Time Zone: -9 hours.
Tel. Country Code: 680
USADirect Tel.: 0
Electrical Standards: Electrical current is 240/50 (volts/hz). Grounding Adaptor Plug E.
• U.S. Embassy
Tel:  488-2920
Fax:  488-2911
• There is no Canadian consular representation in Palau. The Canadian High Commission in Canberra, the Canadian Consulate General in Sydney and the Canadian Honorary Consuls in Melbourne and Perth cover the Pacific Islands of Federated States of Micronesia, Marshall Islands, Nauru, Palau, Papua New Guinea, Solomon Islands and Vanuatu.
Canadian High Commission
Tel:  (2) 6270 4000
Consular Fax:  (2) 6270 4081 or (02) 6270 4060
Alternatively, a collect call can be made to the Operations Centre in Ottawa at  (613) 996-8885.
• There is no British consular representation in Palau. Consular matters are covered by the British Embassy in Manila, the Philippines.
6752 Ayala Avenue
Tel:  (2) 580 8700
Fax:  (2) 840 1361
• Australia does not have an Embassy or Consulate in Palau. You can obtain consular assistance from the nearest Australian Embassy which is in Micronesia.
Federated States of Micronesia
Tel:  320 5448
HIV Test: Not required.
Required Vaccinations: A yellow fever vaccination certificate is required from all travellers over 1 year of age coming from countries with risk of yellow fever transmission or from countries in any part of which there is a risk of yellow fever transmission.
Passport/Visa: The Republic of Palau is a constitutional democracy in free association with the United States. Palau is an archipelago consisting of several hundred volcanic and limestone islands and coral atolls, few of which are inhabited, and is politically divided into 16 states. Palau’s developing economy depends on tourism, marine resources and a small agricultural sector. There are two kinds of public transportation available, taxi and Airai bus service. Palau International Airport is located on Babeldaob Island, near Koror Island. Direct commercial air service exists from Manila, Taipei and Guam to Palau.
ENTRY/EXIT REQUIREMENTS: Citizens and nationals of the United States of America, with the exception to United States military personnel must have a valid passport or other travel document for entry. United States military personnel shall have in their possession official orders or documents certifying the status of the individual or group. Such orders or documents shall be shown on request to the appropriate authorities of the Government concerned. For the purpose of their identification while in Palau, United States military dependents ten years of age or older shall have in their possession a personal identification card authorized by the Government of the United States which shall show the name, date of birth, status, and photograph of the bearer. Such card shall be shown on request to the appropriate authorities of the Government concerned. A passport shall not be considered valid if it expires in less than six months from date of entry. A visa is not required for U.S. citizens visiting Palau for one year or less, provided the visitor otherwise complies with applicable regulations, for example, on employment. For more information about entry requirements of Palau, travelers may consult with the Embassy of Palau, 1700 Pennsylvania Avenue NW, Suite 400, Washington, DC 20036, (202) 452-6814. Visit the Embassy of Palau website at http://www.palauembassy.com/ for the most current 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 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.
• 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-stay visitors who restrict their meals to hotels or resorts.
HOSPITALS / DOCTORS
All travelers should be up-to-date on their immunizations and are advised to carry a customized first aid 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 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 medical evacuation to Guam (830 miles), The Philippines or Australia.
Divers visiting Palau should have travel and health insurance that includes coverage for deep sea diving, hyperbaric chamber and evacuation costs. Many of the popular dive sites are located away from the capital, Koror. The hospital in Koror has one hyperbaric chamber.
Medical care is adequate for routine problems, but the quality is variable. The main health facility is the 80-bed Belau National Hospital, which has a regularly maintained hyperbaric chamber for divers. There are also three private clinics.
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 Palau. A small number of AIDS cases and HIV infections have been reported from various areas. At the present, HIV/AIDS is not considered a major public health problem in Oceania. (Source: www.Avert.org)
• 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 & 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.
Animal Hazards: There are no venomous land snakes in Palau.
Crime/Security/Civil Unrest: The crime rate in Palau is low, though there has been an increase in the incidence of petty crime and assault.
Local Travel: The safety standards you might expect of tour operators are not always met, especially for adventure sports such as diving and yachting. Sufficient life jackets and adequate safety equipment may not be provided. Recommended maintenance standards and safety precautions may not be observed. Check operator credentials and safety equipment beforehand and ensure your travel insurance policy covers your planned activities.
Dengue Fever: A large outbreak was described in 1995 (http://www.ajtmh.org/cgi/content/abstract/69/2/135) and also in 2000. There has been an increase in the number of cases over the past 12 months. Many cases may go underdiagnosed or underreported. Dengue fever is a mosquito-transmitted, flu-like viral illness occurring in throughout the Pacific Islands. 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
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 may be endemic but levels are unclear. 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.
• Hepatitis B is hyperendemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 15%. 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 prevalence in the general population is unclear. 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.
Japanese Encephalitis (JE): Sporadic cases and outbreaks have been reported. Vaccination against JE, however, is not recommended by the CDC as a routine precaution.
• Japanese encephalitis is transmitted by night-biting Culex mosquitoes. All travelers should take measures to prevent mosquito bites, especially in the evening and overnight. 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.
Malaria: There is no risk of malaria in this country.
Marine Hazards: Hazards to bathers include corals, jellyfish, poisonous fish, and sea snakes. There are saltwater crocodiles in parts of Palau and no warning signs to indicate their presence. Avoid mangrove areas and check with local authorities before considering water activities.
• 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.
Rabies: Palau is reported to be rabies-free at this time, but surveillance is limited. Animal bites of any type should be thoroughly cleansed with soap and water and evaluated by a competent healthcare provider for possible post-exposure treatment.
Travelers' Diarrhea: Medium risk. 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 milk and dairy products. Do not eat raw or undercooked food (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). Peel all fruits.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene helps prevent travelers’ diarrhea.
• 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 fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people (except short-stay visitors and cruise ship passengers) 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.