Time Zone: -3 hours. No daylight savings time in 2008.
Tel. Country Code: 597
USADirect Tel.: 156
Electrical Standards: Electrical current is 120/60 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
Travel Advisory - Suriname
Travelers to Central and South America and the Caribbean need to protect themselves against mosquito-transmitted viruses, such as dengue and Zika, as well as nighttime biting mosquitoes in countries where there is the threat of malaria. I recommend all travelers use a combination of DEET or Picaridin repellent on their skin and Permethrin fabric insecticide on their clothing for greater than 99% protection against mosquito and tick bites.
Dr. Rose Recommends for Travel to Suriname
The U.S. Embassy is located at Dr. Sophie Redmondstraat 129, telephone (011)(597) 472-900, web site http://paramaribo.usembassy.gov. The Consular Section hours of operation for routine American citizen services are Mondays and Wednesdays from 1:30 pm - 3:30 pm, or by appointment, except on American and Surinamese holidays. U.S. citizens requiring emergency assistance evenings, weekends, and holidays may contact an Embassy duty officer by cell phone at (011) (597) 088-08302. The U.S. Embassy in Paramaribo also provides consular services for French Guiana.
HIV Test: Not required.
Required Vaccinations: Yellow fever vaccination certificate is required of all travelers arriving from infected areas.
Passport/Visa: The Republic of Suriname is a developing nation located on the northern coast of South America. Tourist facilities are widely available in the capital city of Paramaribo; they are less developed and in some cases non-existent in the country's rugged jungle interior. English is widely used, and most tourist arrangements can be made in English.
ENTRY/EXIT REQUIREMENTS: A passport, visa and, if traveling by air, return ticket are required for travel to Suriname. There is a processing fee for business and tourist visas. A business visa requires a letter from the sponsoring company detailing the reason for the visit. There is an airport departure charge and a terminal fee, normally included in the price of airfare. Travelers arriving from Guyana, French Guiana and Brazil are required to show proof of a yellow fever vaccination. For further information, travelers can contact the Embassy of the Republic of Suriname, 4301 Connecticut Avenue, NW, Suite 460, Washington, DC 20008, telephone (202) 244-7488, email: email@example.com, or the Consulate of Suriname in Miami, 7235 NW 19th Street, Suite A, Miami, Fl 33126, telephone (305) 593-2697.
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 infected blood or body fluids from unprotected sex; 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 infection.
Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.
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: Typhoid vaccine is recommended for all unvaccinated people traveling to or working in the South America, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water.
Yellow Fever: Yellow fever vaccination is required for all travelers >1 year of age arriving from any country in the yellow fever endemic zones in Africa or the Americas. Vaccination is recommended for all travelers >9 months of age.
Hospitals / Doctors
Medical care, including emergency medical care, is limited and does not meet U.S. standards. There is one public emergency room in Paramaribo with only a small ambulance fleet providing emergency transport with limited first response capabilities. The emergency room has no neurosurgeon, and other medical specialists may not always be available. As a rule, hospital facilities are not air-conditioned, although private rooms with individual air-conditioning are available at extra cost and on a space-available basis. Emergency medical care outside Paramaribo is limited, and is virtually non-existent in the interior of the 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; 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.
• 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 the U.S.
Medical facilities in Suriname include:
• St. Vincentius (Sint Vincentius Ziekenhuis)
Koninginnelaan no. 4
Tel:  47-12-12
Private hospital; 4-bed ICU.
• Academic Hospital
Flustraat (2 miles from US Embassy)
Tel: 44 22-22
Ambulance service; emergency room.
Destination Health Info for Travelers
AIDS/HIV: The majority of countries in the region have prevalence rates of less than 1%, but the prevalence among specific groups, such as men who have sex with men (MSM) and sex workers, is often much higher.
• 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.
More information on HIV/AIDS in Latin America is at: www.avert.org/aidslatinamerica
Arboviral Encephalitis: At least six distinct viruses causing encephalitis have been detected in Suriname. The area of greatest risk occurs in the savanna region located 20 to 40 km inland from the coastal strip. All travelers to these inland regions should take measures to prevent mosquito bites.
Cholera: This disease is active in this country but the risk to travelers is 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.
• Antibiotic therapy is a useful adjunct to fluid replacement in the treatment of cholera by substantially reducing the duration and volume of diarrhea and thereby lessening fluid requirements and shortening the duration of hospitalization.
• 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: Limited dengue transmission occurs, primarily in the Paramaribo area. Outbreaks occur at irregular intervals, particularly in urban areas. The Aedes mosquitoes, which transmit dengue fever, bite primarily during the daytime and are present in populous urban areas as well as resort and rural areas.
Dengue is a mosquito-transmitted, flu-like viral illness widespread in the South America and the Caribbean and is the most common cause of fever in travelers returned from this region. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash.
• All travelers 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.
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.
• The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at <7%. 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 5.5% 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.
Leishmaniasis: Cutaneous leishmaniasis (“bush yaws”), as well as mucocutaneous leishmaniasis, occurs primarily in the forested areas of the interior. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite mostly in the evening and at night. They breed in ubiquitous places: in organically rich, moist soils (such as found in the floors of rain forests), animal burrows, termite hills, and the cracks and crevices in stone or mud walls, and earthen floors, of human dwellings.
• 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.
Malaria: Malaria is a high risk throughout the year in the interior of the country beyond the coastal savannah area, with the highest risk along the eastern border and in gold mining areas. Chloroquine-resistant strains of malaria are prevalent. Elevated risk occurs along the upper Marowijne River in the east, and in the southern interior. Only the city of Paramaribo, a narrow strip along the Atlantic coast, and areas of the interior above 1,300 meters elevation are considered risk-free. Falciparum malaria accounts for 80%–90% of cases, the remainder due to P. vivax.
A malaria map is located on the Fit for Travel website (www.fitfortravel.nhs.uk), which is compiled and maintained by experts from the Travel Health division at Health Protection Scotland (HPS). Go to www.fitfortravel.nhs.uk and select Malaria Map from the Suriname page on the Destinations menu or A-Z Index.
Another malaria map is at: http://www.paho.org/English/AD/DPC/CD/maps-cartagena.htm#SUR
Malaria is transmitted via the bite of an infected female 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 have been the gold standard of protection under circumstances in which it is crucial to be protected against insect bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
NOTE: Picaridin repellents (20% formulation, such as Sawyer Picaridin or Natrapel 8-hour) are now recommended by the CDC and the World Health Organization as acceptable non-DEET alternatives to protect against malaria-transmitting mosquito bites. Picaridin is also effective and ticks and biting flies.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.
• Long-term travelers who may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours.
Other Diseases/Hazards: Filariasis (risk may occur in urbanized areas of Brokopondo, Commewijne, and Suriname Districts and in the city of Paramaribo)
• Chagas’ disease (incidence data lacking; northern rural areas may be higher risk)
• Fungal infections (e.g., histoplasmosis, coccidiomycosis), lepr
• Strongyloidiasis and other helminthic infections. (Incidence of hookworm is reported as high as 40%.)
Animal hazards include snakes (vipers), centipedes, scorpions, black widow spiders, brown recluse spiders, banana spiders, and wolf spiders. Electric eels and piranha may be found in the country’s fresh waters. Portuguese man-of-war, sea wasps, and stingrays are found in the coastal waters of Suriname and could be a hazard to swimmers.
Rabies: Rabies is reported in animals, especially dogs and cats, as well as bats. 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.
Schistosomiasis: Risk is present year-round, but elevated during the height of the rainy season (May–June). Infected areas are found in the northern coastal strip from the Commewijne River west to the Nickerie River, with risk of infection apparently highest in Suriname and
Saramacca Districts. Schistosomiasis is a parasitic flatworm infection of the intestinal or urinary system caused by one of several species of Schistosoma. Schistosomiasis is transmitted through exposure to contaminated water while wading, swimming, and bathing. Schistosoma larvae, released from infected freshwater snails, penetrate intact skin to establish infection.
• All travelers should avoid swimming, wading, or bathing in freshwater lakes, ponds, or streams. There is no risk in chlorinated swimming pools or in seawater.
Travelers' Diarrhea: High risk. All water sources outside of Paramaribo should be considered contaminated. Travelers should strictly observe food and drink precautions. 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 milk and dairy products. Do not eat raw or undercooked meat or fish. Peel all fruits.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
• A quinolone antibiotic, azithromycin, or rifaximin (Xifaxin), 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): Tuberculosis is highly endemic in Suriname 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: Focal outbreaks occur throughout the country. 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 Suriname, 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.
Yellow Fever: There is a risk of yellow fever transmission in all areas of this country. Vaccination is recommended for all travelers >9 months of age. Yellow fever is transmitted via the bite of an infected Aedes mosquito (mainly Aedes aegypti). Aedes mosquitoes feed predominantly during daylight hours.
View a map of areas in the Americas with risk of yellow fever transmission here: http://www.nathnac.org/includes/contents/documents/yf_america.gif