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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Benin - US Consular Information Sheet
April 28, 2008

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

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

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

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

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

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

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

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

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

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

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

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

See our information on Victims of Crime.

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

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 ...

United Kingdom

United Kingdom and Gibraltar (England, Wales, Scotland, Northern Ireland) US Consular Information Sheet
October 09, 2008
COUNTRY DESCRIPTION:
The United Kingdom of Great Britain and Northern Ireland is a highly developed constitutional mon
rchy composed of Great Britain (England, Scotland, and Wales) and Northern Ireland.
Read the Department of State Background Notes on the United Kingdom for additional information.
Gibraltar is a UK Overseas Territory bordering Spain, and is located at the southernmost tip of Europe at the entrance to the Mediterranean Sea.
It is one of 13 former British colonies that have elected to continue their political links with London.
Tourist facilities are widely available throughout the United Kingdom and Gibraltar.

ENTRY/EXIT REQUIREMENTS:
A UK visa/entry clearance is not required for tourist or business visits to the United Kingdom of less than six months in duration.
Visitors wishing to remain longer than one month in Gibraltar should regularize their stay with Gibraltar immigration authorities.
Those planning to visit the United Kingdom for any purpose other than tourism or business, or who intend to stay longer than six months, should consult the website of the British Embassy in the United States at http://ukinusa.fco.gov.uk/en for information about current visa/entry clearance requirements.
Those who are required to obtain a visa/entry clearance and fail to do so may be denied entry and returned to their port of origin.
The U.S. Embassy cannot intervene in UK immigration matters.

In the past year, the British government has completely restructured its immigration system, tightening visa/entry clearance regulations and enforcement at its borders.
All American travelers to the United Kingdom are urged to check the web site of the British Embassy in the United States at http://ukinusa.fco.gov.uk/en or the web site of the UK Border Agency at http://www.bia.homeoffice.gov.uk/ to determine whether they must have a visa/entry clearance before traveling to the United Kingdom.
Students should be especially alert to UK visa/entry clearance requirements.
Under no circumstances should Americans seeking to study or work in the United Kingdom attempt to enter the country without the appropriate visa/entry clearance from a British Consulate in the United States.
If you do so, you are likely to be detained by UK immigration officials at the port of entry and held in an immigration detention facility until you can be returned to the United States.
Again, the U.S. Embassy cannot intervene in UK immigration matters.

In addition to the British Embassy web site at http://ukinusa.fco.gov.uk/en, those seeking current UK visa/entry clearance information may also contact UK consular offices in the United States via their premium rate telephone service at 1-900-656-5000 (cost $3/minute) or 1-212-796-5773 ($12 flat fee).
There is also a no-fee website for visa information at www.visainfoservices.com.

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

SAFETY AND SECURITY:
The United Kingdom is politically stable, with a modern infrastructure, but shares with the rest of the world an increased threat of terrorist incidents of international origin, as well as the potential, though significantly diminished in recent years, for isolated violence related to the political situation in Northern Ireland (a part of the United Kingdom).

Like the United States, the United Kingdom shares its national threat levels with the general public to keep everyone informed and explain the context for the various increased security measures that may be encountered. UK threat levels are determined by the UK Home Office and are posted on its web site at http://www.homeoffice.gov.uk/security/current-threat-level/.

Information from the UK Security Service, commonly known as MI5, about the reasons for the increased threat level and actions the public can take is available on the MI5 web site at http://www.mi5.gov.uk/.
American citizens are advised to check with the UK Department for Transport at http://www.dft.gov.uk/transportforyou/airtravel/airportsecurity/ regarding the latest security updates and carry-on luggage restrictions.

The British Home Secretary has urged UK citizens to be alert and vigilant by, for example, keeping an eye out for suspect packages or people acting suspiciously at subway (called the Tube or Underground) and train stations, as well as at airports, and reporting anything suspicious to the appropriate authorities.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.
For more information about UK public safety initiatives, consult the UK Civil Contingencies Secretariat web site at http://www.ukresilience.gov.uk.

The political situation in Northern Ireland has improved dramatically.
The potential remains, however, for sporadic incidents of street violence and/or sectarian confrontation.
American citizens traveling to Northern Ireland should therefore remain alert to their surroundings and should be aware that if they choose to visit potential flashpoints or attend parades, sporadic violence remains a possibility.
Tensions may be heightened during the summer marching season (April to August), particularly during the month of July (around the July 12th public holiday).

The phone number for police/fire/ambulance emergency services – the equivalent of 911 in the United States – is 999 in the United Kingdom and 112 in Gibraltar.
This number should also be used for warnings about possible bombs or other immediate threats.
The UK Anti-Terrorist Hotline, at 0800-789-321, is for tips and confidential information about possible terrorist activity.

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 current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the U.S. Embassy's American Citizens Services web page at http://london.usembassy.gov/cons_new/acs/index.html.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States, or for callers outside the United States 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 United Kingdom and Gibraltar benefit from generally low crime rates, which decreased slightly in 2007 in significant categories, including violent crime.
The crime situation in the United Kingdom is similar to that in the United States: typical incidents include pick pocketing; muggings; “snatch and grab” thefts of mobile phones, watches and jewelry; and thefts of unattended bags, especially at airports and from cars parked at restaurants, hotels, and resorts.
Pickpockets target tourists, especially at historic sites and restaurants, and on buses, trains, and the London subway (known as the Tube or Underground).
Thieves often target unattended cars parked at tourist sites and roadside restaurants, looking for laptop computers and handheld electronic equipment, especially global positioning satellite equipment.
Walking in isolated areas, including public parks, especially after dark, should be avoided, as these are advantageous venues for muggers and thieves.
At night or when there is little foot traffic, travelers should be especially careful using the underground pedestrian tunnels.
As a general rule, either walk the extra distance to use a surface crossing or wait until there are other adult pedestrians entering the tunnel.

In London, travelers should use only licensed Black Cabs or car services recommended by their hotel or tour operator.
Unlicensed taxis or private cars posing as taxis may offer low fares, but are often uninsured and may have unlicensed drivers.
In some instances, travelers have been robbed and raped while using these cars.
You can access 7,000 licensed Black Cabs using just one telephone number: 087-1871-8710.
This taxi booking service combines all six of London’s radio taxi circuits, allowing you to telephone 24 hours a day if you need a cab.
Alternatively, to find a licensed minicab, text HOME to 60835 on your mobile phone to get the telephone number to two licensed minicab companies in the area.
If you know in advance when you will be leaving for home, you can prebook your return journey.
The Safe Travel at Night partnership among the Metropolitan Police, Transport for London, and the Mayor of London maintains a web site with additional information at http://www.cabwise.com/.
Travelers should not leave drinks unattended in bars and nightclubs.
There have been some instances of drinks being spiked with illegal substances, leading to incidents of robbery and rape.

Americans should take steps to ensure the safety of their U.S. passports.
Visitors in England, Scotland, Wales, Northern Ireland, and Gibraltar are not expected to produce identity documents for police authorities and thus may secure their passports in hotel safes or residences.
Abundant ATMs that link to U.S. banking networks offer an optimal rate of exchange, and they preclude the need to carry a passport to cash travelers’ checks.
Travelers should be aware that U.S. banks might charge a higher processing fee for withdrawals made overseas.
Common-sense personal security measures taken in the United States when using ATMs should also be followed in the United Kingdom.
ATM fraud in the United Kingdom is becoming more sophisticated, incorporating technologies to surreptitiously record customer ATM card and PIN information.
Travelers should avoid using ATMs that look in any way temporary in structure or location, or are located in isolated areas.
Travelers should be aware that in busy public areas, thieves use distraction techniques, such as waiting until the PIN number has been entered and then pointing to money on the ground, or attempting to hand out a free newspaper.
When the ATM user is distracted, a colleague will quickly withdraw cash and leave.
If distracted in any way, travelers should press the cancel transaction button immediately and collect their card before speaking to the person who has distracted them.
If the person’s motives appear suspicious, travelers should not challenge them but remember the details and report the matter to police as soon as possible.
In addition, travelers should not use the ATM if there is anything stuck to the machine or if it looks unusual in any way.
If the machine does not return the card, report the incident to the issuing bank immediately.

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 at the opening of the next business day.
The U.S. Embassy or Consulate issues replacement passports only during regular business hours.
If you are the victim of a crime while overseas, report it to local police.
The nearest U.S. Embassy or Consulate will also be able to assist by helping you to find appropriate medical care, contacting family members or friends, and explaining 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.

Visit the Victim Support web site, maintained by an independent UK charity to help people cope with the effects of crime: http://www.victimsupport.org.uk/.

See our information for Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
While medical services are widely available, free care under the National Health System is allowed only for UK residents and certain EU nationals.
Tourists and short-term visitors will be charged for medical treatment in the United Kingdom.
Charges may be significantly higher than those assessed in the United States.

Hiking in higher elevations can be treacherous.
Several people die each year while hiking, particularly in Scotland, often due to sudden changes in weather.
Visitors, including experienced hikers, are encouraged to discuss intended routes with local residents familiar with the area, and to adhere closely to recommendations.

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 from the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site at http://www.who.int/en.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance companies prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
If your medical insurance policy does not provide overseas coverage, you may want to purchase a short-term policy for your trip.
The Department of State provides an online list of travel insurance companies that can provide the additional insurance needed for the duration of one’s trip abroad.

Remember also that most medical care facilities and medical care providers in the United Kingdom do not accept insurance subscription as a primary source of payment.
Rather, the beneficiary is expected to pay for the service and then seek reimbursement from the insurance company.
This may require an upfront payment in the $10,000 to $20,000 range

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

UK penalties for driving under the influence of even minimal amounts of alcohol or drugs are stiff and often result in prison sentences.
In contrast to U.S. and continental European traffic, which moves on the right side of the road, UK traffic moves on the left.

The maximum speed limit on highways/motorways in the United Kingdom is 70 mph.
Motorways generally have a hard shoulder (breakdown lane) on the far left, defined by a solid white line.
It is illegal to stop or park on a hard shoulder unless it is an emergency.
In such cases, you should activate your hazard lights, get out of your vehicle, and go onto an embankment for safety.

Emergency call boxes (orange telephone booths with SOS printed on them) may be found at half-mile intervals along the motorway.
White and blue poles placed every 100 yards along the motorway point in the direction of the nearest call box.
Emergency call boxes dial directly to a motorway center.
It is best to use these phones rather than a personal cell phone, because motorway center personnel will immediately know the location of a call received from an emergency call box.

Roadside towing services may cost approximately £125 (as of 10/08, approximately $225).
However, membership fees of automotive associations such as the RAC (Royal Automobile Club) or AA (Automobile Association) often include free roadside towing service.

Visitors uncomfortable with or intimidated by the prospect of driving on the left-hand side of the road may wish to avail themselves of the United Kingdom’s extensive bus, rail, and air transport networks.
Roads in the United Kingdom are generally excellent but are narrow and often congested in urban areas.
If you plan to drive while in the United Kingdom, you may wish to obtain a copy of the Highway Code, available at http://www.direct.gov.uk/en/TravelAndTransport/Highwaycode/index.htm.

Travelers intending to rent cars in the United Kingdom should make sure that they are adequately insured.
U.S. auto insurance is not always valid outside the United States, and travelers may wish to purchase supplemental insurance, which is generally available from most major rental agents.
A congestion charge of £8 (as of 10/08, approximately $15) is imposed on all cars entering much of central London Monday through Friday from 7:00 a.m. to 6:30 p.m.
Information on the congestion charge can be found at http://www.tfl.gov.uk/roadusers/congestioncharging/.
Public transport in the United Kingdom is excellent and extensive.
However, poor track conditions may have contributed to train derailments, resulting in some fatalities.
Repairs are under way and the overall safety record is excellent.
Information on disruptions to London transportation services can be found at http://www.tfl.gov.uk/tfl/livetravelnews/realtime/tube/default.html and information about the status of National Rail Services can be found at http://nrekb.nationalrail.co.uk/service_disruptions/today.html.
Many U.S. pedestrians are injured, some fatally, every year in the United Kingdom because they forget that oncoming traffic approaches from the opposite direction than in the United States.
Extra care should be taken when crossing streets; remember to remain alert and look both ways before stepping into the street.

Driving in Gibraltar is on the right-hand side of the road, as in the United States and continental Europe.
Persons traveling overland between Gibraltar and Spain may experience long delays in clearing Spanish border controls.
Please refer to our Road Safety Overseas page for more information.
For specific information concerning UK driving permits, vehicle inspection, road tax, and mandatory insurance, refer to the UK Department of Environment and Transport web site at http://www.dft.gov.uk/ or the Driving Standards Agency web site at http://www.dsa.gov.uk/.
The U.S. Embassy London’s web site at http://london.usembassy.gov/ also provides information.

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

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SPECIAL CIRCUMSTANCES:
The legal drinking age in the United Kingdom is generally lower than that in the United States, and social drinking in pubs is often seen as a routine aspect of British life.
Parents, organizers of school trips, and young travelers should be aware of the impact that this environment may have when combined with the sense of adventure that comes with being abroad.
Please see our Students Abroad web site as well as Studying Abroad to help students plan a safe and enjoyable adventure.

The United Kingdom has strict gun-control laws, and importing firearms is extremely complicated.
Travelers should consider leaving all firearms in the United States.
Restrictions exist on the type and number of weapons that may be possessed by an individual.
All handguns, such as pistols and revolvers, are prohibited, with very few exceptions.
Licensing of firearms in the United Kingdom is controlled by the police.
Applicants for a license must be prepared to show “good reason” why they require each weapon.
Applicants must also provide a copy of their U.S. gun license, a letter of good conduct from their local U.S. police station, and a letter detailing any previous training, hunting, or shooting experience.
Background checks will also be carried out.
Additional information on applying for a firearm certificate and/or shotgun certificate can be found on the Metropolitan Police Firearms Enquiry Teams web site at http://www.met.police.uk/firearms-enquiries/index.htm.

A number of Americans are lured to the United Kingdom each year in the belief that they have won a lottery or have inherited from the estate from a long-lost relative.
Americans may also be contacted by persons they have “met” over the Internet who now need funds urgently to pay for hospital treatment, hotel bills, taxes, or airline security fees.
Invariably, the person contacted is the victim of fraud.
Any unsolicited invitations to travel to the United Kingdom to collect winnings or an inheritance should be viewed with skepticism.
Also, there are no licenses or fees required when transiting a UK airport, nor is emergency medical treatment withheld pending payment of fees.
Please see our information on International Financial Scams.

Please read ourCustoms Information.

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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 British law, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the United Kingdom 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.

Many pocket knives and other blades, and mace or pepper spray canisters, although legal in the United States, are illegal in the United Kingdom and will result in arrest and confiscation if detected.
A UK Metropolitan Police guide to items that are prohibited as offensive weapons is available at http://www.met.police.uk/youngpeople/guns.htm.
A UK Customs Guide, detailing which items visitors are prohibited from bringing into the United Kingdom, is available at http://customs.hmrc.gov.uk/channelsPortalWebApp/downloadFile?contentID=HMCE_CL_001734.

Air travelers to and from the United Kingdom should be aware that penalties against alcohol-related and other in-flight crimes (“air rage”) are stiff and are being enforced with prison sentences.
Please also see our information on customs regulations that pertain when returning to the United States.

CHILDREN'S ISSUES:
Visit our web site for information on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the United Kingdom are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within the United Kingdom.
By registering, Americans make it easier for the Embassy or Consulate to contact them in case of emergency, and to relay updated information on travel and security within the United Kingdom.
The Embassy and Consulates regularly send security and other information via email to Americans who have registered.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
The Consular Section also disseminates a newsletter every month.
Those wishing to subscribe to the monthly consular newsletter in London should send a request by email to LondonACSNewsletter@state.gov.

The U.S. Embassy is located at 24 Grosvenor Square, London W1A 1AE; telephone: in country 020-7499-9000, from the United States 011-44-20-7499-9000 (24 hours). Consular Section fax: in country 020-7495-5012, from the United States 011-44-20-7495-5012, and on the web at http://london.usembassy.gov.

The U.S. Consulate General in Edinburgh, Scotland, is located at 3 Regent Terrace, Edinburgh EH7 5BW; telephone: in country 013-1556-8315, from the United States 011-44-13-1556-8315.
After hours: in country 012-2485-7097, from the United States 011-44-12-2485-7097.
Fax: in country 013-1557-6023, from the United States 011-44-13-1557-6023.
Information on the Consulate General is included on the Embassy’s web site at http://london.usembassy.gov/scotland.

The U.S. Consulate General in Belfast, Northern Ireland, is located at Danesfort House, 228 Stranmillis Road, Belfast BT9 5GR; telephone: in country 028-9038-6100, from the United States 011-44-28-9038-6100.
Fax:
in country 028-9068-1301, from the United States 011-44-28-9068-1301.
Information on the Consulate General is included on the Embassy’s web site at: http://london.usembassy.gov/nireland.

There is no U.S. consular representation in Gibraltar.
Passport questions should be directed to the U.S. Embassy in Madrid, located at Serrano 75, Madrid, Spain; telephone: 34-91-587-2200 and fax 34-91-587-2303.
The web site is http://madrid.usembassy.gov.
All other inquiries should be directed to the U.S. Embassy in London.
* * *
This replaces the Consular Information Sheet dated May 8, 2008 and updates the sections on Entry Requirements, Safety and Security, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Mon, 17 Feb 2020 21:19:05 +0100 (MET)
By Joe JACKSON

London, Feb 17, 2020 (AFP) - Britain on Monday battled the fallout from Storm Dennis after the second severe storm in seven days left one woman dead over the weekend.   Winds of more than 90 miles (140 kilometres) an hour, along with more than a month's worth of rain in 48 hours in some places, led officials to issue rare "danger to life" warnings.   A 55-year-old woman was found dead after being swept away by near the flood-prone town of Tenbury Wells in western England.   "We are all devastated," her family said in a statement after a body was discovered.

James Bevan, chief executive of the Environment Agency, which is responsible for flood protection, said more than 400 homes in England had been flooded while at least 1,000 agency staff were working "to protect and support those communities which have been hit".   "This is not yet over," he told BBC radio.   "We still have many flood warnings in force and we may still see significant flooding in the middle of this week from larger rivers."   The storm also pummelled much of France, with some 20,000 people without electricity on Monday after suffering power cuts in the northwest.

- 'More extreme' -
In Britain, more than 600 warnings and alerts -- a record number -- were issued on Sunday, extending from the River Tweed on the border of England and Scotland to Cornwall in the southwest.   After a day of torrential rain, major flooding incidents were declared in south Wales and parts of west central England.  In northern England, the defence ministry deployed troops in West Yorkshire, which had also been hit by flooding from last weekend's Storm Ciara.   There were fears that rivers there could burst their banks.

Newly appointed environment secretary George Eustice said the government had done "everything that we can do with a significant sum of money" to combat increased flooding.    "We'll never be able to protect every single household just because of the nature of climate change and the fact that these weather events are becoming more extreme," he said.   Youth climate activists gathering for a national conference in Staffordshire, west central England, were forced to cancel the event because of the storm.   "There's a bleak irony in our being beaten back by climate change," 15-year-old attendee Sophia said in a statement released by organisers.

- 'Supercomputer' announced -
Two rivers in south Wales burst their banks on Sunday, prompting rescue workers to launch operations to evacuate hundreds of people and their pets trapped in their homes.   Police said a man in his 60s died after entering the River Tawe, north of the Welsh city of Swansea, but later clarified that the death was not "linked to the adverse weather".

Meanwhile the bodies of two men were pulled from rough seas off the south coast of England on Saturday as the storm barrelled in.   Britain's Coastguard said it had sent a helicopter and rescue team to join navy and other search vessels after receiving reports of a man overboard in the sea near Margate, Kent.   "After many hours of searching, a body was sadly found in the water... and was brought to shore," it added.

Around the same time in nearby Herne Bay, emergency responders discovered another dead man following reports a person had been pulled from the sea, according to Kent police.   In a timely announcement the Met Office, Britain's national weather service, said Monday it would invest £1.2 billion ($1.6 billion) in a state-of-the-art supercomputer to improve forecasting.   The government claims it is the world's "most powerful weather and climate supercomputer".
Date: Sat 8 Feb 2020
Source: Food Safety News [edited]

Almost 200 people have fallen ill after eating oysters in the United Kingdom in recent months. Since November 2019 there have been at least 180 reported cases of gastroenteritis associated with oyster consumption linked to multiple food outlets and oyster producers. A Public Health England spokeswoman told Food Safety News that norovirus had been identified as the cause of a number of these outbreaks.

"Public Health England is working with the Food Standards Agency and Food Standards Scotland as well as affected local authorities to investigate outbreaks of gastrointestinal illness reported since November 2019 associated with consumption of oysters."

Officials say there is no connection to the norovirus outbreaks from oysters in Europe. In Sweden, 70 people fell sick after eating oysters, some of which came from domestic production and others from France. In Denmark, 180 people were ill after eating oysters from France. In France, 1033 people have been sickened and 21 needed hospital treatment. Italy and Netherlands also reported outbreaks linked to live oysters from France. Products were also recalled due to potential norovirus contamination in Belgium, Luxembourg, Switzerland, Hong Kong, and Singapore.

A spokeswoman for the Food Standards Agency told Food Safety News that it has identified that the outbreaks appear to be linked to consumption of oysters from several different harvesters. "We have identified from our investigations that there are numerous sites around the UK where oysters are produced and harvested. We have identified producers in East and South West of England and in Scotland that have supplied oysters that were eaten by a number of people reporting illness."

Two harvesters in the South and West of England voluntarily ceased production in mid-November [2019], and a harvester in the East of England decided to stop harvesting in early January 2020. When asked why there haven't been any product recalls when illnesses have been reported from November 2019, the spokeswoman said: "Oysters have a short shelf-life, and by the time cases of illness are reported, the affected oysters have normally been consumed. The official advice to consumers remains the same as usual: people should be aware of the risks of eating raw oysters. Elderly people, pregnant women, very young children, and people who have a weakened immune system should avoid eating raw or lightly cooked shellfish to reduce their risk of getting food poisoning. To prevent passing norovirus on to family and friends, it's vital to follow good personal hygiene practices."

The main symptoms of norovirus illness are diarrhea, vomiting, nausea, and stomach cramps. Symptoms can also include low-grade fever, headache, chills, muscle aches, and fatigue. People who are ill should drink plenty of liquids to replace lost body fluids and prevent dehydration.

Symptoms appear 1-2 days after being infected and typically last for 2-3 days. Norovirus is transmitted by having contaminated food or water or from person to person through contact with the skin, objects, or inhaling airborne particles.  [Byline: Joe Whitworth]
=================
[Researchers have analyzed the genetic sequences of 1077 samples of noroviruses found in oysters. Some sequences had been stockpiled in genetic databases since 1983. The scientists found that 80% of the known human noroviruses matched those found in oysters. The majority of the matches were in oysters from coastal waters, more likely to be contaminated with human sewage.

Noroviruses mutate very quickly, as do influenza viruses, and big outbreaks usually begin after a new strain emerges. There was a "convergence" between new strains circulating in oysters and those circulating in humans, the researchers also found.

Yongjie Wang, a food science specialist at Shanghai Ocean University and lead author of the study, concluded that oysters were an important reservoir for human noroviruses, a place where they can hide between outbreaks and mutate. They also can be transmitted back to humans, presumably when oysters are eaten raw.

Citation: Yongxin Yu, et al. Molecular Epidemiology of Oyster-Related Human Noroviruses and Their Global Genetic Diversity and Temporal-Geographical Distribution from 1983 to 2014. Appl Environ Microbiol. 2015; 81(21): 7615-7624. DOI: 10.1128/AEM.01729-15. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Wed 15 Jan 2020
Source: Lancs [abridged, edited]

Cases of suspected mumps rocketed in Lancashire last year [2019].

In 2019, 314 suspected cases were reported in the area to Public Health England (PHE). That's almost triple the 120 suspected cases in 2018.

It is also the highest number since comparable records began in 2011. The figures include 64 suspected cases in West Lancashire, 32 in Lancaster, 31 in Preston, and 30 in Blackpool.

The area also saw 30 suspected cases of measles last year [2019], the same number as in 2018. Doctors are required to report any suspected cases of certain infectious diseases to their local authority or local health protection team, although not all cases will be confirmed.  [Byline: Claire Miller Ruth Ovens]
Date: Wed 15 Jan 2020
Source: Devon Live [abridged, edited]

An outbreak of 19 new cases of mumps has been reported across Devon in the last week. The contagious viral disease particularly affects under 25s. The new mumps figures have been released in the official Government weekly Statutory Notifications of Infectious Diseases report, with the highest number in Exeter.

It follows a warning that mumps is on the rise, particularly in university towns. Traditionally known as the "kissing disease" because it spreads fast between groups of young people, mumps is a contagious viral infection recognisable by the painful swellings in the side of the face under the ears (the parotid glands), giving a person a distinctive "hamster face" appearance.

In severe cases, it can develop into viral meningitis if it moves in the outer layer of the brain. Other complications include swelling of the testicles or ovaries (if the affected person has gone through puberty), which may affect a person's fertility.  [Byline: Colleen Smith]
Date: Thu 2 Jan 2020 18:18 GMT
Source: Somerset Live [abridged, edited]

People across Somerset and Bath have been urged to be aware of the symptoms of scarlet fever after a huge outbreak of the illness across the county over the Christmas period. A total of 25 cases were confirmed across the county in the final 2 weeks of December [2019], according to figures released by Public Health England.

It represents a huge rise in the number of cases seen across Somerset -- which had seen 14 people diagnosed with the bacterial infection in the previous 2 weeks. 10 people caught the infection in Bath and North East Somerset alone over Christmas, with a further 5 cases being reported in North Somerset and 5 in Mendip. There were 2 cases in South Somerset and Taunton Deane, with a single case of scarlet fever reported in Sedgemoor.

During the festive period, 6 people caught scarlet fever in Wiltshire while there were 4 fresh confirmed cases in Dorset. A further 7 people have been diagnosed with the illness in Bristol.  [Byline: Stephen D'Albiac]
=====================
[HealthMap/ProMED-mail map of England, United Kingdom:

Somerset is a county in South West England, which borders Gloucestershire and Bristol to the north, Wiltshire to the east, Dorset to the south-east and Devon to the southwest (<https://en.wikipedia.org/wiki/Somerset>). A map showing the location of these counties can be found at (<https://en.wikipedia.org/wiki/Ceremonial_counties_of_England>). The city of Bath (<https://en.wikipedia.org/wiki/Bath,_Somerset>), North East Somerset (<https://en.wikipedia.org/wiki/North_East_Somerset_(UK_Parliament_constituency)>), North Somerset (<https://en.wikipedia.org/wiki/North_Somerset>), Mendip (<https://en.wikipedia.org/wiki/Mendip_District>), Sedgemoor (<https://en.wikipedia.org/wiki/Sedgemoor>), and Taunton Deane (<https://en.wikipedia.org/wiki/Taunton_Deane>) are located in Somerset County.

ProMED-mail has posted multiple reports since 2013 on outbreaks of scarlet fever, a non-invasive form of group A streptococcus (GAS) disease, throughout England and Wales (see list below). ProMED-mail also posted reports of an outbreak of invasive GAS infection since February 2019 that is occurring in Essex, a county in southeast England (<https://en.wikipedia.org/wiki/Essex>). See ProMED-mail posts Streptococcus, group A, invasive - UK (02): (England) fatal, WGS http://promedmail.org/post/20190807.6611267 and Streptococcus, group A, invasive - UK: (England) fatal, RFI http://promedmail.org/post/20190628.6542184.

One particular _emm_ type of GAS, _emm_1, has become increasingly common among isolates from both non-invasive and invasive GAS disease in England and Wales over the past several years. Whole genome sequencing of _emm_1 identified an outbreak strain, called M1UK, that by 2016 accounted for about 84% of _emm_1 strains. M1UK was also found to produce 9 times more toxin responsible for the characteristic rash in scarlet fever (<https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30446-3/fulltext>). - ProMED Mod.ML]
More ...

Congo, Democratic Republic

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

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

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

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

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for overseas callers, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
In the DRC, poor economic conditions continue to foster crime, especially in urban areas. Travel in many sections of Kinshasa, Kisangani, Lubumbashi and most other major cities, is generally safe during daylight hours, but travelers are urged to be vigilant against criminal activity which targets non-Congolese, particularly in highly congested traffic and areas surrounding hotels and stores. Outlying, remote areas are less secure due to high levels of criminal activity and the lack of adequate training, supervision, and salary payments to the security forces present.

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

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

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

Travelers using public transportation or visiting high pedestrian traffic areas of any type are advised to be vigilant against robbery and pick-pocketing which is a persistent problem in all major cities in the DRC. The presence of “street children”, who can be persistent and sometimes aggressive, remains a problem particularly in Kinshasa.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
In the DRC, medical facilities are severely limited, and medical materials are in short supply. Travelers should carry properly labeled prescription drugs and other medications with them and should not expect to find an adequate supply of prescription or over-the-counter drugs in local stores or pharmacies. Payment for any medical services required is expected in cash, in advance of treatment.

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

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
For planning purposes, the minimum estimated cost of medical air evacuation to the nearest suitable health care facility (in South Africa) is $35,000.

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the DRC is provided for general reference only, and may vary according to location or circumstance.

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

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

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

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

Drivers should stop their cars and pedestrians should stand still when passing a government installation during the raising and lowering of the Congolese flag. This ceremony occurs at roughly 7:30 a.m. and 6:00 p.m.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the DRC’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of the DRC’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
Civil aviation in the DRC continues to experience air incidents and accidents; more than a dozen crashes and in-flight accidents resulted in more than 300 fatalities between 2000 and August 2008. Incidents included hard landings, engine failures, collapsed landing gear, and planes veering off the runway.
In-country air travel schedules are unreliable and planes are frequently overloaded with passengers and/or cargo.
The U.S. Embassy in the DRC has prohibited official travel by U.S. government employees and contractors on all DRC-owned and -operated commercial air transportation services due to concerns regarding safety and maintenance.
International flights on foreign-owned and -operated carriers are not affected by this notice.
SPECIAL CIRCUMSTANCES:
Photography: Travelers should note that photography in public places in Kinshasa and around any public or government building or monument in the DRC is strictly forbidden. Persons caught photographing such sites will likely have their photographic equipment confiscated and risk detention and possible arrest.

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

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

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

CRIMINAL PENALTIES:
While in any foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the DRC are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, so that they can obtain updated information on travel and security within the Congo. Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 310 Avenue des Aviateurs; tel. 243-081-225-5872 (do not dial the zero when calling from abroad). Entrance to the Consular Section of the Embassy is on Avenue Dumi, opposite the Ste. Anne residence. The Consular Section of the Embassy may be reached at tel. 243-081-884-6859 or 243-081-884-4609; fax 243-081-301-0560 (do not dial the first zero when calling from abroad).
*

*

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

Travel News Headlines WORLD NEWS

Date: Sun 16 Feb 2020, 5:00 PM
Source: WHO, Weekly Bulletin on Outbreaks and Other Emergencies, page 9 [abridged, edited]

During week 4 [week ending 26 Jan 2020], a total of 73 suspected cases including one death were reported across the country, compared to 46 suspected cases and no deaths in the previous week. The majority of cases in week 4 were reported from Sankuru province (78%).

In the past 4 weeks (weeks 1 to 4 of 2020) a total of 222 suspected cases with 4 deaths (CFR: 1.8%) were notified in the country, with the majority of cases being reported from the provinces of Sankuru (31%), Bas-Uele (18%), Equateur (15%) and Mai-Ndombe (9%). There has been an increase in the weekly case incidence since week 2 of 2020.

Between weeks 1 and 52 of 2019 a cumulative total of 5288 monkeypox cases, including 107 deaths (CFR 2%) were reported from 133 health zones in 19 provinces.
======================
[Monkeypox (MPX) virus is endemic and widespread geographically in the DR Congo, with cases occurring sporadically in several provinces. January 2020 is off to a similar start with 222 suspected cases and 4 deaths reported in 4 provinces. The 2% CFR is relatively low for the clade of MPX that occurs in the DRC, which can reach 10% or more. The 222 cases are suspected, and there is the possibility that without laboratory confirmation some of them may be varicella cases misdiagnosed as MPX. There is no additional information about the circumstances under which these cases acquired their infection. Monkeys are not the reservoirs of the virus, despite the name that the virus has received. Studies of prevalence of MPX virus in populations of rodent hosts are not mentioned in this or previous reports. The main reservoirs of MPX virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp., an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_. Halting the bushmeat trade and consumption of wild animals to halt MPX virus exposure will be culturally and economically difficult, so continued occurrence of cases can be expected. MPX virus can be transmitted between people but not readily. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Wed, 12 Feb 2020 21:09:17 +0100 (MET)

Geneva, Feb 12, 2020 (AFP) - The UN health agency on Wednesday said it was extending its global emergency designation for the Ebola outbreak in the Democratic Republic of Congo but said the sharp decline in cases was "extremely positive".   The recent outbreak was first identified in August 2018 and has since killed more than 2,300 people in eastern DR Congo -- an area where several militia groups are operating.   "As long as there is a single case of Ebola in an area as insecure and unstable as eastern DRC, the potential remains for a much larger epidemic," WHO chief Tedros Adhanom Ghebreyesus told reporters in Geneva.

The WHO, however, said it was downgrading the national and regional risk of the disease from very high to high, while it kept the global risk at low.    Tedros also voiced hope that the emergency could be lifted within the next three months on the advice of the WHO's Emergency Committee of international experts.   The World Health Organization last July declared it a "public health emergency of international concern" -- a designation that gives the WHO greater powers to restrict travel and boost funding.   Tedros, who will be travelling to DRC on Thursday to meet President Felix Tshisekedi, on Tuesday said only three cases had been reported in the past week.

But for the epidemic to be declared over, there have to be no new cases reported for 42 days -- double the incubation period.   The health emergency designation last year came a few days after a patient was diagnosed with the virus in the provincial capital Goma -- the first case in a major urban hub.   More than a month before that, the WHO reported that the virus had spread to Uganda for the first time.   The Ebola virus is passed on by contact with the blood, body fluids, secretions or organs of an infected or recently deceased person.   The death rate is typically high, ranging up to 90 percent in some outbreaks, according to the WHO.

This is the second worst outbreak of the disease since 2014 when it killed about 11,000 people -- mostly in Guinea, Liberia and Sierra Leone.   Efforts to contain the current outbreak have been hindered by attacks on health workers and conflicts in the east.   The WHO said in November it had moved 49 staff out of the Beni region in eastern DRC because of the insecurity.   The Beni region, straddling the North Kivu and Ituri provinces, has been repeatedly attacked by the Allied Democratic Forces (ADF) rebel group, which activists say has massacred more than 300 people since October.
Date: Fri 31 Jan 2020
Source: MSF (Medecins Sans Frontiers) [abridged, edited]

Since mid-2018, a massive measles outbreak has been ravaging through the Democratic Republic of Congo (DRC). The outbreak has turned into the biggest measles outbreak of the past 10 years in DRC and the biggest currently active worldwide.

Over 310,000 people have been infected and more than 6000 have died over the past year alone; 3/4 of those who have died are children. All 26 provinces of the country have been affected by the outbreak.

MSF teams are working in various areas of DRC to participate to the response; at different times over the past 2 years, they have been active in patient care, vaccination campaigns to prevent the spread of the disease, and surveillance activities to identify new areas of the epidemic and start the intervention as early as possible.

Our teams have set up dedicated facilities such as the laboratory opened at the end of 2019 in Lumbubashi, southeastern DRC, in order to ensure a faster, more effective turnaround of lab analyses.

During the last year in the current measles outbreak in DRC:

- 310 000 people have been infected with measles
- 6000 people have died
- 75% of those who have died are children

[See video at URL: Tackling the world's biggest measles outbreak: MSF responds in Kongo Central; byline: Solen Mourlon/MSF]

An MSF team is currently working in the province of Kongo Central, one of the main hotspots of the epidemic today. Our response in this area began in December 2019 and has been targeting the health zones where the highest numbers of cases of measles have been reported.

The team is providing care for complicated cases in dedicated treatment centres, supporting local health centres to deal with non-complicated cases, contributing to surveillance, and facilitating transfers of patients to healthcare facilities.

Some of the main challenges we face are the complications linked with associated diseases (such as malaria or malnutrition), which increase the risk of mortality, and gaining access to remote, hard-to-reach areas.
Date: Fri, 24 Jan 2020 17:43:54 +0100 (MET)
By Albert Kambale with Samir Tounsi in Kinshasa

Masisi, DR Congo, Jan 24, 2020 (AFP) - In eastern DR Congo, thousands have fled violence to camps in the remote mountain forests where they battle cholera, hunger and misery in a forgotten humanitarian disaster.   Eastern Democratic Republic of Congo has long struggled with violence from several militia groups, a legacy of the 1990s Congo wars that dragged in neighbouring Uganda and Rwanda.   The region is now also the epicentre of the latest Ebola epidemic, which has killed more than 2,200 people since August 2018.

Away from the Ebola headlines, tens of thousands of people are scattered in squalid camps across the mountains around Masisi, where they have fled, traumatised by violence, starving and with no chance to return home.   "I fled my village after clashes broke out," said Gentille, a 26-year-old Hutu Congolese. "We could no longer go to the fields. Many people died because clashes broke out in the middle of the village, very early one morning."

That fighting broke out in November and December involving one of the so-called Mai-Mai militia, the Nduma Defense of the Congo-Renove (NDC-R) and a coalition of other armed rivals, according to UN experts.   Now Gentille, a mother of five lives in a camp of 8,000 displaced people.  Along with the unsanitary conditions, a lack of clean water and food, since late last year, a cholera and measles outbreak has worsened life in the camps.    Several anti-cholera treatment units have been opened by Doctors without Borders (MSF), which reports 520 cases and two deaths.    "Three of my children got cholera. One died," says Gentille. "Here in the camp, we do not have enough toilets. More than 180 people use the same toilet. Since it is always busy, the children defecate outside and all around."

Around 685,000 displaced people survive in the mountainous areas, estimates MSF, a figure the aid group hopes will draw attention of the donors.   A year after coming to power, President Felix Tshisekedi has promised far-reaching reforms and a crackdown on corruption. But militia violence and ethnic clashes still undermine security of populations in the east.
Date: Sat 18 Jan 2020 03:15 WAT
Source: Actualita [in French, machine trans., edited]
<https://actualite.cd/2020/01/18/rdc-une-maladie-inconnue-fauche-des-vies-kiri-5-morts>

An unknown disease has already killed 5 people at Kiri General Hospital, in the province of Mai-Ndombe, in the west of the Democratic Republic of the Congo (DRC), according to the authorities. The provincial minister of public health has said that all measures are underway to detect [diagnose?] the mysterious disease. "Admittedly, this was an abnormal situation; however, the situation is manageable because we have just gone into this health facility and we have tried to carry out investigations. My collaborators and I took some samples which have quickly been sent to the National Institute for Biomedical Research (INRB) in Kinshasa for the appropriate medical tests which can give us accurate [diagnosis] on this abnormal situation," declared the minister Jean Claude Bola. First, added the same official, "it is not an Ebola epidemic, contrary to the rumour circulating in the Kiri territory and in the social networks."

In an exclusive interview with actualita.cd, the provincial authority also confirmed the deaths. "However, I warn all those who broadcast through the various media and social networks that there is Ebola in Mai-Ndombe that they have neither qualification nor competence to do so, because the only authority having jurisdiction in the provinces to declare an epidemic is the provincial governor," declared Paul Mputu Boleilanga. "Severe and disciplinary sanctions will be reserved against usurpers of power," he threatened. According to provincial authorities, a team from the National Institute of Biomedical Research (INRB), a team is expected in the Kiri territory for "rapid" management of all patients and to determine the disease underlying deaths in this region.
=============================
[Other than the number of deaths and the geographical location of the cases there is no additional information to permit reasonable speculation as to the aetiology or dates of illnesses. ProMED Mod.MPP noted that Ebola denial leads one to suspect this is a viral haemorrhagic fever.

Laboratory tests should confirm or rule out diseases such as yellow fever or Lassa fever. However, there is no indication that these cases are due to a virus or other infectious agent. Toxicants should also be ruled out. Additional information about these or new cases would be appreciated. - ProMED Mod.TY]

[Maps of DR Congo: <http://goo.gl/DM2AT8> and
<http://healthmap.org/promed/p/194> and
<http://healthmap.org/promed/p/65284>]
More ...

Western Sahara

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 ...

Equatorial Guinea

Equatorial Guinea US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Equatorial Guinea is an oil-rich, developing country on the western coast of central Africa.
Its capital and main port, Malabo, is located on the isla
d of Bioko, off the coast of Cameroon.
A secondary port, Luba, is also on Bioko.
The mainland territory of Equatorial Guinea is bordered by Cameroon and Gabon.
The principal city on the mainland is Bata.
Facilities for tourism are limited but growing.
Official languages are Spanish, which is widely spoken, and French, which is not widely understood, but sometimes used in business dealings.
Read the Department of State Background Notes on Equatorial Guinea for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and evidence of a yellow fever vaccination are required to enter Equatorial Guinea.
Visas are not required for U.S. citizens unless the traveler will be there for an extended stay or is intending to work there.
U.S. citizens entering without a visa but staying longer than 90 days should register with the local police station.

Private vessels landing in an Equato-Guinean port must get clearance prior to approaching the shore.
Travelers should obtain the latest information and details from the Embassy of the Republic of Equatorial Guinea, 2020 16th Street NW, Washington, DC
20009, telephone (202) 518-5700, fax (202) 518-5252.

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:
Although large public demonstrations are uncommon, U.S. citizens should avoid large crowds, political rallies, and street demonstrations.

In February 2009, approximately 50 gunmen arriving by speedboats attacked government buildings in Malabo but were repelled by Equato Guinean military and police.

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:
Violent crime is rare and the overall level of criminal activity is low in comparison to other countries in the region.
However, there has been a rise in non-violent street crime and residential burglaries.
Travelers should exercise prudence and normal caution, including avoiding dark alleys, remote locations, and traveling alone.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the U.S. Embassy in Malabo at (240) 098895; Embassy personnel will assist in contacting the local police.
If you are the victim of a crime while in Equatorial Guinea, please remember to report the incident to local police, and contact the U.S. Embassy in Malabo for assistance.
The Embassy staff can, for example, assist you in finding 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, the consular officer can help you understand the local criminal justice process and to find an attorney if needed.

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 Equato-Guinean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Equatorial Guinea 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:
It is not uncommon for a uniformed member of the security forces to stop motorists on the pretext of minor or nonexistent violations of the local motor vehicle regulations in order to extort small bribes.
Visitors are advised not to pay bribes, and to request that the officer provide a citation to be paid at the local court.
If visitors encounter any of these problems they should contact the Embassy Consular Officer at 516008 and inform him/her of the situation.

Equatorial Guinea has a strictly cash economy.
Credit cards and checks are not accepted; credit card cash advances are not available and there are no ATMs.
In addition, most local businesses do not accept travelers' checks, dollars or euros.
However, dollars can be changed at local banks for CFA.
Cash in CFA is usually the only form of payment accepted throughout the country.

Special permits from the Ministry of Information and Tourism (or from the local delegation if outside Malabo) are required for virtually all types of photography.
Police or security officials may charge a fine, attempt to take a violator into custody, or seize the camera and film of persons photographing the Presidential Palace and its environs, military installations, airports, harbors, government buildings, and other areas.

Travelers are advised that the possession of camouflage-patterned clothing, large knives, binoculars, firearms, or a variety of other items may be deemed suspicious by the security forces and grounds for confiscation of the item and detention of the carrier.
Please see our Customs Information sheet.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are extremely limited. Pharmacies in Malabo and Bata stock basic medicines including antibiotics, but cannot be counted on to supply advanced medications. Outside of these cities, many medicines are unavailable. Travelers are advised to carry any special medication that they require. The sanitation levels in even the best hospitals are very low though the new Israeli-built and staffed La Paz Hospital in Bata approaches European standards of sanitation and is reported by Red Cross officials to be the best in the region. Doctors and hospitals often require immediate payment for health services, and patients are often expected to supply their own bandages, linen and toiletries.
The Malabo hospital is likewise undergoing a complete update, with expected completion in late 2009.

Malaria is a serious and sometimes fatal disease. The national government, along with U.S. oil companies in the country, has taken aggressive steps to control the mosquito population and limit the impact of malaria on the population centers in Malabo and Bata.
Plasmodium falciparum malaria, the type that predominates in Equatorial Guinea, is resistant to the anti-malarial drug chloroquine. Because travelers to the country are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following anti-malarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). 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 anti-malarials they have been taking.
Visit the CDC travelers’ health page for additional information on malaria, including protective measures.

There are periodic outbreaks of cholera in Equatorial Guinea. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Equatorial Guinea.

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

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Hospitals, clinics, and other businesses and hotels do not accept credit cards.
If there are any concerns that travelers may need medical care or assistance while in Equatorial Guinea, they should make arrangements to have access to enough cash to cover possible expenses.
There are companies such as Western Union where international money orders can be arranged and cash obtained.
There are no ATM machines in the country (See SPECIAL CIRCUMSTANCES Section above).
You can see more 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 Equatorial Guinea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Generally, Equatorial Guinea's road networks are underdeveloped.
There are few road and traffic signs, though more signs are becoming evident.
Livestock and pedestrians create constant road hazards.
During the rainy season, many roads are passable only with four-wheel-drive vehicles.
However, new road construction and repair is taking place all over the country and road conditions have improved markedly over the course of the past year.
If you plan on staying and driving around the country for any length of time you should attempt to purchase a cell phone for assistance in case of an emergency.

Travelers outside the limits of Malabo and Bata may expect to encounter occasional military roadblocks.
Travelers should be prepared to show proper identification (for example, a U.S. passport) and to explain their reason for being at that particular location.
The personnel staffing these checkpoints normally do not speak or understand English or French; travelers who do not speak Spanish would do well to have their reason for being in the country and their itinerary written down in Spanish before venturing into the countryside.

Please refer to our Road Safety page for more information.

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

Commercial air travel to and from Equatorial Guinea can be difficult.
Malabo is served by European airlines a few times per week.
The island of Bioko and the African mainland are connected by several small local airlines offering daily service.
Schedules are subject to change or cancellation without notice; flights are often overbooked and reservations may not guarantee seats.

Malabo Airport has navigational aids and can accommodate night landings.
There are no navigational aids at Bata Airport.
Special clearances are required to land in or overfly Equatorial Guinea territory.

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 Equatorial Guinea are encouraged to register with the U.S. Embassy in Malabo through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Equatorial Guinea.
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 in Malabo to contact them in case of emergency.

The United States reopened its Embassy in Malabo in October 2003.
However, due to reduced staffing, it can offer only limited services to U.S. citizens in distress.
The U.S. Embassy in Malabo can be contacted at (240) 098-895.
Additional services are provided through the U.S. Embassy in Yaoundé, Cameroon, located on Avenue Rosa Parks in the Mbankolo Quartier, adjacent to the Mount Febe Golf Club; mailing address P.O. Box 817; embassy tel. (237) 2220-1500, fax: (237) 2220-1572.
The Embassy Branch Office in Douala, Cameroon, is located on Rue Flatters, in the Citibank Building, tel.: (237) 3342-53-31, fax: (237) 3342-77-90.
* * *
This replaces the Country Specific Information for Equatorial Guinea, dated November 15, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Special Circumstances, Medical Facilities and Health Information, Medical Insurance, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Wed, 15 Jan 2020 23:16:11 +0100 (MET)

Malabo, Equatorial Guinea, Jan 15, 2020 (AFP) - Firefighters battled to bring a blaze at Malabo's cathedral under control on Wednesday, as flames engulfed parts of the historic building, considered the most important Christian church in Equatorial Guinea.     Dozens of people gathered in silence near the cathedral in the early evening as the fire service sprayed water jets onto the century-old structure.

It was not immediately known whether anyone was hurt in the fire, in which huge flames consumed part of the facade of the building.       "We have just extinguished the fire, it's finished. The roof is gone, it is a catastrophe," firefighter Alfredo Abeso told AFP.   Another firefighter at the scene said: "The whole roof is gone, the interior is burned."   The cause of the fire is not known but the cathedral has been closed to the public since January 7 for restoration work.    Built in a neo-gothic style between 1897 and 1916, the cathedral is one of the central African country's main tourist attractions.

The blaze brought comparisons to the devastating fire that ravaged the 13th century Notre-Dame cathedral in Paris in April 2019.     The French Embassy in Malabo said the fire was a "cruel reminder" of the fire at Notre Dame.    "We share the emotion of our friends in Malabo and Equatorial Guinea and hope that the fire can be brought under control quickly," it said on Twitter.      Paris engineers are still working to stabilise the 13th century cathedral in the French capital after fire tore through its roof and dramatically toppled its spire last year.
Date: Sun, 26 May 2019 06:31:33 +0200
By Camille MALPLAT

Sipopo, Equatorial Guinea, May 26, 2019 (AFP) - Gleaming but eerily empty, the luxurious Sipopo resort with its five-star hotel and exclusive facilities rises from a tropical beach, symbolising the dilemma of Equatorial Guinea -- a notoriously closed country that has turned to tourism to help fill its coffers.  The purpose-built town was carved out of an ancient forest in 2011 at a cost of 600 million euros ($670 million), initially to host a week-long African Union summit and showcase the rise of the tiny oil-rich state.   A 16-kilometre (10-mile) drive from Equatorial Guinea's capital Malabo, the resort boasts a vast conference centre, the Sofitel Malabo Sipopo Le Golf hotel, as well as 52 luxury villas -- one for every head of state to attend the summit -- each with its own swimming pool.    There is also an 18-hole golf course, several restaurants and exclusive beaches guarded by police.

For almost a decade, Sipopo has been the crown jewel in a strategy to lure high-end visitors to Equatorial Guinea to diversify an economy badly hit by a slump in oil revenue.   But the town, visited by an AFP reporter two months ago, seemed quite empty -- an impression strengthened by conversations with people who live or who work there.   "It's depressing, there's no-one," said a visiting Gabonese consultant.   A worker, who asked not to be named, said the complex was quiet year-round: "You can hear the sound of your own footsteps."   The occasional visitors tend to be well connected, rich and in search of privacy, the sources said.    Many are guests of a government described by Human Rights Watch as corrupt and repressive.    One of the villas, according to the sources, was occupied by former Gambian dictator Yahya Jammeh after he fled his country in 2017.

- Empty lobby -
At Easter, the 200-room hotel's guests included a Spanish couple on honeymoon, a few families and some businessmen, who were all foreigners.   In the echoing lobby, a huge black and white portrait of the country's 76-year-old authoritarian president, Teodoro Obiang Nguema -- Africa's longest-serving ruler -- hung on the wall, watching over the vacant reception area.   A 1.5-kilometre (nearly mile-long) beach -- an artificial shore secluded from curious eyes -- was virtually deserted, in contrast to a public beach near the capital. The three-lane highway leading from Malabo to Sipopo was mostly empty of traffic.   A hospital was added after the villas were built, but is unused, the sources said.   In 2014, a mall was built at the resort to house 50 shops, a bowling alley, two cinemas and a children's play area.   But a hotel receptionist said the complex was not open yet, adding: "If you want to buy a souvenir, you will have to go to Malabo." At night-time, shiny limousines arrived at a luxury restaurant to drop off diners.

- Tourism hopes -
Located on the mid-Atlantic coast of central Africa, Equatorial Guinea has flooded social media with messages of its allure as a holiday destination.   Plans to build a new passenger terminal at the airport in Bata city have also just received a 120-million-euro ($133-million) injection from the Development Bank of Central African States.   Figures for visitors are unavailable, and the tourism ministry in Malabo did not respond to AFP's requests for information. In the latest global compilation of figures posted by the World Bank, the number of tourists for Equatorial Guinea has been left blank.   But much of the tourism in evidence are business people, such as oil company workers, relaxing for a few days, or attending energy or economic conferences. 

A few travel firms offer trips tailor-made for both luxury and adventure, but they also allude to the difficulties, notably of being allowed to enter the country.   "The country has been a mystery to outsiders, who were discouraged from entering by a difficult visa process and a lack of tourism infrastructure," says the website of British tour operator Undiscovered Destinations.   The firm claimed, however, that "things are changing fast... with an excellent road network and numerous hotels springing up seemingly overnight."   Few Equatoguineans have the chance of staying in such places. At Sipopo's hotel, a basic room costs the equivalent of more than 200 euros ($224) a night, while exclusive accommodation tops 850 euros.   The discovery of vast oil reserves off the coast in the mid-1990s has boosted the country's gross national income to a theoretical annual $19,500 per person per year, according to the UN Development Programme.   But that wealth benefits a small elite among the country's 1.2 million inhabitants. More than two-thirds of Equatoguineans live below the poverty line, and 55 percent of the population aged over 15 are unemployed.
Date: Wed 14 Jan 2015
Source: Eye Witness News [edited]

The Africa Cup of Nations (Afcon) finally gets underway on Sat [17 Jan 2015] after a controversial build-up to the 30th edition, which included a hasty late switch of hosts to Equatorial Guinea in the wake of concerns over the Ebola virus.

16 nations again line up for the biennial continental championship, seeking Africa's top sporting prize at the tournament, which starts on Sat [17 Jan 2015] and finishes on 8 Feb [2015].

Few previous editions have had such a dramatic backdrop, with the hosting of the 2015 finals being switched 2 months ago after Morocco asked for a postponement in the wake of the spread of the Ebola virus in West Africa. That request precipitated a crisis that left the tournament having to be organised almost from scratch in a few weeks.

Fears that travelling fans could spread Ebola and damage Morocco's tourist industry were seen as alarmist by the Confederation of African Football (CAF), who rejected the request and then stripped Morocco of their hosting rights.

>From a country with plentiful resources, who have previously bid to host the World Cup, Afcon is now being played in one of Africa's smallest and most enigmatic countries.

Equatorial Guinea is a family-ruled former Spanish colony which has newfound oil wealth and is reveling in rescuing the continent's most eagerly anticipated sporting event. ... - more
Date: Thu 17 Apr 2014
Source: WHO Global Alert and Response [edited]

Update on polio in central Africa -- polio confirmed in Equatorial Guinea, linked to outbreak in Cameroon
--------------------------------------------------------------------------------
In Equatorial Guinea, 3 new wild poliovirus type 1 (WPV1) cases have been reported, the 1st polio in the country since 1999. Genetic sequencing indicates these cases are linked to an on-going WPV1 outbreak in Cameroon which has subsequently been detected in Equatorial Guinea. The cases had onset of paralysis on [28 Jan 2014], [19 Jan 2014] and [24 Mar 2014], from Centro Sur, Bioko Norte and Litoral. Outbreak response in Equatorial Guinea is currently being planned, including National Immunization Days (NIDs) with bivalent oral polio vaccine (OPV) on [21-24 Apr 2014]. An estimated 40 percent of children are fully immunized against polio in the country.

On [17 Mar 2014], the World Health Organization (WHO) had elevated the risk assessment of international spread of polio from Cameroon to 'very high' (http://www.who.int/csr/don/2014_03_17_polio/en/). The risk assessment was elevated due to: confirmation of 3 additional WPV1 cases (with onset of paralysis on [6, 25 and 31 Jan 2014]) from 3 new regions of Cameroon, confirming continued WPV transmission and geographic expansion of infected areas following detection of 4 cases in October 2013; gaps in surveillance; and, influx of vulnerable refugee populations from Central African Republic. The confirmation of new cases in Cameroon resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity on [11-13 Apr 2014], and implementing nationwide campaigns in May and June 2014. Critical to success will be to ensure substantial improvement in the quality of immunization campaigns that reach all children multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.

Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo. In Gabon, a nationwide immunization campaign is planned for [22-26 Apr 2014] (targeting all children aged less than 15 years), and in the Republic of Congo, a nationwide activity will be conducted on 1 May 2014.

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for acute flaccid paralysis (AFP) cases in order to rapidly detect any new virus importations and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.

WHO's International Travel and Health (http://www.who.int/ith/chapters/en/) recommends that all travellers to and from polio-affected areas be fully vaccinated against polio.
Date: Sat 23 June 2012
Source: Guinea Equatorial [in Spanish, trans. ProMed Mod.JG, edited]

After the last measles vaccination campaign that took place last April 2012, a new outbreak of the disease has been reported in some communities in Malabo district, and for this reason, the Ministry of Health initiated a new vaccination campaign [Malabo is the capital of Equatorial Guinea, located on the northern coast of Bioko Island. - ProMed Mod.CP].

Activities started last Thursday, with the cooperation of the National Vaccination Programme (PAV, according to its Spanish initials). The campaign will concentrate its activities in the most severely affected communities, such as Santa Maria III, Lampert and Sunco.

Some medical officers gathered in Madre Bisila Health Centre in order to organise local vaccination units and to deal with mothers who brought their children to the Health Centre in order to have them vaccinated. Vaccine will be dispensed throughout the next 10 days, and subsequently, the vaccination campaign will continue in the Continental region of Equatorial Guinea.

Local officials from the Ministry of Health are inviting the population, particularly mothers, to bring their children to local health centres or to bring their children to mobile vaccination units when these teams arrive to their communities.
=====================
[According to La Voz de Rusia (<http://spanish.ruvr.ru/2012_06_22/Guinea-epidemia-sarampion/>), the last major measles epidemic in the country occurred in November 2008, when more than a dozen children died in various hospitals in Equatorial Guinea. No fatalities have been reported in the current outbreak so far.

Equatorial Guinea, officially the Republic of Equatorial Guinea, is a country located in central Africa. It has 2 parts: a Continental Region (Rio Muni), including several small offshore islands including Corisco, Elobey Grande and Elobey Chico; and an insular region containing Annobon island and Bioko island (formerly Fernando Po), where the capital Malabo is situated. A map of Equatorial Guinea can be accessed at: <http://www.africa.upenn.edu/CIA_Maps/Equatorial_Guinea_19871.gif>. - ProMed Mod.CP]

[The ProMED HealthMap for Equatorial Guinea can be found at
<http://healthmap.org/r/1KlO>.]
More ...

Belize

Belize US Consular Information Sheet
November 05, 2008
COUNTRY DESCRIPTION:
Belize is a developing country.
Tourism facilities vary in quality, from a limited number of business class hotels in Belize City and resorts on the cayes to
range of ecotourism lodges and very basic accommodations in the countryside.
Crime is a growing concern. Read the Department of State Background Notes on Belize for additional information.

ENTRY/EXIT REQUIREMENTS :
All U.S. citizens must have a U.S. passport valid for the duration of their visit to Belize.
U.S. citizens do not need visas for tourist visits of up to thirty days, but they must have onward or return air tickets and proof of sufficient funds to maintain themselves while in Belize.
Visitors for purposes other than tourism, or who wish to stay longer than 30 days, must obtain visas from the government of Belize.
All tourists and non-Belizean nationalities are required to pay an exit fee of U.S. $35 (payable in U.S. dollars only) when leaving Belize. Additional information on entry and customs requirements may be obtained from the Embassy of Belize at 2535 Massachusetts Avenue NW, Washington, DC
20008, Tel. (202) 332-9636 or at their web site:
http://www.embassyofbelize.org.

Information is also available at the Belizean Consular offices in Miami, and Los Angeles, or at the Belizean Mission to the UN in New York.
Visit the Embassy of Belize web site at http://belize.usembassy.gov for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Visitors should exercise caution and good judgment when visiting Belize.
Crime can be a serious problem (see Crime), particularly in Belize City and remote areas.
Road accidents are common (see Traffic Safety and Road Conditions) and traffic fatalities have included Americans.
Public buses and taxis are frequently in poor condition and lack safety equipment.
Medical care is limited and emergency response services such as ambulances or paramedics may be either unavailable or limited in capability or equipment (See Medical Facilities and Health Information).

Boats serving the public, especially water taxis, often do not carry sufficient safety equipment, may carry an excess number of passengers and may sail in inclement weather.
Rental diving equipment may not always be properly maintained or inspected, and some local dive masters fail to consider the skill levels of individual tourists when organizing dives to some of Belize’s more challenging sites. Deaths and serious mishaps have occurred as a result of negligent diving tour operators and the lack of strict enforcement of tour regulations. The Embassy strongly recommends that anyone interested in scuba diving and snorkeling while in Belize check the references, licenses and equipment of tour operators before agreeing to or paying for a tour.
Both tour guides and boat captains are now required to be licensed by the Government of Belize. Safety precautions and emergency response capabilities may not be up to U.S. standards.

Following a fatal accident at the Cave Branch Archeological Park in September 2008, the Belize Tourism Board (BTB) is implementing new regulations, effective and legally enforced beginning October 15, 2008, to improve safety at cave tubing attractions.
Those policies will include an enhanced, mandatory guest-to-guide ratio of eight-to-one for all operating cave tubing tour companies in Belize.
Additional signage will be posted in each cave tubing excursion site, informing participants of park rules and current water conditions and/or warnings.
Mandatory specialty training for each cave tubing guide will continue and include education on new regulations.

Helmets will also be required for each cave tubing participant starting January 1, 2009.
Furthermore, the National Institute of Culture and History (NICH), which manages the Cave Branch Archeological Park, will be installing additional monitoring equipment for cave tubing excursions which measure currents and other factors needing to be taken into considerations to ensure participant safety,

Cave tubing participants are urged to exercise due caution and their own best judgment regarding safety and river conditions at the time of their tour, particularly during the rainy/hurricane season from June 1 through November 30.
Rainfall upstream from tour sites, sometimes miles away, can cause rapid changes in current strength and water level conditions without notice.

The border between Belize and Guatemala is in dispute, but the dispute thus far has not affected travel between the two countries.
There have not been any terrorist activities in Belize.

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:
The incidence of crime, including violent crimes such as armed robbery, shooting, stabbing, murder, and rape, is on the rise.
The Embassy has noted an increase in recent years in reports of crimes against tourists at resorts and on the roadways and river ways.
The incidence of crimes such as theft, burglary, purse snatching and pick pocketing rises around the winter holidays and spring break.
Several victims who resisted when confronted by criminals have received serious personal injuries, including gunshot wounds.
Although the majority of reported incidents are in Belize City, crime occurs in all districts including tourist spots such as San Pedro, Caye Caulker, and Placencia.

Sexual harassment and/or assault of females traveling alone or in small groups have occurred this past year.
Several American travelers have been the victims of sexual assaults in recent years. One of these occurred after the victim accepted a lift from an acquaintance, while others have occurred during armed robberies in resort areas.
One of these assaults has resulted in the death of the victim.

The Embassy recommends that visitors travel in groups and only in daylight hours, stay off the streets after dark, in urban and rural areas, and avoid wearing jewelry, or carrying valuable or expensive items.
As a general rule, valuables should not be left unattended, including in hotel rooms and on the beach.
Care should be taken when carrying high value items such as cameras, or when wearing expensive jewelry on the street.
Women’s handbags should be zipped and held close to the body.
Men should carry wallets in their front pants pocket.
Large amounts of cash should always be handled discreetly.

If traveling by taxi, use only vehicles with green license plates, do not get in a taxi that is occupied by more than the driver, and do not let the driver pick up additional fares.

Armed robberies of American tourist groups occurred during the summer of 2006 in the Mountain Pine Ridge and Caracol regions of the western district of Belize.
Due to increased police patrols, coordinated tours among resort security managers, and the arrest of two of the "highway bandits," there have not been any additional robberies since June, 2006. In the past, criminals have targeted popular Mayan archeological sites in that region.
Visitors should travel in groups and should stick to the main plazas and tourist sites.
Although there are armed guards posted at some of the archeological sites, armed criminals have been known to prey on persons walking from one site to another.
Victims who resist when confronted by these armed assailants frequently suffer personal injury.

Travel on rural roads, especially at night, increases the risk of encountering criminal activities.
Widespread narcotics and alien smuggling activities can make remote areas especially dangerous.
Though there is no evidence that Americans in particular are targeted, criminals look for every opportunity to attack, so all travelers should be vigilant.

Rather than traveling alone, use a reputable tour organization.
It is best to stay in groups, travel in a caravan consisting of two or more vehicles, and stay on the main roads.
Ensure that someone not traveling with you is aware of your itinerary.
Travelers should resist the temptation to stay in budget hotels, which are generally more susceptible to crime, and stay in the main tourist destinations.
Do not explore back roads or isolated paths near tourist sites.
And remember always to pay close attention to your surroundings.

Americans visiting the Belize-Guatemala border area should consider carefully their security situation and should travel only during daylight hours. Vehicles should be in good operating condition, adequately fueled, and carry communications equipment.
Persons traveling into Guatemala from Belize should check the Country Specific Information for Guatemala and the U.S. Embassy web site at http://guatemala.usembassy.gov for the latest information about crime and security in Guatemala.

A lack of resources and training impedes the ability of the police to investigate crimes effectively and to apprehend serious offenders. As a result, a number of crimes against Americans in Belize remain unresolved.
Nonetheless, victims of crime should report immediately to the police all incidents of assault, robbery, theft or other crimes as well as notifying the U.S. Embassy in Belmopan, telephone 822-4011(after hours and weekends 610-5030).
Tourists may contact the Belizean tourist police unit in addition to the main police office for assistance.

In addition to reporting crimes to local police, American citizens should report all criminal incidents to the U.S. Embassy in Belmopan, telephone 822-4011 (after hours and weekends 610-5030).
The embassy staff can assist an American with finding appropriate medical care, contacting family members or friends, and having funds transferred, as well as in determining whether any assistance is available from the victim’s home state.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help explain the local criminal justice process and assist in finding an attorney if needed.

Drug use is common in some tourist areas.
American citizens should avoid buying, selling, holding, or taking illegal drugs under any circumstances.
Penalties for possession of drugs or drug paraphernalia are generally more severe than in the U.S.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov.

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

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care for minor conditions is generally available in urban areas.
Trauma or advanced medical care is limited even in Belize City; it is extremely limited or unavailable in rural areas.
Serious injuries or illnesses often necessitate evacuation to another country.
The Government of Belize reported an outbreak of dengue fever in April, May and June of 2005.

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

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas .
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Belize is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Valid U.S. driver's licenses and international driving permits are accepted in Belize for a period of three months after entry.
Driving is on the right-hand side of the road.
Buses and private vehicles are the main mode of transportation in Belize; no trains operate in the country.
Roadside assistance can be difficult to summon, as there are very few public telephones along the road and emergency telephone numbers do not always function properly.
The Belizean Department of Transportation is responsible for road safety.

Roads in Belize vary from two-lane paved roads to dirt tracks.
The few paved roads are high-crowned roads, which can contribute to cars overturning, and have few markings or reflectors.
Even in urban areas, few streets have lane markings, leading many motorists to create as many lanes as possible in any given stretch of street or road.
Bridges on the major highways are often only single lanes.
The Manatee Road, leading from the Western Highway to Dangriga, is unpaved, easily flooded after storms and without services.
The Southern Highway from Dangriga to Punta Gorda is mostly completed and in good condition, except for a short portion that is under construction.
Service stations are plentiful along the major roads, although there are some significant gaps in the rural areas.

During Tropical Storm Alma/Arthur in May-June 2008, the Southern Highway bridge over the Sittee River, north of Kendall, Stann Creek District, was destroyed.
In the interim, a temporary causeway has been constructed pending permanent replacement of the Kendall bridge but at times the causeway may not be passable due to conditions on the Sittee River.
The causeway itself has had to be replaced several times following major rainfall and flooding.

Poor road and/or vehicle maintenance causes many fatal accidents on Belizean roads.
Speed limits are 55 miles per hour on most highways and 25 miles per hour on most other roads, but they are seldom obeyed or even posted.
Many vehicles on the road do not have functioning safety equipment such as turn signals, flashers, or brake lights.
Seatbelts for drivers and front-seat passengers are mandatory, but child car seats are not required.
Driving while intoxicated is punishable by a fine; if an alcohol-related accident results in a fatality, the driver may face manslaughter charges. Moreover, Americans can and have been imprisoned in Belize for accidents, even where alcohol is not involved.

Unusual local traffic customs include: pulling to the right before making a left turn; passing on the right of someone who is signaling a right-hand turn; stopping in the middle of the road to talk to someone while blocking traffic; carrying passengers, including small children, in the open beds of trucks; and tailgating at high speeds.

Bicycles are numerous and constitute a traffic hazard at all times.
Bicyclists often ride against traffic and do not obey even basic traffic laws such as red lights or stop signs.
Few bicycles have lights at night. It is common to see bicyclists carrying heavy loads or passengers, including balancing small children on their laps or across the handlebars.
The driver of a vehicle that strikes a bicyclist or pedestrian is almost always considered to be at fault, regardless of circumstances.
Americans who have struck cyclists in Belize have faced significant financial penalty or even prison time.

Driving at night is not recommended, due to poor signage and road markings, a tendency not to dim the lights when approaching other vehicles, and drunk driving.
Pedestrians, motorcyclists and bicyclists without lights, reflectors, or reflective clothing also constitute a very serious after-dark hazard.
Local wildlife and cattle also are road hazards in rural areas.
For safety reasons, travelers should not stop to offer assistance to others whose vehicles apparently have broken down.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Belize’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Belize’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Belize is vulnerable to tropical storms, especially from June 1 until November 30 of each year. General information on weather conditions may be obtained from the National Hurricane Center at http://www.nhc.noaa.gov.

It is not possible to access most U.S. bank accounts through automated teller machines (ATMs) in Belize.
However, travelers can usually obtain cash advances from local banks, Monday through Friday, using major international credit cards.

Special Notice for Dual Nationals:
A person who is a citizen of both the U.S. and Belize is able to enter Belize with only a Belizean passport; such a dual national should be aware, however, that he/she must have a U.S. passport in order to board a flight to the U.S. from Belize, and that average processing time for a passport at the U.S. Embassy in Belize is approximately 10 working days.

Belize customs authorities may enforce strict regulations concerning temporary importation into or export from Belize of firearms.
It is advisable to contact the Embassy of Belize in Washington or one of Belize’s Consulates in the U.S. for specific information regarding customs requirements.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Belize laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Belize 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.
Belize has strict laws making possession of a firearm or ammunition illegal unless a valid permit is obtained.
Penalties for firearms violations are severe.
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 Belize are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site in order to obtain updated information on travel and security within Belize.
Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in the capital city of Belmopan, approximately 50 miles west of Belize City.
The U.S. Embassy is on Floral Park Road, Belmopan, Cayo District, and the telephone number is 822-4011.
The American Citizen Services section fax number is 822-4050.
In the event of an after hours emergency, the embassy duty officer may be reached at 610-5030. The Embassy is open from 8:00 a.m. to 5:00 p.m., Monday through Friday, except for the 12:00 noon to 1:00 p.m. lunch hour, and on U.S. and Belizean holidays.
The Embassy web site is http://belize.usembassy.gov/; the e-mail address is embbelize@state.gov

Travel News Headlines WORLD NEWS

Date: Wed 2 May 2018, 3:30 PM CST.
Source: Breaking Belize News [edited]

Ministry of Health staff from the Western Health Region are currently in Benque Viejo and surrounding areas monitoring a developing situation due to confirmed cases of hepatitis A in Arenal and Benque. According to a statement from the Ministry, there have been 3 confirmed cases in Benque Viejo and 11 suspected cases in Arenal.

Part of the plan includes sensitization of school staff and students about hepatitis A, its transmission and risk factors. Food handlers in Benque and Arenal will also be visited and informed of the risks of hepatitis A and the importance of following established protocols.

The relevant departments in health have been made aware and are working closely with the region to minimize ongoing cases including a sensitization session on the local radio station in Benque.
===================
[No information is given about the age of those affected. In much of the developing world where hepatitis A is quite endemic, the population is almost all seropositive for HAV by the age of 10. I would wonder if the infection was confirmed by a specific IgM anti-HAV antibody. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Cayo District, Belize: <http://healthmap.org/promed/p/6149>]
Date: Mon 8 Oct 2017
Source: Outbreak News Today [edited]

The summer of 2017 appears to be "pink eye", or conjunctivitis season in the Americas with a number of countries in Central and South America and the Caribbean reporting increases of the eye infection.

Now joining the Bahamas, Brazil, Costa Rica, Dominica, the Dominican Republic, Guadeloupe, Martinique, Mexico, Panama, Saint Lucia, Saint Martin, Suriname, and the Turks and Caicos Islands is Belize where health officials report an increase in the number of reported conjunctivitis cases, particularly in the northern and central health regions.

The Belize Health Ministry says the symptoms of pink eye include:
- redness in the white of the eye or inner eyelid;
- watery eyes;
- thick yellow discharge that crusts over the eyelashes, especially after sleep; and
- itchy eyes, blurred vision and increased sensitivity to light

They offer the following measures to prevent the spread of this contagious infection:
- wash your hands often with soap and warm water. Wash them especially before and after cleaning, or applying eye drops or ointment to your infected eye;
- avoid touching or rubbing your eyes. This can worsen the condition or spread the infection;
- with clean hands, wash any discharge from around your eye(s) several times a day using a clean wet washcloth. Wash the used washcloth with hot water and soap, and then wash your hands again with soap and warm water;
- wash pillowcases, sheets, washcloths, and towels often with hot water and soap; wash your hands after handling such items;
- do not wear contact lenses until your eye doctor says it's okay to start wearing them again;
- do not share personal items such as pillows, washcloths, towels, eye drops, eye and face makeup, makeup brushes, contact lenses and contact lens containers, or eyeglasses;
- avoid shaking hands with others;
- persons suffering pink eye should stay away from work, school and public places until the infection clears.  [Byline: Robert Herriman]
==================
[Viral conjunctivitis, also called pinkeye, is a common, self-limiting condition that is typically caused by adenovirus. Other viruses that can be responsible for conjunctival infection include herpes simplex virus (HSV), varicella-zoster virus (VZV), picornavirus (enterovirus 70, Coxsackie A24), poxvirus (molluscum contagiosum, vaccinia), and human immunodeficiency virus (HIV) (<http://emedicine.medscape.com/article/1191370-overview>). But bacteria and allergens also can cause conjunctivitis.

There is no known specific treatment for this disease, and containment includes increased attention to hygiene.

According to <https://www.garda.com/crisis24/news-alerts/73151/belize-conjunctivitis-outbreak>, in the [3 weeks leading up to 26 Sep 2017], 1108 cases have been reported [in Belize] in what government officials are calling the worst such outbreak since 2005. Cases have been reported in Belize City, Corozal, Cayo, Chetumal, and Orange Walk, among other places.

See ProMED Conjunctivitis - Americas (10): Panama, Grenada, Mexico http://promedmail.org/post/20170929.5348507 for further discussion regarding the conjunctivitis outbreak in the Americas.

A HealthMap/ProMED-mail map of Belize can be found at
Date: Sat 26 Aug 2017
Source: Amandala [edited]
<http://amandala.com.bz/news/ciguatera-poisoning-linked-turneffe-barracudas/>

Each year, between 10,000 and 50,000 people who live in or visit tropical and subtropical areas suffer from Ciguatera Fish Poisoning (CFP), which is said to be one of the most frequently reported seafood-toxin illness in the world. Ciguatera poisoning, which causes symptoms such as tingling and numbness in fingers and toes, around lips, tongue, mouth and throat; nausea, vomiting, diarrhoea and/or abdominal cramps; joint pains and headache; and breathing difficulty, has also been reported in Belize, and over the past 4 days, 2 alerts have been issued by the Ministry of Health in Belize, following reports of cases cropping up, which have been linked to the consumption of barracuda fish. In the 1st alert, issued on [Fri 18 Aug 2017], the Ministry of Health reported that "suspected fish poisoning (Ciguatera poisoning) was detected in people that had eaten fish bought from a fish vendor in Ladyville, Belize District."

In the 2nd alert, issued on [Tue 23 Aug 2017], the Ministry said that 2 further cases of suspected Ciguatera poisoning, linked to the consumption of the large predatory fish, had been identified. "Investigations conducted so far reveal that the barracuda fish from the Turneffe Islands area has been the sole carrier of the ciguaxtoin or poison," the alert said. It warned that toxic fish does not have any odor or taste and cooking and freezing does not eliminate the toxin. According to the US Center for Disease Control and Prevention (CDC), ciguatera fish poisoning (or ciguatera) is an illness caused by eating fish that contain toxins produced by a marine microalgae called _Gambierdiscus toxicus_, associated with corals.

Whereas the barracuda is believed to be the culprit for the most recent bouts of illness caused by the toxin, other fish may also carry the toxin, including coral trout, red snapper, donu, parrot fish, grouper, Spanish mackerel, red emperor, wrasse, reef cod, sturgeon fish, trevally and moray eel. The CDC also lists blackfin snapper, cubera snapper, dog snapper, greater amberjack, hogfish, horse-eye jack, and king mackerel among the fish which have been known to carry ciguatoxins. "Anyone who consumes fish contaminated with the ciguatera toxin will become ill," the Ministry's alert said, adding that, "The gastrointestinal or stomach symptoms normally appear within 24 hours of exposure and those of the nervous system can appear 1 to 2 days later."

Although some symptoms may last only a few days, in some cases, the toxin can continue to affect those who ingest it for months. The CDC says people who have ciguatera may find that cold things feel hot and hot things feel cold. The Belize Ministry of Health has shared some guidelines for reducing the risk of CFP.

It advises the following:
- Avoid eating larger reef fish that have a greater likelihood of carrying ciguatoxins, especially the barracuda.
- Limit the weight of a fish to less than 11 pounds, as ciguatera fish poisoning occurs more frequently in larger fish.
- Eat other types of fish not listed above.
- Avoid eating the head, roe or fish egg, liver, or other organs of the fish, as it is where the highest level of toxin is present. [Byline: Adele Ramos]
=========================
[A recent open access review of ciguatera fish poisoning (CFP) has been published in Marine Drugs: Friedman MA , Fernandez M, Backer LC, et al: An updated review of Ciguatera Fish Poisoning: Clinical, epidemiological, environmental, and public health management. Mar Drugs 2017, 15(3): pii: E72; doi:10.3390/md15030072; available at: <http://www.mdpi.com/1660-3397/15/3/72/htm.

The publication does not say that the intoxication occurs related to fish from European waters. The description of the acute illness with the citations intact (the citations can be found at the original URL) has been extracted below: "CFP is characterized by gastrointestinal, neurological, and cardiovascular symptoms. In addition, after the initial or acute illness, neuropsychological symptoms may be reported.

Clinical features can vary depending on elapsed time since eating the toxic meal, and whether the geographic source of the implicated fish was the Caribbean Sea, Pacific, or Indian Ocean [17,36,52-58]. Gastrointestinal symptoms and signs usually begin within 6-12 hours of fish consumption and resolve spontaneously within 1-4 days.

Gastrointestinal symptoms may include nausea, vomiting, abdominal pain, and diarrhoea. The neurologic symptoms usually present within the 1st 2 days of illness. They often become prominent after the gastrointestinal symptoms (particularly in CFP events from Caribbean fish), although they may present concurrently with gastrointestinal symptoms (K Schrank, written communication, April 2016) [59].

The neurologic symptoms vary among patients and include paresthesias (that is, numbness or tingling) in the hands and feet or oral region, metallic taste, sensation of loose teeth, generalized pruritus (itching), myalgia (muscle pain), arthralgia (joint pain), headache, and dizziness. A distinctive neurologic symptom is cold allodynia, sometimes referred to as "hot-cold reversal," an alteration of temperature perception in which touching cold surfaces produces a burning sensation or a dysesthesia (that is, unpleasant, abnormal sensation) [60]. One study revealed that intra-cutaneous injection of CTX in humans elicited this sensation [61].

Cold allodynia is considered pathognomonic of CFP, although not all patients report experiencing it and it can be seen with other human seafood poisoning syndromes (such as neurotoxic shellfish poisoning). Less commonly, severe central nervous system symptoms, such as coma or hallucinations, have been reported [54,62,63].

Neuropsychological symptoms, which often become apparent in the days or weeks after the initial or acute illness, include subjectively reported cognitive complaints such as confusion, reduced memory, and difficulty concentrating [64-67], depression or irritability [64,65,68], and anxiety [65]. Fatigue or malaise have been reported and may be debilitating [6,62,69,70].

Cardiac symptoms and signs may manifest, generally in the early stage of the illness. When present, they usually occur in combination with gastrointestinal and/or neurologic signs and symptoms [71,72]. Cardiac signs often include hypotension and bradycardia which may necessitate emergency medical care." - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/19>.]
Date: Thu 2 Feb 2017 10:41 AM CST
Source: Breaking Belize News [edited]

Yesterday [1 Feb 2017] the Belize Agricultural Health Authority (BAHA) announced that bovine rabies has been confirmed in 3 districts in Belize: Orange Walk, Cayo, and Toledo.

Bovine rabies is a specific type of rabies that affects cattle; however, it can be transmitted to humans and as a result, farmers are advised by BAHA to vaccinate their livestock as well as sheep, cattle and horses.

Bovine rabies is a fatal disease that can be prevented through vaccination of animals.

Affected animals will show aggressive behavior and may salivate more than normal.

If [bovine] rabies is suspected in your district, please contact BAHA immediately at phone number 822-0818.
===================
[Rabies is a viral infection caused by viruses belonging to the Lyssavirus genus. It is a zoonosis -- an animal disease that can spread to humans -- transmitted through saliva from bites, and even scratches of infected animals.

In Belize, as urban rabies is well controlled, most cases of rabies occur as bovine paralytic rabies transmitted by the vampire bat. Rabies in cattle has been reported in all 6 districts. According to the OIE vaccinating 70 percent of dogs allows rabies to be eradicated from a given endemic area.

Generally in Belize the rabies is of vampire bat origin. Cases of human rabies, including deaths, have been reported in Belize. There, several strains of the rabid virus circulate in the vampire bat, _Desmodus rotundus_.

The hairy-legged vampire bat, _Diphylla ecaudata_, is naturally infected by rabies virus (same variant as one infecting _D. rotundus_), so this vampire species is definitely a source for rabies cases in humans.

This vampire species ranges from Southern Tamaulipas (Mexico) to Colombia, Venezuela, Ecuador, Peru, Bolivia, Belize, and Brazil (except the central Amazon basin); a single vagrant individual has also been reported from Southern Texas, USA. (For a picture go to  <https://naturalhistory.si.edu/mna/images/images/831032911523015.jpg>).

Predators and parasites can be plastic when it comes to selecting their preys/hosts, and this confers to them the ability to adapt to environmental changes, and a phenomenon of special interest for public health, as it is associated with the link between human-driven change and emerging diseases.

Notifications of suspect rabies cases are investigated by BAHA, the MoH and the Ministry of Agriculture (MNRA) at no cost to the animal owner. A history of the animal determines the steps to be taken, I.e., whether it is isolated and kept for observation or euthanatized and the brain sent to the veterinary services laboratory in Panama. The MoH will determine human exposure to the virus. If warranted (bite, scratch, saliva) a post exposure regimen will be initiated which consists of 5 vaccines. Laboratory-confirmed cases in cattle trigger control response which includes vaccination of herd, vaccination of susceptible animals in protection zone and vampire bat control at farm and roosts (caves).

If you believe your animal, regardless of whether it is bovine, dog or other animal has rabies or is acting differently than normal, please call your veterinarian. Remember that thinking a bovine is choking and putting your hand in the mouth to remove the blockage may expose you to rabies.

Portions of this comment were extracted from

[Maps of Belize can be seen at
<http://healthmap.org/promed/p/19>. - ProMED Sr.Tech.Ed.MJ]
Date: Thu, 4 Aug 2016 08:41:33 +0200
By Henry MORALES

Puerto Barrios, Guatemala, Aug 4, 2016 (AFP) - A hurricane packing 130 kilometre (80 mile) per hour winds and heavy rain made landfall in Central America near Belize's capital, where officials warned of likely flooding and damage to homes Thursday.   Hurricane Earl swept in from the Caribbean to strike just south of Belize City, population 60,000, around midnight Wednesday (0600 GMT Thursday), according to the US National Hurricane Center (NHC).

Along the way, it had gathered strength and dumped rain on northern Honduras as it brushed past at sea.     The hurricane's heavy rains "could cause flash floods and mudslides especially over higher terrain," Belize's National Emergency Management Organization said in a bulletin just before it arrived.   "For coastal areas, there is also a risk for flooding, especially in low-lying areas."   Nearby Guatemala, Honduras and southern Mexico also issued alerts. Airports in the area were closed.

- Evacuations -
Earl was expected to weaken as it continued west from Belize City, farther inland, toward northern Guatemala and southeastern Mexico.   The Mexican authorities took no chances, evacuating 300 families living close to a river along the border with Belize in the southeastern state of Quinta Roo for fear of flooding.   More than 750 shelters were readied in the state in preparation for expected high winds and fierce gusts.

Other southern Mexican states likely to be affected were Campeche, Tabasco and Yucatan.   In the northern Guatemala town of Puerto Barrios, a military commander, Colonel Nelson Tun, told AFP that "patrols in vulnerable areas" were being carried out.   "We have identified high areas to where the population can evacuate before possible flooding," he said.

Guatemala in particular is prone to rainy season flooding and mudslides that often prove fatal.   Guatemala's population, at 16 million, is much bigger than the 330,000 in Belize, Central America's only English speaking country.   Guatemala's president, Jimmy Morales, late Wednesday offered Belize humanitarian aid and shelters along the border if needed.   That gesture was significant after months of tensions between the two countries following a shooting death of a Guatemalan boy by a Belizean border patrol in April.

- Category 1 hurricane -
The fifth named tropical storm of the 2016 season, Earl strengthened to a Category 1 hurricane on Wednesday, according to the NHC. Winds initially measured at 120 kilometers per hour picked up just before landfall.   Category 1, the lowest of five grades on the hurricane scale, is described as having dangerous winds of between 119 and 153 kilometers per hour that can rip off roofs, bring down trees and cause extensive damage to power lines.   Belizean public and private sector workers were permitted to go to their homes Wednesday to secure property.   Officials warned that people living on the ground floor "will experience flooding" and some older wooden buildings would likely be destroyed.   The authorities have opened 29 shelters.
More ...

Netherlands

The Netherlands - US Consular Information Sheet
January 04, 2007
COUNTRY DESCRIPTION:
The Netherlands is a highly developed, stable democracy.
Tourist facilities are available throughout the Kingdom.
Read the Department of State
ackground notes on The Netherlands for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required.
Visas are not required for U.S. citizens for tourist visits of up to 90 days.
That period begins when you enter any of the Schengen group of countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden.
To be admitted into the Netherlands, travelers must have a passport with a validity that exceeds their intended stay, a return airline ticket, and enough money to finance the planned stay.
For further information on entry requirements, contact the Embassy of the Netherlands at 4200 Linnean Ave. N.W., Washington, D.C. 20008, telephone (202) 244-5300, or one of the Dutch consulates in Chicago, Houston, Los Angeles, New York or Miami.
Additional information is available on the Netherlands' National Bureau for Tourism's Internet web site at http://www.goholland.com.
See our Foreign Entry Requirements brochure for more information on the Netherlands and other countries.
Visit the Embassy of the Netherlands web site at http://www.netherlands-embassy.org/homepage.asp for the most current visa information.
Information on work, residency and immigration requirements in the Netherlands can be found on the web site of the Dutch immigration authorities at www.ind.nl.

Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passport upon initial entry to a Schengen country; many borders are not staffed with officers carrying out this function.
If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry.
Under local law, travelers without a stamp in their passport may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.

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:
In 2004, the Dutch government implemented heightened security measures in response to concerns of international Islamic extremist terrorist activity on Dutch soil.
The November 2004 murder of Dutch filmmaker Theo van Gogh by an Islamic extremist in Amsterdam further increased concerns over Islamic extremist activity in the Netherlands.
One individual was arrested and later sentenced to life in prison for van Gogh's murder and related Islamic extremist activities.
Since the murder, the Dutch government has remained on heightened alert.

U.S. citizens in the Netherlands are encouraged to monitor media reports, and are reminded to maintain a high level of vigilance and to take appropriate steps to increase their security awareness.
As with other countries in the Schengen area, the Netherlands' open borders with its European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
Demonstrations are commonplace in the Netherlands and may range in number from a few people to several thousand.
Prior police approval is required for public demonstrations, and police oversight is routinely provided.
Nonetheless, situations may develop which could pose a threat to public safety.
U.S. citizens are advised to avoid areas in which public demonstrations are taking place.

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

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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:
While the rate of violent crime in the Netherlands is low, tourists are often targets of thieves.
Visitors frequently fall prey to pickpockets, bag snatchers and other petty burglars.
Theft from automobiles and hotel rooms are also on the rise.
Never leave baggage or other valuables unattended.

While thieves may operate anywhere, the U.S. Consulate General in Amsterdam receives frequent reports of thefts from specific areas.
Within Amsterdam, thieves are very active in and around train and tram stations, the city center and public transport.
More specifically, trains to and from Schiphol Airport are considered to be high risk, and theft of laptop computers has increased.
Thieves often work in pairs; one distracts the victim, often by asking for directions, while the accomplice moves in on the victim's momentarily unguarded handbag, backpack, laptop or briefcase.
The timing of these thefts usually coincides with train stops, enabling the thieves to escape.
In addition, many Americans have reported that their purses and briefcases have been stolen while eating in downtown restaurants, including hotel breakfast rooms.
A good rule of thumb is to never leave your personal items unattended when going to the restroom, buffet table, etc.

Confidence artists have victimized a number of Americans.
Typically, a U.S. citizen is notified via email of a winning lottery ticket, an inheritance, or other offer, which requires his/her assistance and cooperation to conclude.
The American is asked to forward advance payments for alleged"official expenses," "taxes," etc. and, often, to come to Amsterdam to conclude the operation.
Several Americans have lost tens of thousands of dollars in such scams.
Funds transferred in response to such offers cannot be recovered.
Information on fraud schemes can be found on the U.S. Embassy's web page.
For additional information, please contact the nearest office of the U.S. Secret Service or visit that agency's web site at www.secretservice.gov.
Additional information is also provided in the Department of State's pamphlet, Advance Fee Business Scams.
Travelers may also contact the Fraud Unit, Amsterdam Police, Police Headquarters, PB 2287, 1000 CG Amsterdam, Netherlands, tel. (31) (20) 559-2380, fax (31) (20) 559-5755.

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.
In the Netherlands, the U.S. Consulate General in Amsterdam provides all passport and American citizen services.
A lost or stolen passport can usually be replaced within a few hours during normal working hours for those with immediate travel plans.
If you are the victim of a crime while in the Netherlands, in addition to reporting to local police, please contact the U.S. Consulate General for assistance.
It is a good idea to make a photocopy of the "biographic page" of your passport, to bring extra passport photos, and to keep these separate from your actual passport just in case it is lost or stolen.
Consulate staff can, for example, help you 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.
Contact information is provided at the bottom of this document.

The Criminal Injuries Compensation Fund (CICF) of the Netherlands provides financial compensation, under specific circumstances, for victims of crime and for those who have suffered injuries and consequent loss caused by such incidents.
The fund also provides for dependents or immediate family members of homicide victims.
For more information, contact the Dutch Ministry of Justice at (31) (70) 414-2000.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Good medical facilities are widely available.
Emergency medical response can be accessed by calling 1-1-2.
Reputable pharmacies are widely available and can assist with emergency prescription needs.
Some common medications are not available in the Netherlands without a prescription, and some prescription drugs cannot be mailed into the country.
Travelers are therefore urged to carry an adequate supply of prescription drugs in their original container while traveling.
Some U.S. over-the-counter medications are not available in the Netherlands and travelers should carry an adequate supply of these as well.
Those traveling with any preexisting medical problems should bring a letter from the attending physician, describing the medical condition and any prescription medications, including the generic name of prescribed drugs.

Vaccinations are not required for travel to the Netherlands.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's Internet site at 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.
Medical evacuations cost thousands of dollars and are not always covered by travel insurance.
Foreign doctors and hospitals usually require payment at the time service is rendered, and this too may not be covered by a traveler's policy.
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 Netherlands is provided for general reference only, and it may not be totally accurate in a particular location or circumstance:

Travel in, around, and between cities is possible via a highly advanced national train, light rail, tram, and bus network, by use of an extensive system of bike paths, and by automobile and motorcycle on the modern highway system.
Rail is often a convenient alternative to driving, particularly in the areas around Amsterdam, The Hague, and Rotterdam, where road congestion is frequent.
Rail network information is available at http://www.ns.nl.

Intercity travel by road is relatively safe in comparison with some other European countries.
Nonetheless, more than 1,000 people die and another 10,000 are injured in traffic accidents in the Netherlands each year.
More than two thirds of the fatal accidents occur outside urban areas.

A valid driver's license issued by a Department of Motor Vehicles in the U.S. is valid for use in the Netherlands for up to 180 days.
Seat belt and child seat use is compulsory.
Driving is on the right side of the road.
The maximum speed limit on highways is 120 km/h, with a highway speed limit of 100 km/h posted in most urban areas.
Secondary roads and some urban area highways have a speed limit of 80 km/h.
The speed limit in towns and cities is 50 km/h, with 30 km/h posted in residential areas.
The Dutch government has reduced speed limits on certain roads near cities in an effort to reduce air pollution.
During traffic jams, authorities also reduce speed limits; drivers should be sure to check for revised limits posted on electronic billboards above the highways.
Please note that drivers must yield the right-of-way to drivers and bikers coming from the right at intersections or traffic circles, unless otherwise posted.
The maximum allowable blood alcohol level in the Netherlands is 0.5 per mille.
The use of cellular telephones while driving is illegal without the use of a "hands-free" device.

Lanes at the center of many urban two-way streets are reserved for buses, trams and taxis.
In cities, pedestrians should be mindful of trams, which often cross or share bicycle and pedestrian paths.
Motorists must be especially mindful of the priority rights of bicyclists.
Pedestrians should not walk along bicycle paths, which are often on the sidewalk and usually designated by red pavement.
Travelers should also be watchful for one-way roads.

Taxi service in the Netherlands is safe but expensive.
Trams and buses are both convenient and economical, but often frequented by pickpockets.

Please refer to our Road Safety page for more information.
Visit the website of the Netherlands Bureau for Tourism at http://www.goholland.com.
Information also is available from the Netherlands Ministry of Transportation, Public Works and Water Management (Ministerie van Verkeer en Waterstraat) at http://www.minvenw.nl.

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

SPECIAL CIRCUMSTANCES:
Dutch customs authorities stringently enforce regulations concerning importation into the Netherlands of items such as firearms and other controlled materials.
Contact the Embassy of the Netherlands in Washington, D.C., or one of the Dutch consulates in Chicago, Houston, Los Angeles or New York for specific information regarding customs requirements.
Please see our Customs Information sheet.

Everyone age 14 and above is required to carry identification at all times while in the Netherlands.
Accepted forms of identification for U.S. citizens are either a Dutch residence card, issued by the Ministry of Foreign Affairs, or a U.S. passport.

U.S. citizens who obtain Dutch nationality may be required by the Dutch authorities to relinquish their U.S. citizenship.
For further information visit http://www.ind.nl/EN/verblijfwijzer/ and/or http://netherlands.usembassy.gov/dual_nationality.html.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the Netherlands are encouraged to register with the U.S. Consulate General through the State Department's travel registration website, and to obtain updated information on travel and security within the Netherlands.
Americans without Internet access may register directly with the U.S. Consulate General in Amsterdam.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency and to provide periodic information on issues of interest to American citizens.

The U.S. Embassy is located in The Hague, at Lange Voorhout 102; tel. (31) (70) 310-2209.
However, all requests for consular assistance should be directed to the Consulate General in Amsterdam at Museumplein 19, tel. (31) (20) 575-5309.
The after-hours emergency telephone number is (31) (70) 310-2209.
The U.S. Embassy and Consulate General web site at http://netherlands.usembassy.gov/ answers many questions of interest to Americans visiting or residing in the Netherlands.
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This replaces the Consular Information Sheet dated June 28, 2006, to update the sections on Safety and Security and Aviation Safety Oversight.

Travel News Headlines WORLD NEWS

Date: Mon, 10 Feb 2020 11:36:09 +0100 (MET)

London, Feb 10, 2020 (AFP) - Storm Ciara caused travel chaos on Monday, severely disrupting commutes and grounding hundreds of flights as swathes of Europe were left without power by torrential rain and winds of up to 180 kilometres (110 miles) per hour that also caused flash flooding and the cancellation of sporting fixtures.   In one of the most violent storms for years, one man died and another was reported missing in southern Sweden when their boat capsized, while three people were seriously injured in Germany by falling trees and branches.   Parts of northern France were put on orange alert and 130,000 homes had electricity cut off.

The Netherlands closed one of its big storm surge barriers as the tempest approached on Sunday night. Police said it caused Monday morning traffic jams over 600 kilometres of roads.   Around 220 flights were cancelled during the morning at Amsterdam's Schiphol airport -- Europe's third-busiest -- most destined for other European cities. Around 240 never took off on Sunday.   Another man was injured by a tree in the Czech Republic, where winds reached up to 180 kph on the country's highest mountain, Snezka. The storm left 100,000 without power there and even toppled over a truck.    Tiny Luxembourg cancelled school classes and morning rush hour traffic ground to a halt in Brussels due to street closures and flooding.

- Britain cleans up -
Britain began a clean-up after bearing the brunt of one of the most of violent and destructive storms in years.   "While Storm Ciara is clearing away, that doesn't mean we're entering a quieter period of weather," Met Office meteorologist Alex Burkill warned. "Blizzards aren't out of the question".   Transport was disrupted across the country with planes and trains cancelled or delayed.

The highest wind speed recorded was 150 kilometres per hour (93 mph) in the northwest Welsh village of Aberdaron.   More than 15 centimetres (six inches) of rain fell over 24 hours at Sleddale Reservoir in northwest England's Lake District national park.   More than 170 flood warnings remained in place Monday.   The West Yorkshire towns of Hebden Bridge and neighbouring Mytholmroyd were among the worst hit by the storm.    Cars were submerged in the floodwaters and tens of thousands of homes had their electricity cut.

- Wind farm shut -
Much of the initial damage and disruption in Europe was along the coasts.   Channel ferry services between the southern English port of Dover and Calais in northern France resumed Monday morning after being halted Sunday.

The whole Belgian offshore wind farm was shut down as powerful gusts caused the turbines to stop automatically for safety reasons.   The storm was so violent that "we are forced to completely stop mainline train traffic in Germany this Sunday evening," Deutsche Bahn spokesman Achim Stauss told AFP.   The disruptions in Germany also began Sunday with more than a hundred flights across three big cities cancelled.

- Sports events hit -
Sports events were also hit.   Sunday's English Premier League fixture between Manchester City and West Ham was called off due to "extreme and escalating weather conditions", City said in a statement.   The entire Women's Super League football programme was also called off. Sunday's Scotland-England clash in the Women's Six Nations rugby tournament has been rescheduled for Monday.

But there was an upside for passengers flying British Airways to London from New York.   The storm helped the flight to finish in the sub-sonic flight record time of 4 hours 56 minutes, according to flight-tracking website Flightradar24.   A British man wearing only a pair of swimming trunks braved the weather on a charity walk the length of mainland Britain from Lands End, southwest England, to John o'Groats, northeast Scotland.   "Speedos are designed to get wet and mine are absolutely soaking in this weather," said fundraiser Michael Cullen as he trekked in Glastonbury.
Date: Fri 4 Oct 2019
Source: Dutch News [edited]

A total of 3 people have died and one woman has had a miscarriage after eating cold meat contaminated with _Listeria_, the public health institute RIVM [Netherlands National Institute for Public Health and the Environment] said on Friday [4 Oct 2019]. All are thought to have become ill after eating meat products from the Offerman company over the past 2 years, the agency said.

In total, at least 20 people have become ill after eating Offerman cold cuts. The company issued a health warning on Friday [4 Oct 2019], and Jumbo, which stocks 135 different products from Offerman, ordered an immediate recall. Aldi too has recalled its Offerman products, which were also widely sold to company canteens.

The source of the infection was traced by the RIVM and product safety board NVWA [Netherlands Food and Consumer Product Safety] after an analysis of the different types of _Listeria_ infection this week. "It has only been recently possible to use this technique and without it, we would not have been able to identify the source," the RIVM said. [Probably they are referring to whole genome sequencing. - ProMED Mod.ML]

The factory where the bacteria originate[d] is located in Aalsmeer and has been closed pending a thorough clean-up, the AD reported on Friday afternoon [4 Oct 2019]. According to broadcaster NOS, the NVWA had ordered Offerman to take extra hygiene measures because there were suspicions that something was going wrong. "But this would appear not to have done the job," an NVWA spokesman told the broadcaster.

_Listeria_ is found in meat that has not been properly cooked and in raw foods [that] have been kept [refrigerated?] for a long time, the RIVM said. Most people suffer mild flu-like symptoms, but the bacteria can cause serious symptoms in the elderly, new-borns and people with weak immune systems. It is particularly dangerous to pregnant women and can cause miscarriages. Every year about 80 cases of [listeriosis] are reported to the RIVM.
========================
[Genotyping, e.g., by whole genome sequencing, clinical isolates of _Listeria monocytogenes_ can identify clusters of cases that have a common source, and genotyping the isolates from the food and environmental surfaces at food processing facilities can confirm the source, if genotypes match, as likely happened in the outbreak described above.

Refrigerated cold cut meats that are not cooked before eating (i.e., ready-to-eat) are well-recognized sources for listeriosis. Even if initial contamination adds only a few _Listeria_ organisms to the food, the contamination can be significant for refrigerated foods because _L. monocytogenes_ can subsequently multiply at refrigerator temperatures to a sufficient number to cause disease. People at increased risk for disseminated listeriosis include pregnant women (and their new-borns), adults aged 65 years or older, and people with weakened immune systems. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Date: Sat 28 Sep 2019
Source: Food Safety News [abridged, edited]

About 30 people are part of a _Salmonella_ outbreak in the Netherlands linked to eggs from Spain. The Dutch Food and Consumer Product Safety Authority (NVWA) in August 2019 advised people not to eat eggs stamped with the code 3-ES-4624944A because of _Salmonella_ contamination. The agency added it was important to wash hands after touching them, as the _Salmonella_ can be found on the outside of the eggs. The eggs were supplied to neighborhood supermarkets, market stalls and catering establishments that may have further processed them into various dishes. They are not thought to have been sold at large supermarket chains in the country.

Salmonellosis is not a notifiable infection in the Netherlands. There were an estimated 27 440 patients with acute gastroenteritis due to salmonellosis in 2017.

A total of 30 patients have been reported with an identical _Salmonella_ Enteritidis type based on whole genome sequencing, some of which fell ill last year, in 2018. At least 5 patients are known to have eaten eggs from the batch the NVWA issued a warning about, according to the Dutch National Institute for Public Health and the Environment (RIVM).

Harald Wychgel, a RIVM spokesman, said because these studies ask people what they have eaten in recent weeks, it is not expected consumption of eggs can be confirmed for all patients. "The outbreak has been going on since 2018 with a number of patients that is insufficient to initiate source detection. RIVM linked a small cluster of patients to a batch of eggs that were withdrawn from the market at the end of August [2019]," he told Food Safety News.

"Although there has been a recall, it may still be the case that patients will be found because they may still have products at home. The eggs in question have been traced by the NVWA and are withdrawn from the market."

Information from the Rapid Alert System for Food and Feed (RASFF) shows the eggs were also distributed to Belgium.  [Byline: Joe Whitworth]
==========================
[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with faecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the eggshell was formed. To avoid this, uncooked eggs should only be used as an ingredient if pasteurized. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Mon 23 Sep 2019
Source: NL Times [edited]

A Hyalomma tick, commonly referred to as a giant tick, was found in Wageningen. This is the 3rd specimen of this type of tick, which can carry dangerous diseases like Crimean Congo virus and spotted fever, to be found in the Netherlands this year [2019]. The other sightings were in Drenthe and in the Achterhoek in July 2019.

This latest giant tick was found on a pony in Wageningen, according to Omroep Gelderland. It was previously thought that the Netherlands is too cold for the giant tick to grow into adulthood, but due to climate change, the conditions in the Netherlands are increasingly favourable for the animal. It is believed that this type of tick enters the Netherlands through migratory birds.

The Hyalomma tick is known as the giant tick because it is much larger than a normal tick. It can be recognized by the line pattern on its legs. Unlike other ticks that passively wait for a host to pass by, this type of tick actively hunts its host, according to the European center for disease control. They've been known to follow a host for 10 minutes or more, covering a distance of up to 100 meters.

This type of tick is a known carrier of the Crimean-Congo virus, which causes Crimean-Congo haemorrhagic fever. This is a serious disease that has a fatality rate of up to 50 percent, according to the American Centers for Disease Control. The tick found in Drenthe earlier this year [2019] was tested for this virus and was not a carrier, public health institute RIVM said at the time.

The Drenthe tick was a carrier of the _Rickettsia aeschlimannii_ bacterium, which causes the rare spotted fever. "Spotted fever is easy to diagnose and treat with antibiotics," Dutch health agency RIVM said in a statement released over the summer.  Several Dutch agencies track sightings of the tick. Those who have seen the Hyalomma tick should report it to the NVWA, the agency said.  [Byline: Janene Pieters]
========================
[With the discovery of this tick in the 3rd locality in the Netherlands, one wonders whether it is as yet undiscovered in other parts of the country. This giant tick that was found earlier this year (2019) in Drenthe was confirmed as a _Hyalomma marginatum_, a species originating in tropical climates and previously confined to southern parts of Europe. Specimens of the tick have been found in several other northern European countries, including Germany, where it is thought to have overwintered, and in Sweden. Most have been found on livestock, primarily horses. Fortunately, Crimean-Congo virus has not been found in any of the ticks in the Netherlands,

An image of _Hyalomma marginatum_ can be accessed at the source URL above. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Sun, 1 Sep 2019 17:22:26 +0200 (METDST)

The Hague, Sept 1, 2019 (AFP) - Dutch national carrier KLM will scrap 10 European flights Monday due to a two-hour strike by ground staff demanding higher wages, an airline spokeswoman said Sunday.   The move, which will see ground staff down tools between 8.00 am and 10.00 am (0600 GMT to 0800 GMT), comes after the airline and Dutch union federation FNV failed to reach an agreement.   "KLM have preventively decided to annul 10 European flights because of the strike," Manel Vrijenhoek said.   "We are still looking at which flights at this stage," she told AFP.

Air France, Delta and other SkyTeam airlines as well as no-frills carrier Transavia are also set to be affected by the strike, KLM spokeswoman Vrijenhoek confirmed.   The FNV said Saturday it was demanding a four percent increase for some 15,000 members of ground staff, with KLM's latest offer stalling at two percent.   "It's no good. Therefore we are calling a work stoppage," FNV campaign leader Joost van Doesburg said.   "If KLM retains its position after the strike, new labour actions cannot be excluded," he said in a statement.   A strike by public transport workers in May forced dozens of flights to be cancelled at Schiphol, one of Europe's busiest air travel hubs.   More than 41 million passengers passed through Schiphol in the first six months of the year, according to the latest airport figures.
More ...

World Travel News Headlines

Date: Thu, 20 Feb 2020 16:20:39 +0100 (MET)

Damascus, Feb 20, 2020 (AFP) - A bomb explosion wounded two people in Damascus Thursday, the state news agency reported, the latest of several such attacks in the Syrian capital.   "An explosive device planted on a pickup truck went off in the Marjeh area" in central Damascus, SANA said, adding that two civilians were wounded by the blast.

The Syrian Observatory for Human Rights war monitor said the device was a "sticky bomb" planted on a military vehicle, although it was not immediately clear what the target was.   There was no immediate claim of responsibility for the blast, nor for a similar explosion that wounded five people in another neighbourhood of Damascus on Tuesday. The Syrian capital was routinely targeted by major car bomb attacks in the course of the nine-year-old conflict but blasts have been less frequent since regime forces reclaimed full control of the Damascus region in 2018.
Date: Thu, 20 Feb 2020 15:40:35 +0100 (MET)
By Laurent Thomet, with Miwa Suzuki in Tokyo

Beijing, Feb 20, 2020 (AFP) - China on Thursday touted a big drop in new virus infections as proof its epidemic control efforts are working, but the toll grew abroad with deaths in Japan and South Korea.   Fatalities in China hit 2,118 as 114 more people died, but health officials reported the lowest number of new cases in nearly a month, including in hardest-hit Hubei province.

More than 74,000 people have been infected by the new coronavirus in China, and hundreds more in over 25 countries.   The number of deaths outside mainland China climbed to 11.   Japan's toll rose to three as a man and a woman in their 80s who had been aboard a quarantined cruise ship died, while fears there mounted about other passengers who disembarked the Diamond Princess after testing negative.

South Korea reported its first death, and the number of infections in the country nearly doubled Thursday to 104 -- including 15 at a hospital in Cheongdo county.   The mayor of Daegu -- South Korea's fourth-largest, with 2.5 million people -- advised residents to stay indoors, while commanders at a major US military base in the area restricted access.   Iran reported two deaths on Wednesday, the first in the Middle East. Deaths have previously been confirmed in France, the Philippines, Taiwan and Hong Kong.

Chinese officials say their drastic containment efforts, including quarantining tens of millions of people in Hubei and restricting movements in cities nationwide, have started to pay off.   "Results show that our control efforts are working," Foreign Minister Wang Yi said at a special meeting on the virus with Southeast Asian counterparts in Laos, citing the latest data.   Wang said the situation was "significantly improving" in Hubei and Wuhan, but an official in a central government team dealing with the epidemic said it was still "very severe".

- 'Not turning point' -
Although more than 600 new infections were reported in Hubei's capital Wuhan, it was the lowest daily tally since late January and well down from the 1,749 new cases the day before.   The national figure has now fallen for three straight days.   Chinese authorities placed the city of 11 million under quarantine on January 23 and quickly locked down the rest of the province in the days that followed.

Wuhan authorities this week carried out a three-day, door-to-door check on residents, with the local Communist Party chief warning that officials would be "held accountable" if any infections were missed.   Cities far from the epicentre have limited the number of people who can leave their homes for groceries, while rural villages have sealed off access to outsiders.   Richard Brennan, a World Health Organization official, said in Cairo that China was making "tremendous progress" and "trends are very encouraging, but we are not at a turning point yet".

- 'Chaotic' cruise quarantine -
While China has boasted progress in its fight against the COVID-19 epidemic, Japan's government has been criticised for the quarantine measures it placed on the Diamond Princess.   The huge vessel moored in Yokohama is easily the biggest coronavirus cluster outside the Chinese epicentre, with 634 cases confirmed among passengers and crew.   Another 13 people on board the ship were diagnosed with the virus Thursday, Japan's health ministry said.   Still, passengers were disembarking after negative tests and having completed a 14-day quarantine period -- packing into yellow buses and leaving for stations and airports.

Questions were asked over the wisdom of allowing them to mingle in Japan's crowded cities.   "Is it really safe to get off?" screamed a headline in the Nikkan Sports tabloid.   The paper quoted one passenger who said he was tested on February 15, but only left four days later.   "I thought I could be infected during the four days. I thought 'Is it really OK'?"

A specialist in infectious diseases at Kobe University slammed as "completely chaotic" the quarantine procedures on board in rare criticism from a Japanese academic.   "The cruise ship was completely inadequate in terms of infection control," said Kentaro Iwata in videos he has since deleted.

South Korea, meanwhile, announced 51 new cases, with more than 40 in a cluster centred on the Shincheonji Church of Jesus, an entity often accused of being a cult.  The infections apparently came from a 61-year-old woman who first developed a fever on February 10 and attended at least four services before being diagnosed.   Local media said she had twice refused to be tested for the coronavirus on the grounds she had not recently travelled abroad.   Authorities were investigating whether she might have visited the hospital where a long-term patient contracted the virus and later died.

Some 15 other patients have now been found to have the virus.   Shincheonji claims its founder, Lee Man-hee, has donned the mantle of Jesus Christ and will take 144,000 people with him to heaven on the day of judgement.   A man in his 60s tested positive for the coronavirus after dying Wednesday following symptoms of pneumonia, South Korean authorities said.
Date: Thu, 20 Feb 2020 10:28:16 +0100 (MET)

Lagos, Feb 20, 2020 (AFP) - An outbreak of Lassa in Nigeria has killed 103 people this year, health authorities said, as the first confirmed case was reported in the economic hub Lagos.    "Cumulatively from week 1 to week 07, 2020, 103 deaths have been reported with a case fatality rate of 17.6%," said the Nigeria Centre for Disease Control (NCDC) in its latest statistics on the virus released on Wednesday.    The overall number of confirmed cases rose by 115 last week to a total of 586 across the country.

Separately, health authorities in Lagos, Nigeria's most populous city with 20 million inhabitants, said an infected person was diagnosed there on February 17 and being treated in isolation in hospital.    "Sixty-three people that may have been in contact with the patient and who may have been infected in the process have been identified and are being monitored," the state government wrote on Twitter on Thursday.

Endemic to Nigeria, Lassa fever belongs to the same family as the Ebola and Marburg viruses, but is much less deadly.   The disease is spread by contact with rat faeces or urine or the bodily fluids of an infected person.    The majority of those infected do not show symptoms but the disease can go on to cause severe bleeding and organ failure in about 20 percent of cases.

An outbreak of Lassa fever killed some 170 people around Nigeria last year.     The number of cases usually climbs around the start of the year linked to the dry season.   While the overall number of confirmed cases and deaths is up this year on the same period in 2019, the mortality rate is lower.    Twenty health workers across the country have been confirmed as contracting the disease so far in 2020.    The virus takes its name from the town of Lassa in northern Nigeria, where it was first identified in 1969.
Date: Thu, 20 Feb 2020 09:58:17 +0100 (MET)
By Nicolas DELAUNAY

Les Mamelles, Seychelles, Feb 20, 2020 (AFP) - On a plain suburban street in Seychelles, far from the idyllic coastline and luxury resorts pampering honeymooners and paradise-seekers, heroin addicts queue anxiously for their daily dose of methadone.   It is a scene few outsiders would associate with the tropical nirvana adrift in the Indian Ocean, and one rarely, if ever, glimpsed by tourists as they shuttle from the airport to five-star luxury on white-sand beaches.

But life for many Seychellois is far from picture perfect: the tiny archipelago nation is battling what officials say are the world's highest rates of heroin addiction.   Nearly 5,000 people are hooked, government figures show, equivalent to nearly 0 percent of the national workforce -- a statistic that has startled the government into action.

In comparison, 0.4 percent of the global population consumed opioids in 2016, half of them in Asia, according to a United Nations report that puts Seychelles among the top consumers alongside producing countries such as Afghanistan.   The Seychelles' heroin boom, which took off over the past decade, gripped young and old alike and cut across class lines.   Among those queueing in the town of Les Mamelles for methadone -- a substitute narcotic used to wean users off heroin -- are parents with young children, an old man leaning on a cane and a taxi driver between shifts.

Graham Moustache, a 29-year-old father of two, described how the arrival of affordable and high-quality heroin in Seychelles swept up his entire family.   "I have four brothers and two sisters, and we have all been heroin addicts at one point," he told AFP, tracing his fingers over the needle scars on his arms.   "I've been to prison twice," he said, adding his mother had turned him in as "she didn't know what to do any more".   "Sometimes, I didn't have enough to eat and I had to choose between eating and buying heroin. I chose heroin."

- Soaring addiction -
The rise of new trafficking routes through East Africa in the late 2000s, coupled with porous borders and relatively high purchasing power among Seychellois, flooded the paradisal islands with heroin.   The average salary in the archipelago is $420 (390) -- high compared to other African nations.   The World Bank considers the Seychelles the only high-income country on the continent, thanks to the growing tourism industry.    But around 40 percent of the population still lives in poverty.

By 2011, around 1,200 people were addicted, prompting a punitive crackdown.   "We did not make a difference between the victim and the trafficker," said Patrick Herminie, director of the state-run Agency for Drug Abuse Prevention and Rehabilitation (APDAR).   By 2017, addiction had risen four-fold, placing Seychelles among the world's most drug-dependent nations.   The government, realising its war on drugs had failed, changed tack and declared a public health emergency.   "The magnitude of the problem is simply because we reacted a bit late," Herminie said.

Money has poured into combating the scourge, with state funds for drug prevention and rehabilitation programmes soaring to 75 million Seychelles rupees ($5.5 million) in 2020 -- almost 10 times the 2016 budget.    APDAR, a specialist drug agency created in 2017 to tackle the problem, employs four times as many staff as the body that preceded it.   A state-run methadone programme has reached 2,500 people, with medical follow-ups helping to track their progress.    But the free availability of methadone has also prompted drug dealers to lower their prices.

Mobile clinics drive around offering methadone to addicts and providing free health checks and advice.    "I've been clean for more than a year. I found a job as a fisherman, and I can see my two kids," said Moustache proudly, as he queued at the white methadone van staffed with healthcare workers.   Others have struggled to stay the course.   "Methadone helps me a lot, but it's difficult not to take heroin at all," said Gisele Moumou, an emaciated 32-year-old addict, drawing ragged breaths and sweating as she waits for her small cup of methadone.

- Stopping the scourge  -
Schoolchildren are being taught about the damage done by drugs through awareness campaigns and billboards in classrooms.    But there is much work to be done, especially among children from families affected by drug use, says Noellie Gonthier from CARE, a local harm-reduction charity.   "Sometimes, four- or five-year-olds at school mimic injecting heroin," she said.   "Our challenge is to make them understand that what they consider normal -- because of their family context -- actually isn't at all."   On Mahe, a small, mountainous island with lush vegetation, most of the population lives near the water. Life is quiet here, without traffic, and the streets are mostly clean.

Poverty is largely hidden, concentrated in a few neighbourhoods behind faded walls or in the hills.   So why do so many Seychellois take drugs? The authorities admit they haven't quite figured it out, but say it appears that while poverty does not quite allow people to live well, it allows them enough money to buy drugs to forget their woes.   "The root of the cause, we're still working on it," said Herminie.   Early studies show that health and social problems associated with heroin use have declined since the government switched its response from punishment to prevention, officials say.

Crime has nearly halved and annual cases of new hepatitis C infections have fallen 60 percent.    Youth unemployment, meanwhile, has shrunk from 6.5 percent to 2.1 percent in recent years.   One recovering addict, a taxi driver who did not want to be named, offered a bleak assessment as he waited for his daily methadone in an empty car park in Les Mamelles.    "We're a small island in the middle of the ocean. What else is there to do here?" he said.
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: Wed, 19 Feb 2020 12:55:06 +0100 (MET)

Beijing, Feb 19, 2020 (AFP) - China's President Xi Jinping called Wednesday for greater protection of medical staff fighting the new coronavirus after the deaths of prominent doctors sparked national anger at the government's handling of the outbreak.   At least seven medical workers have died from the virus, while 1,716 have been confirmed as infected, most at the epicentre of the epidemic in central Hubei province where hospitals have dealt with a huge influx of patients.

Staff have faced shortages of masks and protective bodysuits, with some even wearing makeshift suits and continuing to work despite showing respiratory symptoms, health workers have told AFP.   Xi said China must "strengthen efforts to relieve the stress of medical workers, provide them with daily necessities, arrange time for their rest and give them encouragement", the official Xinhua news agency reported.   Liu Zhiming, the director of Wuchang Hospital in Hubei's capital Wuhan, died Tuesday, more than a week after the death of whistleblowing ophthalmologist Li Wenliang in the same city prompted nationwide mourning and calls for political reforms.

- 'Majestic spirit' -
A paper published by China's Center for Disease Control and Prevention said an additional 1,300 health workers may have been infected but have yet to receive a diagnosis.   Xi said China must ensure medical teams in Hubei and Wuhan "carry out work in a safe, orderly, coordinated, effective and swift manner", Xinhua reported.   The deaths of frontline medical workers "reflected doctors' humane and majestic spirit", Xi said.   The death toll from the virus jumped past 2,000 on Wednesday, while 74,185 cases of infection have been confirmed in mainland China.
Date: Wed, 19 Feb 2020 12:19:59 +0100 (MET)

Tehran, Feb 19, 2020 (AFP) - Two people in Iran tested positive Wednesday for the deadly new coronavirus, the health ministry said, in the Islamic republic's first cases of the disease.   Kianoush Jahanpour, a ministry spokesman, said the cases were detected in the holy city of Qom, south of the Iranian capital.   "In the past two days, some suspect cases of the new coronavirus were observed in Qom city," he said, quoted by state news agency IRNA.

"Teams were dispatched after receiving the reports, and based on the existing protocols the suspect cases were isolated and tested," said Jahanpour.   "Out of the samples sent, a laboratory tested two of them as positive for coronavirus just minutes ago and some of the other samples were type B influenza."

The health ministry spokesman said additional tests were being done on the two cases and final results would be announced "as soon as possible".   The new coronavirus epidemic has killed more than 2,000 people in China and infected more than 74,000. It has spread to at least two dozen countries.   The United Arab Emirates was the first country in the Middle East to report cases of coronavirus last month.
Date: Tue 18 Feb 2020
Source: CIDRAP (Center for Infectious Disease Research & Policy) News [edited]

The WHO's African regional office said that both Chad and the Central African Republic (CAR) are in the midst of measles outbreaks, with both countries reporting increasing case counts since [1 Jan 2020].

In Chad, 1276 cases, including 14 deaths have been reported since 1 Jan 2020, with 352 suspected measles cases and 4 deaths reported in the week ending on 9 Feb 2020.  "Most, 78%, of the investigated cases never received any vaccination against measles," the WHO said. "60% of the investigated cases were under 5 years of age while 19% were between 5 and 14 years and 14% were 15 years and above."

In CAR, a total of 1498 suspected measles cases, including 15 deaths, have been recorded since [1 Jan 2020]. The outbreak has been ongoing since early 2019. From 1 Jan 2019, through 9 Feb 2020, a total of 5724 suspected measles cases, including 83 deaths (case fatality rate, 1.45%) have been reported in 13 health districts.  Almost 3/4 of the cases (72%) are in children under the age of 5.
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[HealthMap/ProMED-mail maps
Central African Republic: <http://healthmap.org/promed/p/6>]
Date: Wed 19 Feb 2020
Source: Circular/News, Veterinary Services, Israel's Ministry of Agriculture [in Hebrew, trans. Mod.AS, edited]

Rabies, Case No. 6 for 2020, dog, Ramot Naftali, Upper Galilee. Reference: Kimron Vet Institute [KVI] Laboratory Test No. A00373420, dated 19 Feb 2020
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On 17 Feb 2020, a dead dog was brought for examination to the KVI [at Beit-Dagan]. The dog died while being transported to a rabies observation kennel since, as reported, it had attacked grazing cattle and attempted to attack people.  It was also reported that the dog had bitten itself. The tested animal has been diagnosed rabies positive.  [Byline: Dr. Avi Wasserman Head, Field Veterinary Services (acting)]
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[The above and 5 earlier rabies cases in Israel since 1 Jan 2020 are located within a small region along the Lebanese border, facing Lebanon's governorate A-Nabatieh. See the rabies map (2020) at <https://moag.maps.arcgis.com/apps/webappviewer/index.html?id=a6d8aae5cbc04c958d5efefd2724318f>.

The 2019 map, presenting a total of 17 cases, is available at

The 6 cases during 2020 are: 3 jackals, 2 dogs, 1 cow. Most likely, rabies is currently circulating within the Lebanese side of the border.

It would be interesting to note whether the rabid dog was owned and, in case affirmative, whether and when this dog was last vaccinated against rabies, as prescribed by law. Israel's owned dogs are included in the national dog registry, currently counting more than 400,000 dogs. - ProMED Mod.AS]
Date: Tue 18 Feb 2020
Source: Qatari Ministry of Public Health [edited]

The Ministry of Public Health (MOPH) declared that a case of Middle East respiratory syndrome (MERS) has been confirmed. The case is a male citizen aged 65 years who has been suffering from several chronic diseases. The patient has been admitted to the hospital to receive the necessary medical care in accordance with the national protocol to deal with confirmed or suspected cases of the disease.

The Ministry of Public Health, in cooperation with the Ministry of Municipality and Environment, is taking all necessary preventive and precautionary measures to control the disease and prevent it from spreading.

MERS is a viral respiratory disease that is caused by one of the coronaviruses (MERS-CoV), but it differs from the novel coronavirus, known as COVID-19, which has recently spread in several countries. Both viruses differ in terms of the source of infection, mode of transmission, and the disease severity. The Ministry of Public Health confirms that no cases of the novel coronavirus (COVID-19) have been diagnosed in Qatar so far.

Only 3 cases of MERS-CoV were registered in Qatar during the past 2 years. The Ministry of Public Health calls on all members of public, and especially people with chronic diseases or those with immunodeficiency disorders, to adhere to public hygiene measures. This includes washing the hands regularly with water and soap, using hand sanitizers, as well as avoiding close contact with camels and seeking medical advice when experiencing symptoms of fever, cough, sore throat, or shortness of breath.

The Rapid Response Team of the Health Protection and Communicable Disease Control is available round-the-clock to receive notifications or inquiries related to communicable diseases on its hotline numbers 66740948 or 66740951.
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[In early December 2019, Qatar reported 3 cases of MERS-CoV infection, a fatal case and 2 asymptomatic contacts of the fatal case. The fatal case denied a history of contact with camels or recent travel. She did have a history of underlying medical conditions (which may have led to contact with the health sector in the 2 weeks prior to onset of illness). Prior to these cases, the most recent report of a case of MERS-CoV infection in Qatar was in 2017 when there were 3 cases reported (see prior ProMED-mail posts listed below.)

The location of residence of this patient was not available, nor were other epidemiological variables, including possible high risk exposures.

The HealthMap/ProMED-mail map of Qatar is available at