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Slovakia



Capital: Bratislava

Time Zone: +1 hour. (GMT +2 from the last Sunday in March to the last Sunday in October)..
Tel. Country Code: 421
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.


Travel Advisory - Slovakia

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 Slovakia


Resource Links

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

Embassies

• U.S. Embassy
The Consulate
Hviezdoslavovo
namestie #4
Bratislava
Tel: [421] (2) 5443 0861
E-mail: consulbratislava@state.gov
Website: http://slovakia.usembassy.gov/

• Embassy of Canada
Carlton Court Yard and Savoy Buildings
Mostova 2
Bratislava
Tel: [421] (2) 5920-4031
E-Mail: brtsv@international.gc.ca

• British Embassy
Panska 16
Bratislava
Tel: [421] (2) 5998 2000
Email: bebra@internet.sk
Website: http://www.britishembassy.sk

Entry Requirements

HIV Test: Applicants for long term or permanent residency visas.

Required Vaccinations: None required.

Passport Information

Passport/Visa: The Slovak Republic is a rapidly developing European nation. Tourist facilities are not as developed as those found in Western Europe, particularly outside the major cities, and some goods and services taken for granted in other European countries are occasionally unavailable.
ENTRY REQUIREMENTS: A passport is required. A visa is not required for stays for tourism or business up to 90 days within six months of the date of first entry into the Slovak Republic. All foreigners seeking entry into the Slovak Republic must carry proof of a medical insurance policy contracted for payment of all costs for hospitalization and medical treatment in the Slovak Republic. Border police have the right to request evidence of finances sufficient to pay for the proposed stay in the Slovak Republic in the amount of $50 per person per day. Travelers who wish further information can contact the Embassy of the Republic of Slovakia: 3523 International Court, NW, Washington, DC, 20008; Tel: [1] (202) 237-1054; e-mail: information@slovakembassy-us.org
Website: http://www.slovakembassy-us.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 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.

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, such as business travelers.

Hospitals / Doctors

Medical facilities in Slovakia are variable. The standard of doctors is generally very good. Medical equipment is constantly being improved. However, many hospitals are showing a lack of maintenance. Possibly the greatest problem with medical facilities in Slovakia is the language. Many receptionists and nurses do not speak English. In 2006, health care workers went on strike over wages and working conditions, especially excess overtime, that threatens to increase the exodus of doctors from this country.
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 be of unreliable quality.
• Travelers are advised to obtain travel insurance that provides for medical evacuation to more advanced medical facility in Western Europe in the event of serious illness or injury requiring more advanced specialty care.
Note: Travelers to ski or hike in the various Slovak mountains and get into difficulties should be aware that since 1 July 2006, if the Slovak Mountain Rescue Service (HZS) is called out, they will be required to meet their full costs. The costs could range from SKK 3,500 ($130) to SKK 300,000 ($12,000) depending on the size of the operation. Skiers and mountain visitors are recommended to ensure they have sufficient insurance to cover any rescue costs.

The U.S. Embassy maiuntains a list of doctors and medical facilities at:
http://slovakia.usembassy.gov/list-of-doctors-and-medical-facilities-in-slovakia.html

Travel Medicine & Infectious Diseases
• Vladimir Strakrle, MD
Outpatient Department for Infectious Diseases
Travel Medicine & Hepatology
Ponavka 2, Brno
Tel: [421] 545 240 743
Website: http://www.e-globals.net/web/ordinace/eng/default.asp

Destination Health Info for Travelers

AIDS/HIV: Central Europe has been relatively spared by the HIV/AIDS epidemic, with the incidence of both AIDS cases and newly diagnosed HIV infections remaining low. However, this region accounts for the largest proportion of pediatric AIDS cases following an outbreak of infection among young children in hospitals in Romania around 1990. Most cases of HIV/AIDS in adults are related to injecting drug use or men having sex with men (MSM). The HIV prevalence rate in adults (15–49) in Slovakia is estimated at <0.1%. (Source: www.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 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.
• 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 (Bird Flu): There have been no further reports of H5N1 infection since two dead wild birds were found in the Bratislava region in February 2006. There have also been no human infections or deaths reported.
• 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.
• 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.

Crimean-Congo Hemorrhagic Fever: This is a viral encephalitis transmitted by Hyalomma marginatum ticks. These ticks are most active from April until August, reaching peak feeding activity April through May. Humans can become infected from a tick bite but usually acquire the virus from direct contact with blood or other infected tissues from livestock. The majority of cases have occurred in those involved with the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. The virus can be transmitted person-to-person and health care workers can be at risk. The risk to travelers is low. Prevention consists of tick-bite avoidance measures and preventing skin contact with infected tissue or blood of animals.

European Tick-Borne Encephalitis (TBE): Between 1998 and 2007, the average annual number of reported cases was 67, ranging from 46 to 92. In 2006, 91 cases of TBE were reported compared to 46 in 2007. Between 2003 and 2007, 66 cases annually were reported. Some of the reported cases were caused by the consumption of homemade raw goat and sheep milk. New foci have recently been identified in areas of eastern Slovakia traditionally thought to be free of the virus.
Source: Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18916
Transmission occurs country-wide, but maximum occurrence is in South-West Slovakia. Vaccination should be considered by those camping near forests, for extended hiking and camping, 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 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.
A map showing the distribution of TBE is here: http://www.nathnac.org/includes/contents/documents/TBEmap.gif

Food-Borne Disease: Campylobacteriosis is the most commonly reported zoonotic disease in humans in the EU. In foodstuffs, Campylobacter is most commonly detected in fresh broiler (poultry) meat where on average up to 26.0% of samples may be contaminated. Campylobacter was also frequently found in animals and most often in poultry flocks and pigs. Campylobacter rates in pig (and bovine) meat typically decrease sharply following slaughter and remain low at retail.
• Salmonella: Salmonellosis is the second most commonly reported zoonotic infection in the EU. A seasonal peak in the number of cases during late summer and autumn is generally observed, usually involving S. Enteritidis bacteria. In food, Salmonella was most commonly found in fresh broiler meat and in pig meat, but also found in flocks of turkeys, ducks and geese.
• Listeria: Listeriosis is an important food-borne zoonosis due to the severity of the disease and high mortality. A high case-fatality rate of 20% was reported in 2007 among the cases for which the information was available, affecting the elderly in particular. Young children, especially newborns, had the second highest notification rate after the group of over 65 year-olds. The risk groups for listeriosis are the elderly, immunocompromised individuals, pregnant women and neonates younger than four weeks [3].
Ready-to-eat foods, i.e. food that is not cooked before consumption, is the most important source of human listeriosis infections (smoked fish, ready-to-eat meat products and various types of cheese most often responsible for disease).

Source: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19100

Hemorrhagic Fever with Renal Syndrome (HFRS): Cases of Hantavirus illness are reported in The Balkans and in eastern Europe. A milder form of HFRS (caused by Puumala virus) occurs in Scandinavia, other European countries, and European Russia. Travelers should avoid contact with rodent urine or rodent feces, which transmit the virus.

Hepatitis: There is a relatively low risk of hepatitis A in this country compared to Eastern Europe. All non-immune travelers, however, should receive hepatitis A vaccine. 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 occur 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.
• The overall hepatitis B carrier rate in the general population is estimated at <2%. 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, tattooing 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 with a prevalence of <2% in healthy people and 20% or less among intravenous drug users (IDUs). 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.

Lyme Disease: Lyme disease occurs country-wide, with most transmission during the warmer months, April through September. The ticks transmitting Lyme disease are found primarily in rural brushy and forested areas at elevations below 1,000 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. (http://content.nejm.org/cgi/content/abstract/345/2/79).

Malaria: There is no risk of malaria in Eastern or Central Europe.

Rabies: There is a potential risk of rabies to the traveler, but human rabies has not been reported recently. Animal rabies, however, does occur, mostly in foxes and raccoons, with the potential for transmission to humans. 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.

Road Safety: The standard of driving is not high and can be aggressive, with drivers often going too fast (especially in bad weather), pushing into dangerously small gaps, tailgating and overtaking with little regard for other road users. Winter driving is especially treacherous. Note that drivers with any trace of alcohol in their body will be arrested. There is no permitted level other than 0%.

Swimmers’ Itch: Widespread increase in cercarial dermatitis has occurred in Central Europe, especially during hot summer months. The causative cercariae (which penetrate the skin) are found in ponds and lakes that are snail-infested and where ducks are found.

Tick-Borne Encephalitis (TBE): Between 1998 and 2007, the average annual number of reported cases was 67, ranging from 46 to 92. In 2006, 91 cases of TBE were reported compared to 46 in 2007. Between 2003 and 2007, 66 cases annually were reported. Some of the reported cases were caused by the consumption of homemade raw goat and sheep milk. New foci have recently been identified in areas of eastern Slovakia traditionally thought to be free of the virus.
Source: Eurosurveillance http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18916
• 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.
• A map showing the distribution of TBE is here: http://www.nathnac.org/includes/contents/documents/TBEmap.gif

Travelers' Diarrhea: Low risk in most Central European countries. Travelers are advised to drink only bottled, boiled, or treated water and avoid undercooked food. A quinolone antibiotic, or azithromycin, combined with loperamide, is recommended for the treatment of diarrhea. Persistent or chronic diarrhea may be due to a parasitic disease such as giardiasis.

Typhoid Fever: Typhoid vaccine is recommended for all unvaccinated people traveling to or working in Central Europe, 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. Travelers should practice strict food, water and personal hygiene precautions even if vaccinated.