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Serbia



Capital: Belgrade

Time Zone: +1 hours. GMT +1 hour daylight savings time.
Tel. Country Code: 381
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.


Travel Advisory - Serbia

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 Serbia


Resource Links

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

Embassies

• U.S. Embassy
Kneza Miloa 50
Belgrade
Tel: [381] (11) 361 9344
E-mail: Consularbelgrd@state.gov
Website: http://belgrade.usembassy.gov/

• Canadian Embassy
Kneza Milosa 75
Belgrade
Consular Services
Tel: [381] (11) 306-3000 ext. 3341
Fax: [381] (11) 306-3042

• British Embassy
Resavska 46
Belgrade
Tel: [381] (11) 2645 055
E-mail: belgrade.consular@fco.gov.uk Consular Enquiries

• British Office Pristina, Kosovo
Ismail Qemajli 6
Arbri/Dragodan
Pristina
Tel: [381] 38 254 700
Faxe: [381] 38 249 799
E-mail: britishoffice.pristina@fco.gov.uk

Entry Requirements

HIV Test: Not required.

Required Vaccinations: None required.

Passport Information

Passport/Visa: Serbia is a country that continues to undergo political changes. Following a May 21, 2006 referendum, Montenegro declared independence and the name of the country changed from Serbia and Montenegro to the Republic of Serbia, with the Republic of Montenegro now a separate state. This change has had minimal impact on foreign travelers.
Tourist facilities are widely available within Serbia but vary in quality. Some facilities may not be up to western standards.
The security environment, travel situation and entry requirements for Kosovo, which is currently administered by the United Nations Mission in Kosovo (UNMIK), may differ from the rest of Serbia. Please see additional specific information on Kosovo that follows the information on Serbia. Read the Department of State Background Notes on Serbia for additional information.

ENTRY REQUIREMENTS: U.S. citizens with tourist, official, or diplomatic passports do not require a visa for entry and stay in Serbia for up to 90 days. Individuals planning to stay longer than 90 days should obtain a visa prior to arrival. This applies to bearers of all types of U.S. passports: tourist, official, and diplomatic. To obtain a visa, travelers should contact the Serbian Embassy in Washington at telephone (202) 332-0333 or fax (202) 332-3933. The address of the Embassy is 2134 Kalorama Road, Washington, DC 20008 and the web site is http://www.mfa.gov.yu. Alternatively, travelers may also contact the Consulate General in Chicago at telephone (312) 670-6707 or fax (312) 670-6787 or by email at yuconsulate@aol.com. The address of the Chicago Consulate is 201 East Ohio St., Suite 200, Chicago, Illinois 60611. 

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; 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.

Rabies: Rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection.

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.

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; may be of dubious origin; or of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance medevac. In the event of a serious illness or injury that can't be treated locally, every effort should be made to arrange medical evacuation to Western Europe.

Medical care is limited. Many physicians in Serbia are well-trained, but hospitals and clinics may lack equipment and supplies.

A list of doctors and hospitals maintained by the U.S. Embassy is at: http://belgrade.usembassy.gov/consular/uscs/doctors.html

Emergency centers:

• Military Medical Academy
Vojno Medicinska Akademija
Centar Za Dijalizu Crnotravska 17
Belgrade
Tekephones:
Emergency Department: 266-2516
Urgent Care Center: 266-2755
Website: http://www.vma.mod.gov.yu

• Emergency Centre
Pasterova 2
Belgrade
Tel: 361-8444

For routine health care in Belgrade, many travelers go to one of the following private clinics:

• Bel Medic General Hospital
Koste Jovanovica 87
Tel: 309-1000
mobile 381 (0)65 309 1000
Website: http://www.belmedic.com/eng/home.php

• Bel Medic Outpatient Clinic
Viktora Igoa 1
Tel: 306-5888, 306-6999
Mobile: 381 (0) 63 206 602
Website: http://www.belmedic.com/eng/home.php

• Bel Medic General Practice
Vladimira Popovica 10
Tel: 309-1000
Mobile 381 (0)65 309 1000
Website: http://www.belmedic.com/eng/home.php

• Medical Center Dr. Ristic
Narodnih Heroja 38
Belgrade
Tel: [381] (11) 2693 287
Website: http://www.dr-ristic.co.yu/english/index.html

• Anlave Clinic
Majora Branka Vukosavljevica 114
Novi Beograd
Bezanijska kosa
Tel. 2271-944, 3175-929
Website: http://www.anlave.co.yu

Destination Health Info for Travelers

AIDS/HIV: In most countries the HIV epidemic is driven by behaviors (e.g., multiple sexual partners, commercial sex, injecting drug use) that expose individuals to the risk of infection. In Serbia, the epidemic is predominantly urban, young, male, injecting drug users and their sexual partners and other transmission groups account primarily for the rise in HIV/AIDS in this country. Central Europe, however, has been relatively spared by the HIV epidemic, with the incidence of both AIDS cases and newly diagnosed HIV infections remaining low. The prevalence of adults living with HIV in Serbia is estimated at 0.2%. (Source: Avert.org)
• 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 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.

