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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: 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]
Date: Mon, 2 Dec 2019 16:12:47 +0100 (MET)

London, Dec 2, 2019 (AFP) - Union members on one of Britain's busiest railway networks walked out on Monday, on the first day of a planned 27-day strike that could affect hundreds of thousands of commuters.   The Rail, Maritime and Transport (RMT) stopped work on lines run by South Western Railway, which operates lines in and around London, and to towns and cities in southwest England.   Passengers have been warned to face disruption in the run-up to Christmas, as only half of services will run, including to and from Britain's busiest railway station Waterloo.

The planned stoppage -- one of the longest in living memory -- was called after talks broke down between unions and bosses about the role of guards on trains.   South Western wants to hand responsibility for closing doors on trains from guards to drivers, but the RMT says that reduces the role of guards and comprises safety.   RMT general secretary Mick Cash said the guard would become "little ore than a passenger in the longer term" and put their jobs at risk "at some point down the line".

South Western called the union's demands "outdated" and said it had offered a "safety-critical role" for train guards.   "Unfortunately, it is clear to us that the RMT is unclear on what this dispute is about and intent on striking no matter what," it said.   Britain's partly privatised rail network is often criticised for scheduling problems and high ticket prices.    On Monday, the main opposition Labour party pledged to slash fares by a third from January next year, and make travel free for under-16s if it is elected at polls on December 12.   Train companies last weekend confirmed they would raise fares by an average of 2.7 percent next year.
Date: Tue 19 Nov 2019 6:07 AM GMT
Source: 3 FM [edited]

There's been an outbreak of a highly contagious disease among wood pigeons on [Isle of Man]. That's according to Manx Wild Bird Aid (MWBA) which says its already taken in a number of the animals from Douglas, Groudle, and Crosby which are suffering with 'canker'.

The infection isn't harmful to humans or mammals but the organisation says it can cause growths in the birds' mouths which can lead them to starve to death.

MWBA is offering advice to people about how to help stop it spreading, including strict hygiene on bird-feeding tables and if you come across a sick pigeon to take it to the nearest vet as soon as possible.  [Byline: Rob Pitchard]
========================
[_Trichomonas gallinae_ is a common protozoan parasite of pigeons (Columbiformes) which principally infects the upper alimentary tract where it can cause necrotic ingluvitis. Epidemic mortalities in columbiform species are sporadically reported, and the parasite may infect other avian taxa such as birds of prey and songbirds. (<http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0012215>). - ProMED Mod.PMB]

[HealthMap/ProMED-mail map of the Isle of Man:

HealthMap/ProMED map available at:
Date: Sat 9 Nov 2019
Source: The Herald Scotland [edited]

Two cases of diphtheria have been confirmed in the Lothian area, the Herald [revealed]. Both individuals, who are believed to be receiving treatment for the disease in an Edinburgh hospital, had recently returned to Scotland after travelling abroad.

[Diphtheria] was once a major cause of death in the UK but is now extremely rare due to high uptake rates for the childhood vaccine. One of the last major outbreaks in Scotland was in 1968, when 6 members of the same household in Motherwell, Lanarkshire, fell ill. Two died.

A spokeswoman for Health Protection Scotland confirmed they were aware of 2 cases of diphtheria but said NHS Lothian were "dealing with this at a local board level."  NHS Lothian stressed that the likelihood of any additional cases was "very small" due to high immunisation rates. Since 2015, there have only been 5 other cases reported in Scotland.

Alison McCallum, director of public health at NHS Lothian said: "Two related cases of diphtheria have been confirmed in the Lothian area, with both patients having recently returned from abroad. "All close contacts of these patients have been identified, contacted and followed up in line with nationally agreed guidelines. "The likelihood of any additional cases is very small, as most people are protected by immunisation given in childhood. "In Lothian, 98% of children are vaccinated against diphtheria by the age of 24 months.

"We encourage people travelling abroad to visit [NHS website] Fit for Travel where they can access information on how to stay safe and healthy abroad, as well as destination specific health advice."

Before mass immunisation was introduced in 1942, there were more than 60,000 cases of diphtheria a year in Britain and over 4000 deaths annually. Diphtheria can also attack the heart, causing fatal heart failure, or the nerves, leading to neurological damage.

In the UK, infants and children are routinely offered the 6-in-one vaccine to protect against diphtheria as well as hepatitis B, whooping cough, polio, tetanus and haemophilus influenzae type b (Hib). Uptake by age 5 averages 98.2% in Scotland, according to the latest figures.

However, the disease remains common in some parts of the world including Asia, the South Pacific, the Middle East, eastern Europe and the Caribbean. Anyone travelling to areas with high rates of diphtheria is advised to have a booster jab if they have not been vaccinated in more than 10 years.  [Byline: Helen McArdle]
====================
[Diphtheria, a life-threatening, vaccine-preventable infection caused by toxin-producing _Corynebacteria_ species, which include _C. diphtheriae_, _C. ulcerans_ and _C. pseudotuberculosis_. _C. ulcerans_ and _C. pseudotuberculosis_, are zoonotic pathogens that can carry the same bacteriophage that encodes diphtheria toxin as do toxigenic strains of _C. diphtheriae_ and produce diphtheria toxin. Diphtheria became rare in England following the introduction of mass immunization in 1942, when the average annual number of cases was about 60,000 with 4000 deaths  (<https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/788746/hpr1019_dphthr.pdf>).

From
January to December 2018, 11 toxigenic strains of _Corynebacteria_ were reported in England; 8 _Corynebacterium diphtheriae_ and 3 _C. ulcerans_.

_Corynebacterium diphtheriae__ is an aerobic gram-positive bacillus with 3 biotypes: gravis, intermedius, and mitis. _C. diphtheriae_ causes respiratory tract or cutaneous diphtheria. Toxin production occurs only when the bacillus is infected (lysogenized) by a specific bacteriophage that carries the gene encoding the toxin. The toxin is responsible for the major complications, myocarditis (e.g., cardiac arrhythmias and heart failure) and neuritis (e.g., paralysis of the soft palate, eye muscles, limbs, and diaphragm).

Humans are the only reservoir of _C. diphtheriae_. Transmission of _C. diphtheriae_ can occur through respiratory droplets, direct contact with cutaneous infections, and articles soiled with discharges from the respiratory tract or skin lesions. Organisms can be shed for up to 4 weeks without antibiotics, but chronic carriers may shed organisms for 6 months or more. Effective antibiotic therapy promptly terminates shedding. The organisms can survive in dust and clothing for up to 6 months (<http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/dip.pdf>). Shedding from cutaneous lesions can cause respiratory and cutaneous infections in contacts.

Lothian is a region of the Scottish Lowlands, lying between the southern shore of the Firth of Forth and the Lammermuir Hills and includes Edinburgh City (<http://en.wikipedia.org/wiki/Lothian>). Edinburgh, with a population in 2013 of 487 500, is the capital of Scotland and is located on the southern shore of the Firth of Forth (<http://en.wikipedia.org/wiki/Edinburgh>).

For a map of Scotland showing the location of Lothian, see

[HealthMap/ProMED map available at:
Scotland, United Kingdom: <http://healthmap.org/promed/p/280>]
Date: Fri, 8 Nov 2019 11:03:11 +0100 (MET)

London, Nov 8, 2019 (AFP) - Royal Mail on Friday made a High Court bid to block a postal strike by workers due next month ahead of Christmas and around the time of Britain's general election.   Members of the Communication Workers Union recently voted to strike amid a dispute with management over pay and other employment conditions.   In a statement, Royal Mail pointed to "potential irregularities in the ballot".   It added: "The company is making this High Court application because the integrity and legal soundness of any electoral process is vital," Royal Mail said in relation to the strike ballot.   "This is particularly the case in relation to potential industrial action around the general election on 12 December 2019.    "Royal Mail is also making this application because of the damage industrial action would do to the company and its customers in the run-up to Christmas," the group added.   It expects the hearing to take place next week.
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: Tue 7 Jan 2020
Source: WHO Africa [edited]

With the death toll from the world's worst measles epidemic in the Democratic Republic of the Congo (DRC) surpassing 6000, the World Health Organization (WHO) is calling for more funding to stop the outbreak.

Under the leadership of the DRC Ministry of Health, WHO, Gavi, the Vaccine Alliance, and other partner aid agencies vaccinated more than 18 million children under 5 across the country in 2019. However, in some areas, routine vaccination coverage remains low, and 25% of the reported measles cases are in children over the age of 5, who are the most vulnerable.

"We are doing our utmost to bring this epidemic under control. Yet to be truly successful we must ensure that no child faces the unnecessary risk of death from a disease that is easily preventable by a vaccine. We urge our donor partners to urgently step up their assistance," said Dr. Matshidiso Moeti, WHO Regional Director for Africa.

Since the start of 2019, around 310 000 suspected measles cases have been reported. The epidemic has been aggravated by low vaccination coverage among vulnerable communities, malnutrition, weak public health systems, outbreaks of other epidemic-prone diseases, difficult access by vulnerable populations to health care and insecurity that has hampered response in some areas.

Lack of funding remains a huge impediment to successfully curbing the outbreak. So far, USD 27.6 million have been mobilized. However, a further USD 40 million are required for a 6-month plan to extend the vaccination to children between 6 and 14 years and to reinforce elements of the outbreak response beyond vaccination, including improving treatment, health education, community engagement, health system strengthening, epidemiological surveillance and response coordination.

"We recognize the Government's engagement in the efforts to end the outbreak and we are grateful for the generosity of our donors. But we still need to do more," said Dr. Amedee Prosper Djiguimde, Officer in charge of WHO office in the DRC. "Thousands of Congolese families need our help to lift the burden of this prolonged epidemic from their backs. We cannot achieve this without adequate finances."

The European Civil Protection and Humanitarian Aid Operations, Gavi, the Vaccine Alliance, Medecins du Monde, Medecins Sans Frontieres, United Nations Children's Fund, WHO and other partners have been supporting the Government to bring the long-running epidemic under control. In December 2019, WHO trained 60 health professionals from the Ministry of Health to conduct a range of services, including community engagement, health education and surveillance. These health professionals are being deployed this week as part of the response.
======================
[Also see Healio:
Date: Tue, 7 Jan 2020 19:01:55 +0100 (MET)

Kinshasa, Jan 7, 2020 (AFP) - Measles has killed more than 6,000 people in the Democratic Republic of Congo since January, the world's worst outbreak and nearly triple the toll in the country's Ebola epidemic, the World Health Organization said Tuesday.   DR Congo declared its latest measles epidemic in June, and last September the country launched an emergency vaccination campaign to counter the outbreak.

In 2019, more than 18 million children under the age of 5 were vaccinated across the DR Congo, the WHO said in a statement.   Around 310,000 suspected cases were reported during the year, it said.   WHO said an additional $40 million in emergency funds was needed from donors for a six-month immunisation plan for children to help curb the epidemic.

Efforts to halt the spread of both Ebola and measles are hampered by a lack of access, weak health care and unrest across the country, especially in the east.   Measles is a highly-contagious disease caused by a virus that attacks mainly children. The most serious complications include blindness, brain swelling, diarrhoea, and severe respiratory infections.   The rapid spread of measles in DRC has garnered far less attention than the Ebola epidemic that has also been raging in the east of the country since August 2018. That outbreak has killed more than 2,230 people.
Date: Sun 29 Dec 2019
Source: WHO Regional Office for Africa weekly bulletin on outbreaks and other emergencies, week 52: 23-29 Dec 2019 [edited]

Since the beginning of 2019, a cumulative total of 5060 monkeypox cases, including 103 deaths (CFR [case-fatality rate] 2%), were reported from 18 provinces. In week 49 (week ending 8 Dec 2019), 56 cases and one death were reported nationally.
=======================
[It is curious that this many monkeypox (MPX) cases (5060) during 2019 did not come to our attention until now. MPX virus is endemic and widespread geographically in the DR Congo, with cases in 18 provinces; fatal cases occasionally occur. The 2% CFR is relatively low for the clade of MPX that occurs in the DRC, which can reach 10% or more. 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-mail map:
Date: Sun, 29 Dec 2019 18:28:40 +0100 (MET)

Beni, DR Congo, Dec 29, 2019 (AFP) - A total of 2,231 people have died out of 3,373 declared cases of Ebola in the current epidemic in the DR Congo, according to the agency overseeing the response, health officials said Sunday.   Deadly unrest in the fragile state has hampered the fight against the disease during the latest epidemic, which broke out on August 1, 2018, with the eastern provinces of North Kivu and Ituri particularly badly hit.

Both areas, beset by violence for two decades, have seen repeated attacks on Ebola health workers by dozens of armed groups as well as on health sites set up to treat victims.   More than 200 civilians have been killed in the troubled east since November in clashes blamed on the Allied Democratic Forces (ADF), a militia group of Ugandan origin which officials blame for a string of massacres in recent weeks.

Health authorities meanwhile said Sunday that 341 suspected Ebola cases were being investigated, a day after the Multisectoral Committee for Epidemic Response (CMRE) monitoring the disease unveiled its latest batch of data Saturday.   The current epidemic is the tenth overall and the second deadliest on record since a 2014-16 outbreak struck west Africa, killing more than 11,300.
Date: Sat, 28 Dec 2019 10:13:40 +0100 (MET)

Tshikapa, DR Congo, Dec 28, 2019 (AFP) - Twenty bodies have been recovered from a river in the Democratic Republic of Congo after a ferry blaze, local officials said Saturday.   The boat, which was transporting dozens of passengers as well as goods, caught fire overnight Monday in Tshimbinda, a village near Tshikapa, the capital of the central province of Kasai.

A report by a naval force in charge of waterway security in the DRC said a member of the crew lit a cigarette just as his comrades were filling up the boat with fuel.   It said 17 bodies were found on Tuesday and another three on Friday along the Kasai river, a tributary of the Congo River.

Several other people suffered burns and a number remain missing, the report said, without giving the total number of people on board the boat at the time of the fire.   Lake and river transport is widely used in the vast country as the highway system is poor, but accidents are common, often caused by overloading and the unsafe state of vessels.
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 ...

Mali

Mali - US Consular Information Sheet
December 19, 2008
COUNTRY DESCRIPTION:
Mali is a developing country in western Africa with a stable and democratic government.
The official language is French.
The capital is Bamako.
Faci
ities for tourism are limited.
Read the Department of State Background Notes on Mali for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
All travelers must have international vaccination cards with a current yellow fever immunization.
Travelers should obtain the latest visa information and entry requirements from the Republic of Mali Embassy at 2130 R Street NW, Washington, DC
20008, telephone (202) 332-2249.
Inquiries can be made at the nearest Malian embassy or consulate.
Visit the Embassy of Mali web site at http://www.maliembassy.us/ 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: The U.S. Embassy in Bamako strongly advises American citizens to avoid traveling to the northern regions of Mali.
U.S. Government employees serving in Mali, including those on temporary duty, are required to have approval from the Chief of Mission prior to traveling to areas north of the Niger River, including Timbuktu and areas or north of Timbuktu.
Travelers should exercise caution when traveling in any isolated areas.

In August 2007, Tuareg dissidents attacked and kidnapped civilian and military convoys near the Mali-Niger border.
On January 3, 2008, four Italians were robbed at gunpoint near Araouane, 150 miles north of Timbuktu, by assailants whose affiliation remains unknown.
Tuareg rebels in the Kidal region attacked Malian military units in Tinzawaten and Boughessa in March 2008, in Abeibara in May 2008, and in Tessalit in July 2008.
On October 16, 2008, bandits in the Kidal region of Mali carjacked two vehicles belonging to the International Committee for the Red Cross.

Al-Qaeda in the Land of the Islamic Maghreb (AQIM) has a presence in northern Mali.
AQIM began as a terrorist group seeking the overthrow of the Algerian government, and has been designated as a terrorist organization by both the United States and the European Union.
On October 31, 2008, in northern Mali, AQIM freed two Austrian tourists kidnapped in Tunisia eight months earlier.
The group has declared its intention to attack Algerian and Western targets.

This recent activity and the porous nature of Mali’s northern borders with Mauritania and Algeria, as well as its eastern border with Niger, reinforce long-standing concerns about security for travel in northern Mali.
The Department of State strongly urges citizens to reconsider traveling to northern Mali, including Timbuktu and Essakane.
Northern Mali hosts several annual music festivals in the desert, including one north of Timbuktu at Essakane, one north of Kidal at Essouk, and another near Menaka.
These are official events sanctioned by the Government of Mali.
Americans planning to attend these festivals or otherwise travel to the northern regions of Mali, despite this caution, are urged to notify the U.S. Embassy about their plans by e-mail at consularbamako@state.gov.
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.
Current information on safety and security can also be obtained by calling 1-888-407-4747 toll-free within the U.S. and Canada, or, for callers outside of the U.S. and Canada, on 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:
Violent crime in Mali is infrequent, but petty crimes, such as pick pocketing and simple theft, are common in urban areas.
Passports and wallets should be closely guarded when in crowded outdoor areas and open-air markets.
Individuals traveling on the Bamako-Dakar railroad are advised to be vigilant for pickpockets, especially at night.
Criminals will not hesitate to use violence if they encounter resistance from their victims.
There are sporadic reports of nighttime robberies occurring on the roads outside of the capital; tourists should not drive outside of Bamako at night.
Travelers should stay alert, remain in groups, and avoid poorly lit areas after dark.

Sporadic banditry and random carjacking have historically plagued Mali's vast desert region and its borders with Mauritania and Niger.
While banditry is not seen as targeting U.S. citizens specifically, such acts of violence cannot be predicted.

On July 1, 2008, six people working as USAID contractors were robbed of their vehicle and all belongings, at gunpoint, by three bandits between the villages of Temera and Bourem, approximately 120 km (75 miles) northeast of Gao along the Niger River.

From May 2008 until July 2008, there were a series of attacks at various Malian government installations.
While most of these have been in eastern Mali, on May 6, bandits attacked a military outpost in Diabali, 175 km (110 miles) north of Segou.
While these actions appear directed exclusively at government security facilities, including military, gendarmerie and national guard bases, bandits have been known to stop cars at gunpoint while making their escape.
Those traveling or living in Mali are strongly encouraged to register with the Embassy to allow e-mail notification should further attacks occur.
Please see the Registration/Embassy Location information at the end of this article.

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

The local equivalent to the “911” emergency line in Mali is:
1212
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Mali are limited, especially outside of the capital, Bamako.
Psychiatric care is non-existent.
The U.S. Embassy in Bamako maintains a list of physicians and other healthcare professionals who may see U.S. citizen patients.
The Embassy cannot guarantee these services or specifically recommend any physicians.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to, or foreign residents of, Mali.
Many American medicines are unavailable; French medications are more easily found.
Available medications can be obtained at pharmacies throughout Bamako, and are usually less expensive than those in the U.S.
Travelers should carry with them an adequate supply of needed medication and prescription drugs, along with copies of the prescriptions, including the generic names for the drugs.
Caution should be taken to avoid purchasing potentially dangerous counterfeit medications when buying on the local market in Mali.
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 Mali is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
U.S. citizens traveling by road in Mali should exercise caution.
Mali has paved roads leading from Bamako to Segou, Mopti and Sikasso.
During the rainy season from mid-June to mid-September, some unpaved roads may be impassable.
On many roads outside of the capital, deep sand and ditches are common.
Four-wheel drive vehicles with spare tires and emergency equipment are recommended.
The Embassy strongly urges all travelers to avoid traveling after dark on roads outside of urban centers.
The roads from Gao to Kidal and Menaka, and the roads around Timbuktu, are desert tracks with long isolated stretches.
Travelers must be prepared to repair their vehicles should they break down or become stuck in the sand.
Travelers should also carry plenty of food and water.
Drivers drive on the right-hand side of the road in Mali.
Speed limits range from 40-60 km per hour (25-40 miles per hour) within towns, to 100 km per hour (60 miles per hour) between cities.
Road conditions often require lower speeds.
Due to safety concerns, the Embassy recommends against the use of motorbikes, van taxis, and public transportation.
Excessive speeds, poorly maintained vehicles, lack of street lighting and roving livestock pose serious road hazards.
Many vehicles are not maintained well and headlights are either extremely dim or not used.
Driving conditions in the capital of Bamako can be particularly dangerous due to limited street lighting, the absence of sidewalks for pedestrians, and the number of motorcycles, mopeds and bicycles.
Please refer to our Road Safety page for more information.
The Malian authority for road safety is the Compagnie Nationale de Circulation Routiere in Bamako at telephone (223) 20-22-38-83.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Mali, the U.S. Federal Aviation Administration (FAA) has not assessed Mali’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:
Mali is signatory to the Treaty on Cultural Property, which restricts exportation of Malian archeological objects, in particular those from the Niger River Valley.
Visitors seeking to export any such property are required by Malian law to obtain an export authorization from the National Museum in Bamako.
It is advisable to contact the Embassy of Mali in Washington or the nearest Malian consulate for specific information regarding customs requirements.
U.S. Customs and Border Protection may impose corresponding import restrictions in accordance with the Convention on Cultural Property Implementation Act.
Currency exchange facilities are slow and often involve out-of-date rates.
The U.S. Embassy cannot provide exchange facilities for private Americans.
There are a few ATMs in Bamako that accept American credit cards and debit cards with a Visa logo only.
Maximum withdrawals are generally limited to $400, and local banks charge up to $20 per transaction for use of their ATMs.
There are no ATMs outside of Bamako.
Credit cards are accepted only at major hotels, a few travel agencies, and select restaurants.
Cash advances on credit cards are available from only one bank in Mali, the BMCD Bank in Bamako, and the only card they accept for this is Visa.

The U.S. Embassy does not always receive timely notification by Malian authorities of the arrest of Americans.
U.S. citizens are encouraged to carry a copy of their passport with them at all times, so that proof of identity and citizenship are readily available in the event of questioning by local authorities.
If arrested, U.S. citizens should always politely insist they be allowed to contact the U.S. Embassy (see section on Registration/Embassy Location below).
Photographing military subjects is restricted.
One should also obtain explicit permission from the Malian government before photographing transportation facilities and government buildings.
Taking a photograph without permission in any public area may provoke a response from security personnel or offend the people being photographed.
Taking photos of the U.S. Embassy is also prohibited.
International telephone calls are expensive, and collect calls cannot be made from outside of Bamako.
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 that are available to individuals under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Mali’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Mali 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 Mali are encouraged to register with the U.S. Embassy or through the State Department’s travel registration web site so that they can obtain current information on travel and security within Mali.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in ACI 2000 at Rue 243, Porte 297.
The Embassy's mailing address is B.P. 34, Bamako, Mali.
The telephone number is (223) 20-70-2300.
The consular fax number is (223) 20-70-2340.
The Embassy web page is at http://mali.usembassy.gov
* * *
This replaces the Country Specific Information for Mali dated February 7, 2008, to update the sections on Safety and Security, Crime, Information for Victims of Crime, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Thu 26 Dec 2019
Source: WHO Emergencies preparedness, response [edited]

From 3 Nov through 8 Dec 2019, 3 laboratory-confirmed cases of yellow fever including 2 deaths (case fatality rate = 67%) were detected through the national surveillance system in Mali. The 1st case-patient was a 15-year-old girl from a village in Kati district, Koulikoro region, Mali. The 2nd and 3rd cases were in 17- and 25-year-old men, nationals from Cote d'Ivoire, living in the district of Bouguimi, Sikasso region, Mali. All 3 cases tested positive for yellow fever by immunoglobulin M (IgM) and reverse-transcriptase polymerase chain reaction (RT-PCR) on 3 Dec 2019 at Institute Pasteur Dakar (IPD). The 1st case was not vaccinated against yellow fever and had no travel history outside of Kati district. Meanwhile, the vaccination status for the other 2 cases was unknown.

Additionally, there were 9 suspected and 3 probable cases reported from the Bouguimi district, including 3 deaths among the probable cases. The age of the suspected, probable, and confirmed cases ranges between 1 and 33 years, and the male-to-female ratio is 2:1. Among the reported symptoms, fever, jaundice, and vomiting were the most common. There are 8 health areas of Bouguimi health district that have been affected, with Manakoro (4 cases) and Mafele (3 cases) reporting the highest number. One suspected case is pending for confirmation at the Institute Pasteur Dakar laboratory.

On 5 Dec 2019, the government of Mali officially declared a yellow fever outbreak in 2 regions of Sikasso and Koulikoro.

Public health response
- An emergency operations centre (EOC) for public health coordination of the outbreak in the regions of Sikasso, Koulikoro, and the affected districts has been set up. In addition, an EOC has been activated in
Bamako city.
- A multidisciplinary rapid response team was deployed to conduct investigations in the affected districts of Sikasso and Koulikoro regions. A plan to conduct an in-depth entomological survey is underway.
- Enhanced epidemiological surveillance, including active case finding in both the affected districts, has been strengthened.
- A comprehensive response plan is being developed with specific objectives, including the preparation for an international-coordination-group (ICG) request to conduct a yellow fever reactive mass-vaccination campaign.
- Risk communication capacity through involvement of relevant stakeholders [is being provided], as well as public communication and awareness efforts on yellow fever (signs, symptoms, and vaccinations), including prevention measures.
- On 3 Dec 2019, a joint investigation team (WHO Country Office and Ministry of Health) was deployed to characterize the risk and develop an intervention plan. Field investigations indicate vaccination coverage under 80% in Kati and 88% in Manakoro districts.

WHO risk assessment
Although population immunity in the southern regions of Mali has benefited from large-scale preventive mass vaccination campaigns in 2008 (5.8 million people protected) combined with nationwide children routine immunization since 2002, the overall national routine immunization coverage for yellow fever in 2018 was estimated to be 67%, with estimates nearly 80% in the non-desert areas (including the recently affected Koulikoro and Sissako regions). This is below herd immunity thresholds and may indicate the presence of pockets of low immunity in the country. Kati district in Koulikoro region is located proximal to the capital city, Bamako, an urban city with more than 2 million inhabitants, and Bouguimi district in Sikasso region borders with Cote d'Ivoire.

The high population movements within Mali and across borders increases the risk of national and regional spread, and this may have diluted the population immunity. The geographical distribution of the virus, coupled with suboptimal vaccination coverage, and the presence of susceptible populations presents a risk of amplification. Furthermore, the protracted humanitarian crisis and concomitant ongoing outbreaks of epidemic-prone diseases (measles, dengue) may impact the response due to competing limited resources.

Based on available information, WHO assesses the overall risk as high at the national level, moderate at the regional level, and low at the global level.

WHO advice
Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life. Supportive care to treat dehydration, respiratory failure, and fever, and antibiotic treatment for associated bacterial infections, is recommended.

Mali is a high-priority country for the Eliminate Yellow Fever Epidemic (EYE) strategy. Vaccination is the primary intervention for prevention and control of yellow fever. In urban centres, targeted vector control measures are also helpful to interrupt transmission. WHO and partners will continue to support local authorities to implement interventions necessary to control the current outbreak.

WHO recommends vaccination against yellow fever for all international travellers more than 9 months of age going to areas south of the Sahara Desert in Mali. The vaccine is contraindicated in children aged less than 6 months and is not recommended for those aged 6-8 months, except during epidemics when the risk of infection with yellow fever virus may be very high. Other contraindications for yellow fever vaccination are severe hypersensitivity to egg and severe immunodeficiency. Caution is recommended before vaccinating people aged above 60 years against yellow fever.

WHO does not recommend vaccination for travellers whose itineraries are limited to areas within the Sahara Desert. Vaccination is recommended, if indicated, for pregnant or breastfeeding women travelling to endemic areas when such travel cannot be avoided or postponed. Mali requires as a condition of entry a yellow fever vaccination certificate for all travellers aged one year or over.

Yellow fever vaccines recommended by WHO are safe and highly effective and provide life-long protection against infection. In accordance with the IHR (2005) 3rd edition, the validity of the international certificate of vaccination against yellow fever extends to the life of the person vaccinated with a WHO-approved vaccine. For both existing or new certificates, revaccination or a booster dose of yellow fever vaccine cannot be required of international travellers as a condition of entry into a state party, regardless of the date their international certificate of vaccination was initially issued.

On 1 Jul 2019, WHO updated the areas at risk of yellow fever transmission and the corresponding recommendations for vaccination of international travelers. The list of countries at risk and revised recommendations for vaccination against yellow fever are available on the WHO website (International travel and health (ITH),  <https://www.who.int/ith/en/>).

WHO encourage its member states to take all actions necessary to keep travellers well informed of risks and preventive measures including vaccination. Travellers should also be made aware of yellow fever signs and symptoms and instructed to seek rapid medical advice should they develop signs of illness. Travellers returning to Mali who may be infected with possible high levels of the virus in the blood may pose a risk for the establishment of local cycles of yellow fever transmission in areas where the competent vector is present.

WHO does not recommend any restrictions on travel or trade to Mali on the basis of the information available on this outbreak.
=======================
[This updated report includes information about 9 suspected and 3 probable yellow fever (YF) cases that were not mentioned in previous reports, indicating that the outbreak was more extensive than originally stated, with an outbreak declared by government authorities in the 2 regions. These additional cases may have been a result of the additional surveillance that has been undertaken. Since vaccination coverage has been found to be less than 80% and 88% in Kati and Manakoro districts, respectively, presumably the preventive measures mentioned will include vaccination. The entomological survey will be an important factor in risk assessment. The presence of abundant populations of the mosquito vector, _Aedes aegypti_, would be of concern, raising the possibility of urban transmission of YF virus that might get out of hand quickly. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Date: Sun 8 Dec 2019
Source: WHO Weekly Bulletin on Outbreaks and Other Emergencies [edited]

On 3 Dec 2019, WHO was informed through internal communication of 3 yellow fever cases in Mali, including one death. Of these, 2 of the cases are from Wogouna and Keregoura villages, Bougoni district, Sikasso region in the South of Mali and one from Nanakenieba village, Kati district, Koulikoro region in the south west of Mali.

The reported cases are young adults (15-25 years), one female and 2 males, with onset of symptoms in early November 2019.

The cases tested yellow fever IgM and PCR positive at Institute Pasteur Dakar on 3 Dec 2019.

The vaccination status of the cases is being investigated (2 of the cases reported vaccination in the past). The latest vaccination campaign in the country was performed in 2008 including the affected areas where the vaccination coverage was reported to be between 50 and 9% in 2008. The average national vaccination coverage for 2017 has been reported at 65% (data from Imperial College). The YF routine vaccination in the country was introduced in 2002.

A field investigation is ongoing. According to historical data, 10 cases were detected in Mali in 2015.
======================
[This report provides some additional details in that 2 patients were male and one female along with their vaccination status, which were not included in the original post (see Yellow fever - Africa (25): Mali (BA, SK), Cote d'Ivoire http://promedmail.org/post/20191207.6827680). As in the original report, no mention is made of plans to vaccinate in the localities where the cases became infected. Vaccination in those areas is an effective preventive measure especially since, as the report notes, the mosquito vector, _Aedes aegypti_, is abundant enough to transmit dengue viruses. Yellow fever can spread rapidly and quickly get out of hand in susceptible populations with abundant mosquito vectors, as it did in Angola in 2016. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Date: Thu 5 Dec 2019
Source: Ministry of Health and Social Affairs [in French, trans.,
edited]

Communication from the Ministry of Health and Social Affairs on yellow fever cases in Mali
-----------------------------------------------------
The Ministry of Health and Social Affairs declares the occurrence of 3 confirmed cases of yellow fever on Tue 3 Dec 2019.

Of the 3 cases, one resides in Sirakoro-Meguetana in the health district of Kati [Bamako region, Mali], the 2nd in Manankoro in the health district of Bougouni [Sikasso region, Mali], and the 3rd in the village of Keregouana in Cote d'Ivoire [unable to locate this village on a map, but presumably it is near the border of Mali and Cote d'Ivoire. - ProMED CopyEd.TW].

In accordance with International Health Regulations, the outbreak has been reported to the World Health Organization.

The Ministry of Health and Social Affairs immediately analyzed the situation and took the following necessary measures:
- sending investigative teams to the field to better understand the epidemiological situation in order to quickly halt the spread of the epidemic,
- strengthening epidemiological surveillance,
- strengthening the response capacity of health workers, and
- disseminating awareness messages.

The Ministry of Health and Social Affairs invites people to observe the following measures:
- destroy larval breeding sites (old tires or any other abandoned objects containing water),
- protect against mosquito bites,
- sleep under insecticide-impregnated mosquito nets,
- keep households and housing clean, and
- get vaccinated before any trips abroad.

The Minister of Health and Social Affairs calls for calm and vigilance and reassures the population that appropriate measures are underway to control the situation.

Bamako, 4 Dec 2019
P / The Minister / PO
The Secretary General
Dr Mama Coumare
Knight of the National Order
===================
[An outbreak of yellow fever has been recognized in Mali by official sources. The statement from the Ministry of Health specifies the number of cases, the location of the cases detected, the measures taken, the recommendations, and the notification of the outbreak to WHO, as stipulated by International Health Regulations.

Cases of haemorrhagic fevers have recurred in Mali. Last month [November 2019], cases of dengue were diagnosed in Bamako, the capital of Mali.

_Aedes aegypti_, (but also to a lesser extent _Aedes albopictus_) is the vector that transmits these haemorrhagic fevers (dengue, chikungunya, yellow fever, and Zika).

Health authorities must use all channels of communication to raise awareness and get people to seek consultation in case of fever or muscle aches. Caregivers, especially clinicians, should consider haemorrhagic fevers (dengue or yellow fever) in any case of fever with a negative thick smear (or negative RDT) for malaria, or in any case of presumptive malaria that does not respond to appropriate antimalarial treatment. - Mod.BM, from ProMED-FRA archive no. http://promedmail.org/post/20191205.6824988, in French, trans., edited]

[The occurrence of yellow fever (YF) in different locations is a serious concern, and the measures to increase surveillance are prudent. It is curious that no mention is made of vaccination, whether the population of individuals is already vaccinated or whether there are plans to vaccinate in the localities where the cases became infected. Vaccination in those areas is an effective preventive measure especially since, as the report notes, the mosquito vector, _Aedes aegypti_, is abundant enough to transmit dengue viruses. YF can spread rapidly and quickly get out of hand in susceptible populations with abundant mosquito vectors, as it did in Angola in 2016. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Date: Tue, 3 Sep 2019 21:09:12 +0200 (METDST)

Bamako, Sept 3, 2019 (AFP) - Fourteen bus passengers were killed Tuesday by a road mine in central Mali, the bus company said, in an attack bearing the hallmarks of jihadists who plague the region.   The vehicle was en route from the central town of Douentza to the northern town of Gao, Oumar Ould Mamoud of the Sonef bus company told AFP.   "The new toll is 14 dead and eight injured," he said, adding that there had been about 50 people on the bus.

Police earlier had given a toll of eight dead and 13 injured, and said the blast occurred 30 kilometres (18 miles) from Douentza.   Another police official said "terrorists" had set down the mine.   A Malian military unit by coincidence had been travelling on the same road and was able to provide assistance to the passengers, the source said, and Sonef said it had sent a second bus to pick up them up.   The UN stabilization force in Mali, MINUSMA, condemned the attack which it said had caused "many deaths and 30 injuries," adding that some of the injured were helicoptered out.

MINUSMA spokesman Olivier Salgado said on Twitter that two women and two children were among the injured.   Northern Mali fell into the hands of jihadists in 2012 before the militants were forced out by a French-led military intervention.   But much of the region remains chronically unstable and since 2015 violence has spread to the centre of the country, an ethnic mosaic.   Jihadists have carried out dozens of hit-and-run raids and mine attacks, striking troops as well as civilians.   In January 2018, 24 Malian and Burkinabe citizens, including women and children, were killed in a blast in central Mali as they headed to a weekly fair.   The insurgents have also inflamed tensions between rival communities, particularly nomadic Fulani herders and sedentary farmers. Hundreds of lives have been lost in tit-for-tat assaults.
Date: Thu, 16 May 2019 18:37:39 +0200

Bamako, May 16, 2019 (AFP) - Heavy floods claimed 15 lives Thursday in the Malian capital Bamako along with serious property damage, authorities said.   A statement said the flooding claimed a "provisional toll" of 15 dead and two injured.   "Teams are in place to rescue the distressed people," the government said, calling on residents to be "prudent" in the face of the disaster.   Flooding is common in Mali, located in the semi-desert Sahel region.
More ...

World Travel News Headlines

Date: Thu, 16 Jan 2020 02:59:31 +0100 (MET)
By Nicolas DELAUNAY

Cousin Island, Seychelles, Jan 16, 2020 (AFP) - Giant tortoises amble across Cousin Island as rare birds flit above.   The scene attests to a stunning success for BirdLife International, a conservation group that bought the tiny Seychelles isle in 1968 to save a songbird from extinction.   Thick vegetation smothers ruins that are the only reminder of the coconut and cinnamon plantations that covered the island when the group stepped in to protect the Seychelles Warbler.

Now teeming with flora and fauna and boasting white beaches, Cousin Island is firmly on the tourist map, with managers scrambling to contain visitor numbers and soften their negative environmental impact.    More than 16,000 people visited the island in 2018, compared with 12,000 a decade earlier.   "Tourism is important for Cousin. That's what allows us to finance the conservation projects we run here.    "But 16,000 tourists... that was too much," said Nirmal Shah, director of Nature Seychelles, which is charged with running the special reserve.

Before the island was in private hands, the population of Seychelles Warblers was thought to have shrunk to just 26, barely hanging on in a mangrove swamp after much of their native habitat had been destroyed.    Now, they number more than 3,000 and the greenish-brown bird has been reintroduced to four other islands in the archipelago.   The former plantations have transformed into native forests, teeming with lizards, hermit crabs and seabirds, and the island is the most important nesting site for hawksbill turtles in the western Indian Ocean.   The International Union for Conservation of Nature (IUCN) waxes lyrical about the "unique biodiversity and conservation achievements" of Cousin, "the first island purchased for species conservation", a model since replicated around the world.

- Nature first -
Tourists have been allowed onto the island since 1972, but the message is clear: nature comes first.   In a well-oiled routine, every morning a handful of luxury sailboats and small motorboats anchor off the island, where their occupants wait for Nature Seychelles to skipper them ashore on their boats.   "Tourist boats cannot land directly on the island, the biohazard risk is too big," Shah said.   "Non-indigenous animals who may accidently be on board could come to the island and threaten its (ecological) balance."   Too many tourists can also upset this balance.

Nature Seychelles in July increased the price of visits from 33 to 40 euros ($36 to $44) and removed a free pass for children under 15, resulting in a welcome 10-percent reduction in visitor numbers.   "Something had to be done, there was too much pressure on the environment," said Dailus Laurence, the chief warden of the island.   "When there are too many tourists it can bother nesting birds and turtles who want to come and lay their eggs on the island."

One guide said that some tourists, bothered by the island's ubiquitous mosquitos, would "leave the paths, move away from the group and walk where they are not supposed to", putting fragile habitats at risk.   Shah said that if they wanted to increase the number of tourists, it would require hiring more wardens and guides who live on the island, which would also have a negative impact on nature.   "Our absolute priority is nature, and it comes before tourists. If we have to take more steps to protect it and reduce the number of tourists, we will," he said.
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: 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: Wed, 15 Jan 2020 21:55:41 +0100 (MET)

Rio de Janeiro, Jan 15, 2020 (AFP) - Widespread complaints over foul-smelling drinking water in Rio de Janeiro have triggered a run on supermarket bottled water, though the public utility denied any health risk Wednesday.   Rio governor Wilson Witzel set alarm bells ringing in a Twitter post on Tuesday, saying the situation -- fuelled by social media rumours -- was "unacceptable" and calling for a "rigorous investigation."

Moving to calm growing fears, public water utility Cedae attributed the problems to the presence of geosmin, a harmless organic compound, insisting the resulting earthy-tasting tap water was safe to drink.   "The results of the analyses show the presence of geosmin, at a rate sufficient to change the taste. But there is no risk to health," Sergio Marques, the official in charge of water quality, told a press conference.   Cedae later said it had fired the head of the Guandu treatment plant, which supplies nearly 80 percent of Rio's drinking water.   It said the supply from Guandu would be treated with carbon in the coming days to get rid of the geosmin.

According to O Globo newspaper, nearly 70 districts of the capital have been affected.   It reported that more than 1,300 cases of gastroenteritis were recorded over the last 15 days in Santa Cruz in the west of Rio, where water quality complaints were rife.   Cedae's president Helio Cabral apologized "to the whole population for the problems in the water supply," which began earlier this month.

The problem has been exacerbated by false rumours circulating on social media that the water was toxic.   Despite assurances, many Rio citizens were taking no chances. In supermarkets, mineral water stocks have been selling out and long queues are formed as soon as they are replenished.   Geosmin is also responsible for the earthy taste in some vegetables.
Date: Wed, 15 Jan 2020 21:25:04 +0100 (MET)

Lima, Jan 15, 2020 (AFP) - Five tourists arrested for damaging Peru's iconic Machu Picchu site will be deported to Bolivia later on Wednesday, police said.   A sixth was released from custody and ordered to remain in Machu Picchu pending trial after paying bail of $910.   The six tourists -- four men and two women -- were arrested for damaging Peru's "cultural heritage" after being found in a restricted area of the Temple of the Sun on Sunday.   They were also suspected of defecating inside the 600-year-old temple, an important edifice in the Inca sanctuary.   "We've got the order. Today the five foreign tourists will be expelled," Cusco police official Edward Delgado told AFP.   "We're going to take them by road to the city of Desaguadero, on the border with Bolivia."   The border town, a nine-hour drive away, is the nearest frontier point to the southern Cusco region where Machu Picchu is located.

The sixth tourist, 28-year-old Nahuel Gomez, must sign at a local court every 10 days while awaiting trial.   He admitted to removing a stone slab from a temple wall that was chipped when it fell to the ground, causing a crack in the floor.   He could face four years in prison if found guilty of damaging Peru's cultural heritage.   Several parts of the semicircular Temple of the Sun are off limits to tourists for preservation reasons.   Worshipers at the temple would make offerings to the sun, which was considered the most important deity in the Inca empire as well as other pre-Inca civilizations in the Andean region.   The group -- made up of a Chilean, two Argentines, two Brazilians, including one of the women, and a French woman -- allegedly entered the Inca sanctuary on Saturday and hid on site so they could spend the night there -- which is prohibited.

A source with the public prosecutor's office told AFP that Nahuel admitted to the damage but said "it wasn't intentional, he only leant against the wall."   The Machu Picchu complex -- which includes three distinct areas for agriculture, housing and religious ceremonies -- is the most iconic site from the Inca empire, which ruled over a large swath of western South America for 100 years before the Spanish conquest in the 16th century.   Machu Picchu, which means "old mountain" in the Quechua language indigenous to the area, is at the top of a lush mountain and was built during the reign of the Inca emperor Pachacuti (1438-1471).
Date: Wed, 15 Jan 2020 20:53:05 +0100 (MET)

Alicante, Spain, Jan 15, 2020 (AFP) - A fire broke out Wednesday on the roof of the airport in Alicante, a city on the eastern Mediterranean coast which is a tourism hotspot, forcing its closure to air traffic.   "The fire is under control but it has not been extinguished. Firefighters are continuing to work," a spokesman for Spanish airport operator Aena told AFP, adding the airport will remain closed to air traffic until noon on Thursday.

Ten flights which were due to land at Alicante were cancelled, as were 12 which were supposed to depart from the airport, he said.    Another four flights which were due to land at Alicante were diverted to other Spanish airports.   The flames were visible from inside the terminal, according to an AFP photographer at the scene.   Passengers and workers stood outside as dense smoke rose from the terminal building.   No one was injured and the authorities are still not sure what caused the fire.

The airport serves the eastern region of Valencia, which is home to several popular resorts such as Benidorm. It handled just under 14 million passengers last year, making it Spain's fifth busiest airport.   Aena recommended in a tweet that passengers contact their airline before heading to Alicante airport to see what the status of their flight was.   "We are coordinating with airlines. Consult your company to know if your flight is cancelled or will operate from an alternative airport," it said.
Date: Wed, 15 Jan 2020 11:12:40 +0100 (MET)

Beijing, Jan 15, 2020 (AFP) - A new virus from the same family as the deadly SARS pathogen could have been spread between family members in the Chinese city of Wuhan, local authorities said Wednesday.   The outbreak, which has killed one person, has caused alarm because of the link with SARS (Sudden Acute Respiratory Syndrome), which killed 349 people in mainland China and another 299 in Hong Kong in 2002-2003.   One of the 41 patients reported in the city could have been infected by her husband, Wuhan's health commission said in a statement on Wednesday.   The announcement follows news that a Chinese woman had been diagnosed with the novel coronavirus in Thailand after travelling there from Wuhan.

No human-to-human transmission of the virus behind the Wuhan outbreak has been confirmed so far, but the health commission said the possibility "cannot be excluded".   The commission said that one man who had been diagnosed worked at Huanan Seafood Wholesale Market, which has been identified as the centre of the outbreak, but his wife had been diagnosed with the illness despite reporting "no history of exposure" at the market.   At a press conference on Wednesday following a fact-finding trip to Wuhan, Hong Kong health officials also said that the possibility of human-to-human transmission could not be ruled out despite no "definitive evidence".

Dr Chuang Shuk-kwan, from Hong Kong's Centre for Health Protection, said there were two family group cases among the recorded cases in Wuhan, including the husband and wife and a separate case of a father, son and nephew living together.   However, he said mainland doctors believed the three men were most likely to have been exposed to the same virus in the market.   The market has been closed since January 1.   The woman diagnosed in Thailand, who is currently in a stable condition, had not reported visiting the seafood market, the World Health Organization (WHO) said on Tuesday.

WHO doctor Maria Van Kerkhove said Tuesday that they "wouldn't be surprised if there was some limited human-to-human transmission, especially among families who have close contact with one another".   The US Centers for Disease Control and Prevention issued a Level 1 "Watch" alert for travellers to Wuhan after the patient was diagnosed in Thailand, saying they should practice normal precautions and avoid contact with animals and sick people.

Wuhan's health commission said on Wednesday that most of the patients diagnosed with the virus were male, and many were middle-aged or elderly.   In Hong Kong, hospitals have raised their alert level to "serious" and stepped up detection measures including temperature checkpoints for inbound travellers.   Hong Kong authorities said on Tuesday that the number of people hospitalised with fever or respiratory symptoms in recent days after travelling to Wuhan had grown to 71, including seven new cases since Friday.   Sixty of that total, however, have already been discharged. None have yet been diagnosed with the new coronavirus.
Date: Wed, 15 Jan 2020 03:48:17 +0100 (MET)
By Emile Kouton with Celia Lebur in Lagos

Lome, Jan 15, 2020 (AFP) - After he was struck down by malaria and typhoid, Togolese tailor Ayawo Hievi thought he was set to recover when he started taking drugs prescribed by his doctor.   But far from curing him, the medication he was given at the neighbourhood clinic made him far worse -- eventually costing him one of his kidneys.    The drugs were fake.   "After four days of care, there was no improvement, but I started to feel pain in my belly," Hievi, 52, told AFP.

After two weeks of suffering he became unable to walk and was rushed into the university hospital in the West African nation's capital Lome.    "The doctors told me that my kidneys had been damaged... the quinine and the antibiotics used to treat me in the medical office were fake drugs."   Now, over four years later, he remains crippled by chronic kidney failure and has to go to hospital for dialysis regularly.    Hievi's horror story is far from unique in a continent awash with counterfeit medicines.    The World Health Organization (WHO) estimates that every year some 100,000 people across Africa die from taking "falsified or substandard" medication.

The American Society of Tropical Medicine and Hygiene estimated in 2015 that 122,000 children under five died due to taking poor quality anti-malaria drugs in sub-Saharan Africa.   Weak legislation, poor healthcare systems and widespread poverty have encouraged the growth of this parallel -- and deadly -- market. Since 2013, Africa has made up 42 percent of the fake medicine seized worldwide.    The two drugs most likely to be out-of-date or poor, ineffective copies are antibiotics and anti-malarials, say experts.    And bogus drugs not only pose a risk to the patient -- they also play a worrying part in building resistance to vital frontline medications.

- 'Difficult to trace' -
In a bid to tackle the scourge, presidents from seven countries -- the Republic of Congo, Gambia, Ghana, Niger, Senegal, Togo and Uganda -- meet Friday in Lome to sign an agreement for criminalising trafficking in fake drugs.    The goal is to bolster cooperation between governments and encourage other African nations to join the initiative.   But even if leaders put pen to paper, the task of stamping out the flows of counterfeit medication is huge.    Medicines spread out on plastic sheets or offered at ramshackle stalls are for sale at markets across West Africa.

Those hawked on the streets are often a fraction of the price of what's available in more reputable pharmacies where controls are stricter and supplies often have to come through official channels.    "It is very difficult to trace where the fake medicines come from," said Dr Innocent Kounde Kpeto, the president of Togo's pharmacist association.    "The countries which are mentioned on the boxes are often not the countries of origin or manufacture of these drugs. The manufacturers cover their tracks so as not to be identified".

It is estimated that between 30 and 60 percent of medicine sold in Africa is fake and Kpeto said most of it comes from China or India.    Efforts to staunch the deadly torrents of counterfeits have made some headway.    Some trafficking hubs have been dismantled, such as Adjegounle market in Cotonou that served as a key gateway for fakes heading to giant neighbour Nigeria.   In mid-November, the police in Ivory Coast made a record seizure of 200 tonnes in Abidjan and arrested four suspects including a Chinese national.

Togo is one of the pioneer countries trying to stop the flow.    It changed the law in 2015 and now traffickers can face 20 years in jail and a fine of some $85,000 (75,000 euros).   In a show of force in July the authorities burnt over 67 tonnes of counterfeit pharmaceuticals discovered between     But even given these recent successes, those in the industry like Dr Kpeto insist that the threat is still grave and involves "highly organised criminal networks".    "The phenomenon remains major," he said.    Traffickers can turn an investment of just $1,000 (900 euros) into a profit of $500,000, he claimed.   The fake medicines are smuggled in the same way as guns or narcotics and often bring higher returns.

- 'Die for nothing' -
Nigeria, Africa's most populous country with a market of 200 million people, is the number one destination on the continent for fake drugs and a showcase of difficulties being faced.    In September 2016 the World Customs Organization seized tens of millions of fake pills and medicines at 16 ports around Africa: 35 percent were intended for Nigeria.    Across the vast nation there are tens of thousands of vendors selling the counterfeits.   Competition between traffickers is fierce and the official agency meant to combat the problem is overwhelmed.

In a bid to improve the situation, Vivian Nwakah founded in 2017 start-up Medsaf and raised $1.4 million to help Nigerians track their medication from producer to user.    "The country doesn't have a reliable and centralised distribution network," she said.    "A hospital sometimes has to deal with 30 or 40 distributors for all the medications it needs. How can you have quality control with so many suppliers?"   As a result, fake or faulty medicine has not just flooded markets but also pharmacies and hospitals -- both state and private.    Sometimes, without hospital administrators even being aware, that means the drugs that reach the patients can be expired, poorly stored or the wrong doses. 

Medsaf works to ensure the quality control of thousands of products at over 130 hospitals and pharmacies in Nigeria. It looks forward to expanding deeper into Nigeria as well as Ivory Coast and Senegal.   The company uses technology, database management and analytics to monitor the movement of medications and verifies their official registration number, the expiry dates and storage conditions.   "Technology we use can help to solve most of the issues related to fake drugs," Nwakah said. "People die for nothing. We can change that."
Date: Mon 13 Jan 2020, 00.45 IST
Source: The Hindu [edited]

A 58-year-old woman from Seegemakki village in Tumari Gram Panchayat limits in Sagar taluk died due to Kyasanur Forest Disease (KFD), also known as monkey fever, at a private hospital in Manipal in Udupi district on [Sat 11 Jan 2020].

The deceased, H, who had complained of high fever and aches in joints was admitted to government sub-divisional hospital in Sagar city for treatment on [Tue 7 Jan 2020]. Her blood tested positive for KFD.

Rajesh Suragihalli, District Health Officer, told The Hindu that as her health condition had worsened, she was shifted to a private hospital in Manipal on [Thu 9 Jan 2020] for advanced treatment. She failed to respond to the treatment and breathed her last on [Sat 11 Jan 2020], he said.

Following the death, the Department of Health and Family Welfare has sounded an alert in Sagar and Tirthahalli taluks from where 7 positive cases have been reported since [1 Jan 2020]. The vaccination drive has been stepped up in the villages from where positive cases are reported. Three advanced life support ambulances have been stationed in government sub-divisional hospital in Sagar to shift KFD patients with health complications to private hospitals in Shivamogga city or Manipal for additional treatment, he said.
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[Kyasanur Forest disease (KFD) is an acute febrile illness caused by Kyasanur Forest disease virus (KFDV), a member of the family _Flaviviridae_, characterized by severe muscle pain, gastrointestinal symptoms, and bleeding manifestations. The virus was 1st identified in 1957 after it was isolated from a sick monkey from the Kyasanur Forest in Karnataka state of India. The disease is transmitted to humans following a tick bite or contact with an infected animal, especially a sick or recently dead monkey. There is no evidence of person-to-person transmission (<https://www.cdc.gov/vhf/kyasanur/index.html>).

The case fatality of Kyasanur Forest disease (KFD) is 2-10% and mortality is higher in the elderly and in individuals with comorbid conditions. There is no specific treatment for KFD. Prompt symptomatic and supportive treatment can reduce morbidity and mortality. Surveillance (human, monkey, and tick), personal protection against tick bites, and vaccination are the key measures for prevention and control of KFD (<https://idsp.nic.in/WriteReadData/l892s/60398414361527247979.pdf>).

As per the media report above, 7 confirmed KFD cases have been reported from Sagar and Tirthahalli taluks in Karnataka state so far in 2020. KFD typically occurs during the dry season from November through May, which correlates with the increased activity of the nymphs of ticks. Exposure to adult ticks and nymphs in rural or outdoor settings increases the risk of infection; herders, forest workers, farmers, and hunters are particularly at increased risk of contracting the disease. Vaccination and personal protective measures against tick bites are keys to prevent KFD.

The recommended preventive measures include using tick repellents, walking along clear trails, avoiding contact with weeds, and wearing full sleeved clothes and long pants to reduce exposed skin to reduce contact with ticks and subsequent tick bites. - ProMED Mod.UBA]

[HealthMap/ProMED map available at:
Karnataka State, India: <http://healthmap.org/promed/p/307>]
Date: Mon 13 Jan 2020
Source: Food Safety News [edited]

An emergency committee to control the sale of food has been created in a city in northwest Argentina after a spike in _Salmonella_ cases in early 2020. There have been 51 confirmed cases of salmonellosis in Salta so far in 2020. At least 5 people have been hospitalized but recovered after treatment.

The committee will be responsible for controlling food sold on public roads at street stalls and at commercial premises. It includes experts from the National University of Salta (UNSA) and Catholic University of Salta (Ucasal). Officials hope by increasing controls they can bring the rise in infections under control and minimize the risk to the public. The group, created by the Mayor of Salta Bettina Romero and Undersecretary of Health and Human Environment Monica Torfe, held a meeting with Juan Jose Esteban, manager of the Hospital Senor del Milagro, and teams from the department of epidemiology of the province on preventive measures to tackle the salmonellosis rise this past week.

Norma Sponton, head of the microbiology sector; Teresita Cruz, of the epidemiological surveillance program of the province; Paula Herrera, from the Ministry of Health, and Jose Herrera, from the hospital also participated. Experts from the 2 universities are involved in training the inspectors who will be in charge of carrying out the control tasks.

Food contaminated with _Salmonella_ bacteria does not usually look, smell, or taste spoiled. Symptoms of salmonellosis infection can include diarrhoea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for 4 to 7 days. In some cases, however, diarrhoea may be so severe that patients require hospitalization.
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[The serotype of _S. enterica_ is not stated and it is not clear what the food reservoir for this ongoing outbreak is. A food diary of affected persons may be helpful.

The city of Salta is located in north-western Argentina in the province of the same name which can be found on a map at

[HealthMap/ProMED-mail map of Argentina: