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  • Summary You can't Edit

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    Summary of recommendations

    Most travelers to Martinique will need vaccination for hepatitis A and medications for travelers' diarrhea. Other immunizations may be necessary depending upon the circumstances of the trip and the medical history of the traveler, as discussed below. All travelers should visit either a travel health clinic or their personal physician 4-8 weeks before departure.

    Vaccinations:

    Hepatitis A Recommended for all travelers
    Hepatitis B Recommended for all travelers
    Measles, mumps, rubella (MMR) Two doses recommended for all travelers born after 1956, if not previously given
    Tetanus-diphtheria Revaccination recommended every 10 years
  • Medications You can't Edit

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    Medications

    Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.

    Most cases of travelers' diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.

    If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

    Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.

  • Immunizations You can't Edit

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    Immunizations

    The following are the recommended vaccinations for Martinique.

    Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available in the United States: VAQTA (Merck and Co., Inc.) (PDF) and Havrix (GlaxoSmithKline) (PDF). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise.

    Older adults, immunocompromised persons, and those with chronic liver disease or other chronic medical conditions who have less than two weeks before departure should receive a single intramuscular dose of immune globulin (0.02 mL/kg) at a separate anatomic injection site in addition to the initial dose of vaccine. Travelers who are less than one year of age or allergic to a vaccine component should receive a single intramuscular dose of immune globulin (see hepatitis A for dosage) in the place of vaccine.

    Tetanus-diphtheria vaccine is recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.

    Measles-mumps-rubella vaccine: two doses are recommended (if not previously given) for all travelers born after 1956, unless blood tests show immunity. Many adults born after 1956 and before 1970 received only one vaccination against measles, mumps, and rubella as children and should be given a second dose before travel. MMR vaccine should not be given to pregnant or severely immunocompromised individuals.

    Typhoid vaccine is recommended for those planning an extended stay in rural areas or expecting to consume potentially contaminated food. Typhoid is uncommon in most Caribbean countries. Most travelers do not require typhoid immunization.

    Hepatitis B vaccine is recommended for travelers who will have intimate contact with local residents or potentially need blood transfusions or injections while abroad, especially if visiting for more than six months. It is also recommended for all health care personnel. Most travelers do not need hepatitis B vaccine.

    Cholera vaccine is not recommended. Cholera outbreaks are not reported from the Caribbean.

    Polio vaccine is not recommended for any adult traveler who completed the recommended childhood immunizations. Polio has been eradicated from the Americas, except for a small outbreak of vaccine-related poliomyelitis in the Dominican Republic and Haiti in late 2000.

  • Recent outbreaks of diseases You can't Edit

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    Recent outbreaks

    A major outbreak of chikungunya fever, a mosquito-borne illness characterized by fever and incapacitating joint pains, was reported from Martinique in December 2013, causing almost 50,000 suspected cases and 13 deaths by the end of July 2014. Symptoms of chikungunya fever include fever, joint pains, muscle aches, headache, and rash. The disease is almost never fatal, but may be complicated by protracted fatigue and malaise. Rarely, the infection is complicated by meningoencephalitis, which is usually seen in newborns and those with pre-existing medical conditions. There is no treatment or vaccine. Insect protection measures are strongly recommended, as described below. Because of the risk of mother-to-child transmission, pregnant women need to take special care to protect themselves from mosquito bites. For further details on the outbreak, go to ProMED-mail. For background information, go to the Chikungunya Fever Fact Sheet on the CDC website.

    An outbreak of dengue fevera flu-like illness which may be complicated by hemorrhage or shock, was reported from Martinique in May 2010, causing more than 40,000 suspected cases and 16 deaths by October. A dengue outbreak also occurred in August 2007, resulting in more than 6400 suspected cases and two deaths by late October, and in July 2005, resulting in more than 6000 suspected cases. Iin the latter outbreak, the areas most affected were centrally located (Fort de France, Lamentin, Saint-Joseph, and Schoelcher), as well as certain localities in the south (Riviere Pilote, Marin, and Francois) and north (Trinite and Basse Pointe). In Martinique, small outbreaks of dengue fever usually occur each year in the early summer. The disease is transmitted by Aedes mosquitoes, which bite primarily in the daytime and favor densely populated areas, though they also inhabit rural environments. No vaccine is available at this time. Insect protection measures are advised, as below.

  • Other Infections You can't Edit

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    Other infections

    A fatal case of melioidosis was reported in a resident of Switzerland who had visited the east coast of Martinique in November 2010, after heavy rains and flooding (see Eurosurveillance).

    Schistosomiasis is endemic. Swimming and bathing precautions are advised, as below.

    Leptospirosis is reported.

    Ciguatera poisoning may result from eating tropical reef fish.

    HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.

    For in-depth public health information, go to the Pan-American Health Organization.

  • Food and Water You can't Edit

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    Food and water precautions

    Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, sea bass, and a large number of tropical reef fish.

    All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if accompanied by nausea, vomiting, cramps, fever or blood in the stool. Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.

    If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

  • Insect Protection You can't Edit

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    Insect Protection

    Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be reapplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accommodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night.

  • Swimming and Bathing You can't Edit

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    Swimming and bathing precautions

    Avoid swimming, wading, or rafting in bodies of fresh water, such as lakes, ponds, streams, or rivers. Do not use fresh water for bathing or showering unless it has been heated to 150 degrees F for at least five minutes or held in a storage tank for at least three days. Toweling oneself dry after unavoidable or accidental exposure to contaminated water may reduce the likelihood of schistosomiasis, but does not reliably prevent the disease and is no substitute for the precautions above. Chlorinated swimming pools are considered safe.

  • General Advice You can't Edit

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    General advice

    Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity.Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.

    Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.

    Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.

    Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.

  • Ambulance You can't Edit

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    Ambulance and Emergency Services

    For an ambulance or other medical emergencies in Martinique, call SAMU 972 (Accident and Emergency Services) at 15.

  • Medical Facilities You can't Edit

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    Medical facilities

    Good medical care is generally available. The main facility is the Centre Hospitalier Universitaire de Fort de France (tel. 596-55-20-00; website http://www.chu-fortdefrance.fr/), a teaching hospital which comprises four separate establishments: Hôpital Pierre Zobda-Quitman, which offers a 24-hour emergency room and a broad range of specialty services; Hôpital Victor Fouche, which includes the pediatric and obstetric-gynecologic services; Hôpital Clarac, which specializes in cancer care; and Centre Emma Ventura, which is devoted to physical therapy and rehabilitation. The Centre Hospitalier Universitaire also includes a hyperbaric chamber and a dialysis unit. Most of its physicians trained in France. If you live in a country which is part of the European Community, you must provide a copy of form E 111 in case of emergency admission; for routine admissions, you must provide a copy of form E 112. If you do not live a country which is part of the European Community, payment will be expected in cash. Life-threatening medical problems may require air evacuation to a country with state-of-the-art medical facilities.

  • Pharmacies You can't Edit

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    Pharmacies

    Pharmacies are well-supplied. All pharmaceutical products, including vaccines, are imported from France. Many travelers go to Pharmacy Cypria in Fort de France (tel. 596-63-22-25) or Pharmacie de la Paix, also in Fort de France (tel. 596-71-94-83).

  • Travel with children You can't Edit

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    Traveling with children

    All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).

    When traveling with young children, be particularly careful about what you allow them to eat and drink (see "Food and water precautions" above), because diarrhea can be especially dangerous in this age group. Young children should be kept well-hydrated and protected from the sun at all times.

    Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, oral replacement salts, and appropriate antibiotics for common childhood infections, such as middle ear infections.

  • Travel and pregnancy You can't Edit

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    Travel and pregnancy

    International travel should be avoided by pregnant women with underlying medical conditions, such as diabetes or high blood pressure, or a history of complications during previous pregnancies, such as miscarriage or premature labor. For pregnant women in good health, the second trimester (18–24 weeks) is probably the safest time to go abroad and the third trimester the least safe, since it's far better not to have to deliver in a foreign country.

    Before departure, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency obstetric care if necessary (see "Medical facilities" above). In general, pregnant women should avoid traveling to countries which do not have modern facilities for the management of premature labor and other complications of pregnancy.

    Strict attention to food and water precautions is especially important for the pregnant traveler because some infections, such as listeriosis, have grave consequences for the developing fetus. Additionally, many of the medications used to treat travelers' diarrhea may not be given during pregnancy. Adequate fluid intake is essential.

  • Maps You can't Edit

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    Maps

    Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.

  • Embassy You can't Edit

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    Embassy/Consulate Location

    (reproduced from the U.S. State Dept. Consular Information Sheet)

    U.S. citizens living in or visiting the French West Indies are encouraged to register at the Consular Section of the U.S. Embassy in Bridgetown, and obtain updated information on travel and security within the French West Indies. The Embassy is located in the First Caribbean International Bank Building on Broad Street. Internet: http://bridgetown.usembassy.gov. The Consular Section is open for American Citizens Services from 8:30am to 11:30pm and 1:00 to 2:pm, Monday-Friday, except Barbados and U.S. holidays. For after-hours service, American citizens may contact the U.S. Embassy in Bridgetown, Barbados, telephone 1-246-436-4950.

  • Safety Information You can't Edit

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    Safety information

    For information on safety and security, go to the U.S. Department of State, United Kingdom Foreign and Commonwealth Office, Foreign Affairs Canada, and the Australian Department of Foreign Affairs and Trade.

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