HEALTH CONCERNS

Georgia provides a relatively healthy continental climate, so tropical diseases - such as malaria - are not a public health problem.

If you plan to be in Georgia for more than a few days or travel outside of Tbilisi extensively, you should receive rabies, tetanus/diphtheria, hepatitis A and B, and typhoid immunizations. Environmental sanitation, food safety, and the availability of piped potable water remain problematic and unpredictable from day-to-day. Warnings of sanitary system failures or other health risks are rarely issued. Americans are advised to be cautious in choosing what to eat or drink, because prevention is far better than having to deal with the consequences of risk-taking. Diarrheal diseases - such as salmonellosis, shigellosis, and giardiasis - are common among the imprudent. Yet, the American community largely retains the good health it enjoyed back home, even while sampling a variety of tasty and nutritious freshly-prepared local foods and specialties. Thus, caution and prudence rather than total avoidance and fearfulness are recommended.

Large numbers of stray dogs roam the streets foraging for food, and the risk of a dog bite is real if one ventures too close or tries to jog in their presence. Having to deal with the consequences of a dog bite, including the problem of rabies prophylaxis, is best avoided, so reasonable caution is advised.

Probably the two greatest health risks to Americans in Georgia are car accidents and passive cigarette smoke. Georgian driving is notoriously bad, the accident rate is much higher than Americans encounter in the United States, and the local capacity to deal with medical trauma is limited. Pedestrians should be alert when crossing the street because drivers often ignore stop signs and traffic signals. Smoking is popular in Georgia, and there are few separate accommodations for non-smokers in restaurants and other public facilities. Non-smokers bothered by passive cigarette smoke should, however, feel free to politely seek ways to minimize their exposure.