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Virgin Islands, US Travel Health Information
Read below for travel health advice on Virgin Islands, US from the MDtravelhealth channel on Red Planet Travel.
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Summary You can't Edit
1Summary of recommendations
Most travelers to the U.S. Virgin Islands 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 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
2Medications
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.
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Immunizations You can't Edit
3Immunizations
The following are the recommended vaccinations for the U.S. Virgin Islands.
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.
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Other Infections You can't Edit
4Other infections
Four cases of chikungunya fever, a mosquito-borne illness characterized by fever and incapacitating joint pains, were reported from the U.S. Virgin Islands in the spring and summer of 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. When outbreaks of chikungunya fever occur, insect protection measures are advised. 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.
A total of five cases of Legionnaires' disease was reported between March 2010 and August 2011 among travelers who had stayed at Marriott's Frenchman's Reef and Morning Star Beach Resort and Marriott's Frenchman's Cove in Saint Thomas, leading to cleaning of the resorts' water systems (go to ProMED-mail, December 15, 2011). Legionnaires' disease is a bacterial infection which typically causes pneumonia but may also involve other organ systems. The disease is usually transmitted by airborne droplets from contaminated water sources, such as cooling towers, air conditioners, whirlpools, and showers. Legionnaires' disease is not transmitted from person-to-person.
Dengue fever, a flu-like illness which may be complicated by hemorrhage or shock, is transmitted by Aedes mosquitoes, which bite primarily in the daytime and favor densely populated areas, though they also inhabit rural environments. A dengue outbreak was reported from the St Thomas-St John District in September 2010, causing a total of 105 suspected and confirmed cases by November. No vaccine is available at this time. When dengue outbreaks occur, insect protection measures are advised.
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.
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Food and Water You can't Edit
5Food 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.
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General Advice You can't Edit
6General 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.
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Ambulance You can't Edit
7Ambulance and Emergency Services
For an ambulance in the Virgin Islands, call 911.
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Medical Facilities You can't Edit
8Medical facilities
The main facility in the U.S. Virgin Islands is the Roy L. Schneider Hospital and Community Health Center on St. Thomas, which is comparable to a good community hospital in the United States (Sugar Estate; tel. 340-776-8311; website http://www.rlshospital.org/; accredited by the Joint Commission; includes a 24-hour emergency room and a decompression chamber for divers). On St. Croix, the main facility is the Gov. Juan F. Luis Hospital and Health Center (6 Diamond Ruby, north of Sunny Isle Shopping Center on Rte. 79, Christiansted; tel. 340-778-6311). On St. John, the only provider of 24-hour health care is the Myrah Keating Smith Community Health Center (tel. 340-693-8900; website http://www.rlshospital.org/myrah.htm), which is affiliated with Roy L. Schneider Hospital. Life-threatening medical problems will require air evacuation to a country with state-of-the-art medical facilities.
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Pharmacies You can't Edit
9Pharmacies
Most pharmacies in the Virgin Islands are well-supplied. Many travelers go to one of the following:
- Kmart Pharmacy (Tutu Park Mall, Tutu, St. Thomas, tel. 340-777-3854; or Sunshine Mall, Cane Estate, St. Croix; tel. 340-692-2622)
- Doctor's Choice Pharmacy (Wheatley Shopping Center, Sugar Estate, St. Thomas, tel. 340-777-1400; or Medical Arts Complex, off Rte. 30, 1½ mi east of Cyril E. King Airport, St.thomas; tel. 340-774-8988)
- Chelsea Drug Store (The Marketplace, Rte. 104, Cruz Bay, St. John; tel. 340-776-4888).
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Travel with children You can't Edit
10Traveling with children
Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed.
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.
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Travel and pregnancy You can't Edit
11Travel 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. 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.
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Maps You can't Edit
12Maps
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.
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