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Andorra

General
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This small country is situated between France and Spain. Because of its elevation and proximity to the Pyrenees the climate is generally pleasant throughout the year.
Climate
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During the summer months the temperatures can rise to 30c but there is usually a cooling breeze. Lightening storms can occur during the summer months associated with torrential rain.
Sun Exposure and Dehydration
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Those from Northern Europe can develop significant sun exposure and so remember to use a wide brimmed hat when necessary. The altitude can also lead to significant tiredness and dehydration so take sufficient initial rest and drink plenty of fluids.
Safety & Security
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The level of crime throughout the country directed at tourists is very low. Nevertheless take care of your personal belongings at all times and use hotel safety boxes where possible.
Local Customs
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There are strict laws regarding the use of illegal drugs. Make sure you have sufficient supplies of any medication you required for your trip and that it is clearly marked. The European E111 form is not accepted in Andorra and so it is essential that you have sufficient travel insurance for your trip.
Winter Sports
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Andorra is one of the regions where many travel to partake of their winter sport facilities. Generally this is well controlled and one of the safer regions. Nevertheless, make certain your travel insurance is adequate for the activities you are planning to undertake.
Vaccination
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The only standard vaccine to consider for Andorra would be tetanus in line with many other developed countries of the world.

Travel News Headlines WORLD NEWS

Date: Thu, 12 Jul 2018 15:24:06 +0200

Andorra la Vella, Andorra, July 12, 2018 (AFP) - The tax haven of Andorra has long been a favourite destination for smokers looking to stock up on cheap cigarettes, but the enclave said Thursday that it would soon stop advertising the fact.   The government said it had signed up to the World Health Organization's (WHO) anti-tobacco convention, which aims to encourage people to quit smoking and combat contraband sales.   "The goal is to contribute to public health and pursue the fight against trafficking," government spokesman Jordi Cinca said at a press conference.

The tiny principality of Andorra, perched in the Pyrenees on the border between France and Spain, attracts millions of shoppers each year to duty-free stores, where prices of alcohol, cigarettes, electronics and clothes can be up to 20 percent cheaper than elsewhere in the EU.   High taxes on tobacco imposed by many countries to help people kick smoking make Andorra's cigarettes a particularly good deal.   The average pack costs just three euros ($3.50) compared with eight euros in France, which has said it will gradually raise the price to 10 euros a pack by November 2020.

Tobacco sales bring in some 110 million euros a year for Andorra, whose economy is otherwise based almost entirely on tourism.   It is also an enticing destination for smugglers, with French and Spanish border agents regularly seizing cartons from people trying to sneak them out, either by car or by hiking down the mountain trails which criss-cross the Pyrenees.   No date has been set for the advertising ban, which will come into effect three months after the ratification of the WHO accord is voted by parliament.
Date: Fri, 16 Mar 2018 02:41:51 +0100

Andorra la Vella, Andorra, March 16, 2018 (AFP) - The tiny principality of Andorra is witnessing a once in a generation phenomenon -- a widespread strike.   Around a third of civil servants across the mountainous micro-state have walked out to protest proposed reforms to their sector in what has been described as Andorra's first large-scale strike since 1933.

With no negotiation breakthrough in sight, picket lines are expected to be manned again on Friday with customs officers, police, teachers and prison staff among those taking part.   The first major strike in 85 years was sparked by plans from the government of Antoni Marti to reform civil servant contracts.   He has assured officials "will not do an hour more" work under the reforms and that 49 million euros would be allocated for the next 25 years to supplement civil servant salaries.   But government workers are unconvinced with unions warning the reforms could risk their 35 hour working week and pay.

Customs officers involved in the strike interrupted traffic on the Andorran-Spanish border this week, according to unions, while some 80 percent of teachers have walked out of classes.   Strikers have occupied the government's main administrative building and held noisy protests outside parliament calling for Marti's resignation.    "We have started collecting signatures to demand the resignation of the head of government and now nobody will stop us," Gabriel Ubach, spokesman for the public service union, told reporters.
Date: Mon 27 Sep 2017
Source: Contagion Live [edited]

A recent Dispatch article published in the Centers for Disease Control and Prevention (CDC)'s Emerging Infectious Diseases journal, offers insight into a large norovirus outbreak that sprung up in Spain in 2016 that had been linked with bottled spring water. The Public Health Agency of Catalonia (ASPCAT) reported a staggering 4136 cases of gastroenteritis from 11-25 Apr 2016. Of the 4136 cases, 6 individuals required hospitalization. The CDC defines a "case-patient" as an "exposed person who had vomiting or diarrhoea (3 or more loose stools within 24 hours)," as well as 2 or more of the following symptoms: nausea, stomach pain, or fever.

ASPCAT investigators traced back the outbreak to contaminated bottled spring water in office water coolers. The water came from a source in Andorra, a small independent principality located between Spain and France. Norovirus is a "very contagious virus," according to the CDC, and it is common for individuals to become infected by eating contaminated food. Although it is possible to be infected by consuming contaminated drinking water, this mode of transmission is "rare in developed countries," according to the article.

The investigators collected water samples from a total of 4 19-L water coolers in 2 different offices located in Barcelona, "from which affected persons had drunk; samples 1 and 2 came from 2 water coolers in one office, while samples 3 and 4 came from 2 water coolers in another office. Using "positively charged glass wool and polyethylene glycol precipitation for virus concentration," the investigators tested the samples.

"We detected high RNA levels for norovirus genotype I and II, around 103 and 104 genome copies/L, in 2 of the 4 water cooler samples concentrated by glass wool filtration and polyethylene glycol precipitation," according to the article. The investigators noted that a drawback of using molecular methods is that they are not able to differentiate between particles that are infectious and those that are not. Therefore, they "predicted the infectivity of norovirus in the concentrated samples by treating the samples with the nucleic acid intercalating dye PMA propidium monoazide and Triton X surfactant before RT-qPCR," which allowed them to "distinguish between virions with intact and altered capsids."

In those 2 water samples, they found high genome copy values -- 49 and 327 genome copies/L for norovirus genotype I and 33 and 660 genomes copies/L for norovirus genotype II. This was not an unexpected finding, due to the large number of infected individuals associated with the outbreak. Through "PMA/Triton treatment before RT-qPCR assays," the investigators found that the proportion of infected virions accounted for 0.3% to 5.6% of the total number of physical particles in the water samples, "which was enough to cause gastrointestinal illness."

The investigators also analyzed faecal samples collected from infected individuals who worked at the office in which the 1st 2 water samples were collected. They detected the following genotypes in those faecal samples: GI.2 and GII.17. In the faecal samples collected from the other office, they isolated the following genotypes: GII.4/Sydney/2012, GI.2, GII.17, and GII.2.

"We hypothesize that the spring water was contaminated by all 4 strains (GI.2, GII.2, GII.4, and GII.17) but levels of viral contamination for each genotype were not homogeneous in all bottled coolers," the investigators wrote. "We may have detected only the GII.4 genotype in water samples 1 and 2 because of a higher concentration of this specific genotype or because of bias caused by the sampling, concentration, and molecular detection procedures."

The investigators admit one limitation to their study: the small number of water samples collected and analyzed. They attribute this to the fact that on 15 Apr 2016, 4 days after the onset of the outbreak, the company that produced the drinking water recalled over 6150 containers of water "of suspected quality" as a precautionary measure. The recall prevented the investigators from collecting more samples to assess, according to the article.

Although the exact cause of the contamination has not yet been identified, the investigators posit that "the high number of affected persons from 381 offices that received water coolers, and the many different genotypes found in some patients' faecal specimens" suggest that the spring aquifer had been contaminated by "sewage pollution," and the Andorra Ministry of Health and Welfare banned further use of the spring.

The investigators suggest that assessing commercially-produced mineral waters for different harmful pathogens, such as norovirus would be beneficial. They note, however, that creating, enhancing, and managing such "virus surveillance systems" would be costly. Thus, the investigators suggest taking a "balanced approach to keep both the cost and the time required for the analyses within feasibility limits."  [Byline: Kristi Rosa]
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[The interesting article published in the September 2017 issue of Emerging Infectious Diseases is:
Blanco A, Guix S, Fuster N, et al: Norovirus in bottled water associated with gastroenteritis outbreak, Spain, 2016. Emerg Infect Dis. 2017; 23(9): 1531-34; https://wwwnc.cdc.gov/eid/article/23/9/16-1489_article. - ProMED Mod.LL]

[Catalonia and Andorra can be located on the HealthMap/ProMED-mail map at http://healthmap.org/promed/p/1341. - ProMED Sr.Tech.Ed.MJ]
Date: Thu, 26 Dec 2013 22:25:05 +0100 (MET)

ANDORRA LA VELLA, Andorra, Dec 26, 2013 (AFP) - A Spanish skier and a French snowboarder have died in avalanches in different mountain ranges in Europe, officials said Thursday.

The 27-year-old skier, a woman from Barcelona, died Wednesday while going off-piste alone in the Soldeu resort in Andorra, in the Pyrenees mountains between France and Spain, a resort manager told AFP.   Although she was rescued within 10 minutes, after her glove was spotted on the surface, she was unable to be revived despite a helicopter dash to hospital.

In the Italian Alps, close to the border with France, a 24-year-old Frenchman who was snowboarding with three friends on a closed run died Thursday when an avalanche swept over him in the resort town of Les Arnauds.   Local officials said he succumbed to multiple injuries, asphyxia and hypothermia.

