Time Zone: +12 hours. No day light savings time in 2008.
Tel. Country Code: 688
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). South Pacific Style Adaptor Plug. Grounding Adaptor Plug E.
Neither the United States, Canada, Australia, nor the United Kingdom has an embassy in Tuvalu.
• The U.S. Embassy in Fiji provides assistance for U.S. citizens in Tuvalu.
31 Loftus Street
Tel:  331-4466
Fax:  330-2267
• British High Commission
47 Gladstone Road
Tel:  322 9100
Fax:  322 9132
A passport, onward/return ticket, and proof of sufficient funds for the stay in Tuvalu are required. Visitor permits valid for up to three months are issued upon arrival. For further information about entry requirements, travelers may wish to contact the Tuvalu Permanent Mission to the United Nations in New York, Suite 400 B, 800 2nd Avenue, NY 10017, tel: (212) 490-0534, fax: (212) 808-4975. This is particularly true for those persons planning to enter by sea.
HIV Test: Not required.
Required Vaccinations: None required.
Tuvalu is a South Pacific island nation consisting of four reef islands and five atolls. A self-governing member of the British Commonwealth, Tuvalu has a parliamentary system of government.
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; from acupuncture, tattooing or body piercing; 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.
Routine Immunizations: Routine
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-stay visitors who restrict their meals to hotels or resorts.
HOSPITALS / DOCTORS
Tuvalu's only hospital is on Funafuti and the outer islands have trained nurses only. Medical facilities are generally adequate for routine medical treatment.
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 may be of unreliable quality.
• 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. For more serious or complicated problems, medical evacuation to Fiji, Hawaii, or Australia may be required.
• Princess Margaret Hospital
A 36-bed facility opened in 1978.
DESTINATION HEALTH INFO FOR TRAVELERS
AIDS/HIV: A small number of AIDS cases and HIV infections have been reported but little data are available for Tuvalu. Seamen are at particular risk. (http://www.unaids.org.fj/_resources/main/files/Country-Profiles/Tuvalu_profile.pdf) The over-all prevalence of adults living with HIV in Oceania is 0.4%.
• 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 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.
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.
Dengue Fever: Sporadic cases and outbreaks are reported. Dengue fever is a mosquito-transmitted, flu-like viral illness occurring throughout the Pacific Islands. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash. A syndrome of hemorrhagic shock can occur in severe cases.
• Dengue is transmitted via the bite of an infected Aedes aegypti mosquito. Aedes mosquitoes feed predominantly during daylight hours. All travelers are at risk and 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.
• There is no vaccination or medication to prevent or treat dengue.
A dengue fever map is at:http://www.nathnac.org/ds/c_pages/documents/dengue_map.pdf
Filariasis: Sporadic cases and outbreaks are reported. Travelers should take protective measures against mosquito bites.
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 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, 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.
• Hepatitis B is hyperendemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at >8%. 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 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.
Malaria: There is no risk of malaria in Tuvalu.
Marine Hazards: Stingrays, poisonous fish, sea anemones, corals and jellyfish are hazards to swimmers.
• Ciguatera poisoning occurs and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
Rabies: Tuvalu is considered rabies-free, but surveillance is limited. Stray and free-roaming dogs may be encountered. All unprovoked animal bites should be medically evaluated for possible post-exposure treatment.
Travelers' Diarrhea: 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. 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.
Typhoid Fever: Typhoid fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people (except short-stay visitors and cruise ship passengers) traveling to or working in Oceania, 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.