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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]
More ...

Spain

Spain and Andorra US Consular Information Sheet
January 13, 2009
Spain and Andorra are both advanced stable democracies and modern economies. Spain is a member of North Atlantic Treaty Organization (NATO) and the European Union.
Read the D
partment of State Background Notes on Spain and Andorra for additional information.

ENTRY/EXIT REQUIREMENTS:
Spain is a party to the Schengen agreement.
As such, U.S. citizens may enter Spain 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 Schengen Fact Sheet.

In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points.
These often include requiring documentary evidence of relationship and permission for the child's travel from the parent(s) or legal guardian not present.
Having such documentation on hand, even if not required, may facilitate entry/departure.
For further information concerning entry requirements for Spain, travelers should contact the Embassy of Spain at 2375 Pennsylvania Avenue NW, Washington, DC 20037, telephone (202) 452-0100, or the nearest Spanish Consulate in Boston, Chicago, Houston, Los Angeles, Miami, New Orleans, New York, San Francisco, or San Juan.
Spanish government web sites with information about entry requirements (in Spanish) can be found at http://www.mae.es and http://www.mir.es.
Additional information may be obtained from the Tourist Office of Spain in New York, telephone (212) 265-8822, or online at http://www.spain.info/.
For further information on entry requirements to Andorra, travelers should contact the Andorran Mission to the UN, 2 U.N. Plaza, 25th floor, New York, NY 10018, telephone (212) 750-8064 or online at http://www.andorra.ad.
Visit the Embassy of Spain and Andorra web sites for the most current visa information.
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:
Spain and Andorra share with the rest of the world an increased threat of international terrorist incidents.
Like other countries in the Schengen area, Spain's open borders with its Western European neighbors allow the possibility of terrorist groups entering and exiting the country with anonymity.
Spain’s proximity to North Africa makes it vulnerable to attack from Al Qaeda terrorists in the Maghreb region.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

In the deadliest terrorist attack in recent European history, in March 2004, Islamist extremists bombed four commuter trains entering Madrid, causing 191 deaths and over 1,400 injuries.
Spanish authorities tried the suspected terrorists and their co-conspirators in February 2007 and convicted in October 2007.
The Basque Fatherland and Liberty (ETA) terrorist organization remains active in Spain.
ETA has historically avoided targeting foreigners, directing their attacks against the police, military, local politicians, and Spanish government targets as well as attempts to disrupt transportation and daily life. However, foreigners have been killed or injured collaterally in ETA attacks.
Two examples of this are the Barajas Airport bombing in December 2006, in which two Ecuadorian nationals were killed and the bombing at the University of Navarre in October 2008, in which 17 students were injured including one American student.
In addition, bombs have been used as part of criminal extortion of businesses, particularly in the Basque region. The risk of “being in the wrong place at the wrong time” in event of an ETA action is a concern for foreign visitors and tourists.
U.S. tourists traveling to Spain should remain vigilant, exercise caution, monitor local developments, and avoid demonstrations and other potentially violent situations.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State’s 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 A Safe Trip Abroad.
CRIME:
Andorra has a low rate of crime.
While most of Spain has a moderate rate of crime and most of the estimated one million American tourists have trouble free visits to Spain each year, street crimes against tourists occur in the principal tourist areas.
Madrid and Barcelona, in particular, report incidents of pick-pocketing, mugging and occasional violent attacks, some of which require the victim to seek medical attention.
Although crimes occur at all times of day and night and to people of all ages, older tourists and Asian Americans seem to be particularly at risk.
Criminals frequent tourist areas and major attractions such as museums, monuments, restaurants, outdoor cafes, Internet cafes, hotel lobbies, beach resorts, city buses, subways, trains, train stations, airports, and ATMs.

In Madrid, incidents have been reported in all major tourist areas, including the area near the Prado Museum, near Atocha train station, in Retiro Park, in areas of old Madrid including near the Royal Palace and in Plaza Mayor.
There have been a number of passport and bag thefts reported at Madrid’s Barajas Airport, local hotels, as well as in El Rastro (Madrid’s flea market) and in the Metro.

In Barcelona, the largest number of incidents reported also occurred in major tourist areas, on Las Ramblas, Barcelona’s El Prat airport, Sants train station, Metro stations, in the Sagrada Familia Area, in the Gothic Quarter, in Parc Güell, in Plaza Real, and along Barcelona’s beaches.
There has been a rise in the number of thefts reported at the Port Olimpic Area and nearby beaches.

Travelers should remain alert to their personal security and exercise caution. Travelers are encouraged to carry limited cash, only one credit card, and a copy of their passport; leaving extra cash, extra credit cards, passports and personal documents in a safe location.
When carrying documents, credit cards or cash, you are encouraged to secure them in a hard-to-reach place and not to carry all valuables together in a purse or backpack.
Thieves often work in teams of two or more people.
In many cases, one person distracts a victim while the accomplices perform the robbery.
For example, someone might wave a map in your face and ask for directions, “inadvertently” spill something on you, or help you clean-up bird droppings thrown on you by a third unseen accomplice.
While your attention is diverted, an accomplice makes off with the valuables.
Thieves may drop coins or keys at your feet to distract you and try to take your belongings while you are trying to help.
Attacks are sometimes initiated from behind, with the victim being grabbed around the neck and choked by one assailant while others rifle through or grab the belongings.
A group of assailants may surround the victim in a crowded popular tourist area or on public transportation, and only after the group has departed does the person discover he/she has been robbed.
Purse-snatchers may grab purses or wallets and run away, or immediately pass the stolen item to an accomplice.
A passenger on a passing motorcycle sometimes robs pedestrians.
There have been reports of thieves posing as plainclothes police officers, beckoning to pedestrians from cars and sometimes confronting them on the street asking for documents, or to inspect their cash for counterfeit bills, which they ultimately “confiscate” as evidence.
The U.S. Embassy in Madrid has received reports of cars on limited access motorways being pulled over by supposed unmarked police cars.
The Spanish police do not operate in this fashion.
American citizens are encouraged to ask for a uniformed law enforcement officer if approached.
Theft from vehicles is also common.
“Good Samaritan" scams are unfortunately common, where a passing car or helpful stranger will attempt to divert the driver’s attention by indicating there is a flat tire or mechanical problem.
When the driver stops to check the vehicle, the “good Samaritan” will appear to help the driver and passengers while the accomplice steals from the unlocked car. Drivers should be cautious about accepting help from anyone other than a uniformed Spanish police officer or Civil Guard.
Items high in value like luggage, cameras, laptop computers, or briefcases are often stolen from cars. Travelers are advised not to leave valuables in parked cars, and to keep doors locked, windows rolled up, and valuables out of sight when driving.
While the incidence of sexual assault is statistically very low, attacks do occur.
Spanish authorities warn of the availability of so-called "date-rape" drugs and other drugs, including "GBH" and liquid ecstasy.
Americans should not lower their personal security awareness because they are on vacation.
A number of American citizens have been victims of lottery or advance fee scams in which a person is lured to Spain to finalize a financial transaction. Often the victims are initially contacted via Internet or fax and informed they have won the Spanish Lottery (El Gordo), inherited money from a distant relative, or are needed to assist in a major financial transaction from one country to another.
For more information, please see the Bureau of Consular Affairs web site on International Financial Scams.

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.
The Embassy’s U.S. Commercial Service receives reports of a type of scam targeting U.S. businesses, utilizing the name of a legitimate Spanish concern and legitimate-appearing Spanish bank references.
The scam usually involves a temptingly large order or business proposal.
The U.S. Commercial Service in Spain at http://www.buyusa.gov/spain/en/ stands ready to counsel any U.S. firm which would like to verify the legitimacy of an unsolicited business proposal purporting to come from a Spanish firm.

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, help you find appropriate medical care, contact family members or friends and explain how funds could be transferred.
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.
Spain does have a Crime Victim’s Assistance program.
More information can be obtained at http://www.mjusticia.es/Directorio/Victimas?menu_activo=1057821035144&lang=es_es.

The local equivalent to the “911” emergency line in Spain is 112.
Please see our information on Victims of Crime, including possible victim compensation programs.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Good medical care is available in both Spain and Andorra.
Regulations regarding medications may vary from those in the United States; Americans with need for specific medications are encouraged to bring a supply sufficient for their anticipated period of stay, as the medication may not be available and customs regulations may prohibit certain medications to be mailed from the United States to Spain or Andorra.
The Department of State strongly urges Americans to consult with their medical insurance companies prior to traveling abroad to confirm whether their policy applies overseas and if it will cover emergency expenses such as a medical evacuation.
U.S. medical insurance plans may not cover health costs incurred outside the United States unless supplemental coverage is purchased.
Further, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. You should contact your insurance provider before departure so appropriate arrangements can be made.
Many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas, including emergency services such as medical evacuations.

When making a decision regarding health insurance, Americans should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the United States may cost well in excess of $50,000.
Uninsured travelers who require medical care overseas often face extreme difficulties, whereas travelers who have purchased overseas medical insurance have found it to be life saving when a medical emergency has occurred.
When consulting with your insurer prior to your trip, please ascertain whether payment will be made to the overseas healthcare provider or if you will be reimbursed later for expenses that you incur.
Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Spain or Andorra.
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:
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 name of country is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic in Madrid and Barcelona is faster-paced than in U.S. cities and can be unnerving due to unfamiliar signs or motorbikes weaving between traffic lanes.
Drivers should always obey the closest traffic light, as there are separate pedestrian lights in the city.
Drivers should be alert when driving at night in urban areas, due to the possibility of encountering drivers or pedestrians under the influence of alcohol.
Night driving in isolated rural areas can be dangerous because of farm animals and poorly marked roads.
Rural traffic is generally heavier in July and August as well as during the Christmas and Easter seasons.
Traffic regulations in effect in Spain include the prohibition on the use of a mobile phone without a hands-free device while driving a car.
There is a fine of 300 euros for violation of this regulation and loss of driving privileges.
In addition, all drivers and passengers are required to carry a reflective vest and put it on if they need to stop on the roadside.
A reflective triangle warning sign for a vehicle stopped on the side of the road is also mandatory.
Those renting vehicles are encouraged to check with the rental company about traffic regulations and safety equipment.
U.S. citizens using U.S. issued drivers licenses must obtain International Driving Permits prior to their arrival if they plan to drive in Spain.
Pedestrians should use designated crossing areas when crossing streets and obey traffic lights.
Public transportation in large Spanish cities is generally excellent.
All major cities have metered taxis, in which extra charges must be posted in the vehicle.
Travelers are advised to use only clearly identified cabs and to ensure that taxi drivers always switch on the meter.
A green light on the roof indicates that the taxi is available.
Rail service is comfortable and reliable, but varies in quality and speed. Intercity buses are usually comfortable and inexpensive.
Please refer to our Road Safety page for more information.
For specific information concerning Spanish driving permits, vehicle inspection, road tax and mandatory insurance, please contact the Spanish National Tourist Organization offices in New York at http://www.spain.info/us/TourSpain.
For information about driving in Andorra, refer to http://www.andorra.ad/en-US/Pages/default.aspx.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Spain’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Spain’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.

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 offences.
Persons violating the laws of Spain or Andorra, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Spain and Andorra are severe, and convicted offenders can expect long jail sentences and heavy fines. The cities of Madrid and Barcelona and The Balearics Regional Government have banned the consumption of alcohol in the street, other than in registered street cafes and bars.
Visitors to Madrid, Barcelona, Mallorca, Ibiza, and Menorca should be aware that failure to respect this law might result in the imposition of 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 living or traveling in Spain or Andorra are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site to obtain updated information on travel and security within Spain or Andorra.
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 Serrano 75; telephone (34) (91) 587-2200, and fax (34) (91) 587-2303. U.S. citizens who register in the Consular Section at the U.S. Embassy, Consulate General, or one of the Consular Agencies listed below can obtain updated information on travel and security within Spain or Andorra.
Additional information and appointments for routine services are available through the U.S. Embassy’s home page at http://madrid.usembassy.gov.
Appointments are required for routine Consular Services.
To make an appointment, go to https://evisaforms.state.gov/acs/default.asp?postcode=MDD&appcode=1.
The U.S. Consulate in Barcelona is located at Paseo Reina Elisenda 23-25; telephone (34) (93) 280-2227 and fax (34) (93) 205-5206.
Visitors to Barcelona can access additional information from the Consulate General’s web page at http://madrid.usembassy.gov/barcelonaen.html.
There are six consular agencies in Spain, which provide limited services to American citizens, but are not authorized to issue passports.
Anyone requesting service at one of the consular agencies should call ahead to verify that the service requested will be available on the day you expect to visit the agency.
Fuengirola (in Malaga Province), at Avenida Juan Gomez Juanito #8, Edificio Lucia 1C, Fuengirola 29640 Spain. Telephone (34) (952) 474-891 and fax (34) (952) 465-189.
Hours 10:00 a.m. to 2:00 p.m.
La Coruna, Calle Juana de Vega 8, 5º Piso, Oficina I, La Coruna 15003 Spain.
Telephone (34) (981) 213-233 and fax (34) (981 22 28 08).
Hours 10:00 a.m. to 1:00 p.m.

Las Palmas, at Edificio Arca, Calle Los Martinez de Escobar 3, Oficina 7, Las Palmas, Gran Canaria 35007 Spain.
Telephone (34)(928) 222-552 and fax (34)(928) 225-863.
Hours 10:00 a.m. to 1:00 p.m.
Palma de Mallorca, Edificio Reina Constanza, Porto Pi, 8, 9-D, 07015 Palma de Mallorca 07015 Spain.
Telephone (34) (971) 40-3707 or 40-3905 and fax (34) (971) 40-3971.
Hours 10:30 a.m. to 1:30 p.m.
Seville, at Plaza Nueva 8-8 duplicado, 2nd Floor, Office E-2 No.4, Sevilla, 41101 Spain. Telephone: (34) (65) 422-8751 and fax (34) (91) 422-0791.
Hours: 10:00 a.m. to 1:00 p.m.
Valencia, at Doctor Romagosa #1, 2-J, 46002, Valencia 46002 Spain.
Telephone (34) (96)-351-6973 and fax (34) (96) 352-9565.
Hours 10:00 a.m. to 2:00 p.m.
For Andorra, please contact the U.S. Consulate in Barcelona.
*

*

*
This replaces the Country Specific Information for Spain and Andorra dated July 15, 2008, to update sections on Safety and Security and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Thu 12 Sep 2019, 10:57 AM
Source: The Olive Press [edited]

An outbreak of the deadly [infection due to the bacterium] _Listeria_ has been confirmed in Mallorca.

A patient is recovering in a private clinic in Palma as samples of the bacterium are being tested in Madrid to confirm if it is the same strain as the recent outbreak in Andalucia. It seems likely to have originated from the same lethal strain since the patient affected [in Mallorca] had come from Granada.

So far 3 people have died and 7 women have aborted babies out of the 200 people confirmed to have been affected.

The dangerous bacterium spreads through food and can cause severe illnesses including sepsis, meningitis and other life-long problems.  [Byline: Jacque Talbot]
========================
[_Listeria_ have been identified in 3 meat products and in needles used to inject lard into the meat before it is cooked at a meat processing facility in Seville implicated in this outbreak (after cooking, the meat is usually served cold and in thin slices). Proper cooking of the meat at the processing facility should have killed _Listeria_, which suggests either that the meat, may have been improperly cooked or that contamination may have occurred after cooking. The prior news report said that _Listeria_ was isolated from an oven cart used at the processing facility in Seville; if the meat was placed on this cart after cooking, it could explain how the meat became contaminated despite having been previously cooked. The meat processing facility has been closed, and all its products have now been recalled, but because it can take up to 70 days after exposure to _Listeria_ for symptoms of listeriosis to develop, more cases can be expected.

Genotyping clinical isolates of _L. monocytogenes_ will help identify clusters of cases that have a common source, and genotyping the isolates from the food and environmental surfaces at the meat processing facility will help confirm the source, if genotypes match. We await further developments in the investigation of this outbreak.

Palma, with a population of 409 661 residents, the capital and resort city of the autonomous community of the Balearic Islands in Spain, is located on the south coast of Mallorca  (<https://en.wikipedia.org/wiki/Palma_de_Mallorca>).

Mallorca is the largest island in the Balearic Islands, located approximately 300 km [186 mi] off the eastern coast of Spain in the western Mediterranean (<https://en.wikipedia.org/wiki/Mallorca>). The autonomous community of Andalucia is located in southern Spain, with the Atlantic Ocean to the west and the Mediterranean Sea to the east (<https://en.wikipedia.org/wiki/Seville>).

A map of Spain showing the locations of Andalucia and Mallorca can be found at

[HealthMap/ProMED map available at:
Mallorca, Balearic Islands, Spain:
Date: Tue 3 Sep 2019
Source: Food Safety News [edited]

Four people are part of a foodborne botulism outbreak in Spain after eating DIA brand tuna. A batch of canned tuna in sunflower oil of the brand DIA has been removed from sale. The Spanish Agency for Food Safety and Nutrition (AESAN) said those who became ill ate a homemade salad that included the tuna. Spanish media reported one of the patients was still in hospital.

The foodborne outbreak was suspected to be caused by the tuna or grated carrots from Spain with distribution including Andorra, according to a Rapid Alert System for Food and Feed (RASFF) notice.

AESAN became aware on 9 Aug 2019, through the Spanish rapid information exchange system (SCIRI), of a notification from health authorities in Castilla y Leon of a food poisoning outbreak caused by botulinum toxin linked to consumption of canned tuna in a homemade "Russian" salad. Products have been analysed, and the presence of botulinum toxin was confirmed in late August 2019 in the consumed can of tuna.

Distribuidora Internacional de Alimentacion (DIA) is a Spanish multinational company specializing in distribution of food, household, and personal care products. The company has more than 6000 stores in Spain, Portugal, Brazil, and Argentina. Tuna was distributed through DIA platforms to the communities of Asturias, Castilla y Leon, Cataluna, Aragon, La Rioja, Murcia, Navarra, Castilla - La Mancha, and Valencia.

Canned tuna in sunflower oil 900-gram with lot code 19/154 023 02587 and expiration date of December 2022 made by Frinsa del Noroeste S.A. is affected. This batch of tuna manufactured by Frinsa was removed from all stores on 10 Aug 2019 by DIA, according to a company statement. The firm asked any customers who had the item to return it to their nearest store.

Botulism is a rare but life-threatening condition caused by toxins produced by _Clostridium botulinum_ bacteria. In foodborne botulism, symptoms generally begin 18-36 hours after eating contaminated food. However, they can start as soon as 6 hours after or up to 10 days later. Botulism can cause symptoms including general weakness, dizziness, double vision, and trouble with speaking or swallowing. Difficulty in breathing, weakness of other muscles, abdominal distension, and constipation may also occur. People experiencing these problems should seek immediate medical attention. Symptoms result from muscle paralysis caused by the toxin.
======================
[Seafood-associated botulism is usually type E. Canned tuna is an uncommon source but has been reported (Johnston RW, Feldman J, Sullivan R: Botulism from canned tuna fish. Public Health Rep. 1963; 78: 561-4).

The following was extracted from ProMED-mail Botulism, smoked fish - Finland ex Canada http://promedmail.org/post/20060721.2000: "_Clostridium botulinum_ type E is naturally highly prevalent in aquatic environments and fish, leading to a high risk of contamination. The hot-smoking processes are usually too low to eliminate botulinum spores. Growth and toxin production from spores in vacuum-packed smoked fish products with anaerobic atmosphere and limited preservative factors is likely during extended storage at temperatures above 3 deg C (37.4 deg F). Therefore, the most important factors controlling _C. botulinum_ growth and toxin production are efficient heat treatments, restricted shelf life, and continuous storage below 3 deg C (37.4 deg F)." - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Fri, 30 Aug 2019 18:36:54 +0200 (METDST)

Madrid, Aug 30, 2019 (AFP) - A man died after eating tainted meat in Spain, the third fatality in a listeria outbreak that has also seen five women lose their babies due to the food-borne bacteria, health authorities said Friday.   More than 200 people have been infected with the common bacteria which poses a serious threat to elderly people, pregnant women or those with serious health conditions.

The source of the outbreak, which was declared on August 15, comes from a product of pork stuffed with garlic and other condiments sold under the commercial name "la Mecha".   The delicacy is made by the company Magrudis, based in the southern city of Seville. Its factory has since been closed and its meat recalled from shops.   On Friday, Spain's health ministry and the government of the southern region of Andalusia, the worst affected, said a 72-year-old man who had terminal pancreatic cancer died from the infection.

That comes on top of the deaths of two elderly women this month.    The ministry and regional government both told AFP on Friday that five women had also lost their babies after eating the tainted meat, one in Madrid and the others in Andalusia.   In a statement, the health ministry warned: "The appearance of new cases cannot be ruled out in the coming days."   But it said, "there is a drop in the number of confirmed cases since the start of the outbreak."
Date: Wed, 28 Aug 2019 13:49:40 +0200 (METDST)

Madrid, Aug 28, 2019 (AFP) - Ryanair pilots in Spain said Wednesday they planned to go on strike for five days in September to protest the planned closure of four bases that threatens 512 jobs.   The work stoppage will come on top of a 10-day September strike called by cabin crew at the budget airline in Spain.   Both are protesting against Ryanair shutting its Canary Islands bases of Tenerife, Lanzarote and Gran Canaria as well as Gerona in north-eastern Spain from January.

The airline, which has suffered from two profit warnings in 10 months, announced the closures on Friday, citing "significant overcapacity in the European short haul market."   A spokesman for the Sepla pilots' union told AFP 120 pilots could lose their jobs.   "They have not proposed relocating the pilots to other bases," he said.   Representatives of the union and company are due to meet this week.   If mediation efforts fail, the strike will take place on September 19, 20, 22, 27 and 29, the union said.   According to the USO union that represents Ryanair cabin crew, altogether 512 pilot and cabin crew posts are threatened.   On Friday, Ryanair said it would try to minimise "job losses with transfers."
Date: Tue, 27 Aug 2019 18:05:42 +0200 (METDST)

Madrid, Aug 27, 2019 (AFP) - A woman died Tuesday after eating tainted meat in Spain, the second fatality in a listeria outbreak that has seen more than 200 people infected with the potentially fatal food-borne bacteria, authorities said.   The government of the southern region of Andalusia said in a statement a 74-year-old patient died in hospital in Seville just over a week after a 90-year-old woman also passed away.

Listeria is a common bacteria and most people who consume tainted foods do not become ill.   But for elderly people, pregnant women or those with serious conditions like diabetes or cancer, it poses a serious threat.   The regional government said a total of 196 people in Andalusia are confirmed to have been infected.   It warned earlier this month that a product of pork stuffed with garlic and other condiments and sold under the commercial name "la Mecha", was the source of the listeria outbreak.

The delicacy is made by Seville-based company Magrudis. Its factory has since been closed and all of its meat recalled from shops.   Spain's health ministry said the outbreak has spread to other regions, with seven confirmed cases outside Andalusia.   A British citizen was infected and diagnosed in France after eating stuffed meat in Seville, it added.   A woman has lost her baby due to the bacteria.   Listeriosis begins with flu-like symptoms including chills, fever and muscle aches. It can take up to six weeks after consuming contaminated foods for symptoms to occur.
More ...

Canada

Canada - US Consular Information Sheet
February 17, 2009
COUNTRY DESCRIPTION: Canada is a highly developed, stable democracy. Tourist facilities are widely available in much of the country, but the northern and wilderness areas are less develop
d and facilities there can be vast distances apart. Read the Department of State Background Notes on Canada for additional information.
ENTRY/EXIT REQUIREMENTS: Entry into Canada is solely determined by Canadian Border Services Agency (CBSA) officials in accordance with Canadian law. Canadian law requires that all persons entering Canada carry both proof of citizenship and proof of identity. A valid U.S. passport, passport card or NEXUS card (see below) satisfies these requirements for U.S. citizens. If U.S. citizen travelers to Canada do not have a passport, passport card or approved alternate document such as a NEXUS card, they must show a government-issued photo ID (e.g. Driver’s License) and proof of U.S. citizenship such as a U.S. birth certificate, naturalization certificate, or expired U.S. passport. Children under sixteen need only present proof of U.S. citizenship.

It is very important to note that all Americans traveling to the U.S. by air, including from Canada, must present a valid U.S. passport to enter or re-enter the U.S. Effective June 1, 2009, a similar requirement goes into effect for entry into the U.S. via land and sea borders. All Americans will need to present a U.S. passport, passport card, NEXUS card, Enhanced Drivers License or other Western Hemisphere Travel Initiative (WHTI)-compliant document in order to enter the U.S. by land or sea. American travelers are urged to obtain WHTI-compliant documents before entering Canada well in advance of their planned travel. For the most recent information on WHTI and WHTI-compliant documents, please see our web site.

One of the WHTI-compliant documents for crossing the land border is the U.S. Passport Card. The card may not be used to travel by air and is available only to U.S. citizens. You can read further information on the U.S. Passport Card on our web site. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Both the U.S. and Canadian governments urge frequent travelers to join the NEXUS trusted traveler program. NEXUS members receive a special travel card that allows expedited border crossings for both private and commercial travelers through both U.S. and Canadian border controls very quickly. The CBP has detailed information about the NEXUS program.
U.S. citizens entering Canada from a third country must have a valid U.S. passport. A visa is not required for U.S. citizens to visit Canada for up to 180 days. Anyone seeking to enter Canada for any purpose other than a visit (e.g. to work, study or immigrate) must qualify for the appropriate entry status, and should contact the Canadian Embassy or nearest consulate and visit the Canadian immigration web site.

Anyone with a criminal record (including misdemeanors or Driving While Impaired (DWI) charges may be barred from entering Canada and must obtain a special waiver well in advance of any planned travel. To determine whether you may be inadmissible and how to overcome this finding, refer to the Canadian citizenship and immigration web site.
For further information on entry requirements, travelers may contact the Canadian Embassy at 501 Pennsylvania Avenue NW, Washington DC 20001, tel. (202) 682-1740; or the Canadian consulates in Atlanta, Boston, Buffalo, Chicago, Dallas, Detroit, Los Angeles, Miami, Minneapolis, New York, San Juan or Seattle.

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: For the latest security information, Americans traveling abroad should regularly monitor the Department of State, 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. 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 A Safe Trip Abroad.
CRIME: Although Canada generally has a lower crime rate than the U.S., violent crimes do occur throughout the country, especially in urban areas. Visitors to large cities should be aware that parked cars are regularly targeted for opportunistic smash-and-grab thefts, and they are cautioned to avoid leaving any possessions unattended in a vehicle, even in the trunk. Due to the high incidence of such crimes, motorists in Montreal, Vancouver and some other jurisdictions can be fined for leaving their car doors unlocked or for leaving valuables in view. Auto theft in Montreal and Vancouver, including theft of motor homes and recreational vehicles, may even occur in patrolled and apparently secure parking lots and decks. SUVs appear to be the particular targets of organized theft. While Canadian gun control laws are much stricter than those of the U.S., such laws have not prevented gun-related violence in certain areas.
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 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. Each of Canada’s provinces has a Crime Victim Compensation Board from which American victims of crime in Canada may seek redress.

As in the U.S., emergency assistance can be reached by dialing “911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: The level of public health and sanitation in Canada is high. Canada’s medical care is of a high standard but is government-controlled and rationed. Quick and easy access to ongoing medical care is difficult for temporary visitors who are not members of each province’s government-run health care plans. Many physicians will not take new patients. Access to a specialist is by only by referral and may take months to obtain. Emergency room waits can be very long. Some health care professionals in the province of Quebec may speak only French. No Canadian health care provider accepts U.S. domestic health insurance, and Medicare coverage does not extend outside the United States. Visitors who seek any medical attention in Canada should be prepared to pay in cash in full at the time the service is rendered. Traveler’s medical insurance is highly recommended even for brief visits.

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

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. For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site. Further health information for travelers is available from the WHO.

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 Canada is provided for general reference only, and may not be totally accurate in a particular location or circumstance. As in the United States, all emergency assistance in Canada can be reached by dialing 911.

Transport Canada is the Canadian federal government agency responsible for road safety, although each province or territory has the authority to establish its own traffic and safety laws and issue driving licenses. For detailed information on road conditions throughout Canada, as well as links to provincial government web sites, please see the Transport Canada web site or the Canadian Automobile Association web site. The CAA honors American Automobile Association membership. Some automobile warranties of vehicles purchased in the U.S. may be invalid in Canada; please check the warranty of your vehicle.

Driving in Canada is similar to driving in many parts of the United States. Distances and speeds, however, are posted in kilometers per hour, and some signs, particularly in Quebec, may only be in French. U.S. driver’s licenses are valid in Canada. Proof of auto insurance is required. U.S. auto insurance is accepted as long as an individual is a tourist in Canada. U.S. insurance firms will issue a Canadian insurance card, which should be obtained and carried prior to driving into Canada. For specific information concerning Canadian driving permits, mandatory insurance and entry regulations, please contact the Canadian National Tourist Organization.
Unless otherwise posted, the maximum speed limit in Canada is 50km/hr in cities and 80km/hr on highways. On rural highways, the posted speed limit may be 100km/hr (approximately 60 miles/hr). Seat belt use is mandatory for all passengers, and child car seats must be used by children under 40 pounds. Some provinces require drivers to keep their vehicles’ headlights on during the day. Motorcycles cannot share a lane, and safety helmets for motorcycle riders and passengers are mandatory. Many highways do not have merge lanes for entering traffic. Tailgating and rapid lane-changes without signaling are common. Emergency vehicles frequently enter the oncoming traffic lane to avoid congestion. Drivers should be aware that running a red light is a serious concern throughout Canada, and motorists are advised to pause before proceeding when a light turns green.
Driving while impaired (DWI) is a criminal offense in Canada. Penalties are heavy, and any prior conviction (no matter how old or how minor the infraction) is grounds for exclusion from Canada. Americans with a DWI record must seek a waiver of exclusion from Canadian authorities before traveling to Canada, which requires several weeks or months to process. It is illegal to take automobile radar detectors into Quebec, Ontario, Manitoba, the Yukon or the Northwest Territories, regardless of whether they are used or not. Police there may confiscate radar detectors, operational or not, and impose substantial fines.

Winter travel can be dangerous due to heavy snowfalls and hazardous icy conditions. Some roads and bridges are subject to periodic winter closures. Snow tires are required in some Provinces. The Canadian Automobile Association has tips for winter driving in Canada. Travelers should also be cautious of deer, elk and moose while driving at night in rural areas.

Highway 401, from Detroit to Montreal, is one of the busiest highways in North America. It has been the scene of numerous, deadly traffic accidents due to sudden, severe and unpredictable weather changes, high rates of speed, and heavy truck traffic. There have been numerous incidents involving road racing and dangerous truck driving. Drivers tend to be aggressive, often exceeding speed limits and passing on both sides, and police enforcement is spotty. In addition, approaches to border crossings into the United States may experience unexpected traffic backups. Drivers should be alert, as lane restrictions at border approaches exist for drivers in NEXUS and FAST expedited inspection programs.
Please refer to our Road Safety page for more information. Visit Canada’s national authority responsible for road safety.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Canada’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Canada’s air carrier operations. For more information, travelers may visit the FAA web site.
SPECIAL CIRCUMSTANCES: IMPORTATION OF FIREARMS: Firearms are much more strictly controlled in Canada than in the United States. Violation of firearms restrictions may result in prosecution and imprisonment. As of January 1, 2001, visitors bringing any firearms into Canada, or planning to borrow and use firearms while in Canada, must declare the firearms in writing using a Non-Resident Firearm Declaration form. Visitors planning to borrow a firearm in Canada must obtain in advance a Temporary Firearms Borrowing License. These forms must be signed before a Canadian Border Services Agency (CBSA) officer at the border and no photocopies are available at the border. Full details and downloadable forms are available from the Canada Firearms Program. Canadian law requires that officials confiscate firearms and weapons from persons crossing the border who deny having the items in their possession. Confiscated firearms and weapons are never returned. Possession of an undeclared firearm may result in arrest and imprisonment.

Canada has three classes of firearms: non-restricted, restricted, and prohibited. Non-restricted firearms include most ordinary hunting rifles and shotguns. These may be brought temporarily into Canada for sporting or hunting use during hunting season, use in competitions, in-transit movement through Canada, or personal protection against wildlife in remote areas of Canada. Anyone wishing to bring hunting rifles into Canada must be at least 18 years old, must properly store he firearm for transport, and must follow the declaration requirements described above. Restricted firearms are primarily handguns; however, pepper spray, mace, and some knives also are included in this category. A restricted firearm may be brought into Canada, but an Authorization to Transport permit must be obtained in advance from a Provincial or Territorial Chief Firearms Officer. Prohibited firearms include fully automatic, converted automatics, and assault-type weapons. Prohibited firearms are not allowed into Canada.
SPECIAL CIRCUMSTANCES: PORNOGRAPHY AND CONTROLLED SUBSTANCES: Canada has strict laws concerning child pornography, and in recent years there has been an increase in random checks of electronic media of travelers entering Canada. Computers are subject to search without a warrant at the border, and illegal content can result in the seizure of the computer as well as detention, arrest and prosecution of the bearer.

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 Canada’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Canada 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.
Canadian law prohibits the unlawful importation or trafficking of controlled substances and narcotics. A number of travelers, including Americans, have been arrested for attempting to smuggle khat, a narcotic from East Africa, into Canada. Smugglers risk substantial fines, a permanent bar from Canada and imprisonment.

Please also 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 living or traveling in Canada are encouraged to register with the U.S. Embassy or nearest U.S. Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within Canada. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is in Ottawa, Ontario, at 490 Sussex Drive, K1N 1G8, telephone (613) 238-5335, fax (613) 688-3082. The Embassy's consular district includes Ottawa, Easter Ontario (Kingston, Lanark, Leeds, Prescott, Refrew, Russell, and Stormont); and those parts of the Quebec Regions of Outaouais and Abitibi-Temiscamingues near Ottawa.
U.S. Consulates General are located at:
Calgary, Alberta, at 10th Floor, 615 Macleod Trail SE, telephone (403) 266-8962; emergency-after hours-to report the death or arrest of an American (403) 2 66 -8962 then press '0'; fax (403) 264-6630. The consular district includes Alberta, Manitoba, Saskatchewan, and the Northwest Territories, excluding Nunavut.
Halifax, Nova Scotia, at 1969 Upper Water Street, Suite 904, Purdy's Wharf Tower II, telephone (902) 429-2480; emergency-after hours-to report the death or arrest of an American (902) 429-2485; fax (902) 423-6861. The consular district includes New Brunswick, Newfoundland, Nova Scotia, Prince Edward Island and the French islands of Saint Pierre and Miquelon.

Montreal, Quebec, at 1155 St. Alexander Street, telephone (514) 398-9695; emergency-after hours-to report the death or arrest of an American (514) 981-5059; fax (514) 398-0702. The consular district includes Greater Montreal and the regions of Southern Quebec Province (Laurentides, Lanaudiere, Laval, Montreal, Montregie, Estrie, and the southern parts of Centre-du-Quebec); including Joliete, Drummondville and Sherbrooke.
Quebec City, Quebec, at 2 rue de la Terrasse Dufferin, telephone (418) 692-2095; emergency-after hours-to report the death or arrest of an American (418) 692-2096; fax (418) 692-4640. The consular district includes Quebec City and those regions of Quebec Province to the North and East of the Montreal and Ottawa Districts (indicated above), plus the Territory of Nunavut.

Toronto, Ontario, at 360 University Avenue, telephone (416) 595-1700; emergency-after hours-to report the death or arrest of an American (416) 201-4100; fax (416) 595-5466. The consular district includes the province of Ontario except the six counties served by the U.S. Embassy in Ottawa.

Vancouver, British Columbia, at 1095 West Pender Street, telephone (604) 685-4311; fax (604) 685-7175. The consular district includes British Columbia and the Yukon Territory.

All visa applicants are seen by appointment only. Information on visa appointments is available from www.nvars.com. Information on visa services for foreigners and consular/passport services for Americans who live in Canada is available from the U.S. Embassy web site. No visa or consular/passport information is available by calling the embassy or consulate switchboards.
* * *
This replaces the Country Specific Information for Canada dated December 11, 2007, to update sections on Entry/Exit Requirements, Crime, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu 22 Aug 2019
Source: The Canadian Jewish News [abridged, edited]

About 350 children in the Tosh Hasidic community north of Montreal have been vaccinated against measles, after 5 cases of the disease were confirmed there this summer (2019).

The 2nd of 2 temporary clinics set up by the public health authority within the community closed on [16 Aug 2019] after vaccinating at least 150 youngsters over 4 days, said Isaac Weiss, who is one of the people responsible for security and public safety in the community, which is located in the town of Boisbriand, Quebec. He said the 1st clinic took place about a month earlier, after "one suspected case" was discovered. About 200 children were vaccinated at that time. The immunization was offered to those whose medical records showed they were unvaccinated or not up to date, but was voluntary.

Community leaders are co-operating fully with the CISSS des Laurentides, which ran the clinics, said Weiss. The public health director, Dr Eric Goyer, said these were the 1st cases of measles in the region since 2011. There are about 500 Tosh families in Boisbriand, or 3000 people.
 
No one knows for sure how the infection spread. Weiss said it is thought that a young man from the community who went to New York to take part in a recreational after-school program may have contracted the virus and brought it back to Boisbriand. It appears that he had been vaccinated, but his shots were not up to date.
The community's leaders are informing members about the necessity of vaccinations and trying to dispel any fear about the risk of negative side effects. Unvaccinated children will not be permitted to attend the community's schools until the outbreak is deemed contained, Weiss said, but parents can only be persuaded, not forced, to vaccinate their children.

A father of 5 who asked that his name not be published, said, "We are outraged that there are parents -- a few -- who are so irresponsible as to refuse (vaccination). The rabbis are talking about it, everyone is talking about it, but some are difficult to convince."

Last spring (2019), when there was a serious measles outbreak in New York, Montreal public health authorities stepped up an educational campaign targeting ultra-Orthodox communities. While the rate of vaccination among those communities is believed to be similar to that of the general population, there is frequent contact between the Montreal and New York communities.

At the time, Rabbi Yonasan Binyomin Weiss, who serves as the chief rabbi of Montreal and heads the medical ethics committee of the Jewish Community Council, stated, "From a religious perspective, and also from an ethical and moral perspective, our message is very clear: families are required to follow the directions of the health authorities."

In April (2019), many Montreal doctors were among over 500 medical professionals serving Orthodox Jewish communities throughout North America who signed a public letter confirming the need for everyone to be vaccinated according to US Centers for Disease Control and Prevention guidelines. The doctors rejected "the dangerous misinformation campaign being spread and reject any unproven unscientific statements that contradict all available current science-based studies on vaccinations" against measles and other illnesses.  [byline: Janice Arnold]
Date: Fri, 2 Aug 2019 04:54:00 +0200 (METDST)
By Julien BESSET

King's Point, Canada, Aug 2, 2019 (AFP) - At dusk, tourists marvel at the sensational collapse of an iceberg at the end of its long journey from Greenland to Canada's east coast, which now has a front row seat to the melting of the Arctic's ice.   While the rest of the world nervously eyes the impact of global warming, the calving of Greenland's glaciers -- the breaking off of ice chunks from its edge -- has breathed new life into the remote coastal villages of Newfoundland and Labrador.

Once a hub of cod fishing, the province now plays host to hordes of amateur photographers and tourists hoping to capture the epic ice melt for posterity. As winter ends, iceberg spotting begins.   "It keeps getting better every year," says Barry Strickland, a 58-year-old former fisherman who now takes tourists in his small boat around King's Point in the north of the province.    "We've got 135, 140 tour buses with older people coming into the town every season so it's great for the economy."   For the past four years, Strickland has taken visitors to bear witness to the death throes of these ice giants, which can measure dozens of meters in height and weigh hundreds of thousands of tons.    Winds and ocean currents bring the icebergs from northwest Greenland, thousands of kilometers (miles) away, to Canada's shores.    In a matter of weeks, ice frozen for thousands of years can quickly melt into the ocean.

- 'Incredible' rise in tourism -
Strickland's boat excursions are often fully booked during the high season from May to July, with tourists coming from all around the world to King's Point, a village of just 600 inhabitants.   The villagers keep track of the icebergs on an interactive satellite tracking map put online by the provincial government.   "There's not much in these small outport towns anymore to keep people around, so tourism is a big part of our economy," said Devon Chaulk, who works in a souvenir shop in Elliston, a small town of 300 on "Iceberg Corridor," as the coastline is now known.   "I've lived here my entire life, and the increase in tourism around here in the past 10 to 15 years has been incredible. It's not surprising to have thousands of people here over the next couple of months," said the 28-year-old.    Last year, a total of 500,000 tourists visited Newfoundland and Labrador, a number roughly equivalent to the province's total population.    Those visitors spent nearly Can $570 million (US $433 million), government figures show.

- Melting ice -
The tourism boom has helped offset the decline in the region's traditional fishing industry, which is in crisis because of overfishing at the end of the last century.   Some are even marketing "iceberg water" as the purest on Earth -- and selling it as a high-end luxury item. The melt is also used in vodka, beer and cosmetics.    But beneath the shiny surface of economic success is the dark truth that the area is in part profiting from accelerated global warming in the Arctic, and that the industry is precarious at best.

In the village of Twillingate, employees at the Auk Island Winery -- which makes its product from iceberg water and locally picked wild berries -- have already seen that business can be unpredictable.   "We see the difference in the number of tourists from year to year, depending on the amount of icebergs in the area," says Elizabeth Gleason, who works at the winery.   "This year was a good year. Last year, we had almost none."   The Arctic is warming three times faster than the rest of the world. In mid-July, record temperatures were recorded near the North Pole.   In recent years, the icebergs have drifted further and further south, posing a threat to shipping on this busy route between Europe and North America.

For now, tourists are enjoying the view and the experience while they can.    "The prevalence of icebergs has good things and bad things about it," says Melissa Axtman, an American traveller.   Laurent Lucazeau, a 34-year-old French tourist, says seeing an iceberg was sobering.   "It is a concrete image of global warming to see icebergs making it to these places where the water is warm," he told AFP.   "There's something mysterious and impressive about it, but knowing too that they are not supposed to be here makes you wonder, and it's a little scary."
Date: Thu 1 Aug 2019
Source: CBC [abridged, edited]

Cristin Muecke, the deputy chief medical officer of health, is urging anyone who develops pneumonia-like or respiratory symptoms to promptly seek medical care.

There is an outbreak of Legionnaires' disease in the greater Moncton area, with 7 confirmed cases of the severe pneumonia in the past month, New Brunswick's deputy chief medical officer of health announced on Thursday [1 Aug 2019].

Public Health is working with "multiple partners" to investigate the source of the _Legionella_ bacteria, which can be found in both natural bodies of water and human-made water systems, such as large air-conditioning units, said Dr. Cristin Muecke.  [Byline: Bobbi-Jean MacKinnon]
======================
[Moncton, with a population of 71 889 residents (2016), is the largest city in the Canadian province of New Brunswick and the inland centre of the Maritime Provinces (New Brunswick, Nova Scotia, and Prince Edward Island); Greater Moncton, encompassing Moncton, and the towns of Riverview and Dieppe, has a population of 144,810 (<https://en.wikipedia.org/wiki/Moncton>).

A map showing the location of Moncton can be found at

Genotyping the clinical isolates of _Legionella_ from the 7 cases of Legionnaires' disease in the Greater Moncton area in the past month will help confirm whether this is a common source outbreak if the genotypes match. Matching the genotypes of clinical and environmental isolates of _Legionella_ will identify the environmental source for the individual cases. However, if the diagnosis of Legionnaires' disease was based only on a positive urinary antigen assay, there will be no clinical isolates for genotyping. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
New Brunswick Province, Canada: <http://healthmap.org/promed/p/269>]
Date: Tue 30 Jul 2019
Source: CBC [edited]

Three people are being treated for possible exposure to rabies after a rabid bat was found in their barn. It's the 1st time a rabid bat has been confirmed in Dufferin County in nearly 30 years. Wellington-Dufferin-Guelph Public Health officials said all 3 people that were exposed were part of the same family.

Health officials are reminding the public that if they come in contact with a bat indoors that they shouldn't touch it and should instead call a local animal control agency. Anyone who has direct contact with a bat should call their doctor or visit an emergency room. People who believe an animal is acting strangely should stay away from it, health officials added.

Rabies is a fatal virus that is spread by raccoons, skunks, foxes and bats through the saliva of an infected animal. That can happen through bites, scratches, open wounds or even mucous membranes near the mouth nose or eyes.

Health officials say rabid bats in Ontario are relatively rare. Last year [2018], 31 bats tested positive for rabies in Ontario. Since 2017, a total of 3 rabid bats have been found in the City of Guelph.
========================
[For information on bats as reservoirs of rabies in North America, go

Despite its ability to infect all mammals, rabies virus persists in numerous species-specific cycles that rarely sustain transmission in alternative species. Rabies viruses recovered from bats were shown to be distinct from rabies viruses recovered from terrestrial mammals, suggesting that these viruses evolved within their bat hosts. Genetic evidence suggests that rabies is an old disease for bats in the New World. Bats from most of the bat species in North America, when sampled in sufficient numbers, have been found to be infected with rabies virus.

Bat rabies viruses are genetically diverse, exhibiting mutations characteristic to each host bat species. It should be taken into account, however, that bat rabies can be transmitted to humans and their domestic animals, with infections almost always fatal unless treated. Also, a dog, cat or ferret infected with a bat rabid virus can infect a human. - ProMED Mod.PMB]

[HealthMap/ProMED-mail map:
Ontario Province, Canada: <http://healthmap.org/promed/p/260>]
Date: Mon 15 Jul 2019
Source: The Star Phoenix [edited]

A British Columbia man has died of a rare viral rabies infection, the 1st such case in the province since 2003. Provincial health officer Dr Bonnie Henry says the man was in contact with a bat in mid-May [2019] and developed symptoms compatible with rabies 6 weeks later. She says in a news release that while the exposure in this case was on Vancouver Island, bats in all areas of BC are known to carry rabies.

The Health Ministry is not releasing further information about the man to ensure privacy for his family. The news release says family members, close community contacts, and healthcare workers who cared for the man are being assessed and given post-exposure rabies preventative measures if needed. Overall in Canada, there have been only 24 known cases of viral rabies infections since the 1920s, and the most recent cases were in Ontario in 2012 and Alberta in 2007.

"If anyone in BC comes in contact with a bat (even if there is no obvious bite or scratch), wash the area with soap and water. Then consult a healthcare provider or local public health department immediately. They will assess the risk of rabies and may provide a vaccine to prevent infection," the release says. It adds that bats are the only known carriers of the rabies virus in the province, and about 13% of bats tested in BC are positive for rabies.

"This presents an ongoing risk for people and for companion animals, such as cats and dogs. It is important to ensure pets' rabies vaccinations are up-to-date. If you believe your pet has had contact with a bat, consult your veterinarian." [Livestock such as cattle and horses are also at risk. There are vaccines for these animals as well. - ProMED Mod.TG]
======================
[HealthMap/ProMED-mail map of Vancouver Island, British Columbia,
More ...

World Travel News Headlines

Date: Mon, 16 Sep 2019 08:19:07 +0200 (METDST)

Tokyo, Sept 16, 2019 (AFP) - Almost 80,000 homes are still without power a week after a powerful typhoon battered eastern Japan, authorities said Monday, with sustained heavy rain prompting evacuation orders and hampering recovery efforts.    Typhoon Faxai powered into the Tokyo region in the early hours of Monday last week, packing record winds that brought down power lines, disrupted Rugby World Cup preparations and prompted the government to order tens of thousands of people to leave their homes.

The storm killed two people, with at least three elderly later confirmed dead due to heatstroke as temperatures soared to above 35 degrees Celsius (95 degrees Fahrenheit) in areas affected by a post-typhoon blackout.   Some 78,700 households were still without power in Chiba, southeast of the capital, Tokyo Electric Co. (TEPCO) spokesman Naoya Kondo told AFP.   "A complete recovery is still unlikely until September 27 as we have difficulties in mountain areas," he added.   Some 16,700 households were also without water because several water purification plants had no power, a local official said.   With help from the military, officials were dispatching water tanker trucks to the affected areas.

The national weather agency Monday issued new warnings for heavy rain in Chiba, while local authorities issued non-compulsory evacuation orders to 46,300 people due to the risk of landslides.   "A delay in recovery work is expected due to heavy rain," said Kenta Hirano, a disaster management official in Futtsu in Chiba, where more than 1,000 houses were damaged by the typhoon.   Local media showed residents in Chiba hurriedly covering broken roofs with blue tarps.   "We are at a loss as we can't live there again," a 66-year-old man told public broadcaster NHK after the typhoon ripped off the roof of his house.
Date: Sun, 15 Sep 2019 15:38:29 +0200 (METDST)

Athens, Sept 15, 2019 (AFP) - More than 160 firefighters on Sunday battled to contain a large fire near Athens blazing for a second day amid gale force winds, officials said.   And in another emergency, authorities evacuated dozens of people from two villages and a hotel on the island of Zakynthos after a new fire broke out on Sunday.

The fire department said the blaze near Athens burned in the mountains above Loutraki, a coastal resort some 60 kilometres (35 miles) west of Athens.   "The fire is burning near the top of the mountain," Stefanos Kolokouris, the fire department's deputy chief of operations, told state TV ERT.   "We are trying to create a perimeter but the terrain is very difficult, with ravines," he said.   Four water bombers and six helicopters were participating in operations. Given a lack of roads in the area, two squads of firefighters had to be carried to the mountaintop by Super Puma helicopter, state agency ANA said.   Officials had already evacuated 50 people from a local monastery when the fire broke out on Saturday, but stressed that other inhabited areas were not in danger.

On Zakynthos, officials ordered the evacuation of the villages of Agalas and Keri in the south of the island. Some 120 tourists were also relocated to a safe area.   The Greek fire department on Sunday said it had been called to nearly 80 fires over the past 24 hours.   It has already faced more than 9,600 rural and urban fires this year.
Date: Sat, 14 Sep 2019 16:08:47 +0200 (METDST)

Singapore, Sept 14, 2019 (AFP) - Pollution from forest fires in Indonesia pushed Singapore's air quality to unhealthy levels for the first time in three years on Saturday, the government said, a week ahead of the Formula One night race in the city.   The toxic smoke caused by burning to clear land for plantations is an annual problem for Indonesia's neighbours, but has been worsened this year by particularly dry weather.   "There has been a deterioration in the haze conditions in Singapore this afternoon," the National Environment Agency (NEA) said in a statement.   "This was due to a confluence of winds over the nearby region that led to more smoke haze from Sumatra being blown toward Singapore," it said, referring to one of the Indonesian islands where fires are raging.

The NEA said the pollutant standards index (PSI) worsened to 112 in parts of the island Saturday night.   An index reading between 101-200 is considered unhealthy, with residents advised against doing prolonged strenuous exercises outdoors.   Singapore may continue to experience hazy conditions over the next few days, the agency warned.   The city-state of 5.6 million people was shrouded in a thin white haze, with a few residents seen wearing face masks, but there was no major disruption to daily activities.   The F1 race is scheduled from Friday to Sunday on a street circuit in the Marina Bay financial district.

Singapore GP, the Formula One organisers, said the possibility of haze is one of the potential issues covered in their contingency plan for this year's grand prix.   "The plan was formulated and refined with stake holders, government bodies and the Formula One community," Singapore GP said in an emailed statement.   "In the event that the haze causes visibility, public health or operational issues, Singapore GP would work closely with the relevant agencies before making any collective decisions regarding the event."

Neighbouring Malaysia has also been affected by the smoke, with air quality in parts of the country including the capital Kuala Lumpur reaching unhealthy levels over the past few days and triggering a diplomatic row with Jakarta.   In 2015, the index reached "hazardous" levels of more than 300 in Singapore, forcing the closure of schools. Indonesian forest fires were the worst in two decades that year, firing up smog that blanketed large parts of Southeast Asia for weeks.
Date: Sat, 14 Sep 2019 11:16:53 +0200 (METDST)

Bangkok, Sept 14, 2019 (AFP) - Floods in northeastern Thailand have submerged homes, roads and bridges, leaving more than 23,000 people in evacuation shelters as anger grows over the government's "slow" emergency response.   Torrential rain has lashed the country for the last two weeks, causing flash floods and mudslides in almost half its provinces, with families evacuated from their homes in boats or makeshift rafts.   Since August 29, 32 people have been killed in the deluge, said a statement from the disaster department on Saturday that also gave the number of people staying in emergency shelters.   Two weather events are behind the widespread floods, the department said -- Storm Podul and a tropical depression that formed over the South China Sea called Kajiki.

Local media reports from the worst-hit province of Ubon Ratchathani showed people wading through chest-deep water and rescuers in boats trying to steer buffalo to higher ground.   Flooding in the province, which borders Laos and Cambodia, has been exacerbated by rising water levels in the Moon and Chi rivers.   "It will take three weeks to drain the floodwater" from up to 90 percent of inundated households, said provincial governor Sarit Witoon.   "The water has slightly receded about four centimetres today and I think it will keep going down," he added.

But the situation is already "unlivable" for families in one-storey homes, said Pongsak Saiwan, local director of opposition party Future Forward.   Access to an entire district is currently cut off due to flood waters, which are about two metres (6.5 foot) deep in the main town, while three major bridges are "impassable", he said.   "The government has been very slow in responding to the situation since the floods started in the beginning of September," Pongsak told AFP.   Ubon Ratchathani's plight started trending on Twitter this week with the hashtag #SaveUbon.   Aerial shots of the flood-hit plains blanketed with muddy river water were widely shared, as well as photos of stray dogs being rescued by passing boats.

One Twitter user compared the flood response to how quickly the government had mobilised and saved 12 young boys and their football coach from a waterlogged cave last year -- an incident that catapulted Thailand to international attention.   "Only 13 lives stuck in the cave and it was still very high-profile, but this is hundreds of thousands of lives," tweeted Yosita8051. "It's not okay."   Thailand's junta leader-turned-premier Prayut Chan O-Cha tweeted on Saturday that he has told agencies to "expedite assistance" to those in the affected areas.
Date: Fri, 13 Sep 2019 16:44:33 +0200 (METDST)

Niamey, Sept 13, 2019 (AFP) - Niger launched a campaign on Friday to vaccinate more than four million children against measles, one of the biggest causes of child mortality in the country, the health ministry said.

The one-week nationwide vaccination programme aims to "eliminate measles by the end of 2020", Health Minister Illiassou Mainassara said, adding, it "will reach 4.254 million children" aged from 9 months up to the age of five.   "Despite all the efforts made in the fight against communicable diseases, we still note the persistence of localised measles epidemics (in Niger)," Mainassara said on his way to the capital Niamey to launch the campaign.    But some experts say the vaccination programme should have kicked in sooner    "The delay of this campaign which should have happened in 2018 has resulted in ...the emergence of epidemics in several health districts," said Niger's UNICEF representative, Felicite Tchibindat.

Since January this year, 9,741 suspected cases have been documented in Niger resulting in 53 deaths, she said.   "Measles is a serious and extremely contagious viral disease and remains one of the leading causes of early childhood death, while it can be prevented by vaccination," TchibiNdat said.    She believes the children of migrants, refugees and displaced people will especially benefit from the campaign.    Niger's vaccination programme is supported by the World Health Organization (WHO), UNICEF (United Nations Children's Fund) and the Gavi vaccine Alliance.
Date: Fri, 13 Sep 2019 16:08:16 +0200 (METDST)

Nairobi, Sept 13, 2019 (AFP) - Kenya on Friday became the third country to start routinely innoculating infants against malaria, using the world's first vaccine to combat a disease that kills 800 children globally every day.   The vaccine -- lab name RTS,S -- targets the deadliest and most common form of malaria parasite in Africa, where children under five account for two-thirds of all global deaths from the mosquito-born illness.

Kenya joins Malawi and Ghana, which commenced their own pilot programs for the vaccine supported by the World Health Organization (WHO) earlier this year.   The vaccine will be introduced in phases across malaria-endemic parts of western Kenya near Lake Victoria, starting with Homa Bay, the country's health ministry said.   "It's an exciting time for Kenya as we roll out this vaccine in parts of the country where the burden of malaria is the highest," Health Minister Sicily Kariuki said in a statement.   RTS,S will be added to the national immunisation schedule in these areas, given alongside other routine shots for children under two.

The health ministry said 120,000 Kenyan children were expected to be vaccinated under the pilot programme.   The country has distributed insecticide-treated mosquito nets, fumigated homes and improved diagnostics in its fight against malaria.   But the disease remains stubborn. The health ministry says malaria claimed more than 10,000 lives in 2016, and infected millions more.   As in the rest of the world, children in Kenya bear the brunt of the disease.    Up to 27 percent of Kenyan children under five have been infected with the disease, the health ministry said.   "This vaccine represents an additional tool that will boost Kenya's efforts in reducing malaria infections and deaths among children," Kariuki said.   WHO says a child dies roughly every two minutes from malaria somewhere in the world.

- 30 years in making -
Known under its commercial name as Mosquirix, the vaccine was developed over 30 years by British pharmaceutical giant GlaxoSmithKline in partnership with nonprofit PATH and African research institutes.   It is the only vaccine to date to show a protective effect against malaria in young children, WHO says.   It acts against Plasmodium falciparum, the deadliest malarial parasite and the most prevalent in Africa, where illness and death from the disease remain high despite some gains.   The shots, administered over four doses, have been shown in clinical trials to significantly reduce cases of malaria, and malaria-related complications, in young children.   The vaccine prevented about four in 10 cases of malaria and three in 10 cases of the most severe, life-threatening form of the disease, within the trial group, WHO says.

Evidence gained from the vaccine pilot schemes could guide decisions about whether RTS,S is rolled out more widely in future, WHO says.   "This is the most advanced malaria vaccine that we have today. It has been in the making for the last almost three decades," Dr Richard Mihigo, WHO's co-ordinator of immunisation and vaccine development programme, told AFP before the Kenyan launch.   "Children are the most vulnerable group to this severe disease that is malaria, so protecting children can make a big impact in preventing malaria."   The disease kills more than 400,000 people around the world every year. Of these about 290,000 are under five.    Most are in Africa, where more than 90 percent of the world's malaria cases -- and fatalities -- occur.
Date: Fri, 13 Sep 2019 11:40:02 +0200 (METDST)

London, Sept 13, 2019 (AFP) - British Airways has cancelled all its scheduled UK flights for September 27, when company pilots will again strike in a long-running row over pay.   It comes after the carrier cancelled all flights departing and arriving in the UK on Monday and Tuesday owing to BA's first strike by pilots in the company's 100-year history.

In a statement released late Thursday, BA called on the British Airline Pilots Association (BALPA) union "to call off their strike and return to negotiations".    The airline added: "We are very sorry that BALPA's actions will affect thousands more travel plans."   This week's strike sparked travel chaos for about 200,000 passengers, mostly using London's Gatwick and Heathrow airports.   BALPA estimates that the 48-hour strike cost the airline £80 million ($99 million, 89 million euros), but BA has yet to provide a figure.
Date: Tue, 10 Sep 2019 13:02:19 +0200 (METDST)

Khartoum, Sept 10, 2019 (AFP) - Sudan reported four confirmed cases of cholera in Blue Nile Tuesday and said three people had also died of acute diarrhoea in the war-torn state.   Health Minister Akram al-Toum has asked the World Health Organization to send supplies of cholera vaccine immediately, the ministry said.

Ministry and WHO officials have been sent to the affected area.   "There are 37 cases of acute diarrhoea in Blue Nile... There have been three deaths," the ministry said in a statement.   Dozens of people died from acute diarrhoea in Sudan in 2016 after thousands of cases were reported nationwide.   Blue Nile state, which has a large ethnic minority population, has been the focus of a rebellion by the Sudan People's Liberation Army-North since 2011.   The army declared a ceasefire after the  overthrow of veteran president Omar al-Bashir earlier this year.
Date: Sat 14 Sep 2019
Source: Vax Before Travel [edited]

A new report from Japan's National Institute of Infectious Disease (NIID) indicates the Rubella virus outbreak continues to spread. As of [4 Sep 2019], there have been 2156 Rubella cases reported by the NIID during 2019.

This is an increase of about 260 rubella cases in Japan since July 2019. On a local basis, the city of Tokyo has reported 37% of Japan's 2019 Rubella cases.

Since Rubella is very dangerous for a pregnant woman and her developing baby, the US Centers for Disease Control and Prevention (CDC) said on [7 Aug 2019], "pregnant women who are not protected against rubella through either vaccination or previous rubella infection, should not travel to Japan during this outbreak."

But, pregnant women should not get a Rubella vaccination with the measles-mumps-rubella (MMR) says the CDC. This is because the MMR vaccine is an attenuated "live virus" vaccine.

The CDC says "pregnant women who are not vaccinated should wait to get [the] MMR vaccine until after they have given birth. And, women of childbearing age should avoid getting pregnant for at least 4 weeks after receiving the MMR vaccine."

Additionally, the CDC says "if a pregnant woman contracts the rubella virus, her baby could have birth defects such as deafness, cataracts, heart defects, mental disabilities, and organ damage."

And, when a rubella infection occurs during early pregnancy, serious consequences, such as miscarriages, stillbirths, and severe birth defects in infants, which are known as Congenital Rubella Syndrome (CRS), [may result].

This new NIID report indicates there have been 3 CRS cases in Japan during 2019. As a comparison, during 2005-2015 in the USA, only 8 babies with CRS were reported.

Moreover, [fewer] than 10 people in the USA are reported as having rubella each year. Since 2012, all rubella cases had evidence that they were infected when they were living or traveling outside the USA.

To alert international travellers, the CDC issued a Level 2 Travel Alert regarding Japan's ongoing Rubella virus outbreak in August 2019. This "Practice Enhanced Precautions" Travel Alert says "travellers to Japan should make sure they are vaccinated against rubella with the MMR vaccine before visiting Japan." This CDC Travel Alert is important since approximately 4.5 million US citizens visit Japan annually.

Additionally, the Public Health Agency of Canada and the UK Foreign Travel Advice recommend "pregnant women who are not protected against rubella avoid traveling to Japan."

In the USA, there are 2 approved rubella vaccines: MMR II-Rubella and ProQuad. Both rubella vaccines are available at most pharmacies. Travelers to Japan can request a rubella vaccine counselling appointment with a local pharmacist.

Rubella vaccines, like any medicine, can produce side effects. [People] are encouraged to report vaccine side effects to a healthcare provider or the CDC.  [Byline: Dani Reiter]
========================
[See discussion of rubella in ProMED-mail Rubella - Japan (02)

[HealthMap/ProMED-mail map:
Date: Tue 10 Sept 2019
Source: Focus Taiwan [edited]

Taiwan's enterovirus cases continued to increase last week, bringing the total number to nearly 20 000 between [1 and 7 Sep 2019], the Centers for Disease Control (CDC) said Tuesday [10 Sep 2019].

A total of 19 254 patients sought outpatient or emergency treatment at hospitals for enterovirus infection around the country, up 4% from the figure recorded the previous week [25-31 Aug 2019] and the highest over the same period in nearly 5 years, according to CDC data.

CDC physician Lin Yung-ching said there were 2 severe cases recorded last week, one of which involved an 8-month-old girl and the other a 4-year-old boy, both in central Taiwan. The 2 children were reported in stable condition after treatment.

Some of the 2 patients' family members or classmates with whom they had had contact have also been confirmed as enterovirus cases, and the CDC judged that the infection might have been spread through contact, Lin said.

A total of 303 cases of enterovirus-71 (EV-71), the most severe enterovirus strain, have been reported so far this year [2019], the highest in the same period from 2016 to 2018.

Meanwhile, a total of 36 cases with severe complications have been recorded nationwide, including 27 EV-71 cases, according to CDC statistics.

EV-71 is a neurological disease that attacks the nervous system, and infants under the age of 5 are at highest risk of developing severe complications from this type of infection.

In extreme cases, EV-71 can cause polio-like permanent paralysis, according to the CDC. As Taiwan is still in the peak season for enterovirus infection, CDC Deputy Director-General Philip Lo urged the public to take precautions against the spread of the illness, especially among children.

Children infected with enterovirus should be kept away from school so as to prevent the spread of the disease, as enterovirus is highly contagious, Lo advised.  [Byline: Chen Wei-ting and Evelyn Kao]
=====================
[The enteroviruses are spread from person to person by coughs, sneezes, or touching objects or surfaces that have the virus on them. Therefore, practicing good personal hygiene -- washing hands regularly and thoroughly with soap and water -- is the best way to prevent from getting and spreading the infectious disease.

However, most people infected with non-polio enteroviruses do not get sick, or present with mild illness, like the common cold. Infants, children, and teenagers are more likely than adults to get infected and become sick because they do not yet have immunity (protection) from previous exposures to the viruses. Adults can get infected too, but they are less likely to have symptoms, or their symptoms may be milder. Symptoms of mild illness may include fever; runny nose, sneezing, and cough; skin rash; mouth blisters; and body and muscle aches.

Some non-polio enterovirus infections can lead to:
- Viral conjunctivitis;
- Hand-foot-mouth disease;
- Viral meningitis (infection of the covering of the spinal cord and/or brain);
- Viral encephalitis (infection of the brain);
- Myocarditis (infection of the heart);
- Pericarditis (infection of the sac around the heart);
- Acute flaccid paralysis (a sudden onset of weakness in one or more arms or legs);
- Inflammatory muscle disease (slow, progressive muscle weakness).

Infants and people with weakened immune systems have a greater chance of having these complications. People who develop myocarditis may have heart failure and require long-term care. Some people who develop encephalitis or paralysis may not fully recover.

Enterovirus cases were reported from Taipei, Taiwan in 2017 (Human enterovirus - Taiwan: alert http://promedmail.org/post/20170418.4978387), and health alerts like the one mentioned in report above were issued to the general public to observe proper hygiene to reduce disease transmission. Also the case number for EV-71 associated severe disease has also increased, which is a cause for public health concern. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map: