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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Sun, 15 Mar 2020 23:58:27 +0100 (MET)

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

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

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

Recently, island residents were irate when two warehouses were found to be filled with abandoned supplies, apparently never used after Hurricanes Irma and Maria in 2017.   The storms' one-two punch left Puerto Ricans without power for months and killed nearly 3,000 people, according to the local government's official numbers.   President Donald Trump has accused the Puerto Rican government of incompetence and siphoning off hurricane relief money.   The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Date: Thu, 16 Jan 2020 02:45:27 +0100 (MET)
By Ivelisse RIVERA, con Leila MACOR en Miami

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled.   Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake.   That earthquake toppled houses and caused power outages, but there were no reports of casualties.
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Benin

Benin - US Consular Information Sheet
April 28, 2008

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

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

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

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

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

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

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

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

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

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

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

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

See our information on Victims of Crime.

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

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Northern Mariana Islands

General:
**********************************
Cuba is an independent island country situated in the Caribbean. It is the largest of the islands and covers 42,000sq miles. The climate is sub tropical throughout the year with most of the rainfall in
the northern parts of the country. Temperatures of between 20C to 35C are fairly standard throughout the year. Generally the winter effects of the American continent only last for short periods.
Safety & Security:
**********************************
The majority of tourists visiting Cuba will have no difficulty but bag snatching and other street crime appears to be increasing. The old Havana area and other major tourist resorts may be particular areas of concern in this regard. On arrival be careful to only use your recognised tour operator. If you are taking a taxi at any stage make sure it is a registered one and not a private vehicle. It is unwise to carry large quantities of money or jewellery away from your hotel and try not to flaunt wealth with your belongings. Pickpockets are too common an occurrence on buses and trains and at train stations so be careful with your essential documents and credit cards. Valuables should not be stored in suitcases when arriving in or departing from Havana as there have been a number of thefts from cases during the time the cases are coming through baggage handling. There is an airport shrink-wrap facility for those departing Havana which reduces the risk of tampering. Remember to carry a photocopy of your main documents (passport, flight tickets etc).
Road Safety:
**********************************
Following a number of serious road accidents involving tourists, you are advised not to use mopeds for travelling around Cuba or in Havana. Also, if you are involved in any accident a police investigation will be required to clear you and this may significantly delay your travel plans. On unlit roads at night there have been a number of accidents associated with roaming cattle (sounds like Ireland!). The traffic moves on the right side of the roads. There is a main highway running the length of the country but many of the country roads are in poor repair.
Local Laws & Customs:
**********************************
When arriving into Cuba make sure you are not carrying any items which could be considered offensive. Any illicit drug offense is treated very seriously and Cuban law allows for the death penalty to be used under these circumstances. If you require personal medication for your health, make sure it is in original packing and carry a letter from your doctor describing the medication. Never agree to carry any item for another individual and always secure your cases once they are packed. Taking photographs of military or police installations or around harbours, rail and airport facilities is strictly forbidden.

Currency:
**********************************
Since 1993 it is now possible to use US dollars for all transactions within Cuba. Remember, there is a 20$ airport departure tax. Certain travellers cheques and credit cards may not be acceptable within Cuba. This is particularly true of American Express cheques and cards but check your situation with the travel operator before departure.
Health Facilities:
**********************************
Generally healthcare facilities outside of Havana are limited and many standard medications may not be available. It is important to carry sufficient quantities of any medications which may be required for the duration of your time in Cuba.
Food & Water:
**********************************
The level of food and water hygiene varies throughout the country and between resorts. On arrival check the hotel cold water supply for the smell of chlorine. If it is not present then use sealed bottled water for both drinking and brushing your teeth throughout your stay. Cans and bottles of drinks are safe but take care to avoid pre-cut fruit. Peel it yourself to make sure it is not contaminated. Food from street vendors should be avoided in most cases. Bivalve shellfish are also a high risk food in many countries and Cuba is no exception in this regard. (Eg Mussels, Oysters, Clams etc)
Malaria & Mosquito Borne Diseases:
***********************************************
Malaria transmission does not occur within Cuba and so prophylaxis is not required. However, a different mosquito borne disease called Dengue has begun to reoccur in the country over the past few years. This viral disease can be very sickening and even progress to death. It is rare for tourists to become infected but avoiding mosquito bites is a wise precaution.
Swimming, Sun & Dehydration:
************************************
The extent of the Cuban sun (particular during the summer months (April to October) can be very excessive so make sure your head and shoulders are covered at all times when exposed. Watch children carefully as they will be a significant risk. Drink plenty of fluids to replace what will be lost through perspiration and, unless there is a reason not to,
take extra salt either on your food or in crisps, peanuts etc. Take care if swimming in the Caribbean to stay with others and to listen to local advice. Never swim after a heavy meal or alcohol.
Rabies Risk in Cuba:
**********************************
This viral disease does occur throughout Cuba and it is essential that you avoid any contact with all warm blooded animals. Dogs, cats and monkeys are the most commonly involved in spreading the disease to humans. Don't pick up a monkey for a photograph! If bitten, wash out the wound, apply an antiseptic and seek urgent medical attention.
Vaccinations for Cuba:
**********************************
There are no essential vaccines for entry / exit if coming from Ireland. However, for your own personal protection travellers are advised to have cover against the following;
*
Tetanus (childhood booster)
*
Typhoid (food & water borne disease)
*
Hepatitis A (food & water borne disease)
For those planning a longer or more rural trip vaccine cover against conditions like Hepatitis B and Rabies may also need to be considered.
Summary:
**********************************
Cuba is becoming a popular destination for tourists and generally most will stay very healthy. However commonsense care against food and water borne disease is essential at all times. Also take care with regard to sun exposure, dehydration and mosquito bites.

Travel News Headlines WORLD NEWS

More ...

Afghanistan

Afghanistal US Consular Information Sheet March 03, 2009


COUNTRY DESCRIPTION:


Afghanistan has made significant progress since the Taliban were deposed in 2001, but still faces daunting challenges, including de

eating terrorists and insurgents, recovering from over three decades of civil strife, dealing with years of severe drought and rebuilding a shattered physical, economic and political infrastructure. Coalition and NATO forces under ISAF work in partnership with Afghan security forces to combat Taliban and al-Qa’ida elements who seek to terrorize the population and challenge the government. Violence in 2008 reached unprecedented levels, as both ISAF/Afghan forces and the Taliban initiated more battles than ever before. President Hamid Karzai was sworn in as President of the Islamic Republic of Afghanistan on December 7, 2004 and the Afghan Parliament was subsequently convened in late 2005. The government is working to develop a more effective police force, a more robust legal system, and sub-national institutions that work in partnership with traditional and local leaders to meet the needs of the population. The U.S. works closely with the international community to provide coordinated support for these efforts. An Afghanistan-hosted Peace Jirga with Pakistan resulted in a commitment to cooperate in combating terrorism, facilitate the return of Afghan refugees, and support regional economic activity. Read the Department of State Background Notes on Afghanistan for additional information.


ENTRY/EXIT REQUIREMENTS:


 A passport and valid visa are required to enter and exit Afghanistan. Afghan entry visas are not available at Kabul International Airport or any other ports of entry in Afghanistan. American citizens who arrive without a visa are subject to confiscation of their passport and face heavy fines and difficulties in retrieving their passport and obtaining a visa, as well as possible deportation from the country. Americans arriving in the country via military air usually have considerable difficulties if they choose to depart Afghanistan on commercial air, because their passports are not stamped to show that they entered the country legally. Those coming on military air should move quickly after arrival to legalize their status if there is any chance they will depart the country on anything other than military air. Visit the Embassy of Afghanistan web site at http://www.embassyofafghanistan.org for the most current visa information. The Consular office of the Embassy of Afghanistan is located at 2233 Wisconsin Avenue NW, Suite 216, Washington, DC 20007, phone number 202-298-9125. 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 latest Travel Warning for Afghanistan emphasizes that the security situation remains critical for American citizens. The Taliban and associated insurgent groups, al-Qaida network terrorist organizations, and narco-traffickers oppose the strengthening of a democratic government. These groups aim to weaken or bring down the Government of Afghanistan and to drive Westerners out of the country. They do not hesitate to use violence, including targeting civilians. Terrorist activities may include, but are not limited to bombings -- including improvised explosive devices and car bombs -- assassinations, carjackings, rocket attacks, assaults and kidnappings. There were over 120 suicide attacks in 2008. There is an ongoing threat to attack and kidnap U.S. citizens and Non-Governmental Organization (NGO) workers throughout the country. In 2008,, more than 30 NGO workers were killed (six foreigners) and at least 78 NGO staff members (seven foreigners) were abducted. Over 25 other foreign civilians, including journalists, were kidnapped. Kabul continues to experience suicide bombings against Afghan government personnel and installations, Afghan and coalition military assets, and international civilians. Riots -- sometimes violent -- have occurred in response to various political or other issues. Crime, including violent crime, remains a significant problem. Official Americans' use of the Kabul-Jalalabad, Kabul-Kandahar highways and other roads throughout the country is often restricted or completely curtailed because of security concerns. Insurgents continue to use roadside and car bombs to conduct attacks and abductions along major highways. Millions of unexploded land mines and other ordinance present a constant danger. The country faces a difficult period in the near term, and American citizens could be targeted or placed at risk by unpredictable local events. Americans should not come to Afghanistan unless they have made arrangements in advance to address security concerns. The absence of records for ownership of property, differing laws from various regimes and the chaos that comes from decades of civil strife have left property issues in great disorder. Afghan-Americans returning to Afghanistan to recover property, or Americans coming to the country to engage in business, have become involved in complicated real estate disputes and have faced threats of retaliatory action, including kidnapping for ransom and death. Large parts of Afghanistan are extremely isolated, with few roads, mostly in poor condition, irregular cell phone signals, and none of the basic physical infrastructure found in Kabul or the larger cities. Americans traveling in these areas who find themselves in trouble may not even have a way to communicate their difficulties to the outside world. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.


