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Vanuatu



Capital: Port-Vila

Time Zone: +11 hours.
Tel. Country Code: 678
USADirect Tel.: 0
Electrical Standards: Electrical current is 230/50 (volts/hz). United Kingdom Style Adaptor Plug and European Style Adaptor Plug. Grounding Adaptor Plugs C, E.

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CDC
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Consular Information
Foreign Commonweatlh Office

Embassies

• U.N. Mission: 212-593-0144/0215. 
There is no U.S. Embassy in Vanuatu. The U.S. Embassy in Papua New Guinea provides primary assistance for U.S. citizens in Vanuatu. The Embassy is located on Douglas Street, adjacent to the Bank of Papua New Guinea, in Port Moresby. Tel: [675] 321-1455; Fax [675] 321-1593. 
E-mail: ConsularPortMoresby@state.gov
For additional information, and to download forms, refer to Virtual Embassy atwww.usvpp-vanuatu.org.

• Canadian Embassy
Australian High Commission
KPMG House
Port Vila
Tel: [678] 22-777
Fax: [678] 23-948

The British High Commission in Port Vila closed to the public in 2005. There is no British consular representation in Vanuatu. Routine consular services for British nationals are provided by the New Zealand High Commission in Port Vila. The British High Commission in Fiji is responsible for non-routine consular matters. 

• British High Commission
Victoria House
47 Gladstone Road
Suva
Fiji
Tel: [679] 3229100 (switchboard)
FaX: [679] 322 9132
E-mail: consularsuva@fco.gov.uk 
Website: www.britishhighcommission.gov.uk/fiji

Entry Requirements

Entry requirements for Americans: A valid passport, and onward/return ticket and proof of sufficient funds are required. Visas are not required for stays up to 30 days. An extension of up to four months in a one-year period is possible. For further information on entry requirements, particularly those planning to enter by a sailing vessel, please contact the Vanuatu Mission to the United Nations at 42 Broadway, Suite 1200-18, New York, NY 10004, tel. (212) 425-9600, fax (212) 425-9652, e-mail: vmsnyc@attglobal.net

Travelers who plan to transit or visit Australia must enter with an Australian visa or, if eligible, through Electronic Travel Authority (ETA). The ETA replaces a visa and allows a stay of up to three months. It may be obtained for a small service fee athttp://www.eta.immi.gov.au/. Airlines and many travel agents in the United States are also able to issue ETA•s. Travelers may obtain more information about the ETA and Australian entry requirements from the Australian Embassy at 1601 Massachusetts Ave. NW, Washington, DC 20036, tel. (202) 797-3000, or via the Australian Embassy•s web site athttp://www.austemb.org.

Entry requirements for Canadians: Canadians do not require a visa to stay in Vanuatu for up to 30 days. An extension of up to four months in a one-year period is possible.

Entry requirements for UK nationals: British citizens, regardless of their national status, do not require a visa to stay in Vanuatu for up to 30 days. An extension of up to four months in a one-year period is possible.

HIV Test: Not required.

Required Vaccinations: None required.

Passport Information

Vanuatu consists of more than 80 islands in a Y-shaped archipelago, 1300 miles northeast of Sydney, Australia. It is an independent parliamentary democracy and a member of the British Commonwealth, with a primarily agricultural economy. Tourist facilities are limited outside the capital, Port Vila, which is located on the Island of Efate. The National Tourism Office of Vanuatu can be contacted at Port Vila, Vanuatu, telephone (678) 22515, 22685, 22813, fax (678) 23889, E-mail: tourism@vanuatu.com.vu

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: 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.
• In addition to tetanus, 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 and Boostrix are new tetanus-diphtheria-pertussis (Tdap) vaccines that not only boost immunity against diphtheria and tetanus, but have the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children. The Tdap vaccines can be administered in place of the Td vaccine when a 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.

Yellow Fever: Not required for entry to this country.

Hospitals / Doctors

Medical facilities are limited. The nearest reliable medical treatment is in Australia or New Zealand. There are two hyperbaric recompression chambers in Vanuatu; one in Luganville, on Espiritu Santo Island, and the other in Port Vila. Please note, however, that diving-related injuries may require medical evacuation to Australia or New Zealand. There is a paramedic service in Vanuatu called ProMedical, which is manned by Australian and New Zealand personnel. They also handle any medical evacuations.
• 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 - the equivalent drugs may not be available; or be of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance transport. In the event of a serious illness or injury that cannot be treated locally, every effort should be made to arrange medical evacuation to Australia or New Zealand.

• Vila Central Hospital
Port Vila
Efat•
Tel: [678] 22 100
The hospital is set on the side of a hill overlooking a lagoon and is 10 minutes walk to the town center. It has medical, surgical, delivery, and pediatric wards totaling 150 beds. There are usually six or seven doctors, but much of the work is done by nurse practitioners. 

• Northern District Hospital
Luganville
Espirito Santo Island
Vanuatu
Tel: [678] 36 345 
Espirito Santo Island is home to the world's largest accessible recreational diving wreck, USS Coolidge and is probably better for diving medicine.

• ProMedical
ProMedical Ambulance Station
Harvest Building
Freswota Rd
Port Vila
Emergency Tel: [678] 25566 (24 hours)
Website: http://www.promedical.com.vu
Provides 24-hour ambulance and local & overseas aeromedical evacuation. ProMedical responds to emergencies on the outer-islands using fixed or rotary wing charter aircraft with paramedic and portable Advanced Life Support equipment.

• On neighbouring islands are Lenakel Hospital, Lenakel, Tanna; Tel: [678] 68 659; Norsup Hospital, Norsup, Malekula; Tel: [678] 48 410; and Lolowai Hospital, Lolowai, East Ambae, Via Longana; Tel: [678] 38 302.

• Diving accidents may require medical evacuation to Australia or NZ. Travelers who anticipate need for on-going medical treatment advised to obtain visas for Australia before leaving USA. Australian visas issued in Port Vila, but in cases involving medical treatment, Australian visa authorities may require referral from local doctor, proof of acceptance by Australian doctor & patient's ability to pay for medical treatment.

Destination Health Info for Travelers

AIDS/HIV: It is estimated that 0.4% of the adult population of Oceania is living with HIV/AIDS, but no statistics are currently available for Vanuatu. The prevalence rate in Papua New Guinea is 1.8% of the adult population 15 to 49 years of age.
• 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 fluid 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.

Cholera: This disease is reported sporadically in this country, but the threat to tourists is very low. Cholera is a rare disease in travelers from developed countries. 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: Robberies, assaults and sexual assaults against foreigners, when alone or in the company of others, have increased during 2008. Females, in particular, should avoid going out alone at night, especially on foot.
Burglaries are an increasing problem. Thieves have struck when the occupants are present. You should lock your accommodation at all times and, if possible, store valuables in a safe.
• Local Travel: Roads are not well maintained and extra care should be taken when driving in Vanuatu. Public transport vehicles are often in poor repair. 
For further advice, see the bulletin on Overseas Road Safety from Smartraveller: (http://www.smartraveller.gov.au/zw-cgi/view/TravelBulletins/Overseas_Road_Safety). 
• Inter-island boats are required to have a current seaworthiness certificate, but many do not and their seaworthiness cannot be relied upon.
• The safety standards you might expect of tour operators are not always met, especially for adventure sports such as diving and yachting. Sufficient life jackets and adequate safety equipment may not be provided. Recommended maintenance standards and safety precautions may not be observed. Check operator credentials and safety equipment beforehand and ensure your travel insurance policy covers your planned activities.
• To avoid trespassing, permission should be sought from local landowners before accessing non-public areas, including beaches. Some landowners may charge a fee for access.
Source: http://www.smartraveller.gov.au/zw-cgi/view/Advice/Vanuatu

Dengue Fever: Recent outbreaks are reported. Dengue fever is a mosquito-transmitted, flu-like viral illness occurring in many parts of Oceania. 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

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 occur. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. 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 >10% in some population groups. 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 with a prevalence of 0.9% 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.

Influenza: Influenza is transmitted year-round in the tropics. The flu vaccine is recommended for all travelers over age 6 months, including pregnant women.

Insect-Borne Diseases: Japanese encephalitis, filariasis, and dengue occur sporadically, with occasional outbreaks reported. Travelers should take measures to prevent mosquito bites. The Japanese encephalitis vaccine is indicated for long stays (>3-4 weeks), adventure travelers, expatriates and, particularly, professionals working in rural areas, especially during the peak transmission season. Travelers who make shorter, repeat visits to rural agricultural areas should also consider JE vaccine.

Insects: All travelers should take measures to prevent both daytime and nighttime insect bites. Insect-bite prevention measures include a DEET-containing repellent applied to exposed skin, insecticide (permethrin) spray applied to clothing and gear, and use of a permthrin-treated bednet at night while sleeping.

Japanese Encephalitis (JE): Geographic Distribution of Japanese Encephalitis:
http://gamapserver.who.int/mapLibrary/Files/Maps/Global_JE_ITHRiskMap.png

Malaria: There is a generally high risk of malaria throughout this country, including urban areas. There is no malaria on Futuna Island. P. falciparum accounts for 60% of cases, P. vivax the remainder. Multidrug-resistant falciparum malaria is reported. Chloroquine-resistant vivax malaria is confirmed. 
• Atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine (G6PD test required) are recommended for malaria prophylaxis. 

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 Vanuatu page on the Destinations menu or A-Z Index.

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 Picaridan 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.

Marine Hazards: Ciguatera poisoning is prevalent and causes significant morbidity. It can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
Swimming-related hazards include sharks, jellyfish, including the Indo-Pacific man-of-war, stonefish, scorpion fish, stingrays, sea snakes, spiny sea urchins, sharp coral and poisonous cone shells. Swimmers should take sensible precautions to avoid these hazards. Stonefish, scorpion fish and stingrays congregate in shallow water along the ocean floor and can be difficult to see. Wearing booties may help protect you, but should not be relied upon as complete protection, as many of the spines are sufficiently rigid and long to penetrate wetsuits, booties, and gloves. 
• The jellyfish population appears to be increasing, due in part to overfishing of jellyfish predators, rising water temperatures, and pollution. Jellyfish travel in groups, so looking before you leap into water may be protective.
Treatment guidelines for jellyfish stings: http://www.emedicine.com/derm/topic199.htm
• To avoid a shark attack, swim or dive with a group. Avoid swimming during hours of darkness or twilight, in fog, or in murky waters. Avoid swimming in the vicinity of sea lions, harbor seals or elephant seals. Avoid swimming near the mouths of rivers where sharks hunt for fish. When diving, minimize time spent at the surface. Wearing a wetsuit and fins or lying on a surfboard creates the silhouette of a seal to a shark below you. Shallow water is not a deterrent to sharks; attacks have occurred in less than 5 ft/1.5 m of water.

The most serious hazards: 
Sea snake venom is highly toxic and the mortality has been reported to be 25% in untreated cases. In severe envenomations, symptoms can occur within 5 minutes, but typically evolve over 8 hours. It is possible that the victim may not have been aware of the bite, since there is little or no pain on envenomation.
Symptoms often include anxiety, muscle aching, salivation and a sensation of tongue swelling, followed by nausea, vomiting, muscle spasms, ascending paralysis, ocular palsy and sometimes loss of vision. Respiratory collapse may ensue, and the need for endotracheal intubation and mechanical ventilation should be anticipated. Sea snake antivenom (older name: antivenin) should be administered in all actual and suspected cases.
• A sea snake bite is always a medical emergency, even if the victim does not appear ill.
• You must get the victim to an emergency department, as fast as possible.
• En route, attempt to keep the bite site in a resting position, while keeping the victim as still as possible.
• Apply a broad pressure bandage over the bite about as tight as an elastic wrap to a sprained ankle. This is intended to slow the spread of the venom through the lymphatic system. Apply a splint to the limb. Make sure that arterial circulation is not cut off, by making sure fingers or toes stay pink and warm.
• Never cut open a sea snake bite and try to suck venom from the victim.
• Sea snake toxin is not inactivated by changes in temperature or pH. Application of ice, hot packs, or vinegar only wastes time.
Read more: http://emedicine.medscape.com/article/771804-overview

The box jellyfish is the most dangerous jellyfish in the world. Box jellyfish belong to the class Cubozoa, and are not a true jellyfish (Scyphozoa), although they show many similar characteristics. When people talk about the extremely dangerous Australian box jellyfish they refer to the species Chironex fleckeri. Chironex fleckeri (sometimes simply called “the box Jellyfish”), is the best-known species of box jellyfish, and is only one of a category which actually contains about 19 different species. The name sea wasp is also applied to some species of Cubozoans, including the aforementioned Chironex fleckeri. 
The other species that is known to have caused deaths is Carukia barnesi, commonly called Irukandji. This tiny jellyfish is only about thumbnail size. 
Chironex fleckeri is present in the waters of Australia, the Indo-Pacific region, including Vietnam, Papua New Guinea, the Phillipines, and Hawaii. Their exact distribution has not been fully determined and they may be present in the waters around Vanuatu.

• Box jellyfish stings are extremely painful, potentially lethal and require treatment with antivenom. Cardio-respiratory arrest may occur within 20 minutes of envenomation. Four other varieties of jellyfish (jimble, Carukia, mauve stinger, and hairy stinger) should also be avoided.
Box jellyfish treatment and antivenom information:
http://emedicine.medscape.com/article/1087794-overview 
http://www.toxinology.com/generic_static_files/cslavh_antivenom_boxjelly.html

The stonefish is a rather unattractive squat fish with a mostly rough “skin” that assists its superb camouflage as it sits on old coral or debris. There is a series of erectile dorsal spines, which, with the associated venom glands, provides the creature means of envenoming potential predators. Stonefish are mostly encountered in shallow water, where they may be stepped on by accident, or picked up by the unwary. Instant and severe pain is a constant feature of stings, followed by local swelling, which may be marked, tenderness and a blue discoloration of skin surrounding the sting site. Dizziness, nausea, hypotension, collapse, cyanosis and pulmonary edema have been described, though are by no means common. Tissue ischemia at the sting site is possible.
• Antivenom: Stonefish antivenom should only be given if there is clear evidence of envenomation. It should be given only IM, not IV. 
• The use of stonefish antivenom in stings by other species of scorpionfish is not clearly recommended, but there is limited evidence that it may be beneficial (e.g. possibly bullrout stings, Notesthes robusta). The potential risks of immediate and delayed adverse reactions to antivenom should be carefully considered before using this antivenom for other than stonefish stings.

Emergency treatment guidelines for marine stings are here:
http://www.jcu.edu.au/interest/stingers/first%20aid%201treatment.htm#firstaidtop

Sources: 
Clinical Toxicology Resources
University of Adelaide
Website: http://www.toxinology.com/index.cfm

Wilderness Medicine and Field Guide to Wilderness Medicine
http://www.travmed.com/catalog/index.php?cPath=172

Rabies: Vanuatu is considered rabies-free, but stray and sometimes viscous dogs may be encountered. All unprovoked animal bites should be thoroughly washed with soap and water and medically evaluated for possible post-exposure treatment.

Road Safety: Vanuatu, formerly known as The New Hebrides, is a chain of 80 islands & atolls situated between New Caledonia and the Solomon Islands. Travel is mainly done by light plane & boat. Only Port Vila & Luganville on Espiritu Santo Island, have surfaced roads on which speed limit of 50 kms/hr is enforced. Surfaced roads are 2 lane & narrow. Travelers should take care especially when driving at night or along unfamiliar routes. Roads found in all other areas are unsurfaced or are dirt tracks. Drivers on all roads should give way to traffic coming from right. Travelers should take care when driving off main roads to avoid trespassing on communal land.

Scrub Typhus: There is a low incidence of scrub typhus reported from this country. Travelers walking through grassy areas should protect themselves from chigger mites by using a DEET-containing skin repellent and permethrin-treated clothing.

Travelers' Diarrhea: The drinking water in this country is collected in ground catchment systems, and water supplies should be considered potentially contaminated. 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 food (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). 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, 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: Vaccination against typhoid fever is recommended for travelers venturing outside of hotels and resort areas; long-term travelers; adventure travelers; those wishing maximum disease protection. 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.