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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Benin - US Consular Information Sheet
April 28, 2008

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

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

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

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

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

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

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

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

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

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

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

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

See our information on Victims of Crime.

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

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Northern Mariana Islands

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

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

Travel News Headlines WORLD NEWS

More ...

United Kingdom

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

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

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

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

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

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

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

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

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

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

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

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the U.S. Embassy's American Citizens Services web page at http://london.usembassy.gov/cons_new/acs/index.html.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States, or for callers outside the United States and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

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

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

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

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate at the opening of the next business day.
The U.S. Embassy or Consulate issues replacement passports only during regular business hours.
If you are the victim of a crime while overseas, report it to local police.
The nearest U.S. Embassy or Consulate will also be able to assist by helping you to find appropriate medical care, contacting family members or friends, and explaining how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

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

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

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

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

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

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

Please see our information on medical insurance overseas.

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

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

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

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

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

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

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

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

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

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

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

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

Please read ourCustoms Information.

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

Please see our information on Criminal Penalties.

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

Date: Mon, 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.
Date: Mon 28 Oct 2019
Source: Shetland Times [abridged, edited]

A 2nd warning over measles has been issued to passengers who sailed on the NorthLink ferry on 3 dates earlier this month [October 2019] after a 2nd case was confirmed. NHS Shetland says it is working with other relevant authorities, including Health Protection Scotland, to ensure all control measures are in place to prevent further spread of the disease.  [byline: Ryan Taylor]
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).
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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

5th December 2019
World Health Organisation

Measles vaccination drive launched, North Kivu targets 2.2 million children 
 
https://www.afro.who.int/news/measles-vaccination-drive-launched-north-kivu-targets-22-million-children

Kinshasa, 5 December 2019 – Around 2.2 million children are to be vaccinated against measles in North Kivu, the Democratic Republic of the Congo (DRC), where efforts are underway to curb the world’s second-worst Ebola outbreak amid persistent insecurity.

The DRC is also currently experiencing the world’s largest and most severe measles epidemic, affecting all its 26 provinces. Since the start of 2019, more than 250 000 suspected cases and over 5000 deaths mostly among children under 5 years, have been recorded.

This drive closes the second phase of a preventive vaccination campaign and will be followed by a third and final phase planned in 10 remaining provinces: Bas Uélé, Equateur, Haut Katanga, Haut Lomami, Haut Uélé, Kasai Oriental, Lualaba, Maniema, Mongala and Tshuapa.

This mass follow-up campaign will ultimately reach 18.9 million children across the country by the end of the year, particularly targeting those who may have been missed by routine immunization.

“While the Ebola outbreak in the DRC has won the world’s attention and progress is being made in saving lives, we must not forget the other urgent health needs the country faces,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This new vaccination campaign aims to protect children in North Kivu, as well as other parts of the country from a disease that is easily preventable with a vaccine.”

Low immunization rates and high levels of malnutrition have contributed to the measles epidemic and associated high rates of mortality.

In North Kivu, the measles vaccination is being carried out under a challenging context, with high insecurity particularly around Beni town and Masisi territory.

“In the context of North Kivu, where the population is highly mobile, it is imperative that we reach out to travellers and ensure that their children are also covered. Every child should receive his or her vaccine so that they are well protected and can grow up healthy,” said Dr Deo Nshimirimana, WHO acting Representative in the DRC.

The five-day campaign is being implemented by the Ministry of Health with the support of WHO and partners and is fully funded by Gavi, the Vaccine Alliance. WHO staff are assisting the health ministry’s national and field coordination efforts, case management, epidemiological surveillance and deployment of a post campaign survey.

“Sadly, measles has claimed more Congolese lives this year than Ebola. We must do better at protecting the most vulnerable, who are often also the hardest to reach. This campaign is an important step in that direction,” said Thabani Maphosa, Managing Director of Country Programmes for Gavi. “For maximum impact, campaigns must be combined with the strengthening of routine immunization and health systems.” 

Strengthening routine immunization, measles case-based surveillance and case management will contribute to ending the current outbreak and eliminating measles as a public health threat in the DRC.  

Lack of funding has hampered efforts for reactive campaigns. To date, US$ 27.5 million have been mobilized; however, another estimated US$ 4.8 million are needed to complete the vaccination campaign and response and to strengthen other elements of response such as disease surveillance, case management and communication.
Date: Wed, 4 Dec 2019 22:05:06 +0100 (MET)

Goma, DR Congo, Dec 4, 2019 (AFP) - Doctors Without Borders (MSF) said Wednesday it was pulling its non-local staff from an eastern region of Democratic Republic of Congo after it said an armed group tried to enter its compound.    The NGO becomes the latest aid agency to withdraw its staff from the Biakato region after an unclaimed attack last week saw three Ebola workers killed at an accommodation camp in Biakato Mines in Ituri province, causing the World Health Organization to withdraw its staff from the area.     MSF and an Ebola Treatment Centre (ETC), which is treating two people with confirmed cases of Ebola and nine suspected cases, decided to stay in the Biakato region despite last week's incident.

The NGO said that on Tuesday night a group wielding machetes and sticks broke into the Biakato Health Centre, which houses the ETC, but did not cause any casualties and did not enter the Ebola facility.   A separate group with the same weapons then tried but failed to enter the MSF facility in Biakato Mines. The NGO said they threw stones but did not do any damage.   "Due to a deterioration in the security situation, MSF made the difficult decision to withdraw all non-local staff from the Biakato region," MSF said in a statement.    According to local authorities, the attackers from last week's incident are likely to be members of the Mayi-Mayi militia group.

The Democratic Republic of Congo is undergoing its 10th Ebola epidemic, which is the second deadliest on record.    An outbreak of the much-feared haemorrhagic virus has killed 2,206 people mainly in North Kivu and neighbouring Ituri, according to the latest official figures.   Insecurity has complicated the epidemic from the outset, compounding resistance within communities to preventive measures, care facilities and safe burials.   On November 4, the authorities said more than 300 attacks on Ebola health workers had been recorded since the start of the year, leaving six dead and 70 wounded, some of them patients.
Date: Fri, 29 Nov 2019 20:07:23 +0100 (MET)

Bukavu, DR Congo, Nov 29, 2019 (AFP) - At least four people, including two children, have died in flooding in the Democratic Republic of Congo, days after 41 died when the capital Kinshasa was battered by torrential rains and landslides.   The victims died in the eastern South Kivu province amid the country's worst flooding in 25 years.   "There have been four deaths and one person missing, 10 injured and more than 70 homes damaged," local administrator Aime Kawaya told AFP.   The latest deaths happened after the heavy rains caused a river to overflow its banks in the Fizi area of south Kivu on Wednesday.   Seven deaths were reported in neighbouring North Kivu earlier this week.
Date: Thu, 28 Nov 2019 19:12:51 +0100 (MET)

Goma, DR Congo, Nov 28, 2019 (AFP) - Four Ebola workers in eastern DR Congo were killed and six injured, adding to the toll of people who have died fighting the nearly 16-month-old epidemic, the UN said Thursday.   A member of the vaccination team and two drivers were killed at an Ebola workers' accommodation camp in Biakato Mines in Ituri province, the World Health Organization (WHO) said.   The attack occurred two kilometres (one mile) from a temporary base used by UN peacekeepers, one of whom was injured in an operation to repel the assailants, the UN said.   A second attack claimed the life of a police guard at an Ebola coordination office in Mangina, a few dozen kilometres (miles) away in North Kivu province.   "We are heartbroken that people have died in the line of duty as they worked to save others," said WHO chief Tedros Adhanom Ghebreyesus.   "The world has lost brave professionals," he said, quoted in a WHO statement issued in Geneva.

Michael Ryan, WHO director of emergency operations, said that after the attack all staff were moved from Biakato Mines to Goma, one of the main cities in the region.   There was no immediate claim for the attacks, which DR Congo's national coordinator for Ebola, Dr. Jean-Jacques Muyembe, said occurred "almost simultaneously, around midnight."   Ryan said that he knew of "no specific intelligence regarding an imminent attack" at Biakato Mines.   None of the dead were WHO staff but a worker with the UN agency was injured, Ryan said.   An outbreak of the much-feared haemorrhagic virus has killed 2,199 in North and South Kivu and Ituri provinces since August 1, 2018, according to the latest official figures.   It is the Democratic Republic of Congo's 10th Ebola epidemic and the second deadliest on record after an outbreak that struck West Africa in 2014-16, claiming more than 11,300 lives.   Mangina is the historic starting point of the epidemic. UN Secretary General Antonio Guterres visited the town on September 1.

- Security fears -
Insecurity has complicated the epidemic from the outset, compounding resistance within communities to preventive measures, care facilities and safe burials.   On November 4, the authorities said more than 300 attacks on Ebola health workers had been recorded since the start of the year, leaving six dead and 70 wounded, some of them patients.    The WHO said that last week, seven cases of Ebola had been recorded, compared with the peak of more than 120 per week in April 2019.    "Ebola was retreating. These attacks will give it force again, and more people will die as a consequence," Tedros warned.    "It will be tragic to see more unnecessary suffering in communities that have already suffered so much. We call on everyone who has a role to play to end this cycle of violence."   Vast tracts of eastern DRC are in the grip of armed groups, especially a shadowy militia called the Allied Democratic Forces (ADF).   The armed forces launched an offensive in the region on October 30, prompting a wave of massacres of civilians by suspected ADF men.   Ninety-nine people have been killed by armed groups in the Beni area alone since November 5, according to the not-for-profit Congo Research Group (CRG).   The bloodshed has sparked a wave of anger at the authorities and the UN mission in the DRC, MONUSCO. Seven people have died in protests since Saturday.

- Low profile -
The latest deaths sparked an immediate reaction Thursday in Beni, where many responders kept a low profile and vaccination teams were not at work, AFP journalists saw.   "A suspected case of Ebola has been reported from the health centre. The investigator has gone there quietly on foot to avoid drawing attention," said Michel Kalongo, a local doctor involved in the anti-Ebola fight.   Normally, an ambulance would have been despatched to conduct tests.   But responders on Thursday did not wear their uniforms, nor did they openly display their medical kits.   "We are blending in with ordinary motorcyclists to avoid public anger," said Timothee Pothsola, a motorbike driver who transports Ebola teams.   Pierre Vernier of the medical charity MSF (Doctors Without Borders) said, "Because of the lack of security, lab work is problematic. It's hard to gather samples."   But, he said, "the real problem is that Ebola monitoring teams cannot carry out work on the ground" to follow up cases where people may have been exposed to the virus.   "Part of the personnel have been evacuated... only veterans who are used to tense situations like this have stayed behind."
Date: Wed, 27 Nov 2019 18:26:08 +0100 (MET)

Geneva, Nov 27, 2019 (AFP) - Measles has killed more than 5,000 people in the Democratic Republic of Congo since January -- more than double the toll in the country's Ebola epidemic -- the World Health Organization said Wednesday.   "The DRC (measles) outbreak is the largest outbreak worldwide. It is one of the largest that we have seen," Kate O'Brien, director of the WHO's immunisation department, told reporters in Geneva.   As of November 17, the country had registered 250,270 measles cases, including 5,110 deaths, the WHO said.

DRC declared its latest measles epidemic in June, and in September the country launched an emergency vaccination campaign to counter the outbreak.   WHO said that campaign was still ongoing, but was expected to be completed by the end of the year.   O'Brien said the epidemic was still "all over the country", pointing out that most of those affected were "children and babies".   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 some 2,200 people.   Ian Norton, at WHO's Emergency Medical Team Unit, said the UN agency had begun training some of the Ebola teams in DRC to also manage measles cases, "because there is such a large burden".   Efforts to rein in the spread of both Ebola and measles are meanwhile being hampered by violence and unrest across the country, and especially in the east.   On Tuesday, WHO said it had moved 49 Ebola-response staff out of the eastern town of Beni as insecurity in the area surged.

Ninety-four civilians in the Beni area have been killed by armed groups since November 5, following the launch of an offensive by the country's army, according to the Congo Research Group (CRG), a not-for-profit organisation.   "The Ebola response is being hampered by the insecurity," Norton told reporters.   "The same can be said... for the measles response, not just in Beni but across the entire country," he said.   Attacks, even when not directed at medical staff or facilities, can block health workers from getting to work, and can prompt people feeling ill to stay home instead of seeking help.   Norton said the WHO was "extremely worried" by the growing insecurity, warning it had a dire "impact on the management of disease".
More ...

New Zealand

New Zealand US Consular Information Sheet
September 22, 2008
COUNTRY DESCRIPTION:
New Zealand is a highly developed, stable parliamentary democracy, which recognizes the British monarch as sovereign. It has a modern economy, and tourist fa
ilities are widely available. The New Zealand Tourist Board, which has a wide range of information of interest to travelers, can be contacted via the internet at http://www.newzealand.com/USA/.
Read the Department of State Background Note on New Zealand for additional information.

ENTRY/EXIT REQUIREMENTS:
U.S. citizens eligible for a visa waiver do not need a visa for tourist stays of three months or less. For more information about visa waivers and entry requirements, contact the Embassy of New Zealand: 37 Observatory Circle NW, Washington, DC 20008, telephone (202) 328-4800; or the Consulate General of New Zealand in Los Angeles: 2425 Olympic Blvd Suite 600E, Santa Monica, CA 90404, telephone (310) 566-6555.
Visit the Consulate of New Zealand web site at http://www.nzcgla.com for the most current visa information.

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

SAFETY AND SECURITY:
U.S. citizens in New Zealand should review their personal security practices, be alert to any unusual activity around their homes or businesses, and report any significant incidents to local police.

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 other 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 personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves overseas, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:
Crime rates in New Zealand are low but have increased in recent years. The most prevalent crime is theft or attempted theft from cars, camper vans and hostels. To help protect against theft, do not leave passports, or other valuable items in unattended vehicles. Violent crime against tourists is unusual; however, visitors who are traveling alone should be especially vigilant, and avoid isolated areas that are not frequented by the public.

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.
In New Zealand, a private organization called Victim Support works both independently and with the NZ Police to assist victims of crime. Victim Support is available 24 hours per day on 0800-842-846, 0800-Victim, by email at victim@xtra.co.nz.

The local equivalent to the “911” emergency line in New Zealand is 111.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Quality medical care is widely available, but waiting lists exist for certain types of treatment.
High-quality medication (both over-the-counter and prescription) is widely available at local pharmacies, though the products’ names may differ from the American versions.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Doctors and hospitals often expect immediate cash payment for health services.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); fax 1-888-CDC-FAXX (1-888-232-3299), or via the CDC’s 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/.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of New Zealand.
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 New Zealand is provided for general reference only.

All traffic travels on the left in New Zealand, and drivers should exercise extra caution if accustomed to driving on the right. Driving on the wrong side of the road is a leading cause of serious injury and death for American tourists.
Cars turning left must yield to oncoming cars that are turning right.
Proceed carefully through intersections.
Red means “stop”—do not turn at a red light.

New Zealand has only 100 miles of multilane divided motorways. Most intercity travel is accomplished on two lane roads.
While these are in good condition, New Zealand's rugged terrain means motorists often encounter sharper curves and steeper grades than those found in the U.S. interstate highway system. Renting a car or camper is a popular way to enjoy New Zealand's natural beauty, but visitors unfamiliar with local conditions should drive particularly conservatively.
Posted speed limit signs should be observed. Drivers should use caution to avoid animals when driving in rural areas.

Pedestrians are advised to look carefully in all directions before crossing a street or roadway, and to use crosswalks.
Pedestrians do not have the right of way except in crosswalks.
New Zealand law requires that cars yield to pedestrians in a crosswalk, and that cars stop at least two meters (approximately 6 feet) from a crosswalk that is in use.

Traffic circles are common throughout New Zealand.
When approaching a traffic circle, always yield to traffic coming from the right –noting that traffic already in the circle has the right-of-way-- and merge to the left into the circle.

Public transportation, including buses, trains and taxis, is for the most part reliable and safe.
In case of emergency, phone the local police at 111.

Please refer to our Road Safety page for more information.
For specific information concerning the operation and rental of motor vehicles, contact the New Zealand Tourist Board via the Internet at http://www.newzealand.com/USA/ or the Land Transport Safety Authority at http://www.ltsa.govt.nz.

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

SPECIAL CIRCUMSTANCES:
Some heavily populated parts of New Zealand are in areas of very high seismic activity. General information regarding disaster preparedness is available from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.

Many tourists come to New Zealand to participate in extreme adventure sports, such as bungee jumping, sky diving, hiking, rappelling, climbing, motorcycling, and kayaking.
All too often, injuries and even death result from participation in such activities.
Travelers are advised to employ caution and common sense when engaging in adventure sports.
Never participate in such sports alone, always carry identification, and let someone else know where you are at all times.
Before kayaking, check the river conditions and wear a life jacket.
When hiking, rappelling, or climbing, carry a first aid kit, know the location of the nearest rescue center, and bring a friend along.

New Zealand is an island nation, and the government is serious about preserving its delicate ecosystem.
The Ministry of Agriculture and Forestry (MAF) imposes strict regulations regarding what can be imported into New Zealand.
People failing to declare goods that could be quarantined can be fined up to $100,000 NZ and/or face up to five years in prison. People failing to declare risk goods such as fresh fruit, seeds, and plants can receive an instant fine of $200 NZ.
When importing a pet, thorough veterinary documentation and a quarantine period are required.
Unfinished wood products, used hiking shoes and gardening tools, fresh food items, and items such as used pet carriers may be seized and destroyed by MAF.
More information can be found at http://www.biosecurity.govt.nz/personal-travel-belongings-and-mail/arriving-by-air/what-you-cannot-bring
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 those in the United States for similar offenses.
Persons violating New Zealand laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs in New Zealand 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 New Zealand are encouraged to register with the nearest U.S. embassy or consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within New Zealand.
Americans without Internet access may register directly with the nearest U.S. embassy or consulate.
By registering, American citizens make it easier for the embassy or consulate to contact them in case of emergency.

The U.S. Embassy in Wellington is located at 29 Fitzherbert Terrace, Thorndon, Wellington.
The telephone number is (64) (4) 462-6000.
The fax number is (64) (4) 471-2380.
The Embassy’s web site is http://wellington.usembassy.gov.
The U.S. Embassy in Wellington does not have a consular section and thus cannot provide consular services to American citizens.
All consular services for American citizens are provided by the Consulate General in Auckland.
The U.S. Consulate General in Auckland is located on the third floor of the Citigroup Centre, 23 Customs Street East, between Commerce and Queen Streets. The telephone number is (64) (9) 303-2724. The fax number is (64) (9) 366-0870.
See information on services to Americans at http://wellington.usembassy.gov/service.html.
The Consulate General in Auckland handles all consular matters in New Zealand.

For after-hours emergencies anywhere in New Zealand, a duty officer can be contacted by telephone. Persons seeking after-hours assistance may call (64) (4) 462-6000; after listening to a brief recording, the caller may leave a message on the voice mail system, describing the nature of the emergency and giving a point of contact. The phone system will automatically call the duty officer in Wellington or in Auckland, who will listen to the message and take the appropriate action .
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This replaces the Country Specific Information dated January 31, 2008, to update the Information for Victims of Crime, Medical Facilities and Health Information sections.

Travel News Headlines WORLD NEWS

Date: Tue, 22 Oct 2019 05:13:16 +0200 (METDST)

Wellington, Oct 22, 2019 (AFP) - A huge fire at a construction site sent clouds of acrid black smoke billowing over Auckland on Tuesday, forcing large parts of the downtown area to be cordoned off as firefighters battled the blaze.   The fire broke out on the roof of the SkyCity convention centre site shortly after 1:10pm (0010 GMT) and quickly spread, Fire and Emergency NZ said.   Office workers were warned to stay inside and turn off air conditioning as a thick pall of smoke engulfed the centre of New Zealand's largest city, but there were no reports on injuries.   Unconfirmed reports said the fire was started by a construction worker using a blowtorch on the building, which is one of the venues for the 2021 APEC summit being held in Auckland.
Date: Wed 11 Sep 2019
Source: Stuff [edited]

People who attended a football tournament in Hamilton and some businesses are being warned they could have been exposed to measles. On [Wed 11 Sep 2019] the Waikato District Health Board confirmed there are 13 measles cases in the Waikato including Hamilton, Paeroa and Morrinsville.

The District Health Board is urging people who attended the New Zealand Secondary School Girls Football tournament in Hamilton to be aware they may have been exposed to measles.

The tournament ran from [3 Sep 2019] and organisers have been asked to alert all participating teams.   [Byline: Libby Wilson]
Date: Thu 5 Sep 2019
Source: BBC News [abridged, edited]

New Zealand's ongoing measles outbreak has hit the milestone of more than 1000 confirmed cases. A total of 1051 people were affected between [1 Jan and 5 Sep 2019], the ministry of health said.

Measles is a highly contagious and potentially fatal illness that causes coughing, rashes and fever. Although effective and safe vaccination is available, some developed countries have seen a measles resurgence in past years.
Worldwide, the number of cases has quadrupled in the first 3 months of 2019 compared with the same time last year [2018], according to the World Health Organization (WHO).

The New Zealand outbreak is largely concentrated around the country's biggest city Auckland, with 877 of the confirmed cases seen there. The Health Ministry has issued a statement calling for everyone aged 12 months to 50 years old to get vaccinated if they have not been already.

Immunisation Advisory Centre director Dr. Nikki Turner told New Zealand's Newshub it is a "very sad" milestone to reach. The ministry has also put out a travel advice to get vaccinated at least 2 weeks before visiting Auckland.

The US Center[s] for Disease Control and Prevention has issued advice to get measles vaccination before visiting New Zealand.
Date: Wed, 4 Sep 2019 08:23:46 +0200 (METDST)

Wellington, Sept 4, 2019 (AFP) - Five Chinese nationals were killed and another six injured when a tourist bus veered off a highway and flipped during bad weather in New Zealand's North Island, police said.   Police said 27 people were in the vehicle when it crashed about 20 kilometres (12 miles) outside Rotorua -- a popular tourist town in the Bay of Plenty area known for its hot springs.    "Unfortunately police believe that five of those 27 onboard have lost their lives as a result of the crash," inspector Brent Crowe told reporters.

Crowe said two of the survivors were seriously injured and four were moderately hurt.   "This is an absolute tragedy for Bay of Plenty roads, even more so because of the fact we have Chinese nationals, visitors to our country, who have been impacted."   Crowe declined to give details of the deceased, saying authorities were still working to identify them and contact their families in China.   He said the driver was not seriously injured and an investigation into the cause of the crash was under way.   He said the accident occurred as the bus approached a bend on a winding, hilly stretch of road.   "At the time, the weather was very unfavourable, there was high winds, fog and a lot of rain. The road surface was clearly wet and therefore slippery," he said.

The Chinese embassy in Wellington told TVNZ that ambassador Wu Xi was on her way to the crash site to help those involved in the crash.   "The embassy attaches great importance to the tragic incident," it said. "Our deep condolences with those who died and injured."
Date: Sat 31 Aug 2019
Source: Stuff [abridged, edited]

Measles cases have been confirmed in more than 50 schools in the Auckland region since the beginning of this year's [2019's] outbreak. There have been 778 cases confirmed in the region as of Saturday [31 Aug 2019], with 19 new diagnoses since Friday [30 Aug 2019], the Auckland Regional Public Health Service said.

Medical officer of health Dr William Rainger said it was seeing 18-20 new cases per day, which had been constant for the last week. The majority of the cases were in south Auckland and in children under age 5 and young people between 15 and 29.

"Some of these people have been very, very unwell, however there have been no deaths as of yet," Dr Rainger said.

The ministry modified its standard MMR (measles-mumps-rubella) vaccination catch-up advice this week. Under its new recommendations, babies as young as 6 months may now be vaccinated for measles at their doctor's discretion if parents have concerns about their potential exposure.  [Byline: Caroline Williams and Laine Moger]
==========================
[Also see the following 2 articles:
 
The worst-affected region in Auckland was the Counties Manukau DHB area, with more than 400 confirmed cases. It is the worst outbreak in 20 years.

Demographics also played a part. "We have a lot of pacific families, and it's a relatively young population as well, both of which we are seeing increasing numbers compared to the total number of cases," Dr Maria Poynter from the Auckland Regional Public Health service said.  <https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12262226>. - ProMED Mod.LK]
More ...

Australia

Travelling to Australia
===========================
Introduction
********************************************
Travelling to Australia for business or pleasure can be a most memorable experience and each year many Europeans travel this
route to experience something of life ‘down-under’. Staying healthy and well is essential if you want to enjoy your trip to its fullest extent. Australia is a huge continent and the climatic conditions vary considerably throughout. The main southern cities have a temperate climate similar to North West Europe, Perth enjoys a Mediterranean climate while Queensland and the Northern Territories have a sub-tropical weather pattern.
Preparation
********************************************
It is important that all travellers are in good general health before undertaking any long-haul trip. Patients who tire easily on light exercise or who have a significant underlying medical condition will need to take extra care. If you are concerned about this aspect of your proposed trip arrange for a meeting with a doctor at an early stage in your preparations.
Long Haul Flights
********************************************
On these long flights you will be travelling across many time zones. You will lose or gain hours depending on the direction of your flight. Your body will take time to adjust to the new time zone and so it is important to allow this to occur naturally. If you arrive during the daylight hours try to stay out in the sun for a period of time as this will help your body release a hormone which counteracts jet lag. (Watch you don’t get sun burnt!) Don’t plan to be too energetic during the first day or two after you arrive. Be sensible. If this is a business trip try not to make any major decisions over the first 24 hours. Even the relatively short flight from South East Asia down to Australia crosses time zones and again it will be important to allow your body to settle.
Stop-Overs in SE Asia
********************************************
Frequently travellers will stop-over in Singapore, Bali, Hong Kong or Bangkok on their way to or from Australia. During these short stops it is essential that travellers take all possible precautions to ensure that they rest and are careful about what they eat or drink as contaminated food or water is more common in some of these regions.

Mosquito protection in SE Asia
********************************************
Mosquito borne diseases are present depending on the location (Malaria, Dengue Fever, Japanese B Encephalitis etc) One of particular concern is Dengue Fever, which is a viral disease transmitted by the bite of an infected mosquito. These mosquitoes tend to bite during the day time. This is in contrast to the mosquitoes which transmit malaria which mainly bite at night. Many of the main tourist destinations throughout SE Asia are malaria free and so tablets to protect against the disease are not usually required. Those going off the usual routes will need to talk this through in depth before leaving.
Road Traffic Accidents
********************************************
Frequently, cars are purchased by tourists to Australia for the duration of their stay. Often the cost is low and the maintenance and safety of the vehicle may be somewhat questionable! Long monotonous driving associated with a lack of concentration can cause serious accidents. Car breakdown in the middle of ‘nowhere’ may lead to the risk of dehydration and potential animal attack (kangaroo, dingos, snakes etc). Make sure you always have sufficient food and water and some means of communication (fully charged mobile phone) before leaving to travel across the continent. Make sure other responsible friends or relations back home know of your intended route and inform them of any changes. Get contact numbers for essential services for your journey.

Health Concerns in Australia
********************************************
Many travellers feel that Australia is the same as at home in Europe and so little care with personal health needs be taken. This is not always the case as there are many local health variations throughout the country which should be considered.
Sun Exposure
********************************************
The northern European skin is usually unaccustomed to intensity of the sun exposure experienced in many parts of Australia. Unfortunately this regularly leads to sun burn among tourists but, more seriously, it also significantly increases the risk of potentially fatal skin cancers. Always use plenty of adequate sun block, cover exposed areas of your body where possible (especially by wearing a wide brimmed hat) and drink plenty of water. (You may also need to replace salt lost through increased perspiration ~ assuming no underlying blood pressure problem)
Northern Australia
********************************************
As mentioned previously, the northern parts of Australia are sub-tropical and mosquito borne diseases are more common. Malaria transmission does not occur and many of the diseases transmitted by mosquitoes or other insects cause mild discomfort. Unfortunately some are which are much more severe and can cause long term difficulties.
Ross River Fever
This viral disease is transmitted by mosquitoes and causes a severe arthritic type condition. The disease is often short lived but in some patients the disease may continue to cause arthritis for months and even years. There is no specific treatment and travellers need to be careful about avoiding bites.
Typhus
This disease occurs in isolated parts of Northern Australia through the bite of infected ticks. The disease can cause a skin rash, fever and general unwellness. Antibiotics can help to ease the symptoms but avoiding bites is essential at all times.
Dengue
This mosquito borne disease also occurs in parts of Northern Australia usually by day-biting mosquitoes. (See Dengue leaflet - TMB)
Other Risks
********************************************
The sea waters in parts of Australia are infested by sharks and jelly fish. Always take competent local advice before undertaking any sea activities. Drowning occurs regularly each year among tourists who disregard some of the basic rules of water safety. If in desert regions, take care with disturbing rocks in case you awaken a peaceful snake or scorpion.
Medical Care for Travellers
********************************************
If travellers have stopped in South East Asia and then become ill on arrival in Australia, they should make contact with a medical centre dealing with Tropical Medicine. Details of the centres in the major cities throughout Australia are available from the Tropical Medical Bureau.
Vaccinations for Stop-Overs
********************************************
Usually travellers will have vaccination cover for Typhoid, Poliomyelitis, Tetanus and Hepatitis A. Malaria prophylaxis may not be required depending on your actual itinerary. There is a higher risk of Hepatitis B in central Australia and so this may need to be considered if the risk of contact (mainly blood following accidents) is thought to be higher than usual. Rabies risk in Australia is almost non existent though obviously contact with all warm blooded animals should be avoided at all times.

Travel News Headlines WORLD NEWS

Date: Fri, 6 Dec 2019 04:23:51 +0100 (MET)

Sydney, Dec 6, 2019 (AFP) - Three hundred animals have been evacuated from a wildlife park north of Sydney as massive bushfires encircled Australia's largest city and foreign firefighters arrived to relieve beleaguered local forces.   Walkabout Wildlife Park said it had shipped out lizards, dingoes, peacocks and marsupials, as firefighters battled more than 100 fires up and down the eastern seaboard.   "This fire has been doing some crazy things, so we have to be prepared," general manager Tassin Barnard told AFP.

Prolonged drought has left much of eastern Australia tinder dry and spot fires have raged every day for the past three months, leaving firefighters struggling to cope.   New South Wales rural fire chief Shane Fitzsimmons said Friday that some US and Canadian firefighters had arrived to help out, easing the strain on the exhausted largely volunteer Australian force.

The incident-management and aviation specialists will help ease "fatigue and crew rotations" he said.   "We are not only appreciative of their presence here today, but of their sacrifice," said Fitzsimmons -- who has become a fixture on Australian television screens for weeks, updating the public on blazes in towns, national parks and backwaters.    "They are volunteering to sacrifice time from loved ones, from families, to give up that special time of the year around Christmas and New Year to come down here and lend us a hand," he said.

More than 600 homes have been destroyed and six people have died since the crisis began in September. That is many fewer than Australia's deadliest recent fire season in 2009 when almost 200 people died, but 2019's toll belies the scale of devastation.    Millions of hectares have burned -- the size of some small countries -- across a region spanning hundreds of kilometres (miles).   Bushfires are common in Australia but scientists say this year's season has come earlier and with more intensity due to a prolonged drought and climatic conditions fuelled by global warming.

The fires have taken a toll in Sydney and other major cities, which have been blanketed in toxic smoke for weeks and occasionally sprinkled with snow-like embers.   Fitzsimmons said he could not "overstate the effect that this profound drought is having" as he warned of a long, painful summer ahead.   "There is an absolute lack of moisture in the soil, a lack of moisture in the vegetation... you are seeing fires started very easily and they are spreading extremely quickly, and they are burning ridiculously intensely."
Date: Tue, 3 Dec 2019 06:24:08 +0100 (MET)

Sydney, Dec 3, 2019 (AFP) - A man and woman have been rescued after surviving two weeks in Australia's arid outback on little more than vodka, groundwater and biscuits, but a third person is still missing, police said Tuesday.   The three friends set out to explore the country's vast sun-baked interior near Alice Springs on November 19 when their car became bogged down in a river bed.   After three days staying put and waiting for a rescue, the group feared supplies were dwindling and two of them decided to walk along a property fence line in the hope of finding help.   Police said Tuesday that a local rancher had found the man, 40-year-old Phu Tran, "slightly disorientated" but in a "good condition" a two-day walk from the vehicle.

His discovery came after Tamra McBeath-Riley, 52, was found on Sunday less than two kilometres from the same vehicle suffering from dehydration.   McBeath-Riley told public broadcaster ABC that the trio -- accompanied by their blue Staffordshire terrier Raya -- had survived by drinking pre-mixed vodka drinks and water from a hole dug for cattle, eating biscuits and sheltering in a hole dug under her car.   But the third person, 46-year-old Claire Hockridge, has not been seen since splitting from Phu two days ago.   "She was still fine when he left but we obviously are now focusing our search to identify where she is," police superintendent Pauline Vicary said.   Police were "hopeful that she's still in that condition," Vicary added, as her colleagues resumed an aerial search.   McBeath-Riley and Hockridge live in Alice Springs, while Phu was visiting from elsewhere in Australia.
Date: Tue, 26 Nov 2019 02:53:22 +0100 (MET)

Sydney, Nov 26, 2019 (AFP) - Australian police on Tuesday found a body they believed to be that of a British backpacker who ran from a campsite on the weekend, prompting an intensive search.   "Officers are yet to formally identify the body" police said in a statement. "However, it is believed to be Aslan King."

King was last seen at a camping ground in Princetown, on the popular and picturesque Great Ocean Road, at about 2 am on Saturday.   He had been camping with friends near the Twelve Apostles about three hours from Melbourne when he had a "medical episode" and hit his head, before suddenly running into bushland.

Fearing King -- who had been on holiday in Australia for two weeks -- had become disorientated and lost in the bush, police deployed a helicopter, horses, motorcycle riders, specialist rescue teams and volunteers to find him.   "The body was located about 10:15 am this morning in a creek just over a kilometre from the camping ground where Aslan was last seen," police said.   "Investigators will prepare a report for the coroner."
Date: Thu, 21 Nov 2019 01:25:15 +0100 (MET)

Sydney, Nov 21, 2019 (AFP) - The fire danger was elevated across wider swathes of southern Australia on Thursday, with residents warned to avoid at-risk areas as smoke from bushfires choked Sydney and other major cities.   Devastating fires along the country's east coast have claimed six lives and destroyed more than 500 homes since mid-October, with climate change and unseasonably hot, dry conditions fuelling the unprecedented blazes.   Now the fire danger has moved into states further south, with a so-called "Code Red" -- the highest possible fire risk in Victoria -- being declared in the state's northwest for the first time in a decade.   "What that means is that if we see fires in those areas they will be fast moving, they will be unpredictable, they will be uncontrollable," emergency management commissioner Andrew Crisp told reporters.

Country Fire Authority chief Steve Warrington told people living in rural areas to leave for the safety of cities.   "We are saying, 'do not be there, do not be there when a fire occurs, because you will not survive if you are there'," he said.   "There is a good chance if a fire occurs that your home will be destroyed."   The fire danger was also elevated to "severe" in the island state of Tasmania off mainland Australia's southeastern coast,  where a total fire ban was declared.   Two bushfires in the state's northeast did not pose an immediate threat to residents, the Tasmania Fire Service said.

For the second time in two days, smoke from bushfires blanketed Sydney, Australia's biggest city and home to more than five million people, sending air quality plummeting to hazardous levels.   More than 110 fires are still burning in worst-hit New South Wales and neighbouring Queensland, while in South Australia more than 40 fires broke out during catastrophic fire conditions Wednesday.    A South Australia Country Fire Service spokeswoman said all of those blazes had been brought under control or extinguished by Thursday, with the exception of a major fire on the Yorke Peninsula that had come perilously close to a small town.

Conditions were expected to ease in the coming days in South Australia, where the state capital Adelaide was also shrouded in bushfire smoke and residents were being told to stay indoors for health reasons.   Bushfire-prone Australia has experienced a horror start to its fire season, which scientists say is beginning earlier and becoming more extreme as climate change pushes temperatures higher and saps moisture from the environment after months of severe drought.   Growing calls to curb fossil fuels and drastically cut greenhouse gas emissions are being ignored by the country's conservative government, which is eager to protect its lucrative mining industry.   The country is bracing for challenging fire conditions to continue throughout the Southern Hemisphere summer.
Date: Tue, 12 Nov 2019 13:10:01 +0100 (MET)
By Holly ROBERTSON, Andrew BEATTY, with Daniel De Cartert in Hillville

Sydney, Nov 12, 2019 (AFP) - Bushfires raging across eastern Australia singed Sydney's suburbs on Tuesday, with firefighters scrambling planes and helicopters to douse a built-up neighbourhood with water and red retardant.   Experts have described the conditions as the worst on record, as spring temperatures climbed toward 40 degrees Celsius (104 Fahrenheit) and winds topped 80 kilometres (50 miles) per hour across a zone which has been plagued by persistent drought.   Although the bushfire season is in its infancy, scientists predict it to be one of Australia's toughest ever, with climate change and unfavourable weather cycles helping created a tinderbox of strong winds, low humidity and high temperatures.

Twin blazes in the north shore suburb of Turramurra -- around 15 kilometres (nine miles) from the centre of Australia's largest city -- tore through a eucalypt forest park and sparked spot fires in homes, before eventually being brought under control.   As night fell, authorities said they were bringing another "clearly suspicious" blaze in a national park in the city's southern suburbs under control.    Throughout the day, more than 300 bushfires burned up and down Australia's east coast, fanned by gale-force winds, scorching temperatures and tinder-dry bushland that has brought some of the most dangerous conditions the country has seen.

In Turramurra, gardens smouldered, thick smoke hung heavy in the air and cars, houses and roads were caked in raspberry-red retardant as if hit by a giant paintball.   "It was the embers that floated up that actually went across and set off spot fires in the front yards" resident Nigel Lush told AFP, adding that one roof had been set alight.   Another resident, Julia Gretton-Roberts, said the blaze spread shockingly quickly.   "Next thing I know the fire was opposite our house and it was massive and the police came and grabbed our kids and took them away," she said.   "My daughter is pretty freaked out."   Firefighter Andrew Connon told AFP "a number of homes were threatened but it was contained by the aerial bombing".

- 'Catastrophic conditions' -
From early morning thousands of firefighters spread out across New South Wales in anticipation of what they called "off the scale" fire risk and "catastrophic" conditions.   They were unable to prevent several bushfires from breaching containment lines and trapping residents who had not already evacuated.   New South Wales Rural Fire Service Commissioner Shane Fitzsimmons said so far only a dozen buildings had been damaged Tuesday and a handful non-life-threatening injuries were reported, but the crisis was far from over.

Firefighters will be "working on these fires for days and weeks given the enormity of the firegrounds," he said.    Even before unfavourable weather hit, days of fires had killed three people and destroyed at least 150 homes.   "The conditions are expected to get worse," Fitzsimmons said, warning residents in adjacent areas to stay alert.   "Complacency kills," he added.   Up to 600 schools were closed, as well as many national parks, a total fire ban was introduced for the affected area and Rally Australia -- due to be held in Coffs Harbour at the weekend -- was cancelled.   The military pitched in, helping firefighters with logistics and water-dropping sorties using more than 100 aircraft.

- 'We'll fight it first' -
In the town of Hillville a fire that has ripped through an area the size of 25,000 soccer fields approached the home of Daniel Stevens.   Like many, his family -- including his mother nursing a broken leg -- have packed their bags, but have resisted leaving their house and everything they own.    "We'll fight it first," he told AFP, "but if it jumps the fence line into the paddock, we'll go."

In the nearby town of Taree, dozens of people have already moved to a showground that has become a makeshift evacuation centre.   Fifty-nine-year-old Caroline Watson arrived last night with her husband and their dog.    "The fires are just rife. They are absolutely everywhere" she told AFP. "They didn't ask us to get out, but we figured it was coming."

Further south in the Blue Mountains on the outskirts of Sydney, veteran Winmalee firefighter Alan Gardiner said locals were "terrified and on edge".    The town still bears the scars of a 2013 blaze that destroyed 200 homes, and residents are acutely aware that with few roads in and out of the mountains, a decision to leave late can be fatal.   Efforts to burn fuel in a controlled way have been limited by months of drought-like conditions that made it too dangerous.
More ...

World Travel News Headlines

Date: Fri, 6 Dec 2019 10:30:54 +0100 (MET)

Moscow, Dec 6, 2019 (AFP) - More than 50 polar bears have gathered on the edge of a village in Russia's far north, environmentalists and residents said, as weak Arctic ice leaves them unable to roam.   The Russian branch of the World Wildlife Fund said climate change was to blame, as unusually warm temperatures prevented coastal ice from forming.   The WWF said 56 polar bears had gathered in a one-square-kilometre (0.4-square-mile) area near the village of Ryrkaipy in Chukotka on the north-eastern tip of Russia.

There were concerns they could enter the village, home to fewer than 1,000 people, and patrols had been set up to monitor their movements.   "The number of human and predator encounters in the Arctic is increasing," the WWF said in statement.    "The main reason is the decline of sea ice area due to the changing climate. In the absence of ice cover, animals are forced to go ashore in search of food."

Residents had gathered walrus carcasses in the area to try to keep the bears from wandering into the village.   "We have created a feeding point with walrus carcasses that we gathered along the coast," Tatyana Minenko of the local "Bear Patrol" told news agency RIA Novosti.   "As long as there is no big freeze, the sea ice will not form and the bears will stay on the coast," she said.

Russia's weather service said temperatures in the region should fall from Saturday and that coastal ice should freeze by December 11.    Polar bears regularly visit areas inhabited by humans in Arctic Russia to search for food, often in rubbish tips.   But the number of visits has been growing as the melting of Arctic ice from climate change forces the bears to spend more time on land where they compete for food.
Date: Fri, 6 Dec 2019 10:28:26 +0100 (MET)
By Joseph Schmid

Paris, Dec 6, 2019 (AFP) - Travellers across France endured a second day of chaos on Friday as unions vowed to keep up their strike until President Emmanuel Macron backs down on controversial pension overhauls.   Rail operator SNCF said 90 percent of high-speed TGV trains were again cancelled, and several airlines dropped flights including Air France, EasyJet and Ryanair.

Nine of the capital's 16 metro lines were shut and most others severely disrupted, sparking some 350 kilometres (220 miles) of traffic jams in the Paris region, well above the usual 200 km, the traffic website Sytadin reported.   Many employees were unable to get to work and several schools again provided only daycare, though fewer teachers were on strike compared with Thursday when some 800,000 people demonstrated across the country according to the interior ministry.   Bike paths were crowded with bikes and electric scooters, with metro operator RATP sponsoring special deals for commuters with a range of ride-hailing companies and other transportation alternatives.

The walkout is the latest test for Macron after months of protests from teachers, hospital workers, police and firefighters as well as the "yellow vest" movement demanding improved living standards.   Unions say his "universal" pension system, which would eliminate dozens of separate plans for public workers, forces millions of people in both public and private sectors to work well beyond the legal retirement age of 62.   Health Minister Agnes Buzyn said Friday that the government had "heard" the protesters' anger and would meet with union leaders to discuss the reform on Monday.   The government has yet to lay out the details of its plan, and Buzyn told Europe 1 radio that "there is indeed a discussion going on about who will be affected, what age it kicks in, which generations will be concerned -- all that is still on the table".

- Macron 'determined' -
Yves Veyrier, head of the hardline FO union, warned Thursday the strike could last at least until Monday if the government did not take the right action.   But it remains to be seen if the protests will match the magnitude of the 1995 strikes against pension overhauls, when France was paralysed for three weeks from November to December in an action that forced the government to back down.

Macron, a former investment banker, has largely succeeded in pushing through a series of controversial reforms, including loosening labour laws and tightening access to unemployment benefits.   But this is the first time the various disgruntled groups have come together in protest.   So far Macron has not spoken publicly on the stoppages though a presidential official, who asked not to be named, said Thursday that the president was "calm" and "determined to carry out this reform" in a mood of "listening and consultation".

While most of Thursday's rallies were peaceful, police fired tear gas to disperse dozens of black-clad protesters smashing windows and throwing stones during the Paris march, with one construction trailer set on fire. Sporadic clashes were also reported in some other cities.   Many people were bracing for further disruptions over the weekend, including the prospect of fuel shortages as unions blocked most of the country's eight oil refineries.

The minimum pension age in France is 62, one of the lowest among developed countries, but there are 42 "special regimes" for railway workers, lawyers, opera employees and others offering earlier retirements and other benefits.   The government says a single system will be fairer for everyone while ensuring its financial viability while acknowledging that people will gradually have to work longer.
Date: Fri, 6 Dec 2019 04:23:51 +0100 (MET)

Sydney, Dec 6, 2019 (AFP) - Three hundred animals have been evacuated from a wildlife park north of Sydney as massive bushfires encircled Australia's largest city and foreign firefighters arrived to relieve beleaguered local forces.   Walkabout Wildlife Park said it had shipped out lizards, dingoes, peacocks and marsupials, as firefighters battled more than 100 fires up and down the eastern seaboard.   "This fire has been doing some crazy things, so we have to be prepared," general manager Tassin Barnard told AFP.

Prolonged drought has left much of eastern Australia tinder dry and spot fires have raged every day for the past three months, leaving firefighters struggling to cope.   New South Wales rural fire chief Shane Fitzsimmons said Friday that some US and Canadian firefighters had arrived to help out, easing the strain on the exhausted largely volunteer Australian force.

The incident-management and aviation specialists will help ease "fatigue and crew rotations" he said.   "We are not only appreciative of their presence here today, but of their sacrifice," said Fitzsimmons -- who has become a fixture on Australian television screens for weeks, updating the public on blazes in towns, national parks and backwaters.    "They are volunteering to sacrifice time from loved ones, from families, to give up that special time of the year around Christmas and New Year to come down here and lend us a hand," he said.

More than 600 homes have been destroyed and six people have died since the crisis began in September. That is many fewer than Australia's deadliest recent fire season in 2009 when almost 200 people died, but 2019's toll belies the scale of devastation.    Millions of hectares have burned -- the size of some small countries -- across a region spanning hundreds of kilometres (miles).   Bushfires are common in Australia but scientists say this year's season has come earlier and with more intensity due to a prolonged drought and climatic conditions fuelled by global warming.

The fires have taken a toll in Sydney and other major cities, which have been blanketed in toxic smoke for weeks and occasionally sprinkled with snow-like embers.   Fitzsimmons said he could not "overstate the effect that this profound drought is having" as he warned of a long, painful summer ahead.   "There is an absolute lack of moisture in the soil, a lack of moisture in the vegetation... you are seeing fires started very easily and they are spreading extremely quickly, and they are burning ridiculously intensely."
Date: Fri, 6 Dec 2019 03:03:18 +0100 (MET)
By Pierre-Henry DESHAYES

Half Moon Island, Antarctica, Dec 6, 2019 (AFP) - The swimsuit-clad tourists leap into the icy water, gasping at the shock, and startling a gaggle of penguins.   They are spectators at the end of the world, luxury visitors experiencing a vulnerable ecosystem close-up.   And their very presence might accelerate its demise.   Antarctica, a vast territory belonging to no one nation, is a continent of extremes: the coldest place on Earth, the windiest, the driest, the most desolate and the most inhospitable.   Now, it's also a choice destination for tourists.

All around Half Moon Island, off the Antarctic Peninsula, blocks of ice of all sizes float by on a calm sea, their varying forms resembling weightless origami shapes.    On this strip of land, that juts out of the Antarctic Polar and towards South America, visitors can see wildlife normally only viewed in zoos or nature documentaries along with spectacular icy landscapes.   The ethereal shades of white that play across the pillowy peaks change with the light, acquiring pastel hues at dawn and dusk.   "Purity, grandeur, a scale that's out of this world," says Helene Brunet, an awestruck 63-year-old French pensioner, enjoying the scene.    "It's unbelievable, totally unbelievable. It's amazing just to be here, like a small speck of dust."

AFP joined the 430 passengers on board the Roald Amundsen, the world's first hybrid electric cruise ship, on its maiden voyage in the Southern Ocean.    "It's not your typical beach, but it's awesome to do it," says a numb Even Carlsen, 58, from Norway, emerging from his polar plunge in the three-degree C (37.4 F) water.   When tourists go ashore, bundled up in neon-coloured windbreakers and slathered in SPF50 sunscreen, they have to follow strict rules: clean your personal effects so you don't introduce invasive species, keep a respectful distance from wildlife to avoid distressing them, don't stray from the marked paths and don't pick up anything.   "We mucked up the rest of the world. We don't want to muck up Antarctica too," says an English tourist, as she vacuums cat hair off her clothes before going ashore.

- 'Heart of the Earth' -
The Antarctic peninsula is one of the regions on Earth that is warming the fastest, by almost three degrees Celsius in the past 50 years, according to the World Meteorological Organization -- three times faster than the global average.    In March 2015, an Argentinian research station registered a balmy 17.5 degrees Celsius, a record.    "Every year you can observe and record the melting of glaciers, the disappearance of sea ice... (and) in areas without ice, the recolonisation of plants and other organisms that were not present in Antarctica before," said Marcelo Leppe, director of the Chilean Antarctic Institute.

Antarctica is "like the heart of the Earth," he added, saying that it expands and contracts like a heart beating, while the mighty current which revolves around the continent is like a circulatory system as it absorbs warm currents from other oceans and redistributes cold water.   The Antarctic Treaty, signed 60 years ago by 12 countries -- it now has 54 signatories -- declared the area a continent dedicated to peace and science, but tourism has gradually increased, with a sharp rise in the past few years.   Tourism is the only commercial activity allowed, apart from fishing -- the subject of international disputes over marine sanctuaries -- and is concentrated mainly around the peninsula, which has a milder climate than the rest of the continent and is easier to access.

Cruise ships have roamed the region for around 50 years, but their numbers only started to increase from 1990, as Soviet ice-breakers found new purposes in the post-Cold War era.   Some 78,500 people are expected to visit the region between November and March, according to the International Association of Antarctica Tour Operators (IAATO).   That's a 40-percent increase from last year, due in part to short visits by a few new cruise ships carrying more than 500 passengers, too many to disembark under IAATO regulations.     "Some might say 'Well, 80,000 people, that doesn't even fill a national stadium'... (and that it) is nothing like Galapagos which welcomes 275,000 a year," says IAATO spokeswoman Amanda Lynnes.    "But Antarctica is a special place and you need to manage it accordingly."

- 'Leave Antarctica to the penguins' -
It is Antarctica's very vulnerability that is attracting more and more visitors.   "We want to see this fantastic nature in Antarctica before it's gone," Guido Hofken, a 52-year-old IT sales director travelling with his wife Martina, says.    They said they had paid a supplement to climate compensate for their flight from Germany.

But some question whether tourists should be going to the region at all.   "The continent probably would be better off being left to penguins and researchers, but the reality is, that is probably never going to happen," said Michael Hall, professor and expert on polar regions at the University of Canterbury in New Zealand.   "Vicarious appreciation never seems to be enough for humans. So with that being the case, it needs to be made as low risk to the Antarctic environment and as low carbon as possible," said Hall.    "However, when the average tourist trip to Antarctica is over five tonnes of CO2 emissions per passenger (including flights), that is a serious ask."

Soot or black carbon in the exhaust gases of the scientific and cruise ships going to the region is also of concern, said Soenke Diesener, transport policy officer at German conservation NGO Nabu.   "These particles will deposit on snow and ice surfaces and accelerate the melting of the ice because the ice gets darker and will absorb the heat from the sun and will melt much faster," he told AFP.   "So the people who go there to observe or preserve the landscape are bringing danger to the area, and leave it less pristine than it was," he added.

- Responsible tourism -
Antarctic tour operators insist they are promoting responsible tourism.   The trend is for more intimate, so-called expedition cruises, in contrast to popular giant cruise liners elsewhere which are criticised for being invasive and polluting.   With greener ships -- heavy fuel, the most commonly used for marine vessels, has been banned in Antarctica since 2011 -- cruise companies have sought to make environmental awareness a selling point, occasionally earning them accusations of greenwashing.

Global warming, pollution and microplastics are the result of human activities on other, faraway continents, say tour operators.   Here, their motto is "Take nothing but photographs, leave nothing but footprints, keep nothing but memories".   But before they've even set foot on the cruise ships departing from South America -- the most common itinerary -- visitors to Antarctica will already have flown across the world, causing emissions that harm the very nature they have come so far to admire.

Most visitors hail from the Northern Hemisphere, and almost half are from the United States and China, IAATO says.   "I'm a tourist who feels a little guilty about taking a flight to come here," admits Francoise Lapeyre, a 58-year-old globetrotter om France.   "But then again, there are priorities. There are some trips I just won't take, because they leave a big footprint and they're not worth it.   "Crisscrossing the planet to go to a beach for example," she says.

- Don't mention climate change -
Like other expedition cruises where accessible science is part of their trademark, the Roald Amundsen, owned by the Hurtigruten company, has no dance floor or casino.  Instead, there are microscopes, science events and lectures about whales and explorers like Charles Darwin.   But they steer clear of climate change, which is only mentioned indirectly.   That's a deliberate decision as the subject has proven "quite controversial", said Verena Meraldi, Hurtigruten's science coordinator.   "We held several lectures dedicated specifically to climate change but it leads to conflicts. There are people who accept it as a fact, others who don't," she said.   Onboard, "passengers" are referred to as "guests" and "explorers" rather than "cruisers".   "Explorers" are typically older, well-heeled, often highly travelled pensioners who are handed walking sticks as they step ashore.   "My 107th country," says a Dane, stepping ashore onto Antarctica.

The Roald Amundsen "guests" choose between three restaurants, from street food to fine dining -- a far cry from the conditions endured by the Norwegian adventurer for whom the ship is named, who had to eat his sled dogs to survive his quest to reach the South Pole in 1911.   They have paid at least 7,000 euros ($7,700) each for an 18-day cruise in a standard cabin, and up to 25,000 euros ($27,500) for a suite with a balcony and private jacuzzi.   Other cruises are banking on ultra-luxury, with James Bond-like ships equipped with helicopters and submarines, suites of more than 200 square metres (2,153 square feet) and butler services.   With a seaplane to boot, the mega-yacht SeaDream Innovation will offer 88-day cruises "from Pole to Pole" starting in 2021. The two most expensive suites, with a price tag of 135,000 euros per person, are already booked.
 
- Worlds collide -
Outside, in the deafening silence, wildlife abounds.   All around are penguins, as awkward on land as they are agile in water. Massive and majestic whales slip through the waves, and sea lions and seals laze in the sun.   On Half Moon Island, chinstrap penguins -- so called because of a black stripe on their chin -- strut about in this spring breeding season, raising their beaks and screeching from their rocky nests.   "This is to tell other males 'This is my space' and also, maybe, 'This is my female'," ornithologist Rebecca Hodgkiss, a member of the Hurtigruten's scientific team, explains, as a group of tourists stroll around ashore.   The colony of 2,500 penguins has been gradually declining over the years, but it's not known if that is man's fault or they have just moved away, according to Karin Strand, Hurtigruten's vice president for expeditions.   Invisible to the naked eye, traces of humankind are however to be found in the pristine landscape.   Not a single piece of rubbish is in sight but microplastics are everywhere, swept in on ocean currents.   "We've detected them in the eggs of penguins for example," Leppe told AFP.

- Venice under water -
The Antarctic, which holds the world's largest reserve of freshwater, is a ticking time bomb, warn experts and studies.   They say that the future of millions of people and species in coastal areas around the world depends on what is happening here.   As a result of global warming, the melting ice sheet -- especially in the western part of the continent -- will increasingly contribute to rising sea levels, radically re-drawing the map of the world, says climate scientist Anders Levermann, of the Potsdam Institute for Climate Impact Research.   This meltwater will contribute 50 centimetres (almost 20 inches) to the global sea level rise by 2100, and much more after that, he said.   "For every degree of warming, we get 2.5 metres of sea level rise. Not in this century, but in the long run," he said.

Even if the international community meets its obligations under the Paris Agreement to limit global warming to under two degrees Celsius, sea levels will still rise by at least five metres.   "Which means that Venice is under water, Hamburg is under water, New York, Shanghai, Calcutta," he said.   It's impossible to predict when, but the scenario appears unavoidable, says Levermann.   In the same way that a cruise ship powering ahead at full speed can't immediately stop, sea levels will continue to rise even if all greenhouse gas emissions were to cease immediately, a study has said.

- Changing the world? -
The tourism industry says it hopes to make "ambassadors" out of Antarctica visitors.   "It's good for the animal life and for the protection of Antarctica that people see how beautiful this area is, because you cherish what you know and understand," said Hurtigruten chief executive Daniel Skjeldam.   Texan tourist Mark Halvorson, 72, says he is convinced.   "Having seen it, I am that much more committed to having a very high priority in my politics, in my own inner core convictions to being as environmentally friendly in my life as I can," he said.   So, do Guido and Martina Hofken see themselves as future "ambassadors of Antarctica"?    "Just a little bit, probably. But I don't think I will change the world," Guido Hofken concedes.    "The best thing would be for nobody to travel to Antarctica."
Date: Thu, 5 Dec 2019 16:37:37 +0100 (MET)

Paris, Dec 5, 2019 (AFP) - French rail operator SNCF said Thursday that it had cancelled 90 percent of all high-speed TGV trains and 70 percent of regional trains for Friday due to a strike over the government's pension reforms.   SNCF said that services would "still be very disrupted" on the second day of the biggest transport strike in the country in years, with the Eurostar service to Britain and the Thalys service to northern Europe set to be "very heavily disrupted".   In Paris, where only two of 16 metro lines were operating normally Thursday, public transport workers voted to remain on strike until Monday.

France's civil aviation authority meanwhile told airlines to cut 20 percent of their flights in and out of airports in Paris, Beauvais, Lyon, Marseille, Toulouse and Bordeaux on Friday, the same proportion as on Thursday.   Striking transport workers, air traffic controllers, teachers, fire fighters, lawyers and other groups all fear they will have to work longer or receive reduced pensions under the government's proposal to scrap 42 special pension schemes and replace them with a single plan.   Anticipating the worst travel chaos in years, many employees opted to work from home on Thursday. Those who did venture out travelled mainly by car, bicycle, electric scooter or on foot.
Date: Thu, 5 Dec 2019 12:19:45 +0100 (MET)
By Sofia CHRISTENSEN

Johannesburg, Dec 5, 2019 (AFP) - South African Airways was placed under a state-approved rescue plan on Thursday to avoid the embattled airline's collapse following a costly week-long strike last month.   Thousands of South African Airways (SAA) staff walked out on November 15 after the flag carrier failed to meet a string of demands, including higher wages and job in-sourcing.   The strike was called off the following week after SAA management and unions eventually clinched a deal.

But the walkout dealt a severe blow to the debt-ridden airline, which has failed to make a profit since 2011 and survives on government bailouts.   "The Board of SAA has adopted a resolution to place the company into business rescue," said a statement by South Africa's Public Enterprises Minister Pravin Gordhan, adding that the decision was also supported by the government.   "It must be clear that this is not a bailout," said Gordhan. "This is the provision of financial assistance in order to facilitate a radical restructure of the airline."   The business rescue process will be directed by an independent practitioner. It is meant to prevent a "disorderly collapse of the airline", he added.   Gordhan said the government would provide 2 billion rand ($136 million) to SAA in "a fiscally neutral manner".   Existing lenders will also provide a 2 billion rand loan guaranteed by the government.

- 'Financial challenges' -
South Africa is struggling to get state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.   Its national airline -- which employs more than 5,000 workers and is Africa's second largest airline after Ethiopian Airlines -- had been losing 52 million rand ($3.5 million) a day during the strike.   SAA's board said the business rescue, scheduled to start immediately, was decided after consultations with shareholders and the public enterprises department "to find a solution to our company's well-documented financial challenges".

"The considered and unanimous conclusion has been to place the company into business rescue in order to create a better return for the company's creditors and shareholders," said the SAA board of directors in a statement.   The rescue plan will include a "new provisional timetable" and ensure "selected activities... continue operating successfully".   With a fleet of more than 50 aircraft, SAA flies to over 35 domestic and international destinations.   "SAA understand that this decision presents many challenges and uncertainties for its staff," said the board.   "The company will engage in targeted communication and support for all its employee groups at this difficult time.

- 'Lesser evil' -
Unions told AFP they would comment later on Thursday.   They have agreed to a 5.9-percent wage increase backdated to April, but which would only start to be paid out next March depending on funding.   SAA had initially refused any pay rise.    The cash-strapped airline needs two billion rand ($136 million) to fund operations through the end of March. But it was unable to cover all of its staff salaries last month.    "Business rescue allows for the airline to continue to operate while it is being restructured, as opposed to liquidation," analyst Daniel Silke told AFP.   He said the rescue was a "lesser evil for SAA" and would save more jobs than a "shutdown".

But Silke still expected jobs to be cut as SAA attempted to reduce costs.   "Various divisions that make of SAA could be privatised," he said. "There will be a review of SAA aircraft and routes covered by SAA."   Unions had already demanded a three-year guarantee of job security following an announcement last month that almost 1,000 SAA employees could lose their jobs as part of another restructuring plan.   SAA pledged to defer that process to the end of January as part of the deal that ended the strike.
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Out of the 7 patients who were admitted to the hospital suspecting Nipah virus infection, one has been tested positive while the other 6 have been tested negative.

Kerala health minister K K Shailaja said at a press briefing in Kochi on Thursday [28 Nov 2019] that of "7 patients admitted to the hospital, one patient's result is positive for Nipah virus, while 6 patients' results are negative. No one has been discharged from the isolation ward. The source of the virus is not confirmed yet."

On the other hand, 2 persons suffering from high fever were put under observation at Trivandrum Medical College on Thursday [28 Nov 2019]. Their samples have been sent for examination.

On 4 Jun [2019], a 23-year-old-man had tested positive for Nipah virus infection, which killed 17 people in Kerala last year [2018].

As of now, a total of 15 people are under observation in the state.

Union minister for health and family welfare Dr Harsh Vardhan had said on 4 Jun [2019] that the centre had rushed a team of doctors to Kerala for investigation in the wake of the scare of Nipah virus. Vardhan had asserted that he was "very vigorously" following the situation.

Nipah virus is transmitted from animals [bats] to humans and then spreads through people to people, causing respiratory illness. Its symptoms include fever, muscle pain, headache, fever, dizziness, and nausea.

The Health Department in Karnataka issued a circular asking administration in Chamarajanagar, Mysuru, Kodagu, Dakshina Kannada, Uttara Kannada, Udupi, Shivamogga, and Chikkamagaluru districts to immediately convene interdepartmental coordination committee meetings, including the veterinary department, the Indian Medical Association, and the Indian Academy of Pediatrics.

Authorities in these 8 districts have been directed to identify 2 isolation beds to quarantine suspected human cases. They have been asked to keep all the logistics available at all levels, read the circular. The department has also asked district authorities to direct government and private hospitals to keep an eye on suspected cases.

Once a patient shows symptoms of Nipah, the hospitals have to monitor for acute encephalitis syndrome, check all vital parameters, and take a travel history of the patients.

The district hospitals should have an ICU with ventilator facilities and capacity to receive emergency cases, the circular read.

The department asked the districts to furnish a daily outbreak report regarding Nipah virus. It also directed authorities to sensitise health assistants and ASHA workers.
==================
[This is the 3rd case of Nipah virus infection [NVI] in Kerala state this year (2019). It is prudent that surveillance and patient-care capacity have been increased. Last year (2018), as of 17 Jul 2018, a total of 19 Nipah virus (NiV) cases, including 17 deaths, were reported from Kerala state: 18 of the cases were laboratory confirmed, and the deceased index case was suspected to have NVI but could not be tested. The 2018 outbreak was localized to 2 districts in Kerala state: Kozhikode and Malappuram.

The exact circumstances under which this or the previous confirmed Nipah virus cases this year (2019) acquired their infections are not stated in the above or in previous reports, nor is it stated whether these individuals had contact with flying fox fruit bats (_Pteropus giganteus_), the reservoir hosts of Nipah virus, or fruit that the bats may have contaminated. It is interesting to note that 12 of 36 fruit bats tested at the National Institute of Virology were positive for Nipah virus. Although Kerala health minister KK Shailaja officially had declared Ernakulam district Nipah-free, it may have been free of human cases but is unlikely to have been free of the virus in _Pteropus giganteus_ fruit bats. - ProMED Mod.TY]

[Maps of India:
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Bihar Health Minister Mangal Pandey on [Sat 30 Nov 2019] said the state government is doing its best to save children, as the death toll due to acute encephalitis syndrome [AES] in Muzaffarpur mounted to 73.

Pandey said doctors and nurses are being called in from Patna for additional help. "We are trying everything and anything that can save children's lives. Everything is being made available from medicines to doctors. We have even called doctors and nurses from AIIMS in Patna," he said. "There is a protocol regarding what kind of medicines and facilities should be given and we are doing the same. We are monitoring things regularly and trying to save our children."

Recalling the situation that prevailed 5 years ago, Pandey said a team that was formed to ascertain the cause of this disease concluded that sleeping empty stomach at night, dehydration due to humidity and eating lychee on empty stomach were some of the causes of encephalitis.

"Our government has tried to spread awareness which will be beneficial as well. Advertisement in newspapers, radio jingles, pamphlets and mic [microphone] announcements are going to spread awareness regarding the disease. Health ministry is also working on it," he said.

On being asked about spread of ASE in Gorakhpur last year [2018], he said, "From Gorakhpur to Muzaffarpur region, this disease had spread last year and the Union government had worked on this and we will continue to fight it now."

"This incident in Muzaffarpur is very saddening and we also feel bad when children of our nation die like this. Not the whole district is affected but a large part is suffering from it," he added.

From [1 Jan 2019], until now [5 Dec 2019], 220 children were admitted in Sri Krishna Medical College and Hospital in Muzaffarpur due to AES, out of which 62 lost their lives.

As per the data of SKMCH hospital, 235 children were admitted, of which 89 died; in 2013 - 90 children were admitted, of which 35 died; in 2014 - 334 children were admitted, of which 117 died; in 2015 - 37 children were admitted, of which 15 died; in 2016 - 31 children were admitted, of which 6 died; in 2017 - 44 children were admitted, of which 18 died; and in 2018 - 43 children were admitted, of which 12 died.

Meanwhile, Minister of State for Union ministry for home affairs, Nityanand Rai, visited Sri Krishna Medical College and Hospital to review the situation after the outbreak of AES.

Encephalitis is a viral disease, which causes mild flu-like symptoms such as high fever, convulsions and headaches and has been claiming lives in the district for the past few weeks.
======================
[The dates within which these AES cases have occurred is not stated. The urgency that has prompted Behar health officials to request the aid of physicians and nurses from adjoining Patna suggests that the AES outbreak is going on currently. The uncertainty about the etiology of AES continues. It is curious that the above report makes no mention of negative or positive tests for Japanese encephalitis among the AES patients, although that virus is endemic in northeastern India, including Bihar state. Neighboring Uttar Pradesh state has had JE cases as well this summer (2019) but has intensified its JE vaccination program.

The issue of the aetiology of AES has been under discussion for a long time. Lychee fruit contain toxins. Encephalopathy and hypoglycaemia have been associated with consumption of lychee fruit contains phytotoxins, specifically alpha-(methylenecyclopropyl)glycine (see ProMED-mail archive no. http://promedmail.org/post/20150201.3132842). However, the current cases cannot be due to lychee consumption, since the season for that fruit has passed.

AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in AES, but existing surveillance for AES does not include routine testing for dengue. Until the etiology (or etiologies) of these AES cases is determined, effective and efficient prevention of these cases will not be possible.

Reference:
Ravi V, Hameed SKS, Desai A, et al. Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. Int J Infect Dis 2019;84 Suppl:19-24. <https://doi.org/10.1016/j.ijid.2019.01.008>.

Available at:

[Maps of India:
HealthMap/ProMED maps available
at:<http://healthmap.org/promed/p/364>, and Bihar, India:
Date: Thu 5 Dec 2019 6:11 PM EET
Source: Enab Baladi [edited]

[Leishmaniasis] is spreading widely among residents of Deir ez-Zor, and especially children. Some of the areas affected are controlled by the Kurdish self-administration while others are under the control of the Syrian regime. Medical sources counted hundreds of infected civilians and confirmed the disease's rapid spread.

According to Atef al-Tawil, a manager of the Leishmania & Environmental Health Programme at the Syrian regime's Ministry of Health, most infections in eastern Deir ez-Zor are spread among school children.

In a Facebook comment on a post by Twasol agency, al-Tawil claimed that cases of leishmaniasis were detected, at the end of November [2019], in primary schools in eastern Deir ez-Zor and its surrounding villages (al-Jalaa, al-Salihiyah, al-Tawtha, al-Abbas, al-Mujawdeh, al-Hasarat, al-Saial, al-Ghabrah).

According to al-Tawil, 455 infections of children were detected. A treatment team of 10 members was formed in the affected locations, to help control the disease to aid in early detection.

The Syrian Ministry of Health acted after several appeals by civilians residing in the area as they noticed the disease spreading among their children. Al-Tawil said that this rapid spread was due to the fact that all the infected people have lately returned to their original areas which lack medical centers.

Autonomous administration areas
-------------------------------
According to Euphrates Post network, leishmaniasis is also widely spread in areas controlled by the Syrian Democratic Forces (SDF). In its post on [Sun 1 Dec 2019], the network claimed that the spread of leishmaniasis is mostly concentrated in the eastern countryside of Deir ez-Zor.

According to the network, unofficial statistics by the SDF-affiliated local council shows more than 7000 leishmaniasis infections among children in al-Baghouz, Hajin, Diban, al-Sha'afa, al-Kishkiye, Abu Hamam, and Gharanij. The local councils' attempts of controlling the disease are still substandard, according to the Euphrates Post.

The network also quoted doctors and nurses calling for international organizations to interfere and provide hospitals and clinics with the required vaccine [there is no vaccine for leishmaniasis; ed.], and to train specialized medical staff in each clinic to deal with the disease.

The autonomous-administration-affiliated media center in Deir ez-Zor also confirmed the spread of leishmaniasis and pointed out that the authorities took actions, by the end of November [2019], to provide treatments.

According to the media center, special medical teams and cadres were distributed among the clinics to provide 12,000 ampoules of the required [medicine] to treat leishmaniasis with the support of the World Health Organization.

Leishmaniasis is a parasitic disease transmitted by the bite of infected female phlebotomine sandflies -- a very small yellow fly that is active at night and makes no sound when it bites -- and the main cause for its spread is dirt and lack of hygiene.  [Byline: Enab Baladi]
========================
[Deir ez-Zor is east and south of the locations in the previous ProMED reports (see below), indicating further increase in cases of cutaneous leishmaniasis beyond its historical concentration in western Syria (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861536/>) and beyond the area of the MENTOR initiative in northern Syria (<https://wwwnc.cdc.gov/eid/article/24/11/17-2146_article>).

Cutaneous leishmaniasis is endemic in Syria with its reservoir in rodents. It has been a problem throughout the Syrian civil war and in ISIS controlled areas during the war due to a breakdown in rodent and vector control. - ProMED Mod.EP]

[Maps of Syria:
Date: Tue 3 Dec 2019
Source: Twitter feed in Arabic [machine trans., edited]

Taiz health official: 24 laboratory-confirmed cases of West Nile virus and more than 300 suspected cases. #Republic_Yemen
===================
[Any information on the actual number of WNV cases, their lab confirmation, and public health response activities in this regard will be highly appreciated. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Yemen: