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) (PDF) 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.

Malaria in the Dominican Republic: malaria prophylaxis is recommended for all areas (including resort areas) except the cities of Santiago and Santo Domingo. Risk is greatest in the western provinces near the Haitian border, including Castanuelas, Hondo Valle, Pepillo Salcedo, Monte Cristi, Dajabon, Elias Pina, and Valverde Mao. For many years, the drug of choice has been chloroquine, which is inexpensive and generally well-tolerated. The recommended dosage is 500 mg weekly, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Chloroquine may cause mild adverse reactions, including gastrointestinal disturbance, headache, dizziness, blurred vision, and itching, but severe reactions are uncommon. Other choices include mefloquine (Lariam), atovaquone/proguanil (Malarone)(PDF), and doxycycline. Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia, and nightmares. Rarely, severe reactions occur, including depression, anxiety, psychosis, hallucinations, and seizures. Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine. Atovaquone/proguanil (Malarone) is a combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Doxycycline is effective, but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics.

Insect protection measures are also recommended.

For further information about malaria in the Dominican Republic, go to the World Health Organization.

The following are the recommended vaccinations for the Dominican Republic.

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.

Typhoid vaccine is recommended for travelers who may eat or drink away from the usual tourist destinations. It is generally given in an oral form (Vivotif Berna) consisting of four capsules taken on alternate days until completed. The capsules should be kept refrigerated and taken with cool liquid. Side-effects are uncommon and may include abdominal discomfort, nausea, rash or hives. The alternative is an injectable polysaccharide vaccine (Typhim Vi; Aventis Pasteur Inc.) (PDF), given as a single dose. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. The oral vaccine is approved for travelers at least six years old, whereas the injectable vaccine is approved for those over age two. There are no data concerning the safety of typhoid vaccine during pregnancy. The injectable vaccine (Typhim Vi) is probably preferable to the oral vaccine in pregnant and immunocompromised travelers.

Hepatitis B vaccine is recommended for all travelers if not previously vaccinated. Two vaccines are currently licensed in the United States: Recombivax HB (Merck and Co., Inc.) (PDF) and Engerix-B (GlaxoSmithKline) (PDF). A full series consists of three intramuscular doses given at 0, 1 and 6 months. Engerix-B is also approved for administration at 0, 1, 2, and 12 months, which may be appropriate for travelers departing in less than 6 months. Side-effects are generally mild and may include discomfort at the injection site and low-grade fever. Severe allergic reactions (anaphylaxis) occur rarely.

Rabies vaccine is recommended for travelers spending a lot of time outdoors, for travelers at high risk for animal bites, such as veterinarians and animal handlers, for long-term travelers and expatriates, and for travelers involved in any activities that might bring them into direct contact with bats. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. In the Dominican Republic, rabies occurs most often after contact with street dogs or wild animals, particularly the small Indian mongoose. A complete preexposure series consists of three doses of vaccine injected into the deltoid muscle on days 0, 7, and 21 or 28. Side-effects may include pain at the injection site, headache, nausea, abdominal pain, muscle aches, dizziness, or allergic reactions.

Any animal bite or scratch should be thoroughly cleaned with large amounts of soap and water and local health authorities should be contacted immediately for possible post-exposure treatment, whether or not the person has been immunized against rabies.

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.

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 (see "Recent outbreaks" below).

Cholera vaccine is not recommended. Cholera is not reported from the Dominican Republic.

A cholera outbreak was reported from the Dominican Republic in November 2010, related to a major cholera outbreak occurring in neighboring Haiti, and was ongoing as of early 2013. As of February 16, 2013, a total of 708 suspected cholera cases and 10 suspected cholera-related deaths were reported for the year. A total of 7,860 suspected cholera cases and 66 suspected cholera-related deaths were reported for the year 2012. For the years 2010 and 2011, more than 21,000 suspected cases and 363 suspected cholera-related deaths were described. In January 2011, a cholera outbreak was reported among those attending a wedding reception at a resort near the Haitian border. Travelers from Venezuela, Spain, Mexico, and the United States were among those affected. In April 2012, a cholera outbreak was reported from Tamboril, province of Santiago, causing more than 500 cases, six of them fatal. Another outbreak of diarrheal illness was reported from Santiago province in August 2012, causing more than 500 cases, at least some of them caused by cholera.

