whitefish, cod, and sole. The parasite is the larval form of a marine roundworm, which may be present in the muscles and organs of the fish just mentioned. The worm is harmless when cooked to an internal temperature of 140 degrees F or frozen (rapid freeze) to -40 degrees or to -4 degrees for three to five days. If salmon is to be eaten raw or cold-smoked, it should have been frozen properly beforehand.
The worm attaches to the lining of the stomach or intestine. Symptoms include nausea and vomiting, or abdominal pain that mimics appendicitis. The treatment is surgical excision of the worm from the intestinal tract.
• Diphyllobothriasis (fish tapeworm disease) This is an infection caused by a fish tapeworm called Diphyllobothrium latum and occurs among people who eat raw, smoked, pickled, or undercooked freshwater fish. These include Eskimos, fishermen, devotees of sushi bars (salmon), and people who taste raw fish (such as whitefish) while cooking. Symptoms are uncommon but may include primarily abdominal cramps and diarrhea, but fatigue and, rarely, anemia from vitamin B12 deficiency can also occur because fish tapeworms consume this important vitamin. Treatment (adults and children) is with a single dose of praziquantel, 10 mg/kg.
• Travelers to Norway and other Scandinavian countries should be aware of the potential risk (not clearly defined) of eating raw, undercooked, salted, or smoked fish.

NOTE: In the EU, conditions concerning control of parasites are laid down in Council Directive no. 91/493/EEC (EC, 1991a). All fish and fish products must be subject to a visual inspection during processing for the purpose of detecting and removing any visible parasite. Further, all fish that are to be consumed raw or almost raw must be subjected to a freezing process (-20 degrees for at least 24 hrs). This also applies to fish products that are heated (e.g. hot smoked) to a temperature of less than 60°C. As far as salted fish is concerned, the process must be sufficient to destroy the larvae of nematodes. The US regulations stipulate that the freezing process to destroy parasites should be -20°C for 7 days or -35°C for 15 h (FDA, 2001a).
• The best prevention and control of anisakiasis is eating well-cooked or well-frozen fish only. A number of well-known fish products can be unsafe. This applies to all lightly preserved fish products (< 5% NaCl in water phase) such as cold smoked fish, gravad fish, matjes herring, lightly salted caviar, ceviche and several other local traditional products. A short period of freezing - either of the raw material or the final product - must be included in the processing as a mean to control parasites.

Sexually-Transmitted Diseases: Quinolone-resistant gonorrhea has been reported in 2008. Although quinolones are currently the recommended treatment for gonorrhea in Norway, ceftriaxone (Rocephin) may be preferred.

Tick-Borne Encephalitis (TBE): Tick-borne encephalitis occurs in rural wooded areas, April through September, along the south and southwest coast.
TBE was first reported in 1997. All 28 cases between 1997 and 2007 were acquired within a limited area along the southern coast and in the municipality of Tromøy. Risk may occur in other areas, but levels are unclear. TBE vaccine, which is available in Europe and Canada, is recommended only for travelers such as hikers and campers, or forestry workers, anticipating extensive outdoor exposure in endemic areas.
• Travelers, especially those engaging in outdoor activities in rural areas, 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.
More information at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18916

Travelers' Diarrhea: There is a very low risk of bacterial or parasitic-caused diarrhea in this country. Tap water is potable throughout Norway. A quinolone antibiotic, or azithromycin, combined with loperamide (Imodium), is recommended for the treatment of acute diarrhea. Diarrhea not responding to treatment with an antibiotic may be due to a parasitic disease such as giardiasis.