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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Benin - US Consular Information Sheet
April 28, 2008

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

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

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

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

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

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

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

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

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

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

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

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

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

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Benin is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

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

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

SPECIAL CIRCUMSTANCES:
U.S. citizens are advised to keep a notarized photocopy of the photo page of their passport with them at all times when traveling in Benin.
The Embassy has had a few reports of officials requesting a "gift" to facilitate official administrative matters (e.g., customs entry). Such requests should be politely but firmly declined.
It is prohibited to photograph government buildings and other official sites, such as military installations, without the formal consent of the Government of Benin. In general, it is always best to be courteous and ask permission before taking pictures of people. Beninese citizens may react angrily if photographed without their prior approval.
Obtaining customs clearance at the port of Cotonou for donated items shipped to Benin from the United States may be a lengthy process. In addition, to obtain a waiver of customs duties on donated items, the donating organization must secure prior written approval from the Government of Benin. Please contact the U.S. Embassy in Cotonou for more detailed information.Please see our Customs Information.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Benin laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Benin are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Moldova - US Consular Information Sheet
October 10, 2008
COUNTRY DESCRIPTION:
Moldova is a republic with a freely elected government. It has been an independent nation since 1991. Its capital, Chisinau, offers adequate hotels and restauran
s, but tourist facilities in other parts of the country are not highly developed, and many of the goods and services taken for granted in other countries are not yet available. Read the Department of State Background Notes on Moldova for additional information.
ENTRY/EXIT REQUIREMENTS: Since January 1, 2007, citizens of the United States, EU member states, Canada, Switzerland, and Japan do not require visas to enter Moldova. For more information on entry requirements, please contact the Moldovan Embassy, 2101 S Street N.W., Washington, D.C. 20008, telephone: (202) 667-1130, (202) 667-1131, or (202) 667-1137, fax: (202) 667-1204, e-mail: moldova@dgs.dgsys.com. Travelers may also wish to consult the Embassy of Moldova’s web site at http://embassyrm.org/en/cons-serv/visas.html for general information on Moldovan visas and for application forms.

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 U.S. Government has no information related to the targeting of U.S. citizens, interests or facilities by terrorist organizations in Moldova, and no Americans have been killed or injured as a result of terrorist activity in Moldova. However, the U.S. government remains deeply concerned about the heightened threat of terrorist attacks against U.S. citizens and interests abroad. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution. Because Moldovan Government authorities often ask to see identification on the street, Americans should carry a copy of their passport with them at all times.
There is a separatist regime in control of the Transnistria region that is not recognized by the United States. Consular assistance to American citizens in that region cannot be ensured. Travelers should exercise caution when visiting or transiting Transnistria. Travelers should be aware that there are numerous road checkpoints along roads leading into and out from Transnistria. Taking photographs of military facilities, public buildings, and security forces, including checkpoints along roads leading into and out from Transnistria, is strictly prohibited.

Racially motivated incidents against foreigners and persons of color have occurred in Moldova. Persons of African, Asian, or Arab heritage may be subject to various types of harassment, such as verbal abuse, and denied entrance into some clubs and restaurants. These Americans are also at risk for harassment by police authorities.

In some instances, Americans have become victims of harassment, mistreatment and extortion by Moldovan law enforcement and other officials. Low-level bribery attempts are commonplace in Moldova. These encounters should always be reported to the U.S. Embassy. Moldovan authorities have cooperated in investigating such cases, but those investigations enjoy the greatest chance of success when the officer is identified by name, physical description, or other identifying characteristics. Please note this information if you ever have a problem with police or other officials. Americans who have refused to pay bribes in Moldova generally report no consequences beyond being delayed or inconvenienced.
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: Moldova’s economic difficulties, as well as organized criminal activity and more frequent travel by foreigners to Moldova, contribute to the risk visitors face from street crime, some potentially violent. While this risk is no greater than in most cities in the United States, many Americans have reported theft of money and small valuables from hotel rooms and local apartments. Cases of breaking and entering into homes and offices have occurred. Sexual assault against foreigners is rare. Travelers are wise to exercise the same precautions with regard to personal safety and protection of valuables in Chisinau that they would in any major U.S. city.
Precautions should also be taken when using ATMs in Moldova. Some Americans have reported unauthorized withdrawals from their accounts after using ATMs. Instances have been reported of PIN theft from use of ATMs in Moldova, either by “skimming” devices, which record the ATM card information while in use, or by surreptitious observation.

Train and bus services are below Western European standards and some U.S. citizens have been victims of crimes involving thefts while traveling on international trains to and from Moldova.
Americans who use the Moldovan postal service report frequent losses from international letter and package mail.
Internet Fraud Warning: The Embassy is aware of various confidence schemes that have taken advantage of American citizens, frequently via the Internet. In some cases these involve the purchase or sale of items on the Internet in which the payment or shipment of goods was not completed by a Moldovan counterpart. In the spring of 2006, Moldovan police recovered over $250,000 in jewelry that was sent to “buyers” in Moldova from the United States via fake online escrow companies. Substantial criminal enterprises specializing in this type of crime (Internet auction fraud) have emerged in Moldova. In other cases, American citizens, particularly males, have met potential Moldovan fiancé(e)s on the Internet who have convinced them to send hundreds or even thousands of dollars, but have no intention of a serious relationship. Once the American citizen starts to question the reason for sending the money, the Moldovan fiancé(e)s suddenly ends his/her contact. On occasion, American citizens who come to Moldova to visit someone they have first met over the Internet have reported becoming subject to crimes such as extortion and involuntary detention. American citizens should be aware that any such activity committed by individuals in Moldova is subject to the Moldovan legal system and could prove difficult to prosecute. In the vast majority of cases, there is little that the U.S. Embassy can do to assist American citizens who are defrauded by Moldovans via the Internet.
Please see our information on International Financial Scams.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Moldova is: 9-0-2 (Police Assistance) or 9-0-3 (Ambulance Assistance)
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Moldova is substandard throughout the country, including Chisinau. In the event of serious medical conditions every effort should be made to go to Western Europe. In the event of emergency, travelers should attempt first to contact the local ambulance service, which is trained to determine which medical facility is most appropriate for treatment and will transport the injured or sick person to that location. Hospital accommodations are inadequate throughout the country and advanced technology is lacking. Shortages of routine medications and supplies may be encountered. Elderly travelers and those with existing health problems may be at particular risk due to inadequate medical facilities. The U.S. Embassy maintains lists of medical facilities and English-speaking doctors, but cannot guarantee or endorse competence. Visitors to Moldova are advised to bring their own supply of both prescription and common over-the-counter medications. Pharmacies are not stocked to Western standards and products are not labeled in English. Poor quality and/or fraudulent medications have been reported.
HIV/AIDS restrictions: Some HIV/AIDS entry restrictions exist for visitors to or foreign residents of Moldova. Short term visitors (periods of less than 90 days) do not require HIV testing. Applicants for residence permits, however, are required to submit to a HIV test and demonstrate that they are HIV negative. Please verify this information with the Embassy of Moldova at www.embassyrm.org before you travel.

Medical Information: Tuberculosis is an increasingly serious health concern in Moldova; the World Health Organization (WHO) has placed it in its “highest risk” category. Travelers planning to stay in Moldova for more than 3 months should have a pre-departure PPD skin test status documented. Given the way TB is transmitted, travelers should consider limiting their exposure to TB by avoiding crowded public places and public transportation whenever possible. Domestic help should be screened for TB. For further information, please consult the CDC's Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
Other major health concerns include Hepatitis A (food-borne), Hepatitis B, and Hepatitis C (blood- and body fluids-borne). The incidence of sexually transmitted diseases is as "high" as it is in most developing countries.

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 WHO’s 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 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 Moldova is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Moldova’s highway infrastructure consists mainly of two-lane roads that often lack markings or signage, are unevenly maintained, and seldom have lighting. Caution should be taken to prevent collisions with agricultural vehicles and/or livestock. Urban roads in Moldova are infrequently maintained and often lack clear signs or lane markings. Travel outside of urban areas before dawn and after dusk should be avoided if at all possible. Drivers and pedestrians should exercise extreme caution to avoid accidents, which are commonplace. Many Moldovan drivers would be considered aggressive or erratic by American standards. Many accidents involve drunk drivers. The quality and safety of public transportation vary widely. Trains, trolleybuses, and buses are often old and may frequently break down. Taxis are available in most urban areas, and vary from old Soviet-era vehicles to newer, Western European or American model vehicles. Emergency services are generally responsive. Police emergency assistance can be called at 902 and emergency ambulance at 903.
Please refer to our Road Safety page for more information. Visit the web site of the Moldova’s national tourist office at http://www.turism.md/
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Moldova, the U.S. Federal Aviation Administration (FAA) has not assessed Moldova’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: Travelers are advised to register any foreign currency brought into Moldova with customs authorities upon entering the country. It is advisable to contact the Embassy of Moldova in Washington for specific information regarding customs requirements. Please see our Customs Information.
Visas and residency: Current Moldovan Government (GOM) border registration procedures will remain unchanged under the new immigration law. As of January 1, 2007, U.S. and most other foreign nationals arriving in Moldova do not require a visa and are permitted stays of up to 90 days in any given six-month period. At the point of entry (i.e., airport or border), the Border Guard Service enters the traveler’s personal data into a computer program and transfers the data to the GOM’s Population Register. Visitors are not given a paper “registration receipt.” U.S. citizens are able to enter Moldova through Transnistria. However, because they will not have been registered at the border, they will still have to register with the nearest office of the Ministry of Information Development (MID) within three days of arrival in right-bank (western) Moldova.

For stays exceeding 90 days, foreign nationals are required to obtain “immigration certificates” and residence permits from the National Bureau for Migration. Foreign nationals planning to work in Moldova must also obtain a work permit. Immigration, residence and work permits usually need to be extended annually, but may be issued for up to five years.
For more information on registering with Moldovan authorities, U.S. citizens are encouraged to call the Consular section of the U.S. Embassy in Chisinau at (373) (22) 40-83-00.
Requirement to Carry Documentation: As noted above, Moldovan police have the right to request identity documents from any person. Individuals who fail to produce appropriate ID upon request may be subject to detention and fines. Therefore, Americans are advised to carry their U.S. passports (or a copy of their passport’s biographic information page) with registration card, if applicable, or a Moldovan-issued identification document when in public.
Consular Access: Moldovan law enforcement authorities, particularly in the Transnistria region, have an uneven record of reporting the arrest or detention of American citizens to the U.S. Embassy, as required under international agreements. American citizens are therefore advised that if they are detained or arrested by Moldovan authorities, they should immediately request that the U.S. Embassy be contacted. Moldovan authorities have generally respected such requests in a prompt manner.
Photography: Americans who choose to travel in Transnistria should be aware that foreigners have reported being detained or harassed by authorities for taking photographs of military facilities or public buildings. Photography of checkpoints along roads leading into and out from the Transnistria region, or the personnel working there, is prohibited.
Dual Nationality: Recent Moldovan legislation allows dual citizenship. There is no requirement that dual nationals enter Moldova on their Moldovan passports. For further questions, please contact the Moldovan Embassy in Washington, D.C.

Telephone and Postal Services: Outside of Chisinau, travelers may have difficulty finding public telephones and receiving or making international and local calls. Losses have been reported from international letter and package mail, both of which are subject to a customs inspection before delivery. “Express” mail services such as DHL and Federal Express are available in Chisinau, although in most instances prices are high, and shipments arrive from (or reach) the United States in no less than five (5) business days.
Disabled Access: Persons with disabilities should be aware that public facilities and transportation in Moldova are rarely designed or built in a way that allows for wheelchair access. Wheelchair entrances, ramps, lifts or similar accommodations are rare; those that do exist are often below Western standards and/or poorly maintained. Most streets, sidewalks and other public paths are not well maintained and can be hazardous, particularly in poor weather conditions.
Commercial Transactions: Although still generally a cash-only economy, traveler’s checks and credit cards may be accepted in Chisinau, although locations that will accept them outside the capital are still rare. Some vendors require the customer dial in a PIN to authorize a sale by credit card. Caution is advised, however, as some travelers have reported incidents of unauthorized expenditures made on credit cards during or following their use in Moldova, and there have also been reported incidents of fraud and account theft using bank machines (ATMs – see “CRIME” above).
Business in Transnistria: As noted in the Safety and Security section above, a separatist regime controls a narrow strip of land in eastern Moldova known as Transnistria ("Pridnestrovie" in Russian). Individuals considering doing business in Transnistria should exercise extreme caution. The Embassy may not be able to offer consular or commercial services to Americans in Transnistria. Moldovan law requires firms (including those located in Transnistria) to register with the Moldovan Government and to use Moldovan customs seals on their exports. Under a December 2005 agreement between Moldova and Ukraine, Ukrainian customs and border officials require Moldovan customs seals on goods exported from Moldova, including Transnistria, and are enforcing this requirement with EU assistance. Transnistrian firms not legally registered with Moldovan authorities operate in contravention of Moldovan law, which may complicate or prevent the import or export of goods. The Government of Moldova has indicated that it will not recognize the validity of contracts for the privatization of firms in Transnistria that are concluded without the approval of the appropriate Moldovan authorities. A number of Internet fraud schemes have originated in Transnistria.
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 Moldovan laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Moldova are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in illicit 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 Moldova are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, and to obtain updated information on travel and security within Moldova. 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 in Chisinau, Moldova, Strada Alexei Mateevici 103; telephone: (373)(22) 23-37-72, after-hours telephone: (373)(22) 23-73-45; Consular Section Fax: (373)(22) 22-63-61. The Embassy’s web site is http://moldova.usembassy.gov
* * *
This replaces the Consular Information Sheet dated January 18, 2008, to update sections on Entry/Exit Requirements, Safety and Security, Medical Facilities and Health Information, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Wed 10 Sep 2014
Source: Jurnal.md [in Romanian, transl., edited]

Cahul: 3 [more] people hospitalized with anthrax
------------------------------------------------
The number of cases of anthrax in the South [of Moldova] increased from day to day. According to the National Center for Public Health, a further 3 people infected with anthrax, cutaneous form, were admitted to the infectious diseases ward in Cahul District Hospital.

Two patients, one woman and her son, were infected from slaughtering a sick sheep. The case was registered for the village of Vadul Isaac, where 6 other people were earlier infected with the same disease after killing [and butchering] a sick calf.

The 3rd patient is a native of the village of Crihana. He became ill after visiting a cattle farm where an animal was slaughtered and butchered in Vad Isaac, which is under quarantine. He was also admitted to the District Hospital in Cahul.

Initially, a man infected with cutaneous anthrax came to the Crihana village hospital. Health of all patients is satisfactory. They are to be discharged after 2 weeks.
-------------------------------------
Communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen
Germany
======================
[To find Cahul district in south west Moldova on the Romanian border, go to:

So to date we have 9 cases, with one dying. This is probably a sound conservative set of numbers when considering what one sick animal, apparently a "calf", can do. Where more care is taken handling dead animals, the number can be flipped to have one human case for every 10 sick animals butchered or rendered. When there is a bias to only report human cases, it can be a guessing game as to the numbers of animals involved. With thanks, as usual, to Sabine. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
Date: 5 Sep 2014
Source: Itar-Tass [edited]

A total of 6 workers of a livestock farm in the Cahul district of Moldova have been hospitalized on the suspicion of contracting anthrax, the national Healthcare Ministry said on Friday [5 Sep 2014].

"The patients are in a satisfactory condition, and the illness makes itself manifest mostly in skin lesions, but they have a normal temperature," Viktor Dyatishin, the head doctor of the infectious diseases hospital in Chisinau told reporters. "They will stay at hospital for about 2 weeks until full recovery."

The previous case of anthrax in Moldova was reported last year [2013]. The experts point to the numerous livestock burial sites -- from where anthrax spores can be washed out on to fields and into rivers by rainwater -- as the main source of the incident.

Moldova's sanitary, veterinary and epidemiological services were taking urgent steps on Friday [5 Sep 2014] to localize the dangerous infection.
-----------------------------
communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen, Germany
******************************
Date: 5 Sep 2014
Source: Press.try.md [edited]

Five people were diagnosed with anthrax yesterday [4 Sep 2014] at the Chisinau infectious diseases hospital. All patients are residents of the Cahul district.

The 1st ill person with symptoms of an open form of anthrax was delivered on Wednesday [3 Sep 2014] to a hospital in the Cahul village of Vadul. He is known to the employee of a private farm in the village.

Under suspicion of doctors were another 4 people. Their relatives say that the 1st symptoms appeared a few days ago, but local doctors gave them the wrong diagnosis. "[He had a fever]; he was sick; his appetite disappeared. [They] gave him headache tablets, but he still complained of feeling unwell."

The woman and her son ate food prepared from contaminated meat. Now they are under the supervision of doctors. "[We bought] half of the cow's head; someone took the other. He has some kind of sore on his leg."

Accidentally or not, one of the men who participated in the slaughter of cattle died. "He died at the hospital. We were not allowed to visit him. The cause of death not reported. He had some sores on his feet."

The mayor of the village said that the owner of the farm knew that the cows were sick but had not reported it to the authorities. "The 1st cases in animals appeared on 9 Aug 2014. Cows died, but the incident was [not] reported to any veterinary service or to the National Centre of Public Health," said the mayor of the village of Vadul.

All 5 were hospitalized in the capital hospital. "The patients are satisfactory; [their] temperature is normal. They will stay with us for about 2 weeks for treatment until they are cured," said the director of the hospital.

Representatives of the agency's food safety say that animals that carry the dangerous disease have not been vaccinated. "The animals were vaccinated. Still, cows were not vaccinated, because they have entered a period of maturation" [whatever that might mean. - ProMed Mod.MHJ], said the head of the agency's food security, Gregory Porchesku.

Epidemiologists went from Chisinau to study the situation on the ground in the Cahul district. Everyone who has been in contact with patients is under the supervision of physicians. A vaccination [campaign] for all the cattle in the village has still to occur.
---------------------------------------------------
communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen, Germany
==========================
[These Moldovan accounts are confused. The simplest explanation would be that 5 patients are in hospital under treatment doing well and for some reason will be released in 2 weeks time, which is a fair period if they are without a raised temperature. At some point, a 6th person died who had skin lesions. As "suspected" is used in relation to their diseased conditions, it would seem that if any samples were taken for laboratory analysis, the results are not back yet -- that is, the diagnoses were symptomatic, thus the prescription for headache. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sun, 27 Apr 2014 14:12:01 +0200 (METDST)

BRUSSELS, April 27, 2014 (AFP) - Citizens of Ukraine's neighbour Moldova will be granted visa-free travel from Monday to most European Union nations as part of the country's bid to sign an association deal with the EU bloc.

The decision shows that "closer relations with the European Union do bring tangible benefits to all," said the EU's home affairs commissioner Cecilia Malmstroem.   Under the deal, Moldovans carrying a biometric passport will be authorised to travel without a visa for short stays to the Schengen zone, which currently comprises 26 countries, 22 of them members of the 28-nation EU.   Between 50,000 and 55,000 Moldova nationals apply for short-term visas into the EU each year.

Moldova is one of the six former Soviet satellites that the EU hoped to draw into a wide-ranging Eastern Partnership programme on its eastern flank until Armenia, Azerbaijan and Belarus decided to turn back towards Moscow, and Ukraine's ousted leader Viktor Yanukovych too backed out in November at Russia's behest.

Moldova and Georgia however stood firm, initialling the partnership programme in November. They are expected to sign a final association deal with the EU in June.   Wedged between Romania to the west and Ukraine to the east, Moldova's 3.5 million people are Europe's poorest.   In the capital Chisinau there was a mixed response to the new visa-free travel, with a poll showing 50 percent of respondents underwhelmed on the grounds they were either too poor to travel or already owned a Romanian passport opening the door to the EU.
Date: Sun 7 Jul 2013
Source: Liga Novosti [in Russian, trans. ProMed Mod.NP, edited]

The Ministry of Health of Moldova has reported an outbreak of anthrax in the village of Veden, in Soroca district, located in northeast Moldova close to the border with Ukraine. Results of an epidemiological survey of several inhabitants of the village revealed the 4 patients were infected after a meal in which the main dish was freshly cooked beef.

All patients were hospitalized to the Republican Infectious Diseases hospital: one of them is in critical condition and the other 3 are in the moderately severe condition.

Specialists of Ministry of Agriculture of Moldova are providing the measures for the localization of the infection to prevent the spread of infection. [Presumably livestock vaccination and destruction of any contaminated meat. - ProMed Mod.MHJ]
==================
[This outbreak is to the north of the previous report of human cases in Dubasari district (Transnistria) and probably reflects an ongoing problem which gathers few reports.

>From their reports to OIE, anthrax in Moldova is sporadic with few outbreaks. And yet it receives considerable government attention via vaccination. For example, in 2012 vaccination coverage for cattle was 226 871/221 113 (103 percent), sheep & goats 937 421/908 079 (103 percent), horses 40 722/49 319 (83 percent), and pigs 3636/496 634 (0.7 percent). Outbreaks occur among pigs almost as frequently as reported for cattle. The last reported outbreak in sheep and goats was in 2004. With this level of vaccination the disease is clearly of concern, and possibly the problem is of poor reporting and poor usage of the vaccines distributed.

A HealthMap/ProMED-mail interactive map of Moldova can be seen at <http://healthmap.org/r/7ytP>.

To find Soroca district in northeastern Moldova, go to

Our thanks to Natalia for the translation. - ProMed Mod.MHJ]
Date: Tue 18 Jun 2013
Source: EVZ.ro [in Romanian, trans., edited]

A suspected case of anthrax has been recorded in Dubasari in Transnistria, in a private household.  According to Tiraspol press, the results of laboratory tests are currently expected to determine if it really is about the disease "mad cow". [Why is "mad cow" not explained? - ProMed Mod.MHJ]

The Regional Veterinarians normally take preventive measures to avoid the possible spread of the disease. Local media did not specify what it is, and the Dubasari President, Gregory Policinschi, did not know any details.

The last case of anthrax disease of animals in Moldova was registered in March last year [2012, in Riscani], and in 2011, 2 [porcine] cases were reported. Anthrax is a potentially fatal disease caused by the bacterium _Bacillus anthracis_. It occurs in cattle, horses, sheep, and goats.  [Byline: Roxana Roseti]
-----------------------------------------------
Communicated by:
Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach
52385 Nideggen
Germany
cvlonghorns@aol.com
=========================
[As at least one of the 2 cases in Dubasari has died I think we can presume that this report refers to livestock cases, and as they quote "mad cow" probably bovine.  A HealthMap/ProMED-mail interactive map of Moldova can be seen at <http://healthmap.org/r/7pn0>. For the location of Dubasari and Transnistria in a map of Moldova, go to <http://www.lib.utexas.edu/maps/commonwealth/moldova_pol01.jpg>; Dubasari Province is currently under the administration of the breakaway government of the Moldovan Republic of Transnistria. - ProMed Mod.MHJ]
More ...

Namibia

Namibia US Consular Information Sheet
August 16, 2007
COUNTRY DESCRIPTION: Namibia is a southern African country with a moderately developed economy.
Facilities for tourism are good and generally increasing in quality.
The capital is
indhoek.
Read the Department of State Background Notes on Namibia for additional information.
ENTRY/EXIT REQUIREMENTS: A passport and visa are normally required.
Bearers of U.S. passports who plan to visit Namibia for tourism for less than 90 days can obtain visas at the port of entry and do not need visas prior to entering the country.
Travelers coming for work or study, whether paid or voluntary, must obtain a work or study permit prior to entering Namibia.

All travelers traveling to or from Namibia via South Africa are strongly encouraged to have several unstamped visa pages left in their passports.
South Africa requires two unstamped visa pages, and Namibia usually also requires an unstamped page to stamp a visa upon arrival.
Visitors who do not have enough free visa pages in their passport risk being denied entry and returned to the U.S. at their own expense.

Travelers should obtain the latest information from the Embassy of Namibia located at 1605 New Hampshire Avenue, NW, Washington, D.C. 20009, telephone (202) 986-0540 or from the Permanent Mission of Namibia to the U.N. at 135 E. 36th St., New York, NY 10016, telephone (212) 685-2003, fax (212) 685-1561.
Overseas, inquiries should be made to the nearest Namibian embassy.
See our Foreign Entry Requirements brochure for more information on Namibia and other countries.
Visit the Embassy of Namibia's website at http://www.namibianembassyusa.org/ for the most current visa information.
See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction.
Please refer to our Customs Information to learn more about customs regulations.
SAFETY AND SECURITY:
American citizens wishing to cross into Angola from Namibia should do so only at official border crossing areas and should consult the State Department's Consular Information Sheet for Angola.
American citizens should avoid street demonstrations.
However, such events are rare in Namibia.
American citizens traveling in Namibia are urged to contact the consular section of the U.S. Embassy in Windhoek for the latest safety and security information.
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 Public Announcements 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: Crime is a serious concern in Namibia, but visitors who employ common-sense preventive measures normally enjoy an incident-free stay.
Incidents of violent crime directed specifically against Americans or other foreigners are rare, but the number of overall incidents continues to increase.
The most common crimes are property-motivated crimes of opportunity, including pick pocketing, purse snatching, vehicle theft, and vehicle break-ins.
Taxi drivers have robbed several American passengers; if taxis must be used, radio taxis that display the NABTA logo (Namibia Bus and Taxi Association) are the most reliable.
Violent crimes are less frequent than non-violent incidents.
Common sense measures such as being alert to one's surroundings, avoiding isolated areas of town, not leaving valuables in parked cars, keeping car doors locked and windows up while driving, safeguarding purses, wallets and especially cellular phones are the best deterrents against becoming a victim.
Drivers should exercise caution at rest stops outside of towns or away from gasoline stations.

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.

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Windhoek has a small number of private medical hospitals and clinics capable of providing emergency care and performing many routine procedures.
Doctors, both general practitioners and specialists, as well as dentists, generally have training and facilities that are comparable with U.S. standards.
Facilities outside the capital vary widely.
Several large towns have well-equipped facilities similar to those available in Windhoek, while smaller towns generally do not.
Malaria is prevalent only in the north of the country.
Malaria prophylaxis is not required in Windhoek but is suggested for travel to the north.
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); fax 1-888-CDC-FAXX (1-888-232-3299), or via the CDC's Internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website 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.
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 Namibia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
In Namibia, driving is done on the left-hand side of the road.
Many of Namibia's rural roads are gravel.
Although these roads are generally well maintained, controlling a vehicle on gravel is significantly more difficult than on pavement.
Drivers should not drive in excess of 80km per hour (45 mph) on gravel roads, should reduce speed significantly for curves or turns, and should heed all warning signs.
Hitting a sand patch or driving around a curve too fast can easily result in a rollover or spinout.
Many accidents on gravel roads occur when tourists exceed safe speeds on corners or in areas recently damaged by rains.
Visitors are reminded that motor vehicle accidents are one of the primary causes of injury and death in Namibia, and drivers are therefore strongly urged to drive with caution.

For those driving outside of the capital, distances between cities can be considerable, and often gasoline is only available at a few service stations along a route.
Fuel availability can be impacted by power outages as well.
All travelers are encouraged to plan their route to ensure a sufficient supply of fuel, and are recommended to bring five liters of water per person when traveling on dirt roads to guard against dehydration if an accident should occur.
Turning on a red traffic light is not permitted in Namibia.
Seat belts are required for all vehicle occupants.
Motorcyclists are required by law to wear protective helmets.
While child car seats are not required, they are recommended.
To drive legally while in Namibia, visitors staying more than a few weeks need an international driving permit.
International driving permits must be obtained prior to leaving the U.S. and are available from either the American Automobile Association or the American Automobile Touring Alliance.
Short-term visitors do not need an international driving permit; a valid U.S. driver's license is sufficient.
Roads in Namibia are generally well maintained.
However, few have shoulders or “pull-off” lanes for broken vehicles.
Wildlife wandering on roads is a special driving hazard in Namibia, especially at night.
An encounter at high speeds with antelope or cattle can be fatal.
The salt-surfaced roads at the coast can also be deceptively dangerous, especially when they have been made slick by morning or evening mist.
Robbery has occurred at roadside "rest stops" and motorists are advised to take rest breaks in towns and/or at gasoline stations.
Most major roads are undivided with one lane in each direction.
Drivers should remain alert for passing vehicles and exercise caution when passing slow moving vehicles.
Accidents involving drunk drivers are an increasing problem on major roads where there are high speed limits.
Driving under the influence is illegal in Namibia.
A charge of culpable homicide can be made against a driver involved in an accident resulting in death.
Roadside assistance and emergency medical services outside of Windhoek may be unreliable or non-existent.
Assistance on main roads that link Namibia's larger towns, however, is generally good due to quality cell phone networks.
Emergency services contact numbers vary from town to town.
The Namibian telephone directory has a list of emergency contact numbers at the beginning of each town listing.
It is recommended that Americans maintain a list of contact numbers for the area in which they plan to drive.
Telephone numbers may change, and 24-hour availability of these numbers is not guaranteed.
Public transportation is not widely available outside of the capital.
Taxis and municipal buses are the only forms of public transportation in Windhoek.
Schedules and routes are limited.
Car rentals or radio taxis are generally the best means of transport but may be relatively expensive.
The Embassy has received reports of foreign citizens being robbed by drivers of taxis hailed on the streets of Windhoek.
The Embassy has not received any such reports regarding radio taxis.
Flashing of high beams and similar signals could mean anything from a friendly greeting to a warning.
When encountering a motorcade, motorists are encouraged to make way immediately and follow promptly any instructions given by the officials present.
Because of the possibility of intoxicated and/or reckless drivers, the poor mechanical condition of some motor vehicles, and the high incidence of single-vehicle rollover accidents, Americans are urged to avoid hitchhiking in Namibia.
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: http://www.met.gov.na/default.htm
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Namibia, the U.S. Federal Aviation Administration (FAA) has not assessed Namibia's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA's Internet web site at www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: Wild animals may pose some danger.
Travelers are advised that, even in the most serene settings, animals are wild and can pose a threat to life and safety.
Travelers are cautioned to observe all local or park regulations and heed all instructions given by tour guides.
In addition, tourists are advised that potentially dangerous areas sometimes lack fences and warning signs.
Appropriate caution should be used in all unfamiliar surroundings.

Namibia does not recognize dual citizenship for adults over the age of 18.
Therefore, despite the fact that these individuals possess U.S. citizenship, they must enter and exit Namibia bearing a Namibian passport.
Namibia recognizes dual citizenship up until the age of 18; however, such children must enter Namibia on their Namibian passport and may face questioning by an immigration officer before being permitted entry.
Please see our information on customs regulations.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offences.
Persons violating Namibian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Namibia 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.
Americans should avoid purchasing diamonds and other protected resources outside of licensed retail establishments.
The penalty for illegal dealing in diamonds in Namibia is stiff -- up to U.S. $20,000 in fines or five years in prison -- and the courts generally impose the maximum sentence.
The purchase and exportation of other protected resources, such as elephant ivory, may also be prohibited by Namibian, international, and/or U.S. law.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Namibia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website and to obtain updated information on travel and security within Namibia.
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 14 Lossen Street, Ausspannplatz, Windhoek, telephone (264-61) 295-8500, fax (264-61) 295-8603.
You can reach the Consular Section at extension 8551; i.e., (264-61) 295-8551 or via e-mail consularwindho@state.gov.
The mailing address for the Embassy is Private Bag 12029, Windhoek, Namibia.
The U.S. Embassy Windhoek website is http://windhoek.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated August 1, 2006, to update the sections on Entry/Exit Requirements, Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Mon 23 Sep 2019
Source: News Ghana, via XinhuaNet [edited]

Hepatitis E cases in Namibia have risen to over 6305 cases in the entire country, health officials said Monday [23 Sep 2019]. Health Ministry director of research Phelomena Ochurus said there is a need for the country to be concerned, as cases are being reported on a weekly basis.

According to statistics Ochurus provided, there have so far been 52 fatal cases since 2017, with pregnant women topping the list of deaths.

"Pregnant women are more susceptible, because when they are pregnant, their immune system is compromised," she said. She added that males are topping the number of cases reported, with 60% of them affected in a specific age group of between 20 and 39 years old.

"In the Khomas and Erongo regions, people affected are living in areas with limited water and sanitation facilities, especially in the informal settlements where there are no proper facilities," she said. Khomas region has so far recorded 3865 cases, while Erongo region has recorded 1358 cases.

Namibia experienced the 1st hepatitis E outbreak in 1983 in Rundu, where 9 cases were confirmed, and the last outbreak was experienced in 1995-1996, also in Rundu.
========================
[Hepatitis E is found worldwide, and different genotypes of the hepatitis E virus determine differences in epidemiology. For example, genotype 1 is usually seen in developing countries and causes community-level outbreaks, whereas genotype 3 is usually seen in developed countries and does not cause outbreaks. Acute epidemic hepatitis E is attributable to infection with hepatitis E virus genotypes 1 and 2. Many of the deaths are in pregnant women, characteristic of genotype 1.

The highest seroprevalence rates (number of persons in a population who test positive for the disease) are observed in regions where low standards of sanitation increase the risk for transmission of the virus. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Mon 1 Jul 2019
Source: Informante [edited]

During the month of June 2019, hepatitis E virus (HEV), which has spread like wildfire through Namibia's sewer-deep informal settlements, carried on unabated, with 113 cases reported countrywide. So far, 45 [persons] have perished since [the outbreak started] in September 2017. From the 45 lives lost, 20 maternal deaths have been reported, signifying the much-extended grave impact that the disease has on Namibia, with new-born babies and children being orphaned due to insatiable spread of the virus. To date, more families are in peril, with 300 more suspected cases of pregnant women with hepatitis E having been reported.

According to the report dated 24 Jun 2019, the 113 cases reported during the month show a significant spike in the spread of the disease, with only 56 cases reported during the prior month (May 2019). Cumulatively, as of 16 Jun 2019, a total of 5423 HEV cases were reported, including 1041 confirmed, and total of 3694 people suspected to have come into close contact with those infected. The majority of cases are reported from Khomas (61%), Hardap (16%), Erongo (15%), Omusati (7%), Omaheke 6 (5%) while Oshana, Ohangwena and Kavango reported 1 (0.9%) case each.

Ministry of Health and Social Services spokesperson, Manga Libita, stated that the National Health Emergency Management Committee (NHEMC) and the response team continued to engage partners, particularly UNDP, City of Windhoek (CoW), and Ministry of Information, Communication and Technology (MICT) to support awareness raising for individuals and collective responsibility, including coordination in fighting HEV in the country. Libita added that UNICEF and partners have expressed readiness to support the CoW and other municipalities to implement Community-Led Total Sanitation (CLTS) tailor-made to suit the urban setting, without compromising the standards of cities.

When they occur, the signs and symptoms of hepatitis E are similar to those of other types of acute viral hepatitis and can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, and jaundice and dark urine. Persons experiencing these symptoms are advised to seek medical counsel at their nearest health facility.  [Byline: Zorena Jantze]
==========================
[Hepatitis E is found worldwide, and different genotypes of the hepatitis E virus determine differences in epidemiology. For example, genotype 1 is usually seen in developing countries and causes community-level outbreaks, whereas genotype 3 is usually seen in developed countries and does not cause outbreaks. Acute epidemic hepatitis E is attributable to infection with hepatitis E virus genotypes 1 and 2. Many of the deaths are in pregnant women, characteristic of genotype 1.

The highest seroprevalence rates (number of persons in a population who test positive for the disease) are observed in regions where low standards of sanitation increase the risk for transmission of the virus. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Tue 18 Jun 2019
Source: The Namibian [edited]

Oyster and black mussel production at Walvis Bay has been halted due to another outbreak of diarrheal shellfish poisoning (DSP), which can be harmful to humans. The Ministry of Fisheries and Marine Resources issued a notice yesterday [17 Jun 2019], warning people not to eat oysters or mussels from Walvis Bay. This comes 3 months after the last outbreak, which was cleared shortly thereafter.

According to the fisheries biologist, contamination is a seasonal occurrence -- mainly during summer from October to April. The recent outbreak could put a dent in the shellfish industry's economy as most exports are to Asia.

The worst affected area is at Walvis Bay's central production sector called "aquaculture production area 1", which is situated near Pelican Point. Once 2 negative results of tested samples are issued, the alert would be withdrawn, and harvesting, consumption and exports would be cleared again. The samples should be taken at 48-hour intervals, the statement from the ministry noted. Marine biotoxins are not destroyed by cooking or freezing.

The statement indicated that DSP symptoms in humans who may have been poisoned might include, as the name suggests, diarrhea, although nausea, vomiting and stomach cramps are also common. These symptoms could manifest themselves after about half an hour of eating the infected shellfish, and could last a day. No deaths have been recorded from DSP to date, the statement indicated. People who show such symptoms should immediately consult a doctor or healthcare centre.  [Byline: Adam Hartman]
=======================
[It is not clear if the term outbreak refers to in the shellfish or in humans.  Diarrheal shellfish poisoning (DSP) (<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20020>) is a gastrointestinal illness caused by the consumption of shellfish contaminated with algal toxins produced by marine dinoflagellates belonging to the genera _Dinophysis_ spp. (_D. fortii_, _D. mitra_, _D. rotundata_, _D. tripos_, _D. acuta_, _D. norvegica_, and _D. acuminata_) and _Prorocentrum_ spp. (_P. lima_, _P. maculosum_, _P. concavum_, and _P. hoffmannianum_).

The DSP toxins, including okadaic acid (OA) and its analogues dinophysistoxin-1 (DTX-1), dinophysistoxin-2 (DTX-2), and dinophysistoxin-3 (DTX-3), belong to the larger group of lipophilic toxins that also includes the azaspiracid, yessotoxin, and pectenotoxin group toxins.

The term diarrhectic (usually diarrhetic) shellfish poisoning (DSP) was used in this report, but this moderator prefers to use diarrheal shellfish poisoning to avoid any confusion between the almost homophones of diarrhetic and diuretic.

DSP is often mistaken for norovirus-like disease. It is treated with rehydration, and affected individuals usually recover in 1 to 2 days. DSP is most commonly found in shellfish in Europe and Japan but can appear anywhere and bears consideration with the appropriate epidemiology. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Sat, 15 Jun 2019 16:27:09 +0200

Windhoek, June 15, 2019 (AFP) - Drought-hit Namibia has authorised the sale of at least 1,000 wild animals -- including elephants and giraffes -- to limit loss of life and generate $1.1 million for conservation, the authorities confirmed Saturday.   "Given that this year is a drought year, the [environment] ministry would like to sell various type of game species from various protected areas to protect grazing and at the same time to also generate much needed funding for parks and wildlife management," environment ministry spokesman Romeo Muyunda told AFP.

The authorities declared a national disaster last month, and the meteorological services in the southern African nation estimate that some parts of the country faced the deadliest drought in as many as 90 years.    "The grazing condition in most of our parks is extremely poor and if we do not reduce the number of animals, this will lead to loss of an animals due to starvation," Muyunda said.

In April, an agriculture ministry report said 63,700 animals died in 2018 because of deteriorating grazing conditions brought on by dry weather.   Namibia's cabinet announced this week that the government would sell about 1,000 wild animals.   They include 600 disease-free buffalos, 150 springbok, 65 oryx, 60 giraffes, 35 eland, 28 elephants 20 impala and 16 kudus -- all from national parks.   The aim is to raise $1.1 million that will go towards a state-owned Game Products Trust Fund for wildlife conservation and parks management.

The government said there were currently about 960 buffalos in its national parks, 2,000 springbok, 780 oryx and 6,400 elephants.   The auction was advertised in local newspapers from Friday.   Namibia, a country of 2.4 million people, has previously made calls for aid to assist in the drought emergency that has already affected over 500,000 people.   In April the government announced that it will spend about $39,400 (35,200 euros) on drought relief this year to buy food, provide water tankers and provide subsidies to farmers.
Date: Tue 21 May 2019
Source: Outbreak News Today[edited]

The Ministry of Health and Social Services of Namibia officially declared an outbreak of Crimean-Congo hemorrhagic fever (CCHF) on [6 May 2019] after reporting a number of cases from different regions of the country.

As of 15 May 2019, 7 suspected cases of CCHF were reported from 5 regions, including one laboratory confirmed case out of 7 samples tested and one death (case fatality ratio 14 percent).

The Ministry of Health and Social Services detail the cases/locations in the following press statement.

The World Health Organization says CCHF outbreaks have been recurrent in Namibia in the past 2 years, with cases reported from Omaheke, Omusati, and Kharas regions. The last recorded outbreak occurred in March 2018 in Kharas region, where one fatal confirmed case was reported.

The current outbreak arises in the context of a national drought emergency that can intensify the risk of transmission and geographical spread of the disease, with livestock movements from arid to less dry areas, if mitigating measures are not implemented in a timely manner.

Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (_Nairovirus_) of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40%.

Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vector.

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible.
============================
[HealthMap/ProMED-mail map of Namibia:

Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Ixodid ticks, especially those of the genus _Hyalomma_, are both a reservoir and a vector for the virus. _Hyalomma_ ticks favour dry climates and arid types of vegetation, in areas with abundant small and large mammals that can support haematophagy and the different stages of the tick life-cycle. Environmental factors (such as climate) and human behaviour are critical determinants for the establishment and maintenance of CCHF endemicity within an area.

Given the wide distribution of the _Hyalomma_ vector, the numerous animals that can serve as hosts, and the favourable climatic and ecologic conditions in several European countries bordering the Mediterranean Sea, and African countries , it is possible that the incidence of CCHF may increase geographically over the region in the future (<http://dx.doi.org/10.1016/j.ijid.2017.02.018>).

In healthcare settings, implementation of standard IPC (infection prevention and control) measures (standard, droplet, and contact precautions) with additional precautions to avoid aerosols can minimize transmission along with isolation and cohorting of patients. Effective risk communication remains central to prevent primary infection, especially among animal handlers, slaughter-house workers, and agriculture farmers. While there are examples of best practice, there is an urgent need to standardize risk communication with messages that are evidence-based and do not encourage stigma or unnecessary panic. - ProMED Mod.UBA]
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Bolivia

Bolivia US Consular Information Sheet
July 19, 2006

COUNTRY DESCRIPTION: Bolivia is a constitutional democracy and one of the least-developed countries in South America. Tourist facilities are generally adequate, but vary greatly in qualit
. The capital is La Paz, accessible by Bolivia's international airport in El Alto. Read the Department of State Background Notes on Bolivia for additional information.

ENTRY/EXIT REQUIREMENTS: A U.S. passport valid for at least six months from the date of proposed entry into Bolivia is required to enter and depart Bolivia. U.S. citizen tourists do not need a visa for a stay of one month or less (that period can be extended up to 90 days upon application to the Bolivian immigration authorities). Visitors for other purposes must obtain a visa in advance. U.S. citizens whose passports are lost or stolen in Bolivia must obtain a replacement passport and present it, together with a police report of the loss or theft, to a Bolivian government immigration office in order to obtain permission to depart. For more information on replacement passport procedures, please consult the U.S. Embassy's Web site at . An exit tax is charged when departing Bolivia by air. Travelers with Bolivian citizenship or residency pay an additional fee upon departure. While the Bolivian Government does not require travelers to purchase round-trip air tickets in order to enter the country, some airlines have required travelers to purchase round-trip tickets prior to boarding aircraft bound for Bolivia. Some tourists arriving by land report that immigration officials did not place entry stamps in their passports, causing problems at checkpoints and upon departure. See our Foreign Entry Requirements brochure for more information on Bolivia and other countries. Visit the Embassy of Bolivia web site at for the most current visa information (please note that the web site is primarily in Spanish).

Bolivian consulates are located in Houston, Los Angeles, Miami, Oklahoma City, New York, San Francisco, and Seattle. For information on in-country visa procedures and requirements, please consult the Bolivian Immigration Service at (please note that the web site is in Spanish), fax/telephone (591-2) 211-0960, street address Avenida Camacho entre Loayza y Bueno, La Paz, Bolivia. See Entry and Exit Requirements for more information pertaining to dual nationality and the international child abduction . Please refer to our Customs Information to learn more about customs regulations.

ADDITIONAL REQUIREMENTS FOR MINORS: In an effort to prevent international child abduction, the Bolivian Government has initiated procedures at entry/exit points. Minors (under 18) who are citizens or residents of Bolivia and who are traveling alone, with one parent or with a third party, must present a copy of their birth certificate and written authorization from the absent parent(s) or legal guardian, specifically granting permission to travel alone, with one parent or with a third party. When a parent is deceased, a notarized copy of the death certificate is required in lieu of the written authorization. If documents are prepared in the United States, the authorization and the birth certificate must be translated into Spanish, notarized, and authenticated by the Bolivian Embassy or a Bolivian consulate within the United States. If documents are prepared in Bolivia, only notarization by a Bolivian notary is required. Using these documents, a t ravel permit may be obtained from the Juzgado del Menor. This requirement does not apply to children who enter the country with a U.S. passport as tourists, unless they hold dual U.S./Bolivian citizenship or have been in Bolivia for more than 90 consecutive days.

SAFETY AND SECURITY: The countrywide emergency number for the police, including highway patrol, is 110. The corresponding number for the fire department is 119. The National Tourism Police has an office in La Paz, with plans to expand to Cochabamba and Santa Cruz, providing free assistance to tourists 24 hours a day. These services include English-speaking officials who may assist tourists in filing police reports of lost/stolen documents or other valuables. The La Paz office is located at Plaza del Stadium, Edificio Olympia, planta baja, Miraflores, telephone number 222-0516.

Protests, strikes, and other civic actions can occur at any time and disrupt transportation on a local and national level. This is particularly true before, during and after elections or other changes in government. While protest actions generally begin peacefully, they have the potential to become violent. The police have used tear gas to break up protests. In addition to rallies and street demonstrations, protesters sometimes block roads; they sometimes react with force when travelers attempt to pass through or go around roadblocks and occasionally have used the threat of explosives to press their point.

U.S. citizens should avoid roadblocks and demonstrations. Demonstrations protesting government or private company policies occur frequently, even in otherwise peaceful times. Roadblocks and demonstrations in June 2005 led to the closure of the El Alto airport in La Paz, resulting in cancellation and diversion of flights and other inconveniences to travelers. U.S. citizens planning travel to or from Bolivia should take into consideration the possibility of disruptions to air service in and out of La Paz and other airports. Americans should monitor Bolivian media reports for updates. The Embassy strongly recommends that U.S. citizens avoid areas where roadblocks or public demonstrations are occurring or planned. Political rallies should similarly be avoided in light of press reports of violence at some rallies in various parts of Bolivia.

U.S. citizens who find themselves in a roadblock should not attempt to "run" a roadblock, as this may aggravate the situation and lead to physical harm. Taking alternative, safe routes, or returning to where the travel started may be the safest courses of action under these circumstances. U.S. citizens embarking on road trips should monitor news reports and may contact the American Citizen Services Unit of the U.S. Embassy in La Paz at (591)(2)(216-8297 or the U.S. consular agencies in Cochabamba at (591)(4)425-6714 and/or Santa Cruz at (591) (3) 351-3477 for updates. Given that roadblocks may occur without warning and have stranded travelers for several days, travelers should take extra food and water. The U.S. Embassy also advises its employees to maintain at least one week's supply of drinking water and canned food in case roadblocks affect supplies, as occurred in June 2005. For more information on emergency preparedness, please consult the Federal Emergency Management Authority (FEMA) Web site at . That Web site includes a Spanish language version.

Americans living or traveling in Bolivia are encouraged to register and update their contact information at the U.S. Embassy in La Paz and/or the U.S. consular agencies in Cochabamba and Santa Cruz, Bolivia. Registration may be done online and in advance of travel. Information on registering may be found at the Department of State's Consular Affairs website .

In February and October 2003, approximately one hundred people died during violent demonstrations and protests in downtown La Paz and the nearby city of El Alto. These demonstrations also affected Cochabamba and other towns and villages in the Altiplano. While the protests and demonstrations subsided, many of the underlying social, political, and economic causes remain, and in March 2005, several intercity roads, including Bolivia's major east-west highway, were closed by blockades for several weeks.

Since 2000 the resort town of Sorata, located seventy miles north of La Paz, has been cut off by blockades on three occasions, ranging from one week to one month. Visitors contemplating travel to Sorata should contact the Consular Section in La Paz prior to travel.

In the Chapare region between Santa Cruz and Cochabamba and the Yungas region northeast of La Paz violence and civil unrest, primarily associated with anti-narcotics activities, periodically create a risk for travelers to those regions.

Confrontations between area residents and government authorities over coca eradication have resulted in the use of tear gas and stronger force by government authorities to quell disturbances. Pro-coca groups have expressed anti-U.S. sentiments and may attempt to target U.S. Government or private interests. U.S. citizen visitors to the Chapare or Yungas regions are encouraged to check with the Consular Section of the U.S. Embassy prior to travel. Violence has also erupted recently between squatters unlawfully invading private land and security forces attempting to remove them.

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 Public Announcements 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: The U.S. Department of State currently classifies Bolivia as a medium to high crime threat country. Street crime, such as pick pocketing and theft from parked vehicles, occurs with some frequency in Bolivia. Theft of cars and car parts, particularly late-model four-wheel-drive vehicles, is common. Hijacking of vehicles has occurred, and travelers should take appropriate precautions to avoid being victimized. In November 2003, an American citizen was murdered during an attempted carjacking in Santa Cruz.

Bolivian police state that there are currently eight organized criminal groups operating in the La Paz area. The techniques employed by these groups vary, but there are a few major patterns that can be identified.

There have been reports of "false police" -- persons using police uniforms, identification, and even buildings modified to resemble police stations -- intercepting and robbing foreign tourists. Under Bolivian law, police need a warrant from the "fiscal" or prosecutor to detain a suspect. Any searches or seizures must occur at a bona fide police station in the presence of the fiscal. The warrant requirement also applies to suspected drug trafficking cases, although such searches and seizures may occur without a fiscal present. If detained, U.S. citizens should request to see the warrant and demand immediate contact with the nearest U.S. Consular Office (in La Paz, Cochabamba or Santa Cruz).

According to press reports, criminals using the "false police" method focus on foreigners in areas frequented by tourists including bus terminals and tourist markets such as Sagarnaga Street in La Paz. The perpetrators will identify a potential victim and have an accomplice typically driving a white taxi offer taxi services to the potential victim. They focus on European/American tourists who are not wearing a traditional "trekker" backpack and are traveling without a large number of bags. A few blocks after the potential victim boards the taxi another accomplice, pretending to be a recently arrived tourist, boards the taxi with the potential victim. With all the accomplices then in place, the "false police" stop the taxi, "search" the passengers, and rob the victim. As part of this scam, the false police may take the victim to a "false police" station.

A similar variation also introduces a "tourist" to the victims. This introduction can take place on a bus, taxi, train, or just walking down the street. The "tourist" will befriend the victims and might seek assistance in some manner. After a period of time, the "police" intercept the victims and the "tourist." At this point, the "police" discover some sort of contraband (usually drugs) on the "tourist." The entire group is then taken to the "police station." At this point, the "police" seize the documents, credit cards, and ATM cards of the victims. The perpetrators obtain pin numbers, sometimes by threat of violence, and the scam is complete.

Another technique again introduces a "tourist" to the victims. This "tourist" can be any race or gender and will probably be able to speak the language of the victims. This meeting can happen anywhere and the goal of the "tourist" is to build the trust of the victims. Once a certain level of trust is obtained, the "tourist" suggests a particular mode of transportation to a location (usually a taxi). The "taxi" picks up the victims and the "tourist" and delivers the group to a safe house in the area. At this point the victims are informed that they are now kidnapped and are forced to give up their credit cards and ATM cards with pin numbers.

Bolivian police sources state that two Austrian citizens fell victim to this scam and had their bank accounts emptied through use of their ATM card. The perpetrators then suffocated the victims and buried them in clandestine graves, where police found their bodies on April 3, 2006. During that timeframe, a Spanish citizen also purportedly fell prey to this scam, and his body was found nearby.

In most instances, the victims are released, but the murder of the victims is still a possibility. The techniques and the perpetrators are convincing. Authentic uniforms, badges, and props help persuade the victims that the situation is real and valid. All tourists visiting Bolivia should exercise extreme caution. Visitors should be suspicious of all "coincidences" that can happen on a trip. If the tourist has doubts about a situation, the tourist should immediately remove him/herself from the scene.

Thefts of bags, wallets, and backpacks are a problem throughout Bolivia, but especially in the tourist areas of downtown La Paz and the Altiplano. Most thefts involve two or three people who spot a potential victim and wait until the bag or backpack is placed on the ground, often at a restaurant, bus terminal, Internet café, etc. In other cases, the thief places a disagreeable substance on the clothes or backpack of the intended victim, and then offers to assist the victim with the removal of the substance. While the person is distracted, the thief or an accomplice grabs the bag or backpack and flees. In such a situation, the visitor should decline assistance, secure the bag/backpack, and walk briskly from the area. To steal wallets and bags, thieves may spray water on the victim's neck, and while the person is distracted, an accomplice takes the wallet or bag. At times the thief poses as a policeman, and requests that the person accompany him to the police station, using a nearby taxi. The visitor should indicate a desire to contact the U.S. Embassy and not enter the taxi. Under no circumstances should you surrender ATM or credit cards, or release a PIN number. While most thefts do not involve violence, in some instances the victim has been physically harmed and forcibly searched for hidden valuables. Visitors should avoid being alone on the streets, especially at night and in isolated areas.

Five years ago female tourists reported being drugged and raped by a tourist guide in the city of Rurrenabaque in the Beni region. Visitors should be careful when choosing a tour operator and should not accept any type of medication or drugs from unreliable sources. The Embassy has received reports of sexual assaults against female hikers in the Yungas Valley, near the town of Coroico. Visitors to Coroico are advised to avoid hiking alone or in small groups.

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 may be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in large cities is adequate for most purposes but of varying quality. Ambulance services are limited-to-non-existent. Medical facilities are generally not adequate to handle serious medical conditions. Pharmacies are located throughout Bolivia, and prescription and over the counter medications are widely available. Western Bolivia, dominated by the Andes and high plains (Altiplano), is largely insect-free. However, altitude sickness (see below) is a major problem. Eastern Bolivia is tropical, and visitors to that area are subject to related illnesses. In March 2005, several cases of yellow fever were reported in the Chapare region. News media periodically report outbreaks of rabies, particularly in the larger cities.

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 Internet site at . For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at . Further health information for travelers is available at .

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. Most medical evacuation flights cannot land at the airport serving La Paz due to the altitude; instead flights may need to use the international airport in Santa Cruz, Bolivia. Please see our information on medical insurance overseas .

HIGH-ALTITUDE HEALTH RISKS: Official U.S. Government travelers to La Paz are provided with the following information: The altitude of La Paz ranges from 10,600 feet to over 13,000 feet (3,400 to 4,000 meters) above sea level. Much of Western Bolivia is at the same altitude or higher, including Lake Titicaca, the Salar de Uyuni, and the cities of Oruro and Potosi. The altitude alone poses a serious risk of illness, hospitalization, and even death, if you have a medical condition that affects blood circulation or breathing.

Prior to departing the U.S. for high-altitude locations (over 10,000 feet above sea level), travelers should discuss the trip with their personal physician and request information on specific recommendations concerning medication and lifestyle tips at high altitudes. Coca-leaf tea is a popular beverage and folk remedy for altitude sickness in Bolivia. Possession of this tea, which is sold in bags in most Bolivian grocery stores, is illegal in the United States.

The State Department's Office of Medical Services does not allow official U.S. Government travelers to visit La Paz if they have any of the following:

Sickle cell anemia or sickle cell trait: 30 percent of persons with sickle cell trait are likely to have a crisis at elevations of more than 8,000 feet.
Heart disease: A man 45 years or older, or a woman 55 years or older, who has two of the following risk factors (hypertension, angina, diabetes, cigarette smoking, or elevated cholesterol) should have a stress EKG and a cardiological evaluation before the trip.
Lung disease: Anyone with asthma and on maximum dosage of medication for daily maintenance, or anyone who has been hospitalized for asthma within the last year should not come to La Paz and surrounding areas.
Given potential complications from altitude sickness, pregnant women should consult their doctor before travel to La Paz and other high-altitude areas of Bolivia.
All people, even healthy and fit persons, will feel symptoms of hypoxia (lack of oxygen) upon arrival at high altitude. Most people will have increased respiration and increased heart rate. Many people will have headaches, difficulty sleeping, lack of appetite, minor gastric and intestinal upsets, and mood changes. Many travelers limit physical activity for the first 36 to 48 hours after arrival and avoid alcohol and smoking for at least one week after arrival.

For additional information, travelers should visit the World Health Organization's website at as well as the CDC's travel warning on high altitude sickness at .

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 Bolivia is provided for general reference only, and may not be totally accurate in a particular location or circumstance. U.S. citizens planning on driving in Bolivia, despite the hazards described below, should obtain an international driver's license through their local automobile club before coming to Bolivia.

Road conditions in Bolivia are hazardous. Although La Paz, Santa Cruz, and Cochabamba are connected by improved highways, the vast majority of roads in Bolivia are unpaved. Few highways have shoulders, fencing or barriers, and highway markings are minimal. Yielding for pedestrians in the cities is not the norm. For trips outside the major cities, especially in mountainous areas, a four-wheel-drive vehicle is highly recommended. Travel during the rainy season (November through March) is difficult, as most routes are potholed, and some roads and bridges are washed out. Added dangers are the absence of formal training for most drivers, poor maintenance and overloaded vehicles, lack of lights on some vehicles at night, and intoxicated or overly tired drivers, including commercial bus and truck drivers.

The majority of intercity travel in Bolivia is by bus, with varying levels of safety and service. In recent years there have been major bus crashes on the highway between La Paz and Oruro, and on the Yungas road. The old Yungas road is considered one of the most dangerous routes in the world. Taxis, vans, and buses dominate intracity transportation. From a crime perspective, public transportation is relatively safe and violent assaults are rare. However, petty theft of unattended backpacks and other personal items does occur. For reasons of safety, visitors are advised to use radio taxis whenever possible.

Drivers of vehicles involved in traffic accidents are expected to remain at the scene until the arrival of local police authorities. Any attempt to leave the scene is in violation of Bolivian law. The Embassy believes any attempt to flee the scene of an accident would place the driver and passengers at greater risk of harm than remaining at the scene until the arrival of local police. 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 Bolivia as being in compliance with ICAO international aviation safety standards for oversight of Bolivia's air carrier operations. For more information, travelers may visit the FAA's Internet web site at www.faa.gov/avr/iasa/index.cfm . There are limited flights within Bolivia and to neighboring countries. Flight delays and cancellations are common. In February and March 2006, strikes at national carrier Lloyd Aereo Boliviano led to the cancellation of both national and international flights with resultant delays and other inconveniences for travelers.

SPECIAL CIRCUMSTANCES: In the run-up to the July 2006 Constituent Assembly elections, President Morales accused the United States military of infiltrating Bolivia with operatives disguised as "students and tourists." As an apparent result of these comments, some U.S. citizens have reported harassment by Bolivian officials and been subjected to unwanted media attention. In one case, a local Bolivian newspaper wrongly identified an American citizen as an operative for the Central Intelligence Agency. Americans planning on traveling to Bolivia should be aware of the political atmosphere and the possibility of unwanted attention from pro-governmental groups and other Bolivian officials.

For information on in-country visa procedures and requirements, please consult the Bolivian Immigration Service at (please note that the Web site is in Spanish), fax/telephone (591-2) 211-0960, street address Avenida Camacho entre Loayza y Bueno, La Paz, Bolivia. In emergency cases, the Immigration Service may permit temporary residency applicants to retrieve their passports from those applications. However, under current regulations in such cases the applicant would need to commence the application anew, including paying the corresponding fees. Any U.S. documents, such as birth, marriage, divorce or death certificates, to be presented in Bolivia must first be authenticated in the U.S. at the nearest Bolivian Embassy or consulate. For information on those procedures, please consult the Department of State Office of Authentications web site, www.state.gov/m/a/auth , and the nearest Bolivian Embassy or consulate.

Please see our information on customs regulations .
MARRIAGE: Please see our information on marriage in Bolivia , available on the Embassy's Web site at
MOUNTAIN TREKKING AND CLIMBING SAFETY: U.S. citizens are advised to exercise extreme care when trekking or climbing in Bolivia. Since June 2002, four American citizens have died in falls while mountain climbing in Bolivia. Three of the deaths occurred on Illimani, a 6,402-meter peak located southeast of La Paz. Many popular trekking routes in the Bolivian Andes cross passes as high as 16,000 feet. Trekkers must have adequate clothing and equipment, not always available locally, and should be experienced mountain travelers. It is not prudent to trek alone. Solo trekking is the most significant factor contributing to injuries and robberies. The safest option is to join an organized group and/or use a reputable firm to provide an experienced guide and porter who can communicate in both Spanish and English. If you develop any of the following symptoms while climbing at altitude - severe headache, weakness, vomiting, shortness of breath at rest, cough, chest tightness, unsteadiness - descend to a lower altitude immediately. Trekkers and climbers are strongly encouraged to purchase adequate insurance to cover expenses in case of injury or death.

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 Bolivian laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Bolivia 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 .

It often takes years to reach a decision in Bolivian legal cases, whether involving property disputes, civil, or criminal matters. Depending on the circumstances of the case, the court can order a defendant held in jail for the duration of the case. Prison conditions are primitive, and prisoners are expected to pay for food and lodging. For further information, please see the Annual Human Rights Report for Bolivia at . Lists of local Bolivian attorneys and their specialties are available from the Consular Section of the U.S. Embassy in La Paz and the Consular Agencies in Santa Cruz and Cochabamba, and may also be found on our Web site at .

CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website . Pending U.S. implementation of the Hague Convention on International Adoptions, under Bolivian law U.S. citizens who are not resident in Bolivia are not permitted to adopt Bolivian children./p>

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Bolivia are encouraged to register with the nearest U.S. Embassy or Consular Agency through the State Department's travel registration website, and to obtain updated information on travel and security within Bolivia. Americans without Internet access may register directly with the nearest U.S. Embassy or Consular Agencies in Cochabamba and Santa Cruz. By registering, American citizens make it easier for the Embassy or Consular Agency to contact them in case of emergency.

The U.S. Embassy is located at 2780 Avenida Arce in La Paz, between calles Cordero and Campos; telephone (591-2) 216-8297 during business hours 8:30 a.m.-5:30 p.m., or (591-2) 216-8000 for after-hours emergencies; fax (591-2) 216-8808; Internet . The U.S. Embassy in La Paz is open for American Citizen Services Monday through Thursday from 1:30PM to 5:00PM and Fridays from 08:30 to12:30 and from 2:00PM to 4:00PM, except U.S. and Bolivian holidays. Questions should be directed to the email address USCit.Services.Bolivia@gmail.com or consularlapaz@state.gov .

There are two consular agencies in Bolivia, which provide limited services to American citizens, but are not authorized to issue passports. Anyone requesting service at one of the consular agencies should call ahead to verify that the service requested would be available on the day you expect to visit the agency.

Santa Cruz: The Consular Agency in Santa Cruz is located at 146 Avenida Roque Aguilera (Tercer Anillo); telephone (591-3) 351-3477, 351-3479, or 351-3480; fax (591-3) 351-3478. The U.S. Consular Agency in Santa Cruz is open to the public Mondays from 09:00 to 12:30 and from 2:00PM to 5:00PM and on Tuesday through Friday from 09:00 to 12:30, except U.S. and Bolivian holidays.

Cochabamba: The Consular Agency in Cochabamba is located at Avenida Oquendo 654, Torres Sofer, room 601; telephone (591-4) 411-6313; fax (591-4) 425 -6714. The U.S. Consular Agency in Cochabamba is open Monday through Friday from 9:00 a.m. - 12:00 noon, excluding U.S. and Bolivian holidays.
* * *
This replaces the Consular Information Sheet dated April 4, 2006 to update Entry/Exit Requirements, Safety and Security, Crime, Marriage, Special Circumstances and web links.

Travel News Headlines WORLD NEWS

Date: Wed 7 Aug 2019
Source: El Deber [in Spanish trans. ProMED Mod.TY, edited]

Soldier LC, who completed his military service in the Bolivian Condors School (ESCONBOL) in Sanadita, died of [a] hantavirus [infection], according to laboratory results issued this [Wed 31 Jul 2019] by the National Center for Tropical Diseases (CENETROP) of the Tarija Department of Health Service (SEDES).

The Chief of Epidemiology, Claudia Montenegro, confirmed that the conscript died from this disease that is transmitted by the long-tailed rat and that he had been infected in a forest locality near to the Campo Largo community, where he was from.

According to Montenegro, this is the 15th hantavirus [infection] case reported in Tarija department in 2019; 5 of them died.

The hantavirus cases correspond to patients from Bermejo and the Chaco region where the rat that carries [the] hantavirus lurks.  [Byline: David Maygua]
=========================
[The case count is now up to 15 in Tarija department; 5 of them, including the case above, died. As noted in earlier posts, cases of hantavirus infections in Tarija department are not new. The department is endemic for hantaviruses, and cases occur there sporadically. Last year (2018), there were 11 cases. The previously reported 2015 cases of hantavirus pulmonary syndrome (HPS) that occurred in Tarija department were confirmed. As noted in the previous comments, earlier cases of hantavirus pulmonary syndrome have been reported from tropical, lowland areas of Bolivia, including 7 cases in Tarija during 2014. The specific hantaviruses involved in these or previous cases in Bolivia were not given.

In the lowland Amazon Basin of Bolivia, the rodent hosts of the hantavirus that might be involved in these hantavirus pulmonary syndrome (HPS) cases, with their images, include the following:
- Laguna Negra virus (small vesper mouse, _Calomys laucha_ <http://www.faunaparaguay.com/calomyslaucha.html> and large vesper mouse, _C. callosus_
- Bermejo (Chaco rice rat, _Oligoryzomys chacoensis_
- Oran (long- tailed pygmy rice rat, _O. longicaudatus_

Since previous cases in Tarija department have occurred in Bermejo, perhaps Bermejo hantavirus was involved.

Dr Jan Clement commented earlier that there is a need to be able to differentiate Seoul orthohantavirus (SEOV) as a causative agent, but that is hampered by the fact that most current commercial ELISA or WB (Western Blot) formats no longer contain a SEOV antigen, so that a preliminary presumption of a hantavirus infection can even be missed in non-research laboratories (Clement J, LeDuc JW, Lloyd G, et al. Wild rats, laboratory rats, pet rats: global Seoul hantavirus disease revisited. Viruses. 2019; 11(7): 652; pii: E652; <https://www.mdpi.com/1999-4915/11/7/652/htm>; and Reynes JM, Carli D, Bour JB et al. Seoul virus infection in humans, France, 2014-2016. Emerg Infect Dis. 2017; 23(6): 973-7; <https://wwwnc.cdc.gov/eid/article/23/6/16-0927_article>.

SEOV is widely distributed around the world in the brown rat and is likely found in Tarija department. - ProMED Mod.TY]

[Maps of Bolivia:
Date: Wed 17 Jul 2019
Source: El Deber [in Spanish trans. ProMED Mod.TY, edited]

The 1st 3 cases of Chapare arenavirus haemorrhagic fever were detected between December 2003 and January 2004, but the vector [reservoir] was not identified. The affected individuals had febrile and cardiac symptoms.

The New World Chapare arenavirus haemorrhagic fever, which has recently affected 5 people in La Paz [department], 3 of whom died, had its 1st outbreak in 16 years in a rural locality in the Cochabamba tropics; however, since then, until now, the vector [reservoir] has not been identified.

It is known that arenaviruses are transmitted by rodents, and because of this the latest investigations in northern La Paz, where the 1st case was reported (that now is known as the Chapare genotype), was focused on searching for _Calomys callous_ [the large vesper mouse. - ProMED Mod.SH], which transmits Machupo virus, but it may also be transmitted by other rodent families, say knowledgeable people.

The chief of epidemiology of the Departmental Health Services (SEDES), Roberto Torrez, recalled that Chapare virus was identified more than a decade ago, after 3 people presented with haemorrhagic fever symptoms in the rural community of Samusaveti (Cochabamba tropics) between December 2002 and January 2004. The ill individuals presented with febrile and haemorrhagic symptoms and, mainly, cardiac problems. The investigation results indicated that they were dealing with a virus that was "very related" to Machupo, but was genetically distinct. In 2006, it was given the name Chapare, for the locality of its origin.

Torrez explained that the focus [of infection] was controlled, but the vector [reservoir] was not identified. Until now, it is still unknown how the virus has reappeared in northern La Paz, although the possibilities are that the vector [reservoir] has migrated from the Cochabamba tropics or has been inhabiting northern La Paz and that recently infected people have presented [with the disease]. "We know that it is transmitted by rodents, but we do not know the vector [reservoir] of the original Chapare virus, neither of the Cochabamba one, nor of the La Paz one," he said.

The chief of epidemiology discarded the idea that Santa Cruz department is at risk of an outbreak, since that "cases of the disease have never been registered nor have rodents of the _Calomys callous_ family [sic; genus and species] infected with Machupo virus been encountered." Torrez said that many years ago, in San Ignacio de Velasco, in the [municipal] limits of Piso Firme, _Calomys callous_ rodents were taken with Latino virus, which is not a human pathogen.

Technicians of the Ministry of Health have captured rodents in the areas of Caranavi and Guanay, where the 1st fatal case (a farmer) lived and worked. Since calomys rodents were not encountered, the investigation was expanded to other types of rodents.

[A hospitalized medical student who died 4 Jun 2019 was first diagnosed with dengue and later with a fatal arenavirus infection. The legal dispute between the patient's family and the hospital physicians is not translated here, since it adds nothing to the understanding of treatment or of epidemiology of the infection. - ProMED Mod.TY]  [byline: Deisy Ortiz, Miguel A Melendres]
====================
[New World arenavirus haemorrhagic fever virus Chapare, that has recently infected 5 patients in La Paz [department], 3 of whom died, brought to mind the 1st outbreak 16 years ago in a rural area of Cochabamba; however, since then it has not been possible to identify the animal reservoir. At that time, 3 people presented with symptoms of haemorrhagic fever in the rural community of Samusaveti (Cochabamba tropics) between December 2003 and January 2004. - ProMED Mod.JT]

This report definitely identifies the virus involved in these cases as Chapare arenavirus. Symptoms of Chapare and Machupo virus infections include: early clinical manifestations consist of nonspecific signs and symptoms, including fever, headache, fatigue, myalgia, and arthralgia. Within 7 days, patients may develop haemorrhagic signs, including bleeding from the oral and nasal mucosa and from the bronchopulmonary, gastrointestinal, and genitourinary tracts. Case fatality rates range from 5% to 30% (see ProMED-mail post Bolivian haemorrhagic fever - Bolivia: background http://promedmail.org/post/20190705.6553672).

The original cases were investigated by a team of Bolivian health authorities, US Navy health experts based in Lima, Peru, and the US Centers for Disease Control and Prevention. The virus was characterized as Chapare arenavirus, a previously unrecognized arenavirus, discovered in serum samples from a patient in rural Bolivia who eventually died of the infection. A full report of the study was published 18 Apr 2008 in the open-access journal PLoS Pathogens cited below.

Reference
---------
Delgado S, Erickson BR, Agudo R, et al. Chapare virus, a newly discovered arenavirus isolated from a fatal hemorrhagic fever case in Bolivia. PLoS Pathog. 2008; 4(4): e1000047; <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277458/>

It is unfortunate that the rodent reservoir of Chapare virus is still unknown. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Bolivia:
Date: Thu 18 Jul 2019
Source: Centers for Disease Control and Prevention (CDC), Haemorrhagic Fever in Bolivia [edited]

Watch-level 1. Practice usual precautions
-----------------------------------------
Key Points:
- An outbreak of haemorrhagic fever was recently reported in Bolivia.
- The outbreak is caused by an arenavirus that appears similar to Chapare virus, which causes Chapare haemorrhagic fever.
- Travellers to Bolivia should avoid contact with rodents, with rodent urine or faeces (droppings), and with people who are sick.

What is the current situation?
Health officials in Bolivia have reported an outbreak of haemorrhagic fever associated with an arenavirus similar to Chapare arenavirus. The 1st case was in a man from Caranavi Province. A health care provider who treated him became ill and was transferred to La Paz. Currently, several additional cases have been reported; all have been in health care providers or family members of the 1st patient.

Testing suggests that the virus is genetically similar to Chapare virus, a New World arenavirus that was 1st documented in Bolivia in 2003. During that outbreak, a small number of people became ill, and one died. Since then, no additional cases have been reported. Additional testing is ongoing to determine the exact cause of this outbreak.

What can travelers do to protect themselves?
- Although the animal source for this virus has not been confirmed, travellers should avoid contact with rodents and rodent urine or faeces.
- Avoid contact with people who are sick.
- Travellers going to Bolivia to provide health care to local populations may be at risk and should wear full personal protective equipment when treating suspect hemorrhagic fever cases.
===========================
[The above CDC precaution is in response the recent occurrence of Chapare arenavirus hemorrhagic fever in the La Paz department of Bolivia (see Chapare virus - Bolivia: (LP) http://promedmail.org/post/20190719.6573996). The initial 3 cases of Chapare arenavirus hemorrhagic fever were detected between December 2003 and January 2004, but the vector [reservoir] was not identified. The virus recently affected 5 people in La Paz [department], 3 of whom died, had its 1st outbreak in 16 years in a rural locality in the Cochabamba tropics; however, since then, until now, the vector [reservoir] has not been identified.

As noted earlier, the original cases were investigated by a team of Bolivian health authorities, US Navy health experts based in Lima, Peru, and the US Centers for Disease Control and Prevention. The virus was characterized as Chapare arenavirus, a previously unrecognized arenavirus, discovered in serum samples from a patient in rural Bolivia who eventually died of the infection. A full report of the study was published 18 Apr 2008 in the open-access journal PLoS Pathogens cited below.

Citation
--------
Delgado S, Erickson BR, Agudo R, et al. Chapare virus, a newly discovered arenavirus isolated from a fatal hemorrhagic fever case in Bolivia. PLoS Pathog. 2008; 4(4): e1000047;

The rodent reservoir of Chapare virus is still unknown. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Fri 5 Jul 2019
Source: GIDEON (Global Infectious Disease Epidemiology Network) [edited]

Re: ProMED-mail Undiagnosed illness - Bolivia (02): (LP) Bolivian haemorrhagic fever conf. http://promedmail.org/post/20190704.6551379

In 2019, a small outbreak of Bolivian haemorrhagic fever was reported at a hospital in La Paz [department], Bolivia. The following background data on Bolivian haemorrhagic fever are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series.[1,2] Primary references are available from the author.

Bolivian haemorrhagic fever (BHF) is caused by Machupo virus (Arenaviridae, Tacaribe complex, _Mammarenavirus_). The disease was initially described in 1959 as a sporadic hemorrhagic illness in rural areas of Beni department, eastern Bolivia, and the virus itself was 1st identified in 1963. BHF is most common during April to July in the upper savanna region of Beni. Principal exposure occurs through rodents ([the large vesper mouse] _Calomys callosus_), which enter homes in endemic areas.

BHF is one of several human _Arenavirus_ diseases reported in the Americas: Argentine haemorrhagic fever (Junin virus), Brazilian haemorrhagic fever (Sabia virus), lymphocytic choriomeningitis, Venezuelan haemorrhagic fever (Guanarito virus) and Whitewater Arroyo virus infection. (At least 2 related diseases are reported in Africa: Lassa fever and Lujo virus infection.)

Infection of _C. callosus_ results in asymptomatic viral shedding in saliva, urine, and feces; 50% of experimentally infected _C. callosus_ are chronically viremic and shed virus in their bodily excretions or secretions. _C. callosus_ acquires the virus after birth, and start shedding it through their urine and saliva while suckling. When mice acquire the virus as adults, they may develop immunity and no longer shed the virus.

Although the infectious dose of Machupo virus in humans is unknown, exposed persons may become infected by inhaling virus in aerosolized secretions or excretions of infected rodents, ingestion of food contaminated with rodent excreta, or by direct contact of excreta with abraded skin or oropharyngeal mucous membranes. Nosocomial and human-to-human spread have been documented. Hospital contact with a patient has resulted in person-to-person spread of Machupo virus to nursing and pathology laboratory staff.

In 1994, fatal secondary infection of 6 family members in Magdalena, Bolivia from a single naturally acquired infection further suggested the potential for person-to-person transmission.

During December 2003 to January 2004, a small focus of haemorrhagic fever was reported in the area of Cochabamba. A 2nd _Arenavirus_, Chapare virus, was recovered from one patient with fatal infection.

Early clinical manifestations consist of nonspecific signs and symptoms, including fever, headache, fatigue, myalgia, and arthralgia. Within 7 days, patients may develop hemorrhagic signs, including bleeding from the oral and nasal mucosa and from the bronchopulmonary, gastrointestinal, and genitourinary tracts. Case fatality rates range from 5% to 30%.

Ribavirin has been used successfully in several cases of BHF. The recommended adult regimen is 2.0 g intravenously (IV), followed by 1.0 g IV every 6 hours for 4 days, and then 0.5 g every 8 hours for 6 days.

Note that the etiologic agent and clinical features of BHF are similar to those of Argentine hemorrhagic fever (AHF). Neurological signs are more common in AHF, while hemorrhagic diatheses are more common in BHF. A vaccine available for AHF could theoretically be effective against BHF as well.

References
1. Berger S. American hemorrhagic fevers: global status, 2019. Gideon e-books.
2. Berger S. Infectious diseases of Bolivia, 2019. 342 pages, 87 graphs, 495 references.
Communicated by:
Steve Berger
Geographic Medicine
Tel Aviv Medical Center, Israel
=======================
[ProMED-mail thanks Dr. Berger for the overview of Bolivian haemorrhagic fever presented above. As noted in the previous comment, and above, Bolivian haemorrhagic fever, caused by Machupo virus, occurs sporadically in lowland Bolivia, especially in Beni department. There was a case there in 2013, and in 2012 ProMED-mail reported that 13 people had been infected with Machupo virus and 7 had died as a consequence of the disease. In Beni department at that time, 5 municipalities, including Magdalena, were reported to have had large populations of _Calomys callosus_ mice, the reservoir host of Machupo virus, which can persistently infect the mice. It is not surprising to find cases in lowland areas of La Paz department again, where the current cases are occurring. The drylands vesper mouse, _C. musculinus_ mentioned in the previous post, although present in southern Bolivia, is unlikely to be the reservoir rodent involved in the current cases. _C. callosus_ mice are the recognized reservoir hosts of Machupo virus. Health officials can provide information about rodent control and assist in implementing it to reduce the risk of exposure to Machupo virus, but effective long-term implementation of rodent control ultimately rests with local residents.

An image of _C. callosus_, the large vesper mouse and reservoir host of Machupo virus, can be seen at

[HealthMap/ProMED-mail map:
Date: Wed 3 Jul 2019 11:53 BOT
Source: La Razon [in Spanish trans. ProMED Mod.TY, edited]

[The Ministry of] Health confirmed that a virus that killed a hospitalized patient and 2 physicians from La Paz is an arenavirus transmitted by rodents. The disease, after 7 days, causes haemorrhagic fever, a symptom presented by the patients hospitalized in intensive care in 2 health centers in La Paz.

One of the viruses in this family is Machupo that causes Bolivian hemorrhagic fever, a disease that, according to hypotheses, is affecting the patients that are under observation, La Razon reported this [Wed 3 Jul 2019] in its printed edition.

"In laboratory terms, from national laboratories such as INLASA [Instituto Nacional de Laboratorios de Salud; National Institute of Health Laboratories] and CENTROP, [Centro de Enfermedades Tropicales; Tropical Diseases Center] they have identified an arenavirus," said Gabriela Montano in a press conference.

The report is also backed by a report from the [US] Centers for Disease Control and Prevention in Atlanta [CDC], Georgia, USA.

"We have a preliminary result from the CDC in Atlanta that also mentions an arenavirus. All of these elements together allow us to provide this information to the public today," the official added.

This virus is transmitted by rodents, specifically called the corn rat or _Calomys musculinus_, and it may also be transmitted person-to-person.  [Byline: Ruben Arinez]
=========================
[Bolivian haemorrhagic fever, caused by Machupo virus, an arenavirus, occurs sporadically in lowland Bolivia, especially in Beni department. There was a case there in 2013 and in 2012, ProMED-mail reported that 13 people had been infected with Machupo virus and 7 had died as a consequence of the disease. In Beni department at that time, 5 municipalities, including Magdalena, were reported to have had large populations of _Calomys callosus_ mice, the reservoir host of Machupo virus, which can cause persistent infections in the mice. It would not be surprising to find cases in lowland areas of La Paz department as well, where the current cases are occurring. The drylands vesper mouse, _C. musculinus_ mentioned above, although present in southern Bolivia, is unlikely to be the reservoir rodent involved in these cases. _C. callosus_ mice are the recognized reservoir hosts of Machupo virus. Health officials can provide information about rodent control and assist in implementing it, but effective long-term implementation ultimately rests with local residents.

An image of _C. callosus_, the large vesper mouse and reservoir host of Machupo virus can be seen at
<http://www.faunaparaguay.com/calomyscallosus.html>.

An image of _C. musculinus_, the drylands vesper mouse, can be seen at
<http://www.faunaparaguay.com/calomysmusculinus.html>. - ProMED Mod.TY]

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

World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."