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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 ...

Czech Republic

Czech Republic US Consular Information Sheet
May 31, 2007
COUNTRY DESCRIPTION:
The Czech Republic is located in the heart of Europe. Tourist facilities in Prague are at the level of those found in most European capitals, while travelers ca
expect lower standards outside of Prague. Travelers are encouraged to be vigilant as pick-pocketing and petty theft occurs often in crowded tourist areas, restaurants and on public transportation. More information can be found in the section on crime. Please read the Department of State Background Notes on the Czech Republic for additional information.

ENTRY REQUIREMENTS: A passport is required and must be valid for 3 months beyond the intended stay. Visas are not required for U.S. citizens for tourist, short study or business visits of up to 90 days. Visas are required for longer stays and for any gainful activity. See our Foreign Entry Requirements brochure for more information on the Czech Republic and other countries.
Visit the Embassy of the Czech Republic’s website at http://www.mzv.cz/washington for the most current visa information.
The Czech Government requires that proof of finances to pay for your stay and for you to have travel/health insurance and is requiring proof of medical insurance for travelers to the Czech Republic. Minimum coverage of the insurance has to be at least $35,000.

According to the Czech Government, a health insurance card or an internationally recognized credit card with health insurance included will generally be accepted as proof of insurance to enter the Republic.

The health insurance requirement does not apply to those who have visas permitting them to work.
See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction.
Please refer to our Customs Information
to learn more about customs regulations.

SAFETY AND SECURITY:
Civil disorder is rare in the Czech Republic, although strikes and demonstrations may occur. U.S. citizens should be vigilant in protecting their security, bearing in mind that even demonstrations meant to be peaceful may turn violent. Americans are advised to avoid street demonstrations.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site, where the current Worldwide Caution Public Announcement, Travel Warnings and Public Announcements can be found.

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

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

CRIME:
The Czech Republic generally has a low rate of crime. However, street crime-particularly pick-pocketing and occasional mugging-is a problem, especially in major tourist areas in Prague. Travelers are encouraged to be especially vigilant in Prague’s restaurants, train stations, and on public transportation around the city center.
Incidents of pick pocketing were reported in significant numbers during 2006. Incidents of violent crime, while still relatively infrequent, are becoming more common in Prague. Travelers should be aware of the reported use of rohypnol, and other “date rape” drugs in the Czech Republic. Caution should be used when accepting open drinks at bars or clubs. Travelers should be very careful while riding trains, trams or metro, where most crime occurs. Travelers should keep a copy of their passport in a safe place separate from the passport itself; this copy can help you to apply for a new passport if yours is lost or stolen. Visitors should be alert to the potential for substantial overcharging by taxis, particularly in areas frequented by tourists. Radio-dispatched taxis are often much more reliable. It is also advisable to set the price in advance.

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 or Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information for Victim’s of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Prague has good Western-style medical clinics with English-speaking doctors and dentists. However, staff members at the majority of Czech medical facilities do not speak English. Doctors and hospitals often expect cash payment for health services, though some facilities do accept credit cards. Hospitalization in the Czech Republic is much more liberal that in the United States; conditions that would be treated on an outpatient basis in the United States are often treated on an inpatient basis in the Czech Republic.
Ambulance services are not on a par with U.S. standards. Response time can sometimes be slow, and different ambulances are dispatched depending on the perceived severity of the patient’s condition.
Many ambulance companies expect payment at the time of delivery. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars or more.
Please note that because euthanasia is not permitted under Czech law, U.S. living wills providing for no exceptional interventions to prolong life cannot be honored in the Czech Republic.

People traveling from April through October who plan to participate in camping or hiking in long grass or woodlands run the risk of both tick-borne encephalitis and Lyme disease. All travelers should take precautions to prevent tick bites. There is a vaccine for the former, but not for Lyme disease.

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-TRTP (1-877-394-8747) or via the CDC’s Internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.

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

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

Travelers should note that road fatalities are occurring at an increasing rate in the Czech Republic, placing it amongst the most lethal places to drive in Europe. First-class roads in the Czech Republic generally meet European standards. However, on side roads, drivers should be prepared to encounter uneven surfaces, irregular lane markings and sign placements that are not clear. Streets in towns are not always in good condition. U.S. drivers should pay special attention to driving on cobblestone and among streetcars in historic city centers. Traffic lights are placed before the intersection and not after as in the United States. Speed limits are 50 km/h in towns, 90 km/h outside of towns and 130 km/h on highways. An International Driving Permit (IDP), available from AAA (in the United States only), must accompany a U.S. driver’s license; failure to have the IDP with a valid license may result in denial of an insurance claim after an accident.

Persons driving into the Czech Republic should be aware that a road usage tax sticker is required to drive legally on major highways. Signs stating this requirement are posted near the border, but they are easy to miss. The stickers are available at gasoline stations. The fine for failing to display a motorways toll sticker is assessed on the spot.

For specific information concerning Czech requirements for driver’s permits, vehicle inspection, road tax and mandatory insurance, please contact the Czech Tourist Authority offices in New York by telephone at (212)288-0830 or via email at infor@czechcenter.com.

Visit the websites of the Czech Republic’s national tourist office and national authority responsible for road safety at http://www.turistik.cz and http://www.mdcr.cz .

Please refer to our Road Safety page for information.

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

SPECIAL CIRCUMSTANCES:
Czech customs authorities enforce strict regulations concerning temporary importation into or export from the Czech Republic of items such as firearms, antiquities, medications, business equipment, etc. It is advisable to contact the Embassy of the Czech Republic in Washington, D.C, or the Consulates General of the Czech Republic in New York and Los Angeles for specific information regarding customs requirements.

Please see our information on Customs Regulations.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Czech Republic laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the Czech Republic are strict and convicted offenders can expect 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 on international adoption of children and international parental child abduction, see the Office of Children’s Issues website.

REGISTRATION/EMBASSY AND CONSULATE LOCATIONS:
Americans living in the Czech Republic are encouraged to register with the U.S. Embassy through the State Department’s travel registration website, and to obtain updated information on travel and security within the Czech Republic.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy in Prague is located at Trziste 15, 118 01 Prague, Czech Republic; telephone (420)257 530 663; for after-hours emergencies only, telephone (420 257 532 716; Consular Section’s fax (420) 257 534 028; webpage: www.usembassy.cz.
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This replaces the Consular Information Sheet dated October 31, 2006, to update information in the Crime section.

Travel News Headlines WORLD NEWS

Date: Fri, 13 Mar 2020 12:25:39 +0100 (MET)

Prague, March 13, 2020 (AFP) - The Czech government said Friday it would ban all foreign travellers from entering and all Czechs from leaving the country as of March 16 in a bid to stem the coronavirus spread.   "As of midnight Sunday-Monday, we ban all foreigners from entering the Czech Republic and, at the same time, all Czech citizens from leaving the Czech territory," Interior Minister Jan Hamacek told reporters in the EU member with 117 confirmed cases of the virus.
Date: Fri 24 May 2019
Source: Radio Praha [edited]

The Czech Republic recorded the highest number of tick-borne encephalitis (TBE) cases in the EU last year [2018]. In the whole of Europe, only Russia recorded more cases of the potentially deadly disease.

There were 712 recorded TBE cases in the country last year [2018], the highest number since 2011, a Czech member of the International Scientific Working Group on TBE (ISW-TBE) said in a press release on Thursday [23 May 2019].

Only about one-quarter of inhabitants of the Czech Republic are vaccinated against TBE, a low percentage compared to other EU countries. Within the bloc, the 2nd-highest number of TBE cases was recorded in Germany, which has a population 8 times larger.

Encephalitis patients suffer from fever, headache, aching joints, and muscles. It can develop into meningitis.  [Byline: Brian Kenety]
========================
[Given the large number of tick-borne encephalitis (TBE) virus infection in the Czech Republic last year (2018), it seems curious that the above report makes no mention of preventive measures such as vaccination and avoidance to tick bites that could be taken currently to avoid infection. The TBE virus transmission season is beginning at this time. TBE virus is endemic in the Czech Republic, and cases occur there annually. A 2016 ProMED-mail post indicated that although Central and Eastern Europe countries are endemic for the European subtype of TBE virus and cases occur there yearly, cases have declined significantly in Austria and remain low in Germany, Poland, and Slovakia, while remaining high in recent years in the Czech Republic [see Tick-borne encephalitis - Czech Republic (02): background http://promedmail.org/post/20160210.4009410].

WHO has stated that "Approximately 10 000-12 000 clinical cases of tick-borne encephalitis are reported each year, but this figure is believed to be significantly lower than the actual total. Immunization offers the most effective protection. Currently, there are 4 widely used vaccines of assured quality: FSME-Immun and Encepur, manufactured in Austria and Germany, respectively, and based on European strains of the virus; and TBE-Moscow and EnceVir, manufactured in the Russian Federation and based on Far-Eastern strains. The 4 vaccines are considered to be safe and efficacious" (<https://www.who.int/immunization/diseases/tick_encephalitis/en/>).

TBE is a virus infection caused by one of 3 TBE virus subtypes belonging to the Flaviviridae family: Central European, Siberian, and Far Eastern (formerly known as Russian spring-summer encephalitis). It is transmitted to humans through the bite of infected _Ixodes_ ticks. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Sat 27 Apr 2019
Source: Food Safety News [edited]

_Salmonella_ in chicken has been linked to over 70 cases in the Czech Republic. Health authorities in the city of Zlin reported the outbreak in the middle of March 2019 at Tomase Bati Regional Hospital. A total of 68 people, of whom 38 were patients and 30 staff, were found to be connected with the salmonellosis outbreak. In addition, 4 people -- 1 staff member and 3 other patients -- were hospitalized in the town of Uherske Hradiste.

A common vehicle of infection was a chicken and rice dish served for lunch on 14 Mar 2019. An epidemiological survey found that all patients consumed this lunch. The alarm was raised on 15 Mar 2019 by the hospital in a message to health authorities. The next day, _Salmonella_ Enteritidis was detected in faecal samples. Samples of raw materials and swabs from the kitchen and storage areas were taken. Sanitation and disinfection of all kitchen and storage areas were ordered. The chicken used in the meals was also destroyed.

Symptoms of _Salmonella_ infection usually appear 12 to 72 hours after infection and include fever, abdominal pain, diarrhoea, nausea and sometimes vomiting. The illness usually lasts 4 to 7 days, and most people recover without treatment. The laboratory analysis at the Institute of Public Health in Ostrava and in the State Veterinary Institute in Olomouc did not confirm _Salmonella_ in any sample of frozen chicken available during the investigation. Clinical material from patients was sent to the lab of the Veterinary Research Institute in Brno.

In an updated statement concluding the investigation, health authorities in Zlin reported that _ S._ Enteritidis, identical to the strain grown from clinical cases, was confirmed in a chicken and rice sample.

In a statement, officials from the hospital said they had introduced strict measures for food after the _Salmonella_ infection, including strengthening controls on the defrosting and cooking of meat so procedures are monitored consistently. Officials said while the hospital cannot influence the incidence of _Salmonella_ in raw materials supplied to the hospital, they want to focus consistently on the correct procedures for processing. The hospital is also considering buying cameras and putting them in areas where hospital food is being prepared so human error can be detected in time and eliminated in the future.
=======================
[Hospital food remains a particular problematic source for foodborne pathogens given the cohort of individuals who may consume it and their comorbidities. Minimizing salmonellosis spread from fowl requires adequate cooking and appropriate kitchen hygiene. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
Zlin District, Czech Republic: <http://healthmap.org/promed/p/62211>]
Date: Tue, 2 Apr 2019 14:58:37 +0200

Prague, April 2, 2019 (AFP) - Czech veterinary authorities said Tuesday they had detected another 510 kilos of chicken breast from Poland tainted with the dangerous salmonella bacteria, following a rift over meat imports.   "The meat has been distributed and... most probably consumed," the State Veterinary Administration (SVS) said in a statement.   Meat from Poland caused a stir in the Czech Republic after local vets slapped mandatory laboratory checks on Polish beef in February following the discovery of a salmonella-tainted batch.

That same month, vets said they had found 1,200 kilos (some 2,600 pounds) of Polish chicken containing salmonella, part of which had already been distributed.   They lifted the measure last week but insisted they would continue random sample checks on imports, especially of beef and poultry from Poland.   SVS spokesman Petr Vorlicek told AFP that vets were not contemplating mandatory lab checks on Polish poultry now.   He noted that salmonella is not uncommon in poultry.   "We are closely monitoring all imports, that's why we have also detected this batch," he added.

The scandal erupted when the TVN24 commercial news channel aired footage of apparently sick or lame cows being butchered at a small slaughterhouse in northeast Poland in secret late at night when veterinary authorities were unlikely to visit.   In January, Poland exported 2.7 tonnes of suspect beef to around a dozen fellow EU members, triggering a probe.   Poland is a leading producer and exporter of meat in Europe, turning out around 600,000 tonnes of beef per year and exporting most of it to the EU, according to meat producer associations.
Date: Thu 20 Dec 2018
Source: Radio Praha [edited]

More than 690 people in the Czech Republic were infected with tickborne encephalitis between January and November this year [2018], which is more or less the same as for the whole of 2017. The figure is also the highest since 2006, according to data published by the National Institute of Public Health on Thursday [20 Dec 2018].

The Czech Republic, along with the Baltic States, has the highest number of tickborne encephalitis cases in Europe. There is no cure for encephalitis, but an increasing number of Czechs get themselves vaccinated against the disease.  [byline: Ruth Frankova]
==========================
[Tickborne encephalitis (TBE) virus is endemic in the Czech Republic, and cases occur there annually. A 2016 ProMED-mail post indicated that although Central and Eastern Europe countries are endemic for the European subtype of TBE virus and cases occur there yearly, cases have declined significantly in Austria and remain low in Germany, Poland, and Slovakia, while remaining high in recent years in the Czech Republic [see Tick-borne encephalitis - Czech Republic (02):  background http://promedmail.org/post/20160210.4009410].

WHO has stated that "Approximately 10 000-12 000 clinical cases of tick-borne encephalitis are reported each year, but this figure is believed to be significantly lower than the actual total. Immunization offers the most effective protection. Currently, there are 4 widely used vaccines of assured quality: FSME-Immun and Encepur, manufactured in Austria and Germany, respectively, and based on European strains of the virus; and TBE-Moscow and EnceVir, manufactured in the Russian Federation and based on Far-Eastern strains. The 4 vaccines are considered to be safe and efficacious"  (<https://www.who.int/immunization/diseases/tick_encephalitis/en/>).

TBE is a virus infection caused by one of 3 TBE virus subtypes belonging to the _Flaviviridae_ family: Central European, Siberian, and Far Eastern (formerly known as Russian spring-summer encephalitis). It is transmitted to humans through the bite of infected ixodes ticks. - ProMED Mod.TY]

[HealthMap/ProMED-mail map: Czech Republic:
More ...

