Time Zone: -4 hours. No daylight saving time in 2008..
Tel. Country Code: 58
USADirect Tel.: 80
Electrical Standards: Electrical current is 120/60 (volts/hz). North American Style Adaptor Plug. Grounding Adaptor Plug A.
Travel Advisory - Venezuela
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 Venezuela
• U.S. Embassy
Calle Suapure and Calle F
Colinas de Valle Arriba
Tel:  (212) 975-6411
• Canadian Embassy
Avenida Francisco de Miranda con Avenida Sur Altamira
Tel:  212-263-4666 or 263-1414
Fax:  212-263-8326
• British Embassy
Torre La Castellana, Piso 11
Avenida La Principal de la Castellana
Tel:  (212) 263 8411
A valid passport and a visa or tourist card are required. Tourist cards are issued on flights from the U.S. to Venezuela for persons staying less than ninety days. Persons traveling for reasons other than tourism, however, should consult the Venezuelan Embassy or nearest Venezuelan consulate regarding possible visa requirements for their specific purpose of travel (http://www.embavenez-us.org). Venezuelan immigration authorities may require that U.S. passports have at least 6 months validity remaining from the date of arrival in Venezuela. Some U.S. citizens have been turned back to the United States if their passports will expire in less than 6 months. Passports should also be in good condition, as some U.S. citizens have been delayed or detained overnight for having otherwise valid passports in poor condition.
Travelers entering Venezuela from certain countries are required to have a current yellow fever vaccination certificate. The Venezuelan government recommends that all travelers, regardless of their country of departure, be vaccinated for yellow fever before entering Venezuela. Mosquito-borne diseases such as malaria and dengue fever are also common in some areas and travelers should take reasonable precautions to prevent infection.
For current information concerning entry, tax, and customs requirements for Venezuela, travelers may contact the Venezuelan Embassy at 1099 30th Street NW, Washington DC 20007, Tel: (202) 342-2214. Visit the Embassy of Venezuela web site athttp://www.embavenez-us.org/. Travelers may also contact the Venezuelan consulates in New York, Miami, Chicago, New Orleans, Boston, Houston, San Francisco or San Juan.
HIV Test: Not required.
Required Vaccinations: None required.
Venezuela is a medium income country with a substantial oil industry. The political situation in Venezuela is highly polarized and volatile. Violent crime is a continuing problem. Assaults, robberies and kidnappings occur throughout the country. Scheduled air service and all-weather roads connect major cities and most regions of the country. The tourism infrastructure varies in quality according to location and price.
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 blood or body fluids from unsafe/unprotected sexual contact; from injecting drug use with shared/re-used needles and syringes; from medical treatment with non-sterile (re-used) needles and syringes. 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. Transmission may occur following contact with the saliva from an infected wild or domestic animal (including bats), most often via a bite or lick to an open wound. Risk of exposure is increased by type of activity (e.g. running, cycling), and longer duration of stay.
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.
Yellow Fever: Yellow fever vaccine should be given to those over 9 months of age. Vaccine is not recommended for travel only to the northern coastal regions, Margarita Island, or to the cites of Caracas and Valencia.
Hospitals / Doctors
Medical facilities in Venezuela vary widely in quality. Medical care at private hospitals and clinics in Caracas and other major cities is generally good. Public hospitals and clinics generally provide a lower level of care and basic supplies at public facilities may be in short supply or unavailable.
• 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. Policies should cover: ground and air ambulance transport, including evacuation to home country; payment of hospital bills; 24-hour telephone assistance. 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 the United States.
• The US Embassy maintains a list of hospitals and doctors at:
Medical facilities used by travelers include:
• Centro Medico de Caracas
Plaza El Estanque
Tel:  (212) 555-9111
Emergency room: 552-9418/9419
Modern, high-quality private facility; most specialties, including trauma.
• Hospital de Clinicas Caracas
Tel:  (212) 508-6111
General medical/surgical facility featuring high-quality care.
• Clinica El Avila
6th transversal with Av. San Juan Bosco
Tel:  (212) 276-1111/1052
• Centro Medico Docente La Trinidad
Carretera towards El Hatillo in La Trinidad
Tel:  949-6411
• Instituto Medico La Floresta
Av. Principal de la Floresta and Fco
Miranda, La Floresta
Tel:  209-6222
• Hospital Universitario de Caracas (1,200 beds)
Tel:  (212) 661-7111
University hospital; all specialties; emergency services.
Destination Health Info for Travelers
AIDS/HIV: More than half of Latin Americans living with HIV reside in the four largest countries in the region: Brazil, Columbia, Mexico and Argentina. The most severe epidemics are found in smaller countries such as Honduras and Belize, which have HIV prevalence rates of 1.5% and 2.5% respectively. 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 commercial sex workers, is often very high. Source: http://www.avert.org/aidslatinamerica.htm
• The estimated HIV/AIDS prevalence in Venezuela is 0.7% of adults (15-49).
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.
Animal Hazards: Animal hazards include snakes (vipers), centipedes, scorpions, black widow spiders, brown recluse spiders, banana spiders, and wolf spiders.
Chagas Disease (American Trypanosomiasis): This disease is endemic to rural areas in the northern one-half of Venezuela. In some areas up to 50% of the population has been exposed. Chagas disease is among the top 10 causes of death in Venezuelans over age 45. Most risk is found in those rural-agricultural areas where there are adobe-style huts and houses that potentially harbor the night-biting triatomid (assassin) bugs. Travelers sleeping in such structures should take precautions against nighttime bites, which typically occur on the face of the sleeping victim.
• Other methods of transmission are possible, from: consumption of food or juice (especially sugar cane juice and acai palm juice) contaminated with crushed triatome insects; from blood transfusions; from in-utero transmission.
Update: In December 2007, ProMED reports that Trypanosoma cruzi infection has been confirmed in 128 cases. It is suspected that a fruit juice was responsible for the fast and widespread transmission of the parasite.
Cholera: This disease is endemic in this country, but no recent outbreaks have been reported. 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: According to the Ministry of Health, over 25,000 cases of dengue fever have been reported so far in 2010. This is a significant increase over the average incidence. Areas most affected include the Distrito Capital and the states of Zulia, Monagas, Merida, and Miranda. Outbreaks of dengue occur regularly in central and northern Venezuela, including Caracas.
• 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: Limited risk of mosquito-transmitted Bancroftian filariasis in coastal areas. Mansonellosis, another type of filariasis, transmitted by blackflies, is endemic in Amazonas Federal Territory. Travelers to these regions should take measures to prevent insect bites.
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 large outbreaks have not been reported. 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 2% to 3%, but rates as high as 31% have been found in some aboriginal populations (e.g., the Yucpa Indians in Zulia State). 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.
Insects: All travelers should take measures to prevent evening and nighttime mosquito 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.
Leishmaniasis: Cutaneous leishmaniasis (CL) is widespread in rural areas under 2,000 meters elevation, especially in rural west-central areas. Transmission of CL has been reported at elevations as high as 2,500 meters in the Andes.
Except for a focus in northern Bolivar State, visceral leishmaniasis is primarily limited to northwestern and northern areas under 500 meters elevation. 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: Risk is present year-round in most rural areas below 600 meters elevation. There is a high risk of malaria in all areas of Venezuela south of and including the Orinoco River. There is no risk in the city of Caracas or on Margarita Island. Elevated risk occurs with the early months of the rainy season (which usually extends from late May through November); however, in the Orinoco Basin, the period of elevated risk may begin with the onset of the dry season. Nationwide, P. vivax accounts for about 75% of all cases. Chloroquine-resistant falciparum malaria occurs in most malarious areas.
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine (requires G6PD test) is recommended in risk areas.
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 Venezuela page on the Destinations menu or A-Z Index.
Another malaria map is located at: http://www.paho.org/English/HCP/HCT/MAL/maps-cartagena.htm#VEN
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.
Marine Hazards: Portuguese man-of-war, sea wasps, and stingrays are found in the coastal waters of Venezuela and could be a hazard to swimmers.
• Ciguatera poisoning is prevalent and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
• Scuba Diving-Hyperbaric Chamber Referral: Divers Alert Network (DAN) maintains an up-to-date list of all functioning hyperbaric chambers in North America and the Caribbean. DAN does not publish this list, since at any one time a given chamber may be non-functioning, or its operator(s) may be away or otherwise unavailable. Through Duke University, DAN operates a 24-hour emergency phone line for anyone (members and non-members) to call and ask for diving accident assistance. Dive medicine physicians at Duke University Medical Center carry beepers, so someone is always on call to answer questions and, if necessary, make referral to the closest functioning hyperbaric chamber. In a diving emergency, or for the location of the nearest decompression chamber, call 919-684-8111.
Onchocerciasis: Also called river blindness, transmission of this disease occurs along fast-flowing rivers at elevations up to 1,000 meters in the northcentral, northeast, and southern regions. Up to 90% of the population is infected in some southern regions. Travelers to these areas should take measures to prevent insect (blackfly) bites.
Other Diseases/Hazards: Angiostrongyliasis (infection with A. cantonensis can occur after consuming raw snails, slugs, or other crustaceans)
• Brucellosis (from infected cattle and unpasteurized dairy products)
• Eastern equine encephalitis
• Fascioliasis (in sheep-raising areas)l
• Mayaro virus disease (semirural areas in central Venezuela)
• Paragonimiasis (Oriental lung fluke disease; from ingesting infected crabs and crayfish; seropositive prevalence of 13% in northeastern Venezuela)
• Venezuelan equine encephalitis (mosquito-borne; highest risk located in northwestern areas, primarily Zulia State; reached epidemic levels in 1995 after unusually heavy rainfalls), Venezuelan hemorrhagic fever (related to rodent exposure)
• Worms (helminthic diseasesdue to hookworm, roundworm, whipworm, and strongyloides. Toxocariasis (helminth infection of humans caused by the dog or cat roundworm) is reported)
Rabies: Sporadic cases of human rabies are reported countrywide. All animal bites or scratches, especially from a dog, should be taken seriously, and immediate medical attention sought. Rabies vaccination may be required. Although rabies is rare among tourists—there is risk. No one should pet or pick up any stray animals. All children should be warned to avoid contact with unknown animals.
RPre-exposure 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.
• Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Prompt medical evaluation and treatment of any animal bite is essential, regardless of vaccination status. Note: If adequate rabies treatment is not available locally, medical evacuation is advised to a facility that can provide treatment.
Schistosomiasis: Risk is present year-round. Risk areas are limited to north-central Venezuela, including the Federal District (but not Caracas) and the surrounding states of Aragua, Carabobo, Guarico, and Miranda.
• 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 outside of Merida, Caracas, Maracaibo, and resort areas. Water supplies in most urban areas are filtered and chlorinated, but may be contaminated within the distribution system. • 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 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, 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: Tuberculosis is a major public health problem in this country. Tuberculosis is highly endemic in Venezuela 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: Typhoid is the most serious of the Salmonella infections. Typhoid vaccine is recommended for all unvaccinated people traveling to or working in the Caribbean, 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. Travelers should practice strict food, water and personal hygiene precautions even if vaccinated.
Yellow Fever: There have been cases of yellow fever in a number of different states of Venezuela. In September-October 2005, seven cases of yellow fever were confirmed in the central state of Portuguesa. In April-May 2005, three cases were reported from Merida State. There is a risk of yellow fever transmission in all areas except the northern coastal region, Margarita Island, and the cities of Caracas and Valencia.
• Map of yellow fever-infected areas here: http://wwwn.cdc.gov/travel/yellowBookCh4-YellowFever.aspx
• Yellow fever is transmitted via the bite of an infected Aedes mosquito. Aedes mosquitoes feed predominantly during daylight hours. Vaccination is recommended for all travelers who visit rural areas. However, vaccination is not recommended for travel to Margarita Island, Puerto La Cruz, or the coastal resorts.
A yellow fever vaccination certificate is not required to enter Venezuela.