All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics, prior to international travel.

Influenza vaccine is recommended for all travelers during flu season, which runs from November through April. The vaccine may cause soreness at the injection site, low-grade fevers, malaise, and muscle aches. Severe reactions are rare. Influenza vaccine should not be given to pregnant women during the first trimester.

All travelers should be up-to-date on routine immunizations, including

• Tetanus-diphtheria vaccine (recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.)
• Measles vaccine (recommended for any traveler born after 1956 who does not have either a history of two documented measles immunizations or a blood test showing immunity. Many people who had only one vaccination show immunity when tested and do not need the second vaccination. Measles vaccine should not be given to pregnant or severely immunocompromised individuals.)
• Varicella (chickenpox) vaccine (recommended for any international traveler over one year of age who does not have either a history of documented chickenpox or a blood test showing immunity. Many people who believe they never had chickenpox show immunity when tested and do not need the vaccine. Varicella vaccine should not be given to pregnant or immunocompromised individuals.)

For an overview of public health in Bermuda, go to the Pan-American Health Organization.

Bring adequate supplies of all medications in their original containers, clearly labeled. U.S. citizens must inform the Bermuda customs officials of all medications at the point of entry. Carry a signed, dated letter from your personal 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.

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.

Bring your insurance card, claim forms, and any other relevant insurance documents. Be sure to ask your insurance company before departure whether you are covered for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation by air, 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. The Medicare and Medicaid programs do not pay for medical services outside the United States.

For an ambulance in Bermuda, call 911.

Good medical care is generally available, though expensive. The main facility is the King Edward VII Memorial Hospital, which is owned and operated by the Bermuda Government (Point Finger Road, Paget Parish DV 04, tel. 441-236-2345). Life-threatening medical problems will require evacuation to the United States.

Bermuda is a hurricane-prone country. The worst of these storms generally skirt the island, however, and little or no property damage is incurred. Cruise ships regularly alter their schedules and courses to and from the U.S. due to hurricanes in the Atlantic. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

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.

U.S. citizens may register with the Consular Section of the U.S. Consulate General, located at Crown Hill, 16 Middle Road, Devonshire DV03, telephone 1-441-295-1342, where they may also obtain updated information on travel and security in Bermuda. Office hours for American citizens services are 8:30 A.M.-11:30 A.M. AND 1:30 P.M.-3:30 P.M., Monday-Friday, except Bermudan and U.S. holidays. American citizens in need of after-hours emergency assistance may call the duty officer at 1-441-235-3828.