Avalanches are common in Europe's ski resorts at this time of year, when early snows are heavy with moisture, and several deaths occur each winter.   Last Sunday, a 35-year-old Frenchman died in an avalanche in the Alps near the Italian border while on a three-day trek with a friend.
Date: Fri 7 Feb 2003 From: Jaime R. Torres Source: EFE Salud, Thu 6 Feb 2003 (translated by Maria Jacobs) [edited] -------------------------------------------------- Close to 300 students in one school and 173 tourists staying in 7 hotels in the Principality of Andorra have been affected by outbreaks of gastroenteritis that, according to local authorities, are not related to each other. Monica Codina, Minister of Health, stated that the outbreak that has affected almost 300 children and 8 adults in the San Ermengol school was detected last Monday [3 Feb 2003] but that it may have started Wednesday or Thursday of the previous week. The epidemiological surveys of a group of pre-school and grammar school students that may also be affected have not been performed yet. Also pending are the results of the microbiological tests of the food and water served in the school dining room, but the minister has indicated that the probable cause of the outbreak is the fact that water pitchers were filled with hoses directly from the faucet. The Minister stated that this outbreak of gastroenteritis is not related to the one that affected 173 tourists, most of them young people on holiday, who where staying in 7 hotels of the Principality. The government is also investigating the cause of this outbreak and has indicated that an anomaly in the system that supplies water to the hotels was detected, requiring a process of chlorination, which has not been carried out due to the heavy snowfall of the past few days. * * * * * * * * * * [The suspicion that defective water supplies may be responsible for all of these independent outbreaks suggests that the etiologic agent may be an enterovirus, hepatitis A virus, or non-viral, rather than one of the noroviruses associated with sudden-onset viral gastroenteritis. Information on the outcome of diagnostic tests in progress would be welcomed. - ProMed Mod.CP]
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Australia

Travelling to Australia
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Introduction
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Travelling to Australia for business or pleasure can be a most memorable experience and each year many Europeans travel this
route to experience something of life ‘down-under’. Staying healthy and well is essential if you want to enjoy your trip to its fullest extent. Australia is a huge continent and the climatic conditions vary considerably throughout. The main southern cities have a temperate climate similar to North West Europe, Perth enjoys a Mediterranean climate while Queensland and the Northern Territories have a sub-tropical weather pattern.
Preparation
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It is important that all travellers are in good general health before undertaking any long-haul trip. Patients who tire easily on light exercise or who have a significant underlying medical condition will need to take extra care. If you are concerned about this aspect of your proposed trip arrange for a meeting with a doctor at an early stage in your preparations.
Long Haul Flights
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On these long flights you will be travelling across many time zones. You will lose or gain hours depending on the direction of your flight. Your body will take time to adjust to the new time zone and so it is important to allow this to occur naturally. If you arrive during the daylight hours try to stay out in the sun for a period of time as this will help your body release a hormone which counteracts jet lag. (Watch you don’t get sun burnt!) Don’t plan to be too energetic during the first day or two after you arrive. Be sensible. If this is a business trip try not to make any major decisions over the first 24 hours. Even the relatively short flight from South East Asia down to Australia crosses time zones and again it will be important to allow your body to settle.
Stop-Overs in SE Asia
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Frequently travellers will stop-over in Singapore, Bali, Hong Kong or Bangkok on their way to or from Australia. During these short stops it is essential that travellers take all possible precautions to ensure that they rest and are careful about what they eat or drink as contaminated food or water is more common in some of these regions.

Mosquito protection in SE Asia
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Mosquito borne diseases are present depending on the location (Malaria, Dengue Fever, Japanese B Encephalitis etc) One of particular concern is Dengue Fever, which is a viral disease transmitted by the bite of an infected mosquito. These mosquitoes tend to bite during the day time. This is in contrast to the mosquitoes which transmit malaria which mainly bite at night. Many of the main tourist destinations throughout SE Asia are malaria free and so tablets to protect against the disease are not usually required. Those going off the usual routes will need to talk this through in depth before leaving.
Road Traffic Accidents
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Frequently, cars are purchased by tourists to Australia for the duration of their stay. Often the cost is low and the maintenance and safety of the vehicle may be somewhat questionable! Long monotonous driving associated with a lack of concentration can cause serious accidents. Car breakdown in the middle of ‘nowhere’ may lead to the risk of dehydration and potential animal attack (kangaroo, dingos, snakes etc). Make sure you always have sufficient food and water and some means of communication (fully charged mobile phone) before leaving to travel across the continent. Make sure other responsible friends or relations back home know of your intended route and inform them of any changes. Get contact numbers for essential services for your journey.

Health Concerns in Australia
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Many travellers feel that Australia is the same as at home in Europe and so little care with personal health needs be taken. This is not always the case as there are many local health variations throughout the country which should be considered.
Sun Exposure
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The northern European skin is usually unaccustomed to intensity of the sun exposure experienced in many parts of Australia. Unfortunately this regularly leads to sun burn among tourists but, more seriously, it also significantly increases the risk of potentially fatal skin cancers. Always use plenty of adequate sun block, cover exposed areas of your body where possible (especially by wearing a wide brimmed hat) and drink plenty of water. (You may also need to replace salt lost through increased perspiration ~ assuming no underlying blood pressure problem)
Northern Australia
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As mentioned previously, the northern parts of Australia are sub-tropical and mosquito borne diseases are more common. Malaria transmission does not occur and many of the diseases transmitted by mosquitoes or other insects cause mild discomfort. Unfortunately some are which are much more severe and can cause long term difficulties.
Ross River Fever
This viral disease is transmitted by mosquitoes and causes a severe arthritic type condition. The disease is often short lived but in some patients the disease may continue to cause arthritis for months and even years. There is no specific treatment and travellers need to be careful about avoiding bites.
Typhus
This disease occurs in isolated parts of Northern Australia through the bite of infected ticks. The disease can cause a skin rash, fever and general unwellness. Antibiotics can help to ease the symptoms but avoiding bites is essential at all times.
Dengue
This mosquito borne disease also occurs in parts of Northern Australia usually by day-biting mosquitoes. (See Dengue leaflet - TMB)
Other Risks
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The sea waters in parts of Australia are infested by sharks and jelly fish. Always take competent local advice before undertaking any sea activities. Drowning occurs regularly each year among tourists who disregard some of the basic rules of water safety. If in desert regions, take care with disturbing rocks in case you awaken a peaceful snake or scorpion.
Medical Care for Travellers
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If travellers have stopped in South East Asia and then become ill on arrival in Australia, they should make contact with a medical centre dealing with Tropical Medicine. Details of the centres in the major cities throughout Australia are available from the Tropical Medical Bureau.
Vaccinations for Stop-Overs
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Usually travellers will have vaccination cover for Typhoid, Poliomyelitis, Tetanus and Hepatitis A. Malaria prophylaxis may not be required depending on your actual itinerary. There is a higher risk of Hepatitis B in central Australia and so this may need to be considered if the risk of contact (mainly blood following accidents) is thought to be higher than usual. Rabies risk in Australia is almost non existent though obviously contact with all warm blooded animals should be avoided at all times.

Travel News Headlines WORLD NEWS

Date: Thu, 10 Oct 2019 06:51:42 +0200 (METDST)
By Holly ROBERTSON

Sydney, Oct 10, 2019 (AFP) - Large numbers of tourists are rushing to scale Uluru -- also known as Ayers Rock -- ahead of a looming ban on climbing a site sacred to indigenous Australians.   Photographs of hundreds of people clambering up the giant red monolith have provoked a social media backlash, with critics lashing as "ignorant" those going against the wishes of the traditional Aboriginal owners of the land, the Anangu.   "A mass of morally and ethically bankrupt people," indigenous woman Laura McBride tweeted alongside an image showing a queue of people snaking up the side of Uluru.    "One even hiking a toddler up, teaching the next generation how to be ignorant."   "Imagine rushing to climb Uluru before it closes just so you could brag about disrespecting the oldest living culture in the world," tweeted National Indigenous Television journalist Madeline Hayman-Reber, who called the scenes "embarrassing".

Officials say the ban, which comes into effect on October 26, is intended to show respect for cultural practices, protect the site from further environmental damage and to ensure visitors' safety.    More than 395,000 people visited the Uluru-Kata National Park in the 12 months to June 2019, according to Parks Australia, about 20 percent more than the previous year. Around 13 percent of those who visited during that period made the climb, park authorities said.    More recent figures are not available but Tourism Central Australia CEO Stephen Schwer said there had been a "significant jump" in the number of people visiting in recent weeks, with the period leading up to the ban coinciding in part with school holidays.   "Its been very busy, particularly down in the national park precinct itself," he told AFP.   "We've had quite an issue with accommodation availability, because there's a lot of people want to climb Uluru before it closes. It's been a busier than normal holiday period."   Japanese visitors and Australians on driving holidays were most likely to want to scale Uluru, Schwer said, though he urged them not to do so.

Australian tourist Belinda Moore, 33, drove to Uluru from her home in central Queensland state to ascend the rock, an experience she said she "absolutely loved".   "It's always been something to tick off the bucket list and when we heard it was closing, we knew it was now or never," she told AFP.   Moore said she did not think her climb was disrespectful to traditional owners as she was not Aboriginal.    "It may be for their own people, because it's their sacred site," she said.   "I'm pretty sad that they're closing it, but it's still amazing just to see it. I would still recommend it."   The climb will be permanently closed as of October 26, the anniversary of ownership being handed back to the Anangu people.

Uluru has great spiritual and cultural significance to indigenous Australians, with their connection to the site dating back tens of thousands of years.   Though visitor numbers were expected to decline once the ban was in place, Schwer said local tourism operators were "not particularly concerned" as it would return the area to normality.   "People need to remember that in central Australia we're a very interconnected community," he said. "The people who are requesting the climb closure are our friends and colleagues.   "We're just looking forward to being able to have the climb consigned to the annals of history."
Date: Tue 8 Oct 2019
Source: Central Telegraph [abridged, edited]

Another measles case has flown into the Gold Coast from New Zealand, which is experiencing an epidemic of the highly contagious virus.

The case is the 3rd reported on the Gold Coast and the 6th measles case diagnosed in Queensland in the past fortnight. It takes the number of cases in Queensland so far this year to 31, more than double the 14 recorded for the whole of 2018.

The traveller was exposed to measles while visiting New Zealand, which has recorded more than 1600 cases this year [2019].  [Byline: Janelle Miles]
Date: Wed 2 Oct 2019 7:54 AM AWST
Source: 10 Daily [edited]

Western Australia [WA] has been hit with an unprecedented outbreak of measles, with 8 confirmed cases in Perth.

The state's health department confirmed there have been 5 cases alone in the Rockingham area, in Perth's south. One of those cases included a baby. A further 3 cases have now been confirmed across the city.

The rare outbreak has been linked to a much bigger one in New Zealand.

Health authorities believe the WA outbreak started with a New Zealand visitor, that man has since returned home.

There have been more than 1300 cases of measles in New Zealand recently.

WA health authorities are in the process of providing information to people who were potentially exposed to offer treatment and immunisations if appropriate.

But they say it's not possible to identify people who may have been exposed in public places.

Acting Director of the Communicable Disease Control Directorate, Paul Effler, said measles was a serious and highly contagious virus spread by tiny droplets released when infected people cough and sneeze.  "Every measles case is treated as a public health emergency because of the risk of local spread," Dr Effler said on [Tue 1 Oct 2019].

"With high vaccination coverage, naturally occurring measles has been eliminated from WA for around 20 years, but occasional cases and small outbreaks still occur, usually associated with tourists or Western Australia residents who are infected overseas."  [Byline: Peter Devlin]
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[HealthMap/ProMED-mail map of Australia:
Date: Thu 19 Sep 2019
Source: Food Safety News [edited]

The New South Wales (NSW) Food Authority advised consumers who bought salted or pickled clams from Koryo Food Co. or Byul Mi Kim Chi to destroy any remaining product or return it to the place of purchase for a refund. Koryo Food Co. and Byul Mi Kim Chi recalled the items because of the potential link with hepatitis A from the salted or pickled clams imported from South Korea.

Authorities in South Korea recently warned domestic consumers to avoid certain types of salted or pickled clams due to a link with hepatitis A infection. Australian-grown clams are not implicated in the outbreak. South Korea, where hepatitis A is usually rare, is experiencing a large outbreak with more than 11,000 cases reported [in 2019].

Lisa Szabo, NSW Food Authority CEO, said testing was underway on a number of products, but results may take several weeks. "Although a contamination has not yet been confirmed, we have advised the companies of a potential link to 8 cases of hepatitis A in NSW, and they have both undertaken a recall of the product," she said. "We want to ensure all consumers who may have these products are aware of the possible link between the product and hepatitis A. While the affected products have been recalled from participating retailers, consumers may still have product they have already purchased in their fridges."

Koryo Food Co. is recalling pickled clams sold at independent Korean and Asian Grocery Stores in New South Wales. The 180-gram pack has "use by" dates of 19 Nov and 28 Nov 2019. Byul Mi Kim Chi salted clams come in a 150-gram plastic container and were sold at Korean Grocery Shops in New South Wales with a "best before" date ranging from 31 Oct to 31 Dec 2019.

[In August 2019], the Australian Capital Territory (ACT) Health Directorate and NSW Health revealed they were investigating a cluster of hepatitis A infections in the South Korean community. Eight adults of South Korean heritage have been affected since June [2019]. Most did not have recent overseas travel and lived in south-eastern Sydney, northern Sydney, and western Sydney. The ACT Health Directorate reminded anyone traveling to South Korea of the importance of vaccination prior to travel and good hand hygiene to reduce the risk of spread.
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[Outbreaks of hepatitis A in the developed world are generally, like these, related to a contaminated food. The huge epidemic of hepatitis A ongoing in many states of the USA is, however, paralleling the developing world with cases related to appalling sanitation and living conditions. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
New South Wales, Australia: <http://healthmap.org/promed/p/284>]
Date: Fri 30 Aug 2019
Source: Esperance Express (abridged, edited)

Esperance residents need to be alert to the risk of measles following confirmation of measles in a person who visited the region. [See URL for time and locations of possible exposure. - ProMED Mod.LK]

"With high vaccination coverage, naturally occurring measles has been eliminated from WA [Western Australia] for around 20 years, but occasional cases and small outbreaks occur, sparked by residents or visitors who were infected overseas," WA County Health Service's Dr Charles Douglas said.  [Byline: Jake Dietsch]
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Cape Verde

General
The Cape Verde islands are situated off the west coast of Africa (adjacent to Senegal) and are becoming a more popular destination for European travellers aiming to avoid the major busy tourist destinations of the world. There are nine inhabi
ed islands within the group and also some uninhabited volcanic ones. The capital is Praia (on Santiago) and Portugese is the official language. The major port is Mindelo on the island of Sao Vicente.

Travelling to Cape Verde
There is a recently opened international airport in Praia and a second international airport (Amilcar Cabral) located on Sal Island which is about 150 kms northeast of the capital. Generally the facilities for tourists are still quite limited though improving and most developed on Sal.
Arriving in Cape Verde
The climate is oceanic tropical with temperatures varying from 20oC to 30oC throughout the year. The light rainfall tends to occur in Aug to November. During this time humidity can be higher but this is not usually a significant factor.
Food & Water
In line with many hotter regions of the world the level of food and water hygiene varies greatly from area to area and depending on the establishment. Travellers are advised to eat freshly cooked hot food, to avoid cold meals (salads etc) and particularly to avoid any undercooked bivalve shellfish meals (clams, mussels, oysters etc). Fresh milk may be unpasteurised and should be avoided.
Travelling around the islands
As with many archipelago destinations there is a way of moving from island to island if you wish to explore. This can be by boat or plane in many but not all cases. However if travelling by plane be aware that the limited baggage handling capacity of the small planes may lead to some delay in eventually receiving your luggage. During the dry dusty season (December to April) flights may be cancelled due to poor visibility. The road traffic moves on the right and seatbelts are compulsory for all in the front seat. Motorcyclists must wear helmets and have their lights on at all times.

Accidents
The majority of accidents occur because of unlit narrow winding roads, aggressive driving and alcohol impairing the senses. There are a large number of festivals and around these times alcohol intake increases considerably with the resultant increase in danger for all road users.
Emergency numbers
The emergency numbers are 130 for medical assistance, 131 for fire assistance and 132 for the police. There is no organised roadside assistance and travellers are strongly advised to avoid hiring cars or motorbikes. Taxis and buses provide a reasonable service and are a much safer option.
Sun Exposure & Dehydration
Many travellers from Europe will enjoy the beautiful climate to excess and run the risk of severe sunburn and dehydration. This is particularly true for the first 24 to 48 hours after arrival (when the traveller may fall asleep under the glaring sun) and also for young children. Sensible covering, avoiding the midday sun and replacing lost fluids and salt are essential to maintain your health.
Swimming and Water Sports
Island life in the tropics tends to increase the amount of water exposure for many tourists. It is important to check out the facilities (both the professionalism of their personnel and the equipment) before undertaking any water sports. Talk to others who have already taken part or your holiday representative and listen to their experiences. This will help you make the right choices. Remember the tides and currents around the various islands can be very strong so always follow local advice and never swim alone. Watch children carefully.
Mosquitoes and Malaria
This island chain has only a few species of mosquitoes and the risk of malaria is thought to be negligible. WHO (2006) does not recommend prophylaxis for travellers but comments that there is a mild risk on Santiago mainly between August and November during the rainy season. Good repellents should be used by all travellers - especially at dusk and dawn.
Safety & Security
Unfortunately there is no idyllic destination throughout the world and petty crime occurs in Cape Verde as elsewhere. Take special care at festivals and in market places. Don't flaunt your personal wealth while out and about. Gangs of children have been involved in attacks against tourists so avoid any potential confrontation.
Contacts
U.S. Embassy: Rua Abilio m. Macedo 81, Praia Tel.: 238-61-56-16/17; Fax: 238-61-13-55; Web: usembassy.state.gov/praia
U.K. Embassy: Shell Cabo Verde, Sarl, Av Amilcar Cabral CP4, Sao Vincente
Tel.: 238-32-66-25/26/27; Fax: 238-32-66-29; E-mail: antonio.a.canuto@scv.sims.com
Vaccines
Travelling directly from Europe there are no essential vaccines for entering Cape Verde. It is a Yellow fever risk region but there have been no cases for many years. Other vaccines need to be considered against food and water borne diseases such as Hepatitis A & Typhoid.
Healthcare
This is a beautiful destination and direct flight will increase the numbers travelling. However all travellers to Cape Verde will need to be seen for a detailed medical consultation to ensure that they have appropriate advice and protection for their individual trip. Further information on health issues and all the latest world travel news reports are available at www.tmb.ie

Travel News Headlines WORLD NEWS

Date: Fri, 3 May 2019 12:24:17 +0200
By Anne-Sophie FAIVRE LE CADRE

Cha das Caldeiras, Cape Verde, May 3, 2019 (AFP) - Four years after the volcano erupted -- razing everything in its path in Cape Verde's Cha das Caldeiras valley -- the floor tiles of the small, rebuilt inn are warm to the touch.    "We constructed too quickly on lava that had not yet cooled down," says hotel owner Marisa Lopes, in her early 30s.   "For the first months, the floors in the rooms were so hot that you couldn't walk on them with bare feet."

Lopes is one of dozens of entrepreneurs locked in a perpetual tug of war with the Pico do Fogo volcano towering over Cha das Caldeiras, whose population numbers 500.    The name means Peak of Fire in Portuguese.   The volcano generates the bulk of the crater community's gross domestic product, attracting some 5,000 tourists every year who need hotel beds, food and tour guides -- about 30 make a living as guides in this remote part of West Africa.   But on the downside, the festering giant erupts once a generation -- six times in the last 200 years -- destroying everything in its path; crops, homes, roads.   On November 23, 2014, Lopes watched helplessly as the Pico -- almost 2,900 metres (9,500 feet) high -- erupted after a 19-year slumber.

Lava engulfed her brand new tourist hostel, eponymously named Casa Marisa.   Three months later, she built a new one, again in the flow zone of the crater.   "The volcano took a house from me, but it gave me another. Without it, there would be no tourism," she told AFP, undeterred.   Despite the constant danger and government efforts to dissuade them, the inhabitants of Cha das Caldeiras keep coming back.     After the last eruption, the military evacuated those in the path of the lava and the state provided food aid for six months afterwards.   But it was the people themselves who reconstructed roads and found the materials for rebuilding homes and hotels. Again.

- 'It's home' -
Cicilio Montrond, 42, was also there in 2014, looking on as a river of molten rock spewing from the Pico do Fogo burnt his fruit trees and buried everything he owned in a thick, grey coat.   The eruption killed no one, but left 1,500 people homeless.   After a few weeks in Sao Filipe, a nearby town to where the valley inhabitants were relocated, Montrond returned to Cha das Caldeiras with his wife.   Not a bird stirred in the air still polluted with ash, not a creature moved on the still warm lava ocean that now covered the valley floor.

For weeks, Montrond and his wife lived in a tent on the roof of their destroyed house with no water, no electricity and no food apart from a few canned goods.   "We lived in makeshift shelters, it was precarious, dangerous. But we were home."   For Montrond, it is unimaginable to live anywhere else than the fertile, lava-fed valley that, between outbursts, boasts an abundance of vines, fig trees and cassava.   "It is the volcano that allows us to live," said Montrond, tourist guide-turned-hotelkeeper and restaurateur.   The Pico's eruptions are rarely deadly in terms of human life.   But what about the next time?   "The volcano is my life," Montrond shrugged, as he gazed upon the house he built with his own hands.    "I was born here, I will die here."

- Rocks were falling -
The volcano gives. The volcano takes.   First it destroys the vines, then it provides fruitful soil for the planting of new ones. These produce wines -- some of it for the export market.   Far from fearing or despising the peak's constant threatening presence, the inhabitants appear to embrace it and have made it part of their identity.   They evoke past eruptions with a smile, sometimes even a touch of nostalgia.   Margarita Lopes Dos Santos, 99, has been forced out of her home by the three last eruptions of the Pico do Fogo.

The first was in June 1951, shortly after she gave birth to her first child.   "I remember the first time like it was yesterday," she said, through a beaming, toothless smile.   "It was a lot more violent. Rocks were falling from the sky. There were tornadoes of ash and of smoke," she recounted, while husking beans.   Outside her house, Lopes Dos Santos has planted flowers -- flashes of red begonias that provide the only colour in the grey and black landscape.   "The resilience of the people of Cha is extraordinary," said Jorge Nogueira, president of the municipal council of Sao Filipe, capital of the island of Fogo, Cape Verde.   "As soon as they could, they came back -- to poor living conditions, but no matter: the only thing that counted for them was to be home."
Date: Tue 3 Oct 2017
Source: Outbreak News Today [edited]

In a follow-up on the locally transmitted malaria increases reported on Cabo Verde [Cape Verde] this year [2017], 254 indigenous cases were reported through [24 Sep 2017].

Most cases (75 percent) have not sought treatment until 48-96 hours after illness onset. Despite this, case fatality rates have remained low (0.4 percent), with one death reported in an indigenous case to date. 7 severe malaria cases and 2 cases of malaria in pregnancy have been reported. There are also anecdotal reports of recrudescence.

To date, the disease has been localized to the city of Praia on Santiago Island without any further spread.

A handful of cases have also been detected on neighbouring islands (Sao Vicente, Sal, and Porto Novo); however, their infections were likely all acquired during travel to Praia or overseas, with no evidence of onward local transmission.

The malaria epidemic in Cabo Verde has begun to show early signs of improvement but the situation remains tenuous, with heavy rainfall continuing between August and October, health officials said.
===================
[The last news from ProMED from 4 Sep 2017 (archive no. http://promedmail.org/post/20170904.5293108) reported 116 cases of malaria in Praia. Thus, over the last month 136 new cases have been diagnosed. It is good news that the outbreak has not spread, showing that the control measures are working. Due to the present outbreak, the CDC is now recommending malaria chemoprophylaxis for travellers visiting the city of Praia on Santiago Island (<https://www.cdc.gov/malaria/new_info/2017/Cape_Verde_2017.html>). - ProMED Mod.EP]

[Maps of Cape Verde can be seen at
<http://healthmap.org/promed/p/6553>. - ProMED Sr.Tech.Ed.MJ]

08 Sep 2017


Following an increase in malaria cases, additional malaria prevention advice for some UK travellers to the capital city of Praia in Cape Verde is recommended.

Since June 2017, the Ministry of Heath for Cape Verde has reported an increase in locally acquired malaria cases in the capital city of Praia on the island of Santiago. As of 5 September 2017, a total of 164 locally acquired falciparum malaria cases have been reported in the local population [2][3]. Currently, there are no reports of malaria in tourists who have visited Cape Verde in 2017.  

Those travelling to Praia who are at increased risk of malaria e.g. long term travellers, or those at risk of severe complications from malaria: pregnant women, infants and young children, the elderly and travellers who do not have a functioning spleen, should consider taking anti-malarials and seek advice about which antimalarial is suitable for them from their travel health advisor.

Date: Sun 3 Sep 2017 08:58:00 WEST
Source: The Portugal News (TPN) Online [edited]
<http://theportugalnews.com/news/portugal-health-department-issues-malaria-warning-for-cape-verde-capital/43059

The Portuguese health department has advised pregnant women not to travel to the Cape Verde island of Santiago [where the capital, Praia, is located], and if travellers cannot put their journey off, they should take anti-malaria drugs.

The health department warning comes after the World Health Organisation (WHO) said in August [2017] that there was an outbreak of malaria in Praia, the archipelago's capital. Travellers are also advised that adults and children should use insect repellent throughout the day and reapply it as often as necessary. If travellers also use sun cream, they should apply the insect repellent on top of the sun cream, not under it, the warning said. So far, there have been 116 cases of malaria in Praia, numbers never before seen in the city, where the highest number was 95 cases in the whole of 2001.
============
[The Cape Verde authorities reported 45 cases of malaria up to 30 Jul 2017 (see archive no. http://promedmail.org/post/20170808.5236283).

The outbreak continues and it is important to introduce identification and spraying of breeding sites. Also using a single dose of primaquine after treatment, which kills gametocytes, to ensure that the cases cannot transmit the infection, as recommended by the WHO (http://www.who.int/malaria/publications/atoz/who_pq_policy_recommendation/en/). - ProMED Mod.EP

Maps of Cape Verde can be seen at
<http://www.nationsonline.org/maps/Cape-Verde-Map.jpg>
and <http://healthmap.org/promed/p/15>. - ProMED Sr.Tech.Ed.MJ]
Date: Tue 8 Aug 2017
Source: Outbreak News Today [edited]

During the past 5 years, an average of one locally acquired case annually of malaria has been reported in Cabo Verde, or Cape Verde. In 2017, between [30 Jun and 30 Jul 2017], 45 indigenous cases and one imported case were reported, all in the capital city of Praia, Santiago Island.

More than half the cases are reported in adult males. The causative agent has been confirmed as _Plasmodium falciparum_ using both microscopy and rapid diagnostic tests (RDTs).

Preliminary investigations have attributed the recent increase in local transmission to several factors, including suboptimal vector control strategies, possibly coupled with inappropriate use (incorrect dilution) of a new insecticide introduced into the country in November 2016; the unauthorized installation of a rice paddy field in the affected area; and an increase in mosquito breeding sites within construction zones of a shopping centre and houses. The local authorities are in the process of removing the paddy field as further investigations are ongoing.

Cape Verde is a low malaria transmission country, eligible for elimination of the disease. With limited underlying immunity, all people (irrespective of their age group) are at risk of infection and of developing severe disease.
======================
[In 2015, Cabo Verde reported 7 _P. falciparum_ infected cases <http://www.who.int/malaria/publications/country-profiles/profile_cpv_en.pdf>. Cabo Verde is close to the African continent, and visitors may be asymptomatic gametocyte carriers and can start a local transmission if the vector control is not optimal, as suggested here. - ProMED Mod.EP]

[A HealthMap/ProMED-mail map can be accessed at:
More ...

Nicaragua

Nicaragua - US Consular Information Sheet
December 22, 2008
COUNTRY DESCRIPTION:
Nicaragua’s fragile democracy remains under stress.
Following municipal elections in November 2008, in which opposition leaders have charged massive fr
ud took place, political tensions have increased significantly.
The economy remains among the poorest in the hemisphere.
Crime has increased significantly in recent months.

The national language is Spanish, although many residents of the Caribbean coastal areas also speak English and indigenous languages.
The climate is hot and humid, with the “summer” dry season running mid-November through mid-May and the “winter” rainy season running from mid-May through mid-November.
Terrain ranges from the hilly and volcanic to coastal beaches and tropical jungles.
Geological faults run throughout the country, along which active volcanoes are situated.
Earthquakes are common, but the last major earthquake, which destroyed the city of Managua, occurred in 1972.

Nicaragua lacks tourist infrastructure.
Except in the cities and major thoroughfares, most roads are unpaved.
Public transportation is unsafe and there are no sidewalks.
Most essential services are sporadic.
Most hospitals are substandard.
Hotels in Managua are adequate, but primarily are oriented to serve a business or government clientele.
Potential tourists may want to obtain information from the National Tourism Institute (INTUR), the governmental agency responsible for developing, regulating, and promoting tourism in Nicaragua at http://www.intur.gob.ni/.
Read the Department of State Background Notes on Nicaragua for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid U.S. passport is required to enter Nicaragua.
Although there is a bilateral agreement that waives the six-month validity passport requirement, U.S. citizens are urged to ensure that their passports are valid for the length of their projected stay in the country before traveling.
U.S. citizens must have an onward or return ticket and evidence of sufficient funds to support themselves during their stay.
A visa is not required for U.S. citizens; however, a tourist card must be purchased for $5 upon arrival.
Tourist cards are typically issued for 30 to 90 days.

A valid entry stamp is required to exit Nicaragua.
Pay attention to the authorized stay that will be written into your entry stamp by the immigration inspector.
Visitors remaining more than the authorized time must obtain an extension from Nicaraguan Immigration at http://www.migracion.gob.ni/.
Failure to do so will prevent departure until a fine is paid.

There is also a $32 departure tax.
Many airlines include this tax in the price of the ticket.
If the tax is not included in the ticket, payment can be made at the airline counter upon departure.

Per Nicaraguan law, individuals should exit Nicaragua with the same passport with which they entered the country.
Dual national minors who entered Nicaragua on their Nicaraguan passports will be subject to departure requirements specific to Nicaraguan children under the age of 18, even though they may also be citizens of other countries.
More information on these requirements can be found on the U.S. Embassy web site at http://nicaragua.usembassy.gov/dual_nationality.html.

According to Nicaragua’s Laws for Foreigners, foreigners must be in possession of a valid identity document at all times while in Nicaragua and may be required to show it to Nicaraguan authorities upon request.
Acceptable identity documents are: (1) a permanent residency card, (2) temporary residency card, or (3) valid passport or travel document accompanied by an entry stamp.

In June 2006, Nicaragua entered a “Central America-4 (CA-4) Border Control Agreement” with Guatemala, Honduras, and El Salvador.
Under the terms of the agreement, citizens of the four countries may travel freely across land borders from one of the countries to any of the others without completing entry and exit formalities at Immigration checkpoints.
U.S. citizens and other eligible foreign nationals, who legally enter any of the four countries, may similarly travel among the four without obtaining additional visas or tourist entry permits for the other three countries.
Immigration officials at the first port of entry determine the length of stay, up to a maximum period of 90 days.
Foreign tourists who wish to remain in the four-country region beyond the period initially granted for their visit are required to request a one-time extension of stay from local Immigration authorities in the country where the traveler is physically present, or travel outside the CA-4 countries and reapply for admission to the region.
Foreigners “expelled” from any of the four countries are excluded from the entire “CA-4” region.
In isolated cases, the lack of clarity in the implementing details of the CA-4 Border Control Agreement has caused temporary inconvenience to some travelers and has resulted in others being fined more than one hundred dollars or detained in custody for 72 hours or longer.

For the most current information about visas to visit Nicaragua, visit the Embassy of Nicaragua web site at http://www.cancilleria.gob.ni.

Information about dual nationality or the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
Municipal elections took place across Nicaragua on November 9, 2008.
Violent demonstrations followed as opposition groups questioned the authenticity of the results.
Activities observed during protests included but were not limited to tear gas, rubber bullets, setting off fireworks, rock-throwing, tire burning, road blocks, bus and vehicle burning, and physical violence between law enforcement and protestors and between political rivals.
Political demonstrations and strikes continue to occur sporadically, are usually limited to urban areas, and occasionally become violent.
U.S. citizens are advised to monitor local media reports, to avoid crowds and blockades during such occurrences and to exercise caution when in the vicinity of any large gathering.

U.S. citizens are cautioned that strong currents and undertows off sections of Nicaragua's Pacific coast have resulted in a number of incidents of drowning.
Powerful waves have also resulted in broken bones, and injuries caused by sting rays are not uncommon in popular resort bathing areas.
Warning signs are not posted, and lifeguards and rescue equipment are not readily available.
U.S. citizens contemplating beach activities in Nicaragua's Pacific waters should exercise appropriate caution.

Hiking in volcanic or other remote areas can be dangerous and travelers should take appropriate precautions.
Hikers should have appropriate dress, footwear, and sufficient consumables for any trek undertaken.
Individuals who travel to remote tourist or other areas for hiking activities are encouraged to hire a local guide familiar with the terrain and area.
In particular, there have been instances of hikers perishing or losing their way on the volcanoes at Ometepe Island.
While they may look like easy climbs, the terrain is treacherous and heavily overgrown.

Although extensive de-mining operations have been conducted to clear rural areas of northern Nicaragua of landmines left from the civil war in the 1980s, visitors venturing off the main roads in these areas are cautioned that the possibility of encountering landmines still exists.
Domestic travel within Nicaragua by land and air, particularly to the Atlantic side can be dangerous.
Domestic airlines use small airstrips with minimal safety equipment and little boarding security.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:
Violent crime in Managua is increasing and petty street crimes are very common.
Gang activity also is increasing, though not at levels found in neighboring Central American countries.
Pick-pocketing and occasional armed robberies occur on crowded buses, at bus stops and in open markets like the Oriental and Huembes Markets.
Gang violence, drive-by shootings, robbery, assault and stabbings are most frequently encountered in poorer neighborhoods, including the Ticabus area, a major arrival and departure point for tourist buses.
However, in recent months it spread to more upscale neighborhoods and near major hotels, including the Zona Hippos.
In 2008, a U.S. citizen was critically injured in a gang-motivated drive-by shooting that occurred in the San Judas area.
Another U.S. citizen was kidnapped and left for dead in the Villa Fontana area of Managua.

U.S. citizens are increasingly targeted shortly after arriving in the country by criminals posing as Nicaraguan police officers who pull their vehicles – including those operated by reputable hotels -- over for inspection.
In each case, the incidents happened after dark and involved gun-wielding assailants who robbed passengers of all valuables and drove them to remote locations where they were left to fend for themselves.
Some assailants employed threats of physical violence.
While the traditional scene of these attacks has been the Tipitapa-Masaya Highway, this activity has recently spread to the Managua-Leon Highway.
The U.S. Embassy warns U.S. citizens to exercise extreme caution when driving at night from Managua’s International Airport and to avoid traveling the Tipitapa-Masaya Highway at night.
U.S. citizens should exercise caution when approached by strangers offering assistance.
Several U.S. citizens traveling by bus from San Juan del Sur to Managua have reported being victimized by fellow women travelers who offered to assist them in locating and/or sharing a taxi upon arrival in Managua.
In all cases, upon entering the taxi, the U.S. citizens have been held at knife-point, robbed of their valuables, and driven around to ATM machines to withdraw funds from their accounts.

Violent criminal activities and petty crime are also increasing in the tourist destination of San Juan del Sur.
In 2008, a U.S. citizen family was violently assaulted and kidnapped by several armed men.
Other American citizens have been the victims of armed robberies by assailants wielding machetes, knives, and/or guns along the beaches in and around San Juan del Sur.
U.S. citizens should exercise particular caution when visiting the following beaches: Maderas, Marsella, Yankee, Coco, and Remanso.

Police coverage is extremely sparse outside major urban areas, particularly in Nicaragua’s Atlantic coast autonomous regions.
Lack of adequate police coverage has resulted in these areas being used by drug traffickers and other criminal elements.
Street crime and petty theft are a common problem in Puerto Cabezas, Bluefields, and the Corn Islands along the Atlantic coast.
For security reasons, the Embassy has limited travel by its staff to the North and South Atlantic Autonomous Regions (RAAN and RAAS), including the Corn Islands.
Given the area’s geographical isolation, the Embassy’s ability to provide emergency services to U.S. citizens who choose to travel in the Caribbean costal area is constrained.
Police presence on Little Corn Island is made up of volunteers with little to no formal training, and is minimal on Corn Island and other remote areas.
In late 2007, a U.S. citizen was assaulted and violently raped while on vacation in Little Corn Island.
U.S. citizens have previously been the victims of sexual assault on this island and other beaches in the country.
The Embassy recommends traveling in groups when in isolated areas.
Single travelers should exercise special caution while traveling in the Corn Islands and other remote areas of the country.
Throughout the country, U.S. travelers should utilize hotels and guest houses that have strong security elements in place, including but not limited to rooms equipped with safes for securing valuables and travel documents and adequate access control precautions.

Visitors should avoid walking and instead use officially registered taxicabs.
Radio-dispatched taxis are recommended and can be found at the International Airport and at the larger hotels.
Robbery, kidnapping, and assault on passengers in taxis in Managua are increasing in frequency and violence, with passengers subjected to beating, sexual assault, stabbings, and even murder.
Several U.S. citizens reported brutal attacks in taxis during 2008, particularly around the International Airport area.

Before taking a taxi, make sure that it has a red license plate and that the number is legible.
Select taxis carefully and note the driver's name and license number.
Instruct the driver not to pick up other passengers, agree on the fare before departing, and have small bills available for payment, as taxi drivers often do not make change.
Also, check that the taxi is properly labeled with the cooperativa (company) name and logo.
Purse and jewelry snatchings sometimes occur at stoplights.
While riding in a vehicle, windows should be closed, car doors locked, and valuables placed out of sight.

Do not resist a robbery attempt.
Many criminals have weapons, and most injuries and deaths have resulted when victims have resisted.
Do not hitchhike or go home with strangers, particularly from nightspots.
Travel in groups of two or more persons whenever possible.
Use the same common sense while traveling in Nicaragua that you would in any high-crime area of a major U.S. city.
Do not wear excessive jewelry in downtown or rural areas.
Do not carry large sums of money, ATM, or credit cards that are not needed, or other valuables.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members, or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care is very limited, particularly outside Managua.
Basic medical services are available in Managua and in many of the smaller towns and villages.
However, treatment for many serious medical problems is either unavailable or available only in Managua.
Emergency ambulance services, as well as certain types of medical equipment, medications and treatments, are not available in Nicaragua.
Physicians and hospital personnel frequently do not speak English, and medical reports are written in Spanish.
Patients must have good understand and an ability to speak Spanish in order to navigate the local medical resources.

In an emergency, individuals are taken to the nearest hospital that will accept a patient.
This is usually a public hospital unless the individual or someone acting on their behalf indicates that they can pay for a private hospital.
Payment for medical services is typically done on a cash basis, although the few private hospitals will accept major credit cards for payment.
U.S. health insurance plans are not accepted in Nicaragua.

Dengue fever is endemic in Nicaragua.
Currently, no vaccine or specific medication is available to prevent or treat Dengue fever.
Malaria is endemic in the Atlantic coast region and anti-malarial medication should be taken before and after travel to this region.
Travelers are advised to take a prophylactic regimen best suited to their health profile.
No prophylaxis anti-malarial medication is required for Managua and the western, Pacific coast region.
For both Dengue fever and malaria, the best prevention is the use of DEET insect repellant, as well as the wearing of protective clothing and bed-nets to prevent mosquito bites.

Tap water is not considered safe in Nicaragua.
All persons should drink only bottled water.
Individuals traveling to Nicaragua should ensure that all their routine vaccinations are up to date.
Vaccination against Hepatitis A, Hepatitis B, rabies and typhoid is strongly recommended.
A yellow fever vaccination is not required to enter Nicaragua unless the traveler has recently visited a country where yellow fever is endemic.
Travelers taking prescription medications should bring an adequate supply with them when coming to Nicaragua.
Many newer combination medications are not available in local pharmacies.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Nicaragua.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
Driving in Nicaragua poses many difficulties and risks, including mandatory arrest for drivers involved in accidents that result in death or serious injury until police are able to determine who is at fault.

Driving is on the right side of the road in Nicaragua.
Motorists driving to Nicaragua should use the principal highways and official border crossings at Guasaule, El Espino, and Las Manos between Nicaragua and Honduras and Penas Blancas between Nicaragua and Costa Rica.
Although some of the principal highways connecting the major cities are in generally good condition, drivers should be aware that seasonal, torrential rains take a heavy toll on road beds.
With few exceptions, secondary roads are in poor repair, potholed, poorly lit, frequently narrow, and lack shoulders.
Road travel after dark is especially hazardous in all areas of the country.
Motorists are encouraged to prepare accordingly and may want to carry a cellular phone in case of an emergency.

Some of the major highways and roads are undergoing major repair, repaving, and upgrading.
Be on the lookout for detours and slow traffic on these roads.
In general, road signs are poor to non-existent.
Bicycles, oxcarts, dogs, horses, and vehicles without lights are at times encountered even on main thoroughfares in Nicaragua.
Motorcycles, often carrying passengers, dart in and out of traffic with little or no warning.
Many vehicles are in poor condition, travel very slowly, and break down without warning.
Drivers should be especially careful on curves and hills, as many drivers will pass on blind spots.
Speed limits vary depending on the type of road, but because the government lacks the resources, traffic rules are rarely enforced.
Due to the age and disrepair of many vehicles, many drivers will not signal their intentions using turn indicators.
Rather, it is common for a vehicle operator to stick his hand out the window to signal a turn.
If you do drive in Nicaragua, you need to exercise the utmost caution, drive defensively, and make sure you have insurance.

Nicaraguan law requires that a driver be taken into custody for driving under the influence or being involved in an accident that caused serious injury or death, even if the driver is insured and appears not to have been at fault.
The minimum detention period is 48 hours; however, detentions frequently last until a judicial decision is reached (often weeks or months), or until a waiver is signed by the injured party (usually as the result of a cash settlement).
Visitors to Nicaragua might want to consider hiring a professional driver during their stay.
Licensed drivers who are familiar with local roads can be hired through local car rental agencies.
In case of accident, only the driver will be taken into custody.

The Embassy has received an increasing number of complaints from U.S. citizens who have been stopped by transit police authorities demanding bribes in order to avoid paying fines.
Motorists in rental cars and those whose cars have foreign license plates are more likely to be stopped by transit police.
Transit police have seized driver licenses and car registration documents from motorists who refuse to or are unable to pay.
Subsequently, these drivers have reported difficulties in recovering the seized documents.
U.S. citizens are urged to ensure that their vehicles comply fully with Nicaraguan transit regulations, including being in possession of an emergency triangle and fire extinguisher, and that the vehicle is properly registered.
If transit police authorities demand an on-the-spot payment, drivers should ask for the officer's name and badge number, as well as a receipt, and inform the Embassy of when/where the event took place.
(Reports should be sent via email to ACS.Managua@state.gov.)
Rental car agencies should also be advised if their vehicles have been deemed negligent in meeting Nicaraguan transit regulations.

As noted in the “Crime” section above, several groups of U.S. citizens driving from Managua’s International Airport at night have been robbed and kidnapped by men dressed as Nicaraguan police officers.
While the majority of these crimes have occurred on the Tipitapa-Masaya Highway, recent reports indicate similar activity along the Managua-Leon Highway.
The U.S. Embassy warns U.S. citizens to exercise extreme caution when driving at night from Managua’s International Airport and to avoid traveling the Tipitapa-Masaya Highway at night.

Avoid taking public transportation buses.
They are overcrowded, unsafe, and often are used by pickpockets.
Because of the conditions discussed above, traffic accidents often result in serious injury or death.
This is most often true when heavy vehicles, such as buses or trucks, are involved.
Traditionally, vehicles involved in accidents in Nicaragua are not moved (even to clear traffic), until authorized by a police officer.
Drivers who violate this norm may be held legally liable for the accident.

Regulations governing transit are administered by the National Police.
For specific information concerning Nicaraguan driver’s permits, vehicle inspection, road tax, and mandatory insurance, you may wish to refer to the National Police web site at http://www.policia.gob.ni.
You may also contact the Embassy of Nicaragua or a Consulate for further information.
Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.mti.gob.ni
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Nicaragua’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Nicaragua’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Purchasing Property: U.S. citizens should be aware of the risks of purchasing real estate in Nicaragua and should exercise caution before committing to invest in property.
The U.S. Embassy has seen an increase in property disputes over the last several years.
The 1979-90 Sandinista government expropriated approximately 28,000 real properties, many of which are still involved in disputes or claims.
Land title remains unclear in many cases.
Although the government has resolved several thousand claims by U.S. citizens for compensation or return of properties, there remain hundreds of unresolved claims registered with the Embassy.
Potential investors should engage competent local legal representation and investigate their purchases thoroughly in order to reduce the possibility of property disputes.

The Nicaraguan judicial system offers little relief when the purchase of a property winds up in court.
The Embassy is aware of numerous cases in which buyers purchase property supported by what appear to be legal titles only to see themselves subsequently embroiled in legal battles when the titles are contested by an affected or otherwise interested third party.
Once a property dispute enters the judicial arena, the outcome may be subject to corruption, political pressure, and influence peddling.
Many coastal properties have been tied up in courts recently, leaving the ”buyer” unable to proceed with the intended development pending lengthy and uncertain litigation.
In other cases squatters have simply invaded the land while the police or judicial authorities are unable (or unwilling) to remove the trespassers.
Again, the Embassy advises that those interested in purchasing Nicaraguan property exercise extreme caution.
Please note that Nicaraguan law currently prohibits any individual from buying beach-front property (including islands) unless the original land title was registered before the 1917 Nicaraguan Agrarian Reform Law.
Coastal properties with titles pre-dating 1917 are not risk-free, however.
In 1987 the Nicaraguan Constitution established the property rights of indigenous communities over territory they have traditionally occupied.
The Embassy advises extreme caution when considering the purchase of coastal property in Nicaragua.

Currency and Credit Cards: U.S. dollars are widely accepted throughout the country, and major credit cards are also typically accepted in hotels, restaurants, stores, and other businesses in urban and tourist areas.
Visitors who need to change dollars are encouraged to do this at their hotel since this is typically the safest place.
ATM machines are available at banks in addition to some shopping centers and gas stations in urban and tourist areas.
However, individuals should exercise caution when using an automaticteller machine since they are typically in or near uncontrolled areas and criminal elements can easily see them withdrawing cash.
Traveler’s checks are accepted at a few major hotels and may also be exchanged for local currency at authorized exchange facilities ("casas de cambio").
Visitors will also find enterprising individuals - ”Cambistas” - waving wads of cash in the street.
Changing money in this fashion can be dangerous and is not recommended.

The U.S. Embassy has noted an increase in credit card fraud.
Although local police authorities have made several arrests in conjunction with credit card scam operations, the danger for abuse continues.
Illegal use can include “skimming” or making a copy of the magnetic strip on the credit card or simply copying the number for later use.
U.S. citizens who do continue to use credit cards in Nicaragua are advised to check statements frequently to monitor for abuse and/or to ask banks to email them when transactions exceed a certain number or size.

Disaster Preparedness: Nicaragua is prone to a wide variety of natural disasters, including earthquakes, hurricanes, and volcanic eruptions.
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
Boundary Disputes:
On the Atlantic side, nautical travelers should be aware that there is an ongoing boundary dispute with Colombia over the San Andres Island archipelago and the surrounding waters, specifically the area east of the 82nd and up to the 79th meridian.
Furthermore, the Government of Nicaragua has also begun to exercise sovereignty over territorial waters that were formerly controlled by Honduras but recently awarded to Nicaragua by the International Court of Justice.
Since October 2007, the Nicaraguan Navy has impounded about a dozen vessels, including two U.S.-owned vessels, for allegedly fishing without a Nicaraguan permit in theses zones.
Maritime boundary disputes also exist on the Pacific side.
In late-2007, the governments of Nicaragua, Honduras, and El Salvador reached an accord regarding shared fishing rights in the Gulf of Fonseca; however, questions remain regarding boundary demarcations in the Gulf of Fonseca.
Commercial fishing vessels should always ensure that they are properly licensed as problems have been reported in the areas off Cabo Gracias a Dios.
As a result of these disputes, in June 2008, the U.S. Coast Guard published a Special Warning on Nicaragua in the U.S. Notice to Mariners, which can be found at http://www.navcen.uscg.gov/Lnm/d1/lnm01242008.pdf (p. 6).

Travelers should also be aware that narcotics traffickers often use both the Caribbean and the Pacific coastal waters.
Customs Regulations: Before excavating archaeological materials, or agreeing to buy artifacts of historical value, all persons are strongly urged to consult with the National Patrimony Directorate of the Nicaraguan Institute of Culture.
Nicaraguan law and a bilateral accord limit the acquisition, importation into the United States and commercialization of said goods.
Severe criminal penalties may apply.
U.S. citizens planning to stay in Nicaragua for an extended period of time with the intention of bringing vehicles or household goods into the country should consult Nicaraguan customs officials prior to shipment.
Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Nicaraguan laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Nicaragua are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans residing or traveling in Nicaragua are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Nicaragua.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Kilometer 5 1/2 (5.5) Carretera Sur, Managua; telephone (505) 252-7100 or 252-7888; after hours telephone (505) 252-7634; Consular Section fax (505) 252-7304; Email: consularmanagua@state.gov or ACS.Managua@state.gov; web page: http://nicaragua.usembassy.gov/
*

*

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This replaces the Country Specific Information for Nicaragua dated June 3, 2008, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu, 25 Oct 2018 22:17:34 +0200

Montreal, Oct 25, 2018 (AFP) - Canadian tour operator Transat has cancelled all flights to Nicaragua this coming winter over the crisis that has left more than 320 dead in the Central American country, the company said Thursday.   This decision was made "because of the ongoing civil unrest and (the) weak demand that arises," Air Transat spokeswoman Debbie Cabana told AFP.   Air Transat would have offered three direct flights weekly form Toronto or Montreal to Managua from December 20 until the end of March.   "Customers who have reservations at the destination can change their booking or get a full refund," Cabana said.

Protests that began in April against a pension reform in Nicaragua grew into a movement demanding the departure of President Daniel Ortega and his wife, Vice President Rosario Murillo, who are accused of authoritarianism.    The protests have been severely repressed by police and paramilitaries, and the government proclaimed the situation normalized.   Canada continues to advise its nationals "to avoid any non-essential travel to Nicaragua."
Date: Fri, 7 Sep 2018 19:57:24 +0200

Managua, Sept 7, 2018 (AFP) - Many shops, banks and gas stations were closed Friday in a 24-hour strike in Nicaragua called by the opposition in protest at "political prisoners" and the rule of President Daniel Ortega's government.   In Mercado Oriental, one of the capital Managua's main trade districts, most of the 20,000 shops and businesses were shut, while few people were out on the streets.   "It's an excellent strike, this is how we are supporting those who were taken, who are being tortured, who have no business being in jail just for protesting," shopkeeper Geidy Areas, 38, told AFP.   The normally busy road south from Managua to Masaya, where many shops operate, appeared more desolate than normal.   Friday's strike, the first since July, was called by the opposition Civil Alliance for Justice and Democracy.   More than 300 Nicaraguans have been charged with crimes for taking part in protests, including 85 who are accused of terrorism.   The Alliance is demanding dialogue with Ortega's government after months of turmoil that left more than 300 people dead, according to rights groups.

In Managua, most banks, gas stations, shopping malls and book shops were closed but there were more buses and public transport vehicles running than during previous strikes in June and July.   In an important economic zone north of Managua, many hardware stores, shops and cafes remained open.   "People have to keep struggling because they've got bank debts and need to feed their children," food vendor Johana Blandon, who works in a busy free trade zone to the east of Managua, told AFP.   Government offices were operating as normal.   Nicaragua's descent into chaos was triggered on April 18 when relatively small protests against now-scrapped social security reforms were met with a government crackdown, backed by armed paramilitaries.

Catholic church-brokered peace talks broke down in June after Ortega rejected a key opposition demand to step down and bring forward presidential elections.   Last week, Ortega expelled the United Nations human rights mission after it published a report criticizing the "climate of fear" in the Central American country, one of the poorest in the region.   The UN denounced a wide range of serious violations, including disproportionate use of force by police, which in some cases resulted in extrajudicial killings, enforced disappearances, arbitrary detention and torture.   Ortega, a former guerrilla leader who has been in power for the last 11 years, denied the claims and described the UN as "an instrument of the policies of terror, lies and infamy."
Date: Thu, 6 Sep 2018 18:06:28 +0200

Managua, Sept 6, 2018 (AFP) - Nicaragua's opposition called a 24-hour strike on Thursday, due to start the next day, in protest against President Daniel Ortega and to demand the release of "political prisoners."   The strike is due to begin at midnight on Thursday, the Civil Alliance for Justice and Democracy, made up of students, businesses and civil service groups, said in a statement.

The opposition is demanding dialogue with Ortega's government after months of turmoil that left more than 300 people dead, according to rights groups.   It called on supporters to "join this national effort from your homes."   "Nicaragua needs an urgent and peaceful solution through dialogue," said the opposition.   "We need to live in security, without kidnappings, without political prisoners, without persecution and without the stigmatization of those who think differently."   Last week, Ortega expelled the United Nations human rights mission after it published a report criticizing the "climate of fear" in the Central American country, one of the poorest in the region.   The UN denounced a wide range of serious violations, including disproportionate use of force by police, which in some cases resulted in extrajudicial killings, enforced disappearances, arbitrary detention and torture.

Ortega, a former guerrilla leader who has been in power for the last 11 years, refuted the claims and described the UN as "an instrument of the policies of terror, lies and infamy."   In addition to the dead and 2,000 people injured in clashes between anti-government protesters and regime forces back by paramilitaries, more than 300 Nicaraguans have been charged with crimes for taking part in the protests, of which 85 are accused of terrorism.   Two Alliance leaders, Medardo Mairena and Edwin Carcache, are amongst those to have been charged.   The opposition says "dialogue is the only path" to overcome the current political crisis.

Nicaragua's descent into chaos was triggered on April 18 when relatively small protests against now-scrapped social security reforms were met with a government crackdown, backed by armed paramilitaries.   Catholic church-brokered peace talks broke down in June after Ortega rejected a key opposition demand to step down and bring forward presidential elections.   Opposition supporters claimed the last strike in mid-July was 90 percent respected, although government media said businesses had remained open in several trade zones.
Date: Fri, 27 Jul 2018 23:17:00 +0200

Managua, July 27, 2018 (AFP) - More than a dozen doctors, nurses and technical staff in a public hospital in Nicaragua have been sacked because they treated wounded anti-government protesters and were seen backing their cause, medical sources said Friday.

Those fired "without any legal justification" worked at the Oscar Danilo Rosales Hospital in the northwestern city of Leon, surgery and endoscopy department chief Javier Pastora told AFP.   The hospital is run by the health ministry.   The allegation bolstered reports that those perceived to back protest claims calling for the ouster of President Daniel Ortega were being persecuted by his government and sympathizers.

Nicaragua has seen more than three months of unrest as those protests were brutally countered by police and armed pro-government paramilitaries.   More than 300 people have been killed and thousands have fled to neighboring Costa Rica for safety, according to rights groups.   Pastora, who has worked in Nicaragua's public health system for 33 years, said the staff members were fired because they were deemed to support the protesters by treating them.   "They said we were people showing solidarity and support for the people's fight," he said.   Pastora said at least nine medical specialists were among those fired.

- Dismissed in surgery -
"I was in surgery when they came from human resources to tell me I could no longer stay because I was fired," said one of the dismissed medics, cancer surgeon Aaron Delgado.   A dismissed pediatrician, Edgar Zuniga, called the axings "arbitrary."   They were fired "for thinking differently, for saying Nicaragua needs democracy, freedom, that the repression and killings must stop and there has to be dialogue," he said.

The staff and residents in Leon held a protest in front of the hospital demanding the sackings be reversed.   Leon used to be a bastion of support for the Sandinista movement Ortega leads, but as the unrest took hold, there too paramilitaries and anti-riot police have stormed the city several times to crush protests.   Rights groups say more than 2,000 people have been hurt across the country since the clashes erupted mid-April.   Many of them sought medical attention for their wounds from volunteers outside the state health system, which was said to have received orders to turn them away.
Date: Wed, 11 Jul 2018 22:06:35 +0200

Washington, July 11, 2018 (AFP) - The known death toll from a four-month crackdown on anti-government protests in Nicaragua has risen to 264, the Inter-American Commission on Human Rights said Wednesday.

"As recorded by the IACHR since the start of the repression against social protests, to date, 264 people have lost their lives and more than 1,800 have been injured," the commission's chief Paulo Abrao told reporters.   He was speaking at a meeting of the Organization of American States -- of which the IACHR is part -- about the situation in the violence-wracked Central American country, where protesters are seeking the ouster of President Daniel Ortega.   The rights body had previously given a toll of 212 dead, although local estimates recently put the toll at about 250.

The influential Roman Catholic church has been mediating between Ortega's government and the opposition to end the unrest, but the process has become bogged down amid continuing violence.   In the latest outburst, at least 14 people died in a weekend raid by a pro-government mob near the opposition bastion of Masaya, in the country's southwest.   The opposition is planning to crank up the pressure on Ortega starting on Thursday with an anti-government protest and general strike.

A former leftist guerrilla, Ortega will next week commemorate the 1979 popular uprising that brought him to power with an annual July 19 march due to start in Masaya.   Once the hero of left-wing revolutionaries, Ortega is now widely viewed as an oppressor.   Having lost a presidential vote in 1990, he was re-elected in 2007 but opponents have accused him -- together with his wife Vice President Rosario Murillo -- of establishing a dictatorship characterized by nepotism and brutal repression.
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San Marino

US Consular Information Sheet Italy, Holy See (Vatican City) and San Marino
January 21, 2009
COUNTRY DESCRIPTION:
Italy is a developed democracy with a modern economy.
The Holy See is a sovereign entity that serves as the ecclesiastic
l, governmental and administrative capital of the Roman Catholic Church, physically located within the State of the Vatican City inside Rome, with a unique, non-traditional economy.
San Marino is a developed, constitutional democratic republic, also independent of Italy, with a modern economy.
Tourist facilities are widely available.

Read the Department of State Background Notes on Italy, the Holy See, and San Marino for additional information.

ENTRY/EXIT REQUIREMENTS:
Italy is a party to the Schengen agreement.
As such, U.S. citizens may enter Italy for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our fact sheet.

For all other purposes, a visa is required and must be obtained from the Italian Embassy or Consulates before entering Italy.
For further information concerning visas and entry requirements for Italy, travelers may contact the Embassy of Italy at 3000 Whitehaven Street NW, Washington, DC 20008, via telephone at (202) 612-4400 or online at http://www.ambwashingtondc.esteri.it/ambasciata_washington, or Italian Consulates General in Boston, Chicago, Detroit, Houston, Los Angeles, Miami, Newark, New Orleans, New York, Philadelphia, or San Francisco, accessible through the Italian Embassy web site.

Americans staying or traveling within Italy for less than three (3) months are considered non-residents. This includes persons on vacation, those taking professional trips, students registered at an authorized school, or persons performing research or independent study.
As of May 2007, under Italian law (http://www.camera.it/parlam/leggi/07068l.htm), all non-residents are required to complete a dichiarazione di presenza (declaration of presence). Tourists arriving from a non-Schengen-country (e.g. the United States) should obtain a stamp in their passport at the airport on the day of arrival. This stamp is considered the equivalent of the declaration of presence. Tourists arriving from a Schengen-country (e.g. France) must request the declaration of presence form from a local police office (commissariato di zona), police headquarters (questura) or their place of stay (e.g hotel, hostel, campgrounds) and submit the form to the police or to their place of stay within eight business days of arrival. It is important that applicants keep a copy of the receipt issued by the Italian authorities. Failure to complete a declaration of presence is punishable by expulsion from Italy. Additional information may be obtained (in Italian only) from the Portale Immigrazione at http://www.portaleimmigrazione.it and the Polizia di Stato at http://www.poliziadistato.it/pds/ps/immigrazione/soggiorno.htm.
Americans staying in Italy for more than three (3) months are considered residents and must obtain a permesso di soggiorno (permit of stay). This includes Americans who will work or transact business and persons who want to simply live in Italy.
An application "kit" for the permesso di soggiorno may be requested from one of 14,000 national post offices (Poste Italiane). The kit must then be returned to one of 5,332 designated Post Office acceptance locations.
It is important that applicants keep a copy of the receipt issued by the post office.
Additional information may be obtained from an Italian immigration website online at http://www.portaleimmigrazione.it/.
Within 20 days of receiving the permit to stay in Italy, Americans must go to the local Vital Statistics Bureau (Anagrafe of the Comune) to apply for residency. It generally takes one to two months to receive the certificate of residence (Certificato di Residenza).

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
There have been occasional episodes of politically motivated violence in Italy, most often connected to Italian internal developments or social issues.
Italian authorities have found bombs outside public buildings, received bomb threats, and were subjects of letter bombs.
Firebombs or Molotov cocktails have been thrown at buildings or offices in the middle of the night.
These incidents have all been attributed to organized crime or anarchist movements.
Americans were not targeted or injured in these instances.

Demonstrations may have an anti-American character.
Even demonstrations intended to be peaceful have the potential to turn into confrontational situations and possibly escalate into violence.
U.S. citizens traveling or residing in Italy should take common sense precautions and follow news reports carefully in order to avoid demonstrations and to be aware of heightened security and potential delays when they occur.
American citizens are encouraged to read the Warden Messages posted on the Embassy’s web site at http://italy.usembassy.gov/acs/demonstration/default.asp.

Italy remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Italy’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S., or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME:
Italy has a moderate rate of violent crime, some of which is directed towards tourists, principally for motives of theft.
Some travelers are victims of rape and beatings.
There are incidents of drinks laced with drugs being used by criminals to rob, and in some cases, assault tourists.
Many of these incidents occur in the vicinity of Rome’s Termini train station and at major tourist centers such as Campo de Fiori and Piazza Navona, as well as in Florence and Naples.
Criminals using this tactic “befriend” a traveler at a train station, bus stop, restaurant, café or bar in tourist areas, then eventually offer a drink laced with a sleeping drug.
When the tourist falls asleep, criminals steal the traveler’s valuables.
There are also instances where the victim is assaulted, either physically or sexually.

Americans are urged to exercise caution at train stations and airports, and when frequenting nightclubs, bars and outdoor cafes, particularly at night, because criminals may make initial contact with potential victims in such settings.
Individuals under the effect of alcohol may become victims of crime, including robbery, physical and sexual assault, due to their impaired ability to judge situations and make decisions.
This is particularly a problem for younger Americans visiting Italy, where the age limit on the sale of alcoholic beverages is lower than in the United States.
If you are a victim of such a crime, please file a police report and contact the U.S. Embassy or nearest consulate.
There are also in-country organizations, which provide counseling, medical, and legal assistance to certain crime victims.

Petty crimes such as pick-pocketing, theft from parked cars, and purse snatching are serious problems, especially in large cities.
Pick-pockets sometimes dress like businessmen.
Tourists should not be lulled into a false sense of security by believing that well-dressed individuals are not potential pick-pockets or thieves.
Most reported thefts occur at crowded tourist sites, on public buses or trains, or at the major railway stations: Rome's Termini; Milan's Centrale; Florence's Santa Maria Novella; and Naples' Centrale and Piazza Garibaldi.
Travelers should also be alert to theft in Milan’s Malpensa Airport, particularly at car rental agencies.
Clients of Internet cafes in major cities are also targeted.
Tourists who have tried to resist petty thieves on motor scooters have suffered broken arms and collarbones.

Thieves in Italy often work in groups or pairs.
Pairs of accomplices or groups of street urchins are known to divert tourists' attention so that another can pick-pocket them.
In one particular routine, one thief throws trash, waste or ketchup at the victim; a second thief assists the victim in cleaning up the mess; and the third discreetly takes the victim's belongings.
Criminals on crowded public transportation slit the bottoms of purses or bags with a razor blade or sharp knife removing the contents.
Theft of small items such as radios, luggage, cameras, briefcases, and even cigarettes from parked cars is a major problem.

Carjackings and thefts are reported by occupants of vehicles waiting in traffic or stopped at traffic lights.
Vehicles parked near beaches during the summer are broken into and robbed of valuables.
Robbers take items from cars at gas stations often by smashing car windows.

In a scam practiced on the highways, one thief signals a flat tire to the driver of another car and encourages the driver to pull over.
Often, the tire has been punctured by an accomplice, while in other instances, there may, in fact, be nothing wrong with the vehicle.
When the driver stops, one thief helps change the tire, while the other takes the driver's belongings.
Use particular caution driving at night on highways, when there may be a greater incidence of robbery attempts.
There are occasional reports of break-ins of rental cars driven by Americans when the precautions mentioned above were not followed during stops at highway service areas.

On trains, a commonly reported crime involves one or more persons who pretend to befriend a traveler and offer drugged food or drink.
Also, thieves are known to impersonate police officers to gain the confidence of tourists.
The thief shows the prospective victim a circular plastic sign with the words "police" or “international police."
If this happens, the tourist should insist on seeing the officer's identification card (documento), as impersonators tend not to carry forged documents.
Tourists should immediately report thefts or other crimes to the local police.

The U.S. Secret Service in Rome is assisting Italian Law Enforcement authorities in investigating an increase in the appearance of ATM skimming devices.
These devices are attached to legitimate bank ATMs, usually located in tourist areas, and capture the account information stored electronically on the card’s magnetic strip.
The devices consist of a card reader installed over the legitimate reader and a pin-hole video camera mounted above the keypad that records the customer’s PIN.
ATMs with skimming devices installed may also allow normal transactions to occur.
The victim’s information is sold, traded on-line, or encoded on another card such as a hotel key card to access the compromised account.
Here are some helpful hints to protect yourself and to identify skimming devices:

1) Use ATMs located in well-lit public areas, or secured inside the bank/business
2) Cover the keypad with one hand as you enter your PIN
3) Look for gaps, tampered appearance, or other irregularities between the metal faceplate of the ATM and the card reader
4) Avoid card readers that are not flush with the face of the ATM
5) Closely monitor your account statements for unauthorized transactions

Organized criminal groups operate throughout Italy, but are more prevalent in the south.
They occasionally resort to violence to intimidate or to settle disputes.
Though the activities of such groups are not generally targeted at tourists, visitors should be aware that innocent by-standers could be injured.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.

According to Italian Law (Law 80 of May 14, 2005), anyone caught buying counterfeit goods (for example, DVD’s, CD’s, watches, purses, bags, belts, sunglasses, etc.) is subject to a fine of no less than EUR 1,000.
Police in major Italian cities enforce this law to varying degrees.
Travelers are advised to purchase products only from stores and other licensed retailers to avoid unknowingly buying counterfeit and illegal merchandise.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Lost or stolen credit cards present risk of identity theft and should be cancelled immediately.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Italy is: 113.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those of the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Italian law, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Italy are severe and convicted offenders can expect long jail sentences and heavy fines.
Engaging in illicit sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

SPECIAL CIRCUMSTANCES:
Strikes and other work stoppages occur frequently in the transportation sector (national airlines, airports, trains, and bus lines).
Most are announced in advance and are of short duration.
Information on strikes may be found at http://www.infrastrutture.gov.it/page/NuovoSito/site.php.
Reconfirmation of domestic and international flight reservations is highly recommended.

U. S citizens using public transportation while in Italy are reminded they must adhere to local transportation laws and regulations. Travelers must purchase train tickets and validate them by punching them in validating machines usually located near the entrance of train tracks prior to boarding.
Failure to follow this procedure may result in an on-the-spot fine by an inspector on the train. Travelers must purchase bus tickets prior to boarding and validate them immediately after boarding. Tickets may be purchased at tobacco stores or kiosks. Failure to follow this procedure may result in an immediate fine imposed by an inspector on the bus. If the violator does not pay the fine on the spot, it will automatically double and will be forwarded to the violator’s home address.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are available, but may be limited outside urban areas.
Public hospitals, though generally free of charge for emergency services, sometimes do not maintain the same standards as hospitals in the United States, so travelers are encouraged to obtain insurance that would cover a stay in a private Italian hospital or clinic.
It is almost impossible to obtain an itemized hospital bill from public hospitals, as required by many U.S. insurance companies, because the Italian National Health Service charges one inclusive rate (care services, bed and board).

In parts of southern Italy, the lack of adequate trash disposal and incineration sites has led to periodic accumulations of garbage in urban and rural areas.
In some cases, residents have burned garbage, resulting in toxic emissions that can aggravate respiratory problems.
The U.S. Navy initiated a public health evaluation in the Naples area in 2008.
Updates on that evaluation can be found at http://www.nsa.naples.navy.mil/risk.
After finding levels of bacterial and chemical contamination of potential health concern, particularly in samples of area well water, the Navy recommended all personnel living off-base in the Naples area use only bottled water for drinking, cooking, ice-making, and brushing teeth.
For more information on safe food and water precautions, see the CDC’s web site below.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Italy.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Italy is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Streets in historic city centers are often narrow, winding and congested.
Motor scooters are very popular and drivers often see themselves as exempt from conventions that apply to automobiles. Travelers who rent scooters should be particularly cautious.
Pedestrians and drivers should be constantly alert to the possibility of scooters’ sudden presence.
Most vehicle-related deaths and injuries involve pedestrians or cyclists who are involved in collisions with scooters or other vehicles.
U.S. citizens should remain vigilant and alert while walking or cycling near traffic.
Pedestrians should be careful, as sidewalks can be extremely congested and uneven.
Drivers of bicycles, motorcycles, and other vehicles routinely ignore traffic signals and traffic flows and park and drive on sidewalks.
For safety, pedestrians should look carefully in both directions before crossing streets, even when using a marked crosswalk with a green avanti ("walk") light illuminated.

Traffic lights are limited, often disobeyed, and a different convention of right-of-way is observed.
Italy has over 5,600 kilometers (3,480 mi.) of Autostrada, or superhighways.
Commercial and individual vehicles travel and pass on these well-maintained roads at very high speeds.
Accidents occur in which contributing factors include excessive speed, alcohol/drug use, and/or sleepiness of long-distance drivers.
Italy has one of the highest rates of car accident deaths in the European Union.

In rural areas, a wide range of speed on highways makes for hazardous driving.
Roads are generally narrow and often have no guardrails.
Travelers in northern Italy, especially in winter, should be aware of fog and poor visibility, responsible for multiple-car accidents each year.
Most Italian automobiles are equipped with special fog lights.
Roadside assistance in Italy is excellent on the well-maintained toll roads, but limited on secondary roads.
Use of safety belts and child restraining devices is mandatory and headlights should be on at all times outside of urban areas.

U.S. citizens driving in Italy are reminded that they must adhere to the local driving laws and regulations.
Vehicle traffic in some historic downtown areas of cities and towns throughout Italy is limited by a system of permits (called “ZTL” and functioning the same way as an EasyPass system in the United States might on the freeway).
Cameras record the license plates of cars driving in parts of the city that require a permit.
Although most of the automated verification stations are clearly marked, if a driver passes one it is impossible to know at the time that a violation occurred or has been recorded.
Violators are not pulled over or stopped, and there is no personal contact with a police officer.
Whenever possible, the fines imposed for these violations are forwarded to the driver’s home in the United States to request payment.
The fines are cumulative for each time a driver passes a control point.
A similar system of automated traffic control cameras is in place in many parts of the highway system and is used to ticket speeding violations.

U.S. citizens driving in Italy should also note that, according to Italian regulation, if a resident of a non-European Union country (e.g. the United States) violates a traffic law, the violator must pay the fine at the time the violation occurs to the police officer issuing the ticket.
If the citizen does not or cannot pay the fine at the time, Italian regulation allows the police officer to confiscate the offender’s vehicle (even if the vehicle is a rental vehicle).

For specific information concerning Italian driving permits, vehicle inspection, road tax and mandatory insurance, contact the Italian Government Tourist Board (ENIT) offices via the Internet at: http://www.enit.it, tel: 212-245-4822 or the A.C.I. (Automobile Club Italiano) at Via Magenta 5, 00185 Rome, tel: 39-06-4477.
For information on obtaining international drivers licenses, contact AAA or the American Automobile Touring Alliance.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office at http://www.italiantourism.com and national authority responsible for road safety at http://www.infrastrutturetrasporti.it.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) assessed the Government of Italy’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Italy's air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

DISASTER PREPAREDNESS:
Several major earthquake fault lines cross Italy.
Principal Italian cities, with the exception of Naples, do not lie near these faults, but smaller tourist towns, like Assisi, do and experience earthquakes.
General information about disaster preparedness is available online from the U.S. Federal Management Agency (FEMA) at http://www.fema.gov.
Detailed information on Italy's earthquake fault lines is available from the U.S. Geological Survey (USGS) at http://www.usgs.gov
Italy also has several active volcanoes generating geothermal events.
Mt. Etna, on the eastern tip of the island of Sicily, has been erupting intermittently since 2000.
Mt. Vesuvius, located near Naples, is currently capped and not active.
Activity at Mt. Vesuvius is monitored by an active seismic network and sensor system, and no recent seismic activity has been recorded.
Two of Italy's smaller islands, Stromboli and Vulcano in the Aeolian Island chain north of Sicily, also have active volcanoes with lava flows.
Detailed information on volcano activity in Italy is available from the U.S. Geological Survey (USGS) at http://www.usgs.gov.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY AND CONSULATE LOCATIONS:
Americans living or traveling in Italy are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, so they can obtain updated information on travel and security within Italy.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Via V. Veneto 119/A, tel.: 39-06-46741 and fax: 39-06-4674-2217; web site: http://italy.usembassy.gov/english/.

The U.S. Consulates are located in:
Florence:
Lungarno Amerigo Vespucci 38, tel: 39-055-266-951, consular fax: 399-055-215-550;
Milan:
Via Principe Amedeo 2/10, tel: 39-02-290-351, and fax:
39-02-290-35-273;
Naples:
Piazza della Repubblica, tel:
39-081-583-8111, and consular fax:
39-081-583-8275.

There are U.S. Consular Agents located in:
Genoa:
Via Dante 2, tel:
39-010-584-492, and fax: 39-010-553-3033;
Palermo:
Via Vaccarini 1, tel:
39-091-305-857, and fax:
39-091-625-6026;
Venice:
Viale Galileo Galilei, 30, tel: 39-041-541-5944, and fax: 39-041-541-6654.
* * *
This replaces the Consular Information Sheet dated June 10, 2008, to update the sections onSafety and Security and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

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World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."