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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]
=====================
[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: Sun, 15 Mar 2020 23:58:27 +0100 (MET)

San Juan, March 15, 2020 (AFP) - The US territory of Puerto Rico on Sunday ordered a 9:00 pm to 5:00 am curfew to stem the spread of the novel coronavirus, the strongest measure yet taken on American soil.   It took effect immediately and lasts until March 30.   "Faced with the possibility of transmission and propagation of the virus, I have ordered the imposition of a curfew for all residents of Puerto Rico," Governor Wanda Vazquez announced in a video message.   "We must take every precaution to ensure that we do not become potential carriers," Vazquez said.

The Caribbean territory of 2.9 million, whose residents are US citizens, also will close many businesses from Sunday until the end of the month, she said.   That includes malls, movie theaters, concert venues, gyms, bars and other businesses that bring together large crowds on the island popular with tourists.   The exceptions will be businesses in the food supply chain, and in the medical care system, as well as drugstores, gas stations, banks and senior citizens' group homes.

At night, only those who are providing or receiving medical care, or carrying out essential duties, will be allowed to be on Puerto Rico's streets.   Anyone defying the curfew faces a six-month jail term and a fine of up to $5,000.   The island declared a state of emergency when its first cases were reported March 12. The island has reported five cases.   On Friday, Vazquez accepted the resignation of Health Secretary Rafael Rodriguez Mercado, who was under fire for his handling the coronavirus emergency.

Recently, island residents were irate when two warehouses were found to be filled with abandoned supplies, apparently never used after Hurricanes Irma and Maria in 2017.   The storms' one-two punch left Puerto Ricans without power for months and killed nearly 3,000 people, according to the local government's official numbers.   President Donald Trump has accused the Puerto Rican government of incompetence and siphoning off hurricane relief money.   The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
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.
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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 ...

Lithuania

Lithuania US Consular Information Sheet
May 19, 2008
COUNTRY DESCRIPTION:
Lithuania is a stable democracy undergoing rapid economic growth. Tourist facilities in Vilnius, the capital, and to a lesser extent in Kaunas and Klaipeda, are simi
ar to those available in other European cities. In other parts of the country, however, some of the goods and services taken for granted in other countries may not be available. Read the Department of State Background Notes on Lithuania for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport is required to enter Lithuania. As there are no direct flights from the U.S. to Lithuania, U.S. citizens should be aware of passport validity requirements in transit countries. American citizens do not need a visa to travel to Lithuania for business or pleasure for up to 90 days. That 90-day period begins with entry to any of the “Schengen Group” countries: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Slovakia, Spain, and Sweden. Multiple visits to Schengen countries may not exceed 90 days in any 6 month period. Travelers remaining in Lithuania for more than 90 days within any six-month period must apply for temporary residency.

Lithuanian authorities recommend applying or a residency permit through a Lithuanian embassy or consulate before initial entry into Lithuania, as processing times can run beyond 90 days. All foreigners of non-European Union countries seeking entry into Lithuania must carry proof of a medical insurance policy contracted for payment of all costs of hospitalization and medical treatment in Lithuania. Visitors unable to demonstrate sufficient proof of medical insurance must purchase short-term insurance at the border from a Lithuanian provider for roughly $1.00 per day. The number of days will be calculated from the day of entry until the date on the return ticket. Children residing in Lithuania must have written permission to travel outside the country from at least one parent if their parents are not accompanying them on their trip. This policy is not applicable to temporary visitors. See our Foreign Entry Requirements brochure for more information on Lithuania and other countries. Visit the Embassy of Lithuania web site at www.ltembassyus.org for the most current visa information.
Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passport upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passport may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information abut customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Civil unrest is not a problem in Lithuania, and there have been no incidents of terrorism directed toward American interests. Incidents of anti-Americanism are rare.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, 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., 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: Lithuania is a relatively safe country. Visitors should maintain the same personal security awareness that they would in any metropolitan U.S. city. Large amounts of cash and expensive jewelry should be secured in a hotel safe or left at home. Crimes against foreigners, while usually non-violent, do occur. Pickpocketing and thefts are problems, so personal belongings should be well protected at all times. Theft from cars and car thefts occur regularly. Drivers should be wary of persons indicating they should pull over or that something is wrong with their car. Often, a second car or person is following, and when the driver of the targeted car gets out to see if there is a problem the person who has been following will either steal the driver’s belongings from the vehicle or get in and drive off with the car. Drivers should never get out of the car to check for damage without first turning off the ignition and taking the keys. Valuables should not be left in plain sight in parked vehicles, as there have been increasing reports of car windows smashed and items stolen. If possible, American citizens should avoid walking alone at night. ATMs should be avoided after dark. In any public area, one should always be alert to being surrounded by two or more people at once. Additionally, criminals have a penchant for taking advantage of drunken pedestrians. Americans have reported being robbed and/or scammed while intoxicated.
Following a trend that has spread across Eastern and Central Europe, racially motivated verbal, and sometimes physical, harassment of foreigners of non-Caucasian ethnicity has been reported in major cities. Incidents of racially motivated attacks against American citizens have been reported in Klaipeda and Vilnius.
In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on these serious problems is available at http://www.cybercrime.gov/18usc2320.htm.
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. For more information about assistance for victims of crime in Lithuania, please visit the Embassy’s web site at http://vilnius.usembassy.gov/service/crime-victim-assistance.html.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Lithuania has improved in the last 15 years, but medical facilities do not always meet Western standards. There are a few private clinics with medical supplies and services that nearly equal Western European or U.S. standards. Most medical supplies are now widely available, including disposable needles, anesthetics, antibiotics and other pharmaceuticals. However, hospitals and clinics still suffer from a lack of equipment and resources. Lithuania has highly trained medical professionals, some of whom speak English, but their availability is decreasing as they leave for employment opportunities abroad. Depending on his or her condition, a patient may not receive an appointment with a specialist for several weeks. Western-quality dental care can be obtained in major cities. Elderly travelers who require medical care may face difficulties. Most pharmaceuticals sold in Lithuania are from Europe; travelers will not necessarily find the same brands that they use in the United States. Serious medical problems requiring hospitalization and/or medical evacuation can cost thousands of dollars or more. Doctors and hospitals often expect immediate cash payment for health services, particularly if immigration status in Lithuania is unclear.

Tick-borne encephalitis and lyme disease are widespread throughout the country. Those intending to visit parks or forested areas in Lithuania are urged to speak with their health care practitioners about immunization. Rabies is also increasingly prevalent in rural areas.
The Lithuanian Government does not require HIV testing for U.S. citizens. However, sexually transmitted diseases are a growing public health problem.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. All foreigners of non-European Union countries seeking entry into Lithuania must carry proof of a medical insurance policy contracted for payment of all costs of hospitalization and medical treatment in Lithuania (please see entry/exit requirements above). 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 Lithuania is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The Police allow Americans to drive in Lithuania with an American driver’s license for up to 90 days. Americans who reside in Lithuania for 185 days or more in one calendar year and who wish to continue driving in Lithuania must acquire a Lithuanian driver's license. The foreign license must be given to the Lithuanian Road Police to be processed by the Consular Department of the Lithuanian Ministry of Foreign Affairs, which in turn sends it to the U.S. Embassy’s Consular Section, where the owner is expected to claim it.
Roads in Lithuania range from well-maintained two- to four-lane highways connecting major cities to small dirt roads traversing the countryside. Violation of traffic rules is common. It is not unusual to be overtaken by other automobiles, traveling at high speed, even in crowded urban areas. Driving at night, especially in the countryside, can be particularly hazardous. In summer, older seasonal vehicles and inexperienced drivers are extra hazards. Driving with caution is urged at all times. Driving while intoxicated is a very serious offense and carries heavy penalties. The speed limit is 50 km/hr in town and 90 km/hr out of town unless otherwise indicated. The phone number for roadside assistance is 8-800-01414 from a regular phone and 1414 from a GSM mobile phone.
Seatbelts are mandatory for the driver and all passengers except children under the age of 12. During the winter, most major roads are cleared of snow. Winter or all-season tires are required from November 10th through April 1st. Studded tires are not allowed from April 10th through October 31st. Drivers must have at least their low beam lights on at all times while driving. Public transportation is generally safe.
Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office and national authority responsible for road safety at www.tourism.lt and at www.lra.lt/index_en.html.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Lithuania, the U.S. Federal Aviation Administration (FAA) has not assessed Lithuania’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 www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Lithuanian customs authorities may enforce strict regulations concerning the temporary importation into or export from Lithuania of items such as firearms and antiquities. Please see our Customs Information.
Telephone connections are generally good. American 1-800 numbers can be accessed from Lithuania but not on a toll-free basis; the international long distance rate per minute will be charged. Local Internet cafes offer computer access. ATMs are widely available. Most hotels and other businesses accept major credit cards.
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 Lithuanian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Lithuania are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or possessing or disseminating child pornography in a foreign country is a crime prosecutable in the United States. For more information about arrest procedures in Lithuania, please visit the Embassy’s web site at http://vilnius.usembassy.gov/arrests.html. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web page.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Lithuania 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 Lithuania. 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 Akmenu Gatve 6, tel. (370) (5) 266-5500 or 266-5600; fax (370) (5) 266-5590. Consular information can also be found on the Embassy Vilnius web site at http://vilnius.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated November 5, 2007 to update sections on Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat, 14 Mar 2020 21:41:50 +0100 (MET)

Vilnius, March 14, 2020 (AFP) - Lithuania said Saturday it would shut its borders to most foreign visitors while fellow Baltic EU members Estonia and Latvia imposed security measures of their own to stem the spread of the novel coronavirus.   Lithuanian Prime Minister Saulius Skvernelis said the country of 2.8 million people has decided to reinstate checks on its borders with Latvia and Poland, becoming the fifth nation to do so within the bloc's zone of free travel.

Foreigners will be banned from entering the country starting 1000 GMT on Sunday, with the exception of individuals with a residence permit, diplomatic workers and NATO troops.   Freight transport will not be affected, he added.   "Our goal is to delay the spread of the virus as long as possible inside the country and to reduce the negative consequences," Skvernelis said.

Lithuania, which has eight confirmed COVID-19 cases, has been on partial lockdown since Friday after the government shut down all schools, kindergartens and universities and banned large public events.   From Monday, the ban will also cover most shops, restaurants and pubs, although food delivery will be allowed. The measure does not concern grocery stores and pharmacies.   Skvernelis said his cabinet will approve an economic stimulus plan on Monday worth "at least one billion euros".

Fellow Baltic states Estonia and Latvia also imposed movement restrictions on Saturday but stopped short of border shutdown.   Latvia, which has a population of 1.9 million people and 26 confirmed cases of the coronavirus, said it will suspend all international flights, ferries, buses and trains from Monday.   "Border crossings by private car will continue, as well as international freight and cargo flow," Latvian Transport Minister Talis Linkaits told reporters.

Estonia, the northernmost Baltic state with 1.3 million people and 115 confirmed cases of COVID-19, banned travel to six of its islands for all but their permanent residents.   The government also decided to close down all leisure centres, sports clubs, spas and swimming pools.    Most of the measures will apply for a couple of weeks but will likely be prolonged according to Baltic authorities.
Date: Wed 7 Aug 2019 01:17:58 EEST
Source: Xinhua News Agency [edited]

The rate of tick-borne encephalitis in Lithuania remains the highest in Europe, announced the country's Center for Communicable Diseases and AIDS (ULAC) on [Tue 6 Aug 2019].

According to ULAC, the rate of tick-borne encephalitis cases was 16.6 cases per 100 000 population in 2017, based on the latest data provided by the European Center for Disease Prevention and Control (ECDC) in its latest annual epidemiological report.  "In Lithuania the rate of encephalitis remains the highest in Europe," said ULAC.

Lithuania was followed by the Czech Republic and Estonia with the rate of 6.4 cases per 100 000 population, according to ULAC.  ULAC notes the largest proportion of tick-borne encephalitis cases is at the age group of 45-64 years and the lowest among the children of the age of 0-4 years.  "ULAC medics remind vaccination is the most reliable protection from tick-borne encephalitis," said ULAC in the announcement, noting vaccines have a reliability rate of 98 percent.

ULAC's warning comes amid increasing number of tick-borne encephalitis cases this year [2019] in Lithuania, a Baltic country with a population of around 3 million.  More than 90 cases of tick-borne encephalitis were reported during the 1st half of the year [2019] in Lithuania, 1/3 more compared to the same period last year [2018], according to local data by ULAC.

According to the ECDC's report, the highest prevalence of tick-borne encephalitis historically is found in the Baltic countries. Tick-borne encephalitis usually reaches its seasonal peak during the warmest months -- July and August.

Tick-borne encephalitis is a human viral infectious disease of central nervous system caused by infected ticks, usually found in woodland habitats. The disease manifests itself with symptoms similar to fever, fatigue, headache, nausea, and can cause meningitis.
=====================
[Cases of tick-borne encephalitis (TBE) have been reported before (see ProMED mail archive Tick-borne encephalitis - EU (Czech Rep., Latvia, Lithuania) http://promedmail.org/post/20040624.1677). Given the high rate of TBE cases in Lithuania reported above, there doubtless have been cases occurring there annually in recent years.

A report in Eurosurveillance Weekly in 2004 stated, "Tick-borne encephalitis (TBE) is endemic in virtually all countries in Central and Eastern Europe. It is caused by several closely related but distinct flaviviruses. 3 subtypes are recognised at present: a Far-Eastern subtype, a Siberian subtype and a European subtype. The Siberian subtype is associated with Russian spring-summer encephalitis and is transmitted predominantly by the tick _Ixodes persulcatus_, whereas the European subtype causes central European encephalitis and is transmitted by _Ixodes ricinus_.

The clinical spectrum of acute TBE ranges from symptoms of mild meningitis to severe meningoencephalitis with or without myelitis. The incubation period of central European TBE is 7-14 days. Onset is generally biphasic. The 1st phase involves a non-specific influenza-like illness with fever, headache, nausea, and vomiting, lasting about a week. After a period of remission lasting a few days, the fever returns with aseptic meningitis or encephalomyelitis. The case fatality rate is 1-5 percent and about 20 percent of survivors have neurological sequelae. Residual motor defects are rare." - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Lithuania:
Date: Wed, 3 Jul 2019 15:49:43 +0200

Vilnius, July 3, 2019 (AFP) - Lithuania declared an emergency on Wednesday as a severe drought hit the Baltic EU state, threatening to slash this year's harvest by up to half.   Apart from jeopardising crops, scant rainfall has also drastically reduced water levels in some rivers, threatening fish stocks and shipping activities.

The formal declaration of an "emergency situation" will allow the government to compensate farmers for some losses as well as help them to avoid EU financial sanctions should they fail to reach production goals.   "Farmers believe their harvest can be slashed by 40 percent or 50 percent, while fish stocks are also endangered," environment minister Kestutis Mazeika told AFP.

Mazeika said "nobody has any doubt" that global climate change is behind the prolonged and more intensive dry spells and heatwaves in recent years.   He also appealed to neighbouring Belarus to increase the water level in the Neris river by allowing more water to flow from its reservoirs.   Last month was the hottest June ever recorded with soaring temperatures worldwide capped off by a record-breaking heatwave across Western Europe, satellite data showed Tuesday.   Lithuania also registered its hottest-ever June, with a peak of 35.7 degrees Celsius (96.2 degrees Fahrenheit) recorded on June 12.

Over the last week, firefighters have fought wildfires triggered by the heat in peat bogs in western Lithuania and neighbouring Latvia.   Elsewhere in Central Europe, Polish authorities said this week that varying degrees of drought have put grain crops at risk in 14 of the EU country's 16 regional districts.   The Czech Academy of Sciences said it expects drought to affect the entire country, with 80 percent of the territory facing "exceptional to extreme drought".
Date: Thu, 13 Jun 2019 15:12:32 +0200

Vilnius, June 13, 2019 (AFP) - Lithuanian temperatures have hit record June highs, meteorologists said Thursday, as a heatwave forced school closures and threatened to reduce harvests in the draught-hit Baltic region.   Kaisiadorys in central Lithuania was the hottest place at 35.7 degrees Celsius (96.2 degrees Fahrenheit) on Wednesday, the highest-ever temperature recorded for June in the country, weather forecaster Paulius Starkus told AFP.   Six people drowned in the Baltic EU state on Wednesday, the deadliest day of the year to date, while some schools put classes on hold or cut lessons short due to the heatwave.

Scientists say the extreme weather is in part a result of climate change.   "Lithuania used to have heatwaves but now they occur more often and are more intense due to climate change," Vilnius University climatologist Donatas Valiukas told AFP.   Starkus said a downpour with thunder and hail could follow in some areas on Thursday afternoon.   Agriculture Minister Giedrius Surplys told lawmakers that some areas were experiencing "a real climatic draught" threatening harvests, while hydrologists warned that river water levels posed a threat to fish.   Demand for air-conditioning has also soared in recent weeks.   Lithuania's hot weather is expected to last through the week, then temperatures may ease below 30 degrees Celsius starting Monday.   Fellow Baltic state Latvia is also experiencing unusual heat for June, with temperatures over 32 degrees Celsius.

In recent days, Latvia's western region of Kurzeme saw thunderstorms with hail damaging buildings, smashing greenhouses and tearing power lines.   Two people have been hospitalised in the northern Latvian town of Cesis after a tree fell on their camper van while they were inside.    Fellow Baltic state Estonia had a heatwave last week and is now experiencing rainy and windy weather.   Poland has also been experiencing high temperatures this month, which has resulted in increased air-conditioner use. The power transmission system operator PSE said that on Wednesday there was record electricity demand for a summer morning at nearly 24.10 gigawatts (GW).   Forty-two people have already drowned in Poland this month, according to the government security centre RCB.
Date: Sat 30 Mar 2019
Source: PM News Nigeria [abridged, edited]

Measles in Lithuania is up to 310 cases this year [2019] compared to 30 cases for 2018 in total. The number of measles cases is projected to increase further in Lithuania, as people have lost their collective immunity to this highly contagious viral disease, Director of Lithuania's Centre for Communicable Diseases and AIDS (ULAC), Saulius Caplinskas, said on Fri [29 Mar 2019].  "The collective immunity has been lost, as a 95 per cent measles vaccination coverage rate is considered as minimum to prevent an outbreak. There are new suspected cases of measles; blood samples are being examined. I have no doubt that in the nearest future, there will be new cases,'' Caplinskas was quoted as saying by local news website lrt.lt.

Recent data from ULAC shows that the proportion of children vaccinated against measles in the country has decreased from 97 per cent in 2009 to 92.2 per cent in 2018 due to parents' reluctance to vaccinate their kids.  According to ULAC, every year, some 5000 children are not vaccinated in Lithuania. "Measles outbreaks feature certain upswings and descents, yet we will have to live under the threat of measles for a while,'' Caplinskas said.

In total, 310 cases of measles have been registered as of Fri [29 Mar 2019] in Lithuania this year [2019], compared to 30 cases for the whole of 2018, ULAC data showed.  The largest number of cases, 149, was registered in Kaunas, Lithuania's 2nd largest city. In Vilnius, the capital, 39 measles cases have been registered to date. Measles is a highly contagious, serious disease caused by a virus, says the World Health Organization.
More ...

Barbados

General
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Barbados is an island country in the West Indies. This Caribbean Island gained its independence from Britain in 1966 and enjoys a pleasant climate throughout much of the year. The main rainfall occurs betwe
n May to October and it may be affected by hurricanes along with many other Caribbean countries during September or October. The tourism facilities are well developed and Barbadian English is the main spoken language.
Safety & Security
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The level of street crime is low but tourists are encouraged to maintain a close eye on personal processions and to use the hotel safety boxes for any particular valuables. Take care when walking through crowded market places, using a body pouch for your belongings. Ask advice before walking along deserted beaches at nighttime. If necessary, use an authorised taxi at all times to and from nightclubs.
Medical Facilities
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Health care facilities throughout the main tourist regions are good but if travelling around the island you should be aware that these facilities are less developed. It is wise to ensure that you carry sufficient personal medication for the duration of your trip though medical supplies within Barbados are usually excellent.
Road Travel
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The traffic in Barbados travels on the left side of the road and generally the infrastructure is well maintained along the tourist routes. Nevertheless, hiring cars or mopeds is usually not recommended due to the high risk of accidents. Hiring a taxi is usually a safer option.
Local Customs
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Many countries (including Barbados) have strict rules regarding the possession of illegal drugs. Never carry any item for another individual and always make sure your own personal medications are well marked at all times. Sometimes it is wise to have an official letter from your prescribing doctor outlining the reason for your medication.
Swimming
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As always when abroad, make sure you take heed of local advice before swimming in the Caribbean. Strong currents can occur and occasionally passing cruise ships or tankers may pollute the sea. Never swim alone, away from the main tourist resorts or soon after a meal. Take care to watch children at all times even around the hotel swimming pools. If planning to undertake water sports while abroad make sure your travel insurance is sufficient and always check that the company you use has well maintained equipment and that good safety procedures are in place. Talking to other tourists or the hotel representative before booking will help give you a clearer picture of the facilities on offer.
Sun Exposure & Dehydration
******************************
The temperature in Barbados is generally similar throughout the year with levels between 20 to 30C at most times. Sun exposure most commonly occurs in those who do not cover up sufficiently and particularly if asleep beside the pool, exhausted due to jet lag, soon after arrival. Take care that children are kept cool, drink plenty of fluids and take extra salt in their diet (crisps, salted biscuits etc) to help overcome these effects.
Food & Water
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The level of food hygiene in the main tourist resorts is high but care should be taken with regard to the consumption of seafood. Contamination of fish and shellfish has been reported in the past. Ciguatera poisoning associated with consumption of snappers, parrot fish, mackerel, moray eels and barracudas has been reported. Water hygiene is usually excellent though drinking bottled water is usually a wise precaution while abroad.
Rabies risks
******************************
Barbados has been rabies free for over 150 years. Nevertheless, avoiding animal bites is still a wise option and particularly take care that young children do not befriend any animals including birds, monkeys, cats and dogs.
Malaria & Mosquito Bites
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Malaria transmission does not occur within the West Indies including Barbados. However other mosquito borne diseases such as Dengue Fever can be a significant problem. Mosquitoes that tend to bite in urban areas during the daylight hours transmit this disease and so care against insect bites is encouraged throughout the whole day.
Vaccinations for Barbados
******************************
There are no vaccines required for entry to Barbados from Ireland. However, most tourists would be encouraged to consider cover against the following:
*
Tetanus (childhood booster)
*
Typhoid (food & water borne)
*
Hepatitis A (food & water borne)
Those planning a more extensive trip or undertaking adventure sports should also consider cover against Hepatitis B.
Summary
******************************
The majority of tourists to Barbados will enjoy a healthy time on the island with little reason for concern providing they follow some simple commonsense rules regarding seafood consumption, sun exposure and dehydration. Further information, including any recent news reports, is available through the Tropical Medical Bureau at the numbers below.

Travel News Headlines WORLD NEWS

Date: Fri 17 Aug 2018
Source: Outbreak News Today [edited]

Barbados health officials are reporting an increase in syphilis in pregnant women in recent years. The health ministry is now seeing an abnormally high rate of syphilis in pregnant women and, by extension, an increase in the number of babies born at risk for congenital syphilis.

Statistics show a rise from the average one or 2 cases a year of syphilis in pregnant women to 17 in 2016. According to the Ministry official, preliminary analyses from 2017 show a similarly high rate.

Dr. Anton Best, senior medical officer of health with responsibility for the HIV/STI programme, said that effective prevention and detection of congenital syphilis depends on the identification of the sexually transmitted infection (STI) in pregnant women. He noted that the Ministry of Health and Wellness' guidelines make it clear that all pregnant women should be offered a screening test for syphilis at booking and at 28 weeks gestation.
===================
[The number of syphilis cases in Barbados was reported to have started to increase in 2012, from 24 in 2011 to 41 in 2012 and to 112 in 2013, and then to have stabilized in 2014 (100 cases), 2015, and 2016 (<http://www.nationnews.com/nationnews/news/98007/stis-major-concern-ministry-health>).  72 percent of new syphilis cases reportedly occurred in men between the ages of 15 and 49 years old, with the average age being 34; more than 95 percent of pregnant women were screened for syphilis during pregnancy, and no increase in syphilis cases in pregnant women occurred during a 4-year study (2011-2014), with only one case of syphilis being transmitted through birth in 2014  (<https://caribbeannewsservice.com/now/syphilis-outbreak-in-barbados/>).

However, the news report above says that, although only one or 2 cases a year of syphilis occurred in pregnant women previously, 17 cases occurred in 2016, and a similar number occurred in 2017, but we are not given the number treated or outcome of these pregnancies.

Syphilis is a bacterial infection caused by the spirochete _Treponema pallidum_. Transmission from mother to fetus occurs via the bloodstream during maternal spirochetal infection. Transmission may also occur during delivery if maternal genital lesions are present. Late abortion, stillbirth, and neonatal death may result from congenital infection in untreated pregnancies. Among survivors, manifestations that develop in the 1st 2 years of life are called "early" and are similar to adult secondary syphilis; manifestations that develop after age 2 years are called "late" and include tooth abnormalities (Hutchinson teeth), bone changes (saber shins), "Clutton's joints" (bilateral painless swelling of the knee joints), neurological involvement, blindness, and deafness.

Control of congenital syphilis is achieved by antenatal screening and treatment of mothers who are infected. Routine serologic screening should be done at the 1st prenatal visit in all pregnant women, and, in communities and populations in which the risk for congenital syphilis is high, serologic testing and a sexual history also should be obtained at 28 weeks gestation and at delivery. Groups at high risk include uninsured women, women living in poverty, sex workers, illicit drug users, women diagnosed with sexually transmitted diseases, and those living in communities with high syphilis morbidity (<http://www.ahrq.gov/clinic/uspstf09/syphilis/syphpgsum.htm>). No mother or neonate should leave the hospital without maternal serologic status having been documented at least once during pregnancy and, if the mother is considered high risk, also at delivery.

Barbados, with a population of 277 821 residents, is a sovereign country and the easternmost island in the Caribbean region of North America; its capital and largest city is Bridgetown  (<https://en.wikipedia.org/wiki/Barbados>).

A map showing the location of Barbados can be found at
<https://en.wikipedia.org/wiki/West_Indies#/media/File:Caribbean_general_map.png>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Date: Tue, 9 Feb 2016 20:01:58 +0100

Miami, Feb 9, 2016 (AFP) - Barbados on Tuesday confirmed three cases of Zika in pregnant women, bringing to seven the number of people on the Caribbean island with the virus, which is believed to be linked to birth defects.   The women will be given specialized obstetric care, the Ministry of Health said in a statement. The new cases were announced on the Barbados government information services Facebook page.

Zika, a primarily mosquito-borne illness, has spread rapidly through Latin America and the Caribbean. It generally causes mild symptoms but has been blamed for a rapid rise in the number of children born with microcephaly -- abnormally small heads and brains.   Barbados said that link has not been confirmed.    "The situation is still evolving and information is being updated regularly," the Ministry of Health said.   The World Health Organization has declared a global medical emergency to combat Zika and individual countries and regions are beginning to mobilize. With no cure or vaccine for the virus, some countries have taken the extraordinary step of urging women to delay getting pregnant.

According to the Pan-American Health Organization, 26 countries have confirmed cases, spanning 7,000 kilometres (4,400 miles) from Mexico to Paraguay.   The hardest hit country is Brazil, which hosts the Summer Olympics starting in August.   Brazil has warned pregnant women not to travel there but Games organizers have said by the time the Olympics start, the main mosquito season will be over and they don't expect the illness to affect the sporting extravaganza.
Date: Tue, 18 Feb 2014 11:17:11 +0100 (MET)

WASHINGTON, Feb 18, 2014 (AFP) - An earthquake measuring 6.7 struck Tuesday in the Caribbean near the island of Barbados, the US Geological Survey said.   The quake hit at 0927 GMT about 170 kilometers (110 miles) northeast of the town of Bathsheba on Barbados, the USGS said.   It struck at a depth of 172 kilometers (11 miles).   There were no immediate reports of damage or injuries in Barbados media outlets.   The Daily Nation newspaper said people called radio stations to report the quake.
Date: Mon, 8 Jul 2013 11:53:25 +0200 (METDST)

MIAMI, United States, July 08, 2013 (AFP) - Tropical Storm Chantal, which formed in the Atlantic overnight, headed towards the Caribbean Sea on Monday, the US National Hurricane Center reported.   At 0900 GMT Chantal was located about 1,130 kilometers (705 miles) east of Barbados packing maximum sustained winds of 65 kilometers (40 miles) per hour, the NHC said.

The storm is moving in a northwesterly direction at 43 kilometers per hour.   If it continues on its current path it will reach southern Puerto Rico and the island of Hispaniola -- shared by the Dominican Republic and Haiti -- on Wednesday or Thursday, according to the NHC forecast.   Tropical storm warnings are in effect for the French islands of Martinique and Guadeloupe, as well as for Barbados, Dominica and Santa Lucia, the NHC said.

Chantal is expected to strengthen during the next 48 hours and "produce rain accumulations of two to four inches over the Leeward and Windward Islands, with maximum amounts of six inches possible," the NHC said.   Poverty-stricken Haiti, which is still recovering from a devastating earthquake in January 2010, is especially prone to landslides triggered by heavy rain.
Date: Fri, 3 Aug 2012 06:28:26 +0200 (METDST)

MIAMI, Aug 3, 2012 (AFP) - Tropical storm Ernesto, the fifth of the Atlantic hurricane season, threatened Barbados and the Windward Islands Friday as it advanced across the Atlantic with winds of 85 kilometers per hour.

At 0300 GMT, the storm's center was 130 kilometers (80 miles) east of Barbados and 295 kilometers (185 miles) east of St Lucia, the Miami-based National Hurricane Center said. "The center of Ernesto should pass near Barbados later tonight, be near the northern Windward Islands by early Friday and emerge over the eastern Caribbean sea by Friday afternoon," the center said. It said tropical storm warnings were up in Barbados, St Vincent and the Grenadines, Dominica, St Lucia, Martinique and Guadeloupe.

Ernesto formed on Thursday from a tropical depression, becoming the fifth tropical storm of the current hurricane season, which runs from June 1 to November 30. The storm was expected to strengthen somewhat over the next two days, the center said. US weather forecasters have said they expect this to be a relatively mild hurricane season, with nine to 15 topical storms and between four and eight hurricanes.
More ...

Congo, Democratic Republic

Democratic Republic of the Congo US Consular Information Sheet
23rd September 2008
COUNTRY DESCRIPTION: The Democratic Republic of the Congo (Congo-Kinshasa) located in central Africa, is the third largest country on the continent. The capital
s Kinshasa. French is the official language. Years of civil war and corruption have badly damaged the country's infrastructure. Read the Department of State Background Notes on the Democratic Republic of the Congo (DRC) for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport, visa and evidence of yellow fever vaccination are required for entry. Some travelers arriving in the DRC without proper proof of yellow fever vaccination have been temporarily detained, had their passports confiscated, or been required to pay a fine. Information about yellow fever vaccination clinics in the U.S. may be found at http://www2.ncid.cdc.gov/travel/yellowfever/.
Visas must be obtained from an embassy of the DRC prior to arrival.
Travelers to the DRC frequently experience difficulties at the airport and other ports of entry, such as temporary detention, passport confiscation and demands by immigration and security personnel for unofficial “special fees.”
All resident foreigners, including Americans, are required to register at the office of the Direction General de Migration (DGM) in the commune of their place of residence.
Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.
Dual nationals arriving in the DRC should carefully consider which passport they use to enter the DRC. For departure from the DRC, airlines will require a valid visa for all destination countries before they will issue a ticket or allow a passenger to board. Airlines also require that the passenger have the correct entry stamp in the passport they wish to use to exit the country. Passengers who are unable to leave the country on the passport they used to enter the DRC may not be able to continue on their travel itinerary.
Additional information about visas may be obtained from the Embassy of the Democratic Republic of the Congo, 1726 M Street NW, Washington, DC 20036, tel. (202) 234-7690, or the DRC's Permanent Mission to the UN, 866 United Nations Plaza, Room 511, New York, NY 10017, tel. 212-319-8061, fax: 212-319-8232, web site http://www.un.int/drcongo. Overseas, inquiries should be made at the nearest Congolese embassy or consulate. 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:
See the Department of State’s Travel Warning for the Democratic Republic of the Congo.

Though the DRC is now significantly more stable than it has been over the past decade, security remains problematic. The first democratic elections in more than forty years were held in 2006, and a new government is now in place. Post-election disturbances occurred as recently as March 2007 in Kinshasa, resulting in deaths of civilians and military personnel. During civil disturbances in 2007 there were incidents of hostility towards U.S. citizens and other expatriates.

Both inside and outside Kinshasa, there can be roadblocks, especially after dark. Vehicles are often searched for weapons and valuables, and travelers are checked for identity papers. Security forces regularly seek bribes. If confronted with such a situation, it is suggested that U.S. citizens remain courteous and calm. If detained, report the incident to the U.S. Embassy in Kinshasa as soon as possible.

The United Nations has its largest peacekeeping operation in the world in the DRC. Known by its French acronym of MONUC, it has close to 17,000 peacekeepers deployed in the country – primarily in the east. Violence nevertheless persists in the eastern DRC due to the presence of several militias and foreign armed groups, with sporadic outbreaks occurring in North Kivu, South Kivu, and northern Katanga provinces, as well as in the Ituri District of Orientale province. Members of the Lord’s Resistance Army entered into northeastern DRC from Sudan in 2005, and have camps in an isolated region of the DRC, Garamba National Park, where they killed eight MONUC peacekeepers in January 2006.

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 overseas 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 pamphlet A Safe Trip Abroad.
CRIME:
In the DRC, poor economic conditions continue to foster crime, especially in urban areas. Travel in many sections of Kinshasa, Kisangani, Lubumbashi and most other major cities, is generally safe during daylight hours, but travelers are urged to be vigilant against criminal activity which targets non-Congolese, particularly in highly congested traffic and areas surrounding hotels and stores. Outlying, remote areas are less secure due to high levels of criminal activity and the lack of adequate training, supervision, and salary payments to the security forces present.

Vehicle thefts, burglaries, and armed robbery occur throughout the country; there have been recent reports of after-dark carjackings, resulting in deaths in the North Kivu area. It is recommended to drive with doors locked and windows closed at all times. If confronted by members of the military or security forces, visitors should not permit soldiers or police officers to enter their vehicles nor get into the vehicle of anyone purporting to be a security official. It is recommended that in such instances U.S. citizens remain courteous and calm and, if threatened, not resist. All incidents should be reported to the U.S. Embassy in Kinshasa.

Consistency in administering laws and regulations is notably absent. Travelers should note that in cases of theft and robbery, legal recourse is limited. Therefore, valuable items may be safer if kept at home or another secure location.

Security officials and/or individuals purporting to be security officials have detained and later robbed American citizens and other foreigners in the city of Kinshasa. This type of crime has increased in recent months, but generally occurs more frequently during the Christmas and New Year's holidays.

Travelers using public transportation or visiting high pedestrian traffic areas of any type are advised to be vigilant against robbery and pick-pocketing which is a persistent problem in all major cities in the DRC. The presence of “street children”, who can be persistent and sometimes aggressive, remains a problem particularly in Kinshasa.
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:
In the DRC, medical facilities are severely limited, and medical materials are in short supply. Travelers should carry properly labeled prescription drugs and other medications with them and should not expect to find an adequate supply of prescription or over-the-counter drugs in local stores or pharmacies. Payment for any medical services required is expected in cash, in advance of treatment.

Malaria is common throughout the DRC and outbreaks of cholera, typhoid, yellow fever, the Ebola virus, and hemorrhagic fever occur.
Travelers should take appropriate precautions to prevent the spread of HIV/AIDS.
Tuberculosis is an increasingly serious health concern in the DRC.
For further information, please consult the CDC's Travel Notice on TB at: http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the DRC.

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:
For planning purposes, the minimum estimated cost of medical air evacuation to the nearest suitable health care facility (in South Africa) is $35,000.

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 DRC is provided for general reference only, and may vary according to location or circumstance.

Inter-city roads are scarce, and throughout the DRC roads are generally in poor condition, and often impassable in the rainy season. When driving in cities, keep windows up and doors locked. At roadblocks or checkpoints, documents should be shown through closed windows. In the event of a traffic incident involving bodily injury to a third party or pedestrian, do not stop to offer assistance under any circumstances. Proceed directly to the nearest police station or gendarmerie to report the incident and request official government intervention. Attempting to provide assistance may further aggravate the incident, resulting in a hostile mob reaction such as stoning or beating.

Presidential and other official motorcades pose serious risks to drivers and pedestrians in Kinshasa. When hearing sirens or seeing security forces announcing the motorcade's approach, drivers should pull off the road as far as possible, stop their vehicles, and extinguish headlights. Vehicles should not attempt to move until the entire motorcade has passed by; the security forces will physically indicate when this has occurred. Failure to comply may result in arrest, and/or vehicle damage with possible personal injury.

Public transportation of all forms is unregulated and is generally unsafe and unreliable. Taxis, mini-buses, and trains are in poor mechanical condition and are invariably filled beyond capacity.

Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.

Drivers should stop their cars and pedestrians should stand still when passing a government installation during the raising and lowering of the Congolese flag. This ceremony occurs at roughly 7:30 a.m. and 6:00 p.m.
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 the DRC’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of the DRC’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.
Civil aviation in the DRC continues to experience air incidents and accidents; more than a dozen crashes and in-flight accidents resulted in more than 300 fatalities between 2000 and August 2008. Incidents included hard landings, engine failures, collapsed landing gear, and planes veering off the runway.
In-country air travel schedules are unreliable and planes are frequently overloaded with passengers and/or cargo.
The U.S. Embassy in the DRC has prohibited official travel by U.S. government employees and contractors on all DRC-owned and -operated commercial air transportation services due to concerns regarding safety and maintenance.
International flights on foreign-owned and -operated carriers are not affected by this notice.
SPECIAL CIRCUMSTANCES:
Photography: Travelers should note that photography in public places in Kinshasa and around any public or government building or monument in the DRC is strictly forbidden. Persons caught photographing such sites will likely have their photographic equipment confiscated and risk detention and possible arrest.

Travel to and from Congo-Brazzaville (Republic of Congo): Ferry service to and from Kinshasa and Brazzaville stops running in the late afternoon, does not operate on Sundays, and may close completely with minimal notice. If ferry service is functioning, a special exit permit from the DRC's Immigration Service and a visa from the Republic of the Congo (Congo-Brazzaville) are required for U.S. citizens to cross the Congo River from Kinshasa to Brazzaville.

Ferry and riverboat service to the Central African Republic is suspended due to rebel control of the Ubangui River.
Phone Service: In the DRC, cellular phones are the norm, as other telephone service is unreliable. Depending on the type of phone, it may be possible to locally purchase a SIM card to use an American-compatible cell phone in the DRC.

Currency: U.S. currency is widely accepted in the urban areas, but most vendors and banking institutions will accept only Series 1996 bills or newer, with the large, off-center portraits, that provide stronger protection against counterfeiting. In addition, bills must be in near perfect condition; even those with minor stains or small tears will be rejected. One dollar bills are rarely accepted, even if in mint condition. U.S. bills should be examined before they are accepted to ensure that they are legitimate, as counterfeit currency is widely circulated. It is recommended that currency exchange be conducted at reputable banks and not on the street where several schemes exist to either short-change the unwitting customer or to pass counterfeit bills.

CRIMINAL PENALTIES:
While in any 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. 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.

Penalties for breaking the law can be more severe in the DRC than in the United States for similar offenses.
Persons violating Congolese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the DRC are severe, and convicted offenders can expect long jail sentences and heavy fines. Accusations of engaging in crimes against the security of the State, which are loosely defined, often result in detention for prolonged periods without being formally arrested. The DRC’s justice system remains plagued by corruption and uneven application of the law. Attorney fees can be expensive and are expected to be paid in advance of services rendered.

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 DRC 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 the Congo. Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 310 Avenue des Aviateurs; tel. 243-081-225-5872 (do not dial the zero when calling from abroad). Entrance to the Consular Section of the Embassy is on Avenue Dumi, opposite the Ste. Anne residence. The Consular Section of the Embassy may be reached at tel. 243-081-884-6859 or 243-081-884-4609; fax 243-081-301-0560 (do not dial the first zero when calling from abroad).
*

*

*
This replaces the Country Specific Information for the Democratic Republic of the Congo, dated April 29, 2008, to update sections on Entry/Exit Requirements and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Thu, 26 Mar 2020 20:08:34 +0100 (MET)

Kinshasa, March 26, 2020 (AFP) - The Democratic Republic of Congo capital Kinshasa will go into "total confinement" for four days from Saturday to help contain the spread of coronavirus, authorities said on Thursday.   Governor Gentiny Ngobila on Thursday decreed intermittent four-day confinements over three weeks, according to a speech seen by AFP. The city will be on lockdown for four days followed by two days to allow residents to shop followed by another four-day lockdown, in a rotation continued for the three-week period.
Date: Tue, 24 Mar 2020 22:52:18 +0100 (MET)

Kinshasa, March 24, 2020 (AFP) - DR Congo's President Felix Tshisekedi on Tuesday declared a state of emergency and ordered the isolation of the capital Kinshasa from the rest of the country to avoid the spread of coronavirus.   The new measures include a ban on all travel from Kinshasa to the provinces and from the provinces to the capital to allow for the confinement of the city, he said.   "Given the seriousness and the dangerous nature of this situation, I declare a state of emergency," Tshisekedi said in a televised address.    The country has registered 45 cases of the virus including three fatalities, all in Kinshasa.

The isolation of the capital means no passenger flights in or out of Kinshasa, though cargo flights will be allowed.   The travel ban includes all public transport and buses as well as river transport in and out of the city.    The president said the DR Congo would also close its borders to all travel except for trucks, ships and planes carrying cargo.

The second largest city in the Democratic Republic of Congo, Lubumbashi, began a 48-hour lockdown on Monday after the arrival of two people with suspected coronavirus aboard a flight from Kinshasha.
Date: Mon, 23 Mar 2020 13:23:59 +0100 (MET)

Lubumbashi, DR Congo, March 23, 2020 (AFP) - The second largest city in the Democratic Republic of Congo (DRC) began a 48-hour lockdown on Monday after the arrival of two people with suspected coronavirus aboard a flight from Kinshasha.   Security forces were deployed in the city of Lubumbashi, in south-eastern DRC, where the streets were deserted and stores were closed, an AFP journalist said.   The move came after two people with suspected coronavirus arrived on Sunday on a scheduled flight from the capital, the authorities of Haut-Katanga province said.

Fast-track tests were carried out on them and the results were positive.   Samples have been sent to the National Institute for Biomedical Research (IRNB) in Kinshasa for confirmation, Health Minister Eteni Longondo said.   "A 48-hour-long total confinement has been declared over all Haut-Katanga province as of Monday," Governor Jacques Kyabula said in a statement.   The measure "will enable the authorities to identify the other passengers aboard this plane for quarantining," he said.   The plane was carrying 77 passengers, the authorities said.

Haut-Katanga, rich in copper and cobalt, is one of 26 provinces in the DRC, the largest country in sub-Saharan Africa.   The DRC has recorded 30 cases of coronavirus since March 10, two of them fatalities.   Four legislators in Kinshasa on Monday urged President Felix Tshisekedi to place the sprawling capital "in quarantine and isolate it from the rest of the country."   "We are extremely concerned about the risk of the virus spreading as a result of travel from Kinshasa and the rest of the country," they said.   Tshisekedi was to chair a meeting on coronavirus later Monday, his press office said.
Date: Wed 4 Mar 2020 11:30 AM
Source: Radio Okapi machine trans, edited]

A total of 30 cholera deaths have been recorded in the Lubumbashi and Kafubu health areas since the beginning of 2020. According to provincial health minister Joseph Sambi Bulanda, the health areas of Kampemba and Kisanga (in Lubumbashi) are the most affected, with more than 200 cases recorded, including 12 deaths. Several health areas in the Kafubu health zone have also been shaken by the disease, with more than 106 cases including 18 deaths.

In addition, the Minister indicated that in Lubumbashi, the cholera treatment centre is set up at the Kenya Commune Reference General Hospital to receive patients free of charge.

Water chlorination is done by the NGO AIDES, a partner of the provincial ministry of health, which also carries out safe burials of victims. In addition, the awareness campaign continues to be done door-to-door to get people to observe hygiene measures to avoid this disease.

The provincial health minister believes that cholera is in the process of being controlled.
Date: Tue, 10 Mar 2020 16:05:32 +0100 (MET)

Kinshasa, March 10, 2020 (AFP) - The DR Congo confirmed its first coronavirus case in the capital Kinshasa, the third most populous city in Africa, the health ministry said on Tuesday.   The patient is a Belgian citizen who has been in the country for several days, Health Minister Eteni Longondo said.   "He is confined to a hospital," the minister said. "We are tracking people who came into contact with him so that they too can be placed in quarantine, and tested."

Kinshasa, which has a population of more than 10 million people, is served by direct flights from Brussels and Paris.   Passengers have their temperature taken upon arrival and must fill out a medical questionnaire.   DR Congo officials have drafted "a strategic national plan" to deal with the new coronavirus, the head of the national biological research institute, Jean-Jacques Muyembe, said Monday.   The Democratic Republic of Congo hopes to declare next month an end to a 19-month Ebola epidemic that has killed 2,264 people, as no new cases have been discovered for three weeks.
More ...

Thailand



*****
Travel in Health in Thailand
*****
General Introduction:
Irish travellers are going to Thailand in great numbers. The relatively cheap cost and also the contrast in culture has captured many hearts. Some are travelli
g for a once off 2 week trip and for others the exploration of Thailand will take longer. It is truly a beautiful country and the people have a charm all of their own but nevertheless your journey can be so very easily ruined by taking health risks.
Water-Borne Disease:
In most of the major cities of Thailand the water supply is well chlorinated and so the risks associated with drinking mains tap water are limited. However many of the bedrooms will not be supplied with mains water so take care. Smell the water and if there is a distinct chlorine odour then it should be safe. Also remember that when you travel around the country, especially around the northern regions, the water supply may be grossly contaminated and so never drink the water or use it for brushing your teeth. Also no ice in your drinks under these circumstances.
Food-Borne Disease:
There is a good selection of food in Thailand and you should have no great difficulty in finding food to suit your taste. In the majority of the restaurants the food is well cooked and maintained in a healthy sterile fashion. These are the places to eat. As you walk around the cities you will see many street traders selling food stuffs from their carts. The level of hygiene is very low and frequently the food will be contaminated. Never indulge yourself by eating from street vendors.
Mosquito-Borne Disease:
Under this title most travellers will only consider the possibility of developing malaria. This is of course one of the most important illnesses transmitted via mosquitoes but by no means the only one in Thailand. For most travellers to Thailand there will be no need to take malarial prophylaxis as the cities are deemed to be free of malaria. This does not mean that you will not be bitten by mosquitoes and develop some of the other diseases such as Dengue Fever or perhaps Japanese Encephalitis. Many travellers also develop a very severe reaction to the mosquito bite and so for all these reasons it is prudent to avoid being bitten whenever possible.
Entertainment-Borne Disease:
It would be wrong not to emphasize the very high risk which travellers face if they are unwise enough to indulge in any form of sexual activity in Thailand. The percentage of street girls with the Aids virus is rising each year and is now thought to be over 80%. This figure may be an underestimate. Be especially careful if you have taken any alcohol. The cities of Bangkok and Pattaya are thought to be among the main centres of HIV transmission throughout the world and within the next few years the extent of the Aids problem in S.E. Asia will have exceeded Africa. There is limited availability of condoms.
Road-Borne Disease:
The traffic situation in Thailand is severe. The motorbikes have no insurance as they are too often involved in accidents. Use only regular taxi cabs and fix your price before you leave.
Vaccination Schedule:
There are no compulsory vaccines for entry into Thailand from Ireland. Nevertheless the usual recommended vaccines include Polio, Typhoid, Tetanus and Hepatitis A cover. For those trekking or staying for longer periods then cover against Hepatitis B and Rabies would be worth discussing.
Most travellers should start their vaccines about 4 to 5 weeks before they leave Ireland.
Note:
For the vast majority of Irish travellers a holiday in Thailand will be a time of great pleasure and, later, fond memories of the people, their customs and the countryside. Just remember that illness can occur so follow some good common sense rules and so you can enjoy yourself
and Travel in Health.

Thailand

Travel News Headlines WORLD NEWS

Date: Wed, 25 Mar 2020 16:18:17 +0100 (MET)

Bangkok, March 25, 2020 (AFP) - Thailand barred entry into the kingdom late on Wednesday, enacting sweeping emergency powers in a bid to stem the local spread of the coronavirus outbreak.    The measures, which stopped short of a full lockdown after days of vacillation by the government, are a hammer blow to the country's vital tourism sector.   Tens of thousands of travellers remain in the kingdom, facing uncertainty with airlines in chaos and restrictions on return to their countries.

Bangkok, a city of 10 million, was hushed Wednesday as shops and restaurants shuttered, and Buddhist monks seated a metre apart led an anti-virus prayer session televised nationwide.   But social media showed thousands of foreigners jammed in chaotic lines at the capital's immigration office to file for visa extensions.    The Royal Gazette announced Wednesday night that authorities would "close all checkpoints and gates" for its land borders, while entry by air and ship will also be halted.   Diplomats and returning Thais who have health certificates will still be allowed to return.

All gatherings are also outlawed, and authorities have asked vulnerable people -- like the elderly -- stay home.   But festive ceremonies, like weddings or family activities, may continue under rules issued by the government.    Authorities also banned "reports of untrue news which could lead to fear", under penalty of up to two years in prison.    The state of emergency will continue until April 30.    Thailand currently has 934 confirmed cases of COVID-19, including four deaths.    The highly infectious virus has killed more 18,000 globally, spurring governments to introduce harsh measures forbidding citizens from leaving their homes.

The kingdom was the first country to confirm a case outside China in January, but incremental measures were taken due to its flagging economy's reliance on tourism.    The tripling in cases over the past week has sent Thais in a panic, and many have taken to social media to criticise the government's spotty containment measures.    Premier Prayut Chan-O-Cha warned earlier Wednesday against sharing "fake news" -- a rebuke coming days after a man was arrested for a Facebook post complaining of lax airport checks.   Thailand has in the past enacted emergency laws to quell political riots, which critics say could be used to muzzle the press.
Date: Fri, 6 Mar 2020 11:36:13 +0100 (MET)

Bangkok, March 6, 2020 (AFP) - Thai health authorities on Friday said they would not order the compulsory quarantine of visitors from four countries hit hard by coronavirus, as the kingdom struggles to balance health fears with the needs of its flatlining economy.   The holidays of possibly tens of thousands of people were cast into doubt on Tuesday when the health minister insisted a quarantine of all entrants from nine countries including China -- its territories of Hong Kong and Macau -- Italy, Iran, South Korea and Japan, would be imposed.   On Friday health authorities spiked the plan, instead "recommending" arrivals from just four countries -- China, Iran, Italy and South Korea -- stay indoors and report to authorities for monitoring.   "We recommend home quarantine," Sukhum Kanchanapimai, from the health ministry told reporters, adding those who register with authorities will receive free food from Thailand's biggest grocery group.

All other travellers from the four countries will have to "report on their health status daily", said Tanarak Plipat of the Disease Control Department, or risk "punishment" under the law.   A British man who entered the kingdom from Hong Kong became the country's 48th confirmed case of the virus, health authorities added.   The kingdom has reported one death so far, but the number of cases detected has remained surprisingly low in a country that attracts some 40 million foreigners a year.   Speculation is pointing to a limited testing regime at a time when Thailand is determined not to frighten off tourists.

Friday's announcement, for now, ends a week-long barrage of conflicting information, which baffled holidaymakers hunting winter sun.    But the Tourism Authority of Thailand confirmed Thursday the country could see a loss of six million visitors in 2020.   As a result the country's tourist-reliant economy has hit the skids, with the impact of COVID-19 crisis hacking back at already sluggish growth forecasts to as low as two percent this year.   With exports seizing up to China and other COVID-19 hit nations, experts warn Thailand is facing a hammer blow to its economy.

The COVID-19 crisis has forced Thailand to cancel full moon beach parties, pare back its celebrations of the annual water festival next month and postpone its leg of the MotoGP until October.   While the number of detected virus cases is yet to spike, Thailand's social media is bubbling with coronavirus rumours and health safety advice.   In a Thai-style antidote to the grim warnings over a deadly virus, the BTS - Bangkok's overground train service - on Friday released a jaunty 'COVID-19: Dance Against The Virus' track.   It drew tens of thousands of likes on Facebook hours after making its debut.
Date: Thu, 5 Mar 2020 13:57:14 +0100 (MET)

Bangkok, March 5, 2020 (AFP) - A popular full-moon party in southern Thailand known for its raucous revelry has been cancelled because of the coronavirus, an official said Thursday, the latest hit to a tourism industry which foresees a loss of six million visitors this year.   Tourism is a cornerstone of Thailand's economy, and the virus has wreaked havoc as visitor numbers have dwindled in the wake of the epidemic.

Attracting some 40 million foreigners a year, the Tourism Authority of Thailand confirmed Thursday the country could see a loss of six million visitors in 2020.    Their absence, particularly the Chinese, has turned once-popular tourist attractions -- such as animal-themed parks in Pattaya and the sandy beaches of Phuket -- into near-ghost towns.

The full moon party on southern island Koh Phangan -- which draws some 10,000 partiers each month -- will be the latest casualty, according to a local official.    "To prevent the spread of COVID-19, (the business association) has voted to suspend the party," Somchai Somwong, Koh Phangan's acting district chief, announced Thursday.

The cancellation comes the week the Thai government plunged tens of thousands of holiday plans in doubt.   Its health minister announced -- and then swiftly rescinded -- an order for all inbound travellers from 11 countries and territories to undergo quarantine, sending waves of concern on Twitter among Thais and foreigner visitors.

On Thursday, the palace mouthpiece Royal Gazette said four countries -- South Korea, Italy, Iran, and China, including Macau and Hong Kong -- would be classified as "high-risk areas".    But details on whether foreign travellers from the four countries would be subjected to a two-week quarantine were not immediately announced.

Thailand currently has 47 confirmed cases of the coronavirus.    The latest announced Thursday include a 42-year-old Thai man and a 29-year-old Italian man, who is currently hospitalised in Chonburi province.    Both had returned from Italy, where there are more than 100 fatalities from the coronavirus.

Despite Bangkok being a major flight hub, Thailand's response to controlling the coronavirus spread has appeared ad hoc.   Conflicting information given by ministries has added to public mistrust, fuelling panic buying of hand sanitisers and face masks across the country.    The Commerce Ministry on Thursday sent out more than 100 "caravans" throughout the country to sell packs of face masks -- drawing lines of retail workers when they stopped at shopping malls.
Date: Mon, 10 Feb 2020 10:59:15 +0100 (MET)

Bangkok, Feb 10, 2020 (AFP) - Russian siblings aged 12 and six-years-old died Monday in a speed boat accident off the tourist island of Phuket, an official said, as two vessels collided near a pier.   The accident took place 100 metres off a privately-run pier in Phuket, after the speed boat carrying Russian tourists to an nearby island crashed into an incoming vessel.   "The cause of accident was speeding by both the drivers," a Phuket government official said, requesting anonymity.

The brother and sister died in the crash, while "21 other Russians were injured, two critically" he added.    Thailand's tourist industry has been hard hit by a combination of the sharp slump in Chinese visitors since the coronavirus outbreak and the strong Thai baht.   Accidents at popular resorts -- mainly car, motorbike and boat crashes -- are common in a kingdom with lax enforcement of safety rules.
Date: Fri 7 Feb 2020
From: Davidson Hamer <dhamer@bu.edu> [edited]

Case report: Japanese encephalitis, Belgian ex Thailand following a short tourist trip
------------------------------------------
We would like to report a case of Japanese encephalitis in a 14 year old Belgian girl who had travelled with her family (total 8 persons) to Khao Lak, Phang Nga province, Thailand, on 20 Dec 2019 for a short holiday. During the following 10 days, she undertook day trips to Krabi, Similan Islands, Phi Phi Islands, Krasom, and Amphoe Kapong.

On 30 Dec 2019, 11 days after arrival in Thailand, symptoms began with fever, headache, fatigue, and difficulty in swallowing. On 31 Dec [2019] whilst on the return flight home, she experienced progressive difficulty in walking due to a right-sided hemiparesis and became confused and lethargic.

On 1 Jan 2020, upon initial evaluation at a hospital in Frankfurt, Germany, she had marked confusion and irritability. An initial MRI scan was inconclusive, and results of a lumbar puncture revealed CSF mononuclear pleiocytosis (182 WBC), and serum PCR was negative for JEV. Sedation and mechanical ventilation were initiated, and the patient was transferred to University Hospital Antwerp, Belgium, on 4 Jan 2020. Between 3-6 Jan 2020, serum JEV IgM and IgG became positive (IIFT Flavivirus 2, Euroimmun, Lubeck, Germany); JEV plaque reduction neutralization testing (PRNT) returned greater. than 50% day 7 and greater than 90% day 21 (ATCC CCL-81); on 6 Jan [2020], CSF JEV IgM and IgG were also positive. EEG showed symmetric sedation-like curves without a clear gradient with predominant alpha rhythm superposed on delta (with isolated frontal slow waves).

Fortunately, her 7 other travel companions (including her monozygotic twin sister and her father) all tested negative for JEV IgM seroconversion.

Within a week after the start of mechanical ventilation, attempts to extubate her failed twice, as a result of hypersalivation, swallowing dysfunction, and muscle weakness (hypercapnic respiratory failure). On 10 Jan 2020, sedative medication was discontinued, and the patient could respond to questions appropriately. The strength in her legs and arms returned to normal, but muscle tone and strength in the neck remained weak, and there is residual respiratory muscle weakness and dysphagia, with gastroparesis and vomiting. She had limited enteral intake and, in part, continues to receive parenteral nutrition. On 17 Jan 2020, tracheal cannulation and G-tube placement were performed to assist with breathing and provision of nutritional support.

By 29 Jan 2020, she was breathing independently, slowly recovering, and was able to be transferred from the PICU to a ward. She will be transferred to a long-term rehabilitation hospital in the coming days.

This sad case report highlights the potentially devastating impact of Japanese encephalitis in travelers and how this may arise even after relatively short-term exposure (in this case less than 2 weeks) in major touristic areas. Although major debates persist about the role of vaccination, given the rarity of the disease, the duration of potential exposure in deciding whether to vaccinate, and the cost of the vaccine, travel-medicine providers should continue to describe the potential risk of infection (low) and complications and mortality if infection occurs (high) to travelers to south and south east Asia.
-----------------------------------
communicated by:
Dr Ralph Huits
GeoSentinel co-site director
Department of Clinical Sciences at the Institute of Tropical Medicine
Antwerp, Belgium
and
Vanessa Field
GeoSentinel tracking and communication working group chair
====================
[Thailand is endemic for Japanese encephalitis (JE) virus, and Phang Nga province, located in the southern part of the country, can susta inyear-round JE virus transmission. The girl was very unfortunate to have become infected despite a short visit there. Her situation raises the question about the advisability of vaccination of visitors to areas endemic for JE. The USA CDC Advisory Committee of Vaccination Practices states, "JE vaccine is recommended for persons moving to a JE-endemic country to take up residence, longer-term (for example, greater than or equal to one month) travelers to JE-endemic areas, and frequent travelers to JE-endemic areas. JE vaccine also should be considered for shorter-term (for example, less than one month) travelers with an increased risk for JE on the basis of planned travel duration, season, location, activities, and accommodations and for travelers to JE-endemic areas who are uncertain about their specific travel duration, destinations, or activities. JE vaccine is not recommended for travelers with very low-risk itineraries, such as shorter-term travel limited to urban areas or outside of a well-defined JE virus transmission season." The girl and her family would normally not be considered at significant risk for such a short stay in Thailand. About one in 4 people with JE clinical encephalitis die, and about 50% of survivors have permanent neurological sequelae. One hopes that the girl will be one of the remaining 50% that recover completely. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Phang Nga, Phang Nga province, Thailand:
More ...

Nauru

Nauru - US Consular Information Sheet
March 06, 2009
COUNTRY DESCRIPTION:
Nauru, a small single-island nation in the South Pacific, is located about 25 miles south of the equator.
It is a constitutional republic with a parliamentary s
stem of government.
Tourist facilities are available on a limited basis. Yaren, the capital, has an international airport.
Read the Department of State Background Notes on Nauru for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, visa, onward/return ticket, and proof of hotel bookings (or sponsorship from a resident of Nauru) are required for tourists. Travelers transiting with a valid ticket for an onward destination do not require a visa, provided that their first connecting flight departs within three days of their arrival in Nauru.
To obtain a visa, travelers should scan a copy of their passport data page, tickets and an explanation of the reason for their visit, and send it to the principal immigration office in Nauru: alf.itsmaera@naurugov.nr.
The immigration office will then email an approved travel letter for the traveler to board a flight and enter Nauru.
Upon arrival, a visa will be stamped in the passport.
The telephone number for immigration in Nauru is 011-674-444-3133.
Tourist visas are issued for a maximum of thirty days.
Business visitors must have a visa and a local sponsor.
Nauru collects a departure tax that must be paid in cash and in Australian dollars.
For more information on entry/exit requirements, travelers may wish to contact Republic of Nauru Permanent Mission to the United Nations in New York at 212-937-0074, or by fax at 212-937-0079.
The address is: 800 Second Avenue, Suite 400A New York, NY 10017.
E-mail addresses are: nauru@onecommonwealth.org and/or Nauru@un.int.

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’ Internet 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 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:
Nauru has a low crime rate.
However, visitors should not be complacent regarding personal safety or the protection of valuables.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, to 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 911 in Nauru is 444-3500
See our information on Victims of Crime.
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 Nauru law, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs are strict, and convicted offenders can expect jail sentences and 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
SPECIAL CIRCUMSTANCES:
In Nauru, the Australian dollar is the legal currency.
Travelers’ checks and all major currencies are accepted by banks and may also be exchanged for local currency at some local hotels.
Nauru's customs authorities may enforce strict regulations concerning temporary importation into or export from Nauru of items such as foodstuffs, animals, and pornographic materials.
It is advisable to contact the Nauru Permanent Mission to the U.N., at 212-937-0074 for specific information regarding customs requirements.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship are readily available.
If detained, U.S. citizens are encouraged to request that a consular officer at the U.S. Embassy in Suva, Fiji be notified.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Health care facilities in the Republic of Nauru are adequate for routine medical problems, but very limited in availability.
Emergency response capability is extremely limited.
Serious medical conditions requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals often expect immediate cash payment for health services.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); or via the CDC's web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Nauru.
Please inquire directly with Republic of Nauru Permanent Mission to the United Nations.
Please see the Entry/Exit Requirements section for contact information.

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

Traffic moves on the left in Nauru.
The main road circling the island is paved, but the remaining roads are unpaved.
There is no organized roadside assistance, although there are a number of mechanics and car repair facilities on the island.
Animals and pedestrians walking in the road make night driving hazardous.
For specific information concerning Nauru driving permits, vehicle inspection, road tax and mandatory insurance, contact the Nauru Consulate General in Melbourne, Australia at telephone (613) 9653-5709, fax (613) 9654-4738. 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 Nauru’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Nauru’s air carrier operations.
For more information, travelers may visit the FAA’s web site at FAA’a website.

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

REGISTRATION / EMBASSY LOCATION:
There is no U.S. embassy or diplomatic post in Nauru.
The U.S. Embassy in Suva, Fiji, provides assistance for U.S. citizens in Nauru.
Americans living or traveling in Nauru are encouraged to register with the U.S. Embassy in Suva through the State Department’s travel registration web site at https://travelregistration.state.gov, and to obtain updated information on travel and security in Nauru.
Americans without Internet access may register directly with the nearest U.S. embassy or consulate.
The U.S. Embassy in Fiji is located at 31 Loftus Street in Fiji’s capital city of Suva.
The telephone number is (679) 331-4-466; the fax number is (679) 330-2-267.
Information may also be obtained by visiting the Embassy’s home page at http://suva.usembassy.gov/.
By registering, American citizens make it easier for the embassy or consulate to contact them in case of emergency.
*

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*
This replaces the Country Specific Information dated August 20, 2008, with updates in the sections on Entry/Exit Requirements, Information for Victims of Crime, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Fri, 26 Dec 2003 07:08:35 +0100 (MET) SYDNEY, Dec 26 (AFP) - Five more Afghan men haved join fellow detainees on a hunger strike at an immigration centre on the Pacific island of Nauru but all have agreed to end the protest if Australian officials attended a meeting to discuss their future, refugee advocates said Friday. The immigration department said a total of 45 mostly Afghan men were on hunger strike, a protest now entering its third week. An immigration spokeswoman said 11 of the protesters were in hospital but were not in a serious condition. National director of refugee advocacy group A Just Australia, Howard Glenn, said the hunger strikers had accepted a memorandum of understanding which would see representatives of the Australian and New Zealand governments, the United Nations and refugee groups meet to discuss the problems faced by detainees. "The Australians who have negotiated with the hunger strikers have done a great job in proposing a process which will end the life threatening behaviour, and find permanent solutions to end this shameful chapter," Glenn said in a statement. "We urge (Australian Immigration Minister) Amanda Vanstone to come to the party and rapidly agree to this summit." But Vanstone rejected the request. "The best thing hunger strikers on Nauru can do is end their dangerous protest of self harm," the minister said in a statement. "The proposal put by a Just Australia appears to hold out false hopes to the non-refugees on Nauru that self harm may be a successful way of achieving a visa to Australia. "No responsible Australian would hold out this false hope for hunger strikers if one of their children or loved ones was involved." A total of 284 asylum seekers, including 93 children, are being held on Nauru under Canberra's the so-called Pacific solution, devised two years ago to keep boat people from Australian shores.
Date: Tue, 23 Dec 2003 06:28:16 +0100 (MET) SYDNEY, Dec 23 (AFP) - An Australian government delegation failed to persuade hunger striking illegal immigrants on the Pacific island of Nauru to end their protest Tuesday, prompting Canberra to reaffirm its hardline stance toward the would-be refugees. Amid conflicting reports about the health of 35 mostly Afghan men who have refused food since December 10, Australia sent a delegation including former immigration minister John Hodges and Afghan community leader Gholam Aboss to convince the protestors their actions would be fruitless. But after a day-and-a-half on the island, the delegation said the protestors remained committed to their protest. "I again urge those residents in the camp to stop their hunger strike and think about returning to their home country," Immigration Minister Amanda Vanstone said in a statement after receiving a briefing from the delegation. "The government will not be pressured into granting visas to people who have had a fair hearing and have been found not to be refugees." Four of the protestors have sewn their lips together and about 15 have been hospitalised but Vanstone said the delegation reported "they appear to be in remarkably good condition". Refugee advocacy group A Just Australia said asylum seekers were passing out as they spoke to the delegation at the detention camp. "Essentially it was a polite meeting but went nowhere, in fact there were some detainees that passed out during the meeting and had to be hospitalised," spokesman Greg Barns told public radio. A total of 284 asylum seekers, including 93 children, are being held on Nauru under Canberra's the so-called Pacific solution, devised two years ago to keep boat people from Australian shores.
Date: Mon, 15 Dec 2003 04:18:41 +0100 (MET) CANBERRA, Dec 15 (AFP) - Five illegal immigrants on hunger strike protesting against being held by Australian authorities on the Pacific island of Nauru have been taken to hospital, a refugee support group claimed Monday. Rural Australians for Refugees spokeswoman Elaine Smith said three of them were taken to hospital on Monday following two others at the weekend. A number of others were said to be urinating blood. She warned of possible deaths as the detainees entered their fifth day of hunger strikes, four with their lips sewn together. More than 280 boatpeople, mostly Afghans diverted to Nauru after the government refused them permission to land on Australian territory, remain on the island under Canberra's mandatory detention policy after their claims for asylum were rejected. The detainees, who include 93 children, have refused to return to Afghanistan. The immigration department confirmed that some 25 men have refused food and water inside the Nauru camp where the protest began last Wednesday. Officials said the condition of the men is being carefully monitored and the government has refused to reconsider their pleas. Smith said normal activities at the Nauru camp had stopped out of respect for the protesters. "The men on the hunger strike are lying quietly," she said. "It is too painful to speak. Helpers wash down their bodies with cool cloths."
Date: Wed, 10 Dec 2003 06:36:54 +0100 (MET) SYDNEY, Dec 10 (AFP) - Illegal immigrants detained by Australian authorities on the South Pacific island of Nauru and in a mainland detention centre have begun a hunger strike, some sewing their lips together, refugee advocates said Wednesday. Hassan Ghulam, president of the Hazara Ethnic Society of Australia, told a rally in Brisbane that the Nauru detainees, including some children, wanted to stage a non-violent protest to highlight their plight. Hundreds of illegal immigrants, including 85 children, are being held on the island as part of the so-called Pacific solution, under which newly arrived boatpeople were sent offshore to prevent them gaining access to Australian courts. Ghulam said he had received a phone call from one of the Nauru refugees, telling him of the hunger strike to coincide with world Human Rights Day. "This is not a hunger strike for a day or two," Ghulam said. "It will be continuing probably until they get a result." Ghulam said conditions on the island were unsatisfactory, with running water reduced to two hours a day and no water for washing other than seawater. "I call on the immigration minister to bring an end to this issue," he said. "It cannot go on indefinitely. "For the last two years they have suffered. There is no more emotional or mental energy left. They are drained." Ghulam said up to six of the refugees were under psychiatric care in the Nauru Hospital and one had attempted suicide last week. Four detainees in an isolation block at Port Hedland detention centre in the north of Western Australia have also joined the hunger strike, immigration officials said. A group calling itself Rural Australians for Refugees said contacts within the centre had informed her that 21 people were being held in isolation and all of them had been on a hunger strike since Monday. A spokeswoman for the group, Helvi Aarnio, said other detainees in the centre's general population had joined in the strike in solidarity and imposed work bans to mark International Human Rights Day. She said the detainees intended to continue the hunger strike until they were released from the isolation block.
Date: Tue 1 Apr 2003 From: ProMED-mail Source: The Australian online, Wed 2 Apr 2003 [edited] ---------------------------------------------- An epidemic of dengue fever is sweeping Nauru, the island at the centre of the Pacific solution refugee policy, as more than 20 asylum-seekers and staff are "strongly suspected" of having the disease. A vigorous attempt to solve the problem is under way in the 2 camps, which house 457 asylum-seekers sent there after being intercepted en route to Australia. Three "fogging" machines have been imported to kill the disease-carrying mosquitoes. Children sleep in air-conditioned demountables, and asylum-seekers are being urged to use insect repellent continuously. The International Organisation for Migration (IOM) says 17 asylum-seekers, including an Afghan girl, 9, and an Afghan boy, 5, are believed to have contracted dengue fever in the past 2 months. A further 5 staff members with the IOM, which manages the camps, are believed to have the disease. All asylum-seekers suspected of having dengue have been sent to the island's hospital for monitoring, but only a small number have had to stay overnight. No one has so far developed the potentially fatal hemorrhagic form of dengue fever. But IOM representatives have expressed frustrations that asylum-seekers are not wearing insect repellent, despite being advised to. Chief of Mission Cy Winter said none of the 22 community representatives or "block leaders" had worn repellent during regular meetings with IOM staff. Mr Winter said authorities were hopeful the worst was over, but there were still concerns that it might spread in the camps because people were not wearing repellent. The outbreak on Nauru was so bad recently that 100 locals a day were reporting to hospital with symptoms. That number has dropped to about 20 people reporting each day. [Byline: Megan Saunders]
More ...

Liberia

Liberia - US Consular Information Sheet
February 21, 2008
COUNTRY DESCRIPTION: Liberia is a country in West Africa that suffered from years of instability and conflict from 1990 - 2003, with attendant destruction of buildings, roads, and infras
ructure and public institutions.
A comprehensive peace accord ended the conflict in August 2003 and a United Nations peacekeeping force (UNMIL) was deployed to facilitate disarmament and demobilization, help arrange democratic elections and provide for security of the country.
In late 2005, Liberians went to the polls and elected Ellen Johnson Sirleaf as president.
The new government was inaugurated in January 2006, and has made tremendous progress towards restoring security and stability to the country.

Despite nearly four years of peace and a renewal of economic growth, Liberia is still one of the poorest countries in the world and many basic services (public power, water and sewage, land line phones) are either limited or unavailable.
Facilities for foreign visitors are adequate in the capital, Monrovia, but virtually non-existent in the rest of the country.
The official language of Liberia is English.
Read the Department of State Background Notes on Liberia for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required for entry, as is evidence of a yellow fever vaccination and a physician's letter attesting to absence of communicable diseases.
Visa applicants may also be asked to provide evidence of health insurance.
Immigration officials no longer issue visas at the airport.
Persons arriving without a visa may be deported immediately, without leaving the airport.
Persons arriving from the United States must obtain a Liberian visa before traveling.
There is a US $25 airport tax on departing passengers, although this is usually collected as part of the ticket price.
For the latest information on entry requirements, visa fees and airport tax for Liberia, contact the Embassy of the Republic of Liberia, 5201 16th Street NW, Washington, DC 20011, tel. (202) 723-0437, web site www.embassyofliberia.org.
Overseas, inquiries should be made at the nearest Liberian embassy or consulate.

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 Department of State urges U.S. citizens to plan proposed travel to Liberia carefully and to exercise caution when traveling in Liberia.
Neither public transport nor taxis are available at the international airport, which is located 40 miles outside of Monrovia; therefore, before traveling to Liberia, Americans are urged to make arrangements for transportation from the international airport into the city center.
Americans traveling to Liberia are also urged to ensure that they have confirmed reservations at a reputable hotel, as rooms can be scarce and difficult to find without advance plans.

Americans who travel to or reside in Liberia should realize that Liberia's police force is in the process of being rebuilt.
There is a UN Mission in Liberia (UNMIL), but its mandate is to ensure political stability in Liberia.
Americans who travel around Liberia must realize that the role of UN Police (UNPOL) officers is to serve as advisors to the Liberia National Police. Accordingly, they do not have the authority to arrest or detain, and they are unarmed.
The Liberia National Police, for its part, has a limited presence in Monrovia, and even less of a presence outside of Monrovia.
In addition, police officers can be a source of problems for visitors as well as a source of aid or assistance.
Although problems with corruption have improved, travelers may be detained by police officers who solicit bribes.
Americans are encouraged to carry a photocopy of their passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
If detained or arrested, U.S. citizens should always ask to be allowed to contact the U.S. Embassy.

U.S. citizens in Liberia should be aware of their surroundings at all times and use caution when moving around, especially at night.
The U.S. Embassy recommends that American citizens observe a suggested curfew of 2:00 a.m. – 6:00 a.m.
Travel outside of Monrovia after dark is strongly discouraged as roads are in poor condition and thus dangerous to navigate at night.
U.S. citizens should avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site, where the current Worldwide Caution Public Announcement, 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., 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).

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:
Crime in Liberia is rated high and is exacerbated by the high rate of unemployment.
Theft, assault, sexual crimes, and murder are problems, and they occur more frequently after dark.
Foreigners, including U.S. citizens, have been targets of street crime, robbery, and sexual assault.
Women have been attacked on deserted beaches.
Residential armed break-ins occur.
The police are ill equipped and largely incapable of providing effective protection or investigation.
Criminal activity is reported in both urban and rural areas.

Perpetrators of business fraud often target foreigners, including Americans.
Formerly associated with Nigeria, these fraud schemes are now prevalent throughout western Africa, including Liberia, and pose a danger of both financial loss and physical harm.
An increasing number of American citizens have been the targets of such scams.
The best way to avoid becoming a victim of fraud is common sense – if it looks too good to be true, it probably is.
Any unsolicited business proposal originating in Liberia should be carefully checked before committing any funds, providing any goods or services, or undertaking any travel.
There is also an increase in Liberian/American Internet relationships, where there are eventual requests for financial assistance under fraudulent pretenses.
For additional information, please see the Department of State's Bureau of Consular Affairs brochure International Financial Scams.

Petty corruption is rampant; poorly paid government officials are not immune from the temptation to collect fees for doing their job.
The result is that travelers may be asked for bribes and inconvenienced for not paying them.

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:
Hospitals and medical facilities in Liberia are very poorly equipped and are incapable of providing many services.
Emergency services comparable to those in the U.S. or Europe are non-existent, and the blood supply is unreliable and unsafe for transfusion.
Americans with serious medical problems travel or are medically evacuated to the United States, Europe or South Africa.
Medicines are scarce, often beyond expiration dates, and generally unavailable in most areas.
As there is neither an effective garbage removal service nor a functioning sewer system, the level of sanitation throughout urban areas is very poor, which increases the potential for disease.
Upper respiratory infections and diarrhea are common, as well as the more serious diseases, typhoid and malaria.
All travelers to Liberia must be vaccinated against yellow fever and should carry a supply of all prescription medication, plus anti-malaria medication, adequate for their entire stay.
A typhoid vaccination is also recommended.

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.
For travel to Liberia, obtaining separate medical evacuation insurance before arriving in Liberia is strongly recommended.
Please see our information on medical insurance overseas.
SWIMMING HAZARD:
Liberia has many excellent beaches along the Atlantic coastline that tourist and those who live in the country enjoy throughout the year, however American citizens should be aware of the threat of dangerous rip currents better known as rip tides.
These strong currents can occur anywhere on the coast given the right surf conditions.
The Liberia Weather Service does not provide information on where and when these tides form and there are no lifeguards posted on beaches.
American citizens who plan to swim in the Atlantic should read from various sources e about the dangers of rip currents and how to navigate if you find yourself in such a situation; or better still do not swim if you are unfamiliar with swimming in water where very strong rip currents occur.

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

Road travel in Liberia can be hazardous.
Potholes and poor road surfaces are common, making safe driving extremely challenging.
Cars, trucks, and taxis are often overloaded with people and goods and make frequent stops without signaling.
Drivers overtake on the right as well as the left.
Many vehicles operate with threadbare tires, and blowouts are frequent.
Public taxis are poorly maintained and usually overloaded.
Intersections must be approached with caution.
The absence of public streetlights makes pedestrians walking in the city streets and those walking on country roads difficult to see at night.
Drivers and pedestrians are cautioned that high-speed car convoys carrying government officials require all other vehicles to pull off the road until they have passed.

Travelers should expect delays at UNMIL security checkpoints, as well as time-consuming detours around the many bridges and roads damaged by war, neglect, or the heavy annual rains, which occur from May to November.
Travelers can expect strict enforcement of border controls by Liberian, Ivorian, Sierra Leonean, and Guinean authorities.
At times border crossings to neighboring countries are closed.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Liberia, the U.S. Federal Aviation Administration (FAA) has not assessed Liberia’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:
Lodging, fuel, transportation, and telephone services are unevenly available in Liberia, and are nonexistent or severely limited in rural areas.
Neither water nor electricity is commercially available in Liberia, including the capital of Monrovia.
Most hotels have utilities available, but not always on a 24-hour basis.
There is no working landline telephone system in Liberia.
Several cell phone companies provide service in Monrovia and some areas outside the capital.
US cellular phones do not always work in Liberia and it is advisable to rent or purchase a local cellular phone.
The postal system is slow and unreliable.
Commercial air courier service is available through UPS, Federal Express (FedEx), and other companies.

The U.S. dollar is readily accepted in Liberia, and there is no limit on the amount of foreign currency that can be transported into and out of the country, provided one follows the specific regulations on how such transfers must be done.
Sums in excess of US $10,000 must be reported at the port of entry and no more than US $7,500 in foreign currency banknotes can be moved out of the country at one time.
Larger sums must be transferred via bank drafts or other financial instruments; persons without a Liberian bank account are limited to two outgoing US $5,000 over-the-counter cash wire transfers per month.
Wire transfers are not widely used and are subject to substantial fees.
ATMs are unavailable and Traveler's checks and credit/debit cards are not accepted anywhere in Liberia.

Photographing military installations, air and seaports, and important government buildings is prohibited.
Visitors should not take photographs of sites or activities that might be considered sensitive, or police are liable to confiscate the camera.

Please see our information on 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 Liberian law, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Liberia are severe, and convicted offenders can expect long jail sentences and heavy fines.
The U.S. Embassy does not always receive timely notification of the arrest of U.S. citizens by Liberian authorities.
If arrested, U.S. citizens should ask to be allowed to contact the U.S. Embassy (see the Registration/Embassy Location section below).
Americans should carry a photocopy of their U.S. passport with them at all times.
The consular section of the U.S. Embassy cannot give legal assistance but can provide a list of Liberian attorneys if one is required.
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 on international adoption of children and international parental child abduction, see the Office of Children’s Issues web pages.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Liberia 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 Liberia.
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 111 United Nations Drive, Mamba Point, Monrovia; telephone 231-77-054-826; fax 231-77-010-370; web site http://monrovia.usembassy.gov.
U.S. citizens who wish to write to the U.S. Embassy in Monrovia may address letters to the Consular Section, 8800 Monrovia Place, U.S. Department of State, Washington, D.C. 20521-8800, or send emails to ConsularMonrovia@state.gov.
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This replaces the Consular Information Sheet on Liberia dated June 15, 2007 to include a caution on swimming at local beaches.

Travel News Headlines WORLD NEWS

Date: Mon 2 Mar 2020
Source: Journal du Cameroun [abridged, edited]

The National Public Health Institute of Liberia (NPHIL) has confirmed a measles outbreak in Grand Kru County in south-eastern Liberia that has affected 73 people with 2 deaths recorded so far, reports said on Mon [2 Mar 2020]. According to Dr. Masoka Fallah, the dead are a 1-year-old boy and an 11-month old baby girl.

Dr. Fallah quoted Grand Kru County health authorities as saying the outbreak is concentrated in the districts of Forpoh, Dorbor, Jloh and Barclayville.

The NPHIL Director General said a massive awareness campaign has been launched, including consultations with citizens, the business community, other government ministries and agencies, and the county leadership on measures to prevent the spread of the disease.

The county health team has also commenced community level awareness to discourage discrimination of persons suspected of the disease.
Monday 10th February 2020

ECDC have informed us, that since the beginning of 2020, there has been a significant increase in the number of Lassa cases in Liberia, in West Africa.  Between 1/1/20 and 28/1/20, 55 suspected Lassa cases have been identified; 24 are confirmed and nine, fatal. Among the 55 cases are three infected healthcare workers (one death).  What has changed, is that, since 2016, Lassa cases have been increasing annually.  Cases are spread across six different counties (Bong, Grand Bassa, Montserrado, Lofa, Margibi and Nimba - the majority in Grand Bassa).  Lassa is endemic in these areas, sporadic cases occasionally being encountered during the dry season (in West Africa, this runs from November until April).  
 
Similarly in Nigeria, Lassa has been increasing since the beginning of 2020, with 258 confirmed cases and 41 deaths in 19 states (Edo, Ondo and Ebonyi states being most affected).  Longer-term Lassa secular trends are increasing, reaching a peak in 2018.  Improved surveillance probably accounts for much of the increase, as the overall case fatality rate for Lassa in Nigeria has halved from 40% to about 20% over the last 20 years.  In affected areas though, the numbers of cases remains high; the greatest danger of exposure occurring during these episodic upsurges.

An estimated 300,000-500,000 cases of Lassa with 5,000 related deaths occur annually in West Africa.
 
The risk of importation of Lassa into EU/EEA is very low. The few recently-reported imports all had a recent travel history to endemic areas (save one secondary case reported by Germany).
 
Travellers to West Africa should be informed of the risk of exposure to Lassa fever virus, particularly in areas experiencing ongoing outbreaks. Travellers should avoid exposure to rodents, and consumption of foods and drinks potentially contaminated by rodent droppings, and to patients with symptoms suggestive of haemorrhagic fever. When caring for patients with suspected or confirmed Lassa, measures should focus on preventing contact with the patient's blood and body fluids, and contaminated surfaces or materials.
 
Further information on Lassa is available from:
 
·         HPSC

·         World Health Organization  

·         Centers for Disease Control and Prevention

Rgds
 
For and on behalf of Dr Kevin Kelleher
A/Director, HSE Health Protection Surveillance Centre
Ireland's National EWRS Focal Point
25-27 Middle Gardiner Street
Dublin, 1
 
Date: Fri 17 Jan 2019
Source: Front Page Africa [edited]

The Surveillance Officer of Grand Bassa County Health team has confirmed to FrontPage Africa that there is a Lassa fever outbreak in District 4, Grand Bassa County leading to 3 deaths and 20 others confirmed infected with the virus.

Gabriel B. Kassay said over 60 specimens were taken to Monrovia for testing as a result of the outbreak.  "Out of the 60 plus, over 20 specimens were confirmed affected with Lassa fever," he said, adding that 3 persons have died from the disease at the Liberia Agricultural Company (LAC) concession area in Wee Statutory District.

Kassay said there were several incidents of Lassa fever in the LAC plantation area in 2019.  "According to the Liberia health law, one confirmed case of Lassa fever is considered an outbreak, and so since August 2019, there have been lots of people affected in the LAC area," he said while expressing concern that "the lack of awareness is a major factor" for the frequent cases of the virus in the county.  "The Grand Bassa Health Team has been very instrumental in helping to curtail the spread of the disease in the affected area, but there is a need for awareness in the entire county."

Kassay said the spread of Lassa fever might increase if the citizens are not trained to know the cause and effects of Lassa fever.
=====================
[The number of cases has increased from 9 on 2 Dec 2019 (See Lassa fever - West Africa (43): Liberia http://promedmail.org/post/20191207.6828798) to 20 confirmed cases now. The reported number of deaths remains at 3. The previous ProMED-mail post (see Lassa fever - West Africa (31): Liberia http://promedmail.org/post/20190902.6653653) reported that according to MoH data, a total of 92 suspected cases between 1 Jan-25 Aug 2019, including 21 deaths, have been reported. Of these, 25 cases have been confirmed by RT-PCR (Nimba (9), Bong (10), Grand Bassa (5), and Grand Kru (1)), while 9 remain suspected cases, the release recorded. The case-fatality rate among confirmed cases in that report was stated as 36% (9 deaths out of 25 confirmed cases). Males are mostly affected by the disease (56%) of confirmed cases as compared to females.

Occurrence of Lassa fever cases in areas outside the usual "Lassa fever belt" is of concern, and the Ministry of Health is wise to increase public information and advize citizens about measures that should be taken to avoid infection with the virus. Occurrence of Lassa fever in Liberia is not new, and cases have occurred there sporadically for several years. Between 1 Jan and 27 Jun 2018, 20 cases were laboratory confirmed (see archive no. http://promedmail.org/post/20180711.5898495). Apparently, all those Lassa fever virus infections were acquired by contact with infected rodents or their excretions. Lassa fever virus can be acquired from infected rodents or patients in the hospital. Transmission can occur in health facilities when personal protective equipment is not employed or barrier-nursing practices or biocontainment facilities in the laboratory are not adequate to protect staff from blood and secretions of infected patients.

As mentioned in previous posts, Lassa fever virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (_Mastomys natalensis_ and _M. erythroleucus_) and the African wood mouse (_Hylomycus pamfi_) or their excreta, as was likely the situation in many of these cases. Rodent control has to be undertaken at the village level with individual households employing the preventive measures listed above. This requires an extensive and continuous public education effort.

Images of the _Mastomys natalensis_ mouse, the rodent reservoir of Lassa fever virus, can be seen at
_M. erythroleucus_ and _Hylomycus pamfi_ at

Date: Tue 3 Dec 2019
Source: Liberian Observer [edited]

A report reaching the Daily Observer from the Nimba County Health Team said that Lassa fever is becoming alarming, with 9 cases confirmed, out of which 3 persons have died.

The county health surveillance officer, Isaac Cole, told reporters in Nimba that 3 districts, including Sanniquellie Mahn, Saclepea, and Tappita have been declared as the "epicenters" of the deadly disease.

Of the 3 districts, Cole said Sanniquellie Mahn is the worst-affected area, where over 30 cases of suspected Lassa cases were registered and 9 confirmed, and from where the 3 deaths are recorded.

He has meanwhile warned locals to avoid rodents (rats) by thoroughly cleaning their surroundings to stop the flow of rats in their homes. The county health team is therefore calling on residents to report any suspected case, particularly people who may have developed prolonged fever, to any of the nearest health facilities. Residents are also advised not to bury the dead (suspected Lassa fever patients) without referencing trained medical practitioners.

"Protect your food from rats, and also avoid touching them at all times should you encounter one," he added.

Lassa fever, also known as Lassa hemorrhagic fever (LHF), is a type of viral hemorrhagic fever caused by the Lassa virus. Many of those infected by the virus do not show symptoms early on. When symptoms do occur, they typically include fever, weakness, headaches, vomiting, and muscle pains.  [Byline: Ishmael F. Menkor]
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[The occurrence of Lassa fever cases in Liberia is continuing with the confirmation of 9 new cases. The previous ProMED-mail post reported that according to MoH data, a total of 92 suspected cases between 1 Jan-25 Aug 2019, including 21 deaths, have been reported. Of these, 25 cases have been confirmed by RT-PCR (Nimba (9), Bong (10), Grand Bassa (5), and Grand Kru (1)), while 9 remain suspected cases, the release recorded. The case-fatality rate among confirmed cases in that report was stated as 36% (9 deaths out of 25 confirmed cases). Males are mostly affected by the disease (56%) of confirmed cases as compared to females.

Occurrence of Lassa fever cases in areas outside the usual "Lassa fever belt" is of concern, and the Ministry of Health is wise to increase public information and advise citizens about measures that should be taken to avoid infection with the virus. Occurrence of Lassa fever in Liberia is not new, and cases have occurred there sporadically for several years. Between 1 Jan and 27 Jun 2018, 20 cases were laboratory confirmed (see archive no. http://promedmail.org/post/20180711.5898495). Apparently, all those Lassa fever virus infections were acquired by contact with infected rodents or their excretions. Lassa fever virus can be acquired from infected rodents or patients in the hospital. Transmission can occur in health facilities when personal protective equipment is not employed or barrier-nursing practices or biocontainment facilities in the laboratory are not adequate to protect staff from blood and secretions of infected patients.

As mentioned in previous posts, Lassa fever virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (_Mastomys natalensis_ and _M. erythroleucus_) and the African wood mouse (_Hylomycus pamfi_) or their excreta, as was likely the situation in many of these cases. Rodent control has to be undertaken at the village level with individual households employing the preventive measures listed above. This requires an extensive and continuous public education effort.

Images of the _Mastomys natalensis_ mouse, the rodent reservoir of Lassa fever virus, can be seen at <https://www.inaturalist.org/taxa/45326-Mastomys-natalensis> and of _M. erythroleucus_ and _Hylomycus pamfi_ at <http://punchng.com/nigerias-large-rat-population-threatens-lassa-fever-war/>. - ProMED Mod.TY]

Date: Mon, 23 Sep 2019 19:35:57 +0200 (METDST)

Monrovia, Sept 23, 2019 (AFP) - More than 10,000 Liberian health workers began a strike Monday to demand salary arrears and regular supplies of medicine and equipment in a country ravaged by civil war and an Ebola epidemic.   Battered two back-to-back civil wars and then in 2014-16 by the worst Ebola epidemic in history, Liberia's health sector is on its knees.   The crumbling infrastructure lacks almost everything -- medicine, beds, equipment, ambulances, even a reliable electricity supply.   "We are striking because we do not have medicines in the hospitals, no materials like gloves to protect ourselves before treating the patients which is dangerous for us, the laboratories are unequipped.... until today most of the workers have not got their July salaries," George Williams, secretary general of the Health Workers Association, told AFP.   "We have realised the exchange rate with the US dollar is so terrible, and these salaries we are making are the same we have been making since eight years, the cost of living has tripled," he said.   State-run hospitals and clinics were closed, sparking protests from patients in Monrovia.   Some 40 pregnant and sick women blocked a road in the northern suburb of Paynesville, shouting slogans.   "I don't have money; I am not rich like the big people, so I cannot afford to go in any private clinic. I am eight months pregnant," Annie Sieh, 35, said.
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World Travel News Headlines

Date: Fri, 27 Mar 2020 22:49:49 +0100 (MET)

Dublin, March 27, 2020 (AFP) - Ireland is to impose a lockdown in a bid to stem the spread of the coronavirus, Prime Minister Leo Varadkar said on Friday.   "Everybody must stay at home, in all circumstances," he said of the new measures to come into force at midnight (0000 GMT) on Saturday and last until 12 April.   Exceptions will be made for essential workers, medical appointments and the purchase of food.   Travel for "vital family reasons", for farming and exercise within two kilometres (one mile) of homes will also be allowed.

All public or private gatherings "of any number of people" outside a single household are also prohibited.   "These are radical actions aimed at saving as many people's lives as possible," said Varadkar at a press conference.   "I'm asking us for a time to forego our personal liberties and freedoms for a greater cause."   There have been 22 COVID-19 related deaths and 2,121 confirmed cases of the virus in Ireland, according to department of health figures released earlier Friday.   Earlier this month the Irish government ordered schools, universities and pubs to close nationwide.   Swathes of non-essential businesses were also ordered shut earlier this week as Ireland braced for an uptick of COVID-19 cases within its borders.

Emergency coronavirus legislation passed through the final stages of Irish parliament and was signed into law by president Michael D. Higgins earlier Friday.   The bill enacts a rent freeze and a moratorium on evictions for the duration of the crisis.   It also streamlines the registration of healthcare and defence forces staff returning to the workforce, and enables the Irish government's financial supports to those laid off as a result of COVID-19 business closures.   "The legislation is emergency legislation for a time of crisis," said Higgins in a statement.   "These are difficult times, but our difficulties will come to an end."
Date: Sat, 28 Mar 2020 11:03:02 +0100 (MET)

Johannesburg, March 28, 2020 (AFP) - South African police enforcing a coronavirus lockdown on Saturday fired rubber bullets towards hundreds of shoppers queueing outside a supermarket in Johannesburg, an AFP photographer said.   Between 200 and 300 people gathered outside a popular grocery store, Shoprite, early Saturday in Yeoville, a crime-prone area in Johannesburg's gritty central business district on day two of a nationwide lockdown.

But as they scrambled to secure their spots, many did not observe the recommended safe distance between them.   Police arrived in 10 patrol vehicles and started firing rubber bullets towards the shoppers.   Startled shoppers trampled on each other and a woman with a baby on her back fell to the ground.   Later the police used whips to get the shoppers to observe social distancing rules.

President Cyril Ramaphosa has ordered South Africa's 57 million people to stay at home for 21 days and deployed the police and the military to enforce the lockdown.   But many people, especially from poor neighbourhoods, have defied the order, going out in numbers looking for food.   While jogging and dog-walking are banned, shopping for food and other basics, but not alcohol, is permitted.   South Africa, which has 1,170 confirmed coronavirus cases, recorded its first death from the virus on Friday.
Date: Sat, 28 Mar 2020 09:41:43 +0100 (MET)

Accra, March 28, 2020 (AFP) - Ghana has announced a two-week lockdown in the country's two main regions starting Monday to curb the spread of coronavirus.   The move came as the authorities reported 137 confirmed cases, including four deaths.   President Nana Akufo-Ado said there would be "restrictions on movement of persons in the Greater Accra Metropolitan Area and the Greater Kumasi Metropolitan Area and contiguous districts for a period of two weeks."

He said residents would only be allowed to go out to buy food, water and medicines and to use public toilets.   "There shall be, during this period, no inter-city movement of vehicles and aircrafts for private or commercial purposes.. except for vehicles and aircrafts providing essential services and those carrying cargo," he said.   Ghana has already closed schools, suspended public events and banned large gatherings.
Date: Fri, 27 Mar 2020 19:25:31 +0100 (MET)

Brussels, March 27, 2020 (AFP) - Belgium on Friday extended its general lockdown to slow the spread of the coronavirus by two weeks to April 18.   The decision, confirmed by top officials, extended a confinement that began on March 18 until the end of the country's Easter holiday break, with schools, restaurants and most shops to remain closed.   Prime Minister Sophie Wilmes said the period could be extended by another two weeks to May 3 if the spread of the virus demanded it.   "Our efforts are only beginning and to ease up now would have catastrophic consequences," she told a media briefing.   Outdoor sports activities and walks outside are still allowed, but only in small groups, with a friend or with family members living under the same roof.

In theory, travelling for work can only be done with a certificate from the employer.    Supermarkets in Belgium remain open, but shoppers are only admitted if there is enough space for one person per 10 square metres, and they must not stay for more than 30 minutes.   Belgium, a country of 11.4 million people, has recorded 7,284 cases of the novel coronavirus strain, and 289 deaths.    The extension in Belgium follows a similar decision in neighbouring France where the lockdown rules are stricter.   Europe is grappling with the global outbreak that has killed more than 10,000 people on the continent, mostly in Italy and Spain.
Date: Fri, 27 Mar 2020 18:17:31 +0100 (MET)

Bangui, Central African Republic, March 27, 2020 (AFP) - The Central African Republic, a poverty-stricken state that the UN has singled out as highly vulnerable to coronavirus, has stepped up measures over fears that the disease is spreading locally.   President Faustin-Archange Touadera, in a statement received by AFP on Friday, said that after four cases of infection ad been detected, all among people coming from abroad, a fifth had now surfaced.

In this light, "there are grounds for fearing local transmission" of coronavirus, he said.   New measures unveiled by the authorities include a two-week ban on people coming in from countries where the virus is being transmitted locally, except for diplomats and NGO workers.

Schools, childcare facilities and universities are being closed, and restrictions have been placed on movement between the capital Bangui and the rest of the country.   The United Nations on Wednesday said the CAR "is one of the least prepared countries to face a COVID-19 outbreak, with 2.2 million people already in need of health assistance and about 70 percent of health services provided by humanitarian organisations."   The country has been ravaged by three civil wars in 20 years and remains prey to violence from armed groups that control two-thirds of the country.
Date: Fri, 27 Mar 2020 17:45:22 +0100 (MET)

Rome, March 27, 2020 (AFP) - Italy recorded a shocking spike in coronavirus deaths Friday with 969 new victims, the worst daily record for any country since the pandemic began.   The infection rate however continued its downward trend, with the civil protection agency reporting nearly 86,500 confirmed cases in Italy -- a 7.4 percent increase, down from around 8.0 percent in previous days.
Date: Fri, 27 Mar 2020 17:41:36 +0100 (MET)

Brussels, March 27, 2020 (AFP) - A pet cat has been infected with the novel coronavirus in Belgium after being contaminated by its owner, Belgian health authorities said Friday.   Cases of contamination of pets are rare and authorities ruled out any risk of contamination to humans from home animals.   The reports follows similar cases in Hong Kong where two dogs tested positive for COVID-19 during a screening campaign carried out on 17 dogs and eight cats living in contact with people carrying the virus.

In Belgium, the discovery was made by researchers at the Faculty of Veterinary Medicine in Liege.   This is "an isolated case" which can occur after "close contact between animals and infected  humans", said Doctor Emmanuel Andre, a government agency spokesman on the pandemic.    The virus can be transmitted from humans to animals but "there is no reason to think that animals can be vectors of the epidemic in our society", he said.

In Hong Kong, "the dogs showed no symptoms", while in Belgium "the cat was suffering from transitory respiratory and digestive problems", said the Belgian food safety agency AFSCA in a statement.    "So far, there is no evidence that a domestic animal can transmit the virus to humans or other pets", the public authority said.

As a precautionary measure, it is "strongly recommended" to apply standard rules of hygiene when dealing with pets: "avoid close contact with pets... wash your hands after handling any animal, do not let the animal lick your face."   The aim is to prevent the transmission of the virus to the animal and to prevent the animal itself from becoming a carrier of the virus.
Date: Fri, 27 Mar 2020 14:53:24 +0100 (MET)

Beijing, March 27, 2020 (AFP) - China reported more than 50 imported cases of the coronavirus on Friday, hours after announcing a ban on foreigners entering the country.   In recent weeks China's tally of infections has dwindled dramatically, with only a handful of domestic patients each day.

But just as the country appears to be bringing the outbreak under control, nations around the globe are battling to control soaring numbers of infections in new hotspots.   There were another 55 new infections in China on Friday, the National Health Commission said, with one local infection and 54 imported cases from overseas.   Beijing has been racing to control the number of infections being brought into the country -- mostly Chinese nationals returning home from overseas, including large numbers of students abroad.

On Thursday Beijing announced dramatic measures to curb arrivals into the country, including reducing the number of international flights, limiting the capacity on board to 75 percent, and imposing a ban on foreigners entering China.   Non-nationals living in China with valid visas and resident permits will be blocked from returning to the country after midnight on Friday night, the foreign ministry said.    The ministry said it was a "temporary measure that China is compelled to take in light of the outbreak situation."

Diplomats and the crew of international airlines and vessels will still be permitted to enter.   Flights in and out of China will also be capped at just one route a week to each country, including for international airlines.   The tally of cases brought into China from abroad climbed to 595 on Friday, health officials said.   A series of strict measures had already been put in place to try and stem the wave of infections coming in.   All Beijing-bound international flights have been diverted to other urban centres, where passengers will first be screened for the virus.

Many Chinese cities including Beijing and Shanghai have also imposed a compulsory 14-day quarantine for all arrivals from abroad.    There were nearly 1,100 return international passenger flights scheduled to come to China this week.   There were another five deaths on Friday, according to the National Health Commission -- all in the province of Hubei where the virus first emerged late last year.   In total 81,340 people have been infected in China, and the outbreak has claimed 3,292 lives.

- Clashes -
Hubei lifted travel restrictions this week after two months in lockdown, but fears remain of a rebound in cases elsewhere in the country, even though only healthy people are allowed to leave the province.   Traffic police in Jiangxi reportedly blocked people trying to enter the province from neighbouring Hubei on Friday.    Videos posted on China's Twitter-like platform Weibo purportedly showed scores of people clashing with police on a bridge connecting the provinces.   Other footage showed people trying to overturn a vehicle.
Date: Fri, 27 Mar 2020 12:37:54 +0100 (MET)

London, March 27, 2020 (AFP) - British police faced criticism on Friday for using "over-the-top" methods to maintain a coronavirus lockdown, after officers armed with sweeping new powers deployed drones to detect walkers far from home.   Civil liberties group Big Brother Watch said the police must behave within the rule of law after it also emerged that road checkpoints had been set up to quiz drivers about their journeys.   "It's understandable why police are dispersing parties and barbecues but demanding drivers give journey details at road checkpoints is over-the-top," said director Silkie Carlo.     "It's critical we protect public health and critical we protect basic democratic norms too. Arbitrary policing will not help the country to fight this pandemic."

The drone incident happened in the Peak District National Park in Derbyshire, central England, while roadblocks were used in other parts of the country.   Social media users compared their actions to "the Stasi", East Germany's notorious state police.    Another civil liberties group, Liberty, said in a statement: "We need a response in terms of public health rather than a response in terms of criminal justice to this epidemic."   Britons have been told since the beginning of the week that they are only allowed to leave their homes for limited reasons such as going to work, essential food shopping, or for exercise once a day.   But they are not allowed to travel for recreational purposes.

To enforce the new rules, police were officially handed powers which prevents people leaving their home "without reasonable excuse".   Those ignoring the tougher restrictions on movement could be hit with a £60 fine doubled to £120 (133 euros,$147) for any second offence.   The measures will be in place for at least six months, with a review every three weeks.   Derbyshire police defended their actions, claiming in a tweet that "we will not be apologetic for using any legal and appropriate methods to keep people safe".   It added: "Our actions and the government's advice are there to keep you and others safe."   A total of 11,658 coronavirus cases have so far been confirmed in Britain, and 578 deaths.
Date: Fri, 27 Mar 2020 11:59:09 +0100 (MET)

Madrid, March 27, 2020 (AFP) - The death toll in Spain soared over 4,800 Friday after 769 people died in 24 hours, in what was a record one-day figure for fatalities, the government said.    Health ministry figures showed the number of deaths reaching 4,858, while cases jumped to 64,059, although the rate of new infections appeared to be slowing, registering a 14 percent increase compared with 18 percent a day earlier.