Time Zone: +2 hours. Daylight saving time: GMT +3 hours.
Tel. Country Code: 90
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
Travel Advisory - Turkey
There is a low risk of malaria in North Africa and the Middle East, but other insect-transmitted diseases, such as leishmaniasis and viral infections, are potential threats. Safe water precautions, safe needle, and insect-bite prevention measures are important.
Dr. Rose Recommends for Travel to Turkey
• U.S. Embassy
110 Ataturk Boulevard
Tel:  (312) 468-6110
Fax:  (312) 467-0019
Consulates: 104-108 Mesrutiyet Caddesi
Tel:  (212) 251-3602
Fax  (212) 252-7851
• British Embassy
Sehit Ersan Caddesi 46/A
Tel:  (312) 455 3344
Email: email@example.com (General enquiries)
firstname.lastname@example.org (Consular enquiries)
ENTRY/EXIT REQUIREMENTS: A passport and visa are required. Currently, holders of all types of passports can purchase a 90-day sticker visa at the port of entry for $20 cash if they are traveling to Turkey as tourists. For further information, travelers in the U.S. may contact the Embassy of the Republic of Turkey at 2525 Massachusetts Avenue, NW, Washington, D.C. 20008, telephone: (202) 612-6700, or the Turkish consulates general in Chicago, Houston, Los Angeles, or New York. Visit the Embassy of Turkey web site athttp://www.turkey.org for the most current visa information. Overseas, travelers may contact a Turkish embassy or consulate.
HIV Test: Not required.
Required Vaccinations: None required.
Turkey is a moderately developed nation with a wide range of tourist facilities of all classes in the main tourist destinations.
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 unscreened blood transfusions; 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.
Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).
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
Turkish hospitals vary greatly. The new, private hospitals in Ankara, Antalya and Istanbul have modern facilities and equipment, and numerous U.S.-trained specialists, but still may be unable to treat certain serious conditions.
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, 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 a more advanced facility.
The U.S. Embassy maintains a list of hospitals throughout Turkey at:http://turkey.usembassy.gov/list_of_doctors_ankara.html
Hospitals used by travelers in include:
• American Hospital, Istanbul (325-beds)
Guzelbahce Sokak, Nisantasi
Tel: (212) 311 2000, (212)231-4050
The Ko• American Hospital has 143 beds and is equipped to treat medical, surgical and maternity patients. A limited number of psychiatric and contagious diseases are accepted.
KAH is operated by a US non-profit foundation founded in 1920. A Turkish doctor serves as Medical Director and a Canadian nurse serves as the Director of Nursing. A 24-hour emergency room operates with a resident doctor and specialists in attendance. The doctors have an adequate command of English. In addition to routine hospital care, services include intensive care, 24-hour emergency coverage, and a complete diagnostic center with ultrasound, angiography, mammography & others. Often used by expatriates.
• International Hospital
Istanbul Cad. 82
Tel:  (212) 663-3000 (25 lines)
Address: Istanbul Cad. 82 Ye•ilk•y
Tel: (212) 663 3000 (25 lines)
Located close to the airport, International Hospital has 154 beds, including 8 coronary-care and 10 surgical-care beds. It is privately owned and equipped with up-to-date technology. A complete range of medical services is provided, including internal medicine, general surgery, obstetrics and gynecology, pediatrics and pediatric surgery, cardiovascular surgery, neurosurgery, orthopedics and nuclear medicine. The International Hospital•s Emergency Department is open 24 hours a day, as is its laboratory.
The International Hospital•s administration, physicians and staff are Turkish. Many of the hospital doctors speak English and have postgraduate experience in the United States.
• Memorial Hospital
Piyale Pasa Bulvari
Tel:  (212) 444-7-888
Memorial Hospital, one of the largest private hospitals in Turkey, has 200 beds in service (48 beds in CCU, NICU, and general ICU) and 11 operating rooms with complete diagnostic center with ultrasound, angiography, mammography & others. A complete range of medical services is provided in 39 different specialities. The emergency department is open 24/7 with 8 different residents full-time, other disciplines are on call.
Memorial Healthcare Group also operates 2 patient clinics, one in European side and the other one in the Asian side of Istanbul.
• The Acibadem Medical Group
Affiliated with Harvard Medical International and accredited by the Joint Commission International. Operates four hospitals and a number of outpatient clinics in Istanbul.
• German Hospital
Universal Hospitals Group
Chengiz Uzun MD
Siraselviler Cd No 119
Tel:  (212) 293-2150
• Volkan Korten, MD
Director of Travel Medicine and Infectious Diseases
Marmara University School of medicine
Nuh Kuyusu Cad. No: 88
Tel.  (216) 651-0000 or (216) 327-4142
Practice includes most specialties, including travel medicine.
• Hacettepe University Hospital
Tel:  (312-310-3545
Considered the best health center in Ankara.
• Mesa Hospital (Mesa Hastanesi)
Yasam Caddesi No:5
Tel:  (312) 292 99 00
• Bayindir Hospital, Ankara; private; most specialties. Considered the best private hospital in Ankara.
• Note: Yellow fever vaccine can only be obtained in
a special unit belong to the Ministry of Health in Istanbul.
Destination Health Info for Travelers
AIDS/HIV: The prevalence of HIV in Turkey is estimated at <0.2% (low incidence). As in other regions, known high-risk groups in Asia Minor and Middle East include men who have sex with men, female sex workers and their clients, injecting drug users and prisoners. The quality of the available data, however, is questionable.
• The development of 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.
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.
Avian Influenza A (Bird Flu): In January 2008, Turkish Authorities confirmed an outbreak of Avian Influenza (Bird Flu) in the Zonguldak province in Northern Turkey. In February 2007, Turkish Authorities confirmed a number of outbreaks of Avian Influenza (Bird Flu) in the Batman and Diyarbakir provinces, South East Turkey. In January 2006 outbreaks of Avian Influenza in Turkey resulted in four deaths in eastern Turkey, believed to have arisen through close contact with infected poultry.
• 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.
Cholera: This disease is reported sporadically 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.
• 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)
Crimean-Congo Hemorrhagic Fever: CCHF is prevalent in central Anatolia to the north and east of Ankara. Recent seasonal outbreaks (from early summer) have been fatal. In June 2008, over 20 deaths from CCHF have been reported, including cases in healthcare providers. No cases have been reported from tourist resorts on the Mediterranean coast. Crimean-Congo hemorrhagic fever is a life-threatening viral infection which is usually transmitted by ticks (less commonly by direct contact with infected animals or by exposure to an infected person).
• Tick-bite prevention measures are recommended for all travelers to northeast Turkey. These 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.
Update from Emerg Inf Diseases (2009): In the Tokat and Sivas provinces of Turkey, the overall Crimean-Congo hemorrhagic fever virus (CCHFV) seroprevalence was 12.8% among 782 members of a high-risk population. CCHFV seroprevalence was associated with history of tick bite or tick removal from animals, employment in animal husbandry or farming, and being >40 years of age.
Geographic Distribution of Crimean-Congo Hemorrhagic Fever
Hepatitis: 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 is endemic with 5% to 9% of the older population seropositive for hepatitis E antibodies. Up to one-third of cases of acute hepatitis in Turkey is due to non-A, non-B hepatitis. 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 6% 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 a moderate level with a prevalence of 1.8% 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 world’s population. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.
Influenza: Influenza is transmitted from November through March. The flu vaccine is recommended for all travelers over age 6 months.
Leishmaniasis: Cutaneous leishmaniasis is common in the southeastern region of Turkey and the Tigris-Euphrates Basin. Visceral leishmaniasis (kala-azar) occurs along the Aegean coast, the Mediterranean coast, the Sea of Marmara coast, and the Black Sea coast.
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: There is a low risk of malaria in Turkey. Cases are reported countrywide, but the majority are reported from southern and eastern Turkey, particularly along the Mediterranean coast, including Diyarbakir and Siirt Provinces, and the provinces bordering Syria, Iraq, and Iran. Transmission occurs up to 1,500 meters elevation in endemic areas, primarily between February–November, peaking in June and July. There is no risk of malaria in the major cities such as Istanbul and Ankara or in any usual tourist areas.
• Vivax malaria accounts for 100% of cases.
• Chloroquine prophylaxis recommended in risk areas. Take chloroquine, once weekly, in a dosage of 500 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after your departure.
A malaria map is located on the Fit for Travel website, which is compiled and maintained by experts from the Travel Health division at Health Protection Scotland (HPS). Go towww.fitfortravel.nhs.uk and select Malaria Map from the Turkey page on the Destinations menu.
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: Picardin repellents (20% formulation, such as Sawyer GoReady 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 endemic areas of this country.
Other Diseases/Outbreaks: Brucellosis (from unpasteurized dairy products; frequently transmitted by raw goat or sheep milk).
• Mediterranean spotted fever (also called boutonneuse fever; this tick-borne disease occurs in the western and southern regions).
• Cutaneous larva migrans (creeping eruption, caused by the larvae of dog or cat hookworms; usually contracted by walking barefoot on moist soil or wet sand, where animals have defecated).
• Echinococcosis (human cases reported sporadically, especially in northern and northeastern areas).
• Fascioliasis (sheep liver fluke disease; acquired by ingestion of larvae-contaminated aquatic plants and vegetation).
• Legionnaire’s diseas (previously reported among travelers returning from Turkey).
• Tick-borne relapsing fever.
• Tick-borne encephalitis (sporadic cases reported; presumed risk in brushy, forested western and northern regions).
• Tularemia (outbreak was reported from western Turkey, Edirne Province, in May 2005; the outbreak appeared to be related to drinking water from a contaminated spring).
• Typhoid fever (An outbreak of typhoid fever was reported in March 2007 from the village of Bascatak).
Rabies: Human cases are reported and are usually due to contact with rabid stray dogs. Travelers should seek immediate treatment following the unprovoked bite, or lick of broken skin, of a dog, cat, or fox. Bites by other animals should be considered on an individual basis. 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: Schistosoma haematobium (urinary) is present in this country, but travelers are at very low risk. Potential for transmission occurs in the southern-most areas of the Belikh branch of the Euphrates River (near the Syrian border), where snail vectors are present.
• 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, streams, cisterns, aqueducts, or irrigated areas. There is no risk in chlorinated swimming pools or in seawater.
Tick-Borne Encephalitis (TBE): Tick-borne encephalitis has not been detected in Turkey.
Travelers' Diarrhea: Moderate risk outside of resorts and first-class hotels. Contamination of existing municipal water systems is common. 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, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). 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.
Over 4000 cases of acute diarrheal syndrome, caused by contaminated water, were reported in May 2008 from Aksaray and Sereflikochis. E. coli O157 infection, most likely from contaminated beef, was reported in July 2007 from the Turkish resort of Marmaris.
Tuberculosis (TB): Tuberculosis is highly endemic in Turkey 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: Seventy cases of typhoid fever have recently been reported from Bascatak, in the Malazgirt district. Typhoid vaccine is recommended by the CDC for all people traveling to or working in Asia Minor, 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.