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South Korea



Capital: Seoul

Time Zone: +9 hours. No daylight savings time in 2008.
Tel. Country Code: 82
USADirect Tel.: 0
Electrical Standards: Electrical standard is 11/220 (voltz/hz). European Style Adaptor Plug. Grounding Adaptor Plugs A, D.


Travel Advisory - South Korea

Malaria, Japanese encephalitis, and dengue fever occur throughout SE Asia and the Indian sub-Continent. Insect-bite protection is essential. Hepatitis E, spread by contaminated water, is also a threat. There is no vaccine. Pregnant women are at special risk. Take measures, as needed, to purify your water outside of first-class hotels.

Dr. Rose Recommends for Travel to South Korea


Resource Links

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

Embassies

• U.S. Embassy
82 Sejong-Ro
Chongro-Ku
Seoul
Tel: [82] (2) 397-4114
Website: www.usembassy.state.gov/seoul.

• Canadian Embassy
10th Floor, Kolon Building
45 Mugyo-Dong
Chung-Ku, Seoul
Tel: [82] (2) 3455-6000
E-mail: seoul@dfait-maeci.gc.ca
Website: www.cec.or.kr/canada

• British Embassy
Taepyeongno 40
4 Jeong-dong
Jung-gu
Seoul
[82] (2) 3210 5500
[82] (2) 3210 5653 Consular and Visa
Website: http://www.uk.or.kr/

Entry Requirements

HIV Test: Foreigners working as entertainers staying over 90 days.

Required Vaccinations: None required.

Passport Information

Passport/Visa: The Republic of Korea (South Korea or ROK) is a highly developed, stable, democratic republic with powers shared between the president and the legislature. It has a modern economy, and tourist facilities are widely available. English is often not spoken outside the main tourist and business centers. 
The Korea National Tourism Organization (KNTO) can be reached from American and Canada by calling 1-800-868-7567 and has a useful website in English at http://www.tour2korea.com. The KNTO also operates a telephone information service in the Republic of Korea, which traveling or resident Americans in Korea can reach by calling 1330 (02-1330 from cell phones) anywhere in the country. The telephone service has English speakers and is available 24 hours every day throughout the year. The Seoul Help Center (SHC) assists foreigners with an English-speaking help line at (02) 731-6800 or 731-6802. The SHC is located in the Seoul City Hall and is open from 9:30 a.m.–12:30 p.m. and 2:30 -5:30 p.m.

ENTRY/EXIT REQUIREMENTS: A passport is required. U.S. passport holders may enter the Republic of Korea without a visa for a stay of up to 30 days for tourism or transit to another country. When staying for more than 30 days or for any purpose other than tourism or transit, the U.S. passport holder must obtain a visa prior to entry. Generally, individuals staying in Korea for longer than 90 days must apply for an Alien Registration Card. 
Exit permits are not required to leave Korea. However, if a parent requests through the Korean Immigration Office that a travel restriction be placed on a child, the child is likely to be prevented from departing Korea.
For the most current visa information, visit the Consular Section of the Embassy of the Republic of Korea at 2320 Massachusetts Avenue NW, Washington, DC 20008, telephone (202) 939-5660, or see the Korean Embassy website at: http://www.koreaembassyusa.org/
Republic of Korea Consulates are also located in Atlanta, Boston, Chicago, Guam, Honolulu, Houston, Los Angeles, New York City, San Francisco, and Seattle. 

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 who might be exposed to blood or body fluids from unsafe/unprotected sexual contact; from injecting drug use; from medical treatment with non-sterile (re-used) needles and syringes, or acupuncture; from unscreened blood transfusions; from contact with open skin sores of another person. Recommended for any traveler requesting protection against hepatitis B.

Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.

Japanese Encephalitis: Recommended for travelers planning to visit rural farming areas for >4 weeks and under special circumstances, such as a known outbreak of Japanese encephalitis.

Rabies: Recommended for travelers spending time outdoors in rural areas where there is an increased the risk of animal bites. 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 in the event of a high-risk animal bite, but does not eliminate the need for treatment with the vaccine.

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 and cruise passengers.

Hospitals / Doctors

Medical facilities are of high quality in Seoul, Pusan, Daegu, and a few other large cities, but adequate care may be difficult to find in rural areas.
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; they should bring drugs for malaria prophylaxis, if needed according to their itinerary. 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 - they may have difficulty finding the equivalent drugs.
• 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.

The U.S. Embassy maintains a listing of hospitals at:
http://seoul.usembassy.gov/health.html

Medical facilities often used by travelers to Korea include:

• Samsung Medical Center
#50, Ilwon-dong, Kangnam-ku
Seoul
Tel: [82] 02-3410-2114, 3410-3114
Registration tel. [82] (2) 3410-0200, 0226
Emergency tel: 010-9933-0200, 0226, 0223
Website: http://english.samsunghospital.com
Modern, with English-speaking staff; International Clinic used by expatriate community.

• Asan Medical Center
International Clinic
Seoul
Tel. (2) 224-5001/5002.
Website: http://www.amc.seoul.kr/eng/patient/patient01.jsp
International Clinic:
Website: http://www.amc.seoul.kr/eng/index.jsp
Largest medical center in South Korea with over 220 medical and surgical specialists, many of them U.S.- and Canadian-Board Certified. VIP suites are available. Affiliated with Harvard Medical International (http://www.hmi.hms.harvard.edu/about_hmi/global_presence/index.php).

Destination Health Info for Travelers

AIDS/HIV: Most people living with HIV in Asia became infected through unprotected sex or injecting drug use. In some countries, transmission through sex between men also accounts for many infections. The HIV prevalence in adults in South Korea is low and estimated at 0.1%. (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: Animal hazards include centipedes and black widow spiders. Lynxes, bears, and wild boars may be encountered in remote areas.

Avian Influenza (Bird Flu): Outbreaks of H5N1 avian influenza were reported in November and December 2006 from poultry farms in the provinces of North Cholla, Jeollabuk-do, and South Chungchong, the first poultry outbreaks in South Korea since December 2003. As of 18 June 2007, South Korea declares itself free of H5N1 avian influenza in birds. The last outbreak was March 2007. No human cases have been reported to date.
• H5N1 avian influenza 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 H5N1 avian influenza in birds, including those countries which have reported associated cases of human infection.

The usual vaccines against influenza are not protective against “bird flu.”
Oseltamivir (Tamiflu) is somewhat effective in the treatment of H5N1 avian influenza. 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 H5N1 cases.

Cholera: This disease is reported sporadically active in this country, but the threat to tourists is very low. 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.
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: There is little apparent risk of dengue in South Korea. Travelers should take precautions against daytime mosquito bites.

Helminthic Infections: Anisakiasis (from eating fish that is consumed raw, lightly pickled or salted), fascioliasis (liver fluke disease; may be contracted by eating freshwater vegetables, such as watercress), fasciolopsiasis, paragonimiasis (lung fluke disease; from ingestion of raw or undercooked freshwater crabs or crayfishes), and clonorchiasis (acquired by eating freshwater fish containing the fluke larvae) are endemic.
• Travelers should avoid eating uncooked water plants and raw or undercooked seafood and shellfish, including Ke Jang (raw crab in soy sauce).
• There is a low risk of ascariasis and hookworm disease.

Hemorrhagic Fever with Renal Syndrome (HFRS): Year-round risk, countrywide. Elevated risk is associated with dusty, dry conditions and peak rodent populations. The virus (hantavirus) that causes HFRS is transmitted by infected rodent secretions and virus-carrying dust particles. Most cases occur from October through December, associated ith peak human activity in rodent-infected areas during harvest.

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 is endemic with about 10% of the population sero-positive. 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 in the general population is estimated at 4.4% to 5%. 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 high level, with a prevalence of 11%, or higher, 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.

Japanese Encephalitis (JE): Risk is present, but at low levels. There is virtually no risk of JE in Seoul or other urban areas. Cases of Japanese encephalitis have been reported in the southwest during the transmission season, June through October.
• The Centers for Disease Control and Prevention (CDC) recommend JE vaccination for travelers spending more than 30 days in an endemic environment, or less than 30 days in areas with epidemic transmission. Knowledge of trip details is necessary to give the best advice; for example, is travel occurring during the peak transmission season. In general, travelers to rural areas (especially where there is pig rearing and rice farming) should be vaccinated if the duration of their trip exceeds 3 to 4 weeks. They may consider vaccination for trips of shorter duration if more intense exposure is anticipated, especially during unprotected outdoor activities in the evening.
In addition:
• Vaccination is advised for expatriates living in this country.
• All travelers should take measures to prevent mosquito bites, especially in the evening and during the night. 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 at night.

Lyme Disease: Lyme borreliosis occurs only rarely. Risk to travelers is presumed to be very low. Seasonality and regions are unclear. Travelers should take measures to prevent tick bites.

Malaria: There is a very low risk of malaria in the extreme northwest of South Korea. Cases of vivax malaria have been reported annually in areass bordering the DMZ and have spread as far as 40 km south of the DMZ.
Chemoprophylaxis is not recommended for travel to this country; however, travelers should be aware of the small risk of malaria in the extreme northwest of the country and should take measures to prevent mosquito bites. Travelers should also know the symptoms of malaria.
• Malaria is transmitted via the bite of an infected Anopheles mosquito. Anopheles mosquitoes feed predominantly during the hours from dusk to dawn. All travelers should take measures to prevent evening and nighttime mosquito bites. 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. DEET-based repellents remain the gold standard of protection under circumstances in which it is crucial to be protected against mosquito bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.

Update: In 2009 chloroquine-resistant vivax malaria was reported for the first time.
Read more: http://www.ncbi.nlm.nih.gov/pubmed/19190216

Update from the Am J Trop Med Hyg. (2009): Plasmodium vivax malaria, which re-emerged in the Republic of Korea (ROK) in 1993, had decreased since 2001. However, case numbers began to increase again in 2005. The number of cases rose 54.0% in 2006, but the rate of increase slowed down in 2007. Among the total of 4,206 cases of P. vivax malaria during 2006-2007, 756 cases (18.0%) were ROK military personnel, 891 cases (21.2%) were veterans, and 2,559 cases (60.8%) were civilians. The rapid increase during this period was mostly contributed by the western part of the malaria-risk areas that is under the influence of adjacent North Korea.
Read more: http://www.ncbi.nlm.nih.gov/pubmed/19815874

Other Diseases/Hazards: Brucellosis (the most common animal source is infected cattle)
Vibrio vulnificus (acquired by eating raw fish or shellfish; also through cuts in the skin; frequent outbreaks from June to October, usually in waters off the south and west coasts; isolated from oysters collected in waters off South Cholla)
• Leptospirosis (rodents are the chief animal reservoir)
• Sscrub typhus (rural areas; transmitted by chigger bites), Murine typhus (transmittedby fleas; rare)
• Tick-borne encephalitis (rural and forested areas in spring and summer)

Rabies: From 1993–2003, a total of 364 rabies cases in five different animal species and five deaths in human beings as a result of rabies were reported. Cattle and dogs accounted for 46.4% and 40.4% of total animal cases, respectively, and raccoon dogs commanded an overwhelming majority of rabies cases in wildlife animal species. All animal and human rabies cases occurred only in two provinces, Gyeonggi and Gangwon; majority of them in two counties of Gyeonggi and one county of Gangwon province that border the demilitarized zone.
Pre-exposure rabies vaccine is recommended for travel longer than 3 months, for shorter stays in rural when travelers plan to venture off the usual tourist routes and where they may be more exposed to the stray dog population; when travelers desire extra protection; or when they will not be able to get immediate medical care.
• All animal bite wounds, especially from a dog, should be thoroughly cleansed with soap and water and then medically evaluated for possible post-exposure treatment, regardless of your vaccination status. Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Even if rabies vaccine was administered before travel, you will need a 2-dose booster series of vaccine after the bite of a rabid animal.

Travelers' Diarrhea: Medium to high risk outside of first-class hotels and resorts. 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 and fish. 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): South Korea has one of the highest rates of tuberculosis (TB) in the world. According to official data, there were 35,269 new TB cases in Korea in 2005; this is the highest figure among the 30 members of the Organization for Economic Cooperation and Development (OECD).
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 with an infected individual. 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 fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people (with the exception of short-term visitors who restrict their meals to hotels or resorts) traveling to or working in South Korea, 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.