In the cases from Haiti and the Dominican Republic, the bacterial strains are susceptible to tetracycline, doxycycline, azithromycin, and ciprofloxacin, but resistant to trimethoprim-sulfamethoxazole, furazolidone, nalidixic acid, and streptomycin (see the World Health Organization, ProMED-mail and the Pan American Health Organization).

The main symptoms of cholera are profuse watery diarrhea and vomiting, which in severe cases may lead to dehydration and death. Most outbreaks are related to contaminated drinking water, typically in situations of poverty, overcrowding, and poor sanitation. Most travelers are at low risk for infection. Cholera vaccine is recommended, where available, for relief workers and health professionals. Two oral vaccines have recently been developed: Orochol (Mutacol), licensed in Canada and Australia, and Dukoral, licensed in Canada, Australia, and the European Union. Cholera vaccine is not available in the United States. The newer vaccines have not been approved for use in the United States, and an older vaccine which was licensed in the past is no longer manufactured or sold, due to low efficacy and frequent side-effects. All travelers should strictly observe food and water precautions, as below, and should wash using safe water. Most importantly, travelers should drink only bottled or boiled beverages.

Dengue fever, a flu-like illness sometimes 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 major dengue outbreak was reported from the Dominican Republic in June 2010, causing more than 21,000 cases and 41 deaths by early September. The city of Santiago was particularly affected. A dengue outbreak was reported from the northern part of the country in September 2009. As of November, almost 5000 cases and 44 deaths had been described, but the outbreak was beginning to subside. More than 3600 cases of dengue fever, including 30 deaths, were reported for the first eleven months of 2008. More than 9000 cases and at least 30 deaths were reported for the first eleven months of 2007. For the year 2006 as a whole, a total of 6143 dengue cases were reported, including 230 cases of dengue hemorrhagic fever and 53 deaths. No vaccine is available at this time. Insect protection measures are recommended when dengue outbreaks occur, as below.

A severe case of leptospirosis was reported in October 2011 in a Dutch traveler who had aspirated muddy water in the Chavon river (see Eurosurveillance). A leptospirosis outbreak was reported from Bahoruco and Barahona provinces in October 2009. A larger outbreak was reported in November 2007, related to flooding from Hurricane Noel in October. The outbreak started in the region along the banks of the Ozama River north and east of Santo Domingo, then spread to the provinces of San Cristobal, Barahona and the National District. The main tourist areas were not affected. As of November 18, a total of 200 cases and 25 deaths had been identified (see NATHNAC and ProMED-mail; November 24, 2007, and November 5, 2009).

Leptospirosis is transmitted to humans by exposure to water contaminated by the urine of infected animals. Symptoms may include fever, chills, headache, muscle aches, conjunctivitis (pink eye), photophobia (light sensitivity), and rash. Most cases resolve uneventfully, but a small number may be complicated by meningitis, kidney failure, liver failure, or hemorrhage. Those working in flooded regions should wear protective clothing and cover cuts and abrasions with waterproof bandages. Those at risk should also consider taking 200 mg of doxycycline once weekly as prophylaxis. Other cases of leptospirosis have been reported among travelers to the Dominican Republic from time to time in the past (see TropNetEurop).

An outbreak of viral conjunctivitis ("pink-eye") was reported in October 2008, affecting more than 40,000 people (see ProMED-mail. October 17, 2008). Viral conjunctivitis may cause itching, redness, and swelling around the eyes, but usually resolves uneventfully. The infection may be prevented by frequent hand washing and by not sharing towels and bedding.

A malaria outbreak was reported in November 2004 among visitors to the Punta Cana resort area in La Altagracia Province, at the eastern end of the island. A total of 20 cases were identified in foreign travelers (four from the United States, six from Canada, and ten from European countries). As of early 2005, it appeared that the outbreak had been controlled by an intensive program of mosquito control, but two additional tourist cases were reported in September and October 2005, followed by one more in a Spanish tourist who had visited the Bavaro Beach area in November 2006. Most recently, a German couple developed malaria after visiting Punta Cana in October-November 2007, and a Canadian traveler developed malaria after a trip there in February 2008. The Centers for Disease Control recommends malaria prophylaxis for all parts of La Altagracia Province and for rural areas elsewhere, whereas French and British authorities recommend malaria prophylaxis for all travelers to the Dominican Republic. For further information, go to Health Canada, Eurosurveillance, and MMWR. In January 2000, a malaria outbreak occurred in the Bavaro Beach area and was promptly ended by mosquito control measures.

An outbreak of gastroenteritis was reported in August 2007 among guests at the Bahia Principe Hotel, Río San Juan, province of Espaillat. At least 600 people were involved. Symptoms included vomiting and diarrhea, usually lasting around 24 hours. Fever and abdominal pains occurred less often. The cause was identified as norovirus. For further information, go to NATHNAC and the Health Protection Agency.

An outbreak of Mycobacterium abscessus infections was reported in April 2004 among U.S. residents who had undergone abdominoplasty (abdominal fat removal) in Santo Domingo. A total of 20 cases were identified, eight of them at a single clinic. Infection with rapidly growing mycobacteria should be considered in patients who have undergone cosmetic surgery procedures in the Dominican Republic and who subsequently have surgical-site infections that fail to respond to standard therapy. For further information, go to MMWR and Clinical Infectious Diseases (CID 2008; 46: 1181-8).

A small outbreak of poliomyelitis occurred between July 2000 and January 2001, resulting in a total of 13 cases before the outbreak was brought under control by a mass vaccination campaign. All cases occurred in people who were either unvaccinated or incompletely vaccinated. For further information, go to MMWR and the World Health Organization (PDF).

• Diffuse cutaneous leishmaniasis (focus reported in the eastern part of the country)
• Schistosomiasis (mainly the eastern lowlands; reported as far west as Jarabacoa; swimming and bathing precautions advised, as below)
• Brucellosis (chief animal source is infected cattle)
• Lymphatic filariasis (chiefly the Santo Domingo area; also reported from the central valley and the north coast)
• Eastern equine encephalitis (outbreaks reported in past)

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.

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.

When visiting undeveloped areas, do not drink tap water unless it has been boiled, filtered, or chemically disinfected, and do not drink unbottled beverages or drinks with ice.

Wear long sleeves, long pants, hats and shoes (rather than sandals). 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 repplied 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. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accomodation 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.

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.

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.

For a private ambulance in Santo Domingo, Santiago, Puerto Plata and La Romana, call Pro Med ambulance services at 809-948-7299 or 809-412-5555. Pro Med will expect payment at time of service.

The phone number for the public ambulance is 911, but its reliability is questionable. Emergency services are extremely limited outside Santo Domingo.

In Santo Domingo, many travelers go to Clínica Abreu (Calle Beller #42 y Ave. Independencia, Santo Domingo; tel. 809-688-4411; website http://www.clinicaabreu.com.do/u/indexus.htm; small private hospital; offers 24-hour emergency room and broad range of specialty services) or Plaza de la Salud (Ortega y Gassette, Plaza de la Salud, Santo Domingo; tel. 809-565-7477; well-equipped government-supported health center; includes CEDIMAT, which provides state-of-the-art imaging services, including CT and MRI).

In La Romana, emergency and specialist care can be obtained at Centro Medico Doctor Canella (Av. Libertad No. 44; tel. 556-3135; major credit cards accepted). In Punta Cana, you can go to Centro Médico Punta Cana (Seccion El Salado, Bavaro area Higuey; tel. 552-1506, 552-1974).

For a guide to other physicians and clinics in the Dominican Republic, go to the U.S. Embassy website at http://www.usemb.gov.do/Consular/ACS/doctors_and_hospitals.pdf.

Medical care is limited, especially outside Santo Domingo. There are periodic blood shortages at both public and private hospitals. Most doctors and hospitals will expect payment in cash, regardless of whether you have travel health insurance. Serious medical problems will require air evacuation to a country with state-of-the-art medical facilities.

Many travelers go to San Judas Tadeo (Av. Independencia 57, Gazcue, Santo Domingo; tel. 809-689-6664) or Farmacia Deleyte (Av. John F. Kennedy 89, Puerto Plata; tel. 809-586-2583) or .

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 (see the U.S. Embassy website).

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).

The recommendations for malaria prophylaxis are the same for young children as for adults, except that the dosage of chloroquine is lower. DEET-containing insect repellents are not advised for children under age two, so it's especially important to keep children in this age group well-covered to protect them from mosquito bites.

When traveling with young children, be particularly careful about what you allow them to eat and drink (see food and water precautions), because diarrhea can be especially dangerous in this age group and because the vaccines for hepatitis A and typhoid fever, which are transmitted by contaminated food and water, are not approved for children under age two. Baby foods and cows' milk may not be available in developing nations. Only commercially bottled milk with a printed expiration date should be used. 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.

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 the U.S. Embassy website). 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.

As a rule, pregnant women should avoid visiting areas where malaria occurs. Malaria may cause life-threatening illness in both the mother and the unborn child. None of the currently available prophylactic medications is 100% effective. If travel to malarious areas is unavoidable, chloroquine must be taken once a week and insect protection measures must be strictly followed at all times. The recommendations for DEET-containing insect repellents are the same for pregnant women as for other adults.

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. Quinolone antibiotics, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin), should not be given because of concern they might interfere with fetal joint development. Data are limited concerning trimethoprim-sulfamethoxazole, but the drug should probably be avoided during pregnancy, especially the first trimester. Options for treating travelers' diarrhea in pregnant women include azithromycin and third-generation cephalosporins. For symptomatic relief, the combination of kaolin and pectin (Kaopectate; Donnagel) appears to be safe, but loperamide (Imodium) should be used only when necessary. Adequate fluid intake is essential.

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.

Americans living in or visiting the Dominican Republic are encouraged to register at the Consular Section of the U.S. Embassy in Santo Domingo and obtain updated information on travel and security within the Dominican Republic. The U.S. Embassy is located at the corner of Calle Cesar Nicolas Penson and Calle Leopoldo Navarro in Santo Domingo; telephone (809) 221-2171; after hours (809) 221-8100. The Consular Section is a half-mile away at the corner of Calle Cesar Nicolas Penson and Avenida Maximo Gomez. The American Citizens Services Unit can be reached by telephone at (809) 731-4294, or via the Internet at http://www.usemb.gov.do/acs.htm. Consular office hours are 7:30 a.m. to 12:00 p.m. and 1:00 p.m. to 2:00 p.m., Monday through Friday, except U.S. and Dominican holidays.

There is a Consular Agency in the north coast city of Puerto Plata at Calle Beller 51, 2nd floor, office 6, telephone (809) 586-4204; office hours are 9:00 a.m. to 12:00 p.m., and 2:30 p.m. to 5:00 p.m., Monday through Friday, except holidays. The consular agency has a secondary office in Sosua, also on the north coast. That office may be reached at: "Sea Horse Ranch Project" Administrative Office, Carretera Sosua - Cabarete, Sosua, D.R., telephone (809) 571-3880, fax (809) 571-2374.

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.