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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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Egypt

Geographical Information:
Egypt has a total area of about 385,000 sq. miles and sits on the North Eastern corner of Africa. It is bounded by the Mediterranean Sea and on the East by Israel and the Red Sea. The Southern border is with Sudan (the large
t country in Africa) and on the West it shares a border with Libya. The country extends about 675 miles from north to south and is widest at its southern border where it covers 780 miles. Egypt is well known for the great Nile river which courses throughout its length. It is the longest river in the world and has historic links stretching back to at least 3200BC.
Climate:
The hot season in Egypt is from May to September. During this time temperatures can easily reach 370C though northern winds can provide a very necessary respite. November to March is the cooler time of the year and typical temperatures reach 140C though, during the evenings, temperatures can occasionally fall to near freezing. The humidity is mainly along the Mediterranean coastline and the average rainfall here is only about 8".
Medical Facilities:
In the main towns and cities the level of medical care is very adequate for the tourist. English speaking doctors will be associated with all the larger hotels but nevertheless care should always before being admitted to a ‘clinic’ for further treatment should this ever become necessary. Travellers are encouraged to contact the Irish Embassy in Cairo for emergency assistance should the need ever arise.
Food & Water Hygiene:
A significant number of tourists visiting Egypt suffer stomach complaints. In many cases this is due to eating food from the market places or using the hotel tap water supply for drinking or brushing teeth. The hotter climate of the country and the poorer level of food hygiene leave the unwary tourist at particular risk. Salads and shellfish meals should particularly be avoided.
Cruising along the Nile:
Over the past number of years many Irish holiday makers have enjoyed themselves cruising along the Nile for a week and then visiting Luxor in the southern part of the country. In most cases these travellers remain very well with no particular health problems. Nevertheless, in a small number they appear to forget the basic rules of food and water hygiene and will sample the local foods in the market places on shore. This practice is frequently associated with a ruined second half of the holiday. Commonsense rules of looking but not touching are much wiser.
Sun Stroke:
The ambient temperatures in Egypt can be very high and tourists are frequently exposed to the strong sunlight during their time in Egypt. It is essential that an adequate fluid intake is maintained (much higher than at home) and that travellers remember they may need to increase their salt intake (if this is not contraindicated because of heart disease or blood pressure). Small children and the elderly are at special risk.
Malaria risk in Egypt:
The risk of malaria in Egypt is small. The disease is usually only found during the warmer summer months (June to October) in the El Faiyûm area. Travellers may require prophylaxis but they should continuously remember to use adequate protection against mosquitoes and other insects.
Swimming in Egypt:
The fresh water rivers of Egypt are commonly infected with a disease called Schistosomiasis (Bilharzia). This parasite penetrates through intact skin and can cause significant health problems. Travellers are encouraged to swim only in the Mediterranean, the Red Sea or in well maintained swimming pools to avoid exposure.
Health Care while Diving:
Many of the world's most beautiful sites for diving are situated along the Red Sea. These are common tourist destinations and generally the risk of significant health worries will be small. However, check out the professionalism of the diving company before you develop too close a relationship. Make sure their equipment is in good working order and that their instructors are insisting on standard safety procedures for any proposed dive. Never dive after a large meal or following alcohol intake. Remember that you can get significantly sunburnt while snorkeling so take care to cover your back and shoulders with either a suit or sufficient water repellent cream.
Diving at night may be a beautiful experience but take extra care. Never dive beyond your personal limits and ensure that the 'buddy system' is fully operational at all times. Even the most experienced divers can have problems at times so never let you guard down and stay alert.
Rabies:
This disease is widespread in Egypt and is normally transmitted through the bite of warm blooded animals. Any bites, licks or scratches from these animals should be treated seriously by washing out the wound, applying an antiseptic and the seeking urgent competent medical attention.
Vaccines for Egypt:
All Irish travellers to Egypt should ensure that their vaccines against Poliomyelitis, Typhoid, Tetanus and Hepatitis A are in date. Those staying for longer periods or trekking through the country may require further protection against diseases like Rabies, Meningitis and Hepatitis B.
Further Information:
Further general health information on staying healthy while travelling abroad may be obtained free-of-charge from the Tropical Medical Bureau at either of our centres. Please always remember that each traveller is distinct and so individual specific information will require a medical consultation.

Travel News Headlines WORLD NEWS

Date: Tue, 29 Jan 2019 12:22:15 +0100
By Bassem ABOUALABASS

Cairo, Jan 29, 2019 (AFP) - Alaa Hilal was out shopping in Cairo when she was attacked by a stray dog in broad daylight -- an increasing problem of daily life in Egypt which is stirring debate.   "I got out of my car and saw an exceptionally large street dog," the 38-year-old housewife told AFP at her home, northeast of Cairo.   "He approached me and bit me without barking or doing anything else," said Hilal, adding that she had been injured in the thigh.     An overpopulated mega-city of more than 20 million people, Cairo is already plagued by monster traffic jams, widespread waste problems and rampant pollution. Packs of stray dogs are only adding to the city's challenges.   Complaints about dog attacks, exposure to rabies and in some cases even deaths over the years have triggered calls for the animals to be brought under control.

- Hounds unleashed -
Commonly referred to as "baladi dogs", strays are widely viewed as unsanitary and dirty. They are typically seen running around the streets and scavenging garbage for food.   According to the agriculture ministry, there were around 400,000 cases of dog bites in 2017, up from 300,000 in 2014.    And 231 people died over the past four years from the wounds they received, mainly as a result of rabies.

A bite from a dog carrying the rabies virus can be fatal within 24 hours as it damages the human's nervous system, said Shehab Abdel-Hamid, the head of Egypt's society for the prevention of cruelty to animals (SPCA).    Hilal, who had never feared dogs having had several pets when growing up, was rushed to a nearby hospital only to discover that she was the ninth person to be bitten by the same dog.   "Due to the trauma caused by this incident, I became worried and I no longer want to be in the same place with them," she said.   There are no official data on the numbers of stray dogs, but activists say they are running loose in their millions.

A survey by the SPCA showed that the number of stray dogs "may reach up to more than 15 million", Abdel-Hamid said.   And though street dogs appear to fear the most crowded areas, they can be loud and aggressive in poorly lit and rubbish-strewn suburbs.    In November, a video widely circulated on social media showed a car hitting a teenager who was being chased by two stray dogs.   "Garbage is the main reason behind the stray dogs' crisis in Egypt," said Abdel-Hamid, highlighting how the problem was exacerbated when the rubbish men stopped working during the 2011 uprising.

- Government mauled -
The SPCA, however, lacks resources. Its headquarters in downtown Cairo was looted during the uprising and has not been renovated since, Abdel-Hamid added.    And Egyptian authorities say they can only intervene on a case by case basis.    "We do not go around the streets looking for dogs to kill them," said the agriculture ministry spokesman Hamed Abdel-Dayem. "We only take measures following complaints."   He didn't specify what measures are taken to bring the stray dog population under control.    But animal rights advocates often lambast the government, accusing it of mass culls.

In 2017, authorities killed more than 17,000 stray dogs following multiple complaints of dog "disturbances" and "biting" in Beni Sueif, south of Cairo, according to an August report by the governorate's veterinary directorate.    The Red Sea governor even offered a 100 Egyptian pounds ($5.58) award to those who capture and hand over at least five strays.   Animal rights defenders also accuse the government of killing dogs using a drug, known as "strychnine", a chemical substance listed as "unacceptable on animal welfare grounds" for euthanasia by the World Organisation for Animal Health.     But Abdel-Dayem denied that the government imported banned substances.   "Is it logical that we (the ministry) allow internationally prohibited substances to enter the country?" he told AFP when asked about the strychnine claim.

- 'Shelter of Hope' -
Animal rights advocates have sought to offer solutions, actively removing dogs from the streets and giving them homes.   Ahmed al-Shorbagi, 35, opened two dog shelters in a desert area west of Cairo, near the famed Giza pyramids.    The buildings with sheer concrete walls have kept more than 250 dogs safe for the past three years. Shorbagi contributes 40 percent to the funding of the shelters while the rest comes from donations.    "At first I followed the animal rescue pages on Facebook," Shorbagi told AFP, rubbing one dog's belly as she wagged her tail in joy.   "I saved a dog that I called 'Hope' and when I opened the shelter, I named it after her."

Shorbagi believes the solution lies in dog sterilisation programmes, providing rabies vaccinations and removing the garbage.    "Instead of the government paying millions of dollars to import poison, it should consider sterilisation," he said.    "We, as associations, proposed to the ministry of agriculture to solve the problem but it refused."   The ministry's spokesman denied however refusing to cooperate with private entities and hailed their work to help resolve the crisis.
Date: Sat, 29 Dec 2018 20:35:18 +0100
By Menna Zaki

Giza, Egypt, Dec 29, 2018 (AFP) - Crowds of tourists stared in awe at the towering pyramids of Giza near Cairo Saturday undaunted by a nearby bomb attack a day earlier that killed holidaymakers from Vietnam.    A roadside bombing claimed the lives of three tourists and their Egyptian guide Friday when it ripped through the bus they were on as it travelled near the world-famous attraction.

