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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 ...

Mozambique

Mozambique US Consular Information Sheet
July 15, 2008
COUNTRY DESCRIPTION:
Mozambique is a developing country in southern Africa which has steadily rebuilt its economy and civic institutions since ending a 16-year civil war in 1992.
he country stabilized following Mozambique's first multi-party elections in October 1994, and a new president was elected in December 2004.
Despite high economic growth rates in recent years, Mozambique remains among the world's poorest countries.
Facilities for tourism in Maputo, the capital city, are steadily improving but remain limited in other areas as many of the goods and services taken for granted in other countries are not yet available.
The official language is Portuguese, although English is spoken in many tourist areas, and in some rural areas only local languages are widely spoken.
Read the Department of State Background Notes on Mozambique for additional information.
ENTRY/EXIT REQUIREMENTS:
A visa is required for entry into Mozambique.
It is recommended that travelers acquire the appropriate visa prior to departing for Mozambique, although a one-entry visa can be obtained at country points of entry, including airports.
Foreigners in Mozambique without a valid visa can expect to pay a substantial fine for each day they are in Mozambique illegally.
The fine can be assessed upon departure or if caught while in Mozambique by authorities.
The passports of all travelers who wish to enter Mozambique must be valid for six months upon arrival and must contain at least three clean (unstamped) visa pages each time entry is sought.
The Mozambican Embassy and Consulates in South Africa charge up to five times the amount charged in the U.S. or at border crossing points for a tourist visa to Mozambique.
In September 2007 the Mozambican Interior and Health Ministries decreed that all travelers entering Mozambique, having previously visited a country where yellow fever is present, must present a valid certification of vaccination against yellow fever.
We recommend all travelers be vaccinated to avoid complications at the border.
Any passenger who cannot present such a certificate at the port of entry will be vaccinated at a cost of $50 US dollars or the equivalent in metical.
Additionally, all travelers entering Mozambique must carry their yellow vaccination book.
For further information on entry requirements, contact the Embassy of Mozambique located at 1525 New Hampshire Avenue NW, Washington, DC 20036, telephone: (202) 293-7146, email: embamoc@aol.com, fax: (202) 835 0245, or the nearest Mozambican embassy or consulate. Visit the Embassy of Mozambique web site at http://www.embamoc-usa.org/ 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:
Overland travel after dark is extremely dangerous due to poor road conditions, lack of emergency services, and the increased potential for vehicle hijacking.
Visitors should be particularly vigilant when driving on the main thoroughfares connecting Mozambique and South Africa as incidents of vehicle theft, including assault and robbery, have been reported.
Official Americans serving in Mozambique are prohibited from overland travel outside Maputo city limits after dark and are encouraged to travel in convoys of two or more vehicles when outside of the city during daylight hours.
Accidents involving pedestrians are increasingly common, and some reports suggest pedestrians purposely throw themselves in front of vehicles driven by foreigners in order to extort reparation payment.
Due to residual landmines, overland travelers are advised to remain on well-traveled roads or seek local information before going off-road outside of Maputo and other provincial capitals.
Drivers should obey police signals to stop at checkpoints, which are common throughout Mozambique.
Foreigners in Mozambique for more than 90 days are required to have an International Driver’s License or to obtain a Mozambican driver’s license. Although demonstrations do occur in Mozambique, they are infrequent and there have been no recent demonstrations against U.S. interests.
If any demonstrations do occur, they should be avoided.
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:
Although the vast majority of visitors complete their travels in Mozambique without incident, the most serious threat facing U.S. citizens visiting Mozambique is crime.
Street crimes, including mugging, purse snatching and pick-pocketing are common, both in Maputo and in secondary cities.
Carjacking is increasingly common in Maputo.
Visitors must be vigilant when out in public areas and should not display jewelry or other expensive items.
Isolated areas should be avoided.
Joggers and pedestrians have frequently been mugged, even during daylight hours.
Visitors should take caution when walking at night, even in well-known tourist areas.

Mozambican police are not at the standard U.S. citizens are accustomed to in the United States and visitors should not expect the same level of police service.

Many airline trips from Mozambique to the U.S., Europe, or African destinations transit Johannesburg, South Africa.
Baggage pilferage is an ongoing problem at Johannesburg's Oliver Tambo International Airport.
Travelers are encouraged to secure their luggage, use an airport plastic wrapping service, and avoid placing currency, electronics, jewelry, cameras, cosmetics, running shoes, or other valuables in checked luggage.
Having a complete inventory of items placed in checked baggage can aid in processing a claim if theft does occur.

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.
There is no local equivalent to the “911” emergency line in Mozambique.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are rudimentary, and most medical providers do not speak fluent English.
Medicines are not always consistently available.
There are both public and private medical facilities in the city of Maputo and most provincial capitals.
All health care institutions and providers require payment at the time of service, and may even require payment before service is given.
While some private clinics accept credit cards, many medical facilities do not.
Doctors and hospitals outside Maputo generally expect immediate cash payment for health services.
Outside of Maputo, available medical care ranges from very basic to non-existent.

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

Tuberculosis is an increasingly serious health concern in Mozambique.
For further information, please consult the CDC's Travel Notice on TB
http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Mozambique is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The main north-south thoroughfare is passable until the city of Caia (Sofala province), where vehicle passengers must disembark and cross the Zambezi River by ferryboat.
On the north side of the river, the road continues to the Northern provinces.
The road network connecting provincial capitals is in fair condition, but can be riddled with potholes and other obstacles.

The EN4 toll road between Maputo and South Africa is well-maintained.
Official Americans are prohibited from traveling outside cities after dark because of the increased risk of banditry, poor road conditions in some areas, poor maintenance of many vehicles in the country (e.g., no headlights or rear lights), as well as the threat imposed by livestock that graze on roadsides.
Travel outside Maputo often requires a four-wheel drive vehicle, which creates an additional security risk since these vehicles are high-theft items.
Public transportation is limited and often has poor safety standards.
Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office at http://www.turismomocambique.co.mz/.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Mozambique, the U.S. Federal Aviation Administration (FAA) has not assessed Mozambique’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:
Mozambican law requires that all persons carry an identity document, such as a passport, when out in public, and produce it if requested by police.
Notarized copies of both the biographic page of a passport and a valid Mozambican visa are acceptable forms of identification, although police will occasionally demand original documents.
There are certain areas in Mozambique where pedestrian traffic is prohibited and the ban is strictly enforced.
These areas include the front of the presidential offices located north of the Hotel Polana on the seaside of Avenida Julius Nyerere and the Praça dos Herois on Avenida Acordos de Lusaka near the airport, both in Maputo.

It is against the law to destroy Mozambican currency; offenders can expect a jail sentence or fine.
The limit for an undeclared amount of U.S. dollars one can take out of the country is $5,000.
The limit on local currency is 500 metical, which is approximately 20 U.S. dollars.
Some American travelers have reported having difficulties cashing traveler’s checks and have relied instead on ATMs and credit cards for money withdrawals in Mozambique.
Outside of the major hotels and restaurants, credit cards are not widely accepted in Mozambique.
The South African rand and U.S. dollar are sometimes accepted as legal tender, although this is more common in the southern part of the country or in tourist areas; all transactions must have a local currency (metical) payment option. 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 Mozambique’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Mozambique 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 Mozambique 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 Mozambique.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in Maputo at 193 Avenida Kenneth Kaunda, telephone (258) 21 49 2797.
The after-hours telephone number for use in emergencies is (258) 21 49 0723.
The Consular Section's fax number is (258) 21 49 0448.
The Consular Section's e-mail address is consularmaputo@state.gov.
The Embassy's web site is http://maputo.usembassy.gov/
*

*

*
This replaces the Country Specific Information for Mozambique dated January 14, 2008, to update sections on Entry/Exit requirements, Information for Victims of Crime, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Sat, 3 Aug 2019 12:59:45 +0200 (METDST)

Maputo, Aug 3, 2019 (AFP) - Mozambique on Saturday set up disease checkpoints along its border with Malawi as a precaution against any spreading of a deadly Ebola outbreak, a senior health ministry official said.   More than 1,800 people have died in eastern Democratic Republic of Congo since Ebola broke out there in August last year.   Mozambique has yet to report an Ebola case, but DRC's regional neighbours have been on high alert while the World Health Organization (WHO) has elevated the crisis to a global health emergency.

Checkpoints began operating in the Milage and Morrumbala districts in the Zambezia province and controls are expected to widen to other provinces of Mozambique that share borders with Malawi, according to a ministry of health official.   "Setting up Ebola checkpoints is a guideline given by decision of the Ministry of Health and World Health Organization to prevent the spread of the disease to other countries" Zambezia province health director, Hidayate Kassim told reporters.   "The checkpoints aim to track all people entering Mozambique having fevers or if they have had contact with anyone who has been in Congo," he said.   "Depending on this control we will determine whether there is a risk or not in our province," Kassim added.   Authorities characterised the screening of people entering Mozambique as a preventive control measure to prepare, prevent, detect and treat any Ebola case that could develop in the country.

The deadliest epidemic of Ebola broke out in West Africa in December 2013 and lasted more than two years, killing more than 11,300 of the 29,000 infected people recorded.   The current one-year old epidemic has left 1,823 dead, according to the DR Congo health ministry, making it second only to the 2013-2016 crisis.   Rwanda on Thursday shuttered its border with DRC after a third case of the deadly virus was detected in the border city of Goma.
Date: Fri 3 May 2019
Source: France24, Agence France-Presse (AFP) [edited]

Provincial authorities said Fri 3 May 2019 that 14 cholera cases have been confirmed in northern Mozambique following floods caused by a powerful cyclone that battered the country last week. The city of Pemba registered 11 cases of the disease while the neighbouring district of Mecufi had 3. "We were already prepared for that -- the healthcare sector has been on the alert since Cyclone Kenneth started," the provincial health director, Anastacia Lidimo, told reporters.

Cyclone Kenneth made landfall in northern Cabo Delgado province on 25 Apr 2019, packing winds up to 220 kilometres (137 miles) per hour -- hitting a region that has not experienced a tropical cyclone in the modern era.

According to the UN humanitarian agency OCHA, Pemba, a city of 200,000 people and the capital of Cabo Delgado province, is in one of the most cholera-endemic regions in Mozambique. In Beira, the impoverished and aid-dependent country administered nearly 900 000 doses of oral cholera vaccines after Cyclone Idai [4-9 Mar 2019] to avert an epidemic.
====================
[Maps of Mozambique:
Date: Fri, 3 May 2019 12:08:16 +0200

Maputo, May 3, 2019 (AFP) - Fourteen  cholera cases have been confirmed in northern Mozambique following floods caused by a powerful cyclone that battered the country last week, provincial authorities said Friday.   The city of Pemba registered 11 cases of the disease while the neighbouring district of Mecufi had three.   "We were already prepared for that - the health care sector has been on the alert since Cyclone Kenneth started," the provincial health director, Anastacia Lidimo, told reporters.

Cyclone Kenneth made landfall in northern Cabo Delgado province on April 25, packing winds up to 220 kilometres (137 miles) per hour -- hitting a region that has not experienced a tropical cyclone in the modern era.   It killed at least 41 people, with some 226,000 affected, destroyed thousands of homes and wrecked water supply systems.   It was the second massive storm to hit Mozambique in six weeks after Cyclone Idai devastated the port city of Beira 1,000 kilometres (600 miles) to the south, causing huge floods and more than 600 deaths.    Cholera is transmitted through contaminated drinking water or food and causes acute diarrhoea.

According to the UN humanitarian agency OCHA, Pemba, a city of 200,000 people and the capital of Cabo Delgado province, is in one of the most cholera-endemic regions in Mozambique.   In Beira, the impoverished and aid-dependent country administered nearly 900,000 doses of oral cholera vaccines after Cyclone Idai to avert an epidemic.    At least four deaths from cholera were recorded in Beira and surrounding districts out of 4,979 cases.
Date: Wed, 24 Apr 2019 19:23:46 +0200

Moroni, Comoros, April 24, 2019 (AFP) - Violent winds caused landslides and flooding and cut off roads in Comoros in the vanguard of tropical storm Kenneth, set to hit Wednesday evening before heading to recently cyclone-ravaged Mozambique, officials said.   As the storm neared, schools were closed and inter-island hopper flight suspended.    Chief of the Comoros Centre for Relief and Civil Protection Centre (COSEP) Mouigni Daho said the arrival of the cyclone on the island was preceded by strong winds and floods.    There have been no reports of injuries.   Comoros Interior Minister Mohamed "Kiki" Daoudou urged citizens Wednesday to "stay calm and follow the instructions."

After Comoros, Kenneth is expected to reach the far north of Mozambique late Thursday or early Friday, if it stays on its current course.   This comes a month after cyclone Idai ravaged the country and neighbouring Zimbabwe, claiming some 1,000 lives and causing about $2 billion in damage, according to the World Bank.   The Mozambique National Meteorology Institute (INAM) warned in a statement that the storm system was intensifying.    "The severe tropical storm has intensified in the past few hours into a Category Three tropical cyclone, and forecasts project that the cyclone could intensify to a Category Four on April 25," it said.

Heavy rains and winds of up to 140 kilometres per hour (87 miles per hour) would follow, it added.   Mozambique's National Institute of Disaster Management (INGC) cautioned Wednesday that 692,000 people could be affected.    The INGC said it would relocate rescue equipment, including boats and helicopters previously reserved in Sofala province for victims of Idai, to Cabo Delgado where Kenneth is expected.   "We have water, we have a generator, we are prepared. We've done everything we were told to," said a hotel owner in the small town of Mucojo which is projected to be close to the eye of the cyclone.

- 'Concerned' -
"We've learned with Idai that it's a good strategy to allocate the rescue means before the cyclone..." Augusto Maita, general director of INGC told AFP.   The province of Cabo Delgado, bordering Tanzania, is also dealing since 2017 with a wave of deadly violence attributed to a jihadist group that advocates the application of Islamic law.   Volunteers of the Red Cross and Red Crescent, who had assisted in cyclone Idai rescue efforts, said teams were already "on alert".   "We are concerned about the impact that this storm could have across the three countries," regional director for Africa for the International Federation of Red Cross and Red Crescent Societies (IFC), Dr Fatoumata Nafo-Traore said.   "We are especially concerned about its possible impact in Mozambique where communities are still recovering from the devastation of Cyclone Idai," she said.   In Mozambique alone, Idai killed more than 600 people and affected 1.85 million, while over 340 died in Zimbabwe.   "Typically cyclones occur in the rainy season which is already over. This cyclone at the end of April is unusual," Comoros environment ministry expert Youssouf Hamadi told AFP.   "It confirms the increasing intensity and frequency of cyclones in the Indian Ocean" -- a phenomenon some blame on global warming.
Date: Tue, 23 Apr 2019 17:10:55 +0200

Maputo, April 23, 2019 (AFP) - A tropical system off Mozambique threatens to unleash a cyclone on the northern Cabo Delgado province just weeks after the country's central parts were ravaged by a powerful storm, meteorologists warned Tuesday.   The poor southern African country is still reeling from the impact of deadly cyclone Idai -- the most powerful storm to hit the region in recent decades -- which left about 1,000 dead in Mozambique and Zimbabwe.   The storm is forecast to make landfall late this week in Cabo Delgado province, reeling from violence at the hands of Islamists who have been terrorising villagers in remote communities for the past 18 months.   "The (weather) system we are talking about was a low pressure and today evolved into tropical depression," Aniceto Tembe, spokesman for the Mozambique Meteorology Institute told AFP in the capital Maputo.

The depression was north of Madagascar island Tuesday, approaching the Mozambique Channel where warm conditions are conducive for it to grow into a cyclone.    "We are projecting that a severe tropical cyclone may arrive and if the conditions allow it can even reach Category 3 tropical cyclone" strength -- with winds of between 140 and 160 kilometres (87 to 99 miles) per hour, he added.   "The projections indicate that the system will approach the coast of Mozambique... mainly the northern part of Cabo Delgado and the southern part of Tanzania," Tembe told AFP.   In a statement Monday, the public works ministry issued a warning of strong winds and heavy rains that could cause flooding and destruction of property in the province of Cabo Delgado and its southern neighbouring province of Nampula.   It said 80,000 people were at risk.

The centre for disaster management issued a warning Tuesday of a tropical storm with wind speeds of between 80 and 120 kilometres per hour, expected to make landfall Friday in the gas-rich district of Palma, the nerve centre of Mozambique's nascent gas industry.   Hardline Islamists have launched several deadly attacks in the Muslim-majority, oil and gas-rich Cabo Delgado province in the past year, killing about 200 people, beheading some of them, and forcing thousands from their homes.   Last month Cyclone Idai cut a path of destruction through Mozambique, Malawi and Zimbabwe on the night of March 14-15, causing damage worth about $2 billion, according to the World Bank.   In Mozambique alone, more than 600 people died among the 1.85 million affected, while over 340 died in Zimbabwe.
More ...

World Travel News Headlines

Date: Wed, 20 Nov 2019 22:35:51 +0100 (MET)

Manila, Nov 20, 2019 (AFP) - Philippine police were ordered Wednesday to arrest anyone caught vaping in public, just hours after Philippine President Rodrigo Duterte announced he would ban e-cigarettes.   The abrupt prohibition, revealed by Duterte late Tuesday adds to a growing global backlash against a product once promoted as less harmful than tobacco smoking.

Duterte, a former smoker, called the devices "toxic" and said vaping introduced "chemicals" into the user's body.   He ordered the arrest of anyone vaping publicly in a country that already has some of Asia's toughest anti-smoking rules.    No formal, written order has been made public that spells out the scope of the ban or penalties for violations.   Duterte is notorious internationally for his deadly anti-narcotics crackdown, but he has also targeted tobacco with a wide-ranging ban on smoking in public.   Citing "the order of the president", on Wednesday a statement from the head of the Philippine police ordered "effective today, all police units nationwide to enforce the ban on use of vapes; ensure that all violators will be arrested".

The ban came days after Philippine health authorities reported the nation's first vaping-related lung injury, which resulted in a 16-year-old girl being hospitalised.   Vaping has taken off in the Philippines, with speciality shops and vapers puffing away in public a common sight.     E-cigarette users were caught off guard by the ban and questioned the utility of arresting people who, at worst, were hurting themselves.   "It's inappropriate. In any case, we don't hurt people, the environment or animals," said 22-year-old student Alexis Martin.   "Why are vapers being targeted?"

E-cigarettes warm flavoured liquid to produce vapour that is free of the estimated 7,000 chemicals in tobacco smoke, but does contain a number of substances that could potentially be harmful.  Critics say that apart from being harmful in themselves, the multiple exotic flavours of e-cigarette liquids appeal particularly to youngsters and risk getting them addicted to nicotine.

The devices have become hugely popular in the past decade but a rash of vaping-linked deaths and illnesses in the United States is feeding caution about the product, already banned in some places.   In September 2019 India became the latest country to ban the import, sale, production and advertising of e-cigarettes, citing in particular concerns for its youth.   The devices are already banned in several places such as Brazil, Singapore, Thailand and the US state of Massachusetts.
Date: Wed, 20 Nov 2019 17:17:39 +0100 (MET)

Lagos, Nov 20, 2019 (AFP) - Nigerian President Muhammadu Buhari on Wednesday announced a campaign to end defecation in public, in a country where tens of millions of people going to the toilet outside poses a major health risk.    "Nigeria has committed to end open defecation throughout the country by 2025," a statement by the presidency said a day after the United Nations marked World Toilet Day.     The decree set up a new body called the Clean Nigeria Campaign Secretariat to ensure "that all public places including schools, hotels, fuel stations, places of worship, market places, hospitals and offices have accessible toilets and latrines within their premises". 

According to the United Nations children agency, UNICEF, Nigeria has amongst the highest number of people practising open defecation in the world, estimated at over 46 million people -- almost a quarter of the population.   Around Nigeria each year 87,000 children die from diarrhoea, with more than 90 per cent of deaths caused by a lack of water, sanitation and hygiene, according to the World Bank.   The new agency will be disbanded when the goal of ending open defecation has been met, the presidency said.
Date: Wed, 20 Nov 2019 12:59:15 +0100 (MET)

Kampala, Nov 20, 2019 (AFP) - Global health charity Marie Stopes said Wednesday it had recalled hundreds of thousands of faulty condoms on sale in Uganda, where HIV rates are among the highest in the world.   The recall followed a warning from Uganda's National Drug Authority (NDA) that the Life Guard brand condoms had failed manufacturing "quality tests" because they contained holes and may burst.   The affected condoms were manufactured by India-based MHL Healthcare in April 2019 and have an expiry date of April 2024, the government regulator said.   Marie Stopes Uganda spokesman David Kamu told AFP on Wednesday that the two affected batches each contained "around 400,000" condoms.

Earlier reports had suggested millions of condoms could have been involved but NDA spokesman Fred Ssekyana told AFP the figure was below one million.   Marie Stopes Uganda said more than half of the condoms of concern had been recalled.   "While the LifeGuard brand follows strict quality controls, unfortunately two recent batches have fallen short of the quality we demand," the charity's country director, Carole Sekimpi, said in a statement Tuesday.   Marie Stopes is the largest and most specialised sexual reproductive health organisation in Uganda, the charity says on its website.   According to UNAIDS, 1.4 million Ugandans are living with HIV.   Last year 53,000 people were newly infected with the disease in the East African country, the UN agency said.
Date: Wed, 20 Nov 2019 15:08:18 +0100 (MET)

Luanda, Nov 20, 2019 (AFP) - Angola recorded an outbreak of polio this week after almost a decade without cases of the paralysing viral disease, the government said.   The highly infectious condition mainly affects children under the age of five. It attacks the nervous system and can lead to total paralysis, or in some cases death.   "After seven years without polio we are unfortunately confronted with a difficult situation," Angola's health minister Sante Silvia Lutucuta said on Monday, at the launch of a new vaccination campaign in the capital Luanda.   "We have recorded 44 new cases in ten of the country's 18 provinces," she added.

The vaccination campaign is expected to reach 2.5 million children aged five and under.   "All children must be protected by three doses of the oral anti-poliomyelitis vaccine," said Lutucuta, adding that the campaign would span over two weeks to "control the epidemic".   Two out of three strains of the wild polio virus have been eradicated so far, according to the World Health Organization (WHO).           While only 33 wild polio cases were reported globally last year, vaccine-derived polio still breaks out sporadically in some parts of Africa and Asia.    The Centers for Disease Control and Prevention has recommended that all travellers to Angola be fully vaccinated against the virus.
Date: Thu, 21 Nov 2019 01:34:32 +0100 (MET)

Bangkok, Nov 21, 2019 (AFP) - A 6.1-magnitude earthquake hit north-western Laos near the Thai border early Thursday, the United States Geological Survey reported.    The shallow quake hit at 6:50 am local time (2350 Wednesday GMT), USGS said. 
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: Mon 18 Nov 2019
Source: 112.UA [edited]

Eight school classes in Odesa [Odessa] have been closed for quarantine. More than 30% of school students in these classes are sick with Coxsackie virus, a highly contagious respiratory disease, said Olena Buynevych, the director of the city hall's department for science and education, as quoted by UNN news agency.

"More than 30% of students in these classes are sick wi h acute
respiratory diseases, which include cases of cases and Coxsackievirus," the official said. She urged the parents to keep the children away from schools in case they have any symptoms of acute respiratory diseases.

The symptoms are basically the same as flu; the key difference is the rash on the palms, in case of the Coxsackievirus.

Coxsackievirus is a member of a family of viruses called enteroviruses. Enteroviruses are made up of a single strand of ribonucleic acid (RNA). The enteroviruses are also referred to as picornaviruses ("pico" means "small," so, "small RNA viruses"). They are present all over the world and spread by fecal-oral route. About 90% of infections don't cause symptoms or present with a fever only. Infants and young kids are particularly susceptible to symptomatic coxsackie.
======================
[Coxsackievirus belongs to a family of nonenveloped, linear, positive-sense, single-stranded RNA viruses, Picornaviridae and the genus _Enterovirus_, which also includes poliovirus and echovirus. Enteroviruses are among the most common and important human pathogens, and ordinarily its members are transmitted by the fecal-oral route. Coxsackieviruses share many characteristics with poliovirus. With control of poliovirus infections in much of the world, more attention has been focused on understanding the nonpolio enteroviruses such as coxsackievirus.

Coxsackieviruses are divided into group A and group B viruses based on early observations of their pathogenicity in neonatal mice. In general, group A coxsackieviruses tend to infect the skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis, and hand, foot, and mouth (HFM) disease. Both group A and group B coxsackieviruses can cause nonspecific febrile illnesses, rashes, upper respiratory tract disease, and aseptic meningitis.

Group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis (inflammation of the liver not related to the hepatotropic viruses). Coxsackie B infection of the heart can lead to pericardial effusion.

The development of insulin-dependent diabetes (IDDM) has recently been associated with recent enteroviral infection, particularly coxsackievirus B pancreatitis.

It is common for the coxsackievirus to cause a febrile upper respiratory tract infection with sore throat and/or a runny nose. Some patients have a cough resembling bronchitis. Less commonly, coxsackievirus may cause pneumonia. Some people with coxsackievirus have a rash. In many, this is a nonspecific generalized red rash or clusters of fine red spots. The rash may not appear until the infection has started to get better.

Coxsackievirus is spread from person to person. The virus is present in the secretions and bodily fluids of infected people. The virus may be spread by coming into contact with respiratory secretions from infected patients. If infected people rub their runny noses and then touch a surface, that surface can harbor the virus and become a source of infection. People who have infected eyes (conjunctivitis) can spread the virus by touching their eyes and touching other people or surfaces. Conjunctivitis may spread rapidly and appear within one day of exposure to the virus. Coxsackieviruses are also shed in stool, which may be a source of transmission among young children. The virus can be spread if unwashed hands get contaminated with fecal matter and then touch the face. This is particularly important for spread within  day-care centers or nurseries where diapers are handled. Diarrhoea is the most common sign of coxsackievirus intestinal infection.

Most infections are self-limiting, and no specific treatment is required or available. Some options include intravenous immune globulin (IVIG), which contains antibodies and may be somewhat effective.

HealthMap/ProMED-mail map:
Odesa oblast, Ukraine: <http://healthmap.org/promed/p/51897>]
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: Tue 19 Nov 2019
Source: Caracas Chronicles [edited]

The Venezuelan Public Health Society and the Let's Defend The National Epidemiology Network issued an alert after a case of yellow fever was confirmed in the state of Bolivar, after 14 years without the disease. The Health Ministry hasn't published information about the case or issued an alert, but Venezuela must formally report it to international institutions, due to the risk to a population that isn't vaccinated, having the vector (mosquitoes) in all of the territory (increasing the odds of an epidemic), and the poor access to an epidemiologic report [about the case]. Doctor Julio Castro wrote about the case for Prodavinci.  [Byline: Naky Soto]
======================
[There is little information about this case: where and when it occurred in Bolivar state, tests used to diagnose the case, condition of the patient, and any follow-up measures taken by public health authorities. Yellow fever (YF) virus is endemic in Venezuela as it is in many South American countries.

The most recent ProMED-mail report of YF in Venezuela was in 2010, in Anzoategui state, where there were 3 probable YF cases in monkeys. This outbreak was enzootic, as determined by the Ministry of Health (see Yellow fever - South America: Venezuela (AN) monkey, susp http://promedmail.org/post/20101112.4114).

Presumably, this current case is one of spill-over from the sylvan (forest) transmission cycle. Maintenance of a high level (80-90%) of coverage is essential to prevent cases and avoid outbreaks involving the urban cycle with _Aedes aegypti_ transmission. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Venezuela:
Date: Thu 14 Nov 2019
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]

On 10 Oct 2019, the National IHR Focal Point for Sudan notified WHO of 47 suspected [human] cases of Rift Valley fever (RVF), including 2 deaths in Arb'aat Area, Towashan Village, in El Qaneb locality, Red Sea State. The suspected cases presented with high-grade fever, headaches, joint pain, vomiting. There were no hemorrhagic signs or symptoms observed. The 1st case presented to the health facility on 19 Sep 2019.

On 28 Sep 2019, a total of 14 samples were sent to the National Public Health Laboratory in Khartoum, and 5 tested positive for RVF by immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) and reverse-transcriptase polymerase chain reaction (RT-PCR). These samples were also tested for malaria and were found negative.

On 13 Oct 2019, a total of 10 suspected RVF cases were recorded in Barbar and Abu Hamed localities, of River Nile State. Of the 10 suspected RVF cases, 5 samples were tested and 4 were found positive for RVF. From 19 Sep 2019 until 11 Nov 2019, a total of 293 suspected human RVF cases, including 11 associated deaths have been reported from 6 states; including the Red Sea (120), River Nile (168), Kassala (2), White Nile (1), Khartoum (1), and Al Qadarif (1) States. The most affected age group is 15-45 years old, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5%).

These human RVF cases are concomitant with abortions and deaths among goats in the areas where the human suspected and confirmed cases have been reported. From 25 Sep through 3 Nov 2019, 21 goats in Red Sea State were reported as positive for RVF, including 4 deaths; and in River Nile State 16 goats, with 3 deaths, and 37 sheep, with 5 deaths, were confirmed positive for RVF by ELISA test at the Central Veterinary Research Laboratory in Khartoum.

Public health response
----------------------
Red Sea State
-------------
- Activation of RVF task force committee;
- printing and distribution of RVF guidelines;
- deployment of surveillance teams for daily reporting and active case finding in the affected areas;
- establishment of 2 health centers and one dispensary with a capacity of 11 beds, laboratory items, drugs, and supplies to provide health services in the affected villages;
- conducting household inspections and fogging: In Arb'aat area, a total of 452 households were inspected, out of which 30 were found positive for the presence of a competent vector; in Port Sudan, out of 1225 households inspected, 29 were found positive for the competent vector, and fogging was provided to 1949 households;
- the Veterinary Epidemiology Department of the Ministry of Animal Resources conducted vector control in 4 animal enclosures in the affected villages.

River Nile State
- A joint investigation conducted by the State Ministry of Health (SMoH) and WHO on 12 Oct 2019;
- initiation of an RVF Action plan by the SMoH and WHO;
- initiation of Integrated Vector Management (IVM), surveillance, case management, and Rapid Response Team (RRT) activities.

WHO risk assessment
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RVF is endemic in Sudan. There have been 3 outbreaks affecting humans previously documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths.

The recent floods, following heavy rains on 13 Aug 2019, caused flash floods in 17 of the 18 states, including Abyei area in West Kordofan State. These floods have favored vector abundance, distribution, and longevity. The current RVF outbreak started on 19 Sep 2019 and has affected states impacted by the floods.

The uncontrolled movements of animal populations within and outside the country borders may increase the spread of the disease to new areas.

RVF can cause significant economic losses due to livestock travel and trade restrictions, as well as high mortality and abortion rates among infected animals.

In a country where the export of livestock is one of the major sources of the national income, the current RVF outbreak, in the context of political unrest and a debilitated health system requires an urgent need for external assistance.

WHO advice
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Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that primarily affects animals but also has the capacity to infect humans. The majority of human infections result from direct or indirect contact with the blood or organs of infected animals. Herders, farmers, slaughterhouse workers, and veterinarians have an increased risk of infection.

Awareness of the risk factors of RVF infection and measures to prevent mosquito bites is the only way to reduce human infection and deaths. Public health messages for risk reduction should focus on:
- reducing the risk of animal-to-human transmission resulting from unsafe animal husbandry and slaughtering practices;
- practicing hand hygiene as well as wearing gloves or other personal protective equipment when handling sick animals or their tissues and when slaughtering animals;
- reducing the risk of animal-to-human transmission arising from the unsafe consumption of raw or unpasteurized milk or animal tissue. in endemic regions, all animal products should be thoroughly cooked before eating;
- reducing the risk of mosquito bites through the implementation of vector control activities (e.g. insecticide spraying and use of larvicidal to reduce mosquito breeding sites), use of insecticide-impregnated mosquito nets and repellents, light-coloured clothing (long-sleeved shirts and trousers);
- restricting or banning the movement of livestock to reduce the spread of the virus from infected to uninfected areas;
- routine animal vaccination is recommended to prevent RVF outbreaks. Vaccination campaigns are not recommended during an outbreak as they may intensify transmission among the herd through needle propagation of the virus;
- outbreaks of RVF in animals precede human cases, thus the establishment of an active animal health surveillance system is essential in providing early warning for veterinary and public health authorities.

WHO advises against the application of any travel or trade restrictions with the affected country based on the current information available on this event.
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[The report above provides a good overview of the development of the current Rift Valley fever outbreak. Surveillance and responses require a One Health approach since both humans and animals are affected and environmental change, in this situation extensive flooding, has promoted vector abundance. Effective vector control over extensive geographical areas is difficult to achieve and is expensive. Maintenance of herd immunity through vaccination of animals can be a successful preventive measure prior to the occurrence of cases. - ProMED Mod.TY]

[Neighbouring Egypt, which suffered introductions of RVF from Sudan in the past, has undertaken preventive measures. This relates initially to the 2 governorates bordering Sudan, namely the Red Sea and the New Valley governorates. In the Red Sea governorate, vaccination has already started. Reportedly, as of 18 Nov 2019, a total of 12 801 animals have been vaccinated, including 11 568 sheep and goats, 712 camels, and 421 cows and buffalo. The vaccination, which is free of charge, is being continued. In the New Valley governorate, 62 guidance seminars about RVF for animal breeders in the 5 provincial centers have been undertaken; the implementation of a "magnified immunization campaign for a month" is said to commence "next Saturday" (23 Nov 2019), "aimed at immunizing 120 000 cattle, goats, and sheep." Intensified surveillance in animals has, reportedly, been applied in both governorates; no suspected cases detected. - ProMED Mod.AS]