CRIME:


 A large portion of the Afghan population is unemployed, and many among the unemployed have moved to urban areas. Basic services are rudimentary or non-existent. These factors may directly contribute to crime and lawlessness. Diplomats and international relief workers have reported incidents of robberies and household burglaries as well as kidnappings and assault. Any American citizen who enters Afghanistan should remain vigilant for possible banditry, including violent attacks.


INFORMATION FOR VICTIMS OF CRIME:


The loss or theft abroad of a U.S. passport should be reported immediately to the local police and to the U.S. Embassy in Kabul. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy in Kabul for assistance. The Embassy 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 provide a list of attorneys if needed. The local equivalent to the "911" emergency line in Afghanistan is: 119 Please see our information on Victims of Crime, including possible victim compensation programs in the United States.


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 Afghanistan’s laws, even unknowingly, may be expelled, arrested or imprisoned. During the last several years, there have been incidents involving the arrest and/or detention of U.S. citizens. Arrested Americans have faced periods of detention—sometimes in difficult conditions—while awaiting trial. Penalties for possession or use of, or trafficking in illegal drugs in Afghanistan are severe, and convicted offenders can expect long jail sentences and heavy fines. Another sensitive activity is proselytizing. Although the Afghan Constitution allows the free exercise of religion, proselytizing is often viewed as contrary to the beliefs of Islam and considered harmful to society. Proselytizing may lead to arrest and/or deportation. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.


SPECIAL CIRCUMSTANCES:


Because of the poor infrastructure in Afghanistan, access to banking facilities is limited and unreliable. Afghanistan's economy operates on a "cash-only" basis for most transactions. Credit card transactions are not available. International bank transfers are limited. Some ATM machines exist at Standard Charter Bank and Afghan International Bank (AIB) in the Wazir Akbar Khan neighborhood of Kabul, but some travelers have complained of difficulties using them. International communications are difficult. Local telephone networks do not operate reliably. Most people rely on satellite or cellular telephone communications even to make local calls. Cellular phone service is available locally in Kabul and some other cities, but can be unreliable. Injured or distressed foreigners could face long delays before being able to communicate their needs to family or colleagues outside of Afghanistan. Internet access through local service providers is limited. In addition to being subject to all Afghan laws, U.S. citizens who are also citizens of Afghanistan may also be subject to other laws that impose special obligations on Afghan citizens. U.S. citizens who are also Afghan nationals do not require visas for entry into Afghanistan. The Embassy of Afghanistan issues a letter confirming your nationality for entry into Afghanistan. However, you may wish to obtain a visa as some Afghan-Americans have experienced difficulties at land border crossings because they do not have a visa in their passport. For additional information on dual nationality in general, see the Consular Affairs home page for our dual nationality flyer. U.S. citizens are encouraged to carry a copy of their U.S. passport with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. As stated in the Travel Warning, consular assistance for American citizens in Afghanistan is limited. Islam provides the foundation of Afghanistan's customs, laws and practices. Foreign visitors -- men and women -- are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts. Women in particular, especially when traveling outside of Kabul, may want to ensure that their tops have long sleeves and cover their collarbone and waistband, and that their pants/skirts cover their ankles. Almost all women in Afghanistan cover their hair in public; American women visitors should carry scarves for this purpose. Afghan customs authorities may enforce strict regulations concerning temporary importation into or export from Afghanistan of items such as firearms, alcoholic beverages, religious materials, antiquities, medications, and printed materials. American travelers have faced fines and/or confiscation of items considered antiquities upon exiting Afghanistan. It is advisable to contact the Embassy of Afghanistan in Washington for specific information regarding customs requirements. Travelers en route to Afghanistan may transit countries that have restrictions on firearms, including antique or display models. If you plan to take firearms or ammunition to another country, you should contact officials at that country's embassy and those that you will be transiting to learn about their regulations and fully comply with those regulations before traveling. Please consult http://www.customs.gov for information on importing firearms into the United States. Please see our Customs Information sheet.


MEDICAL FACILITIES AND HEALTH INFORMATION:


Well-equipped medical facilities are few and far between throughout Afghanistan. European and American medicines are available in limited quantities and may be expensive or difficult to locate. There is a shortage of basic medical supplies. Basic medicines manufactured in Iran, Pakistan, and India are available, but their reliability can be questionable. Several western-style private clinics have opened in Kabul: the DK-German Medical Diagnostic Center (www.medical-kabul.com), Acomet Family Hospital (www.afghancomet.com), and CURE International Hospital (ph. 079-883-830) offer a variety of basic and routine-type care; Americans seeking treatment should request American or Western health practitioners. Afghan public hospitals should be avoided. Individuals without government licenses or even medical degrees often operate private clinics; there is no public agency that monitors their operations. Travelers will not be able to find Western-trained medical personnel in most parts of the country outside of Kabul, although there are some international aid groups temporarily providing basic medical assistance in various cities and villages. For any medical treatment, payment is required in advance. Commercial medical evacuation capability from Afghanistan is limited and could take days to arrange. Even medevac companies that claim to service the world may not agree to come to Afghanistan. Those with medevac insurance should confirm with the insurance provider that it will be able to provide medevac assistance to this country. There have been outbreaks of Avian Influenza in poultry in Afghanistan, to include the areas of Nangahar, Laghman, and Wardak provinces, and in the city of Kabul, however, there have been no reported cases of the H5N1 virus in humans. Updates on the Avian Influenza situation in Afghanistan are published on the Embassy’s web site at http://kabul.usembassy.gov/information_for_travelers.html. For additional information on Avian Influenza, please refer to the Department of State's Avian Influenza Fact Sheet available at http://travel.state.gov/travel/tips/health/health_1181.html Tuberculosis is an increasingly serious health concern in Afghanistan. For further information, please consult the CDC's Travel Notice on TB. http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx| The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Afghanistan. However, if one has questions, please inquire directly with the Embassy of Afghanistan at http://www.embassyofafghanistan.org before you travel. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site. For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site. Further health information for travelers is available from the WHO.


MEDICAL INSURANCE:


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


SAFETY AND ROAD CONDITIONS:


 While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Afghanistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance. All drivers face the potential danger of encountering improvised-explosive devices and land mines that may have been planted on or near roadways. An estimated 5-7 million landmines and large quantities of unexploded ordinance exist throughout the countryside and alongside roads, posing a danger to travelers. Robbery and kidnappings are also prevalent on highways outside of Kabul. The transportation system in Afghanistan is marginal, although the international community is constructing modern highways and provincial roads. Vehicles are poorly maintained, often overloaded, and traffic laws are not enforced. Vehicular traffic is chaotic and must contend with numerous pedestrians, bicyclists and animals. Many urban streets have large potholes and are not well lit. Rural roads are not paved. Please refer to our Road Safety page for more information.


AVIATION SAFETY OVERSIGHT:


As there is no direct commercial air service to the United States by carriers registered in Afghanistan, the U.S. Federal Aviation Administration (FAA) has not assessed Afghanistan’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 website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa. U.S. Government personnel are not authorized to travel on Ariana Afghan Airlines or any other airline falling under the oversight of the Government of Afghanistan’s Civil Aviation Authority, owing to safety concerns; however, U.S. Government personnel are permitted to travel on international flights operated by airlines from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA’s International Aviation Safety Assessment (IASA) program.


CHILDREN'S ISSUES:


 For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. R


EGISTRATION / EMBASSY LOCATION:


Americans living or traveling in Afghanistan 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 Afghanistan. Americans without internet 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 in Kabul on Great Massoud (Airport) Road, local phone number 0700-108-001 or 0700-108-002, and for emergencies after hours 0700-201-908. The web site is http://kabul.usembassy.gov/ * * * * * This replaces the Country Specific Information dated June 16, 2008 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties, Special Circumstances, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Mon, 24 Feb 2020 09:00:05 +0100 (MET)

Kabul, Feb 24, 2020 (AFP) - Afghanistan has detected its first novel coronavirus case, the country's health minister said Monday, a day after Kabul announced it would suspend air and ground travel to Iran, where 12 people have died from the outbreak.   "I announce the first positive coronavirus (case) in Herat," health minister Firozuddin Feroz told a press conference, calling on citizens to avoid travel to the western province which borders Iran.
Date: Sat 15 Feb 2020 2:34:10 PM AFT
Source: MENAFN, Afghanistan Times News report [edited]

At least 35 people including women and children have died in the past few weeks due to pneumonia outbreak in Badakhshan Province in the north-western mountainous area, the provincial health department confirmed.