The attack comes as Egypt's vital tourism sector has begun to recover after years of instability and jihadist violence that scared visitors away.    "I think terrorism can strike anywhere in the world," Somand Yang from South Korea told AFP.    "You have to be careful but it is also like luck."   Security forces guarded the entrance to the sprawling site and Yang, 32, said she had no qualms about visiting.   "Lightning never strikes twice in the same place. So I figured it will be even safer today," she said.

- 'Completely devastated' -
Excited holidaymakers rode camels and queued to enter a tomb as they snapped pictures of the Great Pyramid, the only surviving structure of the seven wonders of the ancient world.   Hawkers followed the tourists, doggedly trying to sell trinkets and souvenirs.   Despite the steady flow of visitors, Egyptians working at the site said they were shaken by the attack -- and concerned that it could hit their livelihoods.    "I knew the guide who died yesterday," said Dalia Sadaka, as she accompanied a group of sightseers.    "I completely broke down yesterday, but I had to get to work in the morning," she said, pointing to her visibly swollen eyes.

- 'Truly regrettable' -
Earlier hit hard by a string of bloody attacks and unrest, visitor numbers to Egypt have more recently staged a partial recovery.    In October 2015, a bomb claimed by a local affiliate of the Islamic State jihadist group killed all 224 people on board a passenger jet carrying Russian tourists over the Sinai peninsula.     That incident dealt a severe blow to Egypt's tourism industry, which was still reeling from the turmoil set off by the 2011 uprising that forced veteran leader Hosni Mubarak from power.

The official statistics agency says arrivals reached 8.2 million in 2017, up from 5.3 million the year before.   But that figure was still far short of the record influx in 2010 when over 14 million came.    "I fear yesterday's incident may have an impact on our source of income," said an elderly man who offers camel rides, declining to give his name.    "It is very regretable," he said. "We were finally happy that tourism started picking up a bit."
Date: Thu, 13 Dec 2018 16:07:04 +0100

Cairo, Dec 13, 2018 (AFP) - Egyptian authorities Thursday arrested a camel driver and a woman accused of having helped two Danes scale the Great Pyramid of Giza to take a video and naked photograph, sparking outrage in the country.   The interior ministry said the woman had put the pair into contact with the camel driver who took them to the site illegally at night on November 29 for 4,000 Egyptian pounds ($225, 200 euros).   The two had acknowledged their role in the incident and would be put on trial.

In a video called "Climbing the Great Pyramid of Giza", Danish photographer Andreas Hvid appears to scale the 4,500-year-old tomb on the outskirts of Cairo with a woman who is later seen removing her top.   Hvid says the video was shot in late November and posted on YouTube on December 8, setting in motion an investigation by Egypt's public prosecutor.   A photograph also released by Hvid appears to show the pair completely naked on top of each other while looking in the direction of a nearby pyramid.

The nearly three-minute video has so far notched up 4.5 million views on YouTube, while stirring a public outcry in Egypt.   "A 7,000-year-old civilisation has turned into a bed sheet," a Twitter user in Egypt lamented.   Hvid, 23, has explained back home to the Danish newspaper Ekstra Bladet that he had "dreamed for many years of climbing the Great Pyramid" as well as of taking a naked photograph.   The young Dane, who runs his own YouTube channel, said the woman in the video was not his girlfriend. "It was just a pose. We did not have sexual relations," he said.

The Great Pyramid is the largest in Giza, standing 146 metres (480 feet) tall, and the only surviving structure of the seven wonders of the ancient world.   Climbing pyramids is forbidden in Egypt.   In 2016, a German tourist was barred from entering the country for life after he posted online footage of climbing one of the ancient structures.
Date: Fri, 24 Aug 2018 10:22:25 +0200

London, Aug 24, 2018 (AFP) - British tour operator Thomas Cook said it is removing all its customers from a hotel in Egypt after a UK couple staying there died in unexplained circumstances and other guests fell ill.   The company said late Thursday it was unclear what caused the deaths of the Britons, reportedly in their 60s, who had been staying at the Steigenberger Aqua Magic Hotel in the Red Sea resort of Hurghada.

