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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: Thu, 16 Jan 2020 02:45:27 +0100 (MET)
By Ivelisse RIVERA, con Leila MACOR en Miami

Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid.   Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.

In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA.  "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning.    "We are living in constant fear of another powerful tremor," he said.

He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said.   Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake.    The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.

Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old.  "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later.   "It's different to a hurricane. What is happening now is much nastier," he said.

As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted.   The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant.    The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.

- Seeking disaster designation -
Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more.   The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said.   On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.

In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster.   It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests.   The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Date: Sat, 11 Jan 2020 15:43:12 +0100 (MET)

Washington, Jan 11, 2020 (AFP) - A 5.9 magnitude earthquake rocked Puerto Rico Saturday, the latest in a series of powerful tremors that have shaken the US territory in recent days, the US Geological Survey reported.

The latest quake occurred at 8:54 am local time (1254 GMT) around 13 kilometres (eight miles) southeast of Guanica, a town on the island's southern Caribbean coastline that was hard hit by earlier quakes.   The USGS revised its initial report of a 6.0 magnitude quake to 5.9.   It follows a 6.4 magnitude quake Tuesday that killed one person, knocked
out electric power and caused widespread damage.

Puerto Rico Governor Wanda Vazquez declared a state of emergency after Tuesday's quake, which forced an automatic shutdown of the power grid.    Puerto Rico's electric power authority reported outages in the towns of Ponce, Lares, Adjuntas and San German after the latest quake.   The Pacific Tsunami Information Center in Hawaii issued a statement saying there was "no significant tsunami threat" but a small possibility of tsunami waves along coasts nearest the epicentre.

The island is still recovering from Hurricane Maria, which came ashore more than two years ago as a devastating Category 4 storm.   Starting December 28, a wave of tremors have swept the island, putting residents on edge.   The 6.4 quake on January 7 came a day after a 5.8 magnitude quake; it was followed by major aftershocks.   Saturday's quakes were also preceded by a string of smaller tremors.
Date: Tue, 7 Jan 2020 23:44:45 +0100 (MET)
By Ricardo Arduengo

Guayanilla, Puerto Rico, Jan 7, 2020 (AFP) - Puerto Rico's governor declared a state of emergency on Tuesday after a powerful 6.4 magnitude earthquake killed at least one person in the south of the island and caused widespread damage.   Governor Wanda Vazquez said the declaration would allow for the activation of National Guard troops in the US territory still recovering from a devastating 2017 hurricane.   The US Geological Survey said the quake struck at 4:24 am (0824 GMT) with the epicenter off the coast of the southern city of Ponce, and was followed by more than a dozen aftershocks.

Tuesday's quake was the most powerful in a series of tremors that have shaken the island since December 28.   Scientists initially sent out an alert about a potential tsunami but it was later canceled.   The island's electricity authority said the quake had forced an automatic shutdown of the power grid, already severely damaged by Hurricane Maria more than two years ago.   The worst damage appeared to be in towns on the southwest coast, including Ponce, Guayanilla and Guanica.   El Nuevo Dia newspaper said a 73-year-old man died after a wall fell in his home in Ponce. Eight others there were reported injured.

Two power plants in Guayanilla sustained major damage, the Puerto Rico Electric Power Authority said. The city could be without power for two weeks, its mayor Nelson Torres Yordan said.   Celebrity chef Jose Andres announced that a charity he runs, World Central Kitchen, had started serving meals and distributing solar-powered lamps in quake-hit areas.   Vazquez announced that $130 million in emergency aid funding will be disbursed.   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep."   "Everybody is awake & scared all over," she posted.   In Guayanilla, the Inmaculada Concepcion church, built in 1841, was heavily damaged.   Volunteers salvaged statues and other valuable items from the ruins as a priest consoled distraught parishioners.

- 'Be safe' -
A 5.8 magnitude quake on Monday toppled some structures, caused power outages and small landslides, but did not result in any casualties.   It also destroyed a popular tourist landmark, Punta Ventana, a natural stone arch that crumbled on the island's southern coast.   Vazquez, the governor, said government employees were being given the day off on Tuesday to take care of their families.   "We want everyone to be safe," she said.   She said ports were undamaged and there are several weeks' supply of gasoline, diesel and natural gas stored so people need not worry about shortages.

The White House said President Donald Trump had been briefed and Pete Gaynor, head of the Federal Emergency Management Agency (FEMA), had been in touch with the governor.   Trump's administration came under severe criticism for its response to Hurricane Maria.   The Category 4 storm destroyed the island's already shaky power grid, overwhelmed public services, left many residents homeless and claimed several thousand lives, according to government estimates.
Date: Tue, 7 Jan 2020 12:52:34 +0100 (MET)

Washington, Jan 7, 2020 (AFP) - A strong earthquake struck south of Puerto Rico early Tuesday, the US Geological Survey said, the latest in a series of tremors that have shaken the island since December 28.   The shallow 6.5 magnitude quake struck 13.6 kilometres (8.5 miles) south of the city of Ponce, the USGS said, revising down its initial reading of 6.6.   The quake struck just off the US territory's southern Caribbean coastline at 4:24 am local time (0824 GMT).   "The whole island is without power," the director of Puerto Rico Electric Power Authority, Jose Ortiz, told local media.

Puerto Rico's governor Wanda Vazquez Garced posted on Twitter that the government's security protocols had been activated.   She said government employees were not expected at work, adding: "We want everyone to be safe."   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep", adding "Everybody is awake & scared all over."

Dramatic images also shared on social media appeared to show widespread damage in the town of Guayanilla, home to around 20,000 people, as well as nearby Guanica.   The mayor of Guayanilla told local news channel NotiUno that the town's church had collapsed in the incident.

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled.   Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake.   That earthquake toppled houses and caused power outages, but there were no reports of casualties.
Date: Mon, 6 Jan 2020 18:04:21 +0100 (MET)

Miami, Jan 6, 2020 (AFP) - A 5.8-magnitude earthquake shook Puerto Rico Monday, toppling houses and causing power outages and small landslides but there were no reports of casualties, the US Geological Survey said.   The quake, just off the US territory's southern Caribbean coastline, was felt throughout much of the island, including the capital San Juan.

Some 250,000 customers were hit by electric power outages after the quake, which struck at 6:32 am local time (1032GMT).   Images posted on social media showed houses tumbled from their supporting pillars, cracks in walls, cars crushed under collapsed houses and small scale landslides.   The quake was the strongest of a series that have rippled through the island since December 28, and it was followed by at least eight aftershocks, officials said.   No tsunami alerts were issued.
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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".
More ...

Saint Kitts and Nevis

St. Kitts and Nevis - US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
St. Kitts and Nevis is a developing Caribbean nation consisting of two islands.
Tourist facilities are widely available.
Read the Department
f State Background Notes on St. Kitts and Nevis 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.

Visitors may be asked to present an onward/return ticket and proof of sufficient funds to cover the cost of their visit.
Stays of up to three months are granted at immigration.
Anyone requiring an extension must apply to the Ministry of National Security.
There is an airport departure tax and environmental levy charged when leaving the country.

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 St. Kitts and Nevis, as well as the occasional burglary; visitors and residents should take common-sense precautions.
Avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents.
Do not leave valuables unattended on the beach or in cars.
Exercise caution when walking alone at night.

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 care is limited.
The main hospitals are Joseph N. France General Hospital (telephone (869) 465-2551) on St. Kitts and Alexandria Hospital (telephone (869) 469-5473) on Nevis.
St. Kitts has two additional hospitals and both islands have several health clinics.
Neither island has a hyperbaric chamber.
Divers suffering from decompression illness are transported to the island of Saba, in the Netherlands Antilles.
Serious medical problems requiring hospitalization and/or medical evacuation to the U.S. can cost thousands of dollars.
Doctors and hospitals 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 St. Kitts and Nevis is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic in St. Kitts and Nevis moves on the left-hand side of the road.
Roads are reasonably well paved but narrow and sometimes poorly marked.
Drivers often stop on the side of or in the middle of the road to visit with other drivers, blocking one lane of traffic.
Honking one's horn is a common form of greeting, not a warning.
Travelers are required to obtain a visitor's drivers license, which may be obtained from the Traffic Department or the Fire Station for a small fee on presentation of a valid home or international license.
Public Transportation consists of mini-buses and taxis.
Established fares are available from airport dispatchers and local hotels.
Complaints regarding taxi or minibus services may be lodged with The Department of Tourism or with your hotel.

More detailed information on roads and traffic safety can be obtained from the Ministry of Tourism, Culture and the Environment, Bay Road, Pelican Mall, P.O. Box 132, Basseterre, St. Kitts, telephone (869) 465-4040.
For specific information concerning St. Kitts and Nevis driving permits, vehicle inspection, road tax and mandatory insurance, contact the St. Kitts and Nevis national tourist organization via the Internet at http://www.stkitts-tourism.com/index.asp.
Please refer to our Road Safety page for more information

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of St. Kitts and Nevis’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of St. Kitts and Nevis’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 St. Kitts and Nevis.
The U.S. Embassy in Bridgetown, Barbados, is responsible for American citizen services in these islands.
U.S. citizens are encouraged to carry a copy of their U.S. passports or other proof of citizenship with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship are readily available.

All Caribbean countries 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 St. Kitts and Nevis laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in St. Kitts and Nevis 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 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 St. Kitts and Nevis 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 St. Kitts and Nevis.
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 in Barbados in the Wildey Business Park, Wildey, St. Michael, telephone 1-246-436-4950, web site http://barbados.usembassy.gov/.
The Consular Section telephone number is 1-246-431-0225. The Consular Section fax number is 1-246-431-0179. Hours of operation are 8:30 a.m. to 4:00 p.m. Monday-Friday, except Barbados and U.S. holidays.
In certain circumstances, the U.S. Consular Agency in Antigua can be of assistance.
Persons seeking assistance should call the Consular Agent, Rebecca Simon, at 1-268-463-6531 to schedule an appointment.
*

*

*
This replaces the Country Specific Information for St. Kitts and Nevis dated June 6, 2006, to update sections on Entry/Exit Requirements, Safety and Security, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed 21 May 2014
Source: West Indies News Network (WINN) FM [edited]

There are now 20 confirmed cases of chikungunya disease in St Kitts, according to Acting Chief Environmental health Officer Alexander Riley. Mr Riley made this confirmation Tuesday [20 May 2014] during an edition of WINN FM's Talking Trash programme.

Chikungunya is a mosquito-borne disease that causes fever and joint pain in humans. Other symptoms of the disease include rash, muscle pain, and fatigue.

As the hurricane season approaches Mr Riley lists measures that the environmental health department will be taking to prevent the spread of chikungunya [virus] include fogging beginning this Wednesday [20 May 2014].

Meanwhile, Mr Riley sought to allay fears and concerns about the health and environmental health department risks of fogging, noting that the chemicals used are environmentally friendly.  [Byline: Andre Huie]
===================
[Fogging will provide only temporary vector mosquito control. Elimination or treatment of breeding sites is necessary for significant vector mosquito population reduction. This same report was also sent in by Roland Hubner.

Maps of St Kitts and Nevis can be accessed at
and <http://healthmap.org/promed/p/31>. - ProMed Mod.TY]
Date: Thu 20 Feb 2014
Source: Winn FM [edited]

The Federation [St. Kitts and Nevis] has recorded its 1st confirmed case of the chikungunya virus [infection]. A statement from the Ministry of Health Thursday morning [20 Feb 2014] indicated that the 30-year-old male resident of St. Kitts was hospitalized and discharged without complications 2 weeks ago. Confirmation testing was done by the Trinidad-based Caribbean Public Health Agency (CARPHA).

Speaking to WINN FM Thursday morning, Chief Medical Officer Dr. Patrick Martin assured that there was no need to panic. "There is no need for travel or trade restrictions, no need for alarm, no need to panic. If you have the fever and pain, Paracetamol, lots of fluids... don't tire out yourself," Dr. Martin said Thursday.

Like dengue, chikungunya is characterized by fever and pain which appear up 3-7 days after being bitten by an infected mosquito. Other symptoms include headache, nausea, vomiting, fatigue and rash.

Acute chikungunya fever typically lasts a few days to a few weeks, but as with dengue, some patients have prolonged fatigue lasting several weeks. There is no risk of bleeding complications with chikungunya which distinguishes it from dengue.

Dr. Martin advised that persons exhibiting symptoms can be treated at, and use over the counter medications except for aspirin and ibuprofen.

Dr. Martin said Thursday [20 Feb 2014] that in all likelihood the virus has been in the Federation [St. Kitts and Nevis] for several weeks and that there have been other cases.   [Byline: Toni Frederick]
-----------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===================
[This report does not indicate whether the chikungunya virus infection was acquired locally on St. Kitts or in another locality where transmission is going on. No mention was made of the individual's travel history off of St. Kitts island, and the Chief Medical Officer mentioned that it is likely that the virus has been present in the Federation for several weeks with occurrence of other cases; these factors suggest that the infection was, in fact, acquired locally.

A HealthMap/ProMED-mail map showing the location of St. Kitts can be accessed at
<http://healthmap.org/r/1E3K>. - ProMed Mod.TY]
Wednesday 15th February 2012

WASHINGTON, Feb 14, 2012 (AFP) - US Supreme Court Justice Stephen Breyer was robbed at his Caribbean island vacation home last week by a masked, machete-wielding bandit, a court spokeswoman said Tuesday.  The incident took place February 9 at the justice's home in Nevis, with about $1,000 cash taken, the spokeswoman said.  "No one was hurt," said the official, noting that the 73-year-old Breyer was "robbed by an armed intruder" and that "the individual was armed with a machete."  Breyer was on vacation during a break from the schedule of the top US court, which resumes hearings Friday.

St Kitts and Nevis

Flag of St Kitts and Nevis
Still current at: 30 November 2011
Updated: 29 November 2011

This advice has been reviewed and reissued, with an amendment to the Entry Requirements - Passport Validity section (updated). The overall level of the advice has not changed; there are no travel restrictions in place in this travel advice for St Kitts and Nevis.

(see travel advice legal disclaimer)


  • There is no British High Commission in St Kitts and Nevis. British nationals requiring emergency consular assistance may contact the British Honorary Consul, Sarah Percival, on +1 (869) 764 4677 begin_of_the_skype_highlighting +1 (869) 764 4677 end_of_the_skype_highlighting. If the Honorary Consul is not available and for all other non-consular related matters please contact the British HighCommission in Bridgetown, Barbados.
  • Around 4,700 British nationals visited St Kitts and Nevis in 2008 (Source: Ministry of Tourism). Most visits to St Kitts and Nevis are trouble-free. The main type of incidents for which British nationals required consular assistance in St Kitts and Nevis in 2008 were replacing lost and stolen passports and dealing with hospitalisations. Over the past year, there has been an overall increase in crime in St Kitts, including gun crimes although these tend to occur within the local community.
  • There is a low threat from terrorism. But you should be aware of the global risk of indiscriminate terrorist attacks which could be in public areas, including those frequented by expatriates and foreign travellers.
  • The hurricane season in St Kitts and Nevis normally runs from June to November. See the Natural Disasters section of this Travel Advice.
  • You should take out comprehensive travel and medical insurance before travelling. See General - Insurance.

Safety and Security - Terrorism
There is a low threat from terrorism. But you should be aware of the global risk of indiscriminate terrorist attacks which could be in public areas, including those frequented by expatriates and foreign travellers. For more general information see our Terrorism Abroad page.

Safety and Security - Crime
Around 5,000 British nationals visit St Kitts and Nevis each year (Source: Ministry of Tourism) and the vast majority of visits are trouble-free. St Kitts and Nevis is a friendly and welcoming country but incidents of violent crime including murder do occur. Gun crime is increasingly problematic; there have been more than 25 murders in 2011, the majority as a result of shootings. Although these tend to occur within the local community, there have been a number of recent incidents involving British nationals in the Half Moon Court area, including a double murder and violent attack.

You should maintain vigilance at all times even when staying with family or friends. Avoid walking alone in isolated areas, including beaches, after dark. Do not carry large amounts of cash or jewellery. Valuables and travel documents should be left, where possible, in safety deposit boxes and hotel safes.

For more general information see our Victims of Crime Abroad page.

Safety and Security - Local Travel

Safety and Security - Local Travel - Road Travel
In order to be able to drive a car in St Kitts and Nevis you must purchase a local driving licence, usually from the car hire company, at a cost of EC$ 100. You must show your current driving licence to obtain this. Motorists drive on the left in St Kitts and Nevis. Main roads are generally well maintained but many follow winding routes so careful driving is necessary. Roads are not well lit at night. You must be alert for stray livestock and speed bumps in some areas that are not well marked. Hiring of scooters is popular amongst visitors but safety equipment is not included in the hire price; despite the additional cost this is highly recommended for your own protection. You should be cautious when driving a scooter, as other road users do not always give them due consideration.

For more general information see our Driving Abroad page.

Safety and Security - Local Travel - Air Travel
You will have to pay a departure tax when leaving St Kitts and Nevis. Departure tax is EC$58 (per adult) and EC$25 (child under 12).

Safety and Security - Political Situation
St Kitts and Nevis Country Profile

You should note that there are severe penalties for all drug offences. Pack all luggage yourself and do not carry anything through customs for anyone else. You should be aware that it is an offence for anyone, including children, to dress in camouflage clothing. Certain homosexual acts are illegal under the laws of St Kitts and Nevis. For more general information for different types of travellers see our Your Trip page.

Entry requirements - Visas
British Passport holders do not require visas to visit St Kitts and Nevis. On entry you are granted a one month stay. If you wish to stay longer you must apply and pay for an extension of stay through the St Kitts and Nevis Immigration Department. It is an offence to overstay the entry period granted or to work without a work permit.

Entry requirements may change from time to time and should be checked with the High Commission of St Kitts and Nevis in London.

Entry requirements - Passport validity
You must hold a valid passport to enter St Kitts & Nevis. Your passport must be valid for a minimum period of six months from the date of entry into St Kitts & Nevis.

The medical facilities on the islands are limited to one hospital, which can deal only with routine medical cases. More serious cases will need to be dealt with in Puerto Rico, USA once the patient is in a stable condition.

Dengue fever is common across the Caribbean and can occur throughout the year. Dengue is a mosquito-borne infection that can cause a feverish illness associated with headache, muscle aches and pains, and rash. Some cases of dengue are severe. Dengue can be prevented by avoiding being bitten by the disease-carrying mosquitoes that feed predominately during daylight hours. For more information on prevention, see the National Travel Health Network and Centre website.

You should exercise normal precautions to avoid exposure to HIV/AIDS. For more general information on how to do this see our HIV and AIDS page.

You should seek medical advice before travelling to St Kitts & Nevis and ensure that all appropriate vaccinations are up-to-date. For further information on vaccination requirements, health outbreaks and general disease protection and prevention you should visit the websites of the National Travel Heath Network and Centre (NaTHNaC) and NHS Scotland's Fit For Travel or call NHS Direct on 0845 46 47.

For more general health information see our Travel Health and Swine Flu page.


The hurricane season in St Kitts and Nevis normally runs from June to November. You can also access the World Meteorological Organisation for updates and the US National Hurricane Centre. For more general information see our Tropical cyclones page.

General - Insurance

You should take out comprehensive travel and medical insurance, which includes medical evacuation, before travelling. Check for any exclusions and that your policy covers you for all the activities you want to undertake. Be especially careful about cover for recurring illnesses as they may not be include in all insurance policies. For more general information see our Travel Insurance page.

If things do go wrong when you are oversees see our When Things Go Wrong page.

General - Registration

Register with our LOCATE service to tell us when and where you are travelling abroad or where you live abroad so our consular and crisis staff can provide better assistance to you in an emergency. More information about registering with LOCATE can be found here.

General - Package Holidays

If you are on a package holiday, you must travel on the specified return date. If you fail to do so it is likely that you will have to pay for a return ticket yourself.

General - Passports


Keep a copy of the photo page of your passport and relevant entry stamp in case your documents are stolen.

The passport service for British nationals in St Kitts and Nevis has now moved from Barbados to the UK Passport Service Centre for the Americas and Caribbean in Washington D.C. (http://ukinusa.fco.gov.uk/passports).

If you are applying for a renewal of your UK passport and you are in St Kitts and Nevis your application, with the appropriate passport fee plus a return courier fee of US $21, should be sent direct to:

The UK Passport Service for the Americas and Caribbean
British Embassy
19 Observatory Circle, NW
Washington, DC 20008

The British High Commission in Bridgetown will continue to issue Emergency Passports for people who have lost their passports and who have an urgent need to travel to the UK.

Date: Fri 15 Jan 2010
Source: Institut de Veille Sanitaire: Le point epidemiologique - N2 [in French, trans. & summ. ProMed Mod.TY, edited]
<http://www.invs.sante.fr/surveillance/dengue/points_sbsm/2009/pe_sb_2009_14_dengue.pdf>

Surveillance of cases clinically suggestive of dengue
-----------------------------------------------------
After reaching very high values between mid-Nov and mid-Dec [2009], the number of cases clinically suggestive of dengue fever has abruptly decreased in week 2009-52 without, however, running below the epidemic threshold. Since then, there has been a gradual increase in new cases, with an estimated 40 cases in the 1st week of Jan [2010]. The number of suggestive [dengue] cases has been well above the epidemic threshold for the past 2 months. It is estimated that during this period, 340 cases suggestive of dengue were seen by general practitioners on the island, averaging over 40 per week. The number of cases clinically suggestive of dengue fever is an estimate for the entire population of the island, based on the number of people who consulted a general practitioner for a clinical syndrome suggestive of dengue. This estimation is performed using data collected from the network of sentinel physicians.

Monitoring of laboratory confirmed cases
----------------------------------------
The number of laboratory confirmed cases of dengue fever follows a dynamic similar to that of suggestive cases. After a sharp decline in week 2009-52, there was a further increase in the number of confirmed cases during the last week of Dec (2009-53), then an equally high number of laboratory confirmations during the past week (2010-01). Since the 3rd week of Nov (2009-47), 239 laboratory confirmed cases were recorded, and the number of weekly cases has far exceeded the epidemic threshold.

Positivity rate of requests for laboratory confirmation and circulating [dengue virus, DENV] serotypes
-------------------------------------------------------
As in the previous week, the positivity rate has been very high in the week 2010-01, since 26 of the 41 samples analyzed have been positive (66 per cent). This is the 2nd consecutive week for this rate, so it is increasing during the upswing of the epidemic. Since mid-Nov 2009 (week 2009-47), DENV-1 has constituted the vast majority [of isolates], accounting for 95 per cent of viruses isolated (73 of 77 samples analyzed). DENV-2 has also been identified but only 4 times.

Hospitalized cases
------------------
Since early Dec [2009], no new confirmed cases of dengue have been hospitalized for more than 24 hours. The number of laboratory confirmed hospitalized cases has been constant since October 2009, with 2 hospitalizations occurring each month.

Spatial distribution
--------------------
The geographical distribution of laboratory confirmed cases indicates their presence on all sectors of the island, indicating that there still is widespread circulation of the virus.

Situation analysis
------------------
At Saint Barthelemy, the epidemic continues. Virus circulation is still important and widespread on the island. The number of hospitalized cases remains very low. The epidemiological situation is still in Phase 3 of PSAG of the Northern Islands as an epidemic phase.
======================
[A map of Saint Barthelemy (St. Barts) in the Caribbean can be accessed at
<http://www.worldatlas.com/webimage/countrys/namerica/caribb/stbarts.htm>. - ProMed Mod.TY]
More ...

Mongolia

Mongolia US Consular Information Sheet
November 21, 2008
COUNTRY DESCRIPTION:
Mongolia is a vast country of mountains, lakes, deserts and grasslands approximately the size of Alaska.
It peacefully abandoned its communist system in 199
and has been successfully making the transition to a parliamentary democracy.
Economic reforms continue, although the country’s development will depend on considerable infrastructure investment, particularly in the mining, energy, transportation, and communication sectors.
Travelers to Mongolia should be aware that shortcomings in these areas might have an impact on travel plans.
Read the Department of State Background Notes on Mongolia for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid passport is required for American visitors.
No visa is required for Americans visiting for fewer than 90 days; however, visitors planning to stay in Mongolia for more than 30 days are required to register with the Office of Immigration, Naturalization and Foreign Citizens in Ulaanbaatar within the first seven days of arrival.
American visitors who fail to register and who stay longer than 30 days, even for reasons beyond their control, will be stopped at departure, temporarily denied exit, and fined.
It is recommended that visitors who will be in Mongolia beyond 30 days register with the Office of
Immigration, Naturalization and Foreign Citizens within the first seven days of their arrival.

Americans planning to work or study in Mongolia should apply for a visa at a Mongolian embassy or consulate outside of Mongolia.
Failure to do so may result in authorities denying registration, levying a fine, and requiring that the visitor leave the country.
Travelers arriving or departing Mongolia through China or Russia should be aware of Chinese and Russian visa regulations (transiting twice will require a double- or multiple-entry visa) and note that some land-entry points have varying days and hours of operation. Many small land border posts do not operate on a fixed schedule.
Travelers need to check with immigration authorities to make certain the post they intend to use will be open when they want to enter. Travelers planning travel to Russia should get visas prior to arriving in Mongolia, because they are difficult to obtain at the Russian Embassy in Mongolia. For more information on these requirements, see the Country Specific Information for Russia and China.

Travelers without Mongolian visas are subject to an exit tax payable either in U.S. dollars or Mongolian Tugrugs upon departure.
American citizen visitors to Mongolia do not require a visa if they stay less than 30 days and no fee is payable if they depart within the 30 day period.
If they stay longer without having registered with immigration, a penalty fee will be assessed at time of departure.
Travelers should inquire whether the exit tax is included with the price of the airline ticket at the time of purchase. In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points.
These often include requiring documentary evidence of relationship and permission for the child’s travel from the parent(s) or legal guardian if not present.
Having such documentation on hand, even if not required, may facilitate entry/departure.

Visit the Embassy of Mongolia web site at http://www.mongolianembassy.us for the most current visa information.
Travelers can also contact the Embassy of Mongolia at 2833 M Street NW, Washington, DC
20007, telephone (202) 333-7117 for the most current visa information.

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

SAFETY AND SECURITY:
There have been no significant acts of terrorism or extremism in Mongolia. There are no regions of instability in the country.
U.S. citizens are advised to avoid all protests, including political protests, and street demonstrations that occur occasionally in Ulaanbaatar, as the demonstrations may become violent.

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:
Over the past few years there has been a significant rise in street crime in Mongolia, particularly in Ulaanbaatar, the capital.
Violent crime, particularly aggravated assault, is increasing, and it is not advisable to walk alone through the city after dark.
The most common crimes against foreigners are pick pocketing and bag snatching.
There are reports of organized groups operating in open areas, usually after dark, who surround, grab, and choke an individual in order to search the victim’s pockets.
Thieves have also sliced victims’ clothing in attempts to reach wallets, cell phones and other valuables.
U.S. citizens who detect pick pocket attempts should not confront the thieves, as they may become violent.
Caution is advised when using public transportation and in crowded public areas, such as open-air markets, the Central Post Office and the Gandan Monastery.
Crime rises sharply before, during and after the Naadam Summer Festival in July and throughout the summer tourist season, as well as during and after Tsagaan Sar, the Winter Festival, in January or February.

Travelers should be extremely cautious at these specific locations:
Chinggis Khan International Airport in Ulaanbaatar: tourists arriving at and departing from this airport are frequently targeted for robbery and pick pocketing by organized groups.
The State Department Store:
tourists are targeted by organized pick pocket gangs at the entries/exits/elevators and the area surrounding the store.
Naran Tuul Covered Market:
Organized criminal groups look for and target foreigners for robbery and pick pocketing.
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.
American victims of crime in Mongolia should be prepared to hire their own translators and lawyers if they intend to pursue a criminal complaint against a Mongolian.

The local equivalent to the “911” emergency line in Mongolia are 102 to contact the police department and 103 for a medical emergency.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Mongolia are very limited and do not meet most Western standards, especially for emergency health care requirements.
Many brand-name Western medicines are unavailable.
Ulaanbaatar, the capital, has the majority of medical facilities inside the country; outside of Ulaanbaatar, medical facilities and treatment are extremely limited or non-existent.
Specialized emergency care for infants and the elderly is not available.
Infectious diseases, such as plague, meningococcal meningitis, and tuberculosis, are present at various times of the year. Sanitation in some restaurants is inadequate, particularly outside of Ulaanbaatar.
Stomach illnesses are frequent.
Bottled water and other routine precautions are advisable.

Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars.
A June 2005 medical evacuation from Ulaanbaatar to Seoul, Korea, cost the patient $87,000.
Doctors and hospitals usually expect immediate payment in cash for health services.
Medical evacuation companies will not initiate an evacuation without a fee guarantee beforehand and in full.
Please see Medical Information for Americans traveling abroad.

Local hospitals generally do not contact the Embassy about ill or injured Americans in their care; hospitalized American citizens who need Consular assistance from the Embassy should ask the doctor or hospital to contact the U.S. Embassy in Ulaanbaatar.
For more information, please contact the U.S. Embassy in Ulaanbaatar, which has a list of medical facilities available to foreigners (also available on the U.S. Embassy web site at http://mongolia.usembassy.gov/) or the Centers for Disease Control and Prevention’s international traveler’s hotline (see below).
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Mongolia.

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

Driving in Ulaanbaatar can be extremely difficult due to poorly maintained streets, malfunctioning traffic lights, inadequate street lighting, a shortage of traffic signs, and undisciplined pedestrians.
There has been a dramatic increase in the number of vehicles on the roads in recent years, but the knowledge and skills of the driving population have not kept pace with the growth in the number of automobiles on the streets. There are many metered taxis in Ulaanbaatar.
There are a few car rental companies, but safety and maintenance standards are uncertain, and rental vehicles should be utilized with caution.
Cars with drivers can be obtained from local tourist companies.
Public transportation within the capital is extensive, cheap, and generally reliable, but it is also extremely crowded (see Information on Crime above), with the result that pickpockets often victimize foreigners.
For specific information concerning Mongolian drivers permits, vehicle inspection, road tax, and mandatory insurance, contact the Embassy of Mongolia at: 2833 M Street NW, Washington, DC
20007, telephone (202) 333-7117.

Please refer to our Road Safety page for more information.
Visit the web site of Mongolia’s national tourist office and national authority responsible for road safety at http://www.mongolianembassy.us/default.php.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Mongolia, the U.S. Federal Aviation Administration (FAA) has not assessed Mongolia’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.

The U.S. Embassy prohibits U.S. government personnel from using the domestic services of Mongolian International Air Transport (MIAT) for official travel because of uncertainties regarding service and maintenance schedules, aircraft certification and insurance status.
This prohibition does not extend to MIAT’s international flights or to the domestic flights of other carriers.
SPECIAL CIRCUMSTANCES:
Traveler’s checks in U.S. dollars are accepted at some hotels and may be converted to dollars or Tugrugs at several banks.
Credit cards can be used at a variety of hotels, restaurants, and shops in Ulaanbaatar.
Outside of the capital, travelers should have cash.
Cash advances against credit cards are available at some commercial banks such as Trade and Development Bank, Golomt Bank, Khan Bank, and Xac Bank.
International bank wire transfers are also possible.
There are a handful of VISA and Maestro/Cirrus ATM machines in Ulaanbaatar, but they do not always function and are not reliable.
ATM machines do not exist outside the capital.

U.S. consular offiers may not always receive timely notification of the detention or arrest of a U.S. citizen, particularly outside of Ulaanbaatar.
American citizens are encouraged to carry a copy of their passport with them at all times, so that, if questioned by local officials, evidence of identity and citizenship are readily available.
Severe fuel shortages and problems with central heating and electrical systems may cause seriously reduced heating levels and power outages in Ulaanbaatar and other cities during the winter.
Smaller towns in the countryside may have no heat or electricity at all.
The Embassy advises all American residents in Mongolia to be prepared to depart if there is a complete energy failure.
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/.

Mongolian customs authorities enforce strict regulations concerning import and export of items such as firearms, ammunition, and antiquities.
Import of firearms or ammunition requires prior approval from the Government of Mongolia.
Export of antiquities requires a special customs clearance certificate issued by authorized antique shops at the time of purchase. For additional information contact the Embassy of Mongolia at: 2833 M Street NW, Washington, DC
20007, telephone: (202) 333-7117.
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 those in the United States for similar offenses.
Persons violating Mongolia’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Mongolia 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 Mongolia 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 Mongolia.
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: at Micro Region 11, Big Ring Road, Ulaanbaatar.
The telephone number is (976) 11-329-095, the Consular Section fax number is (976) 11-353-788, and the Embassy’s web site is http://mongolia.usembassy.gov/.
The Consular Section can be emailed directly at cons@usembassy.mn.
The Consular Section is open for American Citizens Services Monday and Thursday from 1-3 p.m., except on U.S. and Mongolian holidays.
*

*

*
This replaces the Country Specific Information for Mongolia dated September 22, 2008 to update the sections on Safety and Security, and Aviation Safety Oversight.

Travel News Headlines WORLD NEWS

Date: Mon, 6 May 2019 17:00:57 +0200

Ulaanbaatar, May 6, 2019 (AFP) - A Mongolian couple has died of the bubonic plague after eating raw marmot kidney, triggering a quarantine that left tourists stranded in a remote region for days, officials said Monday.

The ethnic Kazakh couple died on May 1 in Mongolia's westernmost province of Bayan-Ulgii, which borders Russia and China.   "The two dead were local people," said local governor Aipiin Gilimkhaan. "There were no cases reported after them."   A six-day quarantine was declared on residents in the region, preventing nine tourists from Russia, Germany and Switzerland from leaving.   "We are all fine. No one is ill," said a German tourist named Teresa, who did not want to give her last name.

Sebastian Pique, a 24-year-old American Peace Corps volunteer who has lived in the region for two years, said he and the tourists were invited to the governor's office on Friday to be informed about the situation.    "After the quarantine (was announced) not many people, even locals, were in the streets for fear of catching the disease," Pique told AFP.   The quarantine was expected to be lifted late Monday after no other cases of the plague were reported.   Authorities have warned people against eating raw marmot meat because it can carry Yersinia pestis, the plague germ.

At least one person dies of the plague every year in Mongolia, mostly due to consuming such meat, according to the National Center for Zoonotic Disease.   Some people ignore the warnings as they believe that consuming the innards of the large rodent is good for their health.   The Black Death wiped out millions of people in the Middle Ages but cases are now very rare.    Its most common form is bubonic, which is spread by fleas and causes swelling of the lymph node. The more virulent form is pneumonic plague, which can be transmitted between humans through coughing.
Date: Fri 3 May 2019
Source: Mirror [edited]

A married couple has died, leaving their 4 children orphaned after an outbreak of the bubonic plague, which sparked plane panic.

The man, 38, named only as Citizen T, and his pregnant wife, 37, are thought to have fallen ill after hunting and eating contaminated marmot, a large species of squirrel, in Mongolia. The man died on 27 Apr [2019], and the woman died 3 days later, reports the Siberian Times.

The highly contagious bacterial disease is spread by fleas living on wild rodents. It has sparked fears of an outbreak, and urgent measures and precautions have been put in place to stop the infection spreading. Around 158 people have been put under intensive medical supervision after coming into contact directly or indirectly with the couple.

There were dramatic scenes when a flight from Bayan, Ulgii and Khovd in Mongolia -- the area where the couple fell ill -- was met by workers in white anti-contamination suits as [the plane] landed in the country's capital of Ulaanbaatar. Eleven passengers from the west of the country were held at the airport and sent immediately for hospital checks. Others were examined in a special facility at the airport. Paramedics in anti-contamination boarded the flight as soon as it landed.

Some frontier checkpoints with Russia are reported to have been closed, leading to foreign tourists being stranded in Mongolia.

Dr N. Tsogbadrakh, director of National Centre for Zoonotic Dermatology and Medicine, said, "Despite the fact that eating marmots is banned, Citizen T hunted marmot. He ate the meat and gave it to his wife, and they died because the plague affected his stomach. Four children are orphaned."

Bubonic plague is believed to be the cause of the Black Death that spread through Asia, Europe, and Africa in the 14th century, killing an estimated 50 million people.

The plague is a bacterial disease that is spread by fleas living on wild rodents such as marmots. The disease can kill an adult in less than 24 hours if not treated in time, according to the World Health Organisation.  [Byline: Will Stewart and Amber Hicks]
========================
[HealthMap/ProMED-mail map:
Bayan-Olgiy Aymag, Bayan-Olgiy, Mongolia:
Date: Fri, 15 Mar 2019 02:55:29 +0100
By Khaliun Bayartsogt

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

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

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

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

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

In desperation, Luvsangombo Chinchuluun, a civil society activist, borrowed money to take her granddaughter to Thailand for all of January.   "We can't let her play outside (in Ulaanbaatar) because of the air pollution, so we decided to leave," she said.   The persistent smog has caused tensions in the city, with those living in wealthier areas blaming the ger residents for the pollution and even calling for the tent districts to be cleared.   But the ger residents say coal is all they can afford.   "People come to the capital because they need sustainable income," said Dorjdagva Adiyasuren, a 54-year-old mother of six.   "It's not their fault," she added.    In a bid to tackle the problem, the local government banned domestic migration in 2017, and a ban on burning coal comes into force from May.   But it is unclear whether the moves will be enough to make a difference.   For Naranchimeg, the problems are serious enough to make her consider whether she wants more children.    She explained: "Now, I am terribly afraid of to give birth again. It is risky to carry a child and what will happen to the child after it is born in this amount of pollution?"
Date: Tue 19 Feb 2019
Source: AFP [edited]

Mongolian authorities have temporarily closed all KFC restaurants in the country after more than 200 customers suffered food poisoning symptoms, and dozens were hospitalized.

The 1st cases emerged earlier this month [February 2019], with 16 people showing symptoms of food poisoning, including diarrhoea, vomiting and high fever after eating at the fried chicken franchise. Ulaanbaatar's Metropolitan Professional Inspection Department said 247 similar cases have been reported, and 42 people have been hospitalized.

The department decided to shut down the country's 11 KFC restaurants, all based in the capital, while it investigates what happened.

A preliminary investigation found that 35 employees at a restaurant were not thoroughly vetted to handle food, with most of them having blank medical examination reports, which is illegal. The restaurant also lacked internal hygiene management.

A bacterium known as _Klebsiella_ spp was detected in water at the restaurant. Traces of _E. coli_ were also found in a soda machine, and 4 people contracted _Shigella, -- which causes diarrhoea and fever -- after coming into contact with KFC staff.
=========================
[The aetiology is not directly stated, but if contacts of the cluster have been diagnosed with shigellosis, the primary illness may well be the same.

Ulaanbaatar, formerly anglicized as Ulan Bator (literally "Red Hero"), is the capital and largest city of Mongolia. The city is not part of any aimag (province) (<https://en.wikipedia.org/wiki/Ulaanbaatar>). - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Ulan Bator, Ulaanbaatar, Mongolia:
Date: Tue, 19 Feb 2019 11:40:36 +0100

Ulaanbaatar, Feb 19, 2019 (AFP) - Mongolian authorities have temporarily closed all KFC restaurants in the country after more than 200 customers suffered food poisoning symptoms and dozens were hospitalised.   The first cases emerged earlier this month, with 16 people showing symptoms of food poisoning, including diarrhoea, vomiting and high fever after eating at the fried chicken franchise.   Ulaanbaatar's Metropolitan Professional Inspection Department said 247 similar cases have been reported and 42 people have been hospitalised.   The department decided to shut down the country's 11 KFC restaurants -- all based in the capital -- while it investigates what happened.

A preliminary investigation found that 35 employees at a restaurant were not thoroughly vetted to handle food, with most of them having blank medical examination reports, which is illegal. The restaurant also lacked internal hygiene management.   A strong bacteria known as Klebsiella spp was detected in water at the restaurant. Traces of E-coli were also found in a soda machine, and four people contracted the Shigella germ -- which causes diarrhoea and fever -- after coming into contact with KFC staff.
More ...

American Samoa

Samoa US Consular Information Sheet
January 23, 2008
COUNTRY DESCRIPTION:
Samoa consists of the two large islands of Upolu and Savai’i and seven small islets. The country has a stable parliamentary democracy with a developing economy. To
rist facilities are accessible by bus, taxi and car and are within walking distance of access roads. Infrastructure is adequate in Apia, the capital, but it is limited in other areas. Nearly all Internet connections use a relatively slow dial-up method. Samoa has two digital telephone service providers, and visitors can easily purchase prepaid phones that cover virtually the entire country. The Samoa Tourism Authority, at http://www.visitsamoa.ws/, provides a wide range of information of interest to travelers. Read the Department of State Background Notes on Samoa for additional information.

ENTRY/EXIT REQUIREMENTS:
U.S. nationals who are not U.S. citizens, and who are resident in American Samoa, must obtain a visitor permit prior to all travel to Samoa. U.S. nationals have not been permitted to travel to Samoa on certificates of identity since May 2005 except on a case by case basis. (U.S. law distinguishes between individuals who are citizens and those who are nationals. The U.S. passport bio-page shows one’s status as either a citizen or a non-citizen national.) As of March 22, 2006, visitor permits to travel to Samoa can be applied for at the new Samoa Consulate General office in Pago Pago, American Samoa. A valid passport and an onward/return ticket are required for all Americans (both citizens and nationals) to travel to Samoa. Visitor permits are not required for U.S. citizens (only for U.S. nationals) seeking to stay in Samoa for up to 60 days. All visitors are required to pay a departure tax of 40 Tala (approximately 17.50 USD) upon leaving the country. Further information about entry requirements and the departure tax may be obtained from the Samoa Mission to the United Nations at 800-2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196, fax (212) 599-0797. Visit the Embassy ofSamoa web site at http://www2.un.int/public/Samoa/ for the most current visa information.

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

SAFETY AND SECURITY:
In Apia and many villages, stray dogs wander the streets. Visitors should not approach or feed them; they can become aggressive in the presence of food or if they feel threatened.

Although there have been no major accidents involving the ferry service linking Upolu and Savai’i, vessels are sometimes overloaded. One of the ferries, a multi-deck automobile ferry, sometimes transports passengers on its automobile deck. Americans who choose to use this ferry are encouraged not to remain in the automobile deck during the crossing and to ride only in the passenger compartment in order to avoid injury from shifting vehicles.

Samoa has numerous “blowholes” (lava tubes open to the sea where wave action produces, often spectacular, geysers). These blowholes are popular tourist attractions. The footing around the mouths of most blowholes is very slippery. To avoid being swept in, visitors should not approach too closely and should never stand between the opening of the blowhole and the sea.

Snorkeling and diving in ocean lagoons is a popular activity for many visitors to Samoa. Tide changes can produce powerful currents in these lagoons. Visitors are encouraged to consult local residents and tour operators about hazards and conditions at a particular location before venturing into the water.

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:
Overall, Samoa is considered a low threat environment. Nevertheless, visitors should remain aware of their surroundings, lock their doors at night, and not leave their belongings unattended. Incidents of petty theft/robberies of personal effects are common. Some such incidents have involved residential break-ins. While rare, violent assaults, including sexual assaults have occurred in Samoa. No specific groups have been targeted, nor have there been any racially motivated or hate crimes against Americans. Police responsiveness in Apia is generally good. Because of the very limited police presence elsewhere in Samoa (where order is maintained primarily by local village authorities), police responsiveness elsewhere is problematic.

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:
Health care facilities in Samoa are adequate for routine medical treatment, but are limited in range and availability; complex illnesses and life-threatening emergencies generally need to be treated elsewhere. Dental facilities do not meet U.S. standards, but good dental treatment and some emergency care can be obtained nearby at the LBJ Tropical Medical Center in Pago Pago, American Samoa. The national hospital and a small private hospital are located in Apia, and there are several small district hospitals on Savai'i and in outlying areas of Upolu. There are no hyperbaric chambers on any of the islands for the treatment of scuba diving related injuries. Serious cases of decompression sickness are evacuated to the nearest treatment center in Suva, Fiji, or Auckland, New Zealand. Serious medical conditions and treatments that require hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Travelers should carry emergency evacuation insurance. Doctors and hospitals often expect immediate cash payment for health services. There is no reported incidence of malaria or rabies in Samoa. Occasional outbreaks of typhoid and non-hemorrhagic dengue do occur.

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

Safety of public transportation and rural road conditions in Samoa, are considered fair, while urban road conditions/maintenance is considered good. Taxis in particular are widely available and used by Samoans and visitors alike; buses are slow, generally crowded and uncomfortable, and rarely utilized by visitors. Rental cars can also be obtained. No roadside assistance is available. Most major roads are tar-sealed, but secondary roads are predominantly dirt and gravel and may be overgrown with vegetation. A four-wheel drive vehicle is recommended for travel on these roads. Travelers should be aware that vehicle safety regulations are rarely enforced and traffic violations occur routinely. Roads outside Apia are often narrow, winding, relatively steep, with narrow or no shoulders, and poorly lighted. Pedestrians as well as vehicles and livestock regularly travel these roads. Due to poor and deteriorating road conditions, night driving on unlit rural roads can be dangerous and should be avoided if possible. Roads in Samoa often traverse small streams. Drivers are urged to exercise extreme caution when fording these streams, which can become swollen and dangerous with little warning. Vehicles should never enter a stream if the roadbed is not visible or if the water’s depth exceeds the vehicle’s clearance.

Speed limits in Samoa are 25 miles per hour in the Apia area and 35 miles per hour outside Apia, with certain exceptions. At unmarked intersections, traffic on the left has the right of way. As in the United States, vehicular traffic moves on the right side of the road; although right-hand-drive vehicles (mainly from New Zealand) do exist in Samoa. Importing right hand drive vehicles to Samoa is currently legally forbidden.

Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office at Samoa Tourism Authority at http://www.visitsamoa.ws/.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government ofSamoa’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Samoa’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:
Some overseas treatment centers, known as Behavior Modification Facilities, operate in Samoa. Though these facilities may be operated and staffed by U.S. citizens, the Samoan government is solely responsible for compliance with local safety, health, sanitation and educational laws and regulations, including all licensing requirements of the staff in country. These standards, if any, may not be strictly enforced or meet the standards of similar facilities in the U.S. Parents should be aware that U.S. citizens and non-citizen nationals 14 years of age and older have a right to apply for a passport and to request repatriation assistance from the U.S. government, both without parental consent. Any U.S. citizen or non-citizen enrollee has the right to contact a representative from the U.S. Embassy. For further information, consult the Department of State's Fact Sheet on Behavior Modification Facilities, available via the Bureau of Consular Affairs home page. Parents may also contact the U.S. Embassy in Apia or the country officer in the Office of American Citizens Services, Bureau of Consular Affairs at 202-647-5226.

Financial Transactions:
Although some businesses (especially those in Apia or those frequented by tourists) do accept credit cards, many (including gas stations) do not. Major credit cards (Visa, Master Card, and American Express) are accepted at major hotels and some restaurants and stores. Samoan currency can be obtained from ATMs, which are located in Faleolo Airport and in many locations in Apia. For more information on ATM locations and banking services see ANZ web site at http://www.anz.com/samoa/overview.asp and WESTPAC web site at http://www.westpac.com.ws/pacific/publish.nsf/Content/PFSA+HomePage.

Disaster Preparedness: Samoa is located in an area of high seismic activity. Although the probability that a major earthquake would occur during an individual trip is remote, earthquakes can and will continue to happen. Major cyclones have occurred in the past and are always a concern. Strong winds and very heavy rains are common, especially during the rainy season from November to April. During this period, Samoa receives most of its annual average of over 130 inches of rain. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency’s (FEMA) web site at http://www.fema.gov/.

Customs: Samoa customs authorities may enforce strict regulations concerning temporary importation into or export from Samoa of items such as firearms, fruits, pets and other animals, and drugs. It is advisable to contact the Samoan Mission to the United Nations at 800 2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196 for specific information regarding customs requirements. 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 Samoa’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Samoa 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:
Samoa is not a member of the Hague Convention on the Civil Aspects of International Child Abduction. 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 Samoa 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 withinSamoa. 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 in the Accident Compensation Board (ACB) Building, Fifth Floor, Apia. The Embassy is open to the public from 8:15 a.m. to 5:00 p.m. Monday - Friday. The Embassy's mailing address is U.S. Embassy, P.O. Box 3430, Apia, Samoa 0815. The telephone numbers are (685) 21436/21631/22696 and 21452. The fax number is (685) 22030. An Embassy officer can be reached after hours in an emergency involving the welfare of a U.S. citizen or non-citizen national at (685) 21514 or (685) 777-1776. Visit the U.S. Embassy’s web site at http://samoa.usembassy.gov/.
* * *
This replaces the Consular Information Sheet (now known as Country Specific Information) dated May 21, 2007, to update sections on Country Description and Crime.

Travel News Headlines WORLD NEWS

American Samoa. 8 Mar 2017.
(susp) as of mid-February 30 cases of Dengue.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific can be accessed at <http://healthmap.org/promed/p/380>
and a map of the island at <http://www.nationsonline.org/maps/tutuila-island-map.jpg>. - ProMED Mod.TY
Date: Sat 20 Sep 2014
Source: Radio New Zealand [edited]

Latest figures from Samoa's Ministry of Health show an increase of suspected and confirmed cases of chikungunya [virus infections] from 400 to 626 since the outbreak of the acute fever, rash and joint pain disease was reported in July [2014].

However, the ministry says so far presentation of the main signs and symptoms of those affected have largely been mild.

The highest number of people affected is recorded in the districts of Vaimauga west in the urban area with 151 cases; Faleata east, 139 cases; and 113 in Faleata west.  The majority of patients is young.

In American Samoa, the chikungunya outbreak is on the wane. Health officials say there are now 823 probable cases of the mosquito-borne illness, with 15 people requiring hospital care.
===========
[The chikungunya outbreak continues to grow in Samoa, from 269 cases reported on 25 Aug 2014 to 433 reported on 8 Sep 2014 and now to 626 cases. One hopes that a prompt and aggressive clean up of breeding sites will reduce the vector mosquito population enough to halt, or at least reduce, transmission.

On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month, apparently peaking at 823 probable cases reported above. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A map showing the location of Samoa in the Pacific Ocean can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/wsnewz.gif>. A HealthMap/ProMED-mail map showing the location of both Samoa and American Samoa in the Pacific Ocean can be accessed at <http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
Date: Mon 9 Sep 2014
Source: Radio New Zealand [edited]
<http://www.radionz.co.nz/international/pacific-news/253977/chikungunya-related-cases-reach-over-700-in-american-samoa

The latest reports from American Samoa reveal that chikungunya-related [febrile] cases have now reached over 700, and there is now one probable case in Ofu, Manua. The virus was discovered in the territory in July 2014, but there have been no reported cases in Manua until now.

Health officials are urging residents not to travel to Manua if they have chikungunya, and testing is being done to determine whether the case in Ofu is due to the virus. Since July 2014, there have been 11 hospitalisations with the virus but no deaths.

Health officials continue to urge those with symptoms to drink plenty of fluids, get a lot of rest, and visit the emergency department if symptoms become serious.
=======================
[On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific Ocean can be accessed at
Date: Tue 5 Aug 2014
Source: Radio New Zealand International [edited]

The American Samoan Department of Health says there are now more than 300 confirmed cases of chikungunya or 'chik' virus in the territory.

The Health Director Motusa Tuileama Nua says his department and LBJ hospital have confirmed the outbreak of fever, rashes, and joint pains among people on the main island of Tutuila is due to chikungunya.

He says there have been 343 recorded cases, with 6 patients hospitalised and no deaths, since the beginning of July [2014].

He recommends those who are ill with fever and body aches do not travel off island.
--------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===============
[CHIKV has been circulating in Pacific islands this year (2014).

Maps showing the location of American Samoa in the Pacific Ocean can be accessed at
<http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
****************************
American Samoa: confirmed
Date: Fri 8 Aug 2014
Source: Samoa News [edited]

The American Samoa Department of Health and the LBJ hospital have created a 24 hour a day hotline for the CHIK virus. The CHIK hotline number is 731-7511.

The Health Alert issued yesterday [7 Aug 2014] confirms chikungunya (CHIK) virus as the cause of fever, rash, and joint pains outbreak on Tutuila and there have been more than 390 recorded cases, with 7 patients hospitalized and no deaths since 1 Jul 2014.

According to the health alert, there is no cure for CHIK virus [infection, and] it can usually be treated at home by drinking lots of fluids, taking pain medicine like Tylenol, ibuprofen, or Aleve as needed but only as much and with cautions as recommended on the package.

The health alert urges not to work while your joints are painful, let them rest and apply ice or cold packs on the joints and this may protect against prolonged joint pain.

DOH notes you should go to the Emergency Room to see a doctor if symptoms persist more than 10 days, or if you have bleeding from any part of the body or bruised skin. Call the hotline "or come to the ER or clinic if you are worried about your condition getting worse."

The alert once again urges that people stay indoors in air-con, behind screens, or under bed nets while you are ill, because if you are bitten by mosquitoes while you are ill, you can spread the disease to your family and neighbors.

For travelers, the DOH urges those who are ill not to travel off island, including to Manu'a. "If you travel and become ill when you arrive, tell the doctor who sees you that you may have been exposed to the CHIK virus."  [Byline: B. Chen]
----------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
-----------------------------------
[Interestingly, the 5 Aug 2014 report above indicated that there were 343 reported cases, and in the subsequent report of 8 Aug 2014 above, that number has increased to 390 cases, indicating that transmission of CHIK virus is continuing. - ProMed Mod.TY]
******
Samoa: suspected cases
Date: Fri 8 Aug 2014
Source: Island Business [edited]

Samoa's Ministry of Health has reported 2 deaths from acute fever and rash, saying it is now an outbreak. A press statement from the Director General, Leausa Toleafoa Dr Take Naseri, says there have been 21 recorded cases as of earlier this week with 4 people hospitalised.

The cases are suspected to be chikungunya virus, similar to dengue fever, but results are yet to be confirmed and 3 children and one man have been admitted to the intensive care unit.

The ministry says collaboration with other government agencies, and media campaigns, aim to raise awareness of the outbreak and help its containment.

Samoa has also sought assistance from the Ministry of Health's development partners including the Secretariat of the Pacific Community and the World Health Organisation.

In neighbouring American Samoa, there have been more than 300 confirmed cases of chikungunya.
======================
[This is the 1st ever ProMED-mail report of a chikungunya outbreak in Samoa. Concerning the current outbreak, it would be unusual to have 2 deaths from chikungunya virus infections of a total of 21 recorded cases. One explanation for the high proportion of fatal cases could be significant underreporting of non-fatal cases. No mention is made indicating that there were contributory underlying medical conditions in these 2 fatal cases. ProMED-mail will be interested in receiving results of the laboratory tests when they become available.

Maps showing the location of Samoa in the Pacific Ocean can be accessed at
at <http://healthmap.org/promed/p/2>. - ProMed Mod.TY]
Date: Wed 14 May 2014
Source: Radio New Zealand International [edited]

Health officials in American Samoa are warning the public about an amoebic dysentery outbreak which has so far affected 26 people, half of which have been admitted to the LBJ hospital. A Pacific Island Health Officers' Association Epidemiologist, Mark Duran, says the department of health is leading an investigation into the source of the parasite.

Dr Duran says amoebic dysentery is spread through contamination of human waste. "It especially attacks the intestines and invades its way into the wall of the intestines; it causes abdominal pain, it causes bloody diarrhoea, fever." Dr Duran says in serious cases the parasite can travel through the body and cause abscesses especially in the liver.
===================
[Maps of American Samoa can be seen at
<http://healthmap.org/promed/p/380>. - ProMed Sr.Tech.Ed.MJ]
More ...

Cayman Islands

CAYMAN ISLANDS US Consular Information Sheet
October 02, 2008

COUNTRY DESCRIPTION:
The Cayman Islands are a British dependent territory consisting of three main islands with a total area of approximately 100 square miles and located a
out 500 miles west of Jamaica. There is an international airport located in Grand Cayman, and facilities for tourists are widely available. The U.S. Embassy in Kingston, Jamaica, has consular responsibility for the Cayman Islands. Read the Department of State Background Notes on the Cayman Islands for additional information.

ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside of 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 Western Hemisphere Travel Initiative (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 and have been in full production since July 2008.The card may not be used to travel by air and is available only to U.S. citizens. Further information on passport cards 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.
Visas are not required for U.S. citizens traveling to the Cayman Islands for short-term visits. U.S. citizens traveling to the Cayman Islands for work must obtain a temporary work permit from the Department of Immigration of the Cayman Islands, telephone (345) 949-8344. There is a departure tax for travelers age 12 and older, which is regularly included in airfare. For further information travelers may contact Cayman Islands Department of Tourism offices in Miami at (305) 599-9033, New York (212) 889-9009, Houston (713) 461-1317 and Chicago (630) 705-0650; or via the Internet at http://www.caymanislands.ky.

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:
The Cayman Islands are considered politically stable and enjoy a high standard of living. There have been no reported incidences of terrorism or threats made against Americans or American interests in the Cayman Islands.
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 Public Announcements, including 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 other callers, 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 pamphletA Safe Trip Abroad.
CRIME: The crime threat in Cayman Islands is generally considered low, although travelers should always take normal precautions when in unfamiliar surroundings. Petty theft, pick-pocketing and purse snatchings occur. A few cases involving sexual assault have been reported to the Embassy. Police in the Cayman Islands rigorously enforce laws against illegal drugs. The majority of arrests of American citizens in the Cayman Islands over the past two years have been for possession, consumption, or intent to sell marijuana, cocaine or other illicit drugs. American citizens should avoid buying, selling, holding or taking illegal drugs under any circumstances.
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.

The local equivalent to the “911” emergency line in the Cayman Islands is “911.”
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: The quality of medical care in the Cayman Islands is generally comparable to that available in the United States; however, some procedures and cases requiring critical care may require medical evacuation to the United States. Several American citizens each year drown or suffer cardiac arrest while snorkeling or scuba diving in the Cayman Islands. These deaths may be attributed in part to tourists attempting to do more than they are trained to do or to poor physical conditioning or preexisting medical conditions that are exacerbated when snorkeling or diving. A hyperbaric chamber is available for treatment of decompression illness. Doctors and hospitals often expect immediate 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.

Although there are no express HIV/AIDS entry restrictions exist for visitors to the Cayman Islands, persons suffering from HIV/AIDS can be denied permission to land if a Health Officer certifies that their entry to the Islands would be dangerous to the community pursuant to Section 82 (c) of the Cayman Immigration Law (2007 Revision), which states:

“The following persons, not being Caymanian or permanent residents, are prohibited immigrants – a person certified by a Health Officer to be suffering from a communicable disease that makes his entry into the Islands dangerous to the community.”
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 the Cayman Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
As in Great Britain and its other colonies, vehicles in the Cayman Islands travel on the left-hand side of the road (the opposite side compared with driving in the United States). Due to their size, the Caymans have little highway infrastructure to maintain. Local driving standards, the risk of accidents, the availability of emergency roadside service, quality and frequency of signage, and enforcement of traffic laws, generally meet the standards of the United States. Visitors must obtain a temporary driver's license, easily granted upon presentation of a valid state driver's license and payment of a small fee, at a car rental agency or a police station. Laws against driving while intoxicated are strictly enforced, with a legal maximum blood alcohol level set at 100 milligrams per 100 milliliters of blood. Seatbelt laws are also enforced and require the driver and all passengers to wear seatbelts while in motion. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at www.caymanislands.ky
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Cayman Islands’ Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Cayman Islands’ 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:
Cayman Islands customs authorities may enforce strict regulations concerning temporary importation into or export from the Cayman Islands of items such as firearms of any kind, spear guns (or pole spears or Hawaiian slings), live plants and plant cuttings. Raw fruits and vegetables are also restricted. Visitors from the United States should be aware that products made from farmed green sea turtles at the Cayman Turtle Farm Ltd. are offered for local consumption; however, the importation of genuine sea turtle products is strictly prohibited by the United States, as well as other countries that have signed the Convention on International Trade in Endangered Species. In addition, U.S. Customs prohibits the transshipment of turtle products through the United States and any products discovered will be confiscated. It is advisable to contact the Collector of Customs (345) 949-2473 for specific information regarding customs requirements. Please see our Customs Information.

The Cayman Islands, like all Caribbean countries, can be affected by hurricanes. Hurricane season runs from June 1 to November 30 each year. The Office of Disaster Preparedness and Emergency Management (ODPEM) has put measures in place in the event of an emergency or disaster. General information is available on the subject via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

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 the Cayman Islands’ laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Cayman Islands 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 the Cayman Islands are encouraged to register with the U.S. Embassy in Kingston, Jamaica through the State Department's travel registration web site, and to obtain updated information on travel and security within the Cayman Islands. Americans without Internet access may register directly with the U.S. Consular Agency in George Town, Grand Cayman or the U.S. Embassy in Kingston, Jamaica. By registering, American citizens make it easier for the Embassy or Consular Agency to contact them in case of emergency. The U.S. Consular Agency in the Cayman Islands is located at 222 Mirco Center, North Sound Road, Georgetown, Grand Cayman. Its phone number is (345) 945-8173. Office hours are Monday, Wednesday, and Friday from 08:00 a.m. to 2:00 p.m.

American citizens requiring assistance in Cayman may also contact the American Citizen Services Unit of the U.S. Embassy in Kingston, Jamaica at (876) 702-6000. The Consular Section of the U.S. Embassy is located at 142 Old Hope Road,, Kingston 6. Office hours are Monday through Friday (except Jamaican and U.S. holidays), 7:15 a.m. to 4:00 p.m., with window services 8:30 to 11:30 a.m. Both the Consular Agency and Embassy may provide updated information on travel and security within the Cayman Islands. The Embassy web site is http://kingston.usembassy.gov/
* * *
This replaces the Country Specific Information for the Cayman Islands dated December 3, 2007, to update sections on entry/exit requirements, crime, and medical facilities.

Travel News Headlines WORLD NEWS

Date: Mon 19 Feb 2018
Source: Cayman Compass [edited]

An outbreak of hand-foot-mouth disease that surfaced a few weeks ago is still affecting some schools on Grand Cayman.

The disease is not uncommon on the island and typically affects children under 10 and especially those aged 5 and younger. Children with the virus typically have a fever, sore throat, a red rash on the palms of the hands and soles of the feet, mouth sores, and loss of appetite. There is no specific treatment other than to let the illness run its course. The best prevention is practicing good sanitation and hygiene.

Tim McLaughlin, an epidemiologist with the Public Health department, said the 14 cases reported from 4-10 Feb 2018 were the most he has seen in a single week. Figures for last week [week of 12 Feb 2018] are not yet available, but Mr McLaughlin said it looked as though the spread of the disease had slowed down. Most children were out of school last week and that may be a factor, he said

"14 in a week is a lot," Mr. McLaughlin said. "It also tells me there are more cases out there."

As a consequence, he said, he is more closely monitoring the spread of the disease, which is not uncommon this time of year. If need be, he said, "We'll sound the alarm."

At the Department of Education Services, director Lyneth Monteith said she was unaware of any public schools currently being affected by the disease. But preschools are seeing the problem.

Bri Bergstrom, the owner of the Montessori School of Cayman, said 3 of her students came down with the illness 3.5 weeks ago. It was the 1st such outbreak at the school, she said, adding that no other students have since been affected.

"It seems to be going around," Ms Bergstrom said. "It's almost impossible to avoid sometimes, things coming into the school."

She and others operating schools and preschools said that they have increased their efforts to keep classrooms and play areas sanitary by cleaning more often and doing thorough deep cleaning.

"Even when the flu is going around, we always amp up the sanitation," Ms Bergstrom said.

At the Treasure Garden, a preschool with 35 students, teacher Tonie-Ann Broomfield said 6 pupils have contracted the disease over the past 2-3 weeks. Some of the students, she said, showed no outward symptoms, such as a fever, before breaking out in a rash. She said the staff is being more vigilant.

"As soon as we check their temperature and it's above 100 deg F [37.8 deg F], we call the parents and ask them to take them to the doctor," Ms Broomfield said, adding that the child is kept isolated from other children until they are picked up.  [Byline: Mark Muckenfuss]
========================
[Hand-foot-mouth disease is caused by viruses that belong to the _Enterovirus_ genus (group), which includes polioviruses, coxsackieviruses, echoviruses, and other enteroviruses. - Coxsackievirus A16 is typically the most common cause of hand-foot-mouth disease in the United States, but other coxsackieviruses can also cause the illness. - Enterovirus 71 has also been associated with cases and outbreaks (<https://www.cdc.gov/hand-foot-mouth/outbreaks.html>) of hand-foot-mouth disease, mostly in children in East and Southeast Asia. Less often, enterovirus 71 has been associated with severe disease, such as encephalitis.  - Several types of enteroviruses may be identified in outbreaks of hand-foot-mouth disease, but most of the time, only 1 or 2 enteroviruses are identified.

Generally, a person with hand-foot-mouth disease is most contagious during the 1st week of illness. People can sometimes be contagious for days or weeks after symptoms go away. Some people, especially adults, may become infected and not develop any symptoms, but they can still spread the virus to others. This is why people should always try to maintain good hygiene, such as frequent handwashing, so they can minimize their chance of spreading or getting infections. (Excerpted and edited from <https://www.cdc.gov/hand-foot-mouth/about/transmission.html>). - ProMED Mod.LK]

[HealthMap/ProMED-mail map
Grand Cayman, Cayman Islands: <http://healthmap.org/promed/p/7955>]
Date: Fri 2 Feb 2018
Source: Cayman News Service [edited]

The [Cayman Islands] Public Health Department is issuing an alert for travellers after at least 2 cases of measles were confirmed in the Caribbean and Central America that appear to have been imported from Europe. There have been no cases of measles in the Cayman Islands since 1990. Local immunisation coverage against the disease is around 90% among 15-month-old children and about 97% by the time they reach school age. But officials are urging anyone who becomes unwell after returning from the UK and Europe as well as parts of the US to visit a doctor.

People who are experiencing a sudden high fever accompanied by a rash should seek medical attention immediately and provide their travel history to the doctor for necessary investigation.

"If you are travelling to any of the affected areas where measles has been confirmed, safeguard yourself and your family by ensuring that your and your children's immunisations against measles are up to date," advised Nurse Angela Graham, manager of the Health Services Authority's Expanded Programme on Immunisation. "Unprotected children are at the greatest risk of contracting this virus, should a case be imported to the Cayman Islands. It is the responsibility of parents and guardians, alike, to ensure that their children are protected."

Dr Samuel Williams-Rodriguez, Acting Medical Officer of Health, said that while there has been great progress in the fight against measles regionally, there is a risk of spread and sustained transmission in areas with susceptible populations.

"Vaccination with at least 2 doses remains the most effective measure," he said. "I emphasise that measles can be reintroduced as we have many residents and visitors travelling to and from the Americas and European countries. We should therefore remain vigilant."

He added, "The 1st sign of measles is usually a high fever which begins about 10-12 days after exposure to the virus. A runny nose, cough, along with red and watery eyes and small white spots inside the cheeks, can develop in the initial stage followed by a rash on the face and upper neck, eventually reaching the hands and feet."

Measles is caused by a virus which grows in the cells that line the back of the throat and lungs. It is a human disease and is not known to occur in animals. Close contact with other people following the onset of rash must be avoided 7 for days.

For complete protection, children older than 12 months should have 2 doses of MMR (measles mumps and rubella) vaccine. Children between 6 and 11-months, who are travelling abroad, are recommended to have one dose of MMR vaccine.
====================
[Maps of the Caribbean and Central America can be found at
Date: Thu 17 Apr 2014
Source: cayCompass.com [edited]

More than 400 feral chickens in Bodden Town have died of botulism, according to a post-mortem examination carried out by the Department of Agriculture. The birds began dying more than 2 weeks ago, residents in the area said. Brian Crichlow of the Department of Agriculture said a post-mortem exam on one of the birds revealed botulism. The bird was also tested for avian flu, with negative results. Mr Crichlow said botulism is not spread by direct contact with affected chickens, but there is a "low potential for spreading to humans and other animals through consumption of dead chickens" contaminated with the botulism toxin.

Botulism is a micro-organism that occurs naturally in the soil and in decaying flesh. Since chickens are scavengers, they likely ate a dead animal and got sick, said Mr. Crichlow.

The Department of Environmental Health was expected to begin removing the birds from the site, near the Bodden Town Mission House, on Wednesday afternoon [16 Apr 2014], according to the department's director, Roydell Carter. "We are aware of the situation. We were notified by the Department of Agriculture about it. We went on site today [Wed 16 Apr 2014] and we will be assisting them in getting the birds removed and disinfecting the area," he said. "We're putting together the resources we need -- there are so many [dead chickens] all over the place ... We will go in and help. There could probably be public health implications as well [if the carcasses are not removed]. We don't want all these dead birds lying around ... where other animals might feed on their carcasses," he added.

On Wednesday [16 Apr 2014], many of the dead chickens could be seen around the Mission House and Harry McCoy Park, and under the home of an elderly couple nearby. Mr Crichlow advised that if the dead or dying birds are not removed and disposed of properly, other chickens will feed on the carcasses and the maggots from the dead chickens, leading to more chickens contracting botulism. Botulism is also known as "limberneck," he said, reflecting the neck paralysis typically seen in affected birds. [The son] of the couple under whose home many of the decaying carcasses were seen, said he had picked up as many as he could, but those under the house would have to stay there until he had help removing them.

"The chickens just get crippled, lie down and die," said [the man], who often fed the chickens. For the past 2 weeks, the chickens have been "dropping off like flies," he said.

The feral chickens roam the neighborhood and are considered pests by many in the area. Mr Crichlow said there had been no reports of domestic flocks of chickens owned by local farmers being affected by botulism. However, he said the department had seen similar episodes before of local wild chickens dying, adding that botulism is common in feral chickens in Cayman and elsewhere. Over the past 2 years, his department has responded to deaths of feral chickens in George Town, West Bay and Bodden Town districts, he said.

Karen Rosenthal, a St. Matthews Veterinary School veterinarian who studies birds, said, "It is not so easy for people to get botulism the same way chickens do. But you would never eat the eggs or meat from a chicken with botulism," she said. "What we should worry about is if the people are using the same water source as the dead birds."

Kiran Kumar, medical officer of health at the public health department, said botulism from dead chickens does not spread to human beings through the air, and there is also no evidence of it spreading to humans by consumption of chickens with botulism. However, he advised against eating infected chickens to "prevent any rarest possibility of such occurrence."   [Byline: Jewel Levy]
========================
[Avian botulism is much more often seen in wild ducks and other water birds. But we do have a prior report of an Australian incident which is very similar to this Cayman report. The Australians ascribed it to a buildup of the causative organism, _Clostridium botulinum_, in the soil. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/38613>.]
Date: Fri 17 Jan 2014
Source: Businessweek [summ., edited]

The 1st known outbreak of the chikungunya virus in the western hemisphere has Caribbean governments working to prevent the disease from spreading and damaging the region's tourism-dependent economies.

About 280 cases of chikungunya [virus infection; many more cases than this, see other reports - ProMed Mod.TY], which can cause severe joint pain, fever and headaches, have been reported since early December [2013] in Dutch and French Saint Martin, Saint Barthelemy, Martinique, Guadeloupe, Dominica, the British Virgin Islands, and French Guiana. Officials from Venezuela to the Cayman Islands have warned of the potential for the mosquitoborne virus, 1st identified from a patient in Tanzania in 1953, to spread. There is no treatment, and the illness is rarely fatal.

"The worst case scenario would be that the impact would be significant and slow down the whole economy in the Caribbean," James Hospedales, the executive director of the Caribbean Public Health Agency, said by telephone. "The Caribbean is the most tourism-dependent region in the world, so if it spreads like wildfire you could scare away tourists."   [byline: Isabella Cota and Elizabeth Lopatto]
=====================
[This report is a good illustration of potential adverse economic effects when a new disease appears in a major tourist destination. Although dengue fever poses greater health risks, the addition of a 2nd virus disease to the area increases concern on the part of the traveling public. - ProMed Mod. TY]
Date: Mon 17 Sep 2012.
Source: Cay Compass [edited]

The Cayman Islands Mosquito Research and Control Unit and Oxitec have cited an 80 per cent reduction in the numbers of _Aedes aegypti_ mosquitoes in Grand Cayman after introducing genetically modified mosquitoes into the environment as a control measure. This finding, which was officially published in a report in Nature Biotechnology, was previously reported in the 17 Jan 2012 edition of the Caymanian Compass.

One of the main reasons the report said led to the Cayman Islands "having a need the need for alternative measures of control" was the high level of resistance to insecticide shown by _Aedes aegypti_ mosquitoes in Grand Cayman. The report references research done by MRCU Entomologist Angela Harris and Hilary Ranson of the Liverpool School of Tropical Medicine, who in their findings, "Pyrethroid Resistance in Aedes Aegypti," stated: "The Grand Cayman population of _Aedes aegypti_ is highly resistant to DDT and pyrethroid insecticides."

In an interview with the Caymanian Compass, Dr. Harris said, "For our experiments regarding the issue of resistance to insecticides we used mosquitoes that have been in a secure environment for over 30 years in a colony that was bred repeatedly over time and then compared those with the mosquitoes from the Grand Cayman. The results indicated that those found here are much more resistant and could be exposed to DDT for up to 8 hours."

Ms Harris added that the _Aedes aegypti_ mosquito has only been in the Cayman Islands since 2002 and could have likely acquired its resistance from its places of origin, which have not been determined. She also surmised that their resistance level could be as a result of cross-resistance from a pyrethroid resistance. In any event, much of Dr. Harris' research going forward will be to substantiate the theory that the mosquitoes came to the Cayman Islands with the resistance as opposed to developing it here. The Cayman Islands has never used DDT in its mosquito control efforts.

However, the Mosquito Research and Control Unit of the Cayman Islands was scrutinised in the foreign press for using genetically modified _Aedes aegypti_ mosquitoes to combat the spread of dengue fever. It was the 1st time the method was being used in a real world test area.

At the time, Bill Petrie, director of MRCU, said the initiative was essentially a new spin on an old technique in which males that were made sterile were released. He added that the difference here is that the male mosquitoes' genes were altered, as opposed to their sterility being chemically induced by radiation.

"MRCU along with Oxitec of Oxford University ran the trial for 6 months," Mr. Petrie said. "We chose a small isolated area in East End. This was done in 3 blocks; one block was where the method was introduced, while nothing was done in another block and the 3rd block was used to monitor the natural population of the _Aedes aegypti_ mosquito.

"Once the team perfected the technique, monitoring was done by traps. The final statistical analysis has shown a significant reduction in the population of this potential dengue carrier," he added.

Mr. Petrie said the male _Aedes aegypti_ mosquito cannot bite and lives a short life-span and since their eggs will not survive using this new method of control, the population of the species has decreased, as did the probability of dengue fever transmission.  Since the Cayman Islands' success using the genetic modification technique, several other jurisdictions are following suit.

"Dengue is a dangerous and debilitating disease, which affects up to 100 million people each year. The incidence of dengue has grown very rapidly in recent years: it is now a serious threat to global health, and the only means of prevention is to target the mosquitoes which carry it. We need new tools in the fight against these dangerous pests, and today's publication shows that Oxitec's approach can provide that," Mr. Petrie said.   [Byline: Stuart Wilson]
======================
Reference:
Harris AF, Nimmo D., McKemey AR, Kelly N, Scaife S, Donnelly CA, Beech C, Petrie WD, Alphey L. Field performance of engineered male mosquitoes. Nat Biotechnol 2011 Oct 30;29(11):1034-7.

[This is an interesting field experiment that produced an 80 per cent reduction in the _Aedes aegypti_ population through release of genetically modified mosquitoes into a population of native mosquitoes resistant to 2 common pesticides. The release of genetically modified mosquitoes will be considered controversial and opposed by some, but alternatives such as increasing use of pesticidal chemicals have been of limited success in medium- to long-term vector population reduction efforts. It will be interesting to see how successful the release of these genetically modified mosquitoes will be in other locations. An effective, commercially available dengue virus vaccine is still several years away. Meanwhile, vector control is the only way to prevent dengue virus transmission. - ProMed Mod.TY]

[A HealthMap/ProMED-mail map showing the location of the Cayman Islands in the Caribbean can be accessed at: http://healthmap.org/r/1IG3.]
More ...

World Travel News Headlines

Date: Wed, 22 Jan 2020 17:37:27 +0100 (MET)
By Helen ROXBURGH

Beijing, Jan 22, 2020 (AFP) - A new SARS-like virus has killed 17 people in China, infected hundreds and reached as far as the United States, with fears mounting about its spread as hundreds of millions travel for Lunar New Year celebrations, which start Friday.   Many countries have stepped up screening of passengers from Wuhan, the Chinese city identified as the epicentre, and the World Health Organization has called an emergency meeting.   Here's what we know so far about the virus:

- It's entirely new -
The pathogen appears to be a never-before-seen strain of coronavirus -- a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS), which killed 349 people in mainland China and another 299 in Hong Kong between 2002 and 2003.   Arnaud Fontanet, head of the department of epidemiology at the Institut Pasteur in Paris, told AFP the current virus strain was 80 percent genetically identical to SARS.   China has already shared the genome sequencing of this novel coronavirus with the international scientific community.   It has been named "2019-nCoV".

- It's being passed between humans -
The WHO said Monday it believed an animal source was the "primary source" of the outbreak, and Wuhan authorities identified a seafood market as the centre of the epidemic.   But China has since confirmed that there was evidence the virus is now passing from person to person, without any contact with the now-closed market.

The virus has infected more than 400 people across the country, with most cases in Wuhan, according to officials. Li Bin of China's National Health Commission on Wednesday said 1,394 people were still under medical observation.   Doctor Nathalie MacDermott of King's College London said it seems likely that the virus is spread through droplets in the air from sneezing or coughing.   Doctors at the University of Hong Kong published an initial paper on Tuesday modelling the spread of the virus which estimated that there have been some 1,343 cases in Wuhan -- similar to a projection of 1,700 last week by scientists at Imperial College, London.   Both are much higher than official figures.

- It is milder than SARS -
Compared with SARS, the symptoms appear to be less aggressive, and experts say the death toll is still relatively low.   "It's difficult to compare this disease with SARS," said Zhong Nanshan, a renowned scientist at China's National Health Commission at a press conference this week. "It's mild. The condition of the lung is not like SARS."   However, the milder nature of the virus can also cause alarm.

The outbreak comes as China prepares for the Lunar New Year Holiday, with hundreds of millions travelling across the country to see family.   Professor Antoine Flahault, director of the Institute of Global Health at the University of Geneva, told AFP that the fact that the virus seems milder in the majority of people is "paradoxically more worrying" as it allows people to travel further before their symptoms are detected.   "Wuhan is a major hub and with travel being a huge part of the fast approaching Chinese New Year, the concern level must remain high," said Jeremy Farrar, Director of the Wellcome Trust.

- International public health emergency? -
The WHO will hold a meeting on Wednesday to determine whether the outbreak constitutes a "public health emergency of international concern" and if so, what should be done to manage it.   Cases have so far been confirmed in Thailand, Japan, Taiwan, South Korea, Macau and the United States.

The WHO has only used the rare label a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.   The Chinese government announced Tuesday it was classifying the outbreak in the same category as the SARS outbreak, meaning compulsory isolation for those diagnosed with the disease and the potential to implement quarantine measures on travel.   But if the WHO decides to take this step, it would put the Wuhan virus in the same category as a handful of very serious epidemics.

- Global precautions -
As the number of confirmed deaths and infections has risen, so has concern worldwide about the disease spreading to other countries.   In Thailand, authorities have introduced mandatory thermal scans of passengers arriving at airports in Bangkok, Chiang Mai, Phuket and Krabi from high-risk areas in China.

In Hong Kong, where hundreds died during the SARS outbreak of 2002-2003, authorities have said they are on high alert, carrying out scans at the city's airport -- one of the world's busiest -- and at other international land and sea crossing points.

The United States also ordered the screening of passengers arriving on direct or connecting flights from Wuhan, including at airports in New York, San Francisco and Los Angeles.   Taiwan has issued travel advisories, and went to its second-highest alert level for those travelling to or from Wuhan. Vietnam has also ordered more border checks on its border with China.
Date: Wed, 22 Jan 2020 16:53:32 +0100 (MET)
By Beiyi SEOW

Beijing, Jan 22, 2020 (AFP) - The death toll from a new SARS-like virus that has infected hundreds in China rose to 17 on Wednesday, as authorities urged people to steer clear of the city at the centre of the outbreak.   The coronavirus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.   With hundreds of millions of people travelling across China this week for the Lunar New Year holiday, the National Health Commission announced measures to contain the disease -- including sterilisation and ventilation at airports and bus stations, as well as inside planes and trains.

In Wuhan, the epicentre of the epidemic, large public events were cancelled and international football matches were moved to a new location. Visitors were urged to stay away, while residents were advised to not to leave the central city, which is home to 11 million people.   "If it's not necessary we suggest that people don't come to Wuhan," Wuhan Mayor Zhou Xianwang told state broadcaster CCTV.    The illness is mainly transmitted via the respiratory tract and there "is the possibility of viral mutation and further spread of the disease", health commission vice minister Li Bin told a news conference in Beijing.   More than 500 cases have now been reported, with the majority in Wuhan, capital of Hubei province.

The virus has now infected at least 444 people in Hubei province alone, said provincial officials at a press conference, adding that the death toll had risen from nine to 17.   Major cities, including Beijing, Shanghai, and Chongqing have also reported cases, as well as provinces in northeastern, central, and southern China.   The World Health Organization started an emergency meeting Wednesday to decide whether or not to declare a rare global public health emergency over the disease, which has now been detected in the United States, Taiwan, Thailand, Japan, South Korea and Macau.

The Chinese government has classified the outbreak in the same category as the SARS epidemic, meaning compulsory isolation for those diagnosed with the illness and the potential to implement quarantine measures.   But they still have not been able to confirm the exact source of the virus.   "We will step up research efforts to identify the source and transmission of the disease," Li said, adding that "the cases are mostly linked to Wuhan".   Countries have intensified efforts to stop the spread of the pathogen -- known by its technical name 2019 Novel Coronavirus (2019-nCoV).   Passengers are facing screening measures at five US airports and a host of transport hubs across Asia. Britain and Italy on Wednesday also announced enhanced monitoring of passengers from Wuhan.

- Virus source -
A prominent expert from China's National Health Commission confirmed this week that the virus can be passed between people.   However, animals are suspected to be the primary source of the outbreak.   A Wuhan market is believed to be the epicentre of the outbreak.

A price list circulating online in China for a business there lists a menagerie of animals or animal-based products including live foxes, crocodiles, wolf puppies and rats. It also offered civets, the animal linked to SARS.   "We already know that the disease originated from a market which conducted illegal transaction of wild animals," said Gao Fu, director of the Chinese centre for disease control and prevention.   He said it was clear "this virus is adapting and mutating".   Hong Kong and British scientists have estimated that between 1,300 and 1,700 people in Wuhan may have been infected.

- Containment -
Health authorities are urging people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear a mask if they have a cough.   Anyone with a cough or fever was urged to go to hospital.   In Wuhan, city authorities made it mandatory to wear a mask in public places on Wednesday, according to state-run People's Daily.

In response to skyrocketing demand for masks -- which were starting to sell out at pharmacies and on some popular websites -- China's industry and information technology ministry said it would "spare no effort in increasing supply", state media reported.   "These days, I wear masks even in places that are not too crowded, although I wouldn't have done so in the past," said Wang Suping, 50, who works at a Beijing arts school.   At the capital's main international airport, the majority of people were wearing masks.

Hong Kong flag carrier Cathay Pacific said it had agreed to allow staff to wear surgical masks on mainland China flights, and that passengers from Wuhan would be offered masks and antiseptic wipes.   In Wuhan, police were conducting vehicle spot checks for live poultry or wild animals leaving and entering the city, state media said.   Officials also screened people on roads, the airport and the train station for fever.   The local government has cancelled major public activities and banned tour groups from heading out of the city.   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.
Date: Wed, 22 Jan 2020 15:49:25 +0100 (MET)

Montreal, Jan 22, 2020 (AFP) - A Canadian guide died and five French tourists were missing after at least one snowmobile plunged through ice in northern Quebec, police said Tuesday.   The group were riding close to where a river exits the Saint-Jean lake, and were outside the approved area for snowmobiles, police spokesman Hugues Beaulieu told AFP.   Nine people, including the guide, were on the trip on Tuesday evening when the ice broke underneath them.   Police said they were alerted by two of the tourists who had rescued a third tourist from the freezing water.

The 42-year-old guide was pulled out by emergency response teams and taken to hospital, but he died overnight, Beaulieu said, adding "five French tourists are still missing."   The police and army were searching the area on Wednesday, assisted by divers.   "This sector was not part of a marked trail, they were off-piste," said the spokesman.
Date: Wed, 22 Jan 2020 04:55:57 +0100 (MET)

Hong Kong, Jan 22, 2020 (AFP) - Macau on Wednesday reported its first confirmed case of the new SARS-like coronavirus as authorities announced all staff in the city's bustling casinos had been ordered to wear face masks.   The former Portuguese colony is a huge draw for mainland tourists as the only place in China that allows gambling.

With the Lunar New Year approaching this weekend, a huge influx of mainland tourists is expected in the city.   Asian countries have ramped up measures to block the spread of the new virus, which emerged in the Chinese city of Wuhan and has so far killed at least nine people.

On Wednesday, Macau announced its first confirmed case -- a 52-year-old businesswoman from Wuhan who arrived in the city by high-speed rail on Sunday, via the neighbouring city of Zhuhai.    "A series of tests found that she was positive for the coronavirus and had symptoms of pneumonia," Lei Chin-lon, the head of Macau's health bureau, told reporters.    The woman had been staying at the New Orient Landmark Hotel with two friends who were being monitored since her admission to hospital on Tuesday.

Ao Ieong Iu, Macau's Secretary for Social Affairs and Culture, said staff in all casinos would be required to wear masks while anyone arriving at entry ports along the city's border with the mainland would need to fill out health declaration forms.    "We have not banned tourism groups from Wuhan but we are not encouraging them," Ao Ieong said.    "We will stay in close contact with tourism agencies and require them to notify us of all groups going to and coming from Wuhan," she added.
Date: Tue, 21 Jan 2020 22:23:22 +0100 (MET)
By Issam Ahmed with Helen Roxburgh

Washington/Beijing, Jan 21, 2020 (AFP) - The United States on Tuesday announced its first case of a new virus that has claimed six lives in China and sickened hundreds, joining countries around the world in ramping up measures to block its spread.   The man, a US resident in his 30s who lives near Seattle, is in good condition, according to federal and state officials, and approached authorities himself after reading about the SARS-like virus in news reports.   He is "currently hospitalized out of an abundance of precaution, and for short term monitoring, not because there was severe illness," said Chris Spitters, a Washington state health official.  "This is an evolving situation and again, we do expect additional patients in the United States and globally," added Nancy Messonier, a senior official at the Centers for Disease Control and Prevention (CDC), but stressed that the overall risk to Americans remained low.

The man entered the country on January 15 after traveling to Wuhan, two days before the US began deploying health officials at major airports to screen passengers arriving from that central Chinese city which is at the heart of the outbreak. The efforts are to be extended now to a total of five US airports.   It came as countries ramped up measures to block the spread of the virus -- known by its technical name 2019 Novel Coronavirus or 2019-nCoV -- as the number of cases surpassed 300, raising concerns in the middle of a major Chinese holiday travel rush.

Fears of a bigger outbreak rose after a prominent expert from China's National Health Commission confirmed late Monday that the virus can be passed between people.   That conclusion is shared by the CDC, which said "person-to-person spread is occurring, although it's unclear how easily the virus spreads between people," even as the World Health Organization (WHO) adopted a more cautious approach, saying it is still investigating.   The UN agency will hold an emergency meeting Wednesday to determine whether to declare a rare global public health emergency over the disease, which has also been detected in Thailand, Japan and South Korea and Taiwan.

- Holiday rush -
Authorities previously said there was no obvious evidence of person-to-person transmission and animals were suspected to be the source, as a seafood market where live animals were sold in Wuhan was identified as the center of the outbreak.   Hundreds of millions of people are criss-crossing China this week in packed buses, trains and planes to celebrate the Lunar New Year with relatives.

More than 80 new cases have been confirmed, bringing the total number of people hit by the virus in China to 315, with the vast majority in Hubei, the province where Wuhan lies, according to officials.   But cases have also been confirmed around the country, including Beijing and Shanghai.   The first case on the self-ruled island of Taiwan was also confirmed Tuesday, with a woman taken to hospital on arrival at the airport from Wuhan.   Wuhan mayor Zhou Xianwang told state broadcaster CCTV Tuesday that the death toll had risen from four to six.   The coronavirus has caused alarm because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

- Fever checks -
At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   In Hong Kong, authorities said they were on "extreme high alert," with passengers from Wuhan required to fill out health declarations and face possible jail time if they do not declare symptoms.   Enhanced screening measures have also been set up at airports in Australia, Bangladesh, Nepal, Singapore and Russia, Malaysia and Vietnam.   A man showing symptoms of the disease who had travelled to Wuhan has been put in isolation in Australia as health officials await test results, authorities said Tuesday.   In China, the government announced it was classifying the outbreak in the same category as SARS, meaning compulsory isolation for those diagnosed ith the disease and the potential to implement quarantine measures on travel.

In Wuhan, authorities banned tour groups and police were conducting spot checks for animals in vehicles leaving and entering the city, state media said.   It added that city health authorities had scheduled 800 beds to be made available in three hospitals and 1,200 more would soon be ready, and passengers were being screened for fever at the airport, railway stations and bus terminals.   Doctors at the University of Hong Kong released a study on Tuesday estimating that there have been 1,343 cases of the new virus in Wuhan.   The WHO has only called a global public health emergency a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.
Date: Tue, 21 Jan 2020 20:58:18 +0100 (MET)

Lima, Jan 21, 2020 (AFP) - Peru is installing security cameras at its world renowned Machu Picchu site after it was damaged earlier this month by foreign tourists, authorities said Tuesday.   "We are going to strengthen security at Machu Picchu by installing high-tech cameras," Jose Bastante, head of the archaeological park, told AFP.   Bastante said 18 cameras will be located at three strategic points of the citadel as well as access points from surrounding mountains.   "This will allow us to better control visitors and avoid any action or infraction to the regulations, also any type of risk," he said, adding that drones were also being used for security.

Five tourists accused of damaging the iconic site were deported to Bolivia last week and barred from returning to the country for 15 years.    A sixth, from Argentina, was fined $360 and must pay $1,500 to the culture ministry for repairs after he admitted to damaging the Temple of the Sun at the ancient Inca sanctuary.

The Argentine, 28-year-old Nahuel Gomez, also received a suspended sentenced of three years and four months, but can leave the country once the fines are paid.   Gomez admitted to causing a stone slab to fall from a temple wall. It was chipped when it fell, causing a crack in the floor.   "The damaged caused is significant. The integrity of Machu Picchu has been broken," Bastante said.   Members of the group were also suspected of defecating inside the 600-year-old temple.

The Machu Picchu complex -- which includes three distinct areas for agriculture, housing and religious ceremonies -- is the most iconic site from the Inca empire, which ruled over a large swath of western South America for 100 years before the Spanish conquest in the 16th century.   Machu Picchu, which means "old mountain" in the Quechua language indigenous to the area, is at the top of a lush mountain and was built during the reign of the Inca emperor Pachacuti (1438-1471).
Date: Tue, 21 Jan 2020 17:28:23 +0100 (MET)

Johannesburg, Jan 21, 2020 (AFP) - Beleaguered national airline South African Airways (SAA) announced on Tuesday it was cancelling 10 domestic and one international flight in an effort to streamline services and save cash.   The cash-strapped airline was last month placed under a state-approved business rescue plan to avoid total collapse following a costly week-long strike by thousands of its workers.   SAA said in was dropping 10 domestic flights between Johannesburg, Cape Town and Durban, while canning its direct route between Johannesburg and Munich.

Passengers on cancelled domestic flights will be accommodated on its budget sister airline, Mango, while international travellers would be re-routed via its flights between Johannesburg and Frankfurt, and London Heathrow.   "These decisions are in line with SAA's usual policy of reviewing flights and consolidating services with low demand," it said in a statement.   "Furthermore, during the current process of business rescue, these cancellations represent a responsible strategy to conserve cash and optimise the airline's position ahead of any further capital investment."

The company said there might be further flight schedule changes over the coming days.   Aviation analyst Phuthego Mojapele said a spate of cancellations by clients were exacerbating problems for SAA.   "At the moment SAA's perception out there ... it's not really looking good because there is negative news that is being perpetuated on the wires every single day," Mojapele told local television station, eNCA.   "However, SAA's records in terms of safety, in terms of the service has always been excellent," he added.

The debt-ridden carrier, which has failed to make a profit since 2011 and survives on government bailouts, has been awaiting a two-billion rand ($138 million) payout from the Treasury to fund a rescue plan announced in December.   Finance Minister Tito Mboweni last week told journalists that the government was still trying to "find a solution to finance the airline".    Local media have reported that SAA is selling nine older aircraft to make way for new planes, part of a separate plan to rid itself of its most costly aircraft.   SAA, Africa's second largest airline after Ethiopian Airlines, employs more than 5,000 workers. It has a fleet of more than 50 aircraft flying to more than more 35 domestic and international destinations.
Date: Tue, 21 Jan 2020 12:26:16 +0100 (MET)

Taipei, Jan 21, 2020 (AFP) - Taiwan on Tuesday reported its first confirmed case of the new SARS-like coronavirus as the government warned the public against travelling to Chinese city where it emerged.    The patient is a Taiwanese woman in her fifties, living in Wuhan, who returned to the island on Monday with symptoms including fever, coughing and a sore throat.   Asian countries have ramped up measures to block the spread of the new virus as the death toll in China rose to six and the number of cases jumped to almost 300 since it first emerged in the central Chinese city of Wuhan.

The Taiwan patient reported her symptoms to quarantine officials on arrival at Taoyuan airport and was immediately taken to a hospital for treatment, said the island's Centers for Disease Control (CDC).    The woman told officials that she had not visited any local markets or had contact with birds or wild animals while in Wuhan.    Authorities are monitoring some 46 passengers and crew from the same flight, the agency said.

The CDC raised its alert on Wuhan to the highest level, urging the public against travelling to the city unless necessary.    "We ask the public not to panic as the individual was taken to hospital directly from the airport and did not step into the community," it said in a statement, adding that it reported the case to the World Health Organization and China authorities.   The coronavirus has spread to Thailand, Japan, South Korea and Taiwan.
Date: Tue, 21 Jan 2020 12:08:14 +0100 (MET)

Kathmandu, Jan 21, 2020 (AFP) - Eight Indian tourists, including four children, have died after they were found unconscious in their room at a hill resort in Nepal on Tuesday, police said.   The eight -- two couples and their children -- had slept in one room at a hotel in Daman, a popular tourist destination in Makwanpur district about 55 kilometres (34 miles) from Kathmandu.   "They were found unconscious this morning and airlifted to Kathmandu but died during treatment," police spokesman Shailesh Thapa Chettri told AFP.

The families, from the south-eastern state of Kerala, used a gas heater in their room to keep warm, a district official told AFP.   "We suspect they died of suffocation, but autopsy reports will confirm the cause," Chettri added.   India is Nepal's biggest source of tourists, making up some 16 percent of visitors to the Himalayan nation.
Date: Sun, 19 Jan 2020 14:17:42 +0100 (MET)

Kathmandu, Jan 19, 2020 (AFP) - Avalanches, heavy snow and poor visibility hampered the search Sunday for four South Koreans and three Nepalis caught in an avalanche in the popular Annapurna region of the Himalayas, officials said   Relatives of the missing Koreans have arrived in Kathmandu alongside several officials sent by Seoul to help with the emergency rescue efforts, Ang Dorjee Sherpa of the Korean Alpine Federation told AFP.

The missing group was near the Annapurna base camp around 3,230 metres (10,600 feet) above sea level when the avalanche struck after heavy snowfall on Friday.   "Our team reached the area but could not proceed with their search because of more avalanches. We are exploring ways to move the operation forward," said Mira Acharya from Nepal's tourism department.

Rescuers were working with Korean officials to deploy drones in the search on Monday, said Dilip Gurung of the tourism management committee in Chhomrong, which lies on the trekking route.   "It is difficult for people to go. We will try to fly drones to help find something," Gurung said.   Helicopters were sent out on Saturday to rescue about 200 people stranded around Annapurna and other nearby mountains after the incident.

Guesthouses and the trekking route were blanketed in a thick layer of snow.   "The snow was very deep and it took us more than double the time to dig through and walk," said Jeevan Dahal, a guide who was rescued by helicopter.   "We saw the avalanche-hit area from the helicopter. Everything was white."   Tek Gurung, a guesthouse owner aiding the search operation, said more than two metres of snow (6.6 feet) had fallen on the trekking trails and it was "extremely difficult" to search the snow-covered area on foot.

Six of the missing were part of the same expedition, while one Nepali porter was escorting a different group.   The four foreigners -- two men and two women -- were part of an 11-member team of South Korean nationals. Others have safely descended.    Education officials in Seoul said they were part of a team of volunteer teachers working with children in Nepal.

Two more South Koreans were due to arrive in Nepal on Sunday to help with the search, the country's foreign ministry said.   Sherpa said it had snowed heavily around Annapurna in recent days, making the trek risky.   "The weather and snow got worse and, feeling it was becoming dangerous and difficult, they decided to turn. As they were heading back the avalanche hit," Sherpa told AFP on Saturday.

Annapurna is an avalanche-prone and technically difficult mountain range with a higher death rate than Everest, the world's highest peak.    Thousands of trekkers visit the route every year for its stunning views of the Himalayas.   A snowstorm killed about 40 people on the circuit in 2014, in one of the biggest trekking tragedies to hit Nepal.