Time Zone: +2 hours. Daylight saving time +3 hours March to October.
Tel. Country Code: 380
USADirect Tel.: 8
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.
Travel Advisory - Ukraine
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 Ukraine
• U.S. Embassy
#10 Yuriy Kotsyubynsky St.
Tel: (44) 490-4000
#6 Mykoly Pymonenka St.
Tel:  (44) 490-4422
• Consulate of Canada
2/4 Academika Bohomoltsia Street
Tel:  (322) 97-1772
Fax:  (322) 97-8154
• British Embassy
9 Desyatinna St.
Artyom Business Centre
4, Glybochytska St.
Tel:  (44) 490 3660
Email: firstname.lastname@example.org (Consular & Visa Section)
A passport valid for six months beyond the planned date of travel is required. According to Ukrainian Presidential Decree #1008, dated June 30, 2005, U.S. citizens traveling to Ukraine on short-term tourist, business, or private travel do not need a visa to enter Ukraine. (Visas are still required of other categories of travelers including those who intend to study, reside, or work in Ukraine.) Any requests for extension of stay due to extenuating circumstances should be directed to the Ministry of Interior's Department of Citizenship, Immigration, and Registration (formerly known as OVIR).
Visas may be obtained from the Consular Office of the Embassy of Ukraine in Washington, D.C., or from Ukrainian Consulates General in New York, Chicago, or San Francisco. For additional information about Ukrainian visas and related policy, please contact the Ukrainian Embassy or Consulate nearest you.
Embassy of Ukraine 3350 M Street, NW, Washington, D.C., 20007; Tel: (202) 333-0606; Fax: (202) 333-0817.
Consulate General of Ukraine in New York, 240 East 49th Street, New York, NY 10017; Tel: (212) 371-5690; Fax: (212) 371-5547. Website: http://www.ukrconsul.org/
HIV Test: HIV testing is required for foreigners staying more than 3 months. U.S. test result is currently acceptable.
Required Vaccinations: None required.
Ukraine is undergoing profound political and economic change as it moves from its Soviet past toward a market economy, multi-party democracy, and integration into Euro-Atlantic and other international institutions. In recent years, the availability of goods and services has increased along with increased rates of growth in Ukraine's economy, and facilities for travelers have improved somewhat. Nonetheless, the availability of travel and tourist services remains uneven throughout the country, and Ukraine still lacks the abundance of many of the goods and services taken for granted in other countries.
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 uånprotected sex; 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.
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. Children are considered at higher risk because they tend to play with animals and may not report bites.
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. Note: A diphtheria outbreak was reported from Donetsk in July 2008, chiefly involving the city of Makeevka. Be sure you have been immunized against diphtheria during the past 10 years.
A large measles outbreak was reported in February 2006. The outbreak started in Kyiv city (Kiev), but cases were also reported throughout the country. As of the end of 2006, the outbreak appeared to be waning.
A mumps outbreak was reported in December 2006 from the Perechinskiy district of the Zakarpatye Region of the Ukraine (ProMED-mail; December 13, 2006).
Who should receive the MMR vaccine?
• All infants 12 months of age or older
• Susceptible adults who do not have documented evidence of measles immunity, such as a physician-diagnosed case of measles, a blood test showing the presence of measles antibody, or proof of receiving measles vaccine.
• People born before 1957 who are not in one of these high-risk categories are generally considered immune to measles through environmental exposure.
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 care is adequate for routine problems but not up to Western standards. 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; may be of dubious origin; may be counterfeit, or of unreliable quality.
• 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 Western Europe.
For a guide to physicians, clinics, and hospitals in the Ukraine, go to the U.S. Embassy website: http://kiev.usembassy.gov/amcit_medical_serv_eng.html
Facilities used by travelers and expatriates include:
• AMERICAN MEDICAL CENTER
1, Berdichevskaya St.
Tel:  (44) 213 9411
• Boris Clinic
Krasnoarmeiskaya st. 55A
Tel:  (44) 536 1980, 238 0000
• European Clinic EUROLAB
11A Solomenskaya Street
Tel:  (44) 206 3000
8 Kondratyuk Street
Tel:  (44) 234 0303
Clinic with large staff of English-speaking doctors.
Destination Health Info for Travelers
AIDS/HIV: UNAIDS estimates that HIV prevalence among adults exceeds 1% in Ukraine, Estonia, Moldova and Russia. Injecting drug use has become unusually widespread amongst young people, especially young men. Given the high odds of transmission through needle sharing, the fact that the young people are also sexually active, the lack of motivated HIV prevention work and the high levels of sexually transmitted infections in the wider population, an HIV & AIDS epidemic may be unavoidable. (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.
Health insurance is essential.
Avian Influenza A (Bird Flu): In Ukraine, an outbreak of H5N1 Avian Influenza which killed more than 150 chickens was reported at a farm on Crimea peninsula.
• 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 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.
• 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)
Crime/Security/Civil Unrest: We advise you to exercise caution and monitor developments that might affect your safety in Ukraine because of the risk of civil unrest. Pay close attention to your personal security and monitor the media for information about possible new safety or security risks. You should avoid demonstrations and public gatherings as they may turn violent.
There have been reports of racially motivated violence, mostly in Kyiv.
Crime: Robbery, pickpocketing and bag snatching occurs in Ukraine, particularly on public transport, at crowded markets, in popular tourist areas and in bars and nightclubs. Drink spiking, with the intention of robbing the victim while incapacitated, has been reported. Criminals are known to target foreigners. In downtown Kyiv, there has been an increase in racially motivated attacks by skinhead groups against foreigners, particularly people of Asian, African or other non-European descent.
• Some tourists have been defrauded by bogus internet friendship, dating and marriage schemes purportedly operating from Ukraine. These large-scale, well-organised scams typically result from connections made through internet dating schemes or chat rooms. Once a virtual relationship develops, the traveler is asked by their friend or prospective marriage partner to send money to enable travel to Australia. Once the money has been received, the relationship is usually terminated and any chance of recovering the funds is highly unlikely.
Crimean-Congo Hemorrhagic Fever: Also known as Central Asian hemorrhagic fever. Sporadic infection of people is usually caused by tick bites. Clusters of illness typically appear after people treat, butcher or eat infected livestock, particularly ruminants.
Crimean-Congo hemorrhagic fever is a viral infection, usually transmitted by ticks but also by infected animals. Symptoms include fever, muscle aches, backache, joint pains, headaches, dizziness, and light sensitivity. The risk to travelers is low.
• 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.
Geographic Distribution of Crimean-Congo Hemorrhagic Fever:
Diphtheria: There is continued risk of diphtheria in Ukraine. An epidemic of diphtheria occurred in the 1990s in the Russian Federation and spread extensively to all the countries of the former Soviet Union. Seventy percent of cases occurred in persons older than 15 years of age.
• All travelers, including adults, should be fully immunized against diphtheria. A booster dose of a diphtheria-containing vaccine (Td or Tdap vaccine) should be given to those who have not received a dose within the previous 10 years.
Note: ADACEL is a new tetanus-diphtheria-pertussis (Tdap) vaccine that not only boosts immunity against diphtheria and tetanus, but has the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children.
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 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.
• Hepatitis B is highly endemic in this country. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at over 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 at moderate levels, with a prevalence of 1.2% 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 to April. The flu vaccine is recommended for: all travelers over age 6 months.
Leishmaniasis: Risk for cutaneous leishmaniasis primarily limited to southern regions, including portions of Georgia Republic and the southern Ukraine, below 1,300 meters elevation. Visceral leishmaniasis is confined to areas of the Transcaucasus. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite in the evening and at night and are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• 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.
• Coexistence of visceral leishmaniasis with human immunodeficiency virus (HIV) infection is a serious concern. Leishmaniasis is spreading in several areas of the world because of HIV/AIDS, a serious concern in Ukraine.
Lyme Disease: An increased incidence of Lyme disease was reported from the Donetsk region in July 2008 (ProMED July, 2008). Lyme disease occurs focally in rural forested areas throughout Ukraine. The vector ticks are most abundant and active from May through August. All travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions of endemic areas should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A single 200-mg dose of doxycycline is effective in preventing Lyme disease if taken within 72 hours of being bitten by an infected tick. (Reference:http://content.nejm.org/cgi/content/abstract/345/2/79).
Malaria: There is no risk of malaria in Ukraine.
Mediterranean Spotted (Boutonneuse) Fever: Mediterranean spotted fever (also called boutonneuse fever, Israeli spotted fever, Astrakhan fever, Indian tick typhus) is a rickettsial disease of the spotted fever group, and is transmitted by ticks. It is endemic in eastern regions and along the Black Sea coast in brushy and/or forested areas.
• Travelers, especially those engaging in outdoor activities in rural areas, such as campers and hikers, should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
Other Diseases/Hazards: Anthrax
• Crimean-Congo hemorrhagic fever (reported from Crimea)
• Leptospirosis (3 cases reported from Starosambirsk district, of the Lvov/Lviv/Lwow] region and 13 have been reported in Kherson. The rat population in these areas and in Kiev has increased recently).
Rabies: ProMED reports three children died from rabies in the Zaporozhye Region in southern Ukraine in 2007, as well as a 26- year-old man who died of dog-transmitted rabies. Most rabies in Ukraine is animal rabies in foxes, but dogs and cats get infected after contact with wild animals.
More recent case report: a fatal case of rabies has been reported in Donetsk Oblast. The victim was a 10-year-old girl who was bitten by a stray cat. (Source: ProMED-mail 25 February 2008)
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.
Tick-Borne Encephalitis (TBE): There is a risk of TBE in some areas of the country below 1,400 meters elevation. The area most affected is the mountain forest zone of the Krym Republic (the Crimea). The transmission season varies, however, ticks are most active during early spring to late autumn (March to November). Vaccination against TBE 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 generally 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.
Travelers' Diarrhea: Water- and food-borne diseases are a risk in this country. 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.
Tuberculosis (TB): Eastern Europe - particularly the former Soviet republics - have experienced sharp increases in the number of TB cases reported. The increase in drug resistance to anti-TB medication has contributed to the striking increase in the former Soviet republics. Multidrug-resistant TB (MDR-TB), or the more serious extensively drug resistant TB (XDR-TB), may develop in people when TB infections, in response to non-compliance with required drug and treatment schedules, stop responding to the most common (or all) anti-TB drugs.
Tuberculosis is highly endemic in Ukraine 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.
• Tuberculosis is the leading cause of death among people living with HIV in Ukraine.
Typhoid Fever: Typhoid fever is the most serious of the Salmonella infections. In Ukraine, 13 cases were reported in the Black Sea port of Odessa in 2004.
Typhoid vaccine is recommended by the CDC for all people traveling to or working in Ukraine and Eastern 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, 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.