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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Tue, 24 Sep 2019 07:27:34 +0200 (METDST)

Miami, Sept 24, 2019 (AFP) - A strong 6.0 magnitude struck off the northwest coast of Puerto Rico late Monday, the United States Geological Survey said, although no casualties or damage were reported.   The quake struck 62km northwest of San Antonio at 11:23 pm local time (03:20 GMT) at a depth of 10km, the agency said.  San Antonio is home to Rafael Hernandez Airport, a key air link to the mainland US.    In 2010 nearby Haiti was struck by a devastating 7.0 magnitude earthquake that killed more than 250,000 people and crippled the nation's infrastructure.
Date: Mon, 12 Feb 2018 05:54:19 +0100

San Juan, Feb 12, 2018 (AFP) - Most of San Juan and a strip of northern Puerto Rico municipalities were plunged into darkness Sunday night after an explosion at a power station, five months after two hurricanes destroyed the island's electricity network.

The state electric power authority (AEE) said the blast was caused by a broken-down switch in Rio Piedras, resulting in a blackout in central San Juan and Palo Seco in the north.   "We have personnel working to restore the system as soon as possible," the AEE said.   San Juan's mayor, Carmen Yulin Cruz, said on Twitter that emergency services and local officials attended the scene in the neighbourhood of Monacillos, but no injuries were reported.

Meanwhile, the Puerto Rican capital's airport said it was maintaining its schedule using emergency generators.   The blackout comes as nearly 500,000 of AEE's 1.6 million customers remain without power since Hurricanes Irma and Maria struck the US territory in September 2017.   AEE engineer Jorge Bracero warned on Twitter that the outage was "serious," and advised those affected that power would not be restored until Monday.
Date: Wed, 13 Dec 2017 03:08:12 +0100
By Leila MACOR

Fajardo, Puerto Rico, Dec 13, 2017 (AFP) - Until Hurricane Maria hit Puerto Rico, Jose Figueroa did brisk business renting kayaks to tourists itching to see a lagoon that lights up by night thanks to millions of microorganisms.   Today, things are so dire he's considering selling water to motorists stopped at red lights.   "Now we are trying to survive," the 46-year-old tour guide said.

It used to be that visitors had to reserve a month in advance to get one of his kayaks and paddle around in the dark on the enchanting, bioluminescent body of water called Laguna Grande.   But tourists are scarce these days as the Caribbean island tries to recover from the ravages of the storm back in September.   "We do not know if we will have any work tonight," Figueroa said. "Last week, we worked only one day."    He and another employee of a company called Glass Bottom PR are cleaning kayaks on the seaside promenade of Fajardo, a tourist town in eastern Puerto Rico whose main attraction is the so-called Bio Bay.

The year started off well for Puerto Rico, with the global success of the song "Despacito" by local musicians Luis Fonsi and Daddy Yankee.   The catchy tune helped promote the US commonwealth island of 3.4 million people, which is saddled with huge debts and declared bankruptcy in May.    But the hurricane turned what should be an island bustling with tourists into one with deserted beaches, shuttered restaurants and hotels full of mainland US officials working on the rebuilding of the island.   "What few tourists we have are the federal officials themselves," said Figueroa.

- Locals only -
The grim outlook spreads up and down the seaside promenade of Fajardo, where many restaurants are closed because there is no electricity.   On this particular day around noon, the only restaurant open is one called Racar Seafood. It has its own emergency generator.   "We get by on local tourists," said its 61-year-old owner, Justino Cruz.   "Our clients are local -- those who have no electricity, no generator, cold food or no food."

Puerto Rico's once-devastated power grid is now back up to 70 percent capacity, but this is mainly concentrated in the capital San Juan.   So while inland towns that depend on tourism are struggling mightily, things are getting better in San Juan as cruise ships are once again docking.   On November 30, the first cruise ship since the storm arrived with thousands of vacationers on board. They were received with great fanfare -- quite literally, with trumpet blaring and cymbals crashing.

- Pitching in to help -
The World Travel & Tourism Council, based in London, says tourism accounted for about eight percent of Puerto Rico's GDP in 2016, or $8.1 billion.   Hurricane Maria's damage has been uneven. Although some tour guides now have no work and many eateries are shut down, hotels that have their own generators are doing just fine.   Thanks to the thousands of US government officials and reconstruction crew members that came in after the storm, the hotels that are open -- about 80 percent of the total -- are pretty much full.

These people are starting to leave the island this month but hotels may receive tourists around Christmas, at least in San Juan, where power has for the most part been restored.   The hurricane "undoubtedly cost billions in lost revenue," said Jose Izquierdo, executive director of the Puerto Rico Tourism Company.    But Izquierdo nevertheless says he is "optimistic" and suggests an alternative: put tourists to work as volunteers in the gargantuan reconstruction effort that the island needs.   "We want to look for travellers who want to travel with a purpose, who might have the commitment to help rebuild," said Izquierdo.

The program, called "Meaningful Travel" and launched in mid-November, organizes trips on which residents, Puerto Ricans living abroad and tourists are invited to help the island get back on its feet.   "The plan aims to create empathy with this tourist destination," said Izquierdo.    "We want to be like New Orleans after Katrina, where 10 years after the hurricane, tourism is the driving force of its economy. We want to build that narrative of recovery," he added.   "There are different ways in which the world wants to help Puerto Rico. The best way is to visit us."
Date: Thu, 9 Nov 2017 12:39:04 +0100
By Marcos PÉREZ RAMÍREZ

San Juan, Nov 9, 2017 (AFP) - Andrea Olivero, 11, consults her classmate Ada about an exercise during their daily English class at San Juan's Sotero Figueroa Elementary School. The task: list the positive and negative aspects of Hurricane Maria's passing almost two months ago.

The girls only have to look around. There is no electricity and they "roast" in the heat, Andrea says. At the back of the room, computers and televisions collect dust.   "We would like to move past the topic of the hurricane a bit. It is already getting repetitive," Andrea told AFP.   She is one of more than 300,000 pupils in the public education system, although only half of schools are functioning. Barely 42 per cent of Puerto Ricans have electricity seven weeks after Maria struck, killing at least 51 in the American territory.

The lack of power has prompted disorienting timetable changes on the tropical island, to avoid both the hottest hours of the day and the use of dining facilities.   "The children are very anxious. We manage to make progress in lessons and they change the hours again. Everything is messed up and we fall behind," English teacher Joan Rodriguez explained.   "We can't use the computers to illustrate classes," she said. "They are reading the novel "Charlotte's Web," and we wanted to do exercises comparing it to the film version. But we cannot use the television.

- Suspicions -
From October 23, some directors reopened their schools in the western region of Mayaguez and San Juan.   But last Thursday, the Department of Education ordered their closure, insisting they must be evaluated by engineering and architectural firms, then certified by the US Army Corps of Engineers.   One of those schools was Vila Mayo, also in San Juan. The community presumed it would open, as it had been used as a shelter, its electrical infrastructure had been inspected and it had not suffered structural damage.

But Luis Orengo, the education department's director in San Juan, told protesters outside the school it was closed as inspectors' findings had not reached the central government.   "This is unacceptable! The school is ready to give classes but they don't want to open it. Our children cannot lose a year," fumed Enid Guzman, who protested with her 11-year-old son, Reanny De la Cruz.   There are suspicions the stalled reopening of schools is, in part, related to the prior closure of 240 schools over the past year during Puerto Rico's long-running financial crisis.   The fiscal difficulties have seen the island's population drop over the past decade by 14 percent, leading in turn to a fall in school enrolment.

Before the storms, 300 schools were at risk of closure -- and for the president of Puerto Rico's federation of teachers, Mercedes Martinez, the government's aim is clear.   "Secretary (Julia) Keleher seems to have an orchestrated plan to close schools," she said, referring to the education secretary. "Why do you have to wait 30 days to get a certification so a school can open?"   Keleher has announced she expects most schools to be open by the middle of November.
Date: Tue 24 Oct 2017
Source: KFOR Oklahoma News4 [edited]

Puerto Rico has reported at least 76 cases of suspected and confirmed leptospirosis, including a handful of deaths, in the month after Hurricane Maria, said Dr. Carmen Deseda, the state epidemiologist for Puerto Rico.

Two deaths involved leptospirosis confirmed through laboratory testing, and "several other" deaths are pending test results, Deseda said. The 76 cases, up from 74 last week, also include one patient with confirmed leptospirosis who is currently hospitalized.

The island typically sees between 63 and 95 cases per year, she said. Health officials had expected that there would be a jump after the hurricane. "It's neither an epidemic nor a confirmed outbreak," Public Affairs Secretary Ramon Rosario Cortes said at a news conference Sunday [22 Oct 2017]. "But obviously, we are making all the announcements as though it were a health emergency."

Leptospirosis may be treated with antibiotics, but many people recover on their own. "The majority of leptospirosis cases is a mild, subclinical disease with no complications," Deseda said. "But one out of 10 people who have leptospirosis develop severe illness." In the 1st stage of leptospirosis, symptoms vary widely from fever and headache to red eyes and rashes. Some people may have no symptoms at all. But a small number will develop dire complications: meningitis, kidney and liver damage, bleeding in the lungs and even death.

Doctors are required to report any potential leptospirosis cases to health authorities, Deseda said. Those cases must then be tested to confirm the bacteria, since the symptoms can be difficult to tell apart from other illnesses. After that, health officials may look for patterns or clusters and determine whether there is an outbreak.

The lab tests on the suspected cases have been sent to the US Centers for Disease Control and Prevention, Deseda said. The turnaround time is about 5-6 days.

Doctors on the island have expressed concerns about burgeoning health crises amid hospitals that are overwhelmed, undersupplied and sometimes burning hot. Influenza is another concern on the horizon, Deseda said. Drinking water is also hard to come by on many parts of the island.

Dr. Raul Hernandez, an internist in San Juan, told CNN that people were drinking water from whatever sources they could find, such as rivers and creeks. If that water contains urine from a [leptospirosis-infected rat], those people will be at risk, he said.

Deseda said people should be discouraged from walking barefoot, drinking or swimming in potentially leptospirosis-contaminated waters.

"These diseases are everywhere, and there's a way to prevent them," she said.
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[Leptospirosis is a zoonotic, spirochetal infection that occurs worldwide and is transmitted to humans by exposure to soil or fresh water contaminated with the urine of wild and domestic animals (including dogs, cattle, swine, and especially rodents) that are chronically infected with pathogenic _Leptospira_. _Leptospira_ may survive in contaminated fresh water or moist soil for weeks to months. Outbreaks of leptospirosis frequently follow heavy rainfall, flooding with fresh water, and increasing rodent numbers.

Parts of Puerto Rico saw more than 30 inches of rain and consequent flooding with recent Hurricane Maria. A map showing the estimated rainfall across Puerto Rico with this hurricane is available at <https://twitter.com/NWSSanJuan/status/910983698597777409/photo/1?ref_src=twsrc%5Etfw&ref_url>.

With continued absence of potable water, inadequate sanitation, and flooding in the streets for a large proportion of the population in Puerto Rico, food- and water-borne diseases, like leptospirosis, will be a major problem. - ProMED Mod.ML]

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

Benin - US Consular Information Sheet
April 28, 2008

COUNTRY DESCRIPTION:
Benin is a developing country in West Africa. Its political capital is Porto Novo. However, its administrative capital, Cotonou, is Benin's largest city and the
site of most government, commercial, and tourist activity. Read the Department of State Background Notes on Benin for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are required. Visas are not routinely available at the airport. Visitors to Benin should also carry the WHO Yellow Card (“Carte Jaune”) indicating that they have been vaccinated for yellow fever. Contact the Embassy of Benin for the most current visa information. The Embassy is located at: 2124 Kalorama Road NW, Washington, DC 20008; tel: 202-232-6656.

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:
U.S. citizens should avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.
U.S. citizens should not walk on the beach alone at any time of day. It is also highly recommended not to carry a passport or valuables when walking in any part of the city. Travelers should carry a notarized photocopy of the photo page of their passport (see Crime section). They should not walk around the city after dark, and should take particular care to avoid the beach and isolated areas near the beach after dark.
The ocean currents along the coast are extremely strong and treacherous with rough surf and a strong undertow, and several people drown each year.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME: Street robbery is a significant problem in Cotonou. Robbery and mugging occur along the Boulevard de France (the beach road by the Marina and Novotel Hotels) and on the beaches near hotels frequented by international visitors. Most of the reported incidents involve the use of force, often by armed persons, with occasional minor injury to the victim. Travelers should avoid isolated and poorly lit areas and should not walk around the city or the beaches between dusk and dawn. Even in daylight hours, foreigners on the beach near Cotonou are frequent victims of robberies. When visiting the beach, travelers should not bring valuables and should carry only a photocopy of their passport. If you are a victim of crime, you should contact the U.S. Embassy immediately. There has been a continued increase in the number of robberies and carjacking incidents after dark, both within metropolitan Cotonou and on highways and rural roads outside of major metropolitan areas. Motorists are urged to be wary of the risk of carjacking. Keep the windows of your vehicle rolled up and the doors locked. Stay alert for signs of suspicious behavior by other motorists or pedestrians that may lead to carjacking, such as attempts to stop a moving vehicle for no obvious reason. Travelers should avoid driving outside the city of Cotonou after dark and should exercise extreme caution when driving in Cotonou after dark (see Traffic Safety and Road Conditions below). Overland travel to Nigeria is dangerous near the Benin/Nigeria border due to unofficial checkpoints and highway banditry.
Travelers should avoid the use of credit cards and automated teller machines (ATMs) in Benin due to a high rate of fraud. Perpetrators of business and other kinds of fraud often target foreigners, including Americans. While such fraud schemes in the past have been largely associated with Nigeria, they are now prevalent throughout West Africa, including Benin, and are more frequently perpetrated by Beninese criminals. Business scams are not always easy to recognize, and any unsolicited business proposal should be carefully scrutinized. There are, nevertheless, some indicators that are warnings of a probable scam. Look out for:

Any offer of a substantial percentage of a very large sum of money to be transferred into your account, in return for your "discretion" or "confidentiality";

Any deal that seems too good to be true;
Requests for signed and stamped, blank letterhead or invoices, or for bank account or credit card information;
Requests for urgent air shipment, accompanied by an instrument of payment whose genuineness cannot immediately be established;
Solicitations claiming the soliciting party has personal ties to high government officials;
Requests for payment, in advance, of transfer taxes or incorporation fees;
Statements that your name was provided to the soliciting party either by someone you do not know or by "a reliable contact";
Promises of advance payment for services to the Beninese government; and
Any offer of a charitable donation.
These scams, which may appear to be legitimate business deals requiring advance payments on contracts, pose a danger of both financial loss and physical harm. Recently more American citizens have been targeted. The perpetrators of such scams sometimes pose as attorneys. One common ploy is to request fees for “registration” with fictitious government offices or regulatory authorities. The best way to avoid becoming a victim of advance-fee fraud is common sense – if it looks too good to be true, it probably is. Travelers should carefully check out any unsolicited business proposal originating in Benin before committing any funds, providing any goods or services, or undertaking any travel. For additional information, please see the Department of State’s Bureau of Consular Affairs brochure, International Financial Scams.

Scams may also involve persons posing as singles on Internet dating sites or as online acquaintances who then get into trouble and require money to be "rescued." If you are asked to send money by someone you meet online please contact the U.S. Embassy before doing so.

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.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Benin are limited and not all medicines are available. Travelers should bring their own supplies of prescription drugs and preventive medicines. Not all medicines and prescription drugs available in Benin are USFDA-approved. Malaria is a serious risk to travelers to Benin. For information on malaria, its prevention, protection from insect bites, and anti-malarial drugs, please visit the CDC Travelers' Health web site at http://www.cdc.gov/malaria/.

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 website 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 Benin is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

With the exception of the road linking Cotonou in the south to Malanville on the border with Niger in the north, and from Parakou in central Benin to Natitingou in the northwestern part of the country, roads in Benin are generally in poor condition and are often impassable during the rainy season. Benin's unpaved roads vary widely in quality; deep sand and potholes are common. During the rainy season from mid-June to mid-September, dirt roads often become impassable. Four-wheel drive vehicles with full spare tires and emergency equipment are recommended.
Most of the main streets in Cotonou are paved, but side streets are often dirt with deep potholes. Traffic moves on the right, as in the United States. Cotonou has no public transportation system; many Beninese people rely on bicycles, mopeds, motorbikes, and zemidjans (moped taxis). All official Americans are required to wear safety helmets when on a motorcycle and are strongly discouraged from using zemidjans. Travelers using zemidjans, particularly at night, are much more vulnerable to being mugged, assaulted or robbed. Buses and bush taxis offer service in the interior.
Gasoline smuggled from Nigeria is widely available in glass bottles and jugs at informal roadside stands throughout Cotonou and much of the country. This gasoline is of unreliable quality, often containing water or other contaminants that can damage or disable your vehicle. Drivers should purchase fuel only from official service stations. There are periodic gas shortages, which can be particularly acute in the north of the country where there are few service stations.
U.S. citizens traveling by road should exercise extreme caution. Poorly maintained and overloaded transport and cargo vehicles frequently break down and cause accidents. Drivers often place branches or leaves in the road to indicate a broken down vehicle is in the roadway. Undisciplined drivers move unpredictably through traffic. Construction work is often poorly indicated. Speed bumps, commonly used on paved roads in and near villages, are seldom indicated. Drivers must be on guard against people and livestock wandering into or across the roads. Nighttime driving is particularly hazardous as vehicles frequently lack headlights and/or taillights, and brake lights are often burned out.
With few exceptions, Cotonou and other cities lack any street lighting, and lighting on roads between population centers is non-existent. The U.S. Embassy in Cotonou prohibits non-essential travel outside of metropolitan areas after dusk by official Americans and strongly urges all U.S. citizens to avoid night driving as well. There have been numerous carjackings and robberies on roads in Benin after dark, several of which resulted in murder when the driver refused to comply with the assailants' demands. The National Police periodically conduct vehicle checks at provisional roadblocks in an effort to improve road safety and reduce the increasing number of carjackings. When stopped at such a roadblock, you must have all of the vehicle's documentation available to present to the authorities.
Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at http://www.benintourisme.com.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Benin, the U.S. Federal Aviation Administration (FAA) has not assessed Benin’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
U.S. citizens are advised to keep a notarized photocopy of the photo page of their passport with them at all times when traveling in Benin.
The Embassy has had a few reports of officials requesting a "gift" to facilitate official administrative matters (e.g., customs entry). Such requests should be politely but firmly declined.
It is prohibited to photograph government buildings and other official sites, such as military installations, without the formal consent of the Government of Benin. In general, it is always best to be courteous and ask permission before taking pictures of people. Beninese citizens may react angrily if photographed without their prior approval.
Obtaining customs clearance at the port of Cotonou for donated items shipped to Benin from the United States may be a lengthy process. In addition, to obtain a waiver of customs duties on donated items, the donating organization must secure prior written approval from the Government of Benin. Please contact the U.S. Embassy in Cotonou for more detailed information.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 Benin laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Benin are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Benin are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Benin. Americans withoutInternet access may register directly with the U.S. Embassy. 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 Rue Caporal Anani Bernard in Cotonou. The Embassy's mailing address is B.P. 2012, Cotonou, Benin. The 24-hour telephone numbers are (229) 21-30-06-50, 21-30-05-13, and 21-30-17-92. The Embassy’s general fax number is (229) 21-30-06-70; the Consular Section’s fax number is (229) 21-30-66-82; http://cotonou.usembassy.gov/.
* * *
This replaces the Country Specific Information for Benin dated August 17th, 2007 to update sections on Safety and Security and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 10 May 2019 19:38:30 +0200
By Hazel WARD and Daphne BENOIT

Paris, May 10, 2019 (AFP) - French special forces have freed two French hostages, an American and a South Korean in northern Burkina Faso in an overnight raid in which two soldiers died, authorities announced Friday.   The operation was launched to free two French tourists who had disappeared while on holiday in the remote Pendjari National Park in neighbouring Benin on May 1.

But during the raid, the French troops were surprised to discover two women also in captivity, with top officials saying they had been held for 28 days.    The French tourists were identified as Patrick Picque, 51, and Laurent Lassimouillas, 46, but the women's identities were not immediately clear.     "No one was aware of (the women's) presence," French Defence Minister Florence Parly told reporters, while French armed forces chief Francois Lecointre said.   "We know little about these other two hostages," Parly told reporters, saying that even Seoul and Washington did not appear to be aware the pair were in increasingly unstable Burkina Faso.    The raid was approved by French President Emmanuel Macron in what was seen as the last opportunity to stop the hostages being transferred to lawless territory in Mali to the north.

Parly said it was "too early to say" who had snatched the two French nationals from Benin, which has long been an island of stability in a region where Islamist militants are increasingly active.   "The message to terrorists and criminal gangs is clear: those who attack France and its nationals know that we will not spare any effort to track them down, find them and neutralise them," she said.   Four of the six kidnappers were killed in the raid.    French forces, helped by intelligence provided by the United States, had been tracking the kidnappers for several days as they travelled across the semi-desert terrain of eastern Burkina Faso from Benin to Mali.   They seized the opportunity to prevent "the transfer of the hostages to another terrorist organisation in Mali," Lecointre said, referring to the Macina Liberation Front (FLM).   The FLM is a jihadist group formed in 2015 and headed by a radical Malian preacher, Amadou Koufa. It is aligned with Al-Qaeda in the region.

- US intelligence support -
In a statement, Macron congratulated the special forces on the operation, in which he also expressed sorrow over the death of the two soldiers "who gave their lives to save those of our citizens".   And Parly thanked authorities in Benin and Burkina Faso for their help with the "complex operation", as well as the United States which provided intelligence and support.

The operation was also made possible by the presence of France's Operation Barkhane, which counts some 4,500 troops deployed in Mali, Burkina Faso, Niger and Chad to help local forces battle jihadist groups.   American special forces and drones are also known to operate in the violence-wracked Sahel region, which France fears could become further destabilised as jihadist groups are pushed out of north Africa, Iraq and Syria.   Burkina Faso has suffered from increasingly frequent and deadly attacks attributed to a number of jihadist groups, including the Ansarul Islam group, the Group to Support Islam and Muslims (GSIM) and Islamic State in the Greater Sahara.

- Relief and sadness -
The French tourists -- Patrick Picque who works in a Paris jewellery shop, and Laurent Lassimouillas a piano teacher, -- went missing with their guide on the last leg of their holiday in usually peaceful Benin.   The Pendjari wildlife reserve, which is famed for its elephants and lions, lies close to the porous border with Burkina Faso.   The badly disfigured body of their guide was found shortly after they disappeared, as well as their abandoned four-wheel Toyota truck.   The two freed men will be flown back to France on Saturday, alongside the South Korean woman, where they will be met on arrival by Macron and other top French officials.   Washington thanked the French forces for freeing the American hostage, with France saying she would likely be "repatriated independently" from the other three. 

The two dead French soldiers were named as Cedric de Pierrepont and Alain Bertoncello, decorated naval special forces members born in 1986 and 1991 respectively.   They were part of the prestigious Hubert commando unit of the French naval special forces which was deployed to the Sahel at the end of March.   A total of 24 French soldiers have died in the region since 2013 when France intervened to drive back jihadist groups who had taken control of northern Mali. The last death was on April 2.
Date: Tue 15 Jan 2019
Source: Punch [edited]

The Kwara state government has confirmed 2 cases of Lassa fever infecting a husband and wife in the state.

Speaking with newsmen on Tuesday [15 Jan 2019] at a news briefing, the Kwara commissioner for health, Alhaji Usman Rifun-Kolo, said the outbreak of Lassa fever was identified in a farm settlement in Taberu, Baruten local government area.

He explained that the 2 cases of the disease affected a husband and wife, natives of Benin republic, which shares a border with the state. He added that the husband and wife are farming in Baruten. "These cases of Lassa fever originated from Benin republic, whose citizen have interrelations with people in the Baruten area," he said.

According to him, the husband and wife were diagnosed in a health facility, and the state government had already deployed a disease-surveillance team to identify those who have been in contact with the patients.

Rifun-Kolo further explained that the surveillance team identified 4 people with a history of fever in the area. He said that the 4 cases raised suspicion of Lassa fever, which prompted them to take samples from the individuals for further investigation. He noted that the 4 individuals have commenced treatment in Taberu, Baruten LGA.
=====================
[The above report states that the couple was infected in Benin, although the timeline when that may have occurred is not given. The report also mentions 4 individuals in the Kwara state who had a history of Lassa fever, implying that the virus is present in that state in Nigeria as well. In December [2018], there were Lassa fever cases in Benin that were imported from Nigeria as well as infections that were locally acquired in Benin, so the Lassa fever cases cross the border in both directions. The source of the infecting virus for any of these cases is not mentioned. - ProMED Mod.TY

[HealthMap/ProMED-mail maps:
Kwara state, Nigeria: <http://healthmap.org/promed/p/19690>]
Date: Wed 26 Dec 2018
Source: Quotidein Le Matinal [in French, trans. ProMED Corr.SB, edited]

Minister of health Benjamin Hounkpatin confirmed on Wednesday [26 Dec 2018] 4 new cases of Lassa haemorrhagic fever in Benin, including one in Cotonou. This occurred in the period from 15-26 Dec 2018.

In the case of Cotonou, a 28-year-old (has been infected). His case was detected on 24 Dec [2018], but his illness commenced the previous week. He had a fever, a cough, a cold, and fatigue. Due to the persistence of the cough and cold, and with the appearance of traces of blood in nasal discharge on 24 Dec 2018, the alert was given.

The patient was placed in isolation on [Tue 25 Dec 2018], and on the morning of Wed 26 Dec 2018, his result from the laboratory came back positive [for Lassa fever]. Subsequently, the patient was isolated and put on treatment.

According to the details provided by Hounkpatin, there is no indication of travel [by the patient] to an epidemic locality of Lassa fever. According to the patient's statements, there is no known contact with rodents.

Taking advantage of this opportunity, the minister reassured the public that public health measures are underway. He also reminded people of the behaviours that will help avoid becoming infected. This involves washing hands regularly with soap and water; avoiding contact with stool, sperm, urine, saliva, vomit, and contaminated objects from a person suspected to be ill or dead from Lassa; and protecting food and keeping it in a safe place, out of reach of rodents.

It should be recalled that 7 cases have been recorded since the beginning of the epidemic to date, including 5 positive cases.
=======================
[One case is located in Cotonou on the Benin coast and apparently was locally acquired, perhaps from contact with the rodent host or its excrement. The location of the other 3 cases is not mentioned, but a 13 Dec 2018 report indicated that there were 3 cases in the municipality of Parakou in Borgou Department, in the northern part of Benin. Perhaps these 3 cases, which came from the village Taberou (in Nigeria), located 5 km [3.1 mi] from Tandou in the commune of Tchaourou, are the ones mentioned in this report.

The previous Lassa fever cases in Benin this year [2018] occurred in January and also involved case importation from Nigeria. A previous WHO report stated that Lassa fever is endemic in bordering Nigeria, and, given the frequent population movements between Nigeria and Benin, the occurrence of additional cases is not unexpected. Strengthening of cross-border collaboration and information exchange between the 2 countries is, therefore, needed. - ProMED Mod.TY]

[Images of the rodent reservoirs of Lassa fever virus can be seen as follows:
For _Mastomys natalensis_, see
For _M. erythroleucus_ and _Hylomycus pamfi_, see

HealthMap/ProMED-mail maps:
Date: Fri, 29 Jun 2018 13:37:32 +0200

Cotonou, June 29, 2018 (AFP) - Benin's Constitutional Court has banned the right to strike by workers in the country's defence, security, justice and health sectors, sparking concern among union officials and legal observers.   The ruling, issued late on Thursday, came after months of wrangling between the government and the court, which had previously said the measure was unconstitutional.

"Civil servants, public security forces and equivalents should fulfil their duties in all circumstances and not exercise their right to strike," the court said in its new ruling.   "There should be no disruption to the duties of public sector defence, security, justice and health workers."   The decision was taken "in the public interest" and for "the protection of citizens", it said.

Speaking on Friday, one senior union leader, who asked to remain anonymous, described the ruling as shocking and a "hammer blow".   And Benin legal affairs expert Albert Medagbe told AFP the decision was a "worrying sudden legal U-turn".   Earlier this month, a close ally of President Patrice Talon, Joseph Djogbenou, was elected to lead the Constitutional Court during a vote held behind closed doors.   Djogbenou is Talon's former personal lawyer and was previously  Benin's attorney general.

Until his arrival, the court had strained relations with Talon, and had criticised the government for misunderstanding and failing to respect the constitution.   The small West African nation was last year hit by a wave of public sector strikes, which brought the education, health and justice system to a near halt.   The industrial action was sparked by Talon's attempts to introduce free-market reforms.
Date: Wed, 21 Feb 2018 17:31:52 +0100

Cotonou, Feb 21, 2018 (AFP) - Nine people appeared in a Benin court Wednesday on charges of selling fake drugs at the start of a landmark trial in a regional campaign against illicit medicines.   The suspects, who include executives from major pharmaceutical companies operating in the West African nation, were remanded in custody until March 6 on technical grounds.   They are accused of "the sale of falsified medicines, (and) display, possession with a view to selling, commercialisation or sale of falsified medical substances."   A tenth defendant, the head of the Directorate for Pharmacies, Medications and Diagnostic Evaluation (DPMED) under the control of the ministry of health, was not in court on the trial's opening day.   He is accused of failing to prevent the offences.

Benin launched the crackdown last year after mounting alarm about the scale of the trafficking of expired and counterfeit drugs in West Africa.   Fake medicines are drugs that are bogus or below regulatory standards but often are outwardly indistinguishable from the genuine product.   Taking them may do nothing to tackle an illness or -- in the case of antibiotics -- worsen the problem of microbial resistance.   According to an investigation by the Paris-based International Institute of Research Against Counterfeit Medicines (IRACM), West African markets are awash with fake drugs made in China and India.

In 2015, the American Society of Tropical Medicine and Hygiene estimated that 122,000 children under five died due to taking poor-quality antimalarial drugs in sub-Saharan Africa.   A 15-nation regional body, the Economic Community of West African States (ECOWAS), last April announced an investigation into the fake drugs business.   A lawyer for the civilian plaintiffs told AFP that the trial in Benin was adjourned until March 6 at their request "in order to incorporate another case, of illegal pharmaceutical practice".
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Christmas Island

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Tue, 19 Sep 2006 17:41:31 +0200 (METDST) SYDNEY, Sept 19, 2006 (AFP) - A large earthquake with an estimated magnitude of 6.1 struck Tuesday near the Australian territory of Christmas Island, the US Geological Survey said. The quake struck at 20:58 local time (1358 GMT) and its epicentre was located 191 kilometres (119 miles) east-northeast of Christmas Island, the USGS report said. The reading was based on the open-ended Moment Magnitude scale, now used by US seismologists, which measures the area of the fault that ruptured and the total energy released.
27 Aug 2001 A NORWEGIAN ship carrying 438 sick and starving refugees was moored in limbo off Christmas Island last night, with John Howard refusing to allow them to disembark and Indonesia reluctant to let them berth anywhere in its territory. http://email.ni.com.au/Click?q=96-pjPWQtdfI9qzkLcbUQgkSoeR
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Dominica

Dominica US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
Dominica is an English-speaking developing Caribbean island nation. The tourism industry in is the early stages of development; first-class tourist facilities are l
mited, but medium-range facilities are widely available. Read the Department of State Background Notes on Dominica for additional information.

ENTRY/EXIT REQUIREMENTS:
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
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.

In addition to a valid passport, U.S. citizens may be asked to present a return or onward ticket. U.S. citizens should take special care to secure their passports while traveling as it can be time-consuming and difficult to acquire new proof of citizenship to facilitate return travel should the passport be lost or stolen. There is a departure tax assessed when leaving Dominica. Children under twelve years of age are exempt from the departure tax.
For further information concerning entry requirements, travelers can contact the Embassy of the Commonwealth of Dominica, 3216 New Mexico Avenue NW, Washington, DC
20016, telephone (202) 364-6781, e-mail embdomdc@aol.com, or the Consulate General of Dominica in New York at (212) 768-2480. Visit the Dominica Division of Tourism offical web site at http://www.dominica.dm/site/index.cfm for more 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:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings, and Travel Alerts can be found.

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

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

CRIME:
Petty street crime occurs in Dominica. Valuables left unattended, especially on beaches, are vulnerable to theft.

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.

See information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care is limited. The major hospital is Princess Margaret Hospital, telephone (767) 448-2231/5720.
In addition, there is one other hospital in Dominica and several clinics. There is no operational hyperbaric chamber; divers requiring treatment for decompression illness must be evacuated to Martinique. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Doctors and hospitals often expect immediate cash payment for health services.

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 Dominica is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Vehicles are driven on the left in Dominica. Seatbelt laws are not strictly enforced. Roads are narrow with steep inclines throughout the island. There are few guardrails in areas that have precipitous drop-offs from the road. Road signs are limited outside of the major towns. Drivers should be alert for minibus (taxi) drivers, who often make sudden stops or pull out into traffic without warning or signaling.

Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.dominica.dm/site/index.cfm.

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

SPECIAL CIRCUMSTANCES:
There is no U.S Embassy or Consulate in Dominica. The U.S. Embassy in Bridgetown, Barbados, is responsible for American Citizens Services on the island of Dominica. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.

Like all Caribbean countries, Dominica can be affected by hurricanes. The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

Please see 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 Dominica’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Dominica are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Dominica are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Dominica.
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 in Bridgetown is located in the Wildey Business Park in suburban Wildey, south and east of downtown Bridgetown.
The main number for the Consular Section is (246) 431-0225; after hours, the Embassy duty officer can be reached by calling (246) 436-4950.
The web site for Embassy Bridgetown is http://barbados.usembassy.gov/ . Hours of operation are 8:30 a.m. to 4 p.m. Monday-Friday, except Barbados and U.S. holidays.
*

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This replaces the Country Specific Information for Dominica dated April 2, 2007, to update sections on Entry/Exit Requirements, Safety and Security, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Tue, 12 Jun 2018 05:04:49 +0200
By Gemma Handy

Roseau, Dominica, June 12, 2018 (AFP) - With the hurricane season starting up again in the Atlantic, Irvince Auguiste is feeling vulnerable.   He, his wife Louisette and their three sons are still living in the ruins of their five-bedroom home that Hurricane Maria flattened nine months ago when it ravaged the tiny Caribbean island of Dominica.   They have rebuilt a kitchen, a washroom and a communal living area with sheets of plywood, but they are sleeping in tents.   "We are worried," Irvince says.   "I don't know where we will go if another hurricane comes. We just have to pray it doesn't," adds Louisette. "But we are not moving; this is our home."

More than 30 people were killed on Dominica when Maria crashed ashore on September 18 as a catastrophic Category Five storm, the first stop in a terrifying rampage that also devastated Puerto Rico and the Virgin Islands.     Like the Auguiste family, most of the rest of the 70,000 residents of the former British colony are nervously watching the weather forecasts as they struggle to get back on their feet.   While there has been some progress on Dominica, recovery has been slow and the task is daunting.   Damage to the island has been estimated at $1.33 billion -- or 226 percent of GDP.   Most businesses have reopened in the capital Roseau and electricity has been restored to various communities island-wide.

In Portsmouth, the island's second largest town, ground has been broken on construction of new hurricane-hardened residences for people who lost homes.   The project, which calls for 226 residences to be built by next year, is being funded through a government program in which Dominica offers citizenship in return for investments in the island.   Project manager Christopher Timmins said the new homes -- which will have reinforced concrete walls and roofs, and impact-resistant windows -- are "designed to withstand the worst that Dominican weather can throw at them."

- Public services slow to resume -
But elsewhere, like Touna Village where the Auguistes live, people are still living in tents.   In nearby Marigot, both the health clinic and police station are operating out of private homes.   Telecommunications firm Digicel is repairing six schools in Kalinago Territory and Atkinson, and has replaced roofs on 40 private homes.    But the pace is hindered by the "inordinate amount of time" it takes for materials to be shipped from the United States, said project manager Peter Court.   Roofs are being fixed according to stringent new building guidelines that include a steeper pitch, thicker materials and more rafters to help them stay in place in strong winds.

Lighthouse Christian Academy, a private school, had to fork out almost $20,000 to replace lost desks and benches, computers and books.    It reopened in January but the absence of electricity means school days end early at 1:00 pm due to the stifling heat inside classrooms.    "It's phenomenal trying to run a school without electricity," says principal Hudson Challenger. "Teachers can't do research and kids can't do their homework without lights. It's too expensive to use a generator."   In Roseau, business may be down 50 percent but patriotism is thriving, says market stall vendor Augustina John, whose canvasses embroidered with the ubiquitous mantra "Dominica strong" are popular with consumers.   "Life continues but I don't think Dominica will ever be the same again," John says.

The island's destruction has spawned advantages for some.    Brent Pascal was homeless and jobless for three years before being hired by the government to help clear debris.    "It took three months to clean Roseau's streets and I have found work on and off since," he adds.   Vegetation has returned to Dominica's once lush mountainsides but the defoliated trees could take up to 15 years to return to their former glory, says forest ranger Felix Eugene.   Prime Minister Roosevelt Skerrit planted 80 trees last week to kickstart a national tree-planting program.   Tourism chiefs recently launched a "Rediscover Dominica" campaign featuring a host of discounts to lure vacationers back to the "nature island."
Date: Fri, 22 Sep 2017 12:21:13 +0200

Roseau, Dominica, Sept 22, 2017 (AFP) - The tiny Caribbean island of Dominica appealed for desperately-needed aid and helicopters following the devastation wrought by Hurricane Maria, which left the country struggling to survive without water or electricity.   The island largely lost communications with the outside world after Maria ploughed into it on Monday as a maximum-strength Category Five hurricane packing winds of 160 miles per hour (257 kilometres per hour).

At least 15 people were killed on the island, with six deaths elsewhere in the Caribbean as the storm continued its destructive path north on Friday.   "For now our urgent, urgent matter is to  get supplies to the affected people. We're going to need all of the helicopter help we can get, because we need to ferry the supplies to people," Prime Minister Roosevelt Skerrit said Thursday.

AFP aerial footage showed debris from damaged buildings scattered across the island of 72,000 people and many structures with their roofs ripped off. Trees were snapped in half or ripped out of the ground.    Some streets were so filled with debris -- including splintered tree branches and sheets of corrugated metal -- that they were impassable.   Residents were busy shovelling mud out of their homes and businesses, while laundry was hung out to dry on the frames of half-destroyed homes and along downed utility cables.

In a neighbourhood of candy-coloured houses, families were cooking on makeshift stoves fashioned out of cinder blocks and rocks, fuelled by wood scraps.   The neighbouring French island of Martinique and the South American country of Guyana have dispatched a team of 68 firefighters to Dominica, said Patrick Amoussou-Adeble, secretary-general of Martinique.   "We have carried out a survey by helicopter to assess the situation. We have a naval ship that will supply 40 tons of water to the victims," he said.   Skerrit said that with hurricanes becoming ever stronger, "we really need, all of us, to understand that these issues are of greater concern to small islands like ours."   "We are very very vulnerable," he said.
Date: Tue, 19 Sep 2017 10:49:21 +0200
By Amandine ASCENSIO with Jean-Philippe LUDON in Fort-de-France

Pointe-à-Pitre, Sept 19, 2017 (AFP) - Hurricane Maria smashed into the eastern Caribbean island of Dominica on Tuesday, with its prime minister describing devastating damage as winds and rain from the powerful storm also hit territories still reeling from Irma.   As residents hunkered down in their homes the Category Five hurricane made landfall with top winds swirling at 160 miles (257 kilometres) per hour, the US National Hurricane Center (NHC) said.   "We have lost all what money can buy and replace," Dominica's premier Roosevelt Skerrit posted on Facebook, saying there were initial reports of "widespread devastation".

"My greatest fear for the morning is that we will wake to news of serious physical injury and possible deaths as a result of likely landslides triggered by persistent rains."   Earlier, he said his roof had been blown off, his house was flooding and he was "at the complete mercy of the hurricane".   After being rescued Skerrit appealed for "help of all kinds" but noted specifically that helicopters will be needed so that authorities could survey the damage.

Dominica's airport and ports have been closed.   After moving across the tropical island of 72,000 people, Maria was downgraded to an "extremely dangerous" Category Four hurricane but could strengthen again as it races north towards the British Virgin Islands and Puerto Rico.   The NHC warned of dangerous storm surges, destructive waves, flash floods and mudslides and warned that "preparations to protect life and property should be rushed to completion".

The French territory of Guadeloupe -- the bridgehead for aid for Irma-hit French territories -- ordered all residents to take shelter in a maximum-level "violet alert". Heavy rain lashed the island and several areas were without power Tuesday morning.   The Dominican Republic, the east coast of which was battered by Irma, ordered citizens in part of the north to evacuate ahead of Maria's arrival, expected Wednesday.   St Kitts, Nevis, the British island of Montserrat, Culebra and Vieques were also on alert.   Martinique, a French island south of Dominica, suffered power cuts but avoided major damage as the storm skirted its shores.    Flooding, mudslides and power outages were also reported in parts of St Lucia.

- 'Worst-case scenario' -
Criticised for the pace of relief efforts in their overseas territories devastated by Irma, Britain, France and the Netherlands said they were boosting resources for the Caribbean.   "We are planning for the unexpected, we are planning for the worst," said Chris Austin, head of a UK military task force set up to deal with Irma, as the British Virgin Islands readied for a new onslaught.   On the island of St Martin, which is split between France and the Netherlands, authorities announced a red alert ahead of Maria's arrival.   "We're watching its trajectory very closely, and we're preparing for the worst-case scenario," said local official Anne Laubies.

In Guadeloupe's biggest city of Pointe-a-Pitre, Elodie Corte, the boss of a metalworking company, said there had been frantic preparations to limit the damage from the storm.   "We spent the morning strapping down the aluminium to stop it from flying away if the winds are strong," she said Monday.   The Dutch navy tweeted that troops were heading to the two tiny neighbouring islands of Saba and St Eustatius to ensure security following widespread complaints after the first hurricane of looting and lawlessness on St Martin, among the worst hit by Irma, with 14 killed.   French Interior Minister Gerard Collomb said 110 more soldiers would be deployed to the region to reinforce about 3,000 people already there shoring up security, rebuilding infrastructure and distributing aid.   But he warned of "major difficulties" if Guadeloupe is hard hit.

- Hurricane series
Irma, also a Category 5 hurricane, left around 40 people dead in the Caribbean before churning west and pounding Florida, where the death toll stood at 50 Monday.   It broke weather records when it whipped up winds of 295 kilometres per hour for more than 33 hours straight.   Another hurricane, Jose, is also active in the Atlantic and has triggered tropical storm warnings for the northeastern United States.   Many scientists are convinced that megastorms such as Irma, and Harvey before it, are intensified by the greater energy they can draw from oceans that are warming as a result of climate change.
Date: Tue, 1 Sep 2015 19:08:25 +0200 (METDST)

Roseau, Dominica, Sept 1, 2015 (AFP) - Dominica Prime Minister Roosevelt Skerrit is pleading with world leaders to come to the rescue of his Caribbean island nation after it was battered by a tropical storm that killed at least 31 people.   Another two dozen remain missing, including two French nationals, after Tropical Storm Erika barrelled her way through late last week. The death toll has risen steadily since the storm hit the island of 72,000.    In a message to the nation on Monday night, Skerrit said 21 nationals and two French citizens are missing.

He added: "We have written to all foreign governments for help and assistance and I can tell you that the responses that we have received thus far are tremendous."   At the weekend, in the immediate aftermath of the worst of the storm, which also brought heavy rain to Haiti and Cuba, the prime minister ordered the evacuation of Petite Savanne, a coastal village cut off by mudslides.   Venezuela and Trinidad and Tobago were among the countries helping the evacuation effort by providing helicopters.

The evacuations of Petite Savanne's 750 residents was expected to be completed on Tuesday.   "We welcome the evacuation process because it has been very difficult for us and we were in a state of helplessness since we had no communication," Johna Guiste, a tearful Petite Savanne official, told AFP.   Anelta Hilaire-Francis said she has been marooned on the seashore for the past two days with her children "trying to get out of the village."    "It's hard and difficult to live, to take in and swallow what has happened to us," she said as she boarded a coast guard boat to a shelter in the capital Roseau.   Last week Skerrit said he feared the storm had taken the island back 20 years.   China last week offered $300,000 as emergency humanitarian assistance.
Date: Wed 19 Mar 2014
Source: Da Vibes [summarized & edited]

Dominicans have been called upon to play a greater role in managing the spread of chikungunya disease, which is reportedly increasing across the island.

The disease, 1st confirmed here in January 2014, is a viral disease carried mainly by the _Aedes aegypti_ mosquito. The symptoms of the disease include sudden high fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and severe pain in the wrists, ankles or knuckles.

Chief environmental health officer Anthony Scotland revealed on QFM Radio on Wed 19 Mar 2014 that as of 17 Mar 2014, there were 56 confirmed and 269 suspected cases of the disease in Dominica. These figures are based on confirmed information from the Caribbean Public Health Agency (CPHA). Scotland, therefore, urged citizens to wage war against the _Aedes aegypti_ mosquito by disrupting their breeding areas and refraining from storing water in uncovered and untreated drums. The Ministry of Health, he said, will be placing emphasis on toppling drums, boring holes in drums, and giving notices to offenders.

Scotland emphasized that the cooperation of the public is critical in managing the outbreak.
More ...

Bosnia and Herzegovina

Bosnia & Herzegovina US Consular Information Sheet
December 01, 2008
COUNTRY DESCRIPTION:
Since the December 1995 signing of the Dayton Peace Accords, there has been significant progress in restoring peace and stability in Bosnia and Herze
ovina.
Significant progress has been made in reconstructing the physical infrastructure that was devastated by the war. Nonetheless, political tensions among the ethnic groups persist. Hotels and travel amenities are available in the capital, Sarajevo, and other major towns, but they are relatively expensive. In the more remote areas of the country, public facilities vary in quality.
For more details, read the Department of State Background Notes on Bosnia and Herzegovina.

ENTRY/EXIT REQUIREMENTS:
A passport is required for travel to Bosnia and Herzegovina. American citizens do not require a visa for tourist stays up to three months.
Travelers who are not staying at a hotel (i.e. a private residence) must register with the local police within 24 hours of arrival. U.S. citizens planning to remain in Bosnia and Herzegovina for more than three months must obtain a visa prior to travel, or apply for a temporary residence permit from the local police station having jurisdiction over their place of residence. Applications for temporary residence permits should be submitted 15 days prior to the expiration of the initial three month tourist visa. A police certificate indicating that the applicant has no criminal record is required for this permit and should be obtained from the applicant’s state of residence in the U.S.
For additional information please contact the Embassy of Bosnia and Herzegovina, at 2109 E. Street, NW, Washington, DC 20037, telephone 202-337-6473.
Visit the Embassy of Bosnia and Herzegovina web site at http://www.bhembassy.org for the most current visa information.

Beginning in May 2008, the immigration authorities of Bosnia and Herzegovina began to strictly enforce a provision of a Bosnian law that requires any unaccompanied minor (under 18) to have written permission from both parents in order to enter and leave the country.
If traveling with one parent only, the minor is required to have written permission for the trip from the non-traveling parent. 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:
Landmines remain a problem in Bosnia and Herzegovina. As of 2008, there are still an estimated 13,000 minefields and an estimated 222,000 active land mines.
The area of suspected landmine contamination is estimated at over 2000 square kilometers more than 4% of the country’s territory.
These devices have killed more than 400 people since 1996.
While most urban areas have been largely cleared, special care should be taken when near the former lines of conflict, including the suburbs of Sarajevo.
The de-mining community recommends staying on hard surfaced areas and out of abandoned buildings.
Families traveling with children in Bosnia and Herzegovina should be especially aware of the danger posed by mines and unexploded ordnances.
For more information about landmines please visit http://www.bhmac.org/en/stream.daenet?kat=19
Localized political difficulties continue and random violence may occur with little or no warning.

Bosnian criminals use firearms and explosives to settle personal, business, and political disputes.
In October 2008, an explosive device detonated in a public shopping mall in Vitez, killing a store security guard.
The foreign community is rarely the target of such violence, but there is always the danger of being in the wrong place at the wrong time.
While most Bosnian citizens appreciate the assistance of the international community, occasional anti-foreign sentiment is sometimes encountered.
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:
The overall crime rate throughout the country remains relatively low­the most common being confrontational crimes and residential break-ins.
Pick-pocketing and vehicle break-ins are also a problem. Most pickpockets operate in pairs and employ distraction methods to execute their craft.
There are also documented cases of pick-pocketing and other scams to get money from foreign passengers aboard public transportation.
Travelers should take normal precautions to protect their property from theft and exercise common sense personal security measures, traveling in groups, and staying in well-lighted areas after dark.
Confrontations with local citizens resulting from traffic incidents or public disagreements should be avoided.

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.
See our Victims of Crime, including possible sources of U.S. assistance..
The local equivalent to the “911” emergency line in Bosnia and Herzegovina is: Police­122; Ambulance--124 and Fire­123.
MEDICAL FACILITIES AND HEALTH INFORMATION:
The lack of adequate medical facilities, especially outside Sarajevo, may cause problems for visitors.
Because many medicines are not obtainable, travelers should bring their own supply of prescription drugs and preventive medicines.
Private practitioners and dentists are becoming more common; however, quality of care varies and rarely meets U.S. or western European standards.
All major surgery is performed in public hospitals.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Bosnia and Herzegovina

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 Bosnia and Herzegovina is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road travel is possible throughout most of the country.
However, some roads are still damaged from the war, and poorly maintained.
Roads are sometimes blocked due to landslides, de-mining activity, and traffic accidents.
Bosnia and Herzegovina is among the rare countries in Europe that has fewer than ten kilometers of four-lane highway.
The existing, two-lane roads between major cities are quite narrow at places, lack guardrails, and are full of curves.
Travel by road can be risky due to poorly maintained roads, and morning and evening fog in the mountains.
Driving in winter is hazardous due to fog, snow, and ice.
Local driving habits are poor, and many vehicles are in bad condition.
Many accidents occur when drivers exceed safe speeds along winding mountain roads.
Accidents involving drunk driving are an increasing problem.
Driving after dark is especially dangerous, and street lighting is not common outside the major towns.
Road construction may be poorly marked, and automobiles share the road with heavy vehicles and agricultural equipment.
Travelers are encouraged to convoy with other vehicles, if possible, and to plan their trip to ensure they travel only during daylight hours.

Although the number of service stations outside major cities has increased in recent years, many do not offer mechanical or other services.
The emergency number for vehicle assistance and towing service is 1282; Speed limit traffic signs are not always obvious or clear.
The speed limit on the majority of roads is 60 km/h, and on straight stretches of road it is generally 80 km/h.
The use of seat belts is mandatory.
Talking on a cell phone while driving is prohibited.
The tolerated percentage of alcohol in the blood is .03%.

In order to drive legally in Bosnia and Herzegovina, you must have an international driving permit in addition to your U.S. license.

Please refer to our Road Safety page for more information.
Visit the web site of the Bosnia and Herzegovina’s national tourist office and national authority responsible for road safety at http://www.bihamk.ba
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bosnia and Herzegovina, the U.S. Federal Aviation Administration (FAA) has not assessed Bosnia and Herzegovina’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://faa.gov/safety/programs_initiatives/oversight/iasa .
During the winter months, flights into and out of Sarajevo are frequently delayed or canceled due to heavy fog.
Travelers should be prepared for last-minute schedule changes, lengthy delays, alternate routings, or time-consuming overland transportation.

SPECIAL CIRCUMSTANCES:
Bosnia and Herzegovina is still predominantly a cash economy.
Although the use of credit cards has become more widespread in recent years, travelers still should not expect to use them to cover all expenses. Automated Teller Machines (ATMs) are available in sufficient numbers at international banks in Sarajevo and other major cities and towns.
Traveler's checks can be cashed in banks in major cities, but often with delays of a few weeks or strict monthly limits.
Cash transfers from abroad may also involve delays.
The convertible mark, the national currency, is pegged to the euro under a currency-board regime, which guarantees its stability.
All official payments must be made in convertible marks, though many private stores and service providers also accept euros.
Any bank in Bosnia and Herzegovina should be able to exchange U.S. dollars into convertible marks with the usual bank commission (between 1% and 2%).

Photographing military installations, including airports, equipment, bridges, government checkpoints, troops and the U.S. Embassy, is forbidden.
If in doubt, please ask permission before taking photographs. 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 Bosnia and Herzegovina laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Bosnia and Herzegovina are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Bosnia and Herzegovina are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and to obtain updated information on travel and security within Bosnia and Herzegovina.
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 Alipasina 43, telephone (387) (33) 445-700, fax: (387) (33) 221-837; http://sarajevo.usembassy.gov/.
On weekends, holidays, and after hours, an Embassy duty officer can be reached at telephone (387) (33) 445-700.
If after dialing you receive a recorded message, press “0”, and then ask for the duty officer.
* * *
This replaces the Consular Information Sheet dated March 11, 2008, to update sections on Country Description, Entry and Exit Requirements, Safety and Security; and Crime.

Travel News Headlines WORLD NEWS

Date: Tue, 14 May 2019 17:36:11 +0200

Sarajevo, May 14, 2019 (AFP) - Torrential downpour has flooded hundreds of homes and swamped roads in northern Bosnia, officials said Tuesday, as rescuers searched for a six-year-old boy swept away by a swollen stream.   The child went missing in the northern Zepce region, national television BHRT reported on Tuesday. 

The heavy rain, which started Sunday, has sparked fears of a repeat of the 2014 floods that devastated the Balkan region, killing 77 people.   Weather services have predicted the rain will taper off.   Several Bosnian towns in the hardest-hit north have declared a state of emergency and begun protective evacuations.

More than 200 people have been evacuated in villages around north-eastern Doboj, where two rivers have overflowed.   "About 100 houses were flooded, as well as the offices of five companies and 50 hectares of land," said civil defence official Senad Begic.    Floods have also hit around 200 households in northwest Prijedor and 100 east in the town of Celinac.    "The danger has not passed and I invite inhabitants to follow the instructions of the authorities, without panic," urged Radovan Viskovic, Prime Minister of Republika Srpska, Bosnian's Serb-run region.

Dozens of homes were also flooded in neighbouring Croatia, where eight tourists, including two children, were rescued by firemen at a campsite on the banks of the Korana river, national TV reported.   After rising rapidly overnight, water levels in major rivers are falling slightly or stagnating, according to weather services.   In the spring of 2014, the Balkans region was hit by its worst floods in more than a century, which affected 1.6 million people and caused an estimated two billion euros in damage, mostly to houses and farmland.
Date: Thu, 24 Dec 2015 20:40:42 +0100

Sarajevo, Dec 24, 2015 (AFP) - Air pollution forced Bosnian authorities to shut schools in the capital Sarajevo on Thursday, while smog levels also spiked in other parts of the Balkan country due to a lack of rainfall, local officials said.   The air quality index, whose "normal" levels range from 0 to 50, reached 94 in Sarajevo on Thursday, official data showed.   Registered levels had been even higher in recent days, with the index soaring above the dangerous 300 mark and the city literally shrouded in a smog.

Regional authorities in Sarajevo decided to close primary and secondary schools Thursday, they said in a statement, while the city council demanded an early start to the winter holiday, so that children would be spared from being exposed to the smog.   Winter holidays traditionally start later in Bosnia than in western Europe, just ahead of the New Year.

Health authorities urged citizens meanwhile, particularly those with health problems, pregnant women and children, to refrain from going out at all.   Red Cross and non-governmental activists distributed protective masks to people across the city, which is surrounded by mountains that lock in the air especially during dry spells.   Pollution levels were also exacerbated by fumes from heating tens of thousands of homes.

Weather forecasts indicate that smog levels are not expected to improve before January.   Several other Bosnian towns were also hit by smog, especially those with large industrial areas such as Lukavac and Tuzla, where the air pollution index reached 293 and 193 respectively on Thursday.
Date: Tue, 24 Nov 2015 11:23:17 +0100

Sarajevo, Nov 24, 2015 (AFP) - Bosnian prosecutors were investigating an explosion at a police station Tuesday which authorities said could be an act of "terrorism", days after two members of the country's military were shot dead.   Unknown perpetrators threw an explosive device on the roof of the station in the central town of Zavidovici in the early hours, causing minor damage but no injuries, police spokeswoman Aldina Ahmic said.   "There are indications that this case has elements of the criminal act of terrorism," said Ahmic.

The national prosecutor's office has taken over the case and formed a special team tasked with investigating.   The incident comes less than a week after two military men were killed on November 18 by a man who attacked them with automatic weapons near a barracks in Sarajevo before blowing himself up.   Authorities have said that the perpetrator had links to Islamist circles and that the attack was almost certainly a "terrorist act".

Muslims make up about 40 percent of Bosnia's 3.8 million people while the rest of the Balkan country is mostly Serb Orthodox or Catholic.   The vast majority of Bosnian Muslims are moderates but a tiny minority openly support radical Wahhabism.   After the deadly Islamic State attacks in Paris earlier this month, Bosnia's Islamic spiritual leader Husein Kavazovic urged Europe's Muslims to keep the peace, saying the killings were a "sin towards God".
Date: Mon 27 Apr 2015
Source: WBNS-TV, Associated Press (AP) report [edited]

Authorities in Bosnia's capital have declared a foodborne outbreak after nearly 200 preschool children became sick at public day care centers in Sarajevo. Local health minister Emira Tanovic-Mikulec declared the outbreak on Mon 27 Apr 2015. Lab tests show that the food the children ate last week [week of 20 Apr 2015] was infected with salmonella enteridis [see comment below]. Out of the 193 children with fever, diarrhea, and abdominal cramping, 51 had to be hospitalized but none are in a life-threatening condition, hospital officials say.

About 2900 kids eat food prepared in a central kitchen that supplies the 29 centers in Sarajevo. The symptoms started last Wed 22 Apr 2015, when macaroni with cheese and eggs was on the menu.
================
[Both cheese (especially if unpasteurized) and eggs (if undercooked or recontaminated from poor kitchen hygiene) are common reservoirs for salmonellosis. The serotype is not specially stated as, in the original post, the statement is "was infected with salmonella enteridis" which could mean salmonella enteritis (as the name of the condition) or _Salmonella_ Enteritidis (as the name of the organism). - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Thu 2 Apr 2015
Source: Outbreak News Today [edited]
-------------------------------------------------------------------------
The US Centers for Disease Control and Prevention (CDC) issued 3 travel notices Wednesday due to on-going measles outbreaks in Angola, Bosnia-Herzegovina and Ethiopia. In Angola, the US federal health agency says the country is experiencing an on-going measles outbreak. The number of confirmed measles cases increased from 6558 in 2013 to 12 036 in 2014; and cases continue to occur in 2015.

In Europe, as of February 2015, the Federal Institute of Public Health in the Federation of Bosnia and Herzegovina has reported more than 3800 cases since January 2014. Most of the cases have been in 3 Central Bosnia Canton municipalities: Bugojno, Fojnica, and Travnik.

Finally, on the Horn of Africa, Ethiopia is experiencing an on-going measles outbreak. The number of confirmed measles cases increased from 6100 in 2013 to more than 14,000 confirmed cases in 2014; cases continue to occur in 2015.

The CDC recommends that travellers to all 3 destinations protect themselves by making sure they are vaccinated against measles, particularly infants 6-11 months of age (1 dose of measles vaccine) and children 12 months of age or older (2 doses of measles vaccine). Clinicians should keep measles in mind when treating patients with fever and rash, especially if the patient has recently travelled internationally.  [Byline: Robert Herriman]
More ...

Saudi Arabia

Travelling to the Hajj
============================
Background
Every devout Muslim seeks to perform the Hajj on at least one occasion during their life. This pilgrimage, which is a central duty of Islam, brings Muslims from all over the wor
d together as they visit the holy cities of Mecca and Medina in Saudi Arabia. Each year over two million gather to celebrate the five 'pillars' of Islam.
Coping with the Climate
The dates for this festival vary from year to year but this year it is in December. In the evenings it can be significantly cold in 'tent city' and so travellers should bear this in mind when packing.
Travel Restrictions
With this massive influx of people travel in and out of Saudi can be difficult and, where possible, plans should be made well in advance.
Care for the pilgrims
The Saudi government seek to provide the highest level of health care possible for those visiting their Kingdom. This has involved the setting up of a series of rules and regulations which need to be observed. Nevertheless every pilgrim should ensure that their own personal health is sufficient before agreeing to travel. This may involve a consultation with their GP - especially if they have any underlying medical conditions.
Food Restrictions
No food is allowed into Saudi during this time and will be confiscated on arrival.
Vaccine Requirements
In order to reduce the risk of certain diseases the Saudi authorities insist on all travellers providing correctly certified evidence of vaccination against some diseases.
Meningitis
All travellers are required to provide evidence of vaccination against Meningococcal Meningitis (ACYW-135). This vaccine has to have been given to every traveller within the previous three years and at least 10 days before arrival into Saudi Arabia. (Other vaccinations against Meningitis C or Meningococcal A&C are not acceptable.)
Compulsory Medications
Some travellers arriving from what are regarded as 'higher risk' countries will also be given prophylactic antibiotics to lessen the possibility of their carrying Meningococcal Meningitis into the country. This is a compulsory requirement - though the medication given varies depending on the age of the individual and whether or not the female traveller is pregnant.
Yellow Fever
It is also essential for some travellers to have evidence of Yellow Fever vaccination certification. Generally this is only required for those arriving from the countries of Africa and South America. This vaccine needs to have been given within the previous 10 years and at least 10 days before arrival.
Other Recommended Vaccines
Even though it is not a requirement of entry to perform the Hajj or visit Saudi Arabia, travellers are strongly advised to consider the following vaccinations;
Influenza / Pneumococci
These are air-borne diseases and the close proximity of so many pilgrims will make the risk of contracting either or both of these highly infectious diseases much higher. Influenza vaccine needs to be given each year where as Pneumococcal vaccine is often only given on one occasion in a lifetime.
Poliomyelitis
This viral disease is disappearing from much of the world and may be eradicated within a few years. However during 2005 a significant number of outbreaks occurred in various African countries and India. The Hajj was linked to outbreaks in Yemen and Saudi Arabia itself. Vaccination is recommended for all unprotected travellers.
Hepatitis A / Typhoid
With such a massive number of people to be catered for it is hardly surprising that the level of food and water borne disease is high. These vaccines are strongly recommended for all travellers. They provide excellent protection but all travellers will still need to exercise extra care to lessen their personal exposure.
Hepatitis B
The main specific risk of contracting Hepatitis B probably relates to the ritual head shaving which is performed as part of the celebrations. Professional barbers are used and long lines of men wait for their turn. In some cases the blade is not changed between shaves and this potentially presents a serious risk of contamination with Hepatitis B infection.
Ritual sacrifice
It should also be noted that during the celebrations a ritual sacrifice of a small animal is performed. Pilgrims are strongly advised not to undertake the actual act of sacrifice themselves - unless they are very experienced - as otherwise they could seriously injury themselves.
Avoiding Accidents and Dehydration
The desire to perform the Hajj is strong and it is an emotional time for any Muslim. Unfortunately the presence of so many other pilgrims in a very confined space at the same time does increase the risk of various diseases and accidents. This includes the risk of being crushed, as has occurred with disastrous consequences in the past. The degree of dehydration can also be high as there is a significant amount of exercise and walking involved. A good pair of comfortable walking shoes is certainly worth the investment. It will also be important to bring some plasters to treat minor injuries and blisters.
Being Separated from Companions
Due to the numbers involved it is very easy to become separated from travelling companions. It is wise to have a plan in place before arriving so that each member of the party knows where to meet.
Overview
It is extremely important that all those undertaking this pilgrimage recognise the necessity to stay constantly alert to the personal health and accident risks which are present and do everything within their power to avoid them. The Tropical Medical Bureau centres throughout Ireland usually carry both the required and the recommended vaccines for travellers to the Hajj. Appointments should be made well in advance of visa application to ensure that these are given in sufficient time.

Travel News Headlines WORLD NEWS

Date: 1 Dec 2019
Source: Saudi MOH (14 Nov 2019 to 1 Dec 2019) [edited]

In the period since the last update (13 Nov 2019, MERS-CoV (69): Saudi Arabia (RI, AS, MK) http://promedmail.org/post/20191113.6776647), there have been a total of 3 newly confirmed cases of MERS-CoV infection reported by Saudi Arabia and 11 newly reported outcomes (2 deaths and 9 recoveries).
Date: Mon, 28 Oct 2019 12:42:34 +0100 (MET)

Riyadh, Oct 28, 2019 (AFP) - Seven people have been killed and 11 injured in floods after heavy rain lashed northeastern parts of Saudi Arabia, Al-Ekhbariya state television reported Monday.   Rescue services in the northeastern city of Hafer al-Batin, about 100 kilometres southwest of Kuwait, said that 16 people were forced to evacuate their homes.   Seven affected by the rain were provided with shelter, it added.  Schools in Hafer al-Batin suspended classes on Monday due to the weather.   In January, 12 people were killed in floods in Saudi Arabia.  Ten died in the northwestern city of Tabuk, one in the Islamic holy city of Medina and another in a northern border area.
Date: Sun, 6 Oct 2019 12:04:37 +0200 (METDST)

Riyadh, Oct 6, 2019 (AFP) - Saudi Arabia announced Sunday it would allow unmarried foreign couples to rent hotel rooms together as the ultraconservative kingdom begins offering up tourist visas for the first time.   The tourism authority said in a statement published on Twitter that Saudi women travelling alone would also be able to check into a hotel by presenting valid ID.

In the past, couples wanting to stay in a hotel had to prove they were married.    "This is no longer required for tourists," the statement said.   Saudi Arabia announced on September 27 it was opening its doors to holidaymakers with the goal of diversifying its oil-dependent economy.   The kingdom had previously only issued visas to Muslim pilgrims, foreign workers, and recently to spectators at sporting or cultural events.

Kickstarting tourism is one of the centrepieces of Crown Prince Mohammed bin Salman's Vision 2030 reform programme to prepare the biggest Arab economy for a post-oil era.   Citizens from 49 countries are now eligible for online e-visas or visas on arrival, including the United States, Australia and several European nations.   On September 28, Saudi authorities warned that tourists who violated "public decency", including with immodest clothing and public displays of affection, would be subject to fines.
Date: Sun, 29 Sep 2019 17:39:45 +0200 (METDST)

Riyadh, Sept 29, 2019 (AFP) - Five people were injured in a fire that broke out at a new high-speed train station in Saudi Arabia's western city of Jeddah on Sunday, state television reported, with huge palls of smoke seen rising into the air.    The station serves the main Haramain High Speed Rail system. The route opened to the public in October last year, transporting passengers between Mecca and Medina, Islam's holiest sites.

"Five people who sustained minor injuries because of the fire were transported to hospital," Al-Ekhbariya state television reported.   The General Directorate of Saudi Civil Defence said in an earlier tweet that it was working to extinguish the fire.   A video uploaded on Twitter by the Mecca provincial government showed plumes of grey smoke rising from what looked like the inside of the complex.   An AFP correspondent said security forces closed the main road linking Mecca and Jeddah and cordoned off the site.   The blaze erupted at 12:35 pm local time (0935 GMT), according to the Haramain High Speed Rail's Twitter account.

The railway runs 450 kilometres (280 miles) via the Red Sea port of Jeddah, transporting passengers at speeds of up to 300 kilometres per hour.   Saudi King Salman inaugurated the railway in September 2018. Officials described it as the biggest transportation project in the region.   In 2011, the kingdom signed a deal for a Spanish consortium to build the rail track, supply 35 high-speed trains and handle a 12-year maintenance contract.   Saudi is boosting its infrastructure spending and expanding its railways -- including a $22.5 billion metro system under construction in the capital Riyadh -- as it seeks to diversify its oil-dependent economy.
Date: Sat, 28 Sep 2019 19:56:29 +0200 (METDST)

Riyadh, Sept 28, 2019 (AFP) - Saudi Arabia on Saturday said it would impose fines for violations of "public decency", including immodest clothing and public displays of affection, a day after the austere kingdom opened up to foreign tourists.   The interior ministry said it had identified 19 such "offences" but did not specify the penalties, as the ultra-conservative Islamic country begins issuing tourist visas for the first time as part of a push to diversify its oil-reliant economy.   "The new regulations require men and women to dress modestly and to refrain from public displays of affection. Women are free to choose modest clothing," a statement said.   "The regulations are meant to ensure that visitors and tourists in the kingdom are aware of the law relating to public behaviour so that they comply with it."

Saudi Arabia on Friday said citizens from 49 countries are now eligible for online e-visas or visas on arrival, including the United States, Australia and several European nations.   Kickstarting tourism is one of the centrepieces of Crown Prince Mohammed bin Salman's Vision 2030 reform programme to prepare the biggest Arab economy for a post-oil era.   But the conservative country, which forbids alcohol and is notorious for sex segregation, is seen as an unlikely destination for global tourists aside from Muslim pilgrims visiting holy sites in Mecca and Medina.   Men and women must avoid "tight fitting clothing" or clothes with "profane language or images", read an instruction on an English language website launched by the tourism authority.   "Women should cover shoulders and knees in public," it added.

But tourism chief Ahmed al-Khateeb said foreign women were not obligated to wear the body-shrouding abaya robe that is still mandatory public wear for Saudi women.   Prince Mohammed has sought to shake off his country's ultra-conservative image -- lifting a ban on cinemas and women drivers while allowing gender-mixed concerts and sporting extravaganzas.   The relaxed social norms in a kingdom have been welcomed by many Saudis, two-thirds of whom are under 30.   But new public decency guidelines, first approved by cabinet in April, are widely perceived to be vague and have sparked public concern that they would be open to interpretation.   They have also stoked fears of a revival of morality policing.   Saudi Arabia's religious police once elicited widespread fear, chasing men and women out of malls to pray and berating anyone seen mingling with the opposite sex.   But the bearded enforcers of public morality, whose powers have been clipped in recent years, are now largely out of sight.
More ...

Russia

General Information
***************************************
Russia is one of the largest land masses throughout the world covering an expanse of 6,592,849 sq. miles. The country stretches from the Baltic sea in Europe to the Pacific Ocean in the
east and from the Arctic Ocean in the north to the Black Sea in the south. Moscow, the capital city, is situated in the western region of the country. The nation is undergoing profound political and economic changes. There have been Bank closures and this can make access to funds more difficult for travellers.
Safety & Personal Security
***************************************
Certain regions of the country are closed to travellers and it is important to confirm your itinerary before leaving. Entry to the Caucasus region is restricted. Kidnapping of tourists is well reported in some outlying regions. Good tourist facilities are present in Moscow, St Petersburg and many of the other large cities but many shortages can occur at times. Crime against foreigners can be a problem and it is essential not to flaunt personal wealth and to take care if you need to travel at night. The underground walkways, subway, train stations and airports are particular risk locations. Don’t share a taxi with strangers.
Customs Regulations
***************************************
On entry you will need to complete a form declaring all items of value. Keep this form safe as it will be required on leaving. Take care to obtain receipts for any expensive items to purchase while in Russia.
Stringent controls at Customs when leaving the country may cause significant delays if it is felt that the traveller is trying to export items of historical value.
General Health Precautions
***************************************
The medical services available throughout Russia may not reach Western European standards. Severe shortages of even basic medical supplies are regularly reported. It is wise for travellers to ensure that they are in good general health and that dental work should not be required while abroad. Carry an adequate supply of any medications which you normally take, as these may not be available in many parts of Russia. Adequate travel insurance is essential for your trip.
Diphtheria in Russia
***************************************
Again, according to press reports, over 4000 cases of diphtheria were reported during the outbreak in the early 1990’s. Approximately 104 deaths occurred. At that stage the disease was mainly found in St Petersburg, Moscow and Krasnodar and in the eastern parts of Valdivostok and Saratov. Vaccination (with Tetanus) is usually recommended for all travellers. As Diphtheria is mainly an airborne disease it is usually wise to avoid local public transport if possible.
AIDS risk in Russia
***************************************
The blood supply throughout Russia may not be fully screened against blood borne pathogens and so blood transfusion should be avoided where at all possible. The most common reason that a traveller requires blood is following a road accident. Take special care crossing roads etc. The actual extent of the AIDS problem throughout Russia is uncertain with inaccurate reporting of statistics at this time. Obviously all care should be taken to avoid possible infection. AIDS testing is required for persons staying 3 months or longer.
Hiking in Russia
***************************************
Tick-borne encephalitis has been reported in the vicinity of Novosibirsk, Vladivostok and in the Sverdlovsk Oblast.
Pre-exposure vaccination against this disease is recommended for anyone who will be spending prolonged periods outdoors in the infested areas of Russia. Hikers should wear protective clothing and insect repellent against tick bites throughout rural Russia. Any bite should be reported to competent medical personnel as soon as possible.
Insect Bites
***************************************
Mosquitoes do occur during the summer months. Though there is thought to be no risk of malaria in Russia itself, though there are reports from some of the surrounding CIS countries. Sandflys may also be found during the summer months in the hotter southern areas.
Food Precautions
***************************************
Eat only well cooked foods while they are still hot or fruit that you peel yourself. Always avoid roadside stands and street vendors as the level of hygiene is usually far below acceptable standards. Only purchase ice-cream products from established shops and never from the street side seller. Only pasteurised dairy products should be consumed. Outbreaks of a parasitic disease known as Trichinellosis has been reported from some regions of Russia. This disease is transmitted through eating undercooked meat so all food should never be rare when consumed.
Water Precautions
***************************************
Smell the tap water for a distinct chlorine odour. In many regions the water supply may not be potable and so travellers should where possible drink bottled beverages or beverages made from boiled water (tea/coffee). Do not use ice-cubes in your drinks and never use the mains tap water for drinking or brushing your teeth.
Occasional outbreaks of Typhoid, Cholera are reported and the St Petersburg mains water supply has been closely linked with an intestinal parasite, Giardia lambia.
General Vaccine Information
***************************************
Due to the general economic situation throughout Russia it is reported that there has been a significant shortage of vaccines to combat diseases such as measles, polio, diphtheria, tetanus and pertussis. This has led to a worsening of the risk for the local population and the possibility that travellers may be more exposed.
Vaccines for Travellers
***************************************
Most travellers to Russia will need to consider routine vaccination cover against the following;
Poliomyelitis, Typhoid,
Tetanus & Diphtheria and Hepatitis A.
Longer term travellers or those trekking may also need to consider vaccination cover against Rabies, Hepatitis B, Meningococcal Meningitis and Tick Borne Encephalitis.
Summary
***************************************
The majority of travellers to Russia who exercise due caution will remain in good health. Special care must be taken regarding your food and water consumption. Care against accidents and sensible precautions to avoid petty crime are also essential. If trekking about the country check your itinerary carefully and keep those at home in touch with your plans.

Travel News Headlines WORLD NEWS

Date: Fri, 6 Dec 2019 10:30:54 +0100 (MET)

Moscow, Dec 6, 2019 (AFP) - More than 50 polar bears have gathered on the edge of a village in Russia's far north, environmentalists and residents said, as weak Arctic ice leaves them unable to roam.   The Russian branch of the World Wildlife Fund said climate change was to blame, as unusually warm temperatures prevented coastal ice from forming.   The WWF said 56 polar bears had gathered in a one-square-kilometre (0.4-square-mile) area near the village of Ryrkaipy in Chukotka on the north-eastern tip of Russia.

There were concerns they could enter the village, home to fewer than 1,000 people, and patrols had been set up to monitor their movements.   "The number of human and predator encounters in the Arctic is increasing," the WWF said in statement.    "The main reason is the decline of sea ice area due to the changing climate. In the absence of ice cover, animals are forced to go ashore in search of food."

Residents had gathered walrus carcasses in the area to try to keep the bears from wandering into the village.   "We have created a feeding point with walrus carcasses that we gathered along the coast," Tatyana Minenko of the local "Bear Patrol" told news agency RIA Novosti.   "As long as there is no big freeze, the sea ice will not form and the bears will stay on the coast," she said.

Russia's weather service said temperatures in the region should fall from Saturday and that coastal ice should freeze by December 11.    Polar bears regularly visit areas inhabited by humans in Arctic Russia to search for food, often in rubbish tips.   But the number of visits has been growing as the melting of Arctic ice from climate change forces the bears to spend more time on land where they compete for food.
Date: Wed, 31 Jul 2019 18:00:57 +0200 (METDST)

Moscow, July 31, 2019 (AFP) - Russian President Vladimir Putin on Wednesday called in the army to fight forest fires that have been raging across vast expanses of Siberia for days, enveloping entire cities in black smoke.   Environmentalists have warned that the scale of the blazes could accelerate global warming, aside from any immediate effects on the health of inhabitants.   Around three million hectares (7.4 million acres) of land in the centre and east of the country were in the grip of fires on Wednesday, authorities said.

The acrid smoke has affected not only small settlements but also major cities in Western Siberia and the Altai region, as well as the Urals such as Chelyabinsk and Yekaterinburg, and disrupted air travel.   "After reviewing a report from the emergency situations minister, Putin instructed the ministry of defence to join the effort to extinguish the fires," the Kremlin's press service told Russian media.   Some 2,700 firefighters were already working to tackle the blazes, Interfax news agency reported.   The defence ministry told news agencies that 10 planes and 10 helicopters had been dispatched to the Krasnoyarsk region, one of the worst affected.

- Spread by strong winds -
The Kremlin press service said the armed forces in the Irkutsk region, also badly hit, had been put on high alert, without providing further details of military involvement.    The fires, triggered by dry thunderstorms in temperatures above 30 degrees Celsius (86 degrees Fahrenheit), were spread by strong winds, Russia's federal forestry agency said earlier.    States of emergency have been declared in five Russian regions.    People living in these regions have uploaded images to social media showing roads hazy with smoke and the sun barely visible in the sky.   The majority of the fires, however, are raging in remote or inaccessible areas. Authorities make the decision to extinguish them only if the estimated damage exceeds the cost of the operation.   A petition launched on change.org a week ago calling on authorities to do more to tackle the fires has gathered more than 800,000 signatures.

Summer fires are common in Russia but this year they have spread further than usual.   According to the Russian branch of Greenpeace, almost 12 million hectares of forest have been burnt this year -- causing significant CO2 emissions and reducing the future capacity of forest to absorb the carbon dioxide.   A spokesman for the environmental organisation told the Echo of Moscow radio station that the involvement of the military would not "drastically change" the situation with the forest fires.    Deploying army units to the forest could do more harm to the operation than good, Grigory Kuksin said.    The spokesman also criticised authorities for what he said was a delayed response to the crisis.
Date: Mon, 1 Jul 2019 18:20:04 +0200

Moscow, July 1, 2019 (AFP) - Twelve people have died and nine are missing after heavy rainfall flooded dozens of villages in Russia's south-eastern Siberia, the deputy prime minister said Monday.    A state of emergency has been declared in Siberia's Irkutsk region, where dozens of villages have been partially destroyed by floods after river levels began rising dramatically.   "Unfortunately, twelve people have died and nine are being searched for," Vitaly Mutko said during a government meeting in the Moscow region.

Mutko said some 32,700 people in 83 villages were affected by the floods.  "751 were injured, 153 have been hospitalised," he added.  Infrastructure has also been affected, he said, with around 13 roads and several bridges damaged.    Russia's defence ministry said it had sent more than 1,300 servicemen, vehicles, a plane and two helicopters to the affected areas.

Earlier on Monday, the country's emergency situations ministry said it had evacuated 2,273 people.    Russian President Vladimir Putin visited the region on Sunday, on his way back from the G20 summit in Japan.    He held a meeting with local authorities in Bratsk, a city 4,820 kilometres (3,000 miles) east of Moscow on the Angara River.    The Russian leader called on authorities to compensate those who suffered from the floods and to begin work repairing houses.          "Here the summer is short, winter comes quickly, there is very little time," Putin said in a video published by the Kremlin.
Date: Wed, 8 May 2019 11:35:32 +0200

Moscow, May 8, 2019 (AFP) - Seven hikers were missing and feared dead after an avalanche in Russia's Altai mountains, emergency officials said Wednesday, as search parties were dispatched to the area.   Nine people were caught in the avalanche Monday in the so-called Chuya Alps of Russia's Altai republic in southern Siberia, close to Kazakhstan and China.    "Two people managed to get out" and informed authorities on Wednesday, said the head of Altai's emergency services, Andrei Burlakov.   "Since the avalanche is rather large, the search and rescue operations can stretch out to an indefinite amount of time," he said.

The hikers were experienced adults following a complicated mountain route which was approved by the authorities, their instructor Vladimir Yudin told the BFM news website, adding that a comprehensive search would probably have to wait for the summer season.   He said the hikers were part of a group based in the Siberian city of Novosibirsk.
Source: Belsat TV [in Russian, machine trans., edited]

An outbreak [of suspected echinococcosis] among cadets in Ulyanovsk Suvorov Military School, was discovered in early February [2019]. At least, 49 cadets of the military Suvorov school, instead of 26 as reported earlier, are infected with _Echinococcus_.

The Ministry of Defense of Russia excludes that the infection could have been transmitted through the food and believes that it happened by touching contaminated dogs.

Echinococcosis was initially suspected in 5 cadets. Their X-rays showed suspected cysts in the lungs.

On [5 Feb 2019], a criminal case under part 1, article 236 of the criminal code suspected violations of the sanitary and epidemiological rules, which led to mass disease. On [6 Feb 2019], at the Suvorov School, representatives of the Ministry of Defense of the Russian Federation met with the parents of the students. They reported the investigation, rejecting the version of infection through food in the school's canteen. The head of the institution, Vladimir Shkirkov, and the chief parasitologist of the Ministry of Defense, Sergey Kozlov, informed the parents that the cadets could have become ill by stroking an infected dog, Novaya Gazeta newspaper reported. On [14 Feb 2019], the newspaper "Izvestia" published a new version: the students were infected during the use of nasvaya smokeless tobacco mixture made from chicken or camel dung.

The publication refers to an anonymous source close to the investigation, but it gives the opinion of researchers who believe this option unlikely. The newspaper claims to have found several more sick cadets, 2018 graduates. But on [2 Feb 2019] the media reported about disease among staff of the school cafeteria.

The response of the Ministry of Health to [Ulyanovsk Region State Duma Deputy] Alexei Kurinny, it was specified that the ministry had performed a full examination of more than 518 and 305 employees of Suvorov military school.
********************************
Date: Fri 1 Mar 2019
Source: OTR (Public Television of Russia) [in Russian, machine trans.,
abridged, edited]

As of [20 Feb 2019] it is known about 49 cases in the military Suvorov school.

Foci of infection also have been found in the liver, pancreas, brain, eyes, and spleen.
********************************
Date: Mon 4 Feb 2019
Source: Interfax-Russia [in Russian, machine trans., abridged,
edited]

Initially, echinococcosis was detected during routine examination in 5 cadets after X-ray of the lungs. None of them had health complaints. On [4 Feb 2019], Mass Media published information of already 25 cases among cadets.
=====================
[Infection of humans with _Echinococcus granulosis_ happens when eggs are ingested and hatch in the intestines, penetrate the intestinal wall, and migrate to different organs. The infection can happen through eggs from dog feces contaminating water, greens, and berries.

The notions that the subjects has consumed "nasvaya-tobacco mixture made from chicken or camel dung" does not explain infection with _Echinococcus_ and neither camels nor or chickens excrete _Echinococcus_ eggs in their feces. If the "tobacco" was made from dog feces it could be a source of infection.

The incubation period is usually years, and for instance a study from Kirgyzstan estimated an incubation period of 15 years (Usubalieva J et al. Human alveolar echinococcosis in Kyrgyzstan. Emerg Infect Dis. 2013; 19(7): 1095-7. doi: 10.3201/eid1907.121405).

The news report in item [3] above only mentions chest X-rays, but the article in item [1] mentions "suspected cysts in the lungs" and the article in item [2] mentions that foci of infection [cysts?] have been found in multiple other organs. In 95% of human cases the liver is involved because it receives the blood draining the intestines.

Given the long incubation period of _Echinococcus_, an outbreak involving at least 49 persons developing symptoms within a few months with a common source of infection is highly unlikely if not impossible.

What else can it be?
If the lesions were limited to the lungs TB is much more likely, but an outbreak of pulmonary TB would not be associated with multiple lesions in other organs. Foodborne infections could be caused by _Trichinella_, but _Trichinella_ does not result in cystic lesions; it is a multiorgan infection, it is foodborne, and several outbreaks have been reported from Russia.

ProMED will be happy to post more information including more information on the X-ray and CT results, and whether the patients had eosinophilia (sign of a helminth infection). - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Russia:
More ...

World Travel News Headlines

Date: Tue, 10 Dec 2019 10:50:09 +0100 (MET)

Sydney, Dec 10, 2019 (AFP) - The death toll from New Zealand's White Island volcano eruption rose to six late Tuesday, after an injured person died in an Auckland hospital, police said.   "Police can confirm a further person has died following the eruption on Whakaari/White Island, bringing the official toll to six," a police statement said.   Eight more people who remain missing are presumed dead after the volcano erupted Monday.
Date: Tue, 10 Dec 2019 09:27:57 +0100 (MET)
By Andrew BEATTY, with Daniel de Carteret in Gosford

Sydney, Dec 10, 2019 (AFP) - Toxic haze blanketed Sydney Tuesday triggering a chorus of smoke alarms to ring across the city and forcing school children inside, as "severe" weather conditions fuelled deadly bush blazes along Australia's east coast.   Fire engines raced office-to-office in the city centre with sirens blaring, as inland bushfires poured smoke laden with toxic particles into commercial buildings.   Emergency services responded to an "unprecedented" 500 automatic call-outs inside a few hours according to New South Wales Fire and Rescue's Roger Mentha.

A regional fire headquarters miles from the nearest blazes was itself evacuated while throngs of mask-wearing commuters choked their way through thick acrid air and the organisers of a harbour yacht race declared it was unsafe to proceed.   "The smoke from all the fires is just so severe here on the harbour that you just can't see anything, so it's just too dangerous," said spokeswoman Di Pearson of an event that normally foreshadows the famed Sydney-Hobart yacht race. "The vision is just so poor."   Some of the city's commuter ferries were also cancelled "due to thick smoke" and school kids were kept inside at breaktime and sent home early as pollution levels soared far above "hazardous" levels.

For weeks the east of the country has been smothered in smoke as drought and climate-fuelled bushfires have burned. But the scale of the problem on Tuesday shocked even hardened residents.   Bruce Baker -- an 82-year-old who lives in Gosford, north of Sydney -- said he was skipping his daily morning walk because of the smoke.   "This is the worst it's been, for sure," he told AFP. "It dries your throat. Even if you're not asthmatic, you feel it."   Authorities recommended that the vulnerable cease outdoor activity altogether and that everyone stay inside as much as possible, although one couple braved the toxic air to get married on the waterfront in front of Sydney Harbour Bridge shrouded in smog.

A cricket match between New South Wales and Queensland also went ahead, despite a barely visible ball.   Tuesday had been expected to bring strong winds and high temperatures that made for "severe conditions where embers can be blown ahead of the fire into suburbs and threaten properties."   But New South Wales Rural Fire Service said "deteriorating fire conditions have been delayed by a thick blanket of smoke" over the east of the state.   As the day developed there were nearly 100 bushfire incidents in the state of New South Wales alone and dozens more in Queensland.   Total fire bans were put in place across much of the east of the country and in large parts of western Australia.   Temperatures in some inland areas eased past 44 degrees Celsius (111 Fahrenheit).

- The 'big dry' -
To the northwest of Sydney, several fires already burning for weeks have combined to create a "megafire" that has already destroyed 319,000 hectares (788,000 acres) of land, mostly inside national parks.   Prime Minister Scott Morrison  -- who for weeks has not commented on the smoke haze -- defended his government's handling of the fires and said there were no plans to professionalise the countryside's largely volunteer force.    "Our policy is sensible when it comes to addressing and taking action on climate change. Our actions on climate change are getting the results they're intended to get," he said.   Morrison's conservative coalition has been criticised by former fire chiefs for failing to heed warnings about climate change.   The crisis has been propelled by a prolonged drought that has made vegetation tinder dry.

The Bureau of Meteorology has reported that Australia experienced its driest November on record this year.   The "big dry" has left farmers desperate and small towns facing the prospect of running out of water completely.   A swathe of the east of the country has seen "rainfall deficiencies" since early 2017 -- almost three years.   Many dams in New South Wales are empty and almost all are well below capacity.   Firefighters south of Brisbane recently reported 1,000 litres of water were stolen from tanks at their station.   Amid the shortage, Tuesday also saw the toughest water restrictions in a decade being introduced for Sydney -- with curbs on everything from hosepipe use to washing cars.
Date: Tue, 10 Dec 2019 03:09:17 +0100 (MET)
By Allison JACKSON

Sao Paulo, Dec 10, 2019 (AFP) - Gripping the deadly snake behind its jaws, Fabiola de Souza massages its venom glands to squeeze out drops that will save lives around Brazil where thousands of people are bitten every year.   De Souza and her colleagues at the Butantan Institute in Sao Paulo harvest the toxin from hundreds of snakes kept in captivity to produce antivenom.    It is distributed by the health ministry to medical facilities across the country.

Dozens of poisonous snake species, including the jararaca, thrive in Brazil's hot and humid climate.    Nearly 29,000 people were bitten in 2018 and more than 100 died, official figures show.   States with the highest rates of snakebite were in the vast and remote Amazon basin where it can take hours to reach a hospital stocked with antivenom.   Venom is extracted from each snake once a month in a delicate and potentially dangerous process.

Using a hooked stick, de Souza carefully lifts one of the slithering creatures out of its plastic box and maneuvers it into a drum of carbon dioxide.    Within minutes the reptile is asleep.    "It's less stress for the animal," de Souza explains.    The snake is then placed on a stainless steel bench in the room where the temperature hovers around 27 degrees Celsius (80 degrees Fahrenheit).    De Souza has a few minutes to safely extract venom before the snake begins to stir.      "It's important to have fear because when people have fear they are careful," she says.

- Antivenom 'crisis' -
The snakes are fed a diet of rats and mice that are raised at the leafy institute and killed before being served up once a month.   After milking the snake, de Souza records its weight and length before placing it back in its container.    The antivenom is made by injecting small amounts of the poison into horses -- kept by Butantan on a farm -- to trigger an immune response that produces toxin-attacking antibodies.

Blood is later extracted from the hoofed animals and the antibodies harvested to create a serum that will be administered to snakebite victims who might otherwise die.   Butantan project manager Fan Hui Wen, a Brazilian, says the institute currently makes all of the country's antivenom -- around 250,000 10-15 millilitre vials per year.

Brazil also donates small quantities of antivenom to several countries in Latin America.    There are now plans to sell the life-saving serum abroad to help relieve a global shortage, particularly in Africa.    About 5.4 million people are estimated to be bitten by snakes every year, according to the World Health Organization (WHO). 

Between 81,000 and 138,000 die, while many more suffer amputations and other permanent disabilities as a result of the toxin.   To cut the number of deaths and injuries, WHO unveiled a plan earlier this year that includes boosting production of quality antivenoms.   Brazil is part of the strategy. It could begin to export antivenom as early as next year, Wen says.   "There is interest for Butantan to also supply other countries due to the global crisis of antivenom production," she says.
Date: Mon, 9 Dec 2019 14:14:15 +0100 (MET)

Dec 9, 2019 (AFP) - New Zealand, struck by a deadly volcanic eruption Monday, lies in a zone where Earth's tectonic plates collide, making it a hotspot for earthquakes and volcanic activity.   In one of its worst natural disasters, a huge mass of volcanic debris from the eruption of Mount Ruapehu triggered a mudslide in 1953 that washed away a bridge and caused a passenger train to plunge into a river with the loss of 151 lives.  After Monday's eruption on New Zealand's White Island, here is a recap of some of the deadliest volcanic eruptions around the world in the past 25 years.

- 2018: Indonesia -
In December the Anak Krakatoa volcano, a small island in the Sunda Strait between Java and Sumatra, erupts and a section of its crater collapses, sliding into the ocean and generating a tsunami. More than 420 people are killed and 7,200 wounded.

- 2018: Guatemala -
The June eruption of the Fuego volcano, about 35 kilometres (22 miles) from the capital, unleashes a torrent of mud and ash that wipes the village of San Miguel Los Lotes from the map. More than 200 people are killed.

- 2014: Japan -
The sudden eruption in September of Mount Ontake, in the central Nagano region, kills more than 60 people in Japan's worst volcanic disaster in nearly 90 years. The mountain is packed with hikers at the time. In 1991 an eruption of the southwestern Unzen volcano kills 43.

- 2014: Indonesia -
At least 16 people are killed on the island of Sumatra in February by a spectacular eruption of Mount Sinabung, which had lain dormant for 400 years before roaring back to life five months earlier. In 2016 villages are scorched and farmland devastated after another eruption kills seven.

- 2010: Indonesia -
Indonesia's most active volcano, Mount Merapi on Java island, starts a series of explosions in October, eventually killing more than 320 people. An 1930 eruption of the volcano killed 1,300 people and one in 1994 claimed more than 60 lives.

- 2002: DR Congo -
The eruption in July of Mount Nyiragongo in the eastern Democratic Republic of Congo destroys the centre of Goma town, along with several residential areas, and kills more than 100 people.

- 1997: Montserrat -
The capital of the small British colony, Plymouth, is wiped off the map and 20 are killed or left missing in avalanches of hot rock and ash clouds when its volcano erupts in June.

- 1995: The Philippines -
At least 70 are killed and another 30 missing after the crater of the Parker volcano in the south of the island of Mindanao collapses. Five years earlier the eruption of Mount Pinatubo, 80 kilometres north of the capital Manila, kills more than 800 people.

- Worst ever -
The explosion of Indonesia's Krakatoa volcano in 1883 is considered the worst ever seen. The eruption sent a jet of ash, stones and smoke shooting more than 20 kilometres (12 miles) into the sky, plunging the region into darkness, and sparking a huge tsunami that was felt around the world. The disaster killed more than 36,000 people.

The most famous eruption in history is that of Mount Vesuvius in modern-day Italy in 79 AD, which destroyed the towns of Herculaneum, Stabiae and Pompeii, wiping out an estimated 10 percent of the population of the three cities.
Date: Mon 9 Dec 2019
Source: Fox 29 Philadelphia [edited]

A total of 31 people have been sickened by salmonellosis at 4 health care facilities in south-eastern Pennsylvania. A majority of those cases occurred after individuals ate pre-cut fruit from New Jersey-based Tailor Cut Produce. The Food and Drug Administration (FDA) announced the salmonellosis outbreak in conjunction with the Pennsylvania Department of Health (DOH) on [Fri 6 Dec 2019]. The North Brunswick distributor has recalled its fruit mix with cantaloupe, honeydew, pineapple and grapes as a result.

Tailor Cut Produce reports that its products may be found in restaurants, banquet facilities, hotels, schools and institutional food service establishments in Pennsylvania, New Jersey and New York. "We recommend that any facility who use Tailor Cut Produce pre-cut fruit to immediately stop and throw it away," Pennsylvania Secretary of Health Dr. Rachel Levine said.

Salmonellosis is an infection caused by _Salmonella_ bacteria that generally affects the intestinal tract. People usually become infected by either eating or drinking contaminated food or water, by contact with infected people or animals, or through contact with contaminated environmental sources.
Date: Mon 9 Dec 2019
Source: Sixth Tone [edited]

Dozens of researchers in northwestern China's Gansu province have been infected with brucellosis, an animal-borne disease that causes flu-like symptoms and, potentially, lingering problems. In a statement [Fri 6 Dec 2019], the Lanzhou Veterinary Research Institute, an affiliated institute of the Chinese Academy of Agricultural Sciences, said that the 1st few grad students from the institute's foot-and-mouth disease prevention team tested positive for brucellosis antibodies on [28 Nov 2019]. The labs affected have been closed, the institute said, and national and local health authorities have assembled a team to investigate the outbreak.

Li Hui, an official at the health commission in Lanzhou, the provincial capital, told Sixth Tone on [Mon 9 Dec 2019] that the total number of brucellosis cases at the institute had climbed to 96. None have shown clinical symptoms, according to domestic media, and it remains unclear how they were exposed to the bacteria.

Brucellosis -- also known as Malta, Mediterranean, or undulant fever -- is a zoonotic disease that mainly affects animals, including livestock and dogs, which can in turn transmit the bacteria to humans through direct contact. Symptoms include fever, chills, sweating, lethargy, and aches and pains, according to the WHO. In the absence of early diagnosis and treatment, brucellosis can become a chronic condition that is difficult to cure.

In China, brucellosis is a Class B disease, ranking below a more serious category that includes cholera and plague. Human-to-human transmission has only been known to occur between lactating mothers and their babies. According to state broadcaster China National Radio, the brucellosis outbreak at the Gansu veterinary institute has prompted health checks among local students and staff who fear that they may have come into contact with infected animals.

One of the last brucellosis outbreaks in China occurred in 2011, when an agricultural university in the northeastern Heilongjiang province reported 28 cases stemming from infected goats being used in lab research. The school publicly apologized, fired 2 administrators, and offered each of the students' affected monetary compensation.

Scientific labs are subject to different experimental standards depending on their biosafety level, according to a researcher surnamed Yang at the Shanghai Institutes for Biological Sciences, an affiliate of the Chinese Academy of Sciences.

"If the protection levels don't keep pace (with biosafety levels), there will be a risk of infection," Yang, who studies viruses and works in a Biosafety Level 2+ lab, told Sixth Tone. As a result, labs generally require researchers to undergo safety training or even pass an exam to earn a certification, said Yang, who only used her surname because she was not authorized by her employer to speak to media.

The Lanzhou Veterinary Research Institute describes itself as "China's only authorized research center for working with the live virus that causes foot-and-mouth disease," a highly contagious disease affecting livestock. The institute is reportedly also one of the few in China with Biosafety Level 3 labs, which are required for _brucella_ pathogen studies, according to the National Health Commission.

As the local agriculture department tries to ascertain the source of the recent infections, Lanzhou's health commission said [Fri 6 Dec 2019], it is implementing precautionary measures so that brucellosis does not pose a threat to neighbouring communities. [Byline: Yuan Ye]
=================
[An earlier report suggested that 4 persons were clinically ill but this is not confirmed here.  Brucellosis (<http://www.medicinenet.com/brucellosis/article.htm>) is a disease that is thought to have existed since ancient times, as it was 1st described more than 2000 years ago by the Romans and Hippocrates. It was not until 1887 that a British physician, Dr. David Bruce, isolated the organism that causes brucellosis from several deceased patients from the island of Malta. This disease has had several names throughout its history, including Mediterranean fever, Malta fever, Crimean fever, Bang's disease, and undulant fever (because of the relapsing nature of the fever associated with the disease).

The symptoms and signs of brucellosis may develop from days to months after the initial exposure to the organism. While some individuals may develop mild symptoms, others may go on to develop long-term chronic symptoms. The signs and symptoms of brucellosis are extensive, and they can be similar to many other febrile illnesses, so recognition of potential exposure -- from ingestion of unpasteurized milk or cheese, employment as a veterinarian or veterinary student, in a slaughter house or meat processing plant, or working in a microbiology lab -- is vital. In this outbreak, it is not clear what symptoms the students had or whether they were just seropositive. ProMED would like more information about this episode. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Gansu Province, China: <http://healthmap.org/promed/p/333>]
Date: Tue 3 Dec 2019
Source: Outbreak News Today [edited]

In late November [2019], Uganda health authorities notified the World Health Organization of a fatal Rift Valley fever (RVF) case from Obongi district.  The case was a 35-year-old man from South Sudan who was living in the Palorinya Refugee camp in Obongi district, Uganda. The case had travel history to South Sudan between 12 and 19 Nov 2019 to harvest cassava. While in his home country, he developed fever and other symptoms and was treated for malaria; however, his condition got worse.  He later returned to the refugee camp in Uganda and his symptoms progressed and he was hospitalized. Viral hemorrhagic fever was suspected. Samples were collected and sent to the Uganda Virus Research Institute; however, the patient died. A safe and dignified burial was performed on 22 Nov 2019. As of 24 Nov 2019, a total of 19 contacts were recorded during the active case search including 10 healthcare workers.
===================
[The circumstances and specific location under which the man became infected with Rift Valley fever (RVF) virus in South Sudan is not mentioned. It is worth noting that there was an RVF outbreak in the Eastern Lakes region of South Sudan during the 1st 3 months of last year (2018). At the end of that outbreak, the OIE's follow-up report no. 3 reported: "The event cannot be considered resolved, but the situation is sufficiently stable. No more follow-up reports will be sent. Information about this disease will be included in the next 6-monthly reports."

There were more human cases than animal ones in that outbreak, prompting Mod.AS to comment: "Unfortunately, during the recent South Sudan RVF event, as in most -- if not all -- previous RVF events in other African countries, humans served as sentinels. Improved surveillance in animals is desperately needed in Africa, to allow timely measures applied, predominantly preventive vaccination, before the development of a full-blown epizootic involving secondary infection in humans." Intensified surveillance is needed in South Sudan in those localities where the affected man had been prior to his return to Uganda.

It is likely that RVF virus has persisted in this area in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods of time and hatch when flooded during future rain events, with the subsequent emergence of infected females ready to transmit the virus. This risk provides justification for maintaining livestock of the area well vaccinated into the future. This may have accounted for the reappearance of RVF in South Sudan in 2018, after nearly 2 years without additional reported cases in humans or livestock and again with this human case in 2019. - ProMED Mod.TY]

Obongi district, Uganda is located approximately 50 km (30 mi) from the South Sudan border.
HealthMap/ProMED-mail maps:

According to OIE's data, a total of 2 outbreaks of RVF affecting animals have been reported from Sudan during the event. The 1st outbreak started in the Arabaata dam area, Red Sea state, on 25 Sep 2019, affecting goats. The 2nd (and, so far, last) outbreak started 10 Oct 2019 in the River Nile state, affecting sheep and goats. Both outbreaks have been declared as 'resolved' on 14 Nov 2019.

Outbreak summary:
Total outbreaks = 2 (Submitted)
Species / Susceptible / Cases / Deaths / Killed and disposed of / Slaughtered
Goats / 1700 / 37 / 7 / 0 / 0
Sheep / 1550 / 37 / 5 / 0 / 0

According to the recent (5 Dec 2019) OCHA (UN Office for the Coordination of Humanitarian Affairs) update, the (human) RVF situation in Sudan, as of 26 Oct 2019, was the following: "a total of 345 suspected RVF cases -- including 11 related deaths -- reported in the states of Red Sea (128), River Nile (212), Khartoum (1), White Nile (1), Kassala (2), and Gedaref (1). The most affected age group is 15 to 45 years, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5 per cent). RVF is endemic in Sudan and 3 outbreaks affecting people have been documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths."

Egypt suffered its 1st RVF outbreak in 1977/78 with serious human disease and death as well as severe losses in livestock; several additional events have been recorded since. A recent historical review paper [1] concluded: "due to the availability and abundance of the potential vectors, the suitability of environmental conditions, continuous importation of livestock's from Sudan, and the close association of susceptible domestic animals with humans, the RVF virus could possibly occur and circulate in Egypt."   (https://tinyurl.com/whz3pz5)

Reference
---------
1. Kenawy MA, Abdel-Hamid YM, Beier JC. Rift Valley fever in Egypt and other African countries: Historical review, recent outbreaks, and possibility of disease occurrence in Egypt. Acta Trop. 2018; 181: 40-49; <https://doi.org/10.1016/j.actatropica.2018.01.015>  - ProMED Mods.AS/TY]
Date: Fri 6 Dec 2019 5:53 PM MST
Source: CTV News [edited]

A syphilis outbreak is worsening in Alberta [Canada], and the majority of new cases are in the Edmonton zone. Edmonton saw 1186 of the 1753 infectious syphilis [primary, secondary and early latent syphilis] cases reported in Alberta in 2019, a total of 68 per cent.

Alberta Health Services [AHS] declared an outbreak in July 2019, saying cases had 'increased dramatically' in the province since 2014. The number increased again in July [2019]  [<https://edmonton.ctvnews.ca/alberta-declares-province-wide-syphilis-outbreak-1.4510737>].

AHS sent a new public health alert to doctors on [27 Nov 2019], asking for their help to control the outbreak [<https://www.albertahealthservices.ca/assets/info/hp/phys/if-hp-phys-moh-ez-syphilis-outbreak.pdf>]. "It's very significant," said Dr Ameeta Singh, a clinical professor in infectious diseases. "That's an alarming rise in new syphilis cases in Alberta." She said it's the highest number of cases the province has seen since the 1940s.

According to Dr Singh, the increase in cases being reported is partially due to a greater number of people getting tested. "We know more people are coming in to get tested, but if we look a bit closer at the data we have, we do see there's, in fact, a [bigger] rise in the number of cases than we would expect to see," said Singh.

Another factor could be the rise in methamphetamine use in Edmonton. "I believe this is a major factor. Meth also stimulates risky sexual behaviour and increases the chance people will engage in multiple, usually casual or anonymous partners as well and not use precautions such as condoms to protect themselves during sex," she said.

What's also alarming, Singh said, is the spike in cases of congenital syphilis, where the disease is passed on to newborns. According to AHS, there have been 38 cases of congenital syphilis in 2019, 31 of which were in the Edmonton area. That accounts for more than half of the 61 cases of congenital syphilis reported since 2014.

"Those are not numbers we should be talking about in Canada ever...in a country that has universal access to health care, in a major city in Canada where syphilis testing is offered to all pregnant women who access prenatal care," she said. "What we're seeing with the congenital syphilis cases is many of the women are not accessing prenatal care until they come into the hospital to deliver and then the tests are being done."
===================
[A recent ProMED-mail post (Syphilis - Canada (04): (AB) RFI http://promedmail.org/post/20190718.6574300) reported a rise in "infectious syphilis" cases over a 4-year period: from 2014 to 2018 but made no mentioned of contributing factors. As illicit drug use has been cited as a contributing factor to recent increases in syphilis cases in the Canadian provinces of Ontario and Manitoba, I questioned in this prior ProMED-mail post if use of illicit drugs, in particular, methamphetamine, could similarly be contributing to the rise of syphilis cases in Alberta. The news article above reports that the rise in methamphetamine use in Edmonton, as well as increased testing for syphilis, are thought to be contributing factors in Alberta.

Methamphetamine can be swallowed, snorted, smoked or injected by needle and syringe

When methamphetamine is injected, transmission of syphilis may occur as a consequence of sharing a needle/syringe contaminated with infected blood from somebody who has primary or secondary syphilis (<https://ucsdnews.ucsd.edu/archive/newsrel/health/04-28TransmissionSyphilis.asp>); but syphilis can also be acquired by direct contact with an infected lesion during oral, vaginal, or anal sex when the drug is taken by any route of administration. Methamphetamine use is associated with sexual behaviors that increase the risk for acquiring syphilis and other sexually transmitted diseases, including having multiple sex partners, inconsistent condom use, and exchange of sex for drugs or money (<https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a4.htm>).

The linkage of methamphetamine use and syphilis transmission is reminiscent of the increase in syphilis among heterosexuals during the crack cocaine epidemic of the 1980s and 1990s, when the practice of trading sex with multiple partners for drugs, especially crack cocaine, played a major role in the transmission of syphilis. Under these circumstances, the identities of sex partners are often unknown, which weakens the traditional syphilis-control strategy of partner notification.

Bacteremia due to _Treponema pallidum_, the cause of syphilis, which occurs during primary, secondary, and latent syphilis, can result in transplacental transmission of this organism to the fetus during pregnancy and cause congenital syphilis. An increase in the incidence of syphilis in women in the population is commonly accompanied by increasing rates of congenital syphilis.

Edmonton, with a population of 932 546 residents in 2016, is the capital of the Canadian province of Alberta
(<https://en.wikipedia.org/wiki/Edmonton>).

A map showing the location of Edmonton can be found at
<https://goo.gl/maps/Rfq6XC2vvwi19ypb6>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Alberta, Canada:
9 December 2019
https://www.who.int/bangladesh/news/detail/09-12-2019-cholera-vaccination-campaign-launched-to-protect-635-000-people-in-cox-s-bazar

Cox’s Bazar, Bangladesh

Over 635,000 Rohingya refugees and Bangladeshi host community will be vaccinated against cholera in a 3-week-long campaign beginning today at the refugee camps in Cox’s Bazar and nearby areas, to protect vulnerable population against the deadly disease amidst increasing number of cases of acute watery diarrhoea (AWD).


The Oral Cholera Vaccination (OCV) campaign will be implemented in the refugee camps from 8-14 December to reach 139,888 Rohingya aged 1 year and less than 5 years. In the host community, the campaign will take place from 8-31 December and aims to reach any person older than 1 year (495,197). In total, 635,085 people are expected to be reached.

Led by the Ministry of Health and Family Welfare, with support of the World Health Organization (WHO), UNICEF and other partners, the campaign aims to reach people who missed some or all previous cholera vaccination opportunities. The campaign, including operational costs, is funded by Gavi, the Vaccine Alliance.

“We want to equip these populations with more protection against diarrheal diseases. Despite the progresses made to ensure access to quality water and sanitation, such diseases remain an issue of concern: approximately 80% of host community living near the camps have not been targeted in previous OCV campaigns and are still vulnerable”, says Dr Bardan Jung Rana, WHO Representative in Bangladesh.

Earlier rounds of cholera vaccination, which have taken place since the beginning of the emergency response in 2017, have helped prevent outbreaks of the disease. To this date, over 1 million people were vaccinated against cholera.
6th December 2019
https://www.theguardian.com/world/2019/dec/06/flooding-hits-new-zealand-tourist-hubs-of-wanaka-and-queenstown

Heavy rain has led to rivers bursting their banks, forcing the closure of shops and restaurants

Streets in the South Island tourist towns of Wanaka and Queenstown were slowly going under water on Friday, after Lake Wanaka and Lake Wakatipu burst their banks earlier in the week, flooding businesses and sewerage systems.

Water and large debris closed the main street of Wanaka, a popular spot with Instagrammers thanks to its famous tree that appears to have grown out of the lake. On Friday businesses were sandbagging as heavy rain continued to fall.

Sewerage systems in the town were also at risk of contaminating the lake, with the Queenstown Lakes District council taking the precautionary measure of shutting down the sewer connection to a handful of premises.

Wanaka residents were told to be on “high alert” with heavy rain predicted all weekend.

The streets of the usually bustling tourist town were largely empty, and the popular cafes and restaurants on the lake shore were closed.