Dr Noor Khawari, head of the provincial public health department, said [Sat 15 Feb 2020] that the people had died in the Wakhan district, a remote area surrounded by high and impassable mountains.

He said that 15 of the dead were children, calling malnutrition and cold weather as the main reasons for the fatalities. A medical team had been dispatched to Wakhan to prevent further outbreak of the disease, according to Dr Khawari.

The provincial council had earlier said that at least 10 people had lost their lives since an unknown disease had broken out in the Yomgan district [Badakhshan Province].

The report caused panic and concerns among the residents as coronavirus [infection, COVID-19] in China that borders Badakhshan takes the lives of people every day.

But the ministry of public health denied outbreak of any unknown disease in Badakhshan, saying that the recent deaths happened only due to pneumonia and pertussis (whooping cough) as well as malnutrition. Badakhshan is one of the provinces where seasonal diseases like pneumonia and whooping cough break out during winter. The diseases claim the lives of people in the remote areas behind high mountains as the roads connecting them to the provincial capital are blocked by heavy snowfalls.

The provincial health department has deployed medical teams to the borders with China and Tajikistan to examine those entering from the neighbouring states and to prevent coronavirus [infection, COVID-9].
===========================
[We are told in the news report above that at least 35 people, including 15 children, died in the past few weeks due to a "pneumonia" outbreak in Wakhan district, a remote area surrounded by high and impassable mountains, with a population of about 14 000 residents. Wakhan is a narrow strip about 350 km (220 mi) long and 13-65 km (8-40 mi) wide that extends from Badakhshan Province in Afghanistan in the west to Xinjiang Autonomous Region in China in the east, separating the Pamir Mountains and Tajikistan to the north and the Karakoram Mountains and Pakistan to the south  (<https://en.wikipedia.org/wiki/Wakhan_Corridor>).

A trade route through this valley has been used by travellers since antiquity
(<https://caravanistan.com/afghanistan/wakhan-corridor/>).

A map of this region can be found at

The local residents are concerned that the novel coronavirus infection, COVID-19, may be the cause of the outbreak of pneumonia in Wakhan district. There are about 70 500 total cases of COVID-19 in China, mainly concentrated in Hubei Province in Central China.

Although Xinjiang in Western China has reportedly 75 confirmed cases of COVID-19 and 1 death (assessed 16 Feb 2020 at 9:43 PM EST) (<https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6>), spread of COVID-19 to this very remote region in Afghanistan, that is easily cut off from the rest of the world especially in winter, seems unlikely. Also, 43% of deaths (15/35) occurred in children, which would be unusual for COVID-19. However, we are not told the clinical presentation of the illness, nor how a diagnosis of "pneumonia" was made in this undeveloped region. Other diagnoses, such as influenza, are also possible. More information from knowledgeable sources would be appreciated. - ProMED Mod.ML]

[Maps of Afghanistan:
Date: Wed 11 Dec 2019
Source: MENA FN [edited]

Officials in the Ministry of Public Health has said that 2 fresh positive cases of polio have been registered in southern Uruzgan [Oruzgan] and northern Baghlan provinces.

According to health officials, the families of the polio-affected children live in Dand-e-Ghori [Dahana-i-Ghori] and Khas Uruzgan districts, [respectively], and the areas were out of the government's control and deprived of medical facilities.

Dr. Abdul Qayum Khplwak, head of the medical institute for the southern part of Afghanistan, said that one of the 2 children has been deprived of polio vaccination in Khas Uruzgan district of the province. He said that despite tremendous efforts towards fighting polio, there are great obstacles against the implementation of the process.

"Until every child receives polio vaccination, our efforts would not reach a complete goal," he said, adding that "the fresh case in Uruzgan shows that southern provinces are facing serious polio threats."

Meanwhile, a local medical in charge for polio affairs in Baghlan, Marjan Rasikh, has put the age of the polio-affected child at 4 years old, saying that the case has marked the initial positive polio in the province.

Over 24 positive polio cases have been recorded from the beginning of 2019: more than 8 cases in Uruzgan, 5 in Helmand, 4 in Kandahar, 2 in Paktia, and 3 other cases in Badghis, Nangarhar, and Kunar provinces.

To prevent the positive cases of polio, the health officials said that anti-polio vaccination should be implemented across the country.
===================
[The addition of these 2 newly confirmed cases will increase the total number of cases reported from Afghanistan with dates of onset during 2019 to 24. There was a newly confirmed case from Kandahar reported in last week's GPEI (Global Polio Eradication Initiative) report with date of onset 10 Nov 2019.

Again, the common denominator in the occurrence of WPV1 (wild poliovirus type 1)-associated AFP (acute flaccid paralysis) cases (presumed to be WPV cases) and in cVDPV (circulating vaccine-derived poliovirus)-associated cases is the presence of a significant susceptible population, or, in other words, areas with suboptimal vaccination coverages.

A map of Afghanistan showing provinces can be found at
The HealthMap/ProMED-mail map of Afghanistan can be found at
Date: Mon 2 Dec 2019
Source: China.org.cn, Xinhua News Agency report [edited]

One fresh polio case had been detected in Afghanistan's southern Kandahar province, a local newspaper reported on [Mon 2 Dec 2019].

"With this new case, the total number of polio cases in 2019 reaches 22 in the country. The latest polio case has been reported from Kandahar city, capital of Kandahar province which permanently paralyzed an 18-month-old child," Daily Afghanistan-e-Ma reported.

The paper added that polio is a crippling and potentially fatal infectious disease.

"Most of the Afghan children affected by poliovirus this year [2019] are living in areas where kids do not have access to health facilities and regular anti-polio vaccination campaign. However, this time a child has been affected in a large city where anti-polio vaccination had been conducted repeatedly this year," the report said.

There is no cure for polio and the polio vaccine is the only safe and effective way to protect children.

The ongoing conflicts have been hindering the efforts to stamp out the infectious disease in the mountainous country.
===================
[The addition of 3 newly confirmed cases of polio (all 3 due to WPV1, as per End Polio Pakistan <https://www.endpolio.com.pk/polioin-pakistan/polio-cases-in-provinces>) in Pakistan and one newly confirmed case of polio in Afghanistan brings the total number of WPV1 associated cases with date of onset in 2019 to 116 (94 in Pakistan and 22 in Afghanistan). The key question here is whether Afghanistan and Pakistan, with all the challenges in vaccinating the susceptible populations due to a variety of anti-vaccination impediments, will be able to interrupt transmission of the WPV1 in both countries simultaneously.

Maps of Afghanistan:
and <http://healthmap.org/promed/p/137>. - ProMED Mod.MPP]
Date: Sun 1 Sep 2019
Source: MENAFN - Afghanistan Times [edited]

Two new polio cases have surfaced separately in capital city of Tirinkot and Chora district of southern Uruzgan [Oruzgan] province, a statement from the relevant ministry said [Sun 1 Sep 2019].

A 30-month-old child and another 6-month-old infant were permanently paralyzed as a result of the polio virus.

According to a statement issued by the Ministry of Public Health (MoPH), the total number of polio cases in 2019 reached 15 with the 2 new cases, saying all of these cases had been reported from inaccessible areas.

"Of the 15 polio cases this year [2019], 14 have been reported from the southern region of Afghanistan,' the statement said, adding "7 positive cases came from [Oruzgan], 5 from Helmand, and 2 other from Kandahar."

Only 1 out of 12 polio cases was reported from eastern Kunar province while the rest happened in the southern zone.

"Access to health services is the right of every citizen of the country," said Dr Ferozuddin Feroz, the Minister of Public Health. "We are deeply concerned about the increasing polio cases and the number of children who still don't have consistent and proper access to vaccination," he added.

He said the virus could spread further in the country and more children would be affected and paralyzed by polio virus.

He called upon people to 'work together and protect innocent children against polio and facilitate a safe and secure environment for our frontline workers in order to enable them administer vaccine drops to children in every nook and cranny of the country."

Polio is a crippling and potentially fatal infectious disease. There is no cure and the vaccine is the only safe and effective way to protect children.

The polio vaccine is safe and harmless for new-born children whether they are sick or not. It is very important that new-borns and sick children get the vaccine because they may have lower immunity which makes them more susceptible to the virus.

Polio vaccination has also been strongly endorsed by national and global Islamic scholars.
========================
[As I mentioned in the moderator comment of the last post (Poliomyelitis update (71): global (Pakistan, Congo DR) http://promedmail.org/post/20190901.6651501), "While there have been no newly confirmed cases reported from Afghanistan this week nor have there been positive environmental samples reported from either Pakistan or Afghanistan, it doesn't mean the virus is not still circulating, just that there aren't new confirmations." Unfortunately there were cases under investigation.

As correctly stated in the media report above, the addition of these 2 newly confirmed cases brings the number of confirmed WPV1 cases reported by Afghanistan during 2019 to date to 15.

Oruzgan is located in the central part of Afghanistan, sharing southern and southwestern borders with Kandahar and Helmand provinces where other polio cases have been reported this year (2019) as well (<http://www.lib.utexas.edu/maps/middle_east_and_asia/afghanistan_admin-2009.jpg>).

HealthMap/ProMED-mail map of Afghanistan:
More ...

Travel News Headlines WORLD NEWS

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British Virgin Islands

British Virgin Islands US Consular Information Sheet
February 26, 2009
COUNTRY DESCRIPTION:
The British Virgin Islands (BVI) are a British overseas territory, part of the British West Indies, lying about 60 miles east of Puerto Rico.
here are about 50 islands in the BVI, many of them uninhabited.
Tortola is the main island; other islands include Virgin Gorda, Jost Van Dyke, and Anegada.
Tourist facilities are widely available. Read the Department of State Background Notes on the United Kingdom for additional information.
ENTRY/EXIT REQUIREMENTS:
The Intelligence Reform and Terrorism Prevention Act of 2004 requires all travelers to and from the Caribbean, Bermuda, Panama, Mexico and Canada to have a valid passport to enter or re-enter the United States. U.S. citizens must have a valid U.S. passport if traveling by air, including to and from Mexico.
If traveling by sea, U.S. citizens can use a passport or passport card.
We strongly encourage all American citizen travelers to apply for a U.S. passport or passport card well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

As of June 1, 2009, sea travelers must have a valid U.S. passport or passport card.
While a U.S. passport is not mandatory for sea travel to the BVI, it is required to return to the U.S.
In addition to other documentary requirements, U.S. Citizens should also present onward or return tickets, and sufficient funds for their stay.
Upon initial entry, no more than 60 days will be granted.
At the end of 60 days, visitors must report to the Immigration Department's main office in Road Town for an extension.
Extensions of up to 90 days are issued at the discretion of the Immigration Officer subsequent to an interview.
Visitors entering the BVI by yacht during daylight hours are required to proceed directly to a port of entry and clear immigration controls.
Visitors arriving by yacht outside of business hours should register with Immigration at opening of business the following business day.
Failure to comply with these regulations can lead to heavy fines or imprisonment.

Visit the Embassy of the United Kingdom’s web site at http://www.britainusa.com for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website at http://travel.state.gov, where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, 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:
Thefts, armed robberies, and other violent crimes do occur in the BVI.
Visitors should take common-sense precautions against petty crime.
Travelers should avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents.
Do not leave valuables unattended on the beach or in cars, and do not leave them in plain view in rental properties.
Always lock up boats when going ashore.

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

The local equivalent to the “911” emergency line in the BVI is: 999 or 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care in the BVI consists of a small general hospital, Peebles Hospital (Telephone (284) 494-3497), with an emergency room staffed 24 hours a day by physicians, several clinics on Tortola, and one clinic in Virgin Gorda.
Both islands are served by ambulances staffed with paramedics.
There are no medical facilities on the other islands.
A volunteer organization, Virgin Islands Search and Rescue (VISAR), responds 24 hours a day to medical emergencies at sea or on outer islands.
VISAR transports casualties to the nearest point for transfer to ambulance.
To reach VISAR, dial SOS (767) or call on Marine Channel 16.

There is no hyperbaric chamber in the BVI.
Patients requiring treatment for decompression illness are transferred to St. John, U.S. Virgin Islands.
Most sensitive medical cases are transferred to San Juan, Puerto Rico.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of the BVI.
Anyone who does not appear to be in good health may be required to undergo a medical exam, including HIV test, prior to being granted or denied entry.
Please verify this information with the Embassy of the United Kingdom at http://www.britainusa.com before you travel.
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 the British Virgin Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Vehicles drive on the left (the British side) with most steering wheels on the left (the “American” side).
Road signs are limited and seatbelts are required by law.
Drivers often fail to yield the right-of-way to pedestrians, even at painted crosswalks.
Speeding and reckless driving are fairly common in the BVI.
Drivers can encounter nighttime drag racing on main thoroughfares and livestock on roads.
Roads in Tortola's interior can be steep and extremely slippery when wet.
Travelers planning to drive across the island should consider requesting four-wheel drive vehicles and should ensure that tires and brakes are in good operating condition on any rental vehicle.
Please refer to our Road Safety page for more information, as well as the BVI Tourist Board web site.
AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the British Virgin Islands fall under the jurisdiction of British authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the UK’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
The removal of any marine organism from BVI waters is illegal for non-BV Islanders without a recreational fishing permit.
Fishing without a permit, even for sport, may lead to heavy fines or imprisonment.
Contact the Ministry of Natural Resources and Labour at (284) 468-3701 ext. 2147 for information.
Please see our Customs Information sheet..

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the British Virgin Islands are encouraged to register with the the U.S. Embassy in Bridgetown, Barbados through the State Department’s travel registration website so that they can obtain updated information on travel and security within the BVI.
Americans without Internet access may register directly with the 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 the Wildey Business Park in St. Michael, Barbados.
The Consular Section can be reached by telephone at 1-246-431-0225, by fax at 1-246-431-0179, contact them by e-mail.
* * * * * * *
This replaces the Country Specific Information for the British Virgin Islands dated April 2, 2008 to update sections on Entry/Exit Requirements, Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat, 16 Sep 2017 22:00:48 +0200
By Cécile AZZARO

Pointe-à-Pitre, Sept 16, 2017 (AFP) - The French-Dutch island of St Martin, where white sands and turquoise waters once drew foreign visitors in droves, is now attracting a different kind of population: rats and mosquitoes.   Just over a week after Hurricane Irma devastated the island and neighbouring St Barthelemy, killing 15 people, pools of stagnant water and mounds of trash seem to be the new normal.   Add to that the absence of fresh running water, and the situation is ripe for a health epidemic.   "Yes, there are risks of outbreaks," said Annick Girardin, the French minister for overseas affairs, who spent a week on St Martin following the Category five storm.   "There is an existing problem on the issue of contaminated water, the issue of trash, basically the issue of hygiene."

In poorer neighbourhoods where many families were not able to evacuate, residents fear the spread of mosquitoes -- which can carry diseases ranging from Zika and dengue fever to Chikungunya.   "My son has a fever maybe due to a mosquito," said Natacha, a resident in the Sandy Ground neighbourhood near Marigot. "We will have to clean to prevent too many mosquitoes, or else there will be outbreaks. But it's difficult without water."   "If we get sick, we'll have to go to Guadeloupe".   According to an AFP journalist, in some neighbourhoods like Concordia, control programs had begun on Wednesday.

- Boiling water -
The island, which is still struggling to get its electricity and telecommunications systems back up and running, has found it difficult to reach residents and warn them about the potential health risks.   To get the word out, the French government has distributed notices and posters in French, Spanish, English and Creole.

Still, French health minister Agnes Buzyn said, "We realise there are people on the island, in certain neighbourhoods, who are not following health instructions".   One of the most important notices reminds people that only bottled water is safe to consume, and that if it is unavailable, boiling water before use is paramount.   "We hand out fresh water all over the territory, but it remains difficult," Buzyn said. "There are zones not easily accessed, people that maybe we haven't been able to reach."   According to the government, 150,000 bottles of water are being distributed to residents every day.   But some people have still been fetching water directly from a reservoir.

A desalination plant destined for St Martin arrived Friday on Pointe-a-Pitre, on the French island of Guadeloupe, about 300 kilometres (185 miles) away.   It will continue its journey to the hurricane-hit island by barge and is expected to be operational by September 25, the authorities said.   Meanwhile drinking water has returned to St Barts, which is now able to produce about 800 cubic metres (176,000 gallons) a day.   "We are not yet at a level of signalling an outbreak, far from it," Buzyn said. "Today, it's mostly an individual risk, which means it is essential that people who live on St Martin drink the bottled water that is distributed".   Buzyn had said last Wednesday that there had been some cases of children with diarrhoea, but did not mention any signs of an outbreak.

- Racing the clock -
Medical epidemiologists are aware of and on the lookout for any sign of outbreaks, and will regularly track patients using health surveys, said Guadeloupe's public health director Patrice Richard.   On Saturday, St Martin's health services coordinator Sergio Albarello said there had been no cases of outbreak on the island.   "As of now, there have been no reported cases" of outbreak, he told reporters, adding that as far as mosquitoes, "we are not talking about carriers of genes that are epidemiologically relevant".   And while many buildings were flattened by the storm, the St Martin hospital is still able to treat people "in excellent conditions", even though one of its buildings was partially destroyed.   Philippe Gustin, the French envoy in charge of the islands' reconstruction, said the immediate plan was to fix the damaged buildings.

According to Gustin, about 30 percent of the buildings on the French side of the island were completely destroyed, but he cautioned that teams were still putting together a final estimate of damages -- which has been put at one billion euros ($1.2 billion) or more for roads and buildings.   But repairing them before the high season, which usually starts in November and runs until April, seems nearly impossible.   Cleaning up also remains a priority for St Martin, particularly in areas where rats could proliferate.   Home to some 35,000 people, St Martin -- whose livelihood rests almost entirely on tourists -- attracts around two million visitors a year, most of them American cruise ship passengers.   While visiting St Barts this past week, French President Emmanuel Macron promised emergency financial aid for those "who have lost everything".   As for the Dutch side of the island, the Dutch Red Cross said Saturday that it had collected 13.3 millions euros following a weeklong donation drive.
Date: Tue, 12 Sep 2017 16:18:07 +0200

London, Sept 12, 2017 (AFP) - Over 100 high-risk prisoners escaped in the British Virgin Islands during Hurricane Irma, a British junior minister said on Tuesday, as he raised the death toll in British territories to nine.   "We had a serious threat of a complete breakdown of law and order in the British Virgin islands (BVI)," junior foreign minister Alan Duncan told parliament.   "The prison was breached, over 100 very serious prisoners escaped," he said.

Duncan said Royal Marines were deployed to cope with the threat but did not disclose how many prisoners had been recovered or how many were still at large.   "We have maintained and kept law and order on the BVI, which at one point, could have dramatically threatened the already unfortunate plight of those who had been hit by the hurricane," he said.   Contacted by AFP, the foreign ministry declined to comment.

The Daily Telegraph said notes from a cabinet meeting that were leaked to the press on Tuesday suggested as many as 60 had yet to be recaptured.   "We are working with St Lucia and BVI authorities to secure the transfer to St Lucia of 40 high-risk prisoners that have escaped in BVI," the briefing notes were reported as saying.   Duncan said a total of nine people died in British Caribbean territories -- five in the BVI and four in Anguilla. The authorities had previously reported one person killed in Anguilla.

Britain's response to Irma has been criticised by some local inhabitants as too slow with some complaining about a breakdown of law and order and being left to fend for themselves.   Briton Claudia Knight said her partner Leo Whitting, 38, was stranded on the island of Tortola in the British Virgin Islands archipelago.   "Everyone's turned feral and no-one's going out without being armed... It's turning really nasty," she told the Press Association news agency.   "Leo carries a knife with him," she said.   But Duncan said he "wholeheartedly and comprehensively reject the criticism".   "I think they are unjustified," he added.
Date: Mon 13 Jan 2014
Source: Government of the British Virgin Islands [edited]

The Ministry of Health and Social Development has confirmed 3 cases of chikungunya [virus infections], following reports of confirmed cases in St Martin and increased surveillance throughout the Virgin Islands. Dr Ronald Georges, medical officer of health in the Ministry of Health and Social Development said, "We have confirmed 3 cases on Jost Van Dyke."

Chikungunya is a viral disease transmitted to humans by the bite of infected mosquitoes.

"It is important to note that these confirmed cases were not exposed to travel, which alerts us that the virus is already in our mosquito population," Dr Georges stated.

According to Dr Georges, the ministry has been coordinating a response with the Environmental Health Division to minimise the impact of chikungunya [virus infections]. He is reminding the public to take appropriate measures to minimise exposure to mosquitoes. As such, the health division has stepped up its fogging programme and will be addressing "hotspot" areas known for mosquito breeding.

Dr Georges explained that chikungunya [virus infection] causes symptoms similar to dengue fever, which last 2-5 days. Symptoms include rash, arthritis-like pain affecting multiple joints, headaches, conjunctival infection, back pain, nausea, vomiting, polyarteritis, and a fever of 102 deg F [39 deg C] or higher. "Anyone experiencing one or more of these symptoms should contact their healthcare provider immediately," he said, adding, "Persons are urged to be vigilant in inspecting their premises for mosquito breeding sites."

He said that measures should also be taken to keep mosquitoes out of homes for example: removing catchment of still water, cover containers storing water, and more importantly necessary precautions should be taken to protect babies by placing a protective net over cribs. In addition the use of insect repellent on adults and children is also useful.

Clinicians and health care providers are asked to continue to report syndromic data to the Surveillance Unit in the Ministry of Health and Social Development, especially fever surveillance within 24 hours for continuous monitoring.

The Environmental Health Division will continue surveillance and control measures at ports of entry. However, residents are asked to remain vigilant in preventing mosquitoes from breeding around their homes and businesses.
------------------------------
communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
==================
[Spread of chikungunya virus to other islands continues. In the absence of a commercially available vaccine, mosquito vector control and avoidance of mosquito bites are the only preventive measures that can be taken as noted in the report above. Fogging provides no long-term vector control. Breeding sites must be eliminated or treated with larvicides for effective control. That requires public cooperation and participation. Arrival of chikungunya virus in the dengue virus endemic areas of mainland Americas is probably more a matter of "when" than of "if".

Maps of the British Virgin Islands can be accessed at
Date: Wed, 15 Oct 2008 14:38:28 +0200 (METDST) MIAMI, Oct 15, 2008 (AFP) - Hurricane Omar moved toward the Virgin Islands Wednesday gaining power as warnings were issued across the Caribbean over the latest storm. With its center around 310 miles (495 kilometers) southwest of Puerto Rico's capital San Juan, the US National Hurricane Center said: "Additional strengthening is forecast in the next 24 to 36 hours." The hurricane -- with maximum sustained winds of near 120 kilometers (75 miles) per hour -- was moving slowly northeast toward San Juan. Hurricane warnings were issued for the US Virgin Islands, the British Virgin Islands, Saint Martin, Anguilla and Saint Kitts. "A hurricane warning could be required for Puerto Rico Wednesday morning," the NHC said. On the forecast track, the center of Omar was expected to move over or near the Leeward Islands -- just east of Puerto Rico -- by late Wednesday, the NHC said. Authorities also issued a hurricane warning for the French resort island of Saint Barthelemy, and tropical storm warnings for Antigua, Barbuda and Montserrat. Heavy rain was already falling across far northern Venezuela, where it could produce total rainfall of up to 15 centimeters (six inches), the NHC said. Up to 51 centimeters (20 inches) of rain "will be possible across Puerto Rico and the northern Leeward Islands," the NHC said. "These rains could produce life-threatening flash floods and mud slides," it warned. The busy 2008 hurricane season has included devastating Hurricanes Gustav and Ike, which caused millions of dollars in damage in Haiti, Cuba and the United States. Hurricanes and tropical storms have killed hundreds across the Caribbean and Mexico, with Haiti the worst hit.
Date: July 2008 Source: CAREC Surveillance Report - Communicable Diseases Vol. 28 No. 4 [edited] During epidemiological weeks 1-24, 2008, dengue virus type 2 was identified in the British Virgin Islands, Cayman Islands, Dominica, Grenada, St. Lucia and Trinidad & Tobago. Dengue virus type 4 was also identified in the British Virgin Islands, and virus type 1 was identified in Anguilla and Antigua & Barbuda. ------------------------ [This brief report does not indicate which of the islands had only imported dengue cases and which had local dengue virus transmission. As of mid-December 2007, the Cayman Islands only had imported dengue cases and had mounted an active surveillance and mosquito vector control campaign (see ProMED archive no. 20071218.4074). It would be interesting to know whether the 2008 cases were also all imported cases. An interactive ProMED HealthMap showing the location of the Cayman Islands can be accessed at: . - ProMed Mod.TY]
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Saint Helena

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Travel News Headlines WORLD NEWS

Date: Wed, 22 Nov 2017 14:01:02 +0100
By Beatrice DEBUT

Jamestown, Nov 22, 2017 (AFP) - Cut off from the rest of the world for centuries, St. Helena, which lies isolated in the middle of the Atlantic Ocean, is now reachable by plane for the first time.   The aviation breakthrough promises to lift the British-run territory from obscurity and bring it within reach of international tourists.   The arrival of the first commercial flight was also a relief for islanders frustrated by a delay to the opening because of high winds.

After years of procrastination, London gave the green light in 2011 a full runway on the island.    The ambition was to bring it within six hours of mainland Africa instead of the five days previously needed to make the ocean voyage from Cape Town.   British officials hoped that 30,000 tourists a year would visit the island, which is home to just 4,500 residents -- known as "Saints".   Just don't expect white sandy beaches and palm trees.

Rather, the island is known as a paradise for hikers and divers with dramatic scenery and its volcanic origins, and boasts history as rich as its flora and fauna.   The British have detained various opposition forces on the island over the centuries, including the defeated Napoleon after the Battle of Waterloo who died in exile on St. Helena in 1821.   It was also temporarily home to 25,000 former slaves after they were released in the 19th century on the island, which lay on the slave-trading route from Africa to America and the Caribbean.

- 'We had already invested' -
Encouraged by London's upbeat estimates, islanders began investing in tourism, sensing an opportunity in an economy where the average annual salary is just £7,280 (8,150 euros, $9,600).   Local businessman Johnny Herne runs a pleasure boat that he imported from Scotland 8,000 kilometres (5,000 miles) away on which guests can spot humpback whales and dolphins along the craggy coastline.   He has so far invested £182,000 in his business but now is drowning in debt as a result of the airport delay, which he says contributed to his divorce.   "It ruined my life," he said.

Entrepreneur Paul Hickling produces a cactus liqueur and a local coffee and has invested more than £100,000.   "The government said: 'Invest because the airport is coming... all these people are going to come'," he said.   "Unfortunately the airport got delayed -- but we had already invested the money."   In April 2016, just three weeks before the £285-million airport's grand opening, disaster struck.   Unforeseen winds meant that takeoffs and landings were ruled too dangerous, leaving islanders dismayed.

- 'Big relief' -
Hazel Wilmot, a hotelier in the capital Jamestown, had had large quantities of food and drink shipped to St. Helena and her property was fully booked.   But with the delay, tourists cancelled their trips.   "I had four containers at sea full of food, full of booze that I could not use," she said. In 2016 she says she lost at least £200,000.    Local officials set up a scheme to help businesses affected by the delay -- but no one has yet claimed, according to the island's trade board.

But overly strict criteria and a complex claiming process have deterred claimants, locals say.   After the 18-month delay, the first commercial flight finally touched down on October 14 this year.   A sense of euphoria swept through the cabin as champagne was served and the island edged into view. On the ground, islanders celebrated the long-awaited arrival.   "It was a big relief when the airport finally opened. It has not been easy," said Craig Yon, a manager of a hotel that opened in 2012.

- 'Not going to stop' -
But the island may never experience a tourism boom on the scale that was promised.   For safety reasons, the passenger capacity of the aircraft serving the island is far smaller than planned.   And the single weekly flight from Johannesburg will serve the island at a cost of about £800 return.   "South Africans would prefer to go for three weeks in Thailand than to go to St. Helena," said one South African travel agent, who organises trips to the island.   For this Christmas, Wilmot has just five bookings so far.    "Where are all these tourists we were told were going to swamp the island?" she said.   Tourism chief Helena Bennett now thinks the goal of 30,000 visitors was "unrealistic" -- indeed the small plane can bring less than 4,000 people, including residents, to the island each year.

Even today, the island has just 121 guest beds including a new hotel funded by the local government.   None of the properties have a website, while roads are so small that often only one car can pass.    But with the air link, the flow of tourists will at least be more constant.    "During the two-week period when the Royal Mail Ship is away, the island is dead," said Bennett, referring to the passenger and cargo vessel that calls at the island.   "With the plane, we are going to have visitors every week. The island is not going to stop anymore."
Date: Sat, 14 Oct 2017 22:35:34 +0200
By Beatrice DEBUT

Jamestown, Oct 14, 2017 (AFP) - The first regular commercial flight landed at St. Helena Saturday, opening the small British island in the South Atlantic to the world after centuries of isolation.   Around 100 islanders came out to the airport to watch the historic landing of the Embraer 190 jet which came from Johannesburg.   On the tarmac, some 60 incoming passengers were welcomed by the island's smiling governor, Lisa Phillips.   "It is connecting us to the world and it is opening us to the world," said Niall O'Keeffe, in charge of economic development on the island.

St. Helena, with just over 4,000 residents known as "Saints", is best known as the rocky outcrop where French emperor Napoleon Bonaparte saw out his final days.   After five years of construction, controversy and embarrassing delays due to high winds, the airport built at a cost of £285 million (318 million euros) finally opened for business.   "It will bring in tourists and we will be able to get a better standard of living," said Phillips.

The volcanic tropical island itself measures just 122 square kilometres (47 square miles) and is located almost exactly halfway between Africa and South America.   Its isolated location meant it was chosen as a place of exile for those who suffered defeat at the hands of the British,  with Napoleon held there from 1815 until his death in 1821.

Several thousand Boer prisoners of war were also detained there at the start of the 20th century.   Until Saturday, St. Helena was one of the world's most inaccessible locations.   It has been only reachable by sea, a five-day voyage from Cape Town aboard a Royal Mail vessel that chugs along at a speed of just 15 knots (28 kilometres an hour).   Every three weeks, the RMS St. Helena has been the islanders' link to the outside world, bringing a cargo of food, post, visitors and vehicles.

- Major engineering challenge -
The new flight route, via Windhoek in Namibia, makes the island reachable by air from South Africa in just six hours.   The airport has been a colossal civil engineering challenge.   The island had no suitable flat surface to construct the necessary 1,950 metre-long airstrip.   Engineers were forced to chip away a mountain peak and fill in a valley to create enough of an even surface.   The runway is located on a breathtaking mountain just 300 metres from the sea.   Because of high winds, Comair abandoned plans to operate the route with a Boeing 737, paving the way for AirLink's smaller Embraer 190 jet.

- High winds setback  -
The winds meant that the airport could not be opened in 2016 as originally planned with a ribbon-cutting by Prince Edward, Queen Elizabeth II's youngest son.   The conditions made take-offs and landings much more difficult than expected and just weeks before the scheduled ceremony, it was cancelled and the airport became practically unused.   After more than a year of test flights and studies, the decision was taken to use the Embraer 190.   The island will be served by a weekly service from Johannesburg costing about £800 return ($1,060). The average salary on St. Helena is just £7,280.   "It's more expensive that a flight to London" from South Africa, said
Jacqui Wilson, who saved up to take the "historic" flight.

But on the personal side people are just so glad there is an airport.   "Now we will be able to go home more often. Our family and friends will be able to visit, which is very great," said Catherine Man, the only veterinarian on the island.:   It is also hoped that the air link will help reduce the island's dependence on aid from London which cost the British taxpayer £53.5 million in 2015 alone.   When the RMS St. Helena is retired from service next year, the island will become almost completely dependent on its airport.   But with its Napoleonic heritage, rare birds and exotic plant life, hopes are high that the island will become a nirvana for curious travellers.
Date: Mon 19 Sep 2016, 9:23 AM
Source: Today [edited]

There has been a noticeable increase in cases of hand foot and mouth disease, the Collective Prevention Services (CPS) says in a press release and urges parents and guardians, day care centres and play schools to be on alert for an increase in clusters of the disease amongst the school population. CPS advises to take extra measures to prevent outbreaks by washing of hands often with soap and water.

Hand foot and mouth disease is a common viral illness that usually affects infants and children who are 10-years of age or younger. It can sometimes occur in adults. There is no vaccine to protect against the viruses that cause it.

People with symptoms should consult their family physician and take measures to mitigate an increase in the number of cases.

Symptoms include cold-like conditions, fever, mouth sores, loss of appetite, cough, and a skin rash; a non-itchy red rash that develops on the hand and the feet, and sometimes the rash can develop into painful blisters; painful mouth ulcers.
=====================
[The causative agent for hand foot and mouth disease (HFMD) is an enterovirus. It is not the same as other diseases that have similar names: foot-and-mouth disease (sometimes called hoof-and-mouth disease). See previous ProMED post Hand, foot & mouth disease - USA (04): (CA) http://promedmail.org/post/20160505.4204778 for a discussion of HFMD.

[A map of St. Maarten in the Caribbean can be accessed at
Date: Fri, 15 Jul 2016 16:14:56 +0200

Johannesburg, July 15, 2016 (AFP) - The mail boat that is the only link to St Helena, one of the world's most remote islands, has had its retirement delayed after a new airport failed to open due to dangerous winds.   The airport, constructed between soaring mountains and the South Atlantic Ocean, was designed to boost tourism and revive the community on the British territory where Napoleon was exiled and died in 1821.

But the 250-million-pound ($330 million) facility has been closed indefinitely for more data to be gathered after the first test flights in April measured severe air turbulence.   The RMS St Helena mail boat, which was due to be decommissioned this year after the airport's scheduled opening, takes about five days to reach the island from Cape Town.

The St Helena government said Friday that the boat would be kept in service until at least July 2017.   "Intensive work continues to mitigate wind conditions experienced at St Helena Airport," it added in a statement. "Getting this right will take some time."   Located nearly 2,000 kilometres (1,200 miles) from the African coast, St Helena has about 4,200 residents, one bank, and no cash machines.   A mountain ridge had to be lowered and a small valley filled in during the construction of the airport.
Date: Thu, 28 Apr 2016 14:25:36 +0200

Johannesburg, April 28, 2016 (AFP) - The opening of an airport on St Helena, one of the world's most remote islands, has been postponed indefinitely after test flights revealed dangerous wind conditions, officials said Thursday.   The airport, constructed between soaring mountains and the South Atlantic Ocean, was designed to boost tourism and revive the community on the British territory where Napoleon was exiled and died in 1821.   An opening ceremony to be attended by Prince Edward, the Earl of Wessex, had been scheduled for next month to mark the start of weekly commercial flights from Johannesburg, four and half hours away.   But the 250-million-pound ($360 million) airport will remain closed after a test flight last week measured severe turbulence and wind data.

The only way to reach the island is a five-day journey by sea from Cape Town by a mail boat that is due to be decommissioned this year.   "It is quite a disappointment, but when you are talking about airports, everything revolves around safety," Ian Jones, the St Helena government spokesman, told AFP, speaking from the island's capital Jamestown.   "There are some side winds and wind shear that we knew about, but it is not until you land a full-size aircraft that you fully understand the conditions.   "We did not realise how serious it was."   Jones said the airport had no new opening date, but analysis of wind data, new observational equipment and adjustments to the approach route would be considered to enable the runway to open.

An amateur video on the Internet showed the Boeing 737 test flight aborting its first landing attempt seconds before touchdown and climbing steeply back into the air.   "Difficult wind conditions, including turbulence and windshear, are encountered and safely managed at many airports around the world," the island's government said in a statement.   "Everyone involved remains committed to commencing commercial flights to and from St Helena at the earliest possible opportunity."   A mountain ridge had to be lowered and a small valley filled in during the construction of the airport, which has a 1,950-metre long runway.   It was first due to open in February, but building work was not yet completed.   Located nearly 2,000 kilometres (1,200 miles) from the African coast, St Helena has about 4,200 residents, one bank, and no cash machines.
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World Travel News Headlines

Date: Sat, 4 Apr 2020 16:10:44 +0200 (METDST)

London, April 4, 2020 (AFP) - Britain on Saturday reported 708 more deaths from COVID-19 in a new daily high, as the number of confirmed cases rose to nearly 42,000.   The health ministry said 4,313 people who tested positive for the virus in hospital had died as of 1600 GMT Friday while there were 41,903 confirmed cases as of 0800 GMT Saturday, up 3,735.   The toll has been steadily increasing at more than over 500 deaths a day this week and the country is bracing for an expected peak in the next week to 10 days.   Prime Minister Boris Johnson, who is in self-isolation after developing mild symptoms of the disease, ordered a three-week lockdown of the country on March 23 to try to cut infections.

But there has been concern that warmer weather forecast for this weekend could tempt people from their homes to green spaces and public parks.   "I just urge you not to do that," Johnson said in a video message on Friday. "Please, please stick with the guidance now."   Health Secretary Matt Hancock also warned against any relaxation in social distancing. "If we do, people will die," he told a daily briefing on the government's response on Friday.   A special address on the crisis by Queen Elizabeth II is to be broadcast on Sunday evening.

Imperial College London epidemiologist Neil Ferguson, who is advising the government, told BBC radio on Saturday a peak was expected around the Easter weekend.   "We still think things will plateau but we'll be at quite high levels of infection for weeks and weeks rather than seeing quite a rapid decline as the type seen in China," he said.   But he said that was dependent on people staying at home. If that happened, it could lead to less stringent measures in place "at least by the end of May", he added.

The announcement of another record rise in deaths came after 13 residents at a care home in Glasgow died in one week in a suspected outbreak of coronavirus.   The Burlington Court Care Home in the Cranhill area of the city said those who died had underlying medical conditions and two staff members were being treated for COVID-19.

Tests for coronavirus are currently carried out on the most serious cases that require hospital treatment, suggesting the true extent of confirmed cases and deaths is an under-estimate.   The government meanwhile announced that up to 4,000 low-risk prisoners near the end of their sentence could be release from jails in England and Wales to try to stop the spread of COVID-19.   A total of 88 prisoners and 15 prison staff have tested positive for the virus, and there is concern it could spread rapidly because of shared cells and overcrowding.   The justice ministry said those released would be electronically tagged and temporarily released on licence in stages. High-risk offenders will not be considered for early release.
Date: Sat, 4 Apr 2020 15:38:20 +0200 (METDST)

Madrid, April 4, 2020 (AFP) - Spanish Prime Minister Pedro Sanchez announced Saturday the extension of the country's lockdown until April 25 in order to curb the spread of the novel coronavirus.   "The cabinet on Tuesday will again ask for authorisation from parliament to extend for a second time the state of alert until Saturday April 25 at midnight,' Sanchez said in a televised speech.
Date: Sat, 4 Apr 2020 15:26:30 +0200 (METDST)

Istanbul, April 4, 2020 (AFP) - Turkey stepped up controls Saturday on crowded public spaces including markets and ferries in Istanbul a day after President Recep Tayyip Erdogan imposed the use of face masks to curb the coronavirus outbreak.    Turkey has so far recorded 425 coronavirus-related deaths and nearly 21,000 cases, most of them in the country's economic capital Istanbul, according to official figures.   From Saturday, all those going out to shops or markets must wear a face mask, Erdogan said, calling on the population to maintain a distance of "three paces" from each other when outside.

At an Istanbul bazaar in the Besiktas neighbourhood open every Saturday, police and local municipal employees handled the use of masks and hand disinfectants, while checking the temperature of incoming customers at the entrance.   Veli Yildirim, 50, who sells vegetables including tomatoes, said the measures came "too late."   "We are the latest compared to the rest of the world. Even this is not enough, there should be a complete lockdown" in Istanbul, he told AFP.    A 60-year-old customer in the bazaar, Asuman Karaman wearing a mask, agreed: "If these measures had been taken one or two months earlier, maybe the virus would not have been so widespread."   The bazaar looked quite calm -- in stark contrast to its usual noisy and crowded state.

Vendors complained their business was hit badly.    "This has a had a big impact, there is no one at the market, at this time of the day, we have nothing to do here," said Abbas Kose, who sells vine leaves.   At the ferries in Istanbul, passengers were seen wearing face masks.    The city's mayor Ekrem Imamoglu has been calling for total confinement but authorities have so far stopped short of that.    As part of the measures taken nationwide, authorities suspended international flights, issued a confinement order for everyone aged under 20 and over 65 and shut schools.   Erdogan on Friday also said vehicles would no longer be able to leave or enter 31 towns and cities, including Istanbul, for 15 days.
Date: Sat, 4 Apr 2020 15:22:33 +0200 (METDST)

Geneva, April 4, 2020 (AFP) - Switzerland on Saturday saw the number of cases of the new coronavirus in the country pass 20,000, as its death toll in the pandemic swelled past 500.   The health ministry said 20,201 people in Switzerland had tested positive for COVID-19 as of Saturday morning -- nearly 1,000 more than a day earlier.   The small Alpine country of some 8.5 million people is thus one of the worst hit compared to population size, now counting 236 registered infections per 100,000 people.    At the same time, an additional 76 people died over the past 24 hours, bringing Switzerland's death toll in the pandemic to 540, the health ministry said.   "We have not yet reached the peak," health ministry official Daniel Koch told reporters.

Worldwide, well over 1.1 million cases have been registered across 188 countries, while close to 60,000 people have died, according to a tally compiled by AFP Saturday from official sources.   The high incidence in Switzerland could in part be linked to the fact that it is among the countries that have administered most tests per capita.   Since the first case surfaced in the country on February 24, more than 150,000 tests have been administered with around 15 percent coming up positive.   Drive-in testing stations have been set up in several places, including in the capital Bern, to help simplify safe testing for COVID-19.   In the past 24 hours, the country has conducted nearly 7,000 tests, including 975 that were positive, the health ministry said.

Switzerland's southern canton of Ticino, which borders hard-hit Italy, has registered most cases, followed by Geneva.   As in other countries, men seemed to suffer more from the virus. Slightly more women had tested positive for the virus, but men accounted for 64 percent of the deaths, the ministry found.   Switzerland has unblocked some $60 billion to buffer the harsh blow to its economy from the pandemic and the measures taken to halt the spread of the virus.   The economic affairs ministry said Saturday some 1.3 million people, or a quarter of the country's workforce, have applied for temporary unemployment benefits since the start of the crisis.
Date: Sat, 4 Apr 2020 07:04:32 +0200 (METDST)

Honiara, April 4, 2020 (AFP) - At least 28 ferry passengers were swept overboard in a powerful storm off the Solomon Islands, reports said Saturday, with the captain unaware he had lost anyone until the boat docked.   The passengers were heading from the capital Honiara to West Are'are, more than 120 kilometres (75 miles) away, under a government programme to evacuate people to their home villages during the global coronavirus epidemic.

The MV Taimareho set sail on Thursday night as tropical cyclone Harold bore down on the Solomons, and with weather forecasters warning against any unnecessary voyages.   But the captain ignored advice not to sail, the nation's leader said, as survivors reported dozens of people were swept overboard by huge waves and strong winds. Local media put the death toll at 28.

But police said it was impossible to verify the number.   "Initial reports say the captain of the boat had no knowledge of the missing people until he was informed when the boat arrived at her destination at Are'are," police marine department chief Charles Fox Sau said.    "At this stage we cannot confirm how many people are missing as the investigation into this sad incident continues."

In an address to the nation, Prime Minister Manasseh Sovagare said a search and rescue operation was under way.    "It is with deep regret to learn that a number of passengers are missing at sea after being washed overboard from a passenger vessel which departed ... from Honiara, despite the several weather warnings issued," he said.    Disaster authorities in the Solomons, which has limited healthcare facilities, have been stretched as they prepared for the impact of coronavirus while the region was being battered by tropical cyclone Harold.

The island nation, with a population of just over 600,000, is one of a dwindling number of countries where there have been no reported coronavirus cases so far.   Harold, packing winds of up to 160 kilometres per hour (100 mph), downed trees and damaged homes before heading away and was expected to intensify before reaching Vanuatu late Sunday.   Although the government has not yet completed a damage assessment, Australia has donated Aus$100,000 (US$60,000) in immediate emergency funding.
Date: Sat, 4 Apr 2020 06:20:31 +0200 (METDST)

London, April 4, 2020 (AFP) - The Falklands Islands government has confirmed the territory's first case of the new coronavirus.   A patient tested positive after being admitted to hospital with symptoms on March 31, according to a statement released on Friday that said they were in isolation and in "stable condition".   Located in the southern Atlantic Ocean, the British overseas territory had been among a dwindling number of remote places that have reported no COVID-19 cases during the pandemic.

Health authorities in the Falklands -- home to 3,400 people -- have been sending samples to the UK for testing, the statement said.   "In some respects we are fortunate that we have been COVID-19 free until now, as we have taken this time to plan our approach," Chief Medical Officer Dr Rebecca Edwards said.   "We have reorganised the hospital and staffing arrangements, and put our supplies and pharmaceuticals in place, which many countries were not in a position to do before they identified their first cases."

The disparate group of places to officially remain untouched by the pandemic include Samoa, Turkmenistan, North Korea and bases on the frozen continent of Antarctica.   Argentina, which invaded and briefly occupied the territory in 1982, claims sovereignty over the islands and calls them Las Islas Malvinas.
Date: Fri, 3 Apr 2020 23:54:18 +0200 (METDST)

Kinshasa, April 3, 2020 (AFP) - The Democratic Republic of Congo is prepared to take part in testing of any future vaccine against the coronavirus, the head of the country's taskforce against the pandemic said on Friday.   "We've been chosen to conduct these tests," said the head of the national biological institute, Jean-Jacques Muyembe.    "The vaccine will be produced in the United States, or in Canada, or in China. We're candidates for doing the testing here," Muyembe told a news briefing in comments that sparked controversy in DR Congo amid charges the population was being used as guinea pigs.

Muyembe suggested that clinical trials could begin in July or August.    "At some point, COVID-19 will be uncontrollable," the virologist said.   "The only way to control it will be a vaccine, just like Ebola. It was a vaccine that helped us end the Ebola epidemic."   Muyembe's comments came as two leading French doctors came under a storm of criticism after discussing on a television programme the idea of testing a vaccine for coronavirus in Africa.   Camille Locht, head of research at the National Institute of Health and Medical Research (INSERM) in Lille, and Jean-Paul Mira, head of intensive care at the Cochin hospital in Paris, suggested that Africa offered better conditions for testing the vaccine.

Their remarks sparked furious criticism, with the French anti-racism NGO, SOS Racisme, saying, "No, Africans aren't guinea pigs".    Even former international and Ivory Coast football star Didier Drogba joined in.    "It is inconceivable that we continue to accept this. Africa is not a laboratory. I strongly denounce these very serious, racist and contemptuous words," the former Chelsea and Marseille striker wrote on his Facebook page and on Twitter.   "Help us save lives in Africa and stop the spread of the virus that is destabilising the whole world instead of seeing us as guinea pigs. It is absurd."   The tenth Ebola epidemic in DR Congo is set to be declared over on April 12, after it killed more than 2,200 people in the east of the country since its outbreak on August 1, 2018.    More than 320,000 people were given two different experimental vaccines to stop the spread.
Date: Fri, 3 Apr 2020 21:56:23 +0200 (METDST)

Libreville, April 3, 2020 (AFP) - Gabon on Friday banned the sale and eating of bats and pangolins, which are suspected of sparking the novel coronavirus in China where they are highly prized in traditional medicine.   President Ali Bongo Ondimba also announced the government was planning to lock down the capital Libreville and unveiled an emergency package for those hard hit by the pandemic.   The novel coronavirus is believed to have come from bats, but researchers think it might have spread to humans via another mammal.   Pangolins are critically endangered and have long been protected, but they are sold in the markets of the capital Libreville, as are bats, and their meat is popular.

The central African nation is 88 percent covered in forest and hunting and bush meat have long been a way of life.   The water and forest ministry said the novel coronavirus was a "combination of two different viruses, one close to bats and the other closer to pangolins", and claimed to be quoting a scientific study published in Nature.   Gabon has declared 21 COVID-19 infections, but none from animals, the ministry said.   "A similar decision was taken by the authorities when our country was affected by the Ebola virus -- a ban on eating primates," Forestry Minister Lee White said.

The national parks agency ANPN announced in mid-March that tourists would no longer be allowed to interact with great apes to avoid any risk of contamination by the coronavirus.   The pangolin, the world's most heavily trafficked mammal, also called the scaly anteater, is believed to have possibly been a vector in the leap of the novel coronavirus from animal to human at a market in China's Wuhan city last year.   Its body parts fetch a high price on the black market as they are commonly used in traditional Chinese medicine, although scientists say they have no therapeutic value.

Gabon has also put in place a raft of measures such as grounding international flights, closing schools and ordering a night curfew to stop the spread of the coronavirus.   On Friday, Bongo said Libreville would be put under lockdown "in the coming days" but gave no precise date.   All but one of Gabon's reported 21 cases are in the city, where a large proportion of the country's two million residents live.   Bongo also announced an aid package of 250 billion CFA francs (380 million euros) to help both individuals and businesses whose livelihoods have suffered because of the crisis.
Date: Fri, 3 Apr 2020 20:36:36 +0200 (METDST)

Istanbul, April 3, 2020 (AFP) - Turkish President Recep Tayyip Erdogan on Friday issued a mandatory confinement order for everyone aged under 20 starting from midnight, as part of tougher measures to stem the spread of the coronavirus in Turkey.    In a television address, Erdogan also announced that vehicles would no longer be able to leave or enter 31 towns and cities, including Istanbul and Ankara, for 15 days.   People aged over 65 or those with chronic medical conditions are already subject to mandatory confinement in Turkey.    "Throughout the country, people aged under 20, that is to say born after January 1, 2000, will not be allowed to go out on the street" from midnight on Friday, Erdogan said.

Also, from Saturday, all those going out to shops or markets will be obliged to wear a face mask, the Turkish leader added, calling on the population to maintain a distance of "three paces" from each other when outside.   Turkey has registered over 20,000 coronavirus cases, 425 of which have been fatal.   Health Minister Fahrettin Koca warned on Friday that the country is just at the beginning of the outbreak, which has left over 50,000 people dead worldwide.   More than half of the Turkish cases have been in the economic capital Istanbul, which has a population of around 16 million people.

The city's mayor Ekrem Imamoglu has been calling for total confinement.    Erdogan's announcements on Friday are the latest moves to stem the spread of the virus in Turkey in recent weeks.   Schools have been closed down, flights grounded and gatherings banned.   Next week the Turkish parliament is set to consider a draft law to free 90,000 prisoners, a third of the population of the overcrowded prisons.   It will concern several categories of prisoners, among them pregnant women and older people with medical conditions.   But it excludes convicted murderers, sexual offenders and narcotics criminals, as well as political prisoners charged under Turkey's controversial anti-terrorism laws.
Date: Fri, 3 Apr 2020 11:49:00 +0200 (METDST)

Singapore, April 3, 2020 (AFP) - Singapore will close schools and workplaces while people are being told to stay home, as the city-state ramps up curbs to stem the spread of coronavirus, the premier said Friday.   The country has won praise for its handling of the outbreak, and had largely kept the crisis in check by carrying out large numbers of tests and tracing close contacts of those infected.   Authorities had slowly been introducing curbs, such as closing bars and nightclubs, but had so far avoided the kind of tough restrictions seen in worse-hit nations.

However, after a jump in the number of locally transmitted cases in recent days, Prime Minister Lee Hsien Loong said it was time to apply a "circuit breaker" to halt the virus's spread.   Workplaces except for essential services, such as supermarkets and hospitals, and those deemed to be in key economic sectors will be closed from Tuesday, he said in a televised address.

Schools will also be closed from next week except for children of those who have to continue to work and cannot make alternative arrangements, he said.   People are being told to stay at home as much as possible, and only go out for essentials -- such as buying food and getting exercise.   "Looking at the trend, I am worried that unless we take further steps, things will gradually get worse, or another big cluster may push things over the edge," Lee said.   Singapore has reported 1,114 virus infections including five deaths. Globally, the number of confirmed cases has soared past one million and deaths have topped 50,000.