Bulgaria
Avoid dental care throughout Bulgaria with the exception of the capital Sofia
Supplies of international medications are generally available in Bulgaria
Blood supplies should be considered as unsafe in Bulgaria as they may not be screened to international standards
Although Bulgarian physicians are trained to a very high standard, most hospitals and clinics are generally not equipped and maintained at U.S. or Western European levels. Basic medical supplies are widely available, but specialized treatment may not be obtainable.
Recent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.
Drink only bottled beverages (including water) or beverages made with boiled water. Do not use ice cubes or eat raw seafood or rare meat. Eat well-cooked foods while they are still hot and fruits that can be peeled without contamination. Avoid roadside stands and street vendors. Only pasteurized dairy products should be consumed.
AIDS occurs. Single-use, disposable needles and syringes may be unavailable. When possible, travelers should defer medical treatment until reaching a facility where safety can be assured. (Bulgaria's strict stance regarding AIDS includes mandatory testing for resident foreigners, newlyweds, pregnant women, and Bulgarians who have lived abroad. Bulgaria has also imposed a ban on blood donations from prostitutes, foreigners and intravenous drug users.)
Hikers should take protective measures against ticks.
Hepatitis A: Consider active immunization with hepatitis A vaccine or passive immunization with immune globulin (IG) for all susceptible travelers. Especially consider choosing active immunization for persons planning to reside for a long period or for persons who take frequent short-term trips to risk areas. The importance of protection against hepatitis A increases as length of stay increases. It is particularly important for persons who will be living in or visiting rural areas, eating or drinking in settings of poor or uncertain sanitation, or who will have close contact with local persons (especially young children) in settings with poor sanitary conditions.
Hepatitis B: Vaccination is advised for health care workers, persons anticipating direct contact with blood from or sexual contact with inhabitants, and persons planning extended stays of 6 months or greater (especially those who anticipate using local health care facilities, staying in rural areas, or having intimate contact with the local population).
Polio: A one-time booster dose is recommended for travelers who have previously completed a standard course of polio immunization. Refer to CDC guidelines for vaccinating unimmunized or incompletely immunized persons. Pregnancy is a relative contraindication to vaccination; however, if protection is needed, either IPV or OPV may be used, depending on preference and time available.
Typhoid: Vaccination should be considered for persons staying longer than 3 weeks, adventurous eaters, and those who will venture off the usual tourist routes into small cities, villages and rural areas. Importance of vaccination increases as access to reasonable medical care becomes limited. Contraindications depend on vaccine type.
Note: All routine vaccines (such as DTP or Td, Hib, MMR, polio, varicella, influenza and pneumococcal) should be kept up-to-date as a matter of good health practice unrelated to travel.
Insect-borne illness:
Encephalitis (tick-borne) - occurs
Hemorrhagic fever - occurs
Lyme disease - occurs
Other hazards:
Diseases such as measles and diphtheria are commonly reported. Polio is still considered a possible risk, although cases have rarely been reported in recent years.
Influenza risk extends from November to April.
Rabies - occurs in animals
AIDS: According to the Department of State, testing may be required for all foreigners staying longer than 1 month for purposes of study or work and all intending immigrants. Foreign test results are accepted under certain conditions. Contact Bulgaria's embassy for details.