Uganda

Uganda - US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Uganda is a landlocked, developing country in central eastern Africa. Infrastructure is adequate in Kampala, the capital, but is limited in other areas.
Read t
e Department of State Background Notes on Uganda for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport valid for three months beyond the date of entry, visa and evidence of yellow fever vaccination are required.
Visas are available at Entebbe Airport upon arrival or may be obtained from the Embassy of the Republic of Uganda.
The current fee for a three month tourist visa obtained upon arrival at Entebbe Airport is $50.00.
Travelers should be aware that a visa does not determine how long a person may remain in Uganda.
The Ugandan immigration officer at the port of entry will determine the length of authorized stay, which is generally from one to three months as a tourist.
Extensions of duration of stay may be requested at Ugandan immigration headquarters on Jinja Road in Kampala.
Airline companies may also require travelers to have a visa before boarding.
Travelers should obtain the latest information and details from the Embassy of the Republic of Uganda at 5911 16th Street, NW, Washington, DC
20011; telephone (202) 726-7100.
The Ugandan Embassy may also be contacted by email.
Travelers may also contact the Ugandan Permanent Mission to the United Nations, telephone (212) 949-0110. Overseas, inquiries may be made at the nearest Ugandan embassy or consulate.

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

SAFETY AND SECURITY:
U.S. citizens residing in or planning to visit Uganda should be aware of threats to their safety posed by insurgent groups operating in the Democratic Republic of the Congo and southern Sudan, and the potential of cross border attacks carried out by these armed groups.
In addition, U.S. citizens traveling to the area commonly known as Karamoja in northeastern Uganda should also be aware of ongoing conflict and armed banditry in this region.

Northern Uganda:
After years of conflict, relative stability has returned to northern Uganda with the departure of the Lord’s Resistance Army (LRA) insurgent group in 2006.
Recent LRA activity has been restricted to the remote region of Garamba National Park in the Democratic Republic of the Congo (DRC), where LRA insurgents have continued to attack and terrorize civilian populations.
LRA attacks have also occurred in the neighboring Central African Republic and southern Sudan.
The Governments of Uganda, the DRC, and southern Sudan initiated joint military operations against LRA bases in Garamba National Park on December 14, 2008, after LRA leader Joseph Kony refused to sign a peace agreement following two years of negotiations.
These military operations continue and in order to deter an LRA return to Uganda, the Uganda Peoples Defense Force (UPDF) maintains a significant presence in the northern districts.
Given the continued threat to regional security posed by the LRA, American citizens should exercise caution when traveling in those districts of northwestern Uganda that border the DRC and southern Sudan and which could potentially be subject to LRA incursions.
The Ugandan Government also continues to expand and improve the capacity of the civilian police force in northern Uganda by deploying additional personnel and concentrating resources to further recovery and re-development activities throughout the north.

American citizens traveling to northern Uganda are advised to ensure that they have made appropriate travel, lodging, and communication arrangements with their sponsoring organization before visiting the region.
Local officials in northern Uganda have expressed concern for the safety and security of foreigners visiting the area to assist with relief efforts, but without any specific arrangements with a sponsoring organization.
Foreign citizens who travel to the region without a sponsoring organization may not find secure lodging or safe transport, and may become more susceptible to crime.
They may also find that local officials are unable to provide assistance in the event of an emergency.
There is a general lack of infrastructure throughout northern Uganda, and services such as emergency medical care are nonexistent.
Given crime and other security concerns in northern Uganda, American citizens are advised to restrict travel to primary roads and during daylight hours only.

Cattle rustling, armed banditry, and attacks on vehicles are very common in the Karamoja region of northeastern Uganda, and the UPDF continues to implement a program to disarm Karamojong warriors.
Past incidents have included ambushes of UPDF troops, and attacks on vehicles, residences, and towns that resulted in multiple deaths.
Most of the violence occurred in the districts of Kaabong, Kotido, and Abim, although some violent incidents also occurred in Moroto and Nakapiripirit Districts.
American citizens are advised to avoid travel to the Karamoja region given the frequent insecurity.
Any travel to Karamoja (excluding charter flights to Kidepo National Park) by U.S. Embassy personnel must first be authorized by the Chief of Mission.

Southwestern Uganda:
American citizens traveling in southwestern Uganda should also exercise caution given the ongoing conflict in the districts of North and South Kivu in the DRC, and the close proximity of fighting to the Ugandan border.
During spikes in the conflict, refugee flows across the border number in the thousands and there is also a risk of incursions by armed combatants.
American citizens should review the Travel Warning for the Democratic Republic of the Congo for the most up-to-date information regarding the conflict in the DRC.

On August 8, 2007, a group of armed assailants entered Uganda from the DRC and raided Butogota, a town in Kanungu District, southwestern Uganda.
Three Ugandans were killed and many others assaulted during the raid.
Ugandan officials believe that the perpetrators of the attack were members of one of the various militia groups operating in the southeastern region of the DRC or possibly remnants of the "Interahamwe," a group that participated in the 1994 genocide in Rwanda and was also responsible for the 1999 attack on Bwindi Impenetrable National Park.
The 1999 Bwindi attack killed four Ugandans and eight foreign tourists.
The 2007 raid on Butogota is in an area transited by tourists traveling to Bwindi, a popular gorilla-trekking destination.
Within Bwindi Impenetrable National Park, armed security personnel accompany tourists on the daily gorilla hikes and the UPDF maintains a military presence.
At Ishasha Camp, another popular tourist destination located in the southern sector of Queen Elizabeth National Park, the UPDF also maintains a small military base near the park headquarters for security purposes.

Eastern Uganda:
In February 2008, an isolated incident occurred in Mount Elgon National Park in eastern Uganda that resulted in the death of a foreign tourist.
A Belgian tourist climbing Mt. Elgon in the company of park rangers was shot and killed.
The attack occurred while the group was camped for the night and assailants fired into the campsite.
The tourist was reportedly struck by gunfire when exiting her tent in the darkness.
Ugandan security and park officials suspected that the attack was perpetrated by smugglers engaged in cattle rustling or other illicit activities that are common in the border area.

Demonstrations:
Demonstrations take place in Kampala and other Ugandan cities from time to time in response to world events or local developments.
In most cases, these demonstrations occur with no warning and demonstrations intended to be peaceful can turn confrontational and possibly violent.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if they find themselves in the vicinity of any demonstration.
American citizens should stay current with media coverage of local events and be aware of their surroundings at all times.
Because many demonstrations are spontaneous events, the U.S. Embassy may not always be able to alert American citizens that a demonstration is taking place and to avoid a specific area.
If employed with an institution or other large organization, American citizens may find it helpful to request that local employees notify expatriates when they learn of a demonstration from local radio reports or other sources.
Recent protests have occurred over land disputes involving Kampala market areas, university closures and strikes, opposition political party demonstrations, and protests by taxi drivers over the enforcement of traffic regulations.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, 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 A Safe Trip Abroad.

CRIME:
Crimes such as pick pocketing, purse snatching, and thefts from hotels and parked vehicles or vehicles stalled in traffic jams are common.
The Embassy receives frequent reports of theft of items from locked vehicles, even when the stolen items were secured out of sight and the vehicle was parked in an area patrolled by uniformed security personnel.
Pick pocketing and the theft of purses and bags is also very common on public transportation.
Armed robberies of pedestrians also occur, sometimes during daylight hours and in public places.
Although infrequent, the Embassy also receives reports of armed carjackings and highway robbery.
In May 2007, two American citizens reported an attempted robbery when they were traveling near the town of Bugiri in eastern Uganda.
The Americans reported that a second vehicle with at least one armed assailant tried to stop their vehicle by forcing it off the road.
This incident occurred during daylight hours.
On June 27, 2007, two American citizens were robbed and held at gunpoint when the vehicle transporting them to Entebbe Airport was stopped by a group of armed men.
This incident occurred during the early morning hours on Entebbe Road.
Although some of these attacks are violent, victims are generally injured only if they resist.
U.S. Embassy employees are advised against using roads at night, especially in areas outside the limits of cities and large towns. Home burglaries also do occur and sometimes turn violent.
In April 2008, the Ugandan police reported an increase in armed robberies in the Kampala neighborhoods of Bukoto, Kisaasi, Kiwatule, Naalya, Najera, and Ntinda.
Several of these robberies occurred as the victims were arriving at their residences after nightfall and the assailants struck as they were entering their residential compounds.

Women traveling alone are particularly susceptible to crime.
In early 2008, there was an increase in reports of sexual assaults against expatriate females.
In some instances, the victims were walking alone, or were single passengers on one of the common modes of public transport which include "boda boda" motorcycle taxis.
If the victim of a sexual assault, medical assistance should be sought immediately and counseling provided regarding prophylactic treatment to help prevent the transmission of HIV and other sexually transmitted diseases. The U.S. Embassy provides a list of local medical providers for those with medical needs.

American citizens visiting Uganda are advised not to accept food or drink offered from a stranger, even a child, because such food may contain narcotics used to incapacitate a victim and facilitate a robbery or sexual assault.
In addition, patrons of bars, casinos, nightclubs, and other entertainment centers should never leave their drink or food unattended.
When visiting such establishments, it is advisable to remain with a group of friends as single individuals are more likely to be targeted.
Victims have included female patrons who reported they were drugged, and taken to another location and sexually assaulted.
Robberies have been facilitated on public transportation under similar circumstances.
In 2006, an American citizen traveling by bus from Kenya to Uganda was incapacitated and robbed on the bus when the passenger accepted a sealed beverage from a fellow traveler.
Expatriates traveling by bus to the popular tourist destination of Bwindi Impenetrable National Forest in southwest Uganda were also incapacitated and robbed when they accepted snacks from fellow bus passengers.

There has been a recent, marked increase in financial crime, including fraud involving wire transfers, credit cards, checks, and advance fee fraud perpetrated via email.
The U.S. Embassy recommends using money orders for all fund transfers and protecting all bank account and personally identifiable information such as social security numbers and other types of information.

An increasing number of U.S. exporters (primarily vendors of expensive consumer goods such as computers, stereo equipment, and electronics) have been targeted by a sophisticated check fraud scheme.
A fictitious company in Uganda locates a vendor on the Internet, makes e-mail contact to order goods, and pays with a third-party check.
The checks, written on U.S. accounts and made out to entities in Uganda for small amounts, are intercepted, chemically "washed" and presented for payment of the goods with the U.S. vendor as payee and an altered amount.
If the goods are shipped before the check clears, the U.S. shipper will have little recourse, as the goods are picked up at the airport and the company cannot be traced.
American companies receiving orders from Uganda are encouraged to check with the Political - Economic Section of the Embassy to verify the legitimacy of the company.
The Embassy strongly cautions U.S. vendors against accepting third-party checks as payment for any goods to be shipped to Uganda.

Additional information about the most common types of financial fraud can also be found in the State Department Financial Scams brochure.

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 Uganda is: 999.
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 Ugandan laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Uganda 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.

SPECIAL CIRCUMSTANCES:
Please note that U.S. currency notes in $20 and $50 denominations are exchanged at a lower rate than $100 currency notes.
In addition, travelers often find that they cannot exchange or use U.S. currency printed earlier than the year 2000.
Travelers who find they cannot pay for accommodation or expenses often must request that friends or family wire money to them in Uganda.
There are offices that facilitate Western Union, MoneyGram, and other types of money transfers in Kampala and other cities throughout the country.
ATMs are available in Uganda, particularly in downtown Kampala, but usually only customers who have an account with a specific Ugandan bank may use them.
A few machines function with overseas accounts.

The U.S. Embassy frequently receives requests from American citizens to verify the bona fides of nongovernmental (NGO) and charity organizations operating in Uganda.
The Embassy is unable to provide information regarding the bona fides of these organizations and American citizens traveling to Uganda to work for an organization are encouraged to request that the charity provide references of past volunteers whom they may contact.
American citizens have also reported intimidation and harassment by directors of organizations, when the Americans questioned the organization's activities or use of donated funds.
While the vast majority of NGOs operating in Uganda are legitimate organizations aiding development efforts, there have been reports from concerned Americans regarding the suspected diversion of charity funds for personal gain, etc.

Ugandan Customs authorities may enforce strict regulations concerning the importation of pets.
A Ugandan import permit is required, along with an up-to-date rabies vaccination certificate and a veterinary certificate of health issued by a USDA-approved veterinarian no more than thirty days before arrival.
Travelers are advised to contact the Ugandan Embassy in the United States for specific information regarding customs requirements.
Please see our Customs Information sheet.

Photography in tourist locations is permitted.
However, taking pictures of military/police installations or personnel is prohibited.
Military and police officers have detained tourists for taking photographs of Entebbe Airport and of the area around Owen Falls Dam, near Jinja, although the prohibition on taking photographs is not publicly displayed on signs.

The U.S. Embassy receives frequent inquiries from American citizens wishing to register a nongovernmental organization (NGO) in Uganda.
Information about registering an NGO can be obtained from the Ugandan NGO Board which has offices within the Ministry of Internal Affairs.
The NGO Board can be reached on phone number: 256 414 341 556.
One of the requirements for registering an NGO is that a foreign national employee or volunteer must provide a Certificate of Good Conduct/Criminal Background Check.
The U.S. Embassy Kampala cannot provide a Certificate of Good Conduct or Criminal Background Check, so American citizens intending to travel to Uganda as an employee an NGO or who plan to register an NGO should obtain a Certificate of Good Conduct from their local police or the Federal Bureau of Investigation (FBI) before departing the United States.
More information on how to obtain a Criminal Background Check can be found on the FBI web page about Identification Record Requests.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Uganda, including Kampala, are limited and not equipped to handle most emergencies, especially those requiring surgery. Outside Kampala, hospitals are scarce and offer only basic services.
Recently, American citizens involved in automobile accidents required immediate evacuation from Uganda as surgery could not be performed due to insufficient blood supplies at the hospital where they sought treatment.
Equipment and medicines are also often in short supply or unavailable.
Travelers should carry their own supplies of prescription drugs and preventive medicines.
A list of medical providers is available at the U.S. Embassy.

Tuberculosis is an increasingly serious health concern in Uganda.
For further information, please consult the CDC's Travel Notice on TB.

Malaria is prevalent in Uganda.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, including protective measures, see the CDC’s information on malaria.

In January, 2009, the CDC’s Special Pathogens Branch retrospectively diagnosed a case of Marburg hemorrhagic fever in a U.S. traveler, who had returned from Uganda in January, 2008. The patient developed illness four days after returning to the United States.
The Amcit had visited the “python cave” in Queen Elizabeth Park, western Uganda, which is a popular destination among tourists to see the bat-infested cave.
For additional information on Marburg hemorrhagic fever, including protective measures, visit the CDC web site.

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. Uganda has experienced recent outbreaks of Marburg Hemorrhagic Fever, Ebola Hemorrhagic Fever, Pneumonic Plague, Meningitis, and other types of infectious diseases.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Uganda.
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.
American citizens who are seriously injured in vehicle or other types of accidents in Uganda generally seek medical evacuation to Kenya or other destinations for more advanced emergency medical treatment.
These medical evacuations can be very expensive, and in the event the American citizen does not have sufficient insurance coverage, the evacuation is carried out at their personal expense.
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 Uganda is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Most inter-city transportation in Uganda is by small van or large bus.
Many drivers of these vehicles have little training and some are reckless.
Small vans and large buses are often poorly maintained, travel at high speeds, and are the principal vehicles involved in the many deadly single and multi-vehicle accidents along Ugandan roads.
Accident victims have included American citizens traveling in small vans and personal cars, passengers on motorcycle taxis locally known as "boda bodas," and pedestrians.
Large trucks on the highways are often over-loaded, with inadequately secured cargo and poor braking systems.
Alcohol frequently is a contributing factor in road accidents, particularly at night.
Drivers are advised to take extra care when driving.
Nighttime driving and road transportation should be avoided whenever possible.
Pedestrians often walk in the roads and may not be visible to motorists.
Large branches or rocks in the road sometimes indicate an upcoming obstruction or other hazard.
Highway travel at night is particularly dangerous, including the road between Entebbe Airport and Kampala.
The Embassy recommends caution on this road and use of a reliable taxi service to and from the airport.

Traffic accidents draw crowds.
Ugandan law requires that the drivers stop and exchange information and assist any injured persons.
In some cases where serious injury has occurred, there is the possibility of mob anger.
In these instances, Ugandans often do not get out of their cars, but drive to the nearest police station to report the accident.

Please refer to our Road Safety page for more information.
For specific information concerning Ugandan driving permits, vehicle inspection, road tax and mandatory insurance, please contact Tourism Uganda, IPS building, 14, Parliament Avenue, Kampala, Uganda; telephone 256-414-342 196. You may also wish to consult the Tourism Uganda web site or, for information on government agencies, see the My Uganda web site.

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

International airlines offer several weekly flights to Europe and the United Arab Emirates, and Kenya Airways has daily flights between Entebbe Airport and Nairobi.
Other regional airlines operate weekly flights to other destinations in Africa, such as Dar es Salaam, Addis Ababa, Cairo, and Johannesburg.

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 Uganda are encouraged to register with the U.S. Embassy in Kampala through the State Department’s travel registration web site to obtain updated information on travel and security within Uganda.
Americans without Internet access may register directly with the nearest U.S. embassy or consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at 1577 Ggaba Road, Kampala; telephone 256-414-259-791 or 256 414 306 001; fax 256-414-258-451.
You may contact the Embassy via e-mail.
* * *
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Travel News Headlines WORLD NEWS

Date: Fri 6 Mar 2020
Source: MMWR Morb Mortal Wkly Rep 2020;69:241-244 [edited]

Intervention To Stop Transmission of Imported Pneumonic Plague -- Uganda, 2019
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Plague, an acute zoonosis caused by _Yersinia pestis_, is endemic in the West Nile region of northwestern Uganda and neighbouring north-eastern Democratic Republic of the Congo (DRC) (1-4). The illness manifests in multiple clinical forms, including bubonic and pneumonic plague. Pneumonic plague is rare, rapidly fatal, and transmissible from person to person via respiratory droplets. On 4 Mar 2019, a patient with suspected pneumonic plague was hospitalized in West Nile, Uganda, 4 days after caring for her sister, who had come to Uganda from DRC and died shortly thereafter, and 2 days after area officials received a message from a clinic in DRC warning of possible plague. The West Nile-based Uganda Virus Research Institute (UVRI) plague program, together with local health officials, commenced a multipronged response to suspected person-to-person transmission of pneumonic plague, including contact tracing, prophylaxis, and education. Plague was laboratory-confirmed, and no additional transmission occurred in Uganda. This event transpired in the context of heightened awareness of cross-border disease spread caused by ongoing Ebola virus disease transmission in DRC, approximately 400 km to the south. Building expertise in areas of plague endemicity can provide the rapid detection and effective response needed to mitigate epidemic spread and minimize mortality. Cross-border agreements can improve ability to respond effectively.

Investigation and Findings
-----------------------
The index patient (patient A) was a Ugandan woman, aged 35 years, living in DRC, approximately 5 km from the Ugandan border. On 27 Feb 2019, Ugandan family members traveled to DRC for the funeral of patient A's child, aged 4 years, and found patient A severely ill. They transported her to her ancestral Ugandan village in Zombo District of West Nile. While there, she complained of chest pain, experienced at least one episode of hemoptysis, and was admitted to a nearby clinic around midday the following day, 28 Feb 2019. She died a few hours later; no clinical samples were collected. She was buried in her ancestral village, preparation for which began the day of her death and culminated 2 days later, on 2 Mar 2019 [Table, for table, see original URL. - ProMED Mod.LL].

Meanwhile, on 1 Mar 2019, a local government office in Uganda received an alert from a private health clinic in DRC warning of possible plague circulation in a village near the border, the village from which patient A had come. Consequently, a team from UVRI's plague program, along with local health officials, initiated plague education and risk communication at area health clinics and with village residents, in concert with the burial of patient A. Reportedly, her husband in DRC died of an acute illness at approximately the same time, and others in patient A's family in DRC were ill, some with "fever and swellings."

On 3 Mar 2019, in Uganda, patient B, aged 23 years (the sister of patient A), developed fever. In a health care facility on the following day, she tested positive for malaria and lacked signs of pneumonia. She received intravenous artesunate for malaria, but in light of the suspicion for plague in the area, she was admitted and empirically started on gentamicin. Approximately 8 hours later, she coughed up blood-tinged sputum. Other patients were removed from the room, and droplet precautions were instituted.

Blood from patient B tested negative for Ebola virus disease and other hemorrhagic fever viruses at UVRI using established methods (5). Sputum yielded the maximal positive reaction (4+) on a commercial rapid diagnostic test (RDT) (New Horizons Diagnostics) for detection of _Yersinia pestis_ fraction 1 (F1) antigen. Cultures of blood and sputum (obtained approximately 8 hours after initiation of antibiotic treatment) were negative. Subsequent testing of plasma and sputum by real-time polymerase chain reaction (PCR) yielded evidence of _Y. pestis_ DNA. The patient was treated with gentamicin for 7 days and doxycycline for 4 days and was discharged on 14 Mar 2019. _Y. pestis_ infection was confirmed by seroconversion on a total immunoglobulin F1 antigen passive hemagglutination assay (acute titer = 0 [collected 4 Mar 2019]; convalescent titer = 1:2,048 [collected 18 Mar 2019]).

Patient B did not travel to DRC for the burial of patient A's child and did not arrive in the ancestral village to care for her sister until the morning of 28 Feb 2019. Patient B cared for patient A that morning, including using her hand to clean around patient A's mouth, feeding her, transporting her to the clinic via motorbike, and attending to her at the clinic. She was not involved in transport of patient A's body back to the village or in burial preparations.

Public Health Response
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On 5 Mar 2019, UVRI and district representatives rapidly mobilized and executed contact tracing and prophylaxis administration. In total, 129 persons were identified as contacts of patient A or B, including 8 (6%) clinic staff members; 127 were placed on a 5-day prophylactic course of doxycycline, co-trimoxazole, or ciprofloxacin. Most persons identified as contacts (80; 62%) reported physical contact with or exposure within one meter or less of either patient. 98 (76%) persons reported contact with patient A, including those involved in handling her body after her death. 53 traced contacts (41%) had high-risk exposure, as determined by subjective assessment of their distance from either patient and presumed patient infectiousness [Figure, for figure, see original URL. - ProMED Mod.LL].

During a 10-day follow-up period, no identified contacts developed plague-like symptoms, and no indication of plague activity in Uganda was detected despite active clinic-, community-, and rodent-based surveillance for plague in the region. Comprehensive public health response was limited by jurisdiction; the UVRI team was unable to provide expertise and resources to support plague control just over the border in DRC. The fate of patient A's DRC-based family and community members, given the likely ongoing circulation of _Y. pestis_ among rodents and fleas in that village, is not known.

Discussion
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Plague persists in transmission cycles involving rodents and fleas on several continents, including Africa (1). Although plague generates fear because of its historical reputation, pneumonic plague transmission in modern times can be controlled by implementing droplet precautions, antimicrobial therapy, and prophylaxis of contacts (6,7). This report summarizes importation of plague from DRC into Uganda. Rapid and effective response curtailed epidemic spread of pneumonic plague beyond a single transmission event from patient A to patient B in Uganda.

Worldwide, most plague occurs following the bite of an infected flea and results in bubonic plague, characterized by acute fever and a painful swollen lymph node (1,4). Untreated, infection can spread to the lungs (2). Pneumonic plague transmission occurs via respiratory droplets and requires close contact with severely ill persons (7). The highest-risk exposures are those within 2 meters of persons coughing blood-tinged sputum; transmission might also occur during body preparation in traditional burials (8). The typical incubation period for primary pneumonic plague is less than one day to 4 days, and the condition is often fatal if effective antibiotics are not initiated within 24-36 hours of illness onset (2).

Patient B's exposure to patient A was limited to the morning hours of 28 Feb 2019 and was followed by patient B's illness onset approximately 72 hours later. Persons with high-risk exposures to patient A as identified upon contact tracing were 3-5 days postexposure when antibiotic prophylaxis was initiated on 5 Mar 2019. Because only patient B became ill, the secondary attack rate among all persons with high-risk exposures was 2%. Postexposure prophylaxis might have prevented illness among some of those who received it, particularly those exposed to patient B, who were all still within the incubation period. This outcome highlights that pneumonic plague is not as transmissible as is often believed; and spread typically occurs among persons with close and substantial, rather than incidental, contact with a patient with late-stage disease (7). Secondary transmission rates in outbreaks in Madagascar and Uganda have been estimated at approximately 8%; however, transmission also depends on cultural and behavioral factors that might place persons at increased risk above the inherent transmissibility of the organism (8,9). Engagement with community leaders, members, health workers, and traditional healers in areas where plague is endemic can improve early recognition and implementation of simple interventions to curtail epidemic spread (7,10).

Even in areas with endemic plague, clinical diagnosis is challenging because of the nonspecific nature of the febrile illness in the absence of painful lymphadenopathy or blood-tinged sputum (3). RDT, real-time PCR, and paired serology testing were all positive for plague in patient B, despite collection of clinical specimens after initiation of effective antibiotic treatment, which did, however, hinder recovery of the organism in culture. RDT use occurred as part of ongoing research jointly conducted by CDC and UVRI to evaluate the sensitivity and specificity of RDTs for plague on human clinical specimens. Validated RDTs used by trained personnel might have value in providing rapid information to guide public health response but should be supported by additional diagnostic tests. Even in the remote setting of northwestern Uganda, collection of multiple clinical samples and use of multiple tests allowed for confirmation of the etiology.

CDC has worked with Uganda's Ministry of Health and UVRI since 2003 to provide technical support for clinic- and animal-based plague surveillance, laboratory capacity, and community education and to conduct multifaceted research into improved diagnostics and effectiveness of environmental plague prevention approaches. Despite initial cross-border notification of suspected plague in DRC, lack of an established local cross-border collaboration prevented the resources and plague expertise in Uganda from supporting mitigation of ongoing risk just over the porous geopolitical boundary. Cross-border collaboration can improve capability to effectively respond to public health threats that affect border regions.

References
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1. Pollitzer R. Plague. Geneva, Switzerland: World Health Organization; 1954. <https://apps.who.int/iris/handle/10665/41628>
2. Mead PS. Plague (_Yersinia pestis_) [Chapter 229A]. In: Bennett JE, Dolin R and Blaser MJ, eds. Principles and practices of infectious diseases. 9th ed. Vol. 2. Philadelphia, PA: Elsevier; 2020:2779-87. <https://www.us.elsevierhealth.com/mandell-douglas-and-bennetts-principles-and-practice-of-infectious-diseases-9780323482554.html>
3. Forrester JD, Apangu T, Griffith K, et al. Patterns of human plague in Uganda, 2008-2016. Emerg Infect Dis 2017;23:1517-21.
4. Dennis DT, Gage KL, Gratz ND, Poland JD, Tikhomirov E. Plague manual: epidemiology, distribution, surveillance and control. Geneva, Switzerland: World Health Organization; 1999. <https://apps.who.int/iris/handle/10665/66010>
5. Shoemaker TR, Balinandi S, Tumusiime A, et al. Impact of enhanced viral haemorrhagic fever surveillance on outbreak detection and response in Uganda. Lancet Infect Dis 2018;18:373-5.
6. Mead PS. Plague in Madagascar--a tragic opportunity for improving public health. N Engl J Med 2018;378:106-8.
7. Kool JL. Risk of person-to-person transmission of pneumonic plague. Clin Infect Dis 2005;40:1166-72.
8. Ratsitorahina M, Chanteau S, Rahalison L, Ratsifasoamanana L, Boisier P. Epidemiological and diagnostic aspects of the outbreak of pneumonic plague in Madagascar. Lancet 2000;355:111-3.
9. Begier EM, Asiki G, Anywaine Z, et al. Pneumonic plague cluster, Uganda, 2004. Emerg Infect Dis 2006;12:460-7.
10. CDC. Bubonic and pneumonic plague--Uganda, 2006. MMWR Morb Mortal Wkly Rep 2009;58:778-81.  [Authors: Apangu T, Acayo S, Atiku LA, et al]
======================
[This reports poetically highlights how a rapid response to a single case of a highly transmissible infectious disease in a rapid manner can minimize secondary cases.  This is a followup to ProMED post: Plague - Uganda: Congo DR border, pneumonic, fatal http://promedmail.org/post/20190312.6363171  - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Zombo District, Uganda: <http://healthmap.org/promed/p/24924>]
Date: Fri 21 Feb 2020
Source: WHO Emergencies preparedness, response, Disease Outbreak News [edited]

From 4 Nov [2019] through 14 Feb 2020, 8 laboratory-confirmed cases of yellow fever in Buliisa (3), Maracha (1), and Moyo (4), including 4 deaths (CFR 50%), were detected through the national surveillance system.

On 10 Dec 2019, the Ministry of Health (MoH) was notified by the Uganda Virus Research Institute (UVRI) Regional Reference Laboratory of a case of yellow fever confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR). The case was a 37-year-old male with suspected viral haemorrhagic fever (VHF). His occupation was cattle farming with a history of travel to trade milk between Kizikya cell, Buliisa district in Uganda, and the Democratic Republic of Congo (DRC). On 30 Oct 2019, he presented to hospital with symptoms of fever and headache of a 5-day duration. His symptoms worsened with vomiting, abdominal pain, and epistaxis, and he died on 4 Nov 2019.

During an in-depth investigation in December [2019], 8 samples were collected from close contacts, including family members and neighbours, and tested for yellow fever. On 22 Jan 2020, UVRI notified the MoH of a 2nd case of yellow fever confirmed by serological testing (IgM and PRNT) in Buliisa with connection to the index case and with a similar occupation. The other samples collected during the investigation were negative for yellow fever.

Also, 2 other confirmed cases of yellow fever were identified in Moyo district in West Nile region, which shares a border with South Sudan. The cases were aged 18 and 21 years, traded timber between Uganda and South Sudan, and spent time in both countries. Onset of illness for both cases was 3 Jan 2020, and they were admitted at a health center in Moyo District. They were later referred to a General Hospital with symptoms of fever, vomiting, diarrhoea, fatigue, headache, abdominal and joint pains, confusion, and unexplained bleeding. The cases deteriorated and died in the hospital on 5 and 6 Jan 2020, respectively. Results from UVRI confirmed yellow fever infection by RT-PCR performed at UVRI.

Subsequently, Moyo district notified a 2nd cluster of suspected and confirmed yellow fever infection in a different village. The confirmed case in the suspected cluster was a 59-year-old patient who presented with symptoms including unexplained bleeding and fever on 22 Jan [2020] and died on 23 Jan 2020. A blood sample collected tested positive for yellow fever by RT-PCR at UVRI. His death was preceded by the death of 2 of his family members in early January [2020] with similar symptoms.

The Minister of Health of the Government of Uganda declared an outbreak of yellow fever on 23 Jan 2020.

Subsequent to the declaration of an outbreak, 3 additional cases were confirmed in Buliisa (1), Moyo (1), and Maracha (1). Detailed investigations of these cases are ongoing.

Public health response
National rapid response teams have been deployed to Moyo and Buliisa districts to conduct further investigations and initiate outbreak response. Other response activities include enhanced surveillance and active case finding in all districts in the northwest region and entomological surveys in the affected districts of Buliisa and Moyo. Cross-border notification with South Sudan in reference to the cases in Moyo district has been done. Investigations are ongoing in DRC and South Sudan, and WHO AFRO is supporting coordination.

The Ministry of Health is planning a reactive campaign, approved by the International Coordinating Group on Vaccine Provision for Yellow Fever Control. This reactive campaign will target approximately 1.7 million people to stop transmission and prevent imminent risk of the outbreak spreading in the northwest part of country particularly in Buliisa, Koboko, Maracha, Moyo, and Yumbe districts. To achieve sustained protection across the country, the MoH is preparing to apply for the introduction of yellow fever vaccination into the routine immunization programme in 2021 and implementation of preventive mass vaccination campaigns nationally.

WHO risk assessment
Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. Uganda is classified as a high-risk country in the "Eliminate Yellow Fever Epidemics" (EYE) initiative, with history of recent outbreaks in 2019, 2018, 2016, and 2011. Epidemic spread of yellow fever is a risk in Uganda, as the estimated overall population immunity is low (4.2%) and attributable to past reactive vaccination activities in focal districts that are not affected by the current outbreak.

Due to the negligible population immunity in the affected districts, the detection of yellow fever cases is concerning. The affected districts share international borders with both DRC and South Sudan and are marked by frequent population movements and high interconnectivity. Population immunity for yellow fever in the cross-border areas is also low, and the forest biome between countries is continuous, indicating that there is a risk of international spread. Close monitoring of the situation with active cross-border coordination and information sharing is needed, as the possibility of cases in neighbouring countries and risk of onward spreading to DRC and South Sudan cannot be completely excluded.

WHO advice
Vaccination is the primary means for prevention and control of yellow fever and provides immunity for life. In urban centres, targeted vector control measures are also helpful to interrupt transmission. The country plans to introduce yellow fever vaccination into the routine immunization program and complete preventive mass vaccination activities to rapidly boost population immunity. Expedited planning and implementation of these activities to protect the population will help avert risk of future outbreaks.

WHO recommends vaccination against yellow fever for all international travellers aged 9 months and above going to Uganda as there is evidence of persistent or periodic yellow fever virus transmission. Yellow fever vaccination is safe and highly effective and provides lifelong protection. However, yellow fever vaccination is not recommended for infants aged 6-8 months, except during epidemics when the risk of yellow fever virus transmission may be very high. The risks and benefits of vaccination in this age group should be carefully considered before vaccination. The vaccine should be used with caution during pregnancy or breastfeeding. However, pregnant or breastfeeding women may be vaccinated during epidemics or if travel to a country or area with risk of transmission is unavoidable. Uganda also requires, as a condition of entry, a valid yellow fever vaccination certificate for travelers aged one year and above.

In accordance with the International Health Regulations (2005) 3rd edition, the international certificate of vaccination against yellow fever is valid from 10 days after vaccination and throughout the life of the person vaccinated. A single dose of WHO-approved yellow fever vaccine is sufficient to confer sustained immunity and lifelong protection against yellow fever disease. A booster dose of the vaccine is not needed and is not required of international travellers as a condition of entry.

WHO encourages its member states to take all actions necessary to keep travellers well informed of risks and preventive measures including vaccination. As a general precaution, WHO also recommends avoidance of mosquito bites. The highest risk for transmission of yellow fever virus is during the day and early evening. Travelers should be made aware of the signs and symptoms of yellow fever and instructed to rapidly seek medical advice if experiencing signs and symptoms suggestive of yellow fever infection. Viraemic returning travelers may pose a risk for the establishment of local cycles of yellow fever transmission in areas where a competent vector is present.

WHO does not recommend any restrictions on travel and trade to Uganda on the basis of the information available on this outbreak.
===================
[The earlier ProMED-mail post reported 2 small (2 infected individuals in each locality) yellow fever (YF) outbreaks that were not interconnected, having occurred at 2 sites at far distances from each other (see Yellow fever - Africa (03): Uganda (BL, MY) http://promedmail.org/post/20200124.6913409). The number of confirmed YF cases has now increased to 8 with new localities. The Ministry of Health is wise to increase YF surveillance and to mount a prompt vaccination campaign. The current vaccination coverage (4.2%) is extremely low and far short of the 80% that would provide adequate immunity for the population.

Yellow fever is no stranger in Uganda, and outbreaks occur sporadically. A recent previous outbreak reported by the Ugandan Ministry of Health was in May 2019 after laboratory-confirmed cases were reported from Koboko in the Northern region and Masaka in the Central region districts, 600 km (373 mi) apart. These cases are spillover from endemic sylvan (forest) maintenance of the virus. Maintaining adequate vaccination coverage in these areas is important to prevent initiation of urban transmission of the virus, which can quickly get out of hand. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Wed, 19 Feb 2020 16:12:54 +0100 (MET)
By Michael O'HAGAN

Otuke, Uganda, Feb 19, 2020 (AFP) - Under a warm morning sun scores of weary soldiers stare as millions of yellow locusts rise into the northern Ugandan sky, despite hours spent spraying vegetation with chemicals in an attempt to kill them.   From the tops of shea trees, fields of pea plants and tall grass savanna, the insects rise in a hypnotic murmuration, disappearing quickly to wreak devastation elsewhere.   The soldiers and agricultural officers will now have to hunt the elusive fast-moving swarms -- a sign of the challenge facing nine east African countries now battling huge swarms of hungry desert locusts.

They arrived in conflict-torn South Sudan this week, with concerns already high of a humanitarian crisis in a region where 12 million are going hungry, according to the UN's Food and Agriculture Organization (FAO).    "One swarm of 40 to 80 million can consume food" for over 35,000 people in a day, Priya Gujadhur, a senior FAO official in Uganda, told AFP.

In Atira -- a remote village of grass-thatched huts in northern Uganda -- some 160 soldiers wearing protective plastic overalls, masks and goggles sprayed trees and plants with pesticide from before dawn in a bid to kill the resting insects.   But even after hours of work they were mostly able to reach only lower parts of the vegetation.   Major General Kavuma sits in the shade of a Neem Tree alongside civilian officials as locusts sprayed with pesticide earlier that morning fall around them, convulsing as they die.   An intense chemical smell hangs in the air.

- 'They surrounded me' -
Zakaria Sagal, a 73-year-old subsistence farmer was weeding his field in Lopei village some 120 kilometres (75 miles) away, preparing to plant maize and sorghum, when without warning a swarm of locusts descended around him.   "From this side and this side and this side, they surrounded me," Sagal said, waving his arms in every direction.    "We have not yet planted our crops but if they return at harvest time they will destroy everything. We are not at all prepared."

East Africa's regional expert group, the Climate Prediction and Applications Centre (ICPAC), warned Tuesday that eggs laid across the migratory path will hatch in the next two months, and will continue breeding as the rainy season arrives in the region.   This will coincide with the main cropping season and could cause "significant crop losses... and could potentially worsen the food security situation", ICPAC said in a statement.

- 'Panic mode' -
Since 2018 a long period of dry weather followed by a series of cyclones that dumped water on the region created "excessively ideal conditions" for locusts to breed, says Gujadhur.    Nevertheless, governments in East Africa have been caught off guard and are currently in "panic mode" Gujadhur said.   The locusts arrived in South Sudan this week after hitting Ethiopia, Somalia, Kenya, Djibouti, Eritrea, Tanzania, Sudan and Uganda.   Desert locusts take over on a dizzying scale.

One swarm in Kenya reached around 2,400 square kilometres (about 930 square miles) -- an area almost the size of Moscow -- meaning it could contain up to 200 billion locusts.   "A swarm that size can consume food for 85 million people per day," said Gujadhur.   Ugandan authorities are aware that subsequent waves of locusts may pose problems in the weeks to come, but in the meantime they are attempting to control the current generation.

Gujadhur is quick to praise the "quite strong and very quick" response from the Ugandan government but is concerned that while the army can provide valuable personnel, a military-led response may not be as effective as is necessary.    "It needs to be the scientists and (agriculture officials) who take the lead about where the control operations need to be and how and when and what time," she said.

- 'They eat anything green' -
The soldiers have been working non-stop for two days, criss-crossing the plains on the few navigable roads, trying to keep up with the unpredictable swarms.    Major General Kavuma recognises that the biggest threat is from the eggs which are yet to hatch but is confident the army will be able to control this enemy.   "We have the chemicals to spray them, all we need is to map the places they have been landing and sleeping," he said.   "In two weeks time we will come back and by that time they will have hatched and that will be the time to destroy them by praying."

Back in Lopei village, Elizabeth Namoe, 40, a shopkeeper in nearby Moroto had been visiting family when the swarm arrived.   "When the locusts settle they eat anything green, the animals will die because they have nothing to feed on, then even the people (will suffer)," she said.   "The children will be affected by hunger and famine since all life comes from all that is green. I fear so much."
Date: Sun, 9 Feb 2020 04:22:39 +0100 (MET)

Kampala, Feb 9, 2020 (AFP) - Four endangered mountain gorillas, including three adult females, have been killed by an apparent lightning strike in a Ugandan national park, a conservation group has said.   A post-mortem examination has been performed on the four, including a male infant, who died on February 3 in Mgahinga National Park in southwest Uganda.   "Based on the gross lesions from the post-mortem... the tentative cause of death for all four individuals is likely to be electrocution by lightning," the Greater Virunga Transboundary Collaboration (GVTC) said in a statement Saturday, although laboratory confirmation will take two to three weeks.

The four were members of a group of 17 known as the Hirwa family which had crossed into the Mgahinga National Park in August last year from Volcanoes National Park in neighbouring Rwanda.   "This was extremely sad," GVTC executive secretary Andrew Seguya told the BBC.   "The potential of the three females for their contribution to the population was immense."   The other 13 members of the group had been found.

In 2008, there were estimated to be only 680 of the great apes left but thanks to conservation efforts and anti-poaching patrols, their population has grown to more than 1,000.   Due to these efforts, in 2018 the mountain gorilla, a subspecies of the eastern gorilla, was moved from "critically endangered" to "endangered" on the IUCN's "Red List" of threatened species.   Covering the northern slopes of three volcanoes, Mgahinga National Park is part of the Virunga massif shared with Rwanda and the Democratic Republic of Congo.   The massif is one of the most important conservation sites in the world and one of only two places where mountain gorillas are found.
Date: Fri 24 Jan 2020
Source: Uganda Ministry of Health Tweets [edited]

[This series of tweets is drawn from a video interview that is also available at the above Twitter URL.]

The Ugandan Health Minister confirms an outbreak of yellow fever in Moyo District, West Nile region and Buliisa District in the Hoima region of Uganda.

Original public tweets
------------------------
Minister of Health, @JaneRuth_Aceng confirms the outbreak of Yellow Fever in Moyo District in West Nile region and Buliisa District in Hoima region in #Uganda.

@WHOUganda country representative, @tegegny speaks about the Yellow fever vaccine. "The Yellow Fever vaccine is one of those vaccines where you need to be vaccinated only once," he says.

@MinofHealthUG has also applied to @gavi and WHO for inclusion of the Yellow Fever vaccination into the routine immunisation schedule. Having faced 4 outbreaks, #Uganda now qualifies to introduce Yellow Fever vaccine as a long term measure to prevent Yellow Fever outbreaks.

@JaneRuth_Aceng: We anticipate that within the next 2 weeks, vaccines will be available and vaccination will commence in Moyo and Buliisa districts.

@JaneRuth_Aceng: @MinofHealthUG has requested for the Yellow Fever vaccines from the International Coordination Group that manages global stock piles of Yellow Fever and Meningitis vaccines.

@MinofHealthUG working with partners have dispatched Rapid Response Teams to Moyo and Buliisa Districts to support investigations, active search for cases, community mobilization and sensitization.

@JaneRuth_Aceng: At this time, there was little suspicion, however, his blood sample was withdrawn and sent to @UVRIug [Uganda Virus Research Institute] for testing and results showed positive for Yellow fever virus.

@JaneRuth_Aceng: In Buliisa, there are also 2 confirmed cases. A 37-year old male and his 38-year old wife. The husband was a cattle farmer trading in milk between Uganda and the Democratic Republic of Congo (DRC).

They presented with symptoms of:
- fever
- vomiting
- diarrhea
- fatigue
- headache
- abdominal and joint pain
- confusion
- unexplained bleeding.

@JaneRuth_Aceng: Upon arrival, they got ill and on [3 Jan 2020] were admitted at Logobo Health Center III in Moyo District. They were later referred to Moyo General Hospital.

@JaneRuth_Aceng: In Moyo District, there are 2 confirmed cases, both are males who were dealing in cutting and trading timber between Uganda and South Sudan. On [2 Jan 2020], the 2 cases travelled from South Sudan to Moyo.
==========================
[These 2 small (2 infected individuals in each locality) yellow fever (YF) outbreaks are not interconnected, having occurred at 2 sites at far distances from each other. It is reassuring to learn that the Ministry of Health will be investigating these 2 sites and initiating vaccination in these areas in 2 weeks. There is no indication of the proportion of the residents in these areas who have been vaccinated for YF previously.

Yellow fever is no stranger in Uganda, and outbreaks occur sporadically. The most recent previous outbreak reported by the Ugandan Ministry of Health was in May 2019 after laboratory-confirmed cases were reported from Koboko in the Northern region and Masaka in the Central region districts -- regions 600 km (375 mi) apart. These cases are spillover from endemic sylvan (forest) maintenance of the virus. Maintaining 80%-90% vaccination coverage in these areas is important to prevent initiation of urban transmission of the virus that can quickly get out of hand.

A map showing the location of Buliisa District in the center-west part of Uganda can be accessed at <https://en.wikipedia.org/wiki/Buliisa_District>, and another showing Moyo District in the far north of the country can be seen at <https://en.wikipedia.org/wiki/Moyo_District>. - ProMED Mod.TY]

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World Travel News Headlines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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