Avian Influenza A (Bird Flu): The Serbian Ministry of Agriculture confirmed on 9 March 2006 that the H5N1 form of avian influenza (bird flu) has been found in one dead swan in the Veliki Backi canal near Sombor in north-eastern Serbia. The Serbian authorities have declared the 10-kilometre radius to be an infected area and have taken measures to prevent any spread, including isolating domestic poultry and disinfecting access roads and paths to the area. No human infections or deaths have been reported in Serbia.
• Avian influenza A (H5N1) is predominantly a disease of birds. The virus does not pass easily from birds to people and does not to pass from person to person (except in very rare cases of close contact with an infected blood relative).
• The risk to humans from avian influenza is believed to be very low and no travel restrictions are advised, except travelers should avoid visiting animal markets, poultry farms and other places where they may come into close contact with live or dead poultry, or domestic, caged or wild birds and their excretions. In addition, travelers are advised to: 1. Cook poultry and egg dishes thoroughly. (Well-cooked poultry is safe to eat.) 2. Wash hands frequently with soap and water if around poultry.
• The World Health Organization (WHO) does not recommend travel restrictions to countries experiencing outbreaks of influenza A (H5N1) in birds, including those countries which have reported associated cases of human infection. To date, no cases of avian influenza A (H5N1) illness have been identified among short-term travelers visiting countries affected by outbreaks among poultry or wild birds.

The usual vaccines against influenza are not protective against “bird flu.” Oseltamivir (Tamiflu) is somewhat effective in the treatment of avian influenza A (H5N1). It seems to be effective in some cases, but may fail in others. Recently, resistant strains have been reported. In addition, the dosage and duration of treatment appear to be different in severe cases.

Crimean-Congo Hemorrhagic Fever (CCHF): Crimean Congo hemorrhagic fever (CCHF) is endemic to Kosovo. Although, most cases of CCHF occur in the region of Central Kosovo, during the summer months other rural areas of Kosovo can be affected. CCHF is caused by a virus and is transmitted by tick bite or by exposure to blood or secretions from infected animals or humans. Anyone who has visited Kosovo and is suffering from a fever, headache, chills, muscle aches, vomiting, red rash (which does not fade when pressed under glass), bleeding on the roof of the mouth, or any other unexplained symptoms should seek medical advice immediately.
Risk is seasonal, associated with periods of high tick activity (usually March through September, but seasonal patterns may occur) and increases in tick and rodent host populations.
• Studies have found up to 12% of the population is seropositive in some foci of the former Yugoslavia, with higher rates reported in domestic livestock. A major outbreak also occurred in Kosovo and Montenegro areas in 1995.

Diphtheria: All travelers, especially 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 is a new tetanus-diphtheria-pertussis (Tdap) vaccine that not only boosts immunity against diphtheria and tetanus, but has the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children.

Hepatitis: In November 2007, The Health Ministry declared a widespread outbreak of hepatitis A (food- and water-borne hepatitis) in South Serbia. All travelers not previously immunized against hepatitis A should be vaccinated against this disease. 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 levels are unclear. Transmission of HEV occurs primarily through contaminated drinking water. There is no vaccine.
• The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 8% to 10%. 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 low levels in the general population, but there is a higher incidence in injecting drug users. 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 world’s population. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.

Leishmaniasis: Cutaneous and visceral leishmaniasis is endemic in Serbia, but the levels are unclear. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite in the evening and at night and are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• 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.

Lyme Disease: Risk of transmission occurs in rural brushy, wooded, and forested areas up to 1,500 meters elevation. The ticks that transmit Lyme disease are most abundant and active April through September. All travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A single 200-mg dose of doxycycline is effective in preventing Lyme disease if taken within 72 hours of being bitten by an infected tick. (Reference: http://content.nejm.org/cgi/content/abstract/345/2/79).

Malaria: There is no risk of malaria in Serbia.

Other Diseases/Hazards: Brucellosis (low incidence; unpasteurized dairy products and infected cattle, sheep, and goats are the most common sources of infection), echinococcosis (southern Europe), sandfly fever (cases reported from Albania and Adriatic area), tick-borne relapsing fever (risk in rocky, rural livestock areas), and soil-transmitted helminthic infections (roundworm, hookworm, and whipworm infections; reported occasionally in southern Europe).
• Outbreak of tularemia have occurred since 2001. Most cases have been identified in rural areas of Lipjlan, Ferijaz and Pristine municipalities. Tularemia is transmitted by rodent-contaminated food and water. Symptoms include fever, sore throat, and swollen glands.

Rabies: Cases of rabid foxes and dogs have been reported in Serbia, largely in parks and the outskirts of major cities, including in areas that have been rabies-free for decades. Rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection. 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, but does not eliminate the need for two additional booster doses of vaccine. Prompt medical evaluation and treatment of any animal bite is essential, regardless of vaccination status.

Tick-Borne Encephalitis (TBE): Sporadic cases occur in rural brushy and forested areas country-wide at elevations up to 1,500 meters. Increased risk is associated with periods of high tick activity (usually March through September, peaking in June, with over one-third of all cases historically reported during July), and increases in tick and rodent host populations. Vaccination against TBE should be considered by those camping near forests for extended periods, for those engaged in extended hiking and camping in wooded areas, and for forest workers. The standard vaccination schedule consists of 3 doses given at 0, 1-3 months, and at 9-12 months. An 2-dose accelerated schedule is possible (0, 21 days), with 85% protection resulting. The European vaccine (FSME-IMMUN-Baxter) is available in health clinics in Germany, Austria, Slovakia, Czech Republic and Poland, as well as Canada, but the traveler would have to initiate the vaccine after arriving in the area and hiking/camping delayed for 3 weeks before adequate protection to kick in. This makes administration of vaccine generally impractical for the average traveler. Tick-bite protection is therefore essential.
• Travelers, especially those engaging in outdoor activities in rural areas, are advised to take measures to prevent tick bites during the peak transmission season, March to November. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.

Travelers' Diarrhea: Travelers should drink only bottled, boiled, or treated water and avoid undercooked food. A quinolone antibiotic, or azithriomycin, combined with loperamide (Imodium), is recommended for the treatment of diarrhea. Diarrhea not responding to antibiotics may be caused by a parasitic disease such as giardiasis or cryptosporidiosis.

Tuberculosis (TB): Tuberculosis is highly endemic in Serbia 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 the Balkans, 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.