Thomas Cook added in a statement that all of its other customers staying at the Steigenberger, reported to be 301 by the BBC, had the choice of relocating to another hotel in Hurghada or returning home.   It said it was "deeply saddened" by the deaths of the two guests.   "The circumstances of their deaths are still unclear," Thomas Cook said.   "We have also received further reports of a raised level of illness among guests. Safety is always our first priority, so as a precautionary measure we have taken a decision to remove all our customers from this hotel."   Red Sea governor Ahmad Abdallah told AFP that the couple, who were on holiday with their daughter, had died on Tuesday.

The BBC identified them as John Cooper, 69, and his wife Susan, 63, a Thomas Cook employee. The couple were from the town of Burnley, northwest England.   Abdallah said the man died in hospital after suffering exhaustion, followed by his wife who collapsed at the hotel on hearing the news.     The governor ruled out "criminal motive".

Thomas Cook said customers due to travel in the coming weeks to the hotel -- which the tour operator gave a 96-percent rating in an audit last month -- would be offered alternative holidays.   Egypt's key tourism industry has been recovering from a devastating blow in 2015 when jihadists bombed a Russian airliner carrying holidaymakers from the Red Sea resort of Sharm el-Sheikh, killing all 224 on board.
Date: Mon, 20 Aug 2018 13:04:55 +0200

Cairo, Aug 20, 2018 (AFP) - An Egyptian army captain has been killed by an improvised explosive device blast in North Sinai during a campaign to eliminate jihadists, medics said on Monday.   The officer died Sunday evening after an explosion hit his vehicle west of the coastal city of El-Arish, a local medical source said.   The Egyptian army has since February been conducting a major operation focused on the Sinai Peninsula to wipe out jihadists from the Islamic State group.

The military says that over 250 suspected jihadists and at least 35 soldiers have been killed in its "Sinai 2018" operation.   Jihadists launched an insurgency in Sinai after the 2013 military overthrow of Egypt's Islamist president Mohamed Morsi, who was forced out by the military in the face of mass protests against his rule.
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World Travel News Headlines

Date: Fri, 15 Mar 2019 19:08:37 +0100
By Joaquim Nhamirre

Maputo, March 15, 2019 (AFP) - Tropical cyclone Idai battered Mozambican coastal city Beira Friday, leaving half a million people virtually cut off after power lines crashed, airport shut and roads were swamped by flooding that killed 66 people nationwide.   "There is no communication with Beira. Houses and trees were destroyed and pylons downed," an official at the National Institute of Disaster Management (NIDM) told AFP.   Authorities had to close Beira international airport after the air traffic control tower, the navigation systems and the runways were damaged by the storm.   "Unfortunately there is extreme havoc," said the official.   "Some runway lights were damaged, the navigation system is damaged, the control tower antennas and the control tower itself are all damaged.    "The runway is full of obstacles and parked aircrafts are damaged."

Late on Wednesday, the national carrier LAM cancelled all flights to Beira and Quelimane, which is also on the coast, as well as to Chomoio, which is inland.    Power utility Electricidade de Mocambique said in a statement that the provinces of Manica, Sofala and parts of Inhambane have been without power since Thursday.   Officials did not report any confirmed deaths, but local Beira station STV reported a child had died in Manica province west of the city, apparently the victim of a falling roof.   "There was no tsunami-type storm but Beira and Chinde (400 kilometres, 250 miles northeast of Beira on the coast) were badly hit," added the NIDM official.

Another official, Pedro Armando Alberto Virgula, in Chinde, said a hospital, police station and seven schools there lost their roofs and four houses were destroyed.   Virgula added that efforts were under way to assess the damage caused after Idai made landfall late on Thursday.   Local officials said that this week's heavy rains claimed 66 lives, injured 111 people and displaced 17,000 people.   The World Food Programme (WFP) said it would move 20 tonnes of emergency food aid to the affected areas.   The UN Office for the Coordination of Humanitarian Affairs (OCHA) had warned that the storm could pack winds of up to 190 kilometres per hour (118 miles per hour).

- 'Devastation' -
At least 126 people were killed by the downpour that has struck parts of Mozambique, Malawi and South Africa over the past week, officials said.   Heavy rains in neighbouring Malawi have affected almost a million people and claimed 56 lives, according to the latest government toll.   Authorities there have opened emergency relief camps where malaria and shortages of supplies have led to dire conditions, according to AFP correspondents.

Malawian President Peter Mutharika this week declared a natural disaster.   Mozambique's weather service has warned that heavy rain will continue to batter Beira and surrounding areas until Sunday.   The UN warned of damage to crops, "including about 168,000 hectares (415,000 acres) of crops already impacted by flooding in early March, which will undermine food security and nutrition".   Mozambique and Malawi, two of the poorest countries in the world, are prone to deadly flooding during the rainy season and chronic drought during the dry season.   In neighbouring Zimbabwe, weather services have warned that violent thunderstorms, lightning and strong winds will be experienced in the eastern regions of the country.
Date: Fri, 15 Mar 2019 19:00:39 +0100

Niamey, March 15, 2019 (AFP) - Health authorities in Niger said Friday they had found a fake version of a meningitis vaccine after the country had launched a campaign to innoculate millions of children against the disease.   In a statement, the health ministry asked doctors to be vigilant over a "counterfeit" version of a vaccine called Mencevax ACWY.   The fake drug is marked as having been manufactured in December 2016, with an end-date for use by November 2021, it said.   Niger launched a week-long campaign on March 5 to vaccinate six million children against meningitis, which killed nearly 200 people two years ago.   The country lies in the so-called "meningitis belt" stretching from Senegal in the west to Ethiopia in the east, where outbreaks of the disease are a regular occurrence. 

The vaccination programme is against meningitis A, one of the six groups of meningitis bacteria that can cause epidemics.   The ministry's spokesman told AFP the bogus drug had been discovered during a "routine inspection" of a privately-owned pharmacy in the capital Niamey.   An investigation is underway to try to ascertain how many of the fake vaccines have been used, the spokesman said.   Health workers administering meningitis jabs are being asked to take special care about their supply source, and the public are being urged to scrutinise vaccines clearly, even if they buy them in "licensed" pharmacies.   Fake drugs -- medications that are outright counterfeits or whose active ingredients have been diluted -- are a major problem in West Africa.

In the 2017 outbreak, and in an epidemic in 2015 in which nearly 500 people died, Niger sounded the alarm over purported vials of vaccine that just contained water.   Meningitis is transmitted between people through coughs and sneezes, close contact and cramped living conditions.   The illness causes acute inflammation of the outer layers of the brain and spinal cord, with the most common symptoms being fever, headache and neck stiffness.
Date: Fri, 15 Mar 2019 02:55:29 +0100
By Khaliun Bayartsogt

Bornuur, Mongolia, March 15, 2019 (AFP) - In the world's coldest capital, many burn coal and plastic just to survive temperatures as low as minus 40 degrees -- but warmth comes at a price: deadly pollution makes Ulaanbataar's air too toxic for children to breathe, leaving parents little choice but to evacuate them to the countryside.   This exodus is a stark warning of the future for urban areas in much of Asia, where scenes of citizens in anti-pollution masks against a backdrop of brown skies are becoming routine, rather than apocalyptic.   Ulaanbaatar is one of the most polluted cities on the planet, alongside New Delhi, Dhaka, Kabul, and Beijing. It regularly exceeds World Health Organisation recommendations for air quality even as experts warn of disastrous consequences, particularly for children, including stunted development, chronic illness, and in some cases death.

Erdene-Bat Naranchimeg watched helplessly as her daughter Amina battled illness virtually from birth, her immune system handicapped by the smog-choked air in Mongolia's capital.   "We would constantly be in and out of the hospital," Naranchimeg told AFP, adding that Amina contracted pneumonia twice at the age of two, requiring several rounds of antibiotics.   This is not a unique case in a city where winter temperatures plunge towards uninhabitable, particularly in the districts that rural workers moved to in search of a better life.   Here row upon row of the traditional tents -- known as gers -- are warmed by coal, or any other flammable material available. The resulting thick black smoke shoots out in plumes, blanketing surrounding areas in a film of smog that makes visibility so poor it can be hard to see even a few metres ahead.   Hospitals are packed and young children are vulnerable, common colds can quickly escalate into life-threatening illness.

- Birth defects -
The situation was so bad that doctors told Naranchimeg the only solution was to send her little girl to the clean air of the countryside.   Now aged five, Amina is thriving. She lives with her grandparents in Bornuur Sum, a village 135 kilometres away from the capital.   "She hasn't been sick since she started living here," said Naranchimeg, who makes the three-hour round trip to see Amina every week.   "It was very difficult in the first few months," she said. "We used to cry when we talked on the phone."   But like many parents in Ulaanbaatar, she felt the move was the only way to protect her child.

The levels of PM2.5 -- tiny and harmful particles -- in Ulaanbaatar reached 3,320 in January, 133 times what the World Health Organisation (WHO) considers safe.   The effects are terrible for adults but children are even more at risk, in part because they breathe faster, taking in more air and pollutants.   As they are smaller, children are also closer to the ground, where some pollutants concentrate, and their still-developing lungs, brains, and other key organs are more vulnerable to damage.   Effects to prolonged exposure range from persistent infections and asthma to slowed lung and brain development.   The risks apply in utero, too, because gases and fine particles can enter a mother's bloodstream and placenta, causing miscarriage, birth defects and low birth weights, which can also affect a child for the rest of their lives.   Researchers are now investigating whether pollution, like exposure to tobacco smoke, has health effects that could even be passed down to the next generation.

- 'Terribly afraid' -
Buyan-Ulzii Badamkhand and her husband need to stay in capital for work, but they have decided to send their two-year-old son Temuulen more than 1,000 kilometres away.   The 35-year-old mother-of-three struggled with the decision, even moving from one ger district to another in the hope her son's health would improve.   But successive bouts of illness, including bronchitis that lasted a whole year, finally convinced her to send Temuulen to his grandparents.   Hours after he arrived, she called her mother-in-law to discuss her son's medicines.   "But my mother-in-law asked me 'does he still need medicine? He isn't coughing anymore," she said.   "I tell myself that it doesn't matter that I miss him and who raises him, as long as he is healthy, I am content."   Respiratory problems are the most obvious effect of air pollution, but research suggests dirty air can also put children at greater risk for diabetes and cardiovascular disease later in life.   And the WHO links it to leukaemia and behavioural disorders.   When air pollution peaks in winter, Ulaanbaatar's playgrounds empty and those who are able to are increasingly travelling abroad to wait out the smog.

In desperation, Luvsangombo Chinchuluun, a civil society activist, borrowed money to take her granddaughter to Thailand for all of January.   "We can't let her play outside (in Ulaanbaatar) because of the air pollution, so we decided to leave," she said.   The persistent smog has caused tensions in the city, with those living in wealthier areas blaming the ger residents for the pollution and even calling for the tent districts to be cleared.   But the ger residents say coal is all they can afford.   "People come to the capital because they need sustainable income," said Dorjdagva Adiyasuren, a 54-year-old mother of six.   "It's not their fault," she added.    In a bid to tackle the problem, the local government banned domestic migration in 2017, and a ban on burning coal comes into force from May.   But it is unclear whether the moves will be enough to make a difference.   For Naranchimeg, the problems are serious enough to make her consider whether she wants more children.    She explained: "Now, I am terribly afraid of to give birth again. It is risky to carry a child and what will happen to the child after it is born in this amount of pollution?"
Date: Thu, 14 Mar 2019 18:17:56 +0100

Reykjavik, March 14, 2019 (AFP) - Iceland has blocked the millions of tourists who descend upon the volcanic island each year from visiting a canyon that has been overrun since it was featured in a Justin Bieber music video.   An influx of tourists and a humid winter have disrupted the Fjadrargljufur canyon's fragile ecosystem, so the Environment Agency of Iceland has closed the site to the public until June 1.   "During periods of thaw, the path is completely muddy and is practically unusable for hikers," agency advisor Daniel Freyr Jonsson told AFP on Thursday.   "Because the mud is so thick, visitors step over the fences and walk parallel to the path, which rapidly damages the plant life," he added.

Fjadrargljufur is a gorge about 100 meters (yards) deep and two kilometres (1.25 miles) long, with steep green walls and a winding riverbed. The canyon was created by progressive erosion from water melting from glaciers 9,000 years ago.   The canyon was little known to foreigners until the end of 2015, when Canadian singer Justin Bieber featured the site in his song "I'll Show You".   "Visits to the site have risen by 50 to 80 percent per year since 2016," said Daniel Freyr Jonsson, estimating that around 300,000 people visited the canyon in 2018.   A growing number of tourist sites in Iceland have been closed in a bid to
preserve them.

The popular Reykjadalur valley and its hot springs were temporarily closed in April 2018 and a hiking trail overlooking the Skogafoss waterfall is currently shut.   "The infrastructure is not set up to accomodate so many visitors," said Daniel Freyr Jonsson.    "Tourism in winter and spring, the most sensitive periods for wildlife in Iceland, (was previously) almost unheard of in Iceland."   Since 2010 and the eruption of the Eyjafjallajokull volcano -- which generated a lot of publicity for the island -- the number of visitors has grown by 25 percent per year on average.   Last year, a record 2.3 million people visited Iceland.
Date: Thu, 14 Mar 2019 16:50:58 +0100

Geneva, March 14, 2019 (AFP) - The deadly Ebola outbreak raging in eastern Democratic Republic of Congo should be over within six months, the head of the World Health Organization said Thursday.   Seven months since the outbreak erupted in DRC's violence-torn North Kivu province, WHO Director-General Tedros Adhanom Ghebreyesus told reporters there were clear signs the spread of the virus was "contracting".   "Our target is now to finish it in the next six months," he told reporters in Geneva, warning though that increased unrest in the affected area could reverse the progress being made.   "It's always good to plan beyond the horizon to prepare for any eventualities," he said, while voicing optimism that massive efforts to rein in the outbreak are working.

The ongoing Ebola outbreak, the 10th in DRC's history, emerged in North Kivu in August 2018 and then spread to neighbouring Ituri province.    It has claimed 584 lives out of nearly 1,000 believed to have been infected, WHO said.   Security in eastern DRC, a region rampant with rebel fighters, has dramatically complicated the response, with numerous attacks on Ebola treatment centres.   The Doctors Without Borders (MSF) medical charity has also sounded the alarm over increasingly "toxic" relations with local communities, whose resistance to Ebola response efforts have also fuelled the spread.   MSF pointed out that 40 percent of deaths from the extremely contagious virus are occurring in communities rather than in Ebola treatment centres.

- 'Contracting' -
"The Ebola response is failing to bring the epidemic under control," MSF chief Joanne Lieu told reporters in Geneva last week.   But Tedros denied Thursday that this was the case.   "That's not true," he said. "You cannot say it's failing when the outbreak is contracting. It's contracting."   He stressed that over the past seven months, the virus had been contained to North Kivu and Ituri.

"It hasn't spread to other parts of the country and it hasn't spread to neighbouring countries," he said, adding that transmission had been halted in a number of places, including in Beni and Mangina.   "So the cases are now shrinking in certain geographic areas," he said.   Tedros also stressed that the number of new cases had been cut in half since January, with an average of 25 new cases reported each week now compared to 50 at the beginning of the year.   He acknowledged though that violence, unrest and community resistance remained a challenge in Butembo especially, which along with Katwa is where the spread of the virus is now concentrated.   "I don't want to undermine the risk, because it may again (resurge) if the security situation continues to deteriorate," he said, acknowledging that there is still a chance Ebola could spread to other parts of DRC and neighbouring countries.
Date: Thu, 14 Mar 2019 03:42:36 +0100

Kuala Lumpur, March 14, 2019 (AFP) - Over 100 schools in Malaysia have been closed after the dumping of toxic waste into a river caused hundreds of people to fall ill, including many children, authorities said.   A lorry is believed to have dumped the waste in southern Johor state last week, sending hazardous fumes across a wide area and causing those affected to display symptoms of poisoning such as nausea and vomiting.

Over 500 people, many of them school pupils, have received medical treatment after inhaling the fumes, with over 160 admitted to hospital, according to official news agency Bernama.    It was unclear what type of poisonous gas had been emitted near the industrial town of Pasir Gudang.   Education Minister Maszlee Malik initially ordered the closure of 43 schools in the area Wednesday, but later announced that figure had more than doubled.

"The ministry of education has decided to close all 111 schools in the Pasir Gudang area immediately," he said in a statement.    "The education ministry is requesting that all parties take precautions."   Three men were arrested earlier this week over the toxic waste dumping. One is expected to be charged in court soon and could face up to five years in jail if found guilty of breaking environmental protection laws.
Date: Tue 12 Mar 2019
Source: Carmelo Portal [in Spanish, trans. Mod. TY, edited]

The departmental health director, Dr Jorge Mota, confirmed for Carmelo Portal the death in our city of a young 17 year old girl from [a] hantavirus [infection]. "In Colonia department, there are on average 3 cases per year. The evolution of the disease is in thirds. One-third of the [infected] people do not have notable symptoms; another third have serious symptoms, especially respiratory symptoms and ones in all the systems, but with adequate treatment, [the infected people] survive, sometimes with sequelae. There is another third that die. It is those few with the virus that die with an evolution so drastic, such as is the case of this girl, sadly," Dr Mota stated.

The department health director said that hantaviruses are not contagious person-to-person. "It is transmitted from an intermediate animal, the field mouse. Only 3% of these mice have [a] hantavirus. To become infected, one must be in contact with an [infected] mouse's secretions that have dried, are mixed with dust, and are in a closed space, away from sunlight and ventilation. A spa, a shed, or a wood pile [are examples of such a space]. The person had to have been moving around there and inhaled the dust," he explained.

Dr Mota spoke about the epidemiological surveillance that is carried out. "We tracked places where the person was, even those that could be identified 2 months before contracting the virus; sometimes we found the place, but sometimes not." As a preventive measure, Mota stated that in these cases, ventilate these closed spaces for at least half an hour. Wet down floors and shelves with water [with 10% bleach]. Use masks [and gloves].
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[The report above does not mention the circumstances under which the infection might have been acquired nor which hantavirus was responsible for this or earlier cases in Uruguay. Hantaviruses that cause hantavirus pulmonary syndrome (with rodent hosts found in Uruguay) include Laguna Negra virus (_Calomys laucha_), Maciel virus (_Necromys benefactus_), Central Plata virus, Lechiguanas virus (_Oligoryzomys flavescens_, complex of rodents), and Anajatuba virus and Juquitiba virus (_Ologoryzomys fornesi_).

The rodent reservoir hosts shed the virus in its saliva, urine, and faeces, contaminating the environment in which they live and breed.

A HealthMap/ProMED-mail map showing the location of Uruguay in South America can be accessed at
<http://healthmap.org/promed/p/28995>.

A map of Colonia department in southern Uruguay is available at
<https://en.wikipedia.org/wiki/Colonia_del_Sacramento>
and <http://healthmap.org/promed/p/27367>. - ProMED Mod.TY]
Date: Wed 13 Mar 2019
Source: Outbreak News Today [abridged, edited]

The number of measles deaths has topped 1100 in Madagascar. In an update on the measles epidemic in Madagascar, UN health officials report 6607 cases of measles, including 41 deaths, in the week ending 24 Feb [2019]. Cases are reported in children aged 1 to 14 years. Of 114 districts in all 22 regions, 104 are in the epidemic phase, officials report.
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[The number of cases and deaths from measles in Madagascar is horrifying, even more so since the disease is vaccine-preventable. There is no information on how the health sector in the country is responding, but clearly the clinics are overburdened during this devastating outbreak. - ProMED Mod.LK]

[HealthMap/ProMED-mail map of Madagascar:
Date: Mon 11 Mar 2019
Source: Focus Taiwan [abridged, edited]

A Taipei resident in her 20s has been confirmed to be infected with measles and is suspected of having had contact with 247 people during the incubation period, according to the Centers for Disease Control (CDC). The woman, who works at a restaurant in the ATT 4 Fun shopping centre in Taipei's Xinyi District might have been infected through coming into contact with foreign tourists in her workplace, said CDC deputy director-general Lo Yi-chun in a statement issued on Mon [11 Mar 2019].

To date, 247 people considered to have had contact with the patient, including her family, colleagues and health care personnel, have been traced. The contact tracing will continue until 27 Mar [2019]. The CDC alerted people who used the same bus and had been to the same places the patient visited to beware of possible exposure to the measles virus. It asked those who might have had contact with the woman to conduct self-health management for 18 days.

The reported new case has brought the total number of confirmed measles cases in Taiwan to 29 since the beginning of this year [2019], 16 contracted at home and 13 from abroad. Among the 16 indigenous cases, 8 have been linked to imported cases, the CDC said.

Lo reminded the public that measles is highly contagious and now is the peak transmission season. Outbreaks in some Asian countries have been growing, including the Philippines, Vietnam, Thailand, China, India and Indonesia, he said. As of 24 Feb [2019], the number of measles cases in Japan has risen to 258, the highest in the same period since 2009, Lo added.  [byline: Chang Ming-hsuan and Evelyn Kao]
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[HealthMap/ProMED-mail map of Taiwan:
Date: Thu 14 March 2019
Source: South China Morning Post [abridged, edited]

Health authorities seek passengers on Cathay Pacific Hong Kong-Tokyo flight [1 Mar 2019] after a man [said to be a Cathay Pacific flight attendant] contracted measles, a contagious disease. The man tested positive for the immunoglobulin M antibody that confirms a measles infection. He was admitted to St Paul's Hospital in Causeway Bay after he returned to Hong Kong. He was later declared to be in a stable condition and discharged.

This is the 11th case of measles confirmed in city this year [2019] with at least 7 infections imported. Authorities seek passengers on the Cathay Pacific flight who might have had contact with the 23 year old man.  [byline: Danny Mok]
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[HealthMap/ProMED-mail map of Hong Kong: