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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 ...

Malta

Malta US Consular Information Sheet
November 26, 2008

COUNTRY DESCRIPTION:
Malta is a small, developed, democratic Mediterranean island nation, positioned as a cultural stepping-stone between Europe and North Africa.
Malta became
a member of the European Union with nine other new member states on May 1, 2004, and became a full member of the Schengen area in March 2008.
Tourist facilities of all categories are widely available.
Read the Department of State Background Notes on Malta for additional information.

ENTRY/EXIT REQUIREMENTS:
Malta is a party to the Schengen agreement.
As such, U.S. citizens may enter Malta for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our fact sheet.
For further information concerning entry requirements for Malta, travelers should contact the Embassy of Malta at 2017 Connecticut Avenue, NW, Washington DC
20008, tel.: (202) 462-3611, web site: http://www.foreign.gov.mt/default.aspx?MLEV=47&MDIS=505, or the Maltese Consulate in New York City, tel.: (212) 725-2345.

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:
Malta remains largely free of terrorist incidents. No indigenous terrorist or extremist groups are known to be active in Malta, and no foreign terrorist organization has carried out an attack against U.S. interests in Malta in recent years.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site at http://travel.state.gov where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found

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

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

CRIME:
Malta has a low rate of violent crime.
Theft of unattended personal property and car stereos from vehicles is a common problem.
Visitors are strongly encouraged to secure their valuables, and be aware of pickpockets and purse snatchers.
Such criminals focus on areas and establishments frequented by tourists.
Caution is particularly urged in the Paceville nightclub area, where excessive drinking and poor crowd control have led to instances of violent behavior.
Poverty, homelessness, and panhandling are almost non-existent in Malta.
All visitors to Malta should practice the same good, common sense personal security precautions that are part of everyday life in urban areas within the U.S., particularly when spending time in areas frequented by tourists.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. The crime victim’s assistance agency is ‘APPOGG’- Support Line, tel: 179;
web site: www.appogg.gov.mt.
To learn about resources in the U.S. if you are the victim of a violent crime overseas, please also see our information on Victims of Crime.

The local equivalents to the “911” emergency line in Malta are: Police 191; Ambulance 196; Fire 199.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is available through public and private hospitals.
The quality of medical care in Malta is excellent.
Private hospitals generally offer a higher standard of service than the public hospitals, and the majority of the best doctors practice in private medical facilities.

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
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Malta.
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 Malta is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic in Malta flows on the left, requiring attentiveness and caution from visitors from right-hand drive countries such as the United States.
In addition, drivers may be erratic or undisciplined. Roads flood easily, and are often narrow, winding, and congested, with poor visibility around curves.
Traffic arteries are prone to bottlenecks and accidents.
Buses are the primary means of public transportation.
Though the bus fleet is being modernized, most buses are old, cramped, and not air-conditioned.
Taxis are safe but expensive and are not metered; it is a good practice to agree with the driver in advance on the charge.

Please refer to our Road Safety page for more information.
There is a Malta Tourist Information Office located at Freedom Square Valletta, tel. 21-237-747, web site: http://www.visitmalta.com/getting-around
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Malta’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Malta’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Malta customs authorities may enforce strict regulations concerning currency restrictions and temporary importation into or export from Malta of items such as firearms, antiquities, and any item that might be deemed to have resalable value.
It is advisable to contact the Embassy of Malta in Washington or the Consulate of Malta in New York City for specific information regarding customs requirements.
Malta’s customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters located at U.S. Council for International Business, 1212 Avenue of the Americas, New York, N.Y. 10036, issues and guarantees the ATA Carnet in the United States.
For additional information call (212) 354-4480, send an e-mail to atacarnet@uscib.org or visit http://uscib.org for details.

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

CHILDREN'S ISSUES:
For information 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 Malta are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and to obtain updated information on travel and security within Malta.
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 on the third floor of the Development House, St. Anne Street, Floriana, Valletta, telephone (356) 2561-4000.
The Consular Section’s telephone number is (356) 2156-4115, fax: (356) 2124-3229, web site: http://malta.usembassy.gov/uscit_intro.html.
The Consular Section is open to the public Monday, Wednesday, and Friday from 8:00 a.m. to 11:00 a.m.
* * *
This replaces the Country Specific Information for Malta dated April 29, 2008, to update sections on Safety and Security and Exit and Entry Requirements.

Travel News Headlines WORLD NEWS

Date: Fri 16 Aug 2019
Source: Times of Malta [abridged, edited]

The number of measles cases in Malta has soared to an unprecedented level this year [2019], with 30 cases reported in the 1st 6 months, according to the World Health Organisation.

Data recently published by the health body showed that the figures until June 2019 are in stark contrast to those for the previous years. According to the WHO data, between 2011 and 2018, there were only 11 cases reported. There were no cases reported in a number of these years, and, between 2012 and 2017, there were only 2 cases reported, one in 2013 and another 2 years later.

Earlier this year [2019], the WHO had flagged the issue [slipping vaccine rates] with a rapid increase in measles cases on a global level. At the time, preliminary figures had shown that measles cases rose 300% worldwide through the 1st 3 months of 2019 when compared to the same period last year [2018].

According to the Superintendent of Public Health, Charmaine Gauci, after a number of years with no cases of the disease, in 2018, there were 5 imported cases and one local transmission.

Most of the cases occurred in adults who were not vaccinated. "This year [2019], we have already seen over 15 locally acquired cases. Most of the cases occurred in adults who were not vaccinated," Dr Gauci said when the preliminary figures came out.

In its report on this year's [2019] data, the WHO noted a "dramatic resurgence of measles compared to previous years" in the European region, with 49 of the 53 countries in the region together having reported over 160 000 measles cases and over 100 measles-related deaths by the end of May 2019.

"High national-level coverage can mask pockets of low coverage at the local level, resulting in an accumulation of susceptible individuals that often goes unrecognised until outbreaks occur. An enhanced response is needed to protect all populations in the region from this dangerous disease," WHO said. It has set the ambitious goal of achieving measles and rubella elimination in at least 5 of its regions by 2020.  [Byline: Claire Caruana]
Date: Sun 29 Jul 2018 17:28 CEST
Source: Times of Malta [summ., edited]

The number of salmonellosis cases reported to the health authorities so far in July 2018 has surpassed that in previous years, peaking at 20 cases in July alone.

Figures supplied to The Sunday Times of Malta by the health authorities showed that so far this month [July 2018], 20 cases of the food poisoning infection have been reported, up from 11 in 2017. Since the beginning of 2018, 67 cases have been brought to the authorities' attention.

Salmonellosis is a type of foodborne illness caused by bacteria and is often more common in summer. The infection is contracted when food contaminated with the bacteria is consumed, with young children, older adults, and those with impaired immune systems being more susceptible to severe infection. Symptoms include diarrhoea, fever, and abdominal cramps and usually develop 12 to 72 hours after the infection is contracted. It usually lasts 4 to 7 days.

Just this week, the health authorities confirmed _Salmonella_ had been found in eggs from St Joseph Farm [Southern region] during sampling by the veterinary authorities as part of the Veterinary National Control programme for _Salmonella_. Eggs packed by this farm have since been recalled, with the public being advised not to consume them. The Superintendent of Public Health warned that food that has been listed as recalled should not be consumed, while the general handling of eggs should also be done with caution.

Eggs, she said, should always be cooked until both the yolk and the white are firm, while egg dishes should be cooked to an internal temperature of 71 deg C [160 deg F] or hotter. The eggs used in sauces or any other items that contain raw or lightly-cooked eggs should be pasteurized, Dr Gauci said. Hands, and any implements that come in direct contact with raw eggs, should always be thoroughly washed.  [Byline: Claire Caruana]
============================
[While undercooked eggs are a common source for human salmonellosis, it is not unclear if the finding of contaminated eggs on Malta is related to the upswing of human cases. No information is given regarding the human and egg isolates to assess if they are related. - ProMED Mod. LL]

[HealthMap/ProMED-mail map of Il-Hamrun, Malta:
Date: Mon 13 Mar 2018
From: Christian Lenart <christian@lenart.at> [edited]

We report a case of _Leishmania donovani_/_L. infantum_ in a 56-year-old man from Austria. He travelled to Malta in June 2017 and complained about itchy, partly exulcerated papules in November 2017. His wife too was suffering from the same lesions but did not consult a dermatologist, since the lesions regressed spontaneously.

The patient first contacted a dermatologist, who performed an excision showing _Leishmania_ negative granulomatous inflammation as a histological result. He was then referred to the dermatological ward of the municipal hospital. The lesions were up to 2 cm [0.8 in] in size, disseminated on all extremities.

Another excision was performed, showing plenty of amastigotes affected macrophages. He then was checked for signs of visceral manifestation, but showed no hepatosplenomegaly. The blood sample showed no conspicuity with normal haematological results and normal CRP [C-reactive protein]. The PCR test for _Leishmania_ sp. DNA was positive.

The Western blot (IgG) was positive as well, whilst immunoaffinity chromatography was negative. Skin biopsy genotyping proved a diagnosis of _Leishmania infantum_/_L.donovani_. Since the patient had multiple lesions treatment with miltefosine was initiated.

Leishmania in Malta
-----------------------------------------
While especially leishmaniasis was quite common in the early 20th century in Malta, there were hardly any cases of cutaneous leishmaniasis at the end of the century. For the last years the incidence has been stable with about 3 to 4 cases of visceral leishmaniasis, VL, per year (1).  In 2012, 3 VL and no CL cases were reported (2). All cases of leishmaniasis are caused by _L. infantum_ in Malta, transmitted from dogs to humans by _Phlebotomus perniciosus_. The 2 identified zymodemes in Malta are MON 1, causing visceral and MON 78, causing cutaneous leishmaniasis (3).

References
---------------------------------------
1. Alvar J, Vélez ID, Bern C, et al and the WHO Leishmaniasis Control Team. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012; 7(5): e35671. doi: 10.1371/journal.pone.0035671; available at <http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0035671>.
2. Government of Malta, Ministry for Health, the Elderly and Community Care: Annual report 2012; p. 46; available at <https://www.gov.mt/en/Government/Publications/Documents/Annual%20Reports/MHEC.pdf>.
3. Pace D, Williams TN, Grochowska A, et al. Manifestations of paediatric _Leishmania infantum_ infections in Malta. Travel Med Infect Dis. 2011; 9(1):37-46. doi: 10.1016/j.tmaid.2010.11.005; available at <http://www.travelmedicinejournal.com/article/S1477-8939(10)00196-1/fulltext>.
--------------------------------------
Dr Christian Lenart
Department of Emergency Medicine
Krankenhaus Hietzing (Municipal Hospital Vienna-Hietzing)
Austria
christian@lenart.at
===============================
[Leishmaniasis is endemic in Malta and cases imported from Malta to other countries are not unusual. _Leishmania infantum_ usually results in visceral leishmaniasis and the genotyping in this case could not distinguish between _L. donovani_/_L. infantum_. Miltefosine is the drug of choice for cutaneous leishmaniasis. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps: Austria: <http://healthmap.org/promed/p/63886> Malta: <http://healthmap.org/promed/p/77>]
Date: Tue, 20 Feb 2018 18:18:07 +0100

Valletta, Feb 20, 2018 (AFP) - Malta International Airport was brought to a standstill on Tuesday by a fire that left flights suspended and hundreds of passengers stranded.   Passengers were evacuated from the airport as smoke billowed through the arrivals and departure lounges, an AFP reporter at the scene said.   Firefighters worked for two hours to put out the small blaze, which began at around 1:15 pm and caused no injuries.

Airport operators said 10 outbound international flights were delayed. They added later in an online statement that operations at the terminal were resuming.   The airport said the blaze broke out in the pump room for the airport's small aquarium, located in the arrivals concourse.   "Terminal operations are now resuming, and Malta International Airport's recovery plan has been activated," it said in a statement in the late afternoon.

Hundreds of passengers were left standing outside the airport and some even on the apron.   One flight to nearby Catania in Sicily was expected to take off 11 hours later than scheduled, according to the departures timetable.   Flights to Stockholm, Cyprus, Krakow, London Gatwick and Dublin were also delayed.   Flights from British airports Heathrow and Gatwick were diverted to Catania.
Date: Fri 24 Feb 2017
Source: Times of Malta [edited]

The meningitis B vaccine shortage [is] likely to persist. Malta will have to wait its turn, manufacturers say. Global demand for the vaccine outstrips supply, manufacturers say.

A one-year-old baby died of [meningococcal] meningitis [serogroup] B, a disease against which vaccines are currently unavailable, this newspaper is informed. Sources said the baby died last month [January 2017] after contracting the disease that affects the lining around the brain and spinal cord. The Central Procurement and Supplies Unit (CPSU) was informed that the local agent for the meningitis B vaccine had a stock of vaccines available in a number of local pharmacies, a Health Ministry spokeswoman said.

The representatives of international pharmaceutical company GlaxoSmithKline (GSK) in Malta were in liaison with their suppliers to hasten further delivery, and the CPSU was in liaison with both companies to monitor the situation, the spokeswoman added.

The ministry was also asked about the baby's death, but no reference was made to it in its reply late yesterday [23 Feb 2017] evening.

The government does not supply the vaccine against the specific strain that affected the infant, which can, however, be purchased from private hospitals and pharmacies. Paediatricians said private hospitals had purchased the vaccine from pharmacies abroad, but these too had since run out.

According to one paediatrician, the unavailability of such a vaccine in light of the baby's death was very worrying, particularly to parents. Another paediatrician, however, warned against the matter getting out of hand, saying the issue was not as worrying as parents were making it out to be. Babies who were not vaccinated were not in any immediate danger, he said.

A spokeswoman for the local representative of GSK confirmed that the vaccine was not available and it would not be for some time. She said no fixed date had yet been given as to when a supply would be made available to the local market. According to the spokeswoman, the vaccine was in high demand all over the world, and as GSK [GlaxoSmithKline] had agreements with a number of governments abroad, supplies would be shipped to these countries 1st. At present, demand exceeded the quantity manufactured.

"It's important to understand that, in these cases, we need to stock enough for boosters, so before sufficient doses are available, this will not be made available," the GSK spokeswoman said.

According to the Maltese Paediatric Association, about 10 cases of meningitis have been reported among children. The signs of meningitis are fever, severe headache, neck stiffness, vomiting, dislike of bright light and drowsiness. Infants and younger children may not always show such symptoms but, instead, feed poorly or become very lethargic.  [Byline: Claire Caruana]
===================
[Although there are at least 13 _ Neisseria meningitidis_ serogroups, based on the antigenic specificity of their capsular polysaccharides, disease due to serogroups A, B, C, Y, and W is most common. Meningococcal vaccines contain capsular polysaccharide for _Neisseria meningitidis_ serogroups A, C, Y, and W, either alone or conjugated to protein. The conjugate capsular polysaccharide vaccines are preferable, because, unlike the polysaccharide vaccines, conjugate vaccines immunize infants, reduce the carriage of meningococci in the throat and thus its transmission, as well as confer a more sustained immune response, and, therefore, longer-term protection than the polysaccharide vaccines.

Serogroup B vaccines are based upon meningococcal B outer membrane vesicle protein antigens, because group B polysaccharide is poorly immunogenic in humans and is a potential auto-antigen. At least 2 serogroup B meningococcal vaccines -- Bexsero (GlaxoSmithKline, GSK) and Trumenba (Pfizer) -- are available.

Meningococcal disease often occurs without warning and frequently progresses rapidly to death, even when it is treated appropriately. In addition, about 10-20 percent of survivors of meningococcal disease will suffer disabilities such as hearing loss, brain damage, and amputations. Vaccines are used to prevent meningococcal disease, not treat someone already ill from the disease. Immunity following use of a meningococcal vaccine is specific for the type of capsular polysaccharide the vaccine contains regarding the A, C, Y, and W polysaccharide or conjugate vaccines or the surface proteins regarding serogroup B vaccines, with no cross-protection against infection due to other meningococcal groups.

Vaccines are frequently used to prevent spread of meningococcal disease in the face of an institutional or community outbreak (<https://www.cdc.gov/meningococcal/downloads/interim-guidance.pdf>). Antibiotics are also used to prevent spread of meningococcal disease in persons who are at high risk because they have been in close contact (coughing or kissing) or lengthy contact, especially among people living in the same household.

According to the 2017 Malta National Immunization Schedule, meningococcal vaccines are not included in the series of vaccines for infants and children (<https://health.gov.mt/en/phc/pchyhi/Pages/National-Immunisation-Schedule.aspx>). In the U.S., vaccination against meningococcal disease due to serogroups A, C, Y, and W is only recommended for children aged 2 months through 10 years who are at increased risk for meningococcal disease, i.e., have complement component deficiencies, have functional or anatomic asplenia (including sickle cell disease), are in the risk group for an outbreak for which vaccination is recommended, or are traveling to or residing in regions where meningitis is epidemic or hyper-endemic (for specifics, see Table at <https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6324a2.htm#Tab>). The serogroup B vaccines Bexsero and Trumenba have been licensed by the U.S. Food and Drug Administration (FDA) only for individuals aged 10 through 25 years. However, the European Medicines Agency has approved Bexsero for use in individuals of 2 months of age and older, and Bexsero has been added to the routine childhood immunization schedule in the UK and Ireland (<http://www.meningitis.org/menb-vaccine>).

Malta, a member of the EU, is a southern European island country consisting of an archipelago in the Mediterranean Sea, 80 km (50 miles) south of Italy, with a population of just under 450,000 residents (<https://en.wikipedia.org/wiki/Malta>). - ProMED Mod.ML]

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

Trinidad and Tobago

Trinidad and Tobago - US Consular Information Sheet
March 04, 2009
COUNTRY DESCRIPTION:
Trinidad and Tobago is a developing nation in the Caribbean composed of two islands.
The islands gained independence from the British in 1962.
>The country is one of the most prosperous in the Caribbean, largely as a result of petroleum and natural gas industries.
Tourist travel is mostly to the smaller of the two sister islands, Tobago.
Tourist facilities are widely available.
Read the Department of State Background Notes on Trinidad and Tobago for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid passport is required of U.S. citizens for entry to Trinidad and Tobago.
U.S. citizens do not need a visa for tourism or business-related visits of 90 days or less.
Work permits are required for compensated and some non-compensated employment, including missionary work.
Visas may be required for travel for purposes other than business or tourism.
For further information concerning entry, employment and customs requirements, travelers may contact the Embassy of Trinidad and Tobago, 1708 Massachusetts Avenue NW, Washington, DC
20036, telephone (202) 467-6490, or the Trinidad and Tobago Consulates in Miami or New York City.
Visit the Embassy of Trinidad and Tobago’s web site.

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:
American citizens traveling to or residing in Trinidad and Tobago should avoid large crowds and demonstrations.
While non-violent demonstrations occur on occasion, widespread civil disorder is not typical.
The downtown area of Port of Spain experienced four bombings in 2005.
While no similar incidents have occurred since that time, the perpetrator(s) have not been arrested and their identities and motive remain unknown.
Americans visiting or residing in Port of Spain are advised to exercise caution, especially in crowded urban areas.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Incidents of violent crime have been steadily on the rise on both islands.
Visitors to Trinidad and Tobago should exercise caution and good judgment as in any large urban area. Particular caution should be exercised when traveling after dark from Trinidad's Piarco Airport as incidents have been reported involving armed robbers trailing arriving passengers from the airport and accosting them in remote areas of the airport parking lot, on the highway leading from the airport to downtown Port of Spain, and outside the gates of residences.
Areas of metro Port of Spain to avoid include Laventille, Morvant, Sea Lots, South Belmont, scenic rest stops (after dark), walking across the Queen’s Park Savannah, and downtown Port of Spain (after dark), as tourists are particularly vulnerable to pick pocketing and armed assaults in these locations.
Holiday periods, especially Christmas and Carnival, often see an increase in criminal activity.
Violent crimes, including assault, kidnapping for ransom, sexual assault and murder, have involved foreign residents and tourists, including U.S. citizens.
The perpetrators of many these crimes have not been arrested.
Burglaries of private residences are common.
Robbery is a risk, particularly in urban areas and especially near ATMs and shopping malls.
Visitors should avoid wearing expensive jewelry or displaying large amounts of money in public.
One victim was targeted for driving an expensive new car.
In some cases, robberies of Americans have turned violent and resulted in injuries after the victim resisted handing over valuables.
In Tobago, the media have reported an increase in the incidence of violent crimes.
While local authorities have announced increased measures to fight crime, the U.S. Embassy advises that when making reservations at private accommodations, visitors should ensure that 24-hour security is provided.
There have been reports of home invasions in the Mt. Irvine area, and robberies occurring at the waterfalls and on isolated beaches in Tobago where visitors are not in a group.
Visitors to Tobago should ensure that all villas or private homes have adequate security measures.
Visitors to Trinidad and Tobago are also advised to be cautious when visiting isolated beaches or scenic overlooks where robberies can occur.
Visitors should not walk alone or in unfamiliar areas.
Valuables left unattended on beaches and in other public places are vulnerable to theft.
Visitors should avoid neighborhoods known for high crime rates.
When in doubt, consult the establishment where you are staying to identify areas to be avoided.
Taxis available at the major hotels or through pre-arranged pick-ups with reputable companies are generally safe and reliable.
The U.S. Embassy urges caution in the use of the small buses or vans in Trinidad, known as "Maxi Taxis" (full-size inter-city buses are usually safe.)
Unmarked shared taxis authorized to pick up passengers will have the letter 'H' as the first letter on their license plates.
Some shared taxis and maxi taxis have been linked to petty crime and serious traffic accidents.
Valuables including travel documents should not be left unattended in parked cars, especially in parking lots, as several thefts have been reported.

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

The local equivalent to the “911” emergency line in Trinidad and Tobago is:
Police 999 or 555, Fire 990, Ambulance-Trinidad 811, Ambulance-Tobago 639-4444, and Coast Guard (yachting emergencies) 634-4440.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
We strongly recommend that you obtain comprehensive travel and medical insurance before traveling.
Medical care is limited compared to that in the United States.
Care at public health facilities is significantly below U.S. standards for treatment of serious injuries and illness, with limited access to supplies and medications.
While care at some private facilities is better than at most public health facilities, patients may be expected to prove their ability to pay before assistance is given, even in emergency situations.
Patients requiring blood transfusions are expected to arrange for at least the same amount to be donated on their behalf.
Physicians and nurses may go on strike, causing serious strain on both public and private medical resources.
Ambulance service is extremely limited both in the quality of emergency care and in the availability of vehicles in many parts of the country.
According to the Trinidad & Tobago Ministry of Health, recent monkey deaths on the island of Trinidad have been laboratory confirmed as due to yellow fever.
Although no human cases have been reported since 1979, the virus appears to be permanently embedded in forested areas of the central/south region of the island of Trinidad.
Evident outbreaks among monkeys may appear every 10-20 years after long periods of epidemiologic silence.
CDC continues to recommend yellow fever vaccine for travel to Trinidad & Tobago.
Dengue fever presents significant risk in urban and rural areas.
Precautions against insect bites are recommended such as wearing long sleeved shorts/trousers, the use of bed nets and insect repellants which contain DEET, picaridin (KBR 3023), Oil of Eucalyptus/PMD, or IR 3535.
Ciguatera poisoning is prevalent and results from eating reef fish such as grouper, snapper, amberjack, and barracuda.
The toxin remains even when fish is well cooked.
Marine hazards include corals, jellyfish, sharks, and sea urchins.
Heed posted warnings at organized beaches, and do not bathe at unmarked, unpatrolled beaches.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Trinidad and Tobago.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
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 Trinidad and Tobago is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic moves on the left in Trinidad and Tobago.
Most vehicles are right-hand drive, but left-hand drive vehicles are permitted.
Rental cars are available, and are generally right-hand drive.
A U.S. driver's license and/or an International Driving Permit are valid for up to 90 days after arrival.
Seatbelts are required for drivers and front seat passengers, and cars may be pulled over and drivers fined for not wearing seatbelts.
Trinidad has several good four-lane highways and one controlled-access highway.
However, road quality decreases quickly on secondary roads.
Rural roads are narrow and often have deep drainage ditches on either side.
Some are in poor repair, and are frequently congested.
Night travel should be avoided other than on major highways.
Roadside assistance exists, but is limited and may be subject to lengthy delays.
The Beetham Highway, a main thoroughfare in and out of the city, is dangerous if your vehicle has broken down.
If your vehicle is drivable get out of the area before seeking help.
The Ministry of Works and Transport is responsible for road conditions and safety in the country.
Emergency ambulance services exist but may take prolonged amounts of time to reach the site of an accident and may not provide service in rural areas.
Trinidadian drivers may use hand signals to indicate turning, stopping, or slowing, which do not necessarily correspond to hand signals used in the United States.
Trinidadian drivers are generally courteous, but can be flexible with the rules of the road.
For example, cars traveling north on a two way street may cross into the southbound lane to stop and let passengers out.
Visitors need to be attentive and alert.
Intoxicated drivers on the road are a particular concern on the weekends, especially after dark when many locals are going to or returning from social events.
Drivers should take extra precaution on narrow and winding roads leading in and out of beaches and small towns in Trinidad and Tobago.
As always, defensive driving is strongly encouraged.
The country has an extensive system of taxis, maxi-taxis (vans) and some larger buses.
Although the larger inter-city buses are generally safe, the maxi-taxis have been linked to many road accidents and some instances of crime.
Fares should be agreed upon in advance.
Taxis will often stop at any point along the road to pick up or discharge passengers, often with little or no warning.

Please refer to our Road Safety page, and the Trinidad and Tobago’s Ministry of Tourism home page for more information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Trinidad and Tobago’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Trinidad and Tobago’s air carrier operations.
For more information, travelers may visit the FAA web site.

MARINE SAFETY AND OVERSIGHT:
Visitors arriving in Trinidad and Tobago aboard a private vessel must register any firearms with local customs authorities.
Failure to declare firearms or making false customs declarations is a serious offense.
U.S. citizens have been jailed and fined for possession of unlicensed firearms and ammunition, attempting to export ammunition, making false customs declarations and not declaring their firearms.
There is a small community of private boat owners who stay in Trinidad temporarily during the hurricane season.
There have been several incidents within the past few months in which vessels were boarded and the occupants were assaulted and robbed.
Sailors should report any incidents to the Coast Guard and local police, and are encouraged to check with the Trinidad and Tobago Coast Guard and yacht facility managers for current information.

SPECIAL CIRCUMSTANCES:
Trinidad and Tobago is prone to occasional earthquakes, though no major earthquake has hit in recent history.
Tobago has suffered extensive damage from only two hurricanes since 1963.
In 2004, parts of Tobago were severely affected by flooding and mudslides from Hurricane Ivan and several other major storms that followed soon thereafter.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) website.

Travelers are cautioned against wearing military or camouflage clothing in public, as it is against local laws to do so, unless they are in Trinidad and Tobago on official military business.

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 Trinidad and Tobago laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Trinidad and Tobago 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.

Many of the US citizens incarcerated in Trinidad and Tobago were arrested attempting to transport suitcases or packages containing drugs in or out of the country.
Even if a package or suitcase is being carried for someone else, the traveler is liable for its contents.
Americans should be aware that cursing and use of foul language in public is a criminal offense in Trinidad and Tobago subject to arrest and fines.
Several Americans have been arrested for this offense. While the penalty for public cursing is usually a fine, it can cause considerable disruption in travel plans due to arrest procedures, requirements to appear at hearings, and even incarceration if bail cannot be posted.

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 Trinidad and Tobago 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 Trinidad and Tobago.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is located at 15 Queen's Park West, telephone 868-622-6371, Consular Section fax 868-822-5555.
American Citizen Services public hours of operation are 8:00 AM – 11:30 AM, and 1:00 PM through 3:00 PM, Monday - Friday, except U.S. and Trinidad and Tobago national holidays.
For additional information, you may send email inquiries.
*

*

*
This replaces the Country Specific Information for Trinidad and Tobago dated April 13, 2007, to update sections on Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Mon 10 Jun 2019
Source: Saturday Express [edited]

There have been 17 malaria cases thus far in Trinidad and Tobago in 2019, and 13 are Venezuelans. One case is a Trinbagonian, one is from Uganda, one is from Ghana, and one is from Guyana.

This was disclosed by health minister Terrence Deyalsingh as he responded to a question from Oropouche West MP Vidia Gayadeen-Gopeesingh on whether there was truth to social media reports that many Venezuelan nationals seeking medical attention at Port of Spain and San Fernando general hospitals have malaria and are HIV-positive.  [Byline: Ria Taitt]
=========================
[It is noteworthy that 13 of the 17 imported cases are from Venezuela. Over the past few years, malaria has surged in Venezuela and is not endemic and widespread, with no control policy and a lack of basic drugs. This is a clear threat to neighbouring countries, where imported cases can start new local transmission, so-called "introduced malaria."

"Trinbagonian" refers to a native or inhabitant of Trinidad and Tobago. All malaria cases are imported, and Trinidad and Tobago is indeed regarded as a malaria-free country. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
Date: Thu 29 Mar 2018
Source: Daily Express [edited]

This media source quotes the Health Minister as saying they're imported cases:

"speaking during a news conference at the Ministry of Health in Port of Spain, Deyal Singh, said the cases of malaria in T&T are persons who visited other countries where malaria is present and returned to the country."  [Byline: Camille Hunte]
----------------------------------------
Communicated by
Viki Hansen-Landis
International SOS
=======================
[ProMED thanks Viki Hansen-Landis, International SOS, for informing us about the statement by Deyal Singh that all the 13 cases diagnosed in Trinidad and Tobago are imported cases. However, with a tropical climate and the presence of Anopheles mosquitoes, there is always a risk that malaria may be reintroduced.

A map of Trinidad & Tobago: <http://healthmap.org/promed/p/28>. - ProMED Mod.EP]
Date: Fri 27 Apr 2018
Source: News Day [edited]

With the start of the wet season less than 2 months away, former Health Minister Dr Fuad Khan has described the resurgence of the mosquito-borne disease malaria as "worrying" due to flooding, which occurs in central and south Trinidad every year.

Khan was commenting on World Malaria Day (WMD) 2018 observances themed: "Ready to Beat Malaria."

He observed that while Trinidad and Tobago has been relatively malaria free since 1965, he said the nation was witnessing a "re-emergence of this dreaded disease," as the Ministry of Health has reported 13 cases as of 30 Mar 2018.

He said the number of malaria cases has ranged between 7 and 24 cases over the past 10 years.

"This new development is worrying for a society that has constant issues with flooding, particularly in central and southern areas of Trinidad. Even though malaria was said to be eradicated in 1965, because of our tropical conditions, vast swamplands and thickly forested areas, our environment is still an easy target for the importation of the female anopheles mosquito containing a plasmodium parasite that is then transmitted from one person to another by that infected mosquito," he said. "Therefore, its eradication should not be taken for granted."

Khan said TT was able to begin to get ahead of the malaria problem when in 1944, the New York-based Rockefeller Foundation came to Trinidad to begin testing for the anopheles mosquito utilizing dichlorodiphenyltrichloroethane, commonly known as DDT, which is a larvacide for the spraying of the mosquitoes.

"While we acknowledge the dangers malaria poses to the people of Trinidad and Tobago, we must emphasize the need for the population to do its part in preventing the spread of this disease. We can do so by getting rid of pools of stagnant water, clearing bushes from around houses and planting lemon grass, which can all reduce the number of mosquitoes nearby," he said. "Do your part. Be responsible," he said.

According to the Centres for Disease Control and Prevention, people with malaria often experience fever, chills, and flu-like illness. Left untreated, they may develop severe complications and die.
================
[It is not clearly stated in the text, but we presume that the 13 cases were infected in Trinidad and Tobago and are not imported cases. If that is the case, the previous Minister of Health is indeed right that it is a serious situation because the island thus has sustained local transmission or autochthonous malaria. However, Trinidad and Tobago is not listed as a country with malaria in the 2017 WHO World Malaria Report (<http://www.who.int/malaria/publications/world-malaria-report-2017/wmr2017-regional-profiles.pdf?ua=1>), and thus the 13 cases may indeed be imported cases.

It is also not clear whether it was _Plasmodium falciparum_ or _Plasmodium vivax_. ProMED will be happy for a clarification from the authorities. - ProMED Mod.EP]

[HealthMap/ProMED-mail map:
Trinidad & Tobago: <http://healthmap.org/promed/p/28>]
Date: Fri 10 Nov 2017
Source: Loop [edited]

Agricultural economist Omardath Maharaj is calling for Government to be more proactive regarding post-flooding food safety policies after a number of leptospirosis cases were reported in South Trinidad. According to media reports, 13 cases of leptospirosis were reported at the San Fernando General Hospital.

It is thought the cases connected to unhygienic conditions due to recent flooding in parts of South Trinidad.

Newsday reported that 2 people have since died from the disease.

Maharaj, who represents the Tableland Pineapple Farmers Association and the Felicity Charlieville Fishing Association, is asking what extra measures are being put in place for testing of local produce, meat and shellfish to ensure that the disease is not being spread.

"There has been minimal, if any, information being distributed to the national community as it relates to flooding, food security, diseases (leptospirosis, cholera, meningitis etc) and bacteria (_Salmonella_, _E. coli_, etc)."

"Certainly, I am not aware of any national lessons learnt post-Tropical Storm Bret and the more recent flooding disaster towards mitigating the unsustainability and vulnerability of the local food system as it relates to preserving national food and nutrition security."

"Research suggests that the lack of important information and active surveillance compounds the fact that the level of awareness of these issues is low in the country."

"Leptospirosis, particularly, is still under-reported, and considered to be of significant public health importance. The recent food poisoning of young Tobagonian students in receipt of meals from the School Nutrition Programme is a living case study of our vulnerability," Maharaj said. Maharaj is asking the Ministry to update the public as to whether that has been an increase in the number of persons seeking medical aid for infections or diseases related to recent flooding, such as leptospirosis.

He is also asking what public awareness messages are being conveyed to the public in order to take extra precautions. He added that vendors and farmers should also be advised as to sanitary and safety protocols to ensure their harvests are not tainted. Maharaj is also asking for an update on the planned National Public Health Laboratory, which was recently announced by Health Minister Terrence Deyalsingh.

"There is a vacuum in the national conversation...these issues and inherent discussions are of national importance and every individual, family, and organization should participate in the dialogue contributing to our national development agenda," Maharaj said.
=============
[Leptospirosis is a zoonotic spirochetal infection that occurs worldwide and is transmitted to humans by exposure to soil, fresh water or food 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.

Though the CDC considers leptospirosis can be a foodborne disease, estimating an actual percentage of cases that can be attributed to food is complicated since this disease has various ways of transmission, such as contact with contaminated flood water following heavy rains that may also be simultaneously operative (<https://wwwnc.cdc.gov/eid/article/17/9/10-1766-techapp1.pdf>). - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at:
Monday 6th August 2012
A ProMED-mail post
<http://www.promedmail.org>

- Trinidad & Tobago. 3 Aug 2012. There are more than 200 reported cases of dengue in Trinidad. The mayor of Chaguanas says half of that number is in his borough.
=====================
[A HealthMap/ProMED-mail interactive map showing the location of Trinidad can be accessed at <http://healthmap.org/r/1OyH>. - ProMed Mod.TY]
More ...

Sudan

Sudan US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
Sudan is a diverse, developing country in northeastern Africa. The capital city is Khartoum. The civil war between the northern and southern regions, which began in 1
83, ended in 2005. A multi-party conflict continues in the west in Darfur, and the armed Ugandan group known as The Lord’s Resistance Army is present in the south. Security conditions are adverse in these and some other regions. Transportation networks and other forms of infrastructure are poor and do not meet western standards. Even where available, water and electric services suffer frequent outages. Read the Department of State Background Notes on Sudan for additional information.

ENTRY/EXIT REQUIREMENTS: The Government of Sudan requires all travelers to present a passport and an entry visa. Most travelers must obtain the entry visa before arrival; only American citizens who also possess a Sudanese national identification document (such as a Sudanese passport or national identification card) may apply for an entry visa at Khartoum International Airport. The Government of Sudan routinely denies visas to travelers whose passports contain visas issued by the Government of Israel or other evidence of travel to Israel such as exit or entry stamps.

Travelers must obtain an exit visa before departure from Sudan as well as pay any airport departure tax not included in the traveler’s airline ticket. Visitors may obtain the latest information and further details from the Embassy of Sudan, 2210 Massachusetts Avenue NW, Washington, DC 20008, tel.: 202-338-8565.

Travel permits issued by the semi-autonomous Government of Southern Sudan (GOSS) or by the South Sudan Relief and Rehabilitation Commission (SSRRC) are not adequate for entry to the country, although travelers may find these documents useful to present to local authorities when in the south. Personal baggage, including computers, is routinely searched upon arrival to and departure from Sudan. The authorities will seize material deemed objectionable, such as alcohol or pornography, and may detain or arrest the traveler. Travelers intending to bring electronic items should inquire about entry requirements when they apply for a visa; restrictions apply to many devices, including video cameras, satellite phones, facsimile machines, televisions, and telephones. Travelers are not allowed to depart Sudan with ivory, some other animal products, or large quantities of gold.

All visitors must register with the authorities within three days of arrival. Travelers must register within 72 hours of arrival in Sudan at the Ministry of Interior. All foreigners traveling more than 25 kilometers outside of Khartoum must obtain a travel permit from the Ministry of Humanitarian Affairs in Khartoum. This applies to all travel, including private, commercial, and humanitarian activities. Americans risk detention by Sudanese authorities when traveling more than 25 kilometers outside of Khartoum without a travel permit issued by the Ministry of Humanitarian Affairs. Travelers must register again with the police within 24 hours of arrival. The government requires a separate travel permit for travel to Darfur. These regulations are strictly enforced and even travelers with proper documentation may expect delay or temporary detention from the security forces, especially outside the capital. Authorities expect travelers to strictly respect roadblocks and other checkpoints.

Travelers who wish to take any photographs must obtain a photography permit from the Government of Sudan, Ministry of Interior, Department of Aliens.

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:
On January 1, 2008, unknown assailants shot and killed two U.S. Embassy employees - an American USAID officer and a Sudanese national driver. Terrorists are known to operate in Sudan and continue to seek opportunities to carry out attacks against U.S. interests. Terrorist actions may include suicide operations, bombings, or kidnappings. U.S. citizens should be aware of the risk of indiscriminate attacks on civilian targets in public places, which include tourist sites and locations where westerners are known to congregate, and commercial operations associated with U.S. or Western interests. Terrorists are known to have targeted both official facilities and residential compounds. Anti-American sentiment is prevalent and Americans should exercise utmost caution at all times.

The U.S. Embassy’s ability to provide consular services in Sudan, including emergency assistance, is severely limited. Many areas outside the capital of Khartoum are extremely difficult to access.

Travel in many parts of Sudan is hazardous. Outside the major cities infrastructure is extremely poor, medical care is limited, and very few facilities for tourists exist.

Conflict among various armed groups and government forces continues in western Sudan, in the states of North Darfur, South Darfur, and West Darfur. Banditry and lawlessness are also common in the west. Many local residents are in camps for internally-displaced persons, and receive humanitarian assistance for basic needs such as food, water, and shelter. Expatriate humanitarian workers have been the targets of carjackings and burglaries.

Land mines remain a major hazard in southern Sudan, especially south of the city of Juba. Visitors should travel only on main roads unless a competent de-mining authority such as the UN has marked an area as clear of mines. The armed Ugandan group known as The Lord’s Resistance Army is present along the southern border and reportedly has announced it will target Americans.
Occasional clashes between armed groups representing communal interests continue to occur in the centrally-located states of Upper Nile, Blue Nile, and Bahr al Ghazal. Banditry also occurs.
Sudan shares porous land borders with nine other countries, including Chad, the Central African Republic, Uganda, Democratic Republic of Congo, Ethiopia, and Eritrea. Conflict in these countries occasionally spills over into Sudan.

Americans considering sea travel in Sudan's coastal waters should exercise caution as there have been incidents of armed attacks and robberies by unknown groups in recent years, including one involving two American vessels. Exercise extreme caution, as these groups are considered armed and dangerous. When transiting in and around the Horn of Africa and/or in the Red Sea near Yemen, it is strongly recommended that vessels convoy in groups and maintain good communications contact at all times. Marine channels 13 and 16 VHF-FM are international call-up and emergency channels, and are commonly monitored by ships at sea. 2182 Mhz is the HF international call-up and emergency channel. Wherever possible, travel in trafficked sea-lanes. Avoid loitering in or transiting isolated or remote areas. In case of emergency, contact the nearest U.S. Embassy or Consulate. In the event of an attack, consider activating Emergency Position Indicating Radio Beacons.

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: Crime is on the increase throughout Sudan. Additional security measures should be taken at places of residence to protect life and property. Anti-American sentiments can be found throughout the country. Americans should exercise caution by avoiding crowded public areas and public gatherings. Americans should avoid traveling alone. Report all instances of anti-American acts and crime targeting westerners to the American Embassy, and report incidents of crime to the Sudanese Police.

Americans should guard their backpacks or hand luggage. When traveling by air, travelers should maintain constant contact with their baggage and assure that they do not contain illicit items, such as alcohol or military ordinance. Americans have been removed from international airlines and detained when suspect items have been detected in checked baggage.

Carjacking and armed robbery continue to occur in western and southern Sudan. Sexual assault is more prevalent in the areas of armed conflict. Travelers who do not use the services of reputable travel firms or knowledgeable guides or drivers are especially at risk. Travel outside of Khartoum should be undertaken with a minimum of two vehicles so that there is a backup in case of mechanical failure or other emergency. Solo camping is always risky.

The Sudanese mail system can be unreliable. International couriers provide the safest means of shipping envelopes and packages, although anything of value should be insured.

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: Individuals with medical conditions which may require treatment are discouraged from traveling to Sudan. Medical facilities in Khartoum fall short of U.S. standards; outside the capital, very few facilities exist and hospitals and clinics are poorly equipped. Travelers must pay cash in advance for any medical treatment. Ambulance services are not available. Medicines are available only intermittently; travelers should bring sufficient supplies of needed medicines in clearly-marked containers.

Malaria is prevalent in all areas of Sudan. The strain is resistant to chloroquine and can be fatal. Consult a health practitioner before traveling, obtain suitable anti-malarial drugs, and use protective measures, such as insect repellent, protective clothing, and mosquito nets. Travelers who become ill with a fever or a flu-like illness while in Sudan, or within a year after departure, should promptly seek medical care and inform their physician of their travel history and the kind of anti-malarial drugs used. For additional information about malaria and anti-malarial drugs please see the Center for Disease Control travelers’ health web site, http://www.cdc.gov/malaria/index.htm.

Officially, people with HIV are not granted a visa and are not permitted to enter Sudan. A negative HIV test result must be presented at a Sudanese embassy or at Khartoum airport in order to obtain a visa. However, anecdotal reports indicate this requirement is not enforced in practice. Please confirm this requirement with the Embassy of Sudan at www.sudanembassy.org.

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 Sudan is provided for general reference only, and may not be accurate in a particular location or circumstance.

Road conditions throughout Sudan are hazardous due to erratic driver behavior, pedestrians and animals in the roadways, and the lack of basic safety equipment on many vehicles. Only major highways and some streets in the cities are paved; many roads are narrow, rutted, and poorly maintained. Local drivers do not observe conventions for the right-of-way, stop in the road without warning, and frequently exceed safe speeds for road, traffic, and weather conditions. Driving at night is dangerous and should be avoided if possible; many vehicles operate without lights.

In the north and west, dust storms and sand storms, known locally as haboobs, greatly reduce visibility when they occur. Roads in these areas can be quickly covered with shifting sand at any season of the year. Roads in southern Sudan often are impassable during the rainy season, from March to October.
U.S. citizens are subject to the laws of the country in which they are traveling, including traffic laws. In Sudan vehicles have the steering wheel on the left side and drivers use the right side of the road.

Traffic from side streets on the right has the right-of-way when entering a cross street, including fast-moving main streets. Traffic on the right has the right-of-way at stops. Right turns on a red light are prohibited. Speed limits are not posted, but the legal speed limit for passenger cars on inter-city highways is 120 kph (about 70 mph), while in most urban areas the limit is 60 kph (about 35 mph.) The speed limit in congested areas and school zones is 40 kph (about 25 mph).

Many local drivers carry no insurance despite the legal requirement that all motor vehicle operators purchase third-party liability insurance from the government. Persons involved in an accident resulting in death or injury must report the incident to the nearest police station or police officer as soon as possible. Persons found at fault can expect fines, revocation of driving privileges, and jail sentences, depending on the nature and extent of the accident. Persons convicted of driving under the influence of alcohol face fines, jail sentences, and corporal punishment.

Americans may use their U.S. driver's licenses for up to 90 days after arrival in Sudan, and then must carry either an International Driving Permit (IDP) or a Sudanese driver's license. There are no restrictions on vehicle types, including motorcycles and motorized tricycles.

Public transportation is limited to within and between major urban areas. Passenger facilities are basic and crowded, especially during rush hours and periods of seasonal travel. Schedules are unpublished and subject to change without notice. Vehicle maintenance does not meet U.S. standards. There is routine passenger train service on the route from Khartoum to Wadi Halfa (on the border with Egypt) and to Port Sudan (on the Red Sea.) Bus service between major cities is regular and inexpensive. Intra-city bus service in the major urban areas is regular, but most buses and bus stops are privately-operated and unmarked. Taxis are available in the major cities at hotels, tourist sites, and government offices. The motorized rickshaws in common use in Khartoum are unsafe. Travelers are encouraged to hire cars and drivers from reputable sources with qualified drivers and safe vehicles. Irregularly-scheduled mini-buses provide some public transit to rural communities; many areas lack any public transportation.

Please refer to our Road Safety page for more information.

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

Enforcement of aviation safety standards in Sudan is uneven; civil aviation in Sudan continues to experience air incidents and accidents, including 5 crashes with at least 64 fatalities between November 8, 2007, and June 30, 2008. Incidents included engine failures, collapsed landing gear, and planes veering off the runway. Whenever possible, Americans traveling to Sudan despite the ongoing travel warning are advised to travel directly to their destinations on international carriers from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA’s International Aviation Safety Assessment (IASA) program. Adverse seasonal weather conditions, such as dust or sand storms in the north between April and June and severe rain storms in the south between March and October, cause frequent flight cancellations.

Two hijackings originated in Sudan in 2007; no passengers were harmed.

SPECIAL CIRCUMSTANCES: In November 1997, the U.S. imposed comprehensive financial and commercial sanctions against Sudan, prohibiting U.S. transactions with Sudan. Travelers intending to visit Sudan despite the Travel Warning should contact the Department of the Treasury, Office of Foreign Assets Control (OFAC), Office of Compliance, telephone 1-800-540-6322 or 202-622-2490, regarding the effect of these sanctions.

Travelers must be prepared to pay cash for all purchases, including hotel bills, airfares purchased locally, and all other travel expenses. Major credit cards, including Visa, MasterCard, or American Express, cannot be used in Sudan due to U.S. sanctions. Sudan has no international ATMs. Local ATMs draw on local banks only.

Travelers, including journalists, must obtain a photography permit before taking any photographs. Even with a photography permit, photographing military areas, bridges, drainage stations, broadcast stations, public utilities, slum areas, and beggars is prohibited.

Sudan is a conservative society, particularly in the capital and other areas where the Muslim population is the majority. Alcohol is prohibited by law and modest dress is expected. Loose, long-sleeved shirts and full-length skirts or slacks are recommended attire for women visitors. Women who are not Muslim are not expected or required to cover their heads. Men may wear short-sleeved shirts but short pants are not acceptable in public.

Please see our information on 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 Sudanese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in alcohol or illegal drugs in Sudan 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 as well in Sudan.

Sudan’s Public Order Courts have continued to serve as the state mechanism for morality enforcement since the early 1980's. Today the court still issues punishments ranging from fines, to lashings, to lengthy prison sentences for offences such as drinking alcohol, wearing inappropriate clothing, or associating with unmarried women.

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 Sudan 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 Sudan. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Sharia Ali Abdel Latif, Khartoum, Sudan; tel: 249 1 83 774-701, http://sudan.usembassy.gov/.
* * *
This replaces the Country Specific Information dated March 12, 2008, to update sections on Entry/Exit Requirements, Medical Facilities and Health Information, Aviation Safety Oversight, and Criminal Penalties.

Travel News Headlines WORLD NEWS

Fri 11/10/2019 14:43
WorldHealthOrganizationNews@who.int

Attributable to the Federal Ministry of Health in Sudan, WHO and UNICEF

KHARTOUM, 11 October 2019 -  "Sudan has launched an oral cholera vaccination campaign in response to the ongoing outbreak of cholera. More than 1.6 million people aged one year and above in the Blue Nile and Sinnar states will be vaccinated over the coming five days.  “The announcement of the Federal Ministry of Health in Sudan on the cholera outbreak last month allowed national and state authorities, and health partners, to act quickly and respond to the outbreak.

“Since the announcement on 8 September, 262 cases of suspected cholera and eight related deaths have been reported as of 9 October in the Blue Nile and Sinnar states. No cholera-related deaths have been reported since mid-September. “The vaccines were procured and successfully shipped using funding from Gavi, the Vaccine Alliance. In addition, Gavi is providing nearly US$ 2 million to cover operational costs for the campaign.

“We joined efforts to respond as quickly as possible to contain the current outbreak of cholera and prevent it from spreading further in Sudan. The vaccination campaign kicking off today in combination with other measures including scaling up water, sanitation and hygiene activities, enhancing surveillance, prepositioning supplies and case management, will help protect people who are at highest risk.

“The first round of the campaign will conclude on 16 October and will be followed by a second round in four to six weeks to provide an additional dose to ensure people are protected for at least the next three years.  “As part of the campaign, over 3,560 vaccinators, more than 2,240 social mobilizers, and almost 70 independent monitors have been trained and deployed to the two affected states.”
Date: Wed 9 Oct 2019
Source: Dabanga [edited]

Arbaat in El Ganeb locality in Sudan's Red Sea state reported 10 new cases of suspected Rift Valley fever* on Monday and Tuesday [7 and 8 Oct 2019], bringing the total number of registered cases to 5, and 3 deaths.  Doctor Ahmed Dereir told Radio Dabanga about the spread of the disease in 8 villages in the area of Arbaat, pointing out that the cases were transferred to Port Sudan for treatment. He explained that the governor formed an emergency room of 35 people representing various government agencies, medical committees, and members of the Forces for Freedom and Change.

Ali Bayrak, head of the Community Support Committee for the residents of Arbaat called on the government for the explicit announcement of the results of laboratory testing of samples.  The state Ministry of Health committed to provide 2 doctors to the villages of the Arbaat Administrative Unit and training 10 medical staff, and 3 midwives, in addition to the distribution of water chlorination tablets and the provision of 3 spraying vehicles.

As reported by Radio Dabanga on Sunday [6 Oct 2019], one man and more than 20 head of cattle died in Arbaat on Thursday and Friday [3 and 4 Oct 2019], and that to date, so far, 3 people and 420 cows have died of the disease, now suspected to be Rift Valley fever, that hit the area of Arbaat, north of Port Sudan, over the past weeks, medical doctor Ahmed Dereir told Radio Dabanga.

According to the UN World Health Organisation (WHO) Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals but also has the capacity to infect humans. Infection can cause severe disease in both animals and humans. The disease also results in significant economic losses due to death and abortion among RVF-infected livestock.

RVF virus was 1st identified in 1931 during an investigation into an epidemic among sheep on a farm in the Rift Valley of Kenya, and most cases occur in Sub-Saharan Africa.

Key facts:
- Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals but can also infect humans.
- The majority of human infections result from contact with the blood or organs of infected animals.
- Human infections have also resulted from the bites of infected mosquitoes.
- To date, no human-to-human transmission of RVF virus has been documented.
- The incubation period (the interval from infection to onset of symptoms) for RVF varies from 2-6 days.
- Outbreaks of RVF in animals can be prevented by a sustained programme of animal vaccination.
==================
[On Wed 9 Oct 2019, villages in the area of Arbaat in El Ganeb locality in Red Sea state reported 9 new cases suspected to be Rift Valley fever, bringing the total number of reported cases to 65 (<https://www.dabangasudan.org/en/all-news/article/nine-more-cases-of-rift-valley-fever-in-sudan-s-red-sea-state>). In addition to the Red Sea state outbreak mentioned above, a separate report indicates that Rift Valley fever is occurring in Sudan's River Nile state (see Rift Valley fever - Sudan: (RS,NR) human, animal, alert, OIE Archive Number: http://promedmail.org/post/20191014.6726088). These 2 Sudan states mentioned above are adjoining, so it is not surprising that suspected or confirmed Rift Valley fever (RVF) outbreaks are occurring there simultaneously. The Ministry of Health is investigating the outbreaks in both states. Not only are these outbreaks a human health problem, they are clearly an animal health problem as well, with 420 cattle reported dying of the disease. A One Health response is urgently needed, with participation of physicians, veterinarians and entomologists. There was evidence of RVF virus in the neighbouring Central African Republic this year (2019). Last year (2018), human and animal cases occurred in neighboring South Sudan (see Valley fever - South Sudan (09): (EL) human, animal, WHO http://promedmail.org/post/20180410.5735975).

If focal geographic areas of transmission are identified in this Sudan situation, increased surveillance of people and livestock should be initiated and livestock vaccination considered. RVF-infected livestock can pose a significant risk to humans in contact with them, often livestock owners and veterinarians. Abortions in livestock with a loss in productivity present an economic problem for many ethnic groups that depend on them for livelihoods.

The above report mentions abortion storms in a River Nile state outbreak that could have had serious economic, social and public health consequences. It is likely that RVF virus will persist in this area in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods and hatch when flooded during future rain events, with subsequent emergence of infected females ready to transmit the virus. This risk provides justification for maintaining livestock of the area well vaccinated into the future. - ProMED Mod.TY]

[A media (radio) report on an event of human and animal disease, in Sudan's area of Arbaat, north of Port Sudan, Red Sea state, caused by an "unknown fever" killing 3 people and 420 cows, was posted by ProMED-mail on 6 Oct 2019 as "undiagnosed," RFI (http://promedmail.org/post/20191006.6712623). The commentary suggested RVF as possible etiology, requesting further information. According to Sudan's official OIE report, dated 13 Oct 2019, an event of RVF has been diagnosed in "Arabaata dam area, Alghunub Wa Alolaib, Red Sea state" (http://promedmail.org/post/20191014.6726088), the animals affected being goats, which are thus considered, in this event, the virus' primary victims and main source of human infection, directly or through vectors. The samples from the goats were found RVF-infected by ELISA. In difference with the earlier media (radio) report, the OIE report indicated that there are "no cattle and sheep in this area." A media report dated 12 Oct 2019 (<https://khartoumstar.com/en/2019/10/12/ministry-of-health-rift-valley-fever-in-northern-sudan/>) reported RVF "emerging" in Sudan's River Nile state, naming the locations Berber, north of Bawqa, Ftouar, Joule and Sulaimaniya, and the Artoli region of the East Bank. The report cited Hatem Fadl, an official in the epidemiology and emergency department at the Federal Ministry of Health, saying that "4 cases of Rift Valley fever were diagnosed among 17 samples taken last week, [which] were sent to the Central Laboratory in Khartoum." Hatem pointed out that the Federal Minister of Health commissioned a team to investigate the injuries, [which] arrived in the villages of Artoli, Al-Bawqa, and Fatwwar [Fri 11 Oct 2019], before the disease was officially announced (12 Oct 2019). Additional data were included in the same media source on 13 Oct 2019 (<https://khartoumstar.com/en/2019/10/13/attempts-to-control-rift-valley-fever-in-the-nile-river-state/>). No details on animal cases in River Nile state have become available, nor specific lab results of the human samples. Additional information from Sudan, and clarification on the discrepancies between the media reports as far as animal species are concerned, will be welcomed. - ProMED Mod.AS]

[A map showing the location of the 2 states mentioned above can be accessed at:

HealthMap/ProMED map available at:
Date: Thu 19 Sep 2019
Source: Dabang Sudan [edited]

The Ministry of Health has reported 22 suspected cases of haemorrhagic fever in Kassala in eastern Sudan.

In a press statement, the director of emergencies and epidemics, Emtiaz Ata, told reporters that the ministry is examining suspected cases to make sure of the suspicion and to find out more about the disease.

The director-general of the Ministry of Health, Nureldin Hussein, said that the health situation in Kassala is not reassuring, and there must be measures and considerable precautions to adequately address the health issue and avoid epidemics.
========================
[It is not clear what is the cause of these suspected cases of hemorrhagic fever or whether epidemiological investigations have been carried out, laboratory tests conducted, the clinical course of the illness determined, or any specific response measures taken. Any updates from the public health personnel and physicians on the ground will be highly appreciated. - ProMED Mod.UBA]

25 September, 2019 – A shipment of 36 tons of cholera treatment medicines and supplies have arrived in Khartoum and are being prepared for distribution as part of the World Health Organization’s response activities supporting the Federal Ministry of Health in Sudan to contain and halt a cholera outbreak.

The shipment includes 5000 rapid diagnostic tests (RDTs) for immediate detection and screening of cholera patients at health facilities and high-risk areas. RDTs are an essential part of early detection and response activities as their use ensures timely management and reporting of cholera cases.

The shipment also contains medicines that can treat 2500 severely dehydrated patients, and which will be distributed to cholera treatment centres in Blue Nile and Sinnar states, where cases have been confirmed, as well as in the neighbouring at-risk states of White Nile, Kassala, Gedaref and Khartoum.

“Even with the rapid depletion of our resources, we are accelerating our coordinated response, including delivering more medicines and supplies,” said Dr Naeema Al Gasseer, WHO Representative in Sudan. “We are working around the clock with the Federal Ministry of Health, state authorities and partners to control the outbreak and prevent more deaths.”

As of 24 September, a total of 184 cholera cases have been reported, including 128 cases from Blue Nile State and 56 cases in Sinnar state. Eight cholera-related deaths have been recorded by the Federal Ministry of Health, including 6 in Blue Nile State and 2 in Sinnar State.

Open defecation, lack of clean water outside the capital city and a dilapidated health sector are serious threats in a country of about 40 million people. Cholera, a bacterial disease usually contracted from contaminated water supplies, can be fatal if not treated early.

As part of an overall integrated cholera response plan, WHO is working with the Ministry, state-level health ministries, United Nations agencies and nongovernmental organizations on surveillance of cases to monitor and control spread of the disease; maintain clean water, sanitation and nutrition; and raise awareness among at-risk communities.

To date, WHO has deployed international experts to support the ongoing response activities and has trained and deployed 9 rapid response teams, each consisting of at least 3 members, for assessment and surveillance of high-risk areas. 18 health volunteers have also been trained and deployed to conduct water quality assessments in the 2 affected States. WHO is also actively disseminating awareness messages on health and sanitation through focus group discussions with community leaders, especially women, and training workshops are ongoing for volunteers on conducting house-to-house and community visits to deliver relevant health messages.
Date: Thu, 26 Sep 2019 11:57:24 +0200 (METDST)

Khartoum, Sept 26, 2019 (AFP) - Eight people have died from cholera in Sudan including six in the war-torn state of Blue Nile, according to the World Health Organisation, amid a surge in the number of reported cases.   A total of 184 cases of cholera have been reported in the northeast African country over the past month, including 128 cases from Blue Nile and 56 in Sinnar state, WHO said in a statement late Wednesday citing health ministry records.

"Eight cholera-related deaths have been recorded by the federal ministry of health, including six in Blue Nile state and two in Sinnar state," WHO said.   "We are working around the clock with the federal ministry of health, state authorities and partners to control the outbreak and prevent more deaths," WHO Sudan head Naeema al-Gasseer said in the statement.

WHO said a shipment of 36 tonnes of cholera treatment medicines and supplies have arrived in Khartoum and are being prepared for distribution as part of the organisation's response activities.   The shipment also contains medicine to treat 2,500 severely dehydrated patients, which is set to be distributed to cholera treatment centres in Blue Nile and Sinnar states, as well as other neighbouring high-risk states.

Cholera, a bacterial disease usually contracted from contaminated water supplies, can be fatal if not treated early.   Open defecation, lack of clean water outside Khartoum, and a dilapidated health sector further increases the threats from such diseases in a country of about 40 million people.   Dozens of people died from acute diarrhoea in Sudan in 2016 after thousands of cases were reported nationwide.   Blue Nile state, which has a large ethnic minority population, has been the focus of a rebellion by the Sudan People's Liberation Army-North since 2011.   The army declared a ceasefire after the overthrow of veteran president Omar al-Bashir earlier this year.
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World Travel News Headlines

Fri 11/10/2019 14:43
WorldHealthOrganizationNews@who.int

Attributable to the Federal Ministry of Health in Sudan, WHO and UNICEF

KHARTOUM, 11 October 2019 -  "Sudan has launched an oral cholera vaccination campaign in response to the ongoing outbreak of cholera. More than 1.6 million people aged one year and above in the Blue Nile and Sinnar states will be vaccinated over the coming five days.  “The announcement of the Federal Ministry of Health in Sudan on the cholera outbreak last month allowed national and state authorities, and health partners, to act quickly and respond to the outbreak.

“Since the announcement on 8 September, 262 cases of suspected cholera and eight related deaths have been reported as of 9 October in the Blue Nile and Sinnar states. No cholera-related deaths have been reported since mid-September. “The vaccines were procured and successfully shipped using funding from Gavi, the Vaccine Alliance. In addition, Gavi is providing nearly US$ 2 million to cover operational costs for the campaign.

“We joined efforts to respond as quickly as possible to contain the current outbreak of cholera and prevent it from spreading further in Sudan. The vaccination campaign kicking off today in combination with other measures including scaling up water, sanitation and hygiene activities, enhancing surveillance, prepositioning supplies and case management, will help protect people who are at highest risk.

“The first round of the campaign will conclude on 16 October and will be followed by a second round in four to six weeks to provide an additional dose to ensure people are protected for at least the next three years.  “As part of the campaign, over 3,560 vaccinators, more than 2,240 social mobilizers, and almost 70 independent monitors have been trained and deployed to the two affected states.”
Date: Sun, 20 Oct 2019 21:29:49 +0200 (METDST)

Paris, Oct 20, 2019 (AFP) - French rail services ground to a halt in parts of the country Sunday as workers walked off the job for a third day in a dispute over train staffing levels, stranding holiday travellers.   Services in the Paris suburbs, the northeastern Champagne-Ardenne region and the southern Occitanie region, which includes Toulouse and Montpellier, were particularly affected.   The state railway company SNCF said most services would return to normal on Monday.

The industrial action began on Friday after a train in north-eastern France slammed into a truck at a level crossing, injuring 11 people.  The train driver was himself among those hurt but being the sole employee of state railway company SNCF on board had to help take care of passengers.   Unions said the incident highlighted understaffing on trains, notably the absence of ticket inspectors on some lines.

Since Friday, staff have been exercising their "right to withdraw" their labour -- a clause that allows workers to walk off the job in case of "clear and present danger to their life or health".   SNCF's management has accused the workers of abusing that right on a busy weekend for train travel, at the start of the mid-autumn school holidays.   It argues that some train lines have not had ticket inspectors for decades.
Date: Sun, 20 Oct 2019 17:53:19 +0200 (METDST)

Frankfurt am Main, Oct 20, 2019 (AFP) - Cabin crew at four Lufthansa subsidiary airlines staged a day-long strike Sunday, causing dozens of cancellations at German airports in a battle for better pay and conditions.   The walkout, called by the UFO cabin crew union, was initially set to last from 5:00 am until 11:00 am (0300-0900 GMT) but a worsening spat with Lufthansa bosses prompted the union to extend the strike until midnight.

The industrial action at Eurowings, Germanwings, SunExpress and Lufthansa CityLine led to over 100 flight cancellations, mainly hitting short-haul journeys at Hamburg airport, Munich, Berlin-Tegel, Cologne and Stuttgart, according to DPA news agency.   Frankfurt airport, the country's busiest, reported "only a few" cancellations, affecting CityLine flights.

In a statement, UFO said it had ramped up the strike after the Lufthansa group told employees the walkouts were "illegal" and "endanger your jobs".   "This is not only wrong, it also signals the next level in the threats against cabin crew colleagues," UFO said. "This behaviour must be stopped."   But the Lufthansa group downplayed the impact of the strike, with a spokesman telling DPA that "more than 90 percent of the crew members showed up on time for their shift".

The union had previously called off plans for Lufthansa workers to join Sunday's warning strike after the company offered a surprise two-percent pay hike to flight attendants at the flagship airline.   But other demands for better conditions have yet to be met and UFO has not ruled out further action, with fresh talks at all five airlines scheduled for Monday.   Bosses at the Lufthansa group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.
Date: Sun, 20 Oct 2019 06:45:19 +0200 (METDST)

Niamey, Oct 20, 2019 (AFP) - Floods in southeast Niger have forced 23,000 people to flee their homes since early October, officials said Saturday, threatening a new humanitarian crisis in a region already wracked by Boko Haram Islamist violence.   Heavy rains have caused the Komadougou Yobe river that flows through the semi-desert Diffa region into Lake Chad to burst its banks, inundating villages, flooding fields and damaging crops.   Two villages near the city of Diffa were "completely submerged" and 2,500 households have been forced to move, according to national radio the Voice of the Sahel.

Some 400 families were sheltering in a gym in the city, it added.   "We have been fighting for days to stop the water rising, but it's not working," Amadou Issa, a rice farmer, told AFP. "The sandbags we've been using to keep the water out are completely under water."   Extreme weather events are common in Niger, one of the world's poorest countries.   Between June and September 57 people were killed and more than 130,000 affected by flooding according to government figures.

The capital Niamey was hit badly in September, with the waters of the Niger river -- the third biggest in Africa -- rising to a level not seen in more than 50 years and swamping parts of the city.   Last year, drought and flooding led to food shortages in a crisis which, exacerbated by jihadist violence, left more than 10 percent of the population needing humanitarian aid.   Niger, along with neighbouring Burkina Faso, Chad, Mali and Mauritania is also struggling against escalating attacks by armed Islamists.   According to the UN's human rights agency UNHCR, the Diffa region is home to almost 120,000 refugees and 109,000 internally displaced people.
Date: Fri, 18 Oct 2019 22:45:46 +0200 (METDST)

Washington, Oct 18, 2019 (AFP) - The US moved to further hurt Cuba's vital tourism industry by tightening the ability of the country's airlines to lease aircraft.   The US Department of Commerce said it was revoking existing licenses for US companies leasing aircraft to Cuban carriers, and will deny future applications for aircraft leases.   The move could make it harder for Cuba to service its rapidly growing tourism sector, a key source of foreign revenue for the poor country.

Washington has stepped up pressure on Havana due to its support for the embattled regime of Venezuelan President Nicolas Maduro.   "This action by the Commerce Department sends another clear message to the Cuban regime -- that they must immediately cease their destructive behaviour at home and abroad," Secretary of Commerce Wilbur Ross said in a statement.

It was not immediately clear how many aircraft the move would impact.   Cuba's cash-poor carriers depend on aircraft rented from leasing companies or other airlines, which are often very old.   In May 2018, 112 people died in the crash of a 39-year-old Boeing 737 leased by national carrier Cubana de Aviacion from a small Mexican firm, Global Air.

In June of this year, US President Donald Trump announced a US ban on cruise ship stopovers by Americans on the island, forcing Havana to cut its 2019 tourism target by 15 percent to 4.3 million visitors.   Nearly 900,000 tourists visited the island on cruise ships last year, and almost 40 percent were American, according to official figures.   The announcement Friday also expanded restrictions on imports from Cuba and on products with US content that can be sold to the country.
Date: Fri, 18 Oct 2019 15:43:29 +0200 (METDST)

Accra, Oct 18, 2019 (AFP) - Floods caused by eight days of torrential downpours in north-eastern Ghana have left 28 people dead and displaced hundreds, officials said Friday.     "At the moment the death toll is 28. About 640 people in some six communities have been displaced and we are providing shelters for them," George Ayisi, spokesman for the National Disaster Management Organisation, told AFP.    "We've counted about 286 collapsed houses during this disaster and that is making life difficult for the people."

Relief items were being transported 800 kilometres (500 miles) by road from the capital Accra to the affected region on the border with Burkina Faso as meteorologists warned the rains could last into November.    "We have to just prepare for anything," Ayisi said.   So far this year 46 people have been killed in floods in the West African nation, the disaster relief agency said.   Flooding in northern and other parts of Ghana happens each year during the rainy season.    Last year, 34 people died in northern Ghana during flooding caused by heavy rains and waters spilling from a dam in Burkina Faso.
Date: Fri, 18 Oct 2019 04:33:10 +0200 (METDST)
By Patrick FORT

Bobo-Dioulasso, Burkina Faso, Oct 18, 2019 (AFP) - "They've placed us in the red zone, which means the tourists aren't coming like before. Even the aid workers don't come," said Antoine Atiou, governor of Burkina Faso's Hauts-Bassins region.   The "red zone" refers to the risk of jihadist attacks -- a top-end warning by Western embassies to travellers wanting to visit southwest Burkina and the economic capital, Bobo-Dioulasso, once a popular tourist destination.   The impact has been brutal for local businesses. The city's hotels have emptied, its heritage sites are quiet and the souvenir shops shuttered.    "It's hard, hard, hard!... We haven't seen a tourist for a fortnight," said Sanou Moumouni, a guide at the city's mosque and in the historic Kibidwe district for 22 years.   In the past he could sometimes earn 100,000 CFA francs ($167, 150 euros) in two days, he said, but he has not made 5,000 francs in the last three months.    "I'm living on loans," he said. "We no longer have work because of the murderers. We're sick of it."    The north and the east of the landlocked country in West Africa endure frequent Islamist attacks, which have claimed some 600 lives in the past four years. There have also been some raids in the west.

In December 2018, an Italian man and his Canadian companion were kidnapped on the road from Bobo to the capital Ouagadougou. Last April, the Burkinabe government said it had information that the couple was still alive, but might have been taken to another country.   Bobo-Dioulassou itself has been relatively spared as the jihadist threat expands across poor nations of Africa's Sahel region.   Ministry of tourism statistics from 2017 show that of about half a million annual visitors to Burkina Faso, fewer than 150,000 came from abroad -- down 5.6 percent from 2015.   The number of nights stayed in the country by Westerners fell from 30,000 in 2012 to fewer than 15,000 in 2017. "This trend has probably sped up in 2018 and 2019," a local tour operator said.

- Crafts and wonders -
Renowned for its traditional masks, its batik print textiles and the balafon -- a West African instrument like a xylophone -- Bobo attracted thousands of Western tourists.   The Lonely Planet guide, which notes the security situation currently prohibits travel, says the city's "tree-lined streets exude a languid, semitropical atmosphere that makes it a favourite rest stop for travellers", adding that highlights include a "thriving live-music scene and excellent restaurants". 

The city itself has an array of charms, with its grand railway station, bustling market and striking Great Mosque -- an undulating white-plastered mud structure studded with wooden poles that dominates the historic centre.   Bobo-Dioulasso is a jumping-off point to visit regional highlights like the ruined fortress of Loropeni, a UNESCO World Heritage Site. It was also a base for exploring the Dogon country in Mali, Ivory Coast and Ghana.   "Everyone came through Bobo. We really were a tourist region. Now it's over," said Benjamin Ouedraogo, owner of the Watinoma hotel and president of the professional association of hotel and restaurant owners in High Basins.   He said hotels in the region only do a third of the business they did before the attacks   To avoid closing his hotel, Ouedraogo took on a second job in the building trade. "We asked for help, but state aid is a disaster," he said, explaining that the authorities rejected applications for tax rebates and preferential tariffs on water and electricity.

- 'We subsist' -
In Kibidwe, an old neighbourhood of the city near the mosque, children play in alleys and women wash clothes in the open air, but most of the shops that catered for tourists are now shut.   Sanon Bissiri, an artist, was quick to bring out his batik prints on spotting Western journalists.    "I don't hang them every day any more, that's pointless. Since July, I haven't even sold two. All this because of those jihadists. Now I have to do masonry whenever I'm wanted."   Bissiri used to sell his textiles to an Italian association that made regular visits.   "That's over. We just get by. It's my wife who meets our needs," he said. "I come in to work each day on foot, six kilometres (nearly four miles). I can't afford medicine for my son with his cough."   Bobo's nightlife is not what it was, though the locally-brewed beer is the same.    "There's still a little activity with Burkinabe visitors," said musician Gaoussou Ben Sanou. But "there's less money, fewer dates, fewer gigs. We can't sell records".   Governor Atiou said people were reluctant to go out.   "All that weighs on economic activity. Unfortunately, this is the aim of the terrorists."
Date: Thu, 17 Oct 2019 12:37:14 +0200 (METDST)

Manila, Oct 17, 2019 (AFP) - Five people were killed and dozens were injured after a powerful earthquake hit the southern Philippines, authorities said Thursday.   The 6.4-magnitude quake struck the Mindanao region on Wednesday night, reducing dozens of houses to rubble on the southern third of the Philippines.   On Thursday afternoon, authorities said five people were killed and 53 injured, mainly in a cluster of small farming towns.   Three people were killed in landslides while another was crushed by the collapsed wall of a house. The fifth suffered a fatal heart attack, the National Disaster Risk Reduction and Management Council said.   No fatalities were reported in Mindanao's major cities. Local authorities had earlier told AFP three children were among the dead.   The Philippine seismology office has recorded more than 300 weaker aftershocks in the area since the big quake, but authorities said they do not expect the toll to rise significantly.

The disaster council's spokesman Mark Timbal told local television it had not received any reports of missing people from any of the quake-hit areas.   "People have returned home... They are OK now, unlike last night when they were terrified and slept on roads beside their homes," Zaldy Ortiz, civil defence officer of Magsaysay town, told AFP.   Local school and government holidays were announced in Magsaysay, where the landslides struck, to allow building inspectors to check structures for damage, Ortiz added.   Power was being restored in the bigger cities, but there was substantial damage to some hospitals, government buildings, schools, churches and houses in the small towns, the council said in a report.   In General Santos City, firefighters on Thursday finally put out a blaze that started at a shopping mall shortly after the quake.   The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.
Date: Thu, 17 Oct 2019 05:32:08 +0200 (METDST)
By Tom LITTLE

Kulusuk, Denmark, Oct 17, 2019 (AFP) - Kayaking past blue-white icebergs drifting along near a pristine harbour, wandering around colourful houses or trekking in the snow-capped wilderness: July and August are high season for tourists in eastern Greenland.   Many of the 85,000 tourists who visit each year head to the west coast, but eastern Greenland, with its glaciers, wilderness and wildlife starring whales and polar bears, is also drawing visitors.

Sarah Bovet, a 29-year-old Swiss artist, said it's hard to know what to expect.   "Thinking you're going to be surprised, you are even more so in reality," she said standing outside a hostel in the tiny village of Kulusuk.   Bovet was on an artistic residency in Greenland when she visited Kulusuk and its 250 souls.   Although she had imagined a small village before arriving, its stunning views and bright colours still came as a surprise.   With just one supermarket, an airport built in the 1950s by the US military to serve a Cold War radar base, and a harbour surrounded by brightly painted wooden houses, most of the villagers appreciate the extra revenue from tourism.

Justus Atuaq, a young hunter in Kulusuk, takes tourists out on sled tours in March and April -- the spring high season -- earning money that helps him feed and care for the dogs he uses for racing and hunting.   "Now I can take dogsleds for hunting, and sometimes tourists coming from other countries also want to dogsled," he said outside his wooden house.   Tourists also take boat trips during the summer high season from July to August.   Arrivals to the island grew 10 percent year-on-year from 2014 to 2017, and three percent in 2018, according to the tourist board, Visit Greenland.   Many adventure seekers and nature lovers arrive by plane, but cruise ships also bring admirers, hugging the picture perfect coastline.

- Growing strategic importance -
But they are not alone in taking an interest in the world's largest island.   The Danish territory's rich natural resources and growing strategic importance as the Arctic ice sheet melts have attracted the attention of US President Donald Trump.   The Arctic region has untapped reserves of oil, gas and minerals, as well as abundant stocks of fish and shrimp.   In August, Trump offered to buy Greenland, then called off a visit to Copenhagen over its refusal to sell.

Denmark colonised Greenland in the 1700s, granting it autonomy in 1979.    Today, many Greenlandic political parties advocate full independence.   The territory still receives an annual subsidy from Copenhagen, which was 4.3 billion Danish kroner (576 million euros) in 2017, and tourism could help it to become economically self-reliant.   Like many parts of Greenland, Kulusuk has no tarmac roads and visitors must travel by plane or boat.   The growth in tourism could put a strain on the village's infrastructure, and the sector faces unique challenges given Greenland's location, weather and the cost of travelling there.

Day tours of Kulusuk with flights from the Icelandic capital Reykjavik are 97,000 Icelandic kronur ($780, 700 euros).   Jakob Ipsen, a 48-year-old who grew up between Denmark and Greenland's west coast, runs Kulusuk's sole hotel.   The 32-room hotel stands beside a fjord, and from its dining room, guests can watch icebergs drift by during the summer.    But the region's isolation can be problematic, Ipsen admits.    "We have to get all our supplies in with the first ship for the whole summer season, and for the winter season when everything is frozen over, we have to get all our supplies in with the last ship for the whole winter," he said.

- 'They go back as different people' -
Greenland must tackle its infrastructure challenges if it wants to develop tourism, Visit Greenland says.   Government-funded work is under way to extend runways at the capital Nuuk and Ilulissat, both on the west coast, and a new airport is planned in the south.   The tourist body said it would weigh the environmental impact of boosting infrastructure, both on the environment and on local communities.    Ipsen worries about the effects of uncontrolled tourism to the region.   "We want to try to maintain it as it is, so it's not exploding," he said.

Already, said Johanna Bjork Sveinbjornsdottir, who runs tours in Kulusuk for an Iceland-based company, the rise in visitor numbers is making itself felt.   "In the campsites here out in nature where you used to be alone, there's two, three groups at a time," she said.   Like Ipsen, she is also concerned about the effect that rising visitor numbers could have on the wilderness around the village.    "If you want nature to survive that, you have to build up the infrastructure," she said, pointing to the lack of officially designated campsites around Kulusuk, with no rubbish bins or toilets for travellers outdoors and no one supervising the sites.   Despite the concerns, Sveinbjornsdottir hopes visitors will keep coming.   "They go back as different people," she said. "Everything is beyond what you ever imagined."
Date: Tue, 15 Oct 2019 19:33:58 +0200 (METDST)

Beirut, Oct 15, 2019 (AFP) - Lebanon has turned to its neighbours for help battling forest fires that have ravaged homes and killed a volunteer firefighter in the Mediterranean country, its premier said on Tuesday.   Heavy rain fell on parts of the country including Beirut in the evening, after Cyprus dispatched help and as Greece and Jordan vowed to follow suit.   "We have contacted the Europeans who will send means of help," Prime Minister Saad Hariri said earlier in comments carried by national news agency NNA.

Dozens of blazes have hit Lebanon in recent days, fire chief Raymond Khattar told NNA, amid unusually high temperatures and strong winds.   Thick smoke had been seen drifting over the outskirts of Beirut, the mountainous Chouf region to its southeast, and the southern city of Saida.   In the Chouf, an area famed for its forests, a volunteer firefighter lost his life trying to put out the flames, his family said.   In an area south of Beirut, firefighters have for two days been unable to stop the blaze, which has burnt four homes to the ground and caused dozens to suffer breathing difficulties, NNA said.

Interior Minister Raya El-Hassan said nearby Cyprus and Greece had responded to Lebanon's call for help.   "Two Cypriot planes have been working to put out the fires since yesterday," she said on Twitter.   "Greece has responded to our request and will send two planes to help us," she added.   Jordan's army said the king had ordered two firefighting planes to be dispatched.   NNA said the army was working together with helicopters and the Cypriot planes to fight the blaze, with access sometimes impeded by thick smoke and high-voltage power lines.   Personnel from UN peacekeeping force UNIFIL, who usually patrol the country's southern border with Israel, have also joined in the efforts, the agency said.   Lebanese on social media criticised the government's apparent inability to respond fast enough on its own.

In neighbouring war-torn Syria, fires also killed two people, Syrian state media said.   Flames have ripped through parts of the coastal provinces of Latakia and Tartus, as well as the central province of Homs but most have been brought under control, state news agency SANA said.   Two members of the Latakia forestry department were killed while fighting the blaze, it added.   In Tartus, the fires -- mostly stamped out -- coincided with the olive harvest, the governor told SANA.   In Homs, trees were burnt and electricity networks disrupted in mountainous areas, the agency reported.