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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 ...

Qatar

Qatar - US Consular Information Sheet
February 26, 2008
COUNTRY DESCRIPTION:
Qatar is a monarchy governed by the ruling Al Thani family in consultation with a council of ministers, an appointed advisory council and an elected municipal cou
cil.
Islamic ideals and beliefs provide the foundation of the country’s customs, laws and practices.
Located in the heart of the Persian Gulf, Qatar is a dynamic, modernizing, rapidly developing country that is among the wealthiest per capita in the world.
The capital is Doha.
Tourist facilities are available.
Read the Department of State Background Notes on Qatar for additional information.
ENTRY/EXIT REQUIREMENTS:
Passports and visas are required.
U.S. citizens may obtain a single-entry tourist or business visa at Doha International Airport upon arrival.
Single entry visas cost $28 and must be paid by credit card only.
Cash is not accepted.
Visas are valid for 30 days and may be extended for an additional 30 days for a $28 fee through the Airport Visas Section of the Immigration Department located next to Doha International Airport.
However, U.S.-citizen travelers will be able to clear Qatari immigration more quickly and be granted a longer stay in country by obtaining visas prior to arrival.
If planning to arrive at another port of entry in Qatar, travelers should obtain a tourist or business visa in advance of their arrival from a Qatari embassy or consulate abroad.
Travelers should also note that the Qatari Government charges $55 for each day that an individual overstays a visa, up to a maximum amount of $3,300.

For further information on visas, residence permits and entry requirements, please visit the Qatari Ministry of Interior’s web site at www.moi.gov.qa/English/index.htm.
Travelers may also contact the Embassy of the State of Qatar (www.qatarembassy.net) at 2555 M Street NW, Washington, DC
20037, tel. (202) 274-1600, fax (202) 237-0061.
They may also contact the Consulate General of the State of Qatar, 1990 Post Oak Blvd. Suite 810, Houston TX 77056, telephone (713) 355-8221, fax (713) 355-8184, send email inquiries to info@qatarembassy.org.

Military personnel are subject to different entry/exit requirements and should refer to www.fcg.pentagon.mil for specific information pertaining to their travel requirements.
NOTE FOR DUAL NATIONALS:
Qatari law requires that Qatari citizens only hold Qatari citizenship and enter and exit on a Qatari passport.
Qatari authorities have confiscated the passports of U.S. citizens who acquired Qatari citizenship through marriage to a Qatari national or by virtue of birth in the U.S.
In several cases, Qatari authorities informed U.S. citizens that their U.S. citizenship had been revoked and was no longer valid.
However, foreign governments have no authority to revoke the citizenship of a U.S. citizen.
If this occurs, please contact the U.S. Embassy in Doha immediately.
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:
Incidents of violence are rare in Qatar, although attacks against Western targets have occurred.
To provide for public security, a large police presence is deployed throughout the country.
American citizens in Qatar are strongly encouraged to maintain a high level of vigilance, be aware of local events and take the appropriate steps to bolster their personal security at all times.

The Department of State remains concerned about the possibility of terrorist attacks against U.S. interests worldwide, including the Middle East.
Both historical and recurring information suggests that al-Qa’ida and affiliated organizations continue to plan strikes against Western targets; these attacks may employ a wide variety of tactics to include assassination, kidnapping, hijacking and bombing.
On March 19, 2005, a suicide bomber detonated a vehicle-borne improvised explosive device (VBIED) at a theater in Doha regularly frequented by westerners; a citizen of the United Kingdom was killed, and several other individuals were injured.

Increased security at official facilities has led terrorists and their sympathizers to seek softer, less fortified targets; the March 2005 theater attack in Doha is one such example.
Other locations of potential concern include any venue where U.S. citizens and other foreigners are known to congregate in large numbers such as public assemblies, sporting events, restaurants, residential areas, clubs, places of worship, schools, hotels, etc.
The Government of Qatar occasionally provides security for such locations and events, but to varying degrees.
In most instances, the Embassy cannot gauge the appropriateness of security for a given event prior to its commencement.
The Embassy strongly encourages American citizens to avoid large crowds and demonstrations whenever possible.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site, where the current Worldwide Caution, Travel Warnings and other Travel Alerts and additional resources can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
The crime rate in Qatar is generally low.
A large police presence is apparent to travelers throughout the country.
Incidents of violence are rare but have occurred more frequently as Doha’s population and economic pressures on expatriate workers have increased substantially during the past few years.
Local and third country national young men have been known to verbally and physically harass unaccompanied, expatriate women.
Reports of petty theft have been growing, including ATM and credit card theft, purse snatching and pickpocketing.
Travelers are cautioned not to leave valuables such as cash, jewelry, and electronic items unsecured in hotel rooms or unattended in public places.

The Qatari Police can be contacted for emergency assistance by dialing 999 from any telephone in Qatar.
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 U.S. Embassy in Doha.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy for assistance.
The Embassy 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:
Good modern medical care and medicines are available in Doha, although only basic or no medical care may be available in Qatar’s smaller cities or outlying areas.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals expect immediate cash payment for health services.
Information about the Qatari national healthcare system is available at http://www.hmc.org.qa.
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 Qatar is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Short-term visitors should obtain a valid International Driving Permit prior to arrival and should not drive in Qatar on a U.S. driver’s license.
Short-term visitors and business travelers can also obtain a Temporary Qatari Driving License by presenting their U.S. driver’s license at any branch of Qatar’s Traffic Police.
New and prospective residents should obtain a permanent Qatari Driving License immediately after arrival.
Once an American citizen holds a valid Qatari residence permit, they are no longer permitted to drive in Qatar with an International Driving Permit or a Temporary Qatar Driving License.

Traffic accidents are among Qatar’s leading causes of death.
Safety regulations in Qatar are improving thanks to a more stringent traffic law adopted in October 2007 and a country-wide traffic safety campaign.
However, informal rules of the road and the combination of local and third-country-national driving customs often prove frustrating for first-time drivers in Qatar.
The combination of Qatar’s extensive use of roundabouts, many road construction projects and the high speeds at which drivers may travel can prove challenging.
The rate of automobile accidents due to driver error and excessive speed is declining but remains higher than in the United States.
In rural areas, poor lighting, wandering camels and un-shouldered roads are other hazards.
Despite aggressive driving on Qatar’s roads, drivers should avoid altercations or arguments over traffic incidents, particularly with Qatari citizens who, if insulted, have filed complaints with local police that resulted in the arrest and overnight detention of U.S. citizens.
Drivers can be held liable for injuries to other persons involved in a vehicular accident, and local police have detained U.S. citizens overnight until the extent of the person’s injuries were known.
Due to its conservative Islamic norms, Qatar maintains a zero-tolerance policy against drinking and driving.
Qatar’s Traffic Police have arrested Americans for driving after consuming amounts of alcohol at even smaller levels normally accepted in the U.S.
Any motor vehicle over five years old cannot be imported into the country.
For specific information concerning Qatari driver’s permits, vehicle inspection, road tax and mandatory insurance, please contact either the Embassy of the State of Qatar in Washington, DC or the Consulate General of the State of Qatar in Houston, Texas.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Qatar’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Qatar’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: Qatari customs authorities enforce strict regulations concerning importation into Qatar of items such as alcohol, narcotics, pork products, firearms, or anything deemed pornographic by Qatari authorities.
While importation of religious material for personal use is acceptable, importation of religious material for the purpose of proselytizing is not.
It is advisable to contact the Embassy of the State of Qatar in Washington, DC, or the Consulate General of the State of Qatar in Houston for specific information regarding customs requirements.

Please see our Customs Information.

Pets entering Qatar require an import permit from the Ministry of Agriculture.
Cats with proper documentation are allowed to enter with no difficulty, but some breeds of dogs, especially large dogs, are not admitted.
Application forms for import permits may be obtained from the Ministry of Agriculture through a sponsoring employer.
A copy of the pet's health certificate and vaccination record must be submitted with the application.

Qatari law does not recognize dual nationality.
Persons who possess Qatari citizenship in addition to U.S. citizenship are considered Qatari citizens by the State of Qatar and are subject to Qatar’s laws.
Qatari citizenship imposes special obligations, particularly with regard to child custody and exiting or entering the country.
For additional information, please refer to our dual nationality flyer
or contact the U.S. Embassy in Doha.

All U.S. citizens are encouraged to carry a copy of their passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
Qatari employers/sponsors customarily hold passports of foreign (i.e., non-Qatari) employees during the terms of their employment in Qatar.
Residents carry a Qatari Identification Card (Iqama) for identification in place of a passport.
Foreign nationals, including U.S. citizens, may not leave Qatar without permission in the form of exit visas obtained by their employer/sponsor.
The U.S. Embassy in Doha cannot assist U.S. citizens in Qatar to obtain third country visas for unofficial travel.
Islam provides the foundation of Qatar’s customs, laws and practices.
Foreign visitors are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts.
Western bathing attire is worn at hotel pools and beaches.
BUSINESS AND EMPLOYMENT CONTRACTS:
The written, Arabic text of a contract governs employment and business arrangements under Qatari law.
Before signing a contract, U.S. citizens and companies should obtain an independent English translation of the original Arabic to ensure a full understanding of the contract's terms, limits, and agreements.
No U.S. citizen should work in Qatar or make a business arrangement without having seen and understood the full, written contract.
Verbal assurances or side letters are not binding in Qatar.

In the event of a contract or employment dispute, Qatari authorities refer to the Arabic language of a contract.
Since a Qatari sponsor holds the employee's passport and controls the issuance of exit visas, U.S. citizens cannot simply leave Qatar in the event of an employment or business dispute.
Any U.S. citizen who breaks an employment or business contract may have to pay substantial penalties before being allowed to depart Qatar.
Qatari law favors employers over employees, and Qatari sponsors have substantial leverage in any negotiations and may block the departure of the employee or bar future employment in Qatar.

Transferring employment in Qatar requires the permission of the previous employer, which is discretionary, and is subject to approval by the Ministry of the Interior.
The Ministry of the Interior has denied employment transfers in the past, including ordering U.S. citizens deported and barred from re-entry to Qatar for two years.
The U.S. Embassy has no standing in Qatar’s courts, cannot sponsor visas, and cannot adjudicate labor or business disputes.
U.S. consular officers can provide lists of local attorneys to help U.S. citizens settle disputes, but ultimate responsibility for the resolution of disputes through Qatar’s legal system lies with the parties involved.
To obtain a residence permit in Qatar, the Government of Qatar usually requires foreign citizens to provide a police clearance certificate from their home countries.
Prospective residents can obtain a U.S. police clearance certificate two ways: through a local or state law enforcement agency or through the Federal Bureau of Investigations (FBI).
In both cases, the clearance will run against the National Crime Information Center, which contains all federal, state and local criminal records.
This process requires several weeks, and the U.S. Embassy in Doha strongly recommends that prospective residents obtain a U.S. police clearance before they arrive in Qatar.

For more information on business opportunities and practices in Qatar, please visit the Foreign Commercial Service’s Country Commercial Guide for Qatar at http://www.buyusa.gov/qatar.
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.
Criminal offenses are punished according to Qatari laws, which in some cases are based on Islamic law and sometimes more severe than in the United States for similar offenses.
Persons violating Qatari laws, even unknowingly, may be arrested, imprisoned, deported, or subject to a ban from departing Qatar.
Travel bans are not lifted until both parties resolve a dispute and the case is abandoned or, if not, until the matter is resolved by a court, which may require months to process the case.
Qatari law enforcement authorities have detained potential witnesses or relatives without charges or access to legal counsel during the investigation of a crime.
The U.S. Embassy in Doha cautions American citizens that Qatari police can and have arrested American citizens suspected of or witness to a crime, including traffic accidents involving injuries to pedestrians or the occupants of other cars, traffic arguments, slander, and a variety of lesser offenses.
Once arrested, the Qatari Police have no independent authority to grant a release, an authority reserved solely for Qatar’s Public Prosecution and Courts.
As a result, arrested Americans, regardless of the charges, often spend one night in jail awaiting a hearing with Qatar’s Public Prosecution or the appropriate court.
Qatari law enforcement authorities do not routinely notify the U.S. Embassy in Doha of a U.S. citizen’s arrest and, for more serious crimes, may not allow a U.S. Embassy official to visit an arrested U.S. citizen until the initial interrogation is completed.
Upon arrest, U.S. citizens should ask to speak to the U.S. Embassy immediately, and if not allowed, request a friend or family member notify the U.S. Embassy through the contact information below.
Incidents involving insults or obscene language/gestures often result in arrest, overnight imprisonment and/or fines whether the incident occurs between private parties or involves officers of the law.
Drunk driving, public intoxication and other alcohol-related offenses are treated with severity and will result in arrest, heavy fines, imprisonment, or expulsion from the country.
Penalties for possession, use, or trafficking in illegal drugs in Qatar are severe, and convicted offenders can expect long jail sentences and heavy fines.
Homosexual activity is considered to be a criminal offense, and those convicted may be sentenced to lashing and/or a prison sentence, and/or deportation.
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 Qatar are encouraged to register with the U.S. Embassy in Doha through the State Department’s travel registration web site to obtain updated information on travel and security within Qatar.
Americans without Internet access may register directly with the U.S. Embassy in Doha.
By registering, American citizens make it easier for the U.S. Embassy in Doha to contact them in case of emergency.
The U.S. Embassy is located in the Al-Luqta District on 22nd February Street, PO Box 2399, Doha; phone (974) 488-4101, extension 0 or 6500.
For after-hours emergencies, U.S. citizens may call (974) 488-4101, extension 0 or 6600, to reach the duty officer.
On the Internet, you may reach the Embassy web site at http://qatar.usembassy.gov for additional information and operating hours.
The embassy observes a Sunday through Thursday workweek.
Government offices and most businesses in Qatar also observe a Sunday through Thursday workweek.
*

*

*
This replaces the Country Specific Information for Qatar dated November 26, 2007, to update the sections on Entry/Exit Requirements, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Special Circumstances, and Criminal Penalties.

Travel News Headlines WORLD NEWS

Date: Wed 24 May 2017
Source: State of Qatar, Ministry of Public Health - News [edited]

Ministry of Public Health (MOPH) has announced that a new Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been confirmed for a 29-years-old, resident in Qatar, marking the 3rd MERS-CoV case to be confirmed in the country this year [2017] and bringing the cumulative number of confirmed MERS-CoV cases since 2012 to 21 cases among whom 7 have died.

The patient is a camel worker and had complaints of fever and dry cough for several days. He sought medical attention in Hamad General Hospital where an X-Ray investigation suggested a severe pneumonia. Consequently and as he reported an occupational frequent contact with camels, further samples were withdrawn from the patient. He ultimately tested positive for MERS-CoV according to Hamad Medical Corporation laboratories.

Despite his stable condition, the patient was admitted to hospital; in consistence with the national infection prevention and control protocol for confirmed and suspected MERS-CoV cases to ensure the appropriate medical attention. However, neither a history of contact with similar cases nor a recent travel outside the country was reported for the patient who has no comorbidities.

Once the case has been confirmed, the rapid response team of the Health Protection and Communicable disease Control (HP & CDC) department at the MOPH, accompanied with the team from Animal Health Department, Ministry of Municipality and Environment, have started a field investigation to assess the possible source of the infection and to verify whether any of the patient contacts has suspected symptoms according to the WHO standard case definition. Consequently, all traced contacts will be monitored over a period of 2 weeks, while those who develop suspected symptoms will then be subjected to confirmatory laboratory investigation.

The Ministry of Public Health advices citizens and residents, in particular those with comorbidities or low immunity, to abide to cough etiquette and handwashing with soap and water thoroughly and avoid unnecessary contact with sick animals.

MOPH proclaimed that Health Protection & CDC Hotlines 66740948 & 66740951 are accessible 24/7 to respond to any notification or enquiry related to infectious diseases.
==================
[The above press release mentioned the participation of animal health experts in the investigation of the described case. Information on their observations and findings, including results of laboratory tests (in case animal samples were taken), will be appreciated.

Qatar officially notified the OIE about its 1st event of MERS-CoV in camels, as an emerging disease, on 28 Nov 2013. The start of the event was, reportedly, dated 14 Oct 2013. The 'affected population' was kept on a "small farm with 14 camels, one sheep, one pigeon cage and some chicken" in Al-Shahanya, Ar Rayyan district. The diagnostic laboratory, given as "the Erasmus Medical Center (Rotterdam) and National Institute for Public Health and the Environment (Bilthoven), the Netherlands (OIE Reference Laboratory)", established the diagnosis of MERS-CoV in camels by PCR, on 26 Nov 2013. The report included the following epidemiological comment: "The health authority in Qatar notified the presence of a confirmed human MERS-CoV case. A joint team from both health and veterinary authorities was sent to the patient farm to investigate the health status of animals and the contact person. A farm worker proved to be positive for MERS-CoV and samples were collected from the 14 existing camels in addition to one sheep, some pigeons and chickens and some environmental samples (water, soil, animal food and grass) and all were sent to the Netherlands for testing. All animals were kept under observation and quarantine and all were apparently healthy". The above immediate notification was followed by 3 follow-up reports (29 Dec 2013, 22 Apr 2014 and 09 Jun 2014).

Follow-up report No 1, submitted a month later, namely on 29 Dec 2013, informed: "There are no new outbreaks in this report". The report, however, included the following epidemiological comments: "The samples from the same herd tested, using the same technique were negative and this may show that MERS-CoV infection in camels is a self-limiting disease. The planned massive survey for MERS-CoV in animals is under implementation and the same herd is under systematic retesting. Follow-up reports will be submitted when there will be new data".

Follow-up report No 2, submitted 22 Apr 2014, addressed "A single barn of 26 camels of different ages" in the same location (Al-Shahanyain), Qatar. The diagnostic laboratory was named as "Department of Viroscience, Erasmus Medical Center, Rotterdam (The Netherlands) (Foreign laboratory)"; the tests were performed on 19 Apr 2014, applying PCR and virus isolation, both positive. The report included the following epidemiological comments: "During an existing survey (pilot phase of the survey), nasal swabs were collected from an 8-month-old camel among healthy dromedary camels. The sample was inoculated on Vero cells and cytopathic changes were observed in cells at 48h post-infection. Human hepatoma cells (Huh-7 cells) were inoculated with MERS-CoV to further functionally characterize this viral isolate. After 2 days, virus-induced cytopathic effects were observed in the inoculated cell cultures. Virus production in Huh-7 cells was blocked by pre-incubating MERS-CoV with a 1/200 dilution of serum from MERS-CoV antibody positive camels. Conclusion: these data demonstrate that the MERS-CoV obtained from a dromedary camel is able to replicate in human cells and uses DPP4 as entry receptor, similar as isolates obtained from MERS patients".

Follow-up report No 3, submitted 9 Jun 2014, involved 3 barns with a total number of 12 camels of different ages, similarly in Al-Shahanya. Of the 12 susceptible camels, there were 5 "cases", indicated as an apparent morbidity rate of 41.67 percent. The diagnostic laboratory was "Erasmus Medical Center (Rotterdam) and National Institute for Public Health and the Environment (Bilthoven), The Netherlands (Foreign laboratory)", which applied SNT. This report included the following epidemiological comment: "Milk was collected according to local customs; cria's (dromedary calves) were not weaned after delivery but kept at the farm in paddocks adjacent to their dams throughout lactation. Dams were reunited with their cria to trigger milk production. Once milk production was initiated, the milk samples were collected by the camel owner or caretaker without specific hygienic precautions". The named follow-up report No 3 was the last report of MERS-CoV in camels submitted so far by Qatar to the OIE. It included the statement "continuing". No additional MERS-CoV reports from Qatar have become available since June 2014.

According to WAHID's archive data, the summary of the event since its start, as of June 2014, was:
Total outbreaks = 3 (Submitted)
Species/ Susceptible/ Cases/ Deaths/ Destroyed/ Slaughtered
Camelidae/ 52/ 9/ 0/ 0/ 0
(see at <http://www.oie.int/wahis_2/temp/reports/en_fup_0000015380_20140610_175414.pdf>).

In May 2017, the OIE updated its case definition for the reporting of MERS-CoV, as follows:

"1. Introduction
Dromedary camels have been confirmed by several studies to be the reservoir of the MERS-CoV infection in humans. Zoonotic transmissions of MERS-CoV from dromedary camels to humans were reported in multiple occasions. MERS-CoV has never been reported as a disease in camels though in experimental infections MERS-CoV has been associated with mild upper respiratory signs. Positive PCR results for MERS-CoV or isolation of the virus from camels is notifiable to the OIE because MERS is an emerging disease with a significant public health impact.

2. Confirmed case:
A dromedary camel with laboratory confirmation (*note 1) of MERS-CoV infection, with or without clinical signs.

3. Suspected case:
a) Observed clinical signs of mild respiratory infection (rhinitis in young dromedaries); and
b) Direct epidemiologic link (*note 2) with a confirmed human or camel MERS-CoV case; and
c) Testing for MERS-CoV is unavailable, negative or inconclusive (*note 4) on a single inadequate specimen (*note 3).

Notes
1 A case may be laboratory confirmed by virus isolation or detection of viral nucleic acid. The presence of viral nucleic acid can be confirmed by 1) a positive RT-PCR result on at least 2 specific genomic targets,
2) a single positive target with sequencing of a 2nd target or
3) a single positive target with positive result in a rapid MERS-CoV Ag Test. Serological investigations are of little value as high percentage of tested dromedaries possess antibodies to MERS-CoV.

2. A direct epidemiological link with a confirmed MERS-CoV dromedary camel may include living or traveling together in close proximity or sharing the same environment with individual dromedaries infected with MERS-CoV.

3. An inadequate specimen would include a specimen that has had improper handling, is judged to be of poor quality by the testing laboratory, or was taken too late in the course of illness.

4. Inconclusive tests may include a positive screening test on a single rRT-PCR target without further confirmation. Animals with an inconclusive initial test should undergo additional sampling and testing to determine if the animal can be classified as a confirmed MERS-CoV case. At herd level, having positive single target PCRs in more than one animal could constitute confirmation. Preference should be a repeat nasopharyngeal specimen. Other types of clinical specimens could also be considered for molecular testing if necessary, including blood/serum, and stool/rectal swab. These generally have lower titers of virus than respiratory tract specimens but have been used to confirm cases when other specimens were inadequate or unobtainable".

As commented by Mod.MPP (see http://promedmail.org/post/20170524.5059234), according to a review of cases reported by Saudi Arabia and classified as "primary" cases (N=560), 27.3 percent had a history of camel exposure, and 72.7 percent were reported as still under investigation for high risk exposures at the time of initial confirmation report. The 85th General Session of the World Assembly of OIE Delegates has been held in Paris during this week (21 to 26 May 2017). According to WHO updated information, MERS-CoV has caused, since its initial detection in Sep 2012, at least 1952 human cases, of which at least 693 deaths in 27 countries. It will be interesting to note if the reporting of this disease, according to the OIE criteria, and its possible control in the animal reservoir have been discussed during the General Session.

Subscribers are referred to a recent review paper (Ref 1), and in particular to figure 3 "Hypothesis of MERS-CoV transmission to humans".

A One Health approach to the MERS-CoV issue, its epidemiology and control, will require the active involvement of the 3 relevant international authorities, namely the FAO, OIE and WHO.

References
M. G. Hemida, A. Elmoslemany, F. Al-Hizab, A. Alnaeem, F. Almathen, B. Faye, D. K. W. Chu, R. A. P. M. Perera & M. Peiris. Dromedary Camels and the Transmission of Middle East. Transboundary & Emerging Diseases 64 (2017) 344-353.  <http://agritrop.cirad.fr/580073/7/Hemida_et_al-2017-Transboundary_and_Emerging_Diseases.pdf>. - ProMED Mod.AS]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sat, 26 Nov 2016 20:00:07 +0100

Doha, Nov 26, 2016 (AFP) - Rainfall caused widespread flooding in Qatar on Saturday, potentially raising fresh concerns about infrastructure in the Gulf country due to host the 2022 football World Cup.   Several major roads were flooded, prompting official warnings.   "As the rain continues to pour in most parts of the country, motorists are advised to be cautious," the interior ministry tweeted after earlier calling the rainfall "medium to heavy".   Some apartment buildings on the Pearl Qatar, an artificial island in Doha, estimated to have cost $15 billion (13.5 billion euros) to build, suffered flooding, as did the nearby suburb of Qanat Quartier, built to resemble Venice.

The Doha News website reported that the Qatar Animal Welfare Society pleaded urgently for foster homes to take care of its dogs because of the conditions.   The Peninsula English-language newspaper reported that rain caused leaks at major Doha shopping centre the Landmark Mall.   Many people used social media to post videos and pictures, with some questioning how a relatively small amount of rain -- the first of the winter -- could cause such problems.   The wet weather had been predicted and the government "Rain Emergency Team" had already convened to discuss potential problems.

Last November, the government began an inquiry after rain damaged Doha's Hamad international airport, which opened in 2014, flooded roads and streets and caused some schools to close.   Gas-rich Qatar is spending more than $200 billion on major infrastructure such as roads, the airport, a metro system and a new city ahead of the 2022 World Cup, which will be played at this time of year -- from November 21 to December 18.   World Bank figures show Qatar's average annual rainfall is around 75 millimetres.
Date: Mon 13 Jun 2016 01:58 AM (Qatar)
Source: Gulf Times [edited]

The Ministry of Public Health has announced that a new Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been confirmed in a 23-year-old male resident, marking it the 3rd to be confirmed in the country this year [2016].

The person was not in contact with a confirmed case and does not suffer from any chronic diseases that usually cause immunity suppression. The patient was admitted to Hamad General Hospital as he reported fever, cough, runny nose, and backache where he tested positive for Mers-CoV. The patient is now stable and receives medical care in the isolation ward.

The ministry said that Health Protection and Communicable Disease Control Hotlines, 66740948 and 66740951, are accessible round-the-clock to respond to any notification or query related to infectious diseases.

MERS-CoV was 1st identified in Saudi Arabia in 2012.

According to the World Health Organization (WHO), globally, since September 2012, it has been notified of 1652 laboratory-confirmed cases of infection with MERS-CoV, including at least 591 related deaths [the most recent report from WHO on 16 May 2016 gives a global tally of 1733 laboratory-confirmed cases of infection with MERS-CoV, including at least 628 related deaths (<http://www.who.int/csr/don/16-may-2016-mers-saudi-arabia/en/>) - ProMED Mod.MPP].

Mers-CoV is a zoonotic virus that is transmitted from animals to humans.
==================
[As mentioned in the above report, this is now the 3rd case of MERS-CoV infection reported in Qatar in 2016. The 1st case was reported in February 2016 in a 66 year old Qatari male who had been, for 2 months preceding onset of illness, in Saudi Arabia where he had a camel farm (see MERS-CoV (35): Saudi Arabia, Qatar ex Saudi Arabia, WHO http://promedmail.org/post/20160311.4085518 and MERS-CoV (24): Qatar ex Saudi Arabia, Saudi Arabia (RI) RFI http://promedmail.org/post/20160222.4041719). The 2nd case was a 40 year old Qatari national camel worker with non-specific, non-respiratory symptoms (see MERS-CoV (56): Qatar, Saudi Arabia, WHO http://promedmail.org/post/20160503.4198200).

According to the most recent ECDC Communicable Disease Threats Report, as of 9 June 2016, there have been a total of 1753 cases of MERS-CoV infection, including 680 deaths reported by health authorities worldwide. Besides, there have been a total of 15 cases of MERS-CoV infection including 5 deaths reported by Qatar as of 9 Jun 2016, making this current case the 16th case reported by Qatar since April 2012.  (<http://ecdc.europa.eu/en/publications/Publications/Communicable-disease-threats-report-11-june-2016.pdf>).

In addition to the 16 cases reported by Qatar, there have been 2 additional cases reported in Qatari nationals treated in Europe (see Novel coronavirus - Saudi Arabia (03): UK HPA, WHO, Qatar
East. Med. (07): Saudi Arabia, UK, Germany

We await further information on possible high risk transmission exposures.

The HealthMap/ProMED map of Qatar can be found at:
Date: Mon 2 May 2016
Source: Gulf Times

A 40-year old camel worker has tested positive for the Middle East respiratory syndrome coronavirus (MERS-CoV), the Ministry of Public Health (MoPH) announced.

It is the 2nd case confirmed in Qatar so far this year [2016].

The worker, who was neither in contact with a suspected patient nor abroad during the last 2 weeks, is free from chronic diseases that usually cause immunity suppression. He was admitted to Hamad General Hospital [in Doha] with general symptoms where routine investigations tested positive for MERS-CoV, despite him not exhibiting any respiratory related symptoms.

The patient is currently in stable condition and receiving the necessary medical care in the isolation ward, according to the national protocol for infection prevention and control, the ministry said in a statement.

After the tests proved positive, the rapid response team of MoPH carried out extensive search to list all potential contacts to check for their possible consistence with the standard case definition of the suspected cases, based on the World Health Organisation guidelines. All traced contacts will be monitored over a period of 2 weeks, while those who develop suspected symptoms will then be subjected to confirmatory laboratory investigation, the ministry added.

While research efforts continue on a global and local level to determine the modes of transmission of MERS-CoV infection, the MoPH has advised citizens and residents who suffer from chronic diseases to avoid direct contact with camels and to wash hands with soap and water thoroughly. Also recommended are implementing respiratory hygiene and cough etiquette and the need to boil camel milk before drinking.

MoPH added that Health Protection & CDC Hotlines 66740948 and 66740951 are accessible 24/7 to respond to any notification or inquiry related to infectious diseases.
==================
[The text of the media report above is almost verbatim from the MoPH announcement, also released today (2 May 2016 and available at <https://www.moph.gov.qa/news/moph-announces-the-second-mers-cov-case-in-2016?backArt=326&page=2>). On 22 Feb 2016, there was a report of a case of MERS-CoV infection in a 66 year old Qatari male who had a farm (with camels and sheep) in Saudi Arabia. The addition of this newly confirmed case brings the total number of cases of MERS-CoV infection reported by Qatar to 15 since 2012. It is noteworthy that in the absence of respiratory symptoms, the history of camel contact most probably led to testing for MERS-CoV infection in this patient, suggesting a high index of suspicion on the part of the medical community treating this patient.

The HealthMap/ProMED map of Qatar can be found at
Date: Thu, 10 Mar 2016 14:54:28 +0100

Doha, March 10, 2016 (AFP) - A 66-year-old Qatari man has died after contracting the MERS virus, in the first fatal case in the Gulf state for 10 months, health officials announced Thursday.   The public health ministry, quoted by the official Qatar News Agency, said the man "had been suffering from several chronic diseases and died of complications from the disease".

This was the first such case of Middle East Respiratory Syndrome reported in Qatar since May 2015 when it claimed the life of a 73-year-old man, the ministry added in a statement.   The ministry "continues to monitor acute respiratory diseases and is working in cooperation with all the health institutions in the public and private sectors to monitor any suspected case," it said.   The latest victim had been diagnosed with the virus in February. He was hospitalised after returning from a "neighbouring country", according to an official statement last month.

MERS is a viral respiratory illness and considered a deadlier but less infectious cousin of the SARS virus that appeared in Asia in 2003, infecting more than 8,000 people and killing hundreds.   Like SARS, it appears to cause a lung infection, with patients suffering coughing, breathing difficulties and a temperature.

MERS differs in that it also causes rapid kidney failure.   It first appeared five years ago in neighbouring Saudi Arabia, which has been the country worst hit by the virus, with 1,286 cases of infection and 551 deaths, according to official figures.   Globally, there have been 1,644 confirmed MERS cases and 590 deaths, according to the World Health Organization.
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 ...

Canada

Canada - US Consular Information Sheet
February 17, 2009
COUNTRY DESCRIPTION: Canada is a highly developed, stable democracy. Tourist facilities are widely available in much of the country, but the northern and wilderness areas are less develop
d and facilities there can be vast distances apart. Read the Department of State Background Notes on Canada for additional information.
ENTRY/EXIT REQUIREMENTS: Entry into Canada is solely determined by Canadian Border Services Agency (CBSA) officials in accordance with Canadian law. Canadian law requires that all persons entering Canada carry both proof of citizenship and proof of identity. A valid U.S. passport, passport card or NEXUS card (see below) satisfies these requirements for U.S. citizens. If U.S. citizen travelers to Canada do not have a passport, passport card or approved alternate document such as a NEXUS card, they must show a government-issued photo ID (e.g. Driver’s License) and proof of U.S. citizenship such as a U.S. birth certificate, naturalization certificate, or expired U.S. passport. Children under sixteen need only present proof of U.S. citizenship.

It is very important to note that all Americans traveling to the U.S. by air, including from Canada, must present a valid U.S. passport to enter or re-enter the U.S. Effective June 1, 2009, a similar requirement goes into effect for entry into the U.S. via land and sea borders. All Americans will need to present a U.S. passport, passport card, NEXUS card, Enhanced Drivers License or other Western Hemisphere Travel Initiative (WHTI)-compliant document in order to enter the U.S. by land or sea. American travelers are urged to obtain WHTI-compliant documents before entering Canada well in advance of their planned travel. For the most recent information on WHTI and WHTI-compliant documents, please see our web site.

One of the WHTI-compliant documents for crossing the land border is the U.S. Passport Card. The card may not be used to travel by air and is available only to U.S. citizens. You can read further information on the U.S. Passport Card on our web site. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Both the U.S. and Canadian governments urge frequent travelers to join the NEXUS trusted traveler program. NEXUS members receive a special travel card that allows expedited border crossings for both private and commercial travelers through both U.S. and Canadian border controls very quickly. The CBP has detailed information about the NEXUS program.
U.S. citizens entering Canada from a third country must have a valid U.S. passport. A visa is not required for U.S. citizens to visit Canada for up to 180 days. Anyone seeking to enter Canada for any purpose other than a visit (e.g. to work, study or immigrate) must qualify for the appropriate entry status, and should contact the Canadian Embassy or nearest consulate and visit the Canadian immigration web site.

Anyone with a criminal record (including misdemeanors or Driving While Impaired (DWI) charges may be barred from entering Canada and must obtain a special waiver well in advance of any planned travel. To determine whether you may be inadmissible and how to overcome this finding, refer to the Canadian citizenship and immigration web site.
For further information on entry requirements, travelers may contact the Canadian Embassy at 501 Pennsylvania Avenue NW, Washington DC 20001, tel. (202) 682-1740; or the Canadian consulates in Atlanta, Boston, Buffalo, Chicago, Dallas, Detroit, Los Angeles, Miami, Minneapolis, New York, San Juan or Seattle.

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: 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: Although Canada generally has a lower crime rate than the U.S., violent crimes do occur throughout the country, especially in urban areas. Visitors to large cities should be aware that parked cars are regularly targeted for opportunistic smash-and-grab thefts, and they are cautioned to avoid leaving any possessions unattended in a vehicle, even in the trunk. Due to the high incidence of such crimes, motorists in Montreal, Vancouver and some other jurisdictions can be fined for leaving their car doors unlocked or for leaving valuables in view. Auto theft in Montreal and Vancouver, including theft of motor homes and recreational vehicles, may even occur in patrolled and apparently secure parking lots and decks. SUVs appear to be the particular targets of organized theft. While Canadian gun control laws are much stricter than those of the U.S., such laws have not prevented gun-related violence in certain areas.
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. Each of Canada’s provinces has a Crime Victim Compensation Board from which American victims of crime in Canada may seek redress.

As in the U.S., emergency assistance can be reached by dialing “911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: The level of public health and sanitation in Canada is high. Canada’s medical care is of a high standard but is government-controlled and rationed. Quick and easy access to ongoing medical care is difficult for temporary visitors who are not members of each province’s government-run health care plans. Many physicians will not take new patients. Access to a specialist is by only by referral and may take months to obtain. Emergency room waits can be very long. Some health care professionals in the province of Quebec may speak only French. No Canadian health care provider accepts U.S. domestic health insurance, and Medicare coverage does not extend outside the United States. Visitors who seek any medical attention in Canada should be prepared to pay in cash in full at the time the service is rendered. Traveler’s medical insurance is highly recommended even for brief visits.

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

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 Canada is provided for general reference only, and may not be totally accurate in a particular location or circumstance. As in the United States, all emergency assistance in Canada can be reached by dialing 911.

Transport Canada is the Canadian federal government agency responsible for road safety, although each province or territory has the authority to establish its own traffic and safety laws and issue driving licenses. For detailed information on road conditions throughout Canada, as well as links to provincial government web sites, please see the Transport Canada web site or the Canadian Automobile Association web site. The CAA honors American Automobile Association membership. Some automobile warranties of vehicles purchased in the U.S. may be invalid in Canada; please check the warranty of your vehicle.

Driving in Canada is similar to driving in many parts of the United States. Distances and speeds, however, are posted in kilometers per hour, and some signs, particularly in Quebec, may only be in French. U.S. driver’s licenses are valid in Canada. Proof of auto insurance is required. U.S. auto insurance is accepted as long as an individual is a tourist in Canada. U.S. insurance firms will issue a Canadian insurance card, which should be obtained and carried prior to driving into Canada. For specific information concerning Canadian driving permits, mandatory insurance and entry regulations, please contact the Canadian National Tourist Organization.
Unless otherwise posted, the maximum speed limit in Canada is 50km/hr in cities and 80km/hr on highways. On rural highways, the posted speed limit may be 100km/hr (approximately 60 miles/hr). Seat belt use is mandatory for all passengers, and child car seats must be used by children under 40 pounds. Some provinces require drivers to keep their vehicles’ headlights on during the day. Motorcycles cannot share a lane, and safety helmets for motorcycle riders and passengers are mandatory. Many highways do not have merge lanes for entering traffic. Tailgating and rapid lane-changes without signaling are common. Emergency vehicles frequently enter the oncoming traffic lane to avoid congestion. Drivers should be aware that running a red light is a serious concern throughout Canada, and motorists are advised to pause before proceeding when a light turns green.
Driving while impaired (DWI) is a criminal offense in Canada. Penalties are heavy, and any prior conviction (no matter how old or how minor the infraction) is grounds for exclusion from Canada. Americans with a DWI record must seek a waiver of exclusion from Canadian authorities before traveling to Canada, which requires several weeks or months to process. It is illegal to take automobile radar detectors into Quebec, Ontario, Manitoba, the Yukon or the Northwest Territories, regardless of whether they are used or not. Police there may confiscate radar detectors, operational or not, and impose substantial fines.

Winter travel can be dangerous due to heavy snowfalls and hazardous icy conditions. Some roads and bridges are subject to periodic winter closures. Snow tires are required in some Provinces. The Canadian Automobile Association has tips for winter driving in Canada. Travelers should also be cautious of deer, elk and moose while driving at night in rural areas.

Highway 401, from Detroit to Montreal, is one of the busiest highways in North America. It has been the scene of numerous, deadly traffic accidents due to sudden, severe and unpredictable weather changes, high rates of speed, and heavy truck traffic. There have been numerous incidents involving road racing and dangerous truck driving. Drivers tend to be aggressive, often exceeding speed limits and passing on both sides, and police enforcement is spotty. In addition, approaches to border crossings into the United States may experience unexpected traffic backups. Drivers should be alert, as lane restrictions at border approaches exist for drivers in NEXUS and FAST expedited inspection programs.
Please refer to our Road Safety page for more information. Visit Canada’s national authority responsible for road safety.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Canada’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Canada’s air carrier operations. For more information, travelers may visit the FAA web site.
SPECIAL CIRCUMSTANCES: IMPORTATION OF FIREARMS: Firearms are much more strictly controlled in Canada than in the United States. Violation of firearms restrictions may result in prosecution and imprisonment. As of January 1, 2001, visitors bringing any firearms into Canada, or planning to borrow and use firearms while in Canada, must declare the firearms in writing using a Non-Resident Firearm Declaration form. Visitors planning to borrow a firearm in Canada must obtain in advance a Temporary Firearms Borrowing License. These forms must be signed before a Canadian Border Services Agency (CBSA) officer at the border and no photocopies are available at the border. Full details and downloadable forms are available from the Canada Firearms Program. Canadian law requires that officials confiscate firearms and weapons from persons crossing the border who deny having the items in their possession. Confiscated firearms and weapons are never returned. Possession of an undeclared firearm may result in arrest and imprisonment.

Canada has three classes of firearms: non-restricted, restricted, and prohibited. Non-restricted firearms include most ordinary hunting rifles and shotguns. These may be brought temporarily into Canada for sporting or hunting use during hunting season, use in competitions, in-transit movement through Canada, or personal protection against wildlife in remote areas of Canada. Anyone wishing to bring hunting rifles into Canada must be at least 18 years old, must properly store he firearm for transport, and must follow the declaration requirements described above. Restricted firearms are primarily handguns; however, pepper spray, mace, and some knives also are included in this category. A restricted firearm may be brought into Canada, but an Authorization to Transport permit must be obtained in advance from a Provincial or Territorial Chief Firearms Officer. Prohibited firearms include fully automatic, converted automatics, and assault-type weapons. Prohibited firearms are not allowed into Canada.
SPECIAL CIRCUMSTANCES: PORNOGRAPHY AND CONTROLLED SUBSTANCES: Canada has strict laws concerning child pornography, and in recent years there has been an increase in random checks of electronic media of travelers entering Canada. Computers are subject to search without a warrant at the border, and illegal content can result in the seizure of the computer as well as detention, arrest and prosecution of the bearer.

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 Canada’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Canada 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.
Canadian law prohibits the unlawful importation or trafficking of controlled substances and narcotics. A number of travelers, including Americans, have been arrested for attempting to smuggle khat, a narcotic from East Africa, into Canada. Smugglers risk substantial fines, a permanent bar from Canada and imprisonment.

Please also 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 Canada are encouraged to register with the U.S. Embassy or nearest U.S. Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within Canada. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is in Ottawa, Ontario, at 490 Sussex Drive, K1N 1G8, telephone (613) 238-5335, fax (613) 688-3082. The Embassy's consular district includes Ottawa, Easter Ontario (Kingston, Lanark, Leeds, Prescott, Refrew, Russell, and Stormont); and those parts of the Quebec Regions of Outaouais and Abitibi-Temiscamingues near Ottawa.
U.S. Consulates General are located at:
Calgary, Alberta, at 10th Floor, 615 Macleod Trail SE, telephone (403) 266-8962; emergency-after hours-to report the death or arrest of an American (403) 2 66 -8962 then press '0'; fax (403) 264-6630. The consular district includes Alberta, Manitoba, Saskatchewan, and the Northwest Territories, excluding Nunavut.
Halifax, Nova Scotia, at 1969 Upper Water Street, Suite 904, Purdy's Wharf Tower II, telephone (902) 429-2480; emergency-after hours-to report the death or arrest of an American (902) 429-2485; fax (902) 423-6861. The consular district includes New Brunswick, Newfoundland, Nova Scotia, Prince Edward Island and the French islands of Saint Pierre and Miquelon.

Montreal, Quebec, at 1155 St. Alexander Street, telephone (514) 398-9695; emergency-after hours-to report the death or arrest of an American (514) 981-5059; fax (514) 398-0702. The consular district includes Greater Montreal and the regions of Southern Quebec Province (Laurentides, Lanaudiere, Laval, Montreal, Montregie, Estrie, and the southern parts of Centre-du-Quebec); including Joliete, Drummondville and Sherbrooke.
Quebec City, Quebec, at 2 rue de la Terrasse Dufferin, telephone (418) 692-2095; emergency-after hours-to report the death or arrest of an American (418) 692-2096; fax (418) 692-4640. The consular district includes Quebec City and those regions of Quebec Province to the North and East of the Montreal and Ottawa Districts (indicated above), plus the Territory of Nunavut.

Toronto, Ontario, at 360 University Avenue, telephone (416) 595-1700; emergency-after hours-to report the death or arrest of an American (416) 201-4100; fax (416) 595-5466. The consular district includes the province of Ontario except the six counties served by the U.S. Embassy in Ottawa.

Vancouver, British Columbia, at 1095 West Pender Street, telephone (604) 685-4311; fax (604) 685-7175. The consular district includes British Columbia and the Yukon Territory.

All visa applicants are seen by appointment only. Information on visa appointments is available from www.nvars.com. Information on visa services for foreigners and consular/passport services for Americans who live in Canada is available from the U.S. Embassy web site. No visa or consular/passport information is available by calling the embassy or consulate switchboards.
* * *
This replaces the Country Specific Information for Canada dated December 11, 2007, to update sections on Entry/Exit Requirements, Crime, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Fri 4 Oct 2019
Source: CTV News [edited]

Newfoundland and Labrador's provincial health department is advising residents of an outbreak of _E. coli_ bacteria. There have been 22 cases of _E. coli_ confirmed in the province this week, according to an advisory issued Friday afternoon [4 Oct 2019]. The statement says provincial public health officials and regional authorities are investigating.

The Department of Health and Community Services advises people experiencing symptoms of _E. coli_, including severe or bloody diarrhea and abdominal pain, to seek medical attention. The illness spreads mostly through ingestion of contaminated food or water but can also spread through person-to-person contact.

A provincial medical officer of health says most cases are within the province's eastern health authority, including the capital city of St. John's, but others are in the central and western authorities.

Dr. Janice Fitzgerald said some of the cases are connected to an advisory issued by Memorial University earlier this week, saying Eastern Health was investigating reports of students experiencing gastrointestinal illness.

The university said Wednesday [2 Oct 2019] that test results indicated one student living in residence "may have contracted the _E. coli_ bacteria" and 21 students had reported similar symptoms. Fitzgerald said it's too early in the investigation to determine a cause of the outbreak.
======================
[The news report above alerts people experiencing severe or bloody diarrhoea to seek medical care because there have been 22 cases of a "gastrointestinal illness" due to _Escherichia coli_ in the Canadian province of Newfoundland and Labrador; most cases are occurring within the province's eastern health authority, including the capital city of St. John's.

Although the report fails to characterize the students' GI illness in any detail, most likely the illness is due to an enterohemorrhagic E. coli (EHEC). EHEC is a type of _E. coli_ that produces a toxin called Shiga toxin and causes damage to the lining of the intestinal wall and bloody diarrhoea.

The infection is said to have involved one student "living in residence," perhaps a communal home, and 21 other students developed similar symptoms. But the report fails to say if the students lived together or had some other common exposure. Most EHEC is transmitted by ingestion of contaminated food or water, but EHEC can also spread through person-to-person contact or contact with animals and their environment (<https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/escherichia-coli-diarrheagenic>).

More information on this outbreak would be appreciated from knowledgeable sources.

Newfoundland and Labrador, which incorporates the island of Newfoundland and mainland Labrador to the northwest, is the most easterly province of Canada, with a combined population of 526 702 (<http://en.wikipedia.org/wiki/Newfoundland_and_Labrador>). Approximately 92% of the province's population lives on the island of Newfoundland (including its associated smaller islands). Half of the province's population (262 410) lives on Newfoundland's Avalon Peninsula, which includes the city of St. John's, the province's capital and largest city (<http://en.wikipedia.org/wiki/Avalon_Peninsula>). - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Newfoundland, Newfoundland and Labrador, Canada:
<http://healthmap.org/promed/p/375>]
Date: Wed 2 Oct 2019
Source: Benzinga.com [edited]

This update reflects 14 illnesses that have been added to the outbreak investigation. There are now 110 illnesses under investigation. The Public Health Agency of Canada continues to remind Canadians to always handle raw turkey and raw chicken carefully, and to cook it thoroughly to prevent food-related illnesses like _Salmonella_ infection. The Canadian Food Inspection Agency has not issued any food recall warnings related to this outbreak.

The Public Health Agency of Canada is collaborating with provincial and territorial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of _Salmonella_ infections.
 
Based on the investigation findings to date, exposure to raw turkey and raw chicken products has been identified as the likely source of the outbreak. Many of the individuals who became sick reported eating different types of turkey and chicken products before their illnesses occurred. The outbreak appears to be ongoing, as recent illnesses continue to be reported to the Public Health Agency of Canada.

As of 1 Oct 2019, there have been 110 confirmed cases of _S._ Reading illness investigated in the following provinces and territories: British Columbia (26), Alberta (36), Saskatchewan (8), Manitoba (24), Ontario (7), Quebec (1), New Brunswick (1), Northwest Territories (1), and Nunavut (6). Individuals became sick between April 2017 and August 2019. 32 individuals have been hospitalized. One individual has died. Individuals who became ill are between 0 and 96 years of age. The illnesses are equally distributed among males (50%) and females (50%).

The collaborative outbreak investigation was initiated due to an increase of _S._ Reading illnesses that occurred in October and November 2018. Cases have continued to be reported since the investigation was initiated. Through the use of a laboratory method called whole genome sequencing, some _Salmonella_ illnesses dating back to 2017 were identified to have the same genetic strain as the illnesses that occurred in late 2018. More than half of the illnesses under investigation occurred between October 2018 and August 2019.

It is possible that more recent illnesses may be reported in the outbreak because there is a period of time between when a person becomes ill and when the illness is reported to public health officials. This period of time is called the case reporting delay. In national _Salmonella_ outbreak investigations, the case reporting delay is usually between 5 and 6 weeks.

The United States Centers for Disease Control and Prevention (U.S. CDC) previously investigated similar _Salmonella_ illnesses in several states that were linked to raw turkey exposure. There were some turkey products recalled in the U.S. that were associated with that outbreak. These products were not imported or distributed in the Canadian marketplace. The U.S. investigation was closed in April 2019.

Infants, children, seniors and those with weakened immune systems are at higher risk of serious illness because their immune systems are more fragile. Most people who become ill from a _Salmonella_ infection will recover fully after a few days. It is possible for some people tobe infected with the bacteria and to not get sick or show any symptoms, but to still be able to spread the infection to others.

Raw turkey and raw chicken products carrying _Salmonella_ may look, smell and taste normal, so it's important to always follow safe food-handling tips if you are buying, chilling, thawing, cleaning, cooking and storing any type of raw poultry food products.

Always handle raw turkey and raw chicken carefully, and cook it thoroughly to prevent food-related illnesses like salmonellosis. You can use the following food safety tips to help protect you and your family: Always wash your hands before and after you touch raw turkey and raw chicken. Wash with soap and warm water for at least 20 seconds. Use an alcohol-based hand rub if soap and water are not available. Always cook turkey and chicken products to a safe internal temperature that has been checked using a digital thermometer. Turkey and chicken breasts, as well as ground poultry, including turkey and chicken burgers, should always be cooked to an internal temperature of 74 C (165 F) to kill any harmful bacteria. Whole turkey and chicken should be cooked to an internal temperature of 82 C (180 F). Leftovers should be reheated to 74 C (165 F). Use a digital food thermometer to check, and place it in the thickest part of the food.

Thaw frozen raw turkey and raw chicken in the fridge. Thawing raw turkey and raw chicken at room temperature can allow bacteria to grow. Never rinse raw turkey or raw chicken before cooking it because the bacteria can spread wherever the water splashes. Use a separate plate, cutting board, utensils and kitchen tools when preparing raw turkey and raw chicken. Clean everything that has come in contact with raw turkey or raw chicken with a kitchen cleaner or bleach solution and then rinse with water: Kitchen cleaner (follow the instructions on the container) Bleach solution (5 mL household bleach to 750 mL of water). Keep raw turkey and raw chicken away from other food while shopping, storing, repackaging, cooking and serving foods. If you have been diagnosed with a _Salmonella_ infection or any other gastrointestinal illness, do not cook food for other people. Do not feed raw ground turkey or raw ground chicken to your pets. Bacteria like _Salmonella_ in raw pet food can make your pets sick. Your family also can get sick by handling the raw food or by taking care of your pet.
======================
[_Salmonella_ are widely distributed in animals. In terms of human consumption, poultry and eggs from poultry are often the sources of human infection, but any animal product if not cooked properly is a potential source of salmonellosis. Pets including dogs, cats, birds, snakes, turtles, etc. can be sources of _Salmonella_ infection. The pets develop infection from _Salmonella_ in what they eat and excrete the bacteria in their feces. - ProMED Mod.DK]

[HealthMap/ProMED map available at:
Date: Fri 27 Sep 2019
Source: CBC [edited]

The Windsor Essex County Health Unit [WECHU] said that recently collected data has identified a single mosquito capable of transmitting the Zika virus. The routine mosquito surveillance program, conducted by WECHU in the summer and fall, tested the adult _Aedes aegypti_ mosquito found, and it has tested negative for any vector-borne diseases.

That type of mosquito is capable of transmitting Zika, dengue, chikungunya, and yellow fever. The 1st mosquito capable of transmitting these diseases was discovered in 2016. The 1st such mosquito was found in Canada in 2017 for the 1st time.

WECHU is also testing mosquitos collected for eastern equine encephalitis, a mosquito-borne disease that has recently caused fatalities in Michigan and a number of other states.

"Until the 1st freeze hits, we are still at risk for mosquito bites, and it is important that everyone take steps to avoid being bitten," said Dr. Ahmed, medical officer of health.
=====================
[_Aedes aegypti_ mosquitoes sporadically appear in north temperate zones in the Americas, this time in Windsor, Ontario, Canada. As the above comment indicates, they will not survive the winter and will disappear with the onset of killing frosts, likely to occur in the next 2-3 weeks. The only way that local transmission of Zika, dengue, or chikungunya viruses could occur is in the unlikely event that a viremic individual came to a locality where there was a population of _Aedes aegypti_ large enough to permit ongoing transmission. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Windsor, Ontario, Canada: <http://healthmap.org/promed/p/1458>]
Date: Thu 22 Aug 2019
Source: The Canadian Jewish News [abridged, edited]

About 350 children in the Tosh Hasidic community north of Montreal have been vaccinated against measles, after 5 cases of the disease were confirmed there this summer (2019).

The 2nd of 2 temporary clinics set up by the public health authority within the community closed on [16 Aug 2019] after vaccinating at least 150 youngsters over 4 days, said Isaac Weiss, who is one of the people responsible for security and public safety in the community, which is located in the town of Boisbriand, Quebec. He said the 1st clinic took place about a month earlier, after "one suspected case" was discovered. About 200 children were vaccinated at that time. The immunization was offered to those whose medical records showed they were unvaccinated or not up to date, but was voluntary.

Community leaders are co-operating fully with the CISSS des Laurentides, which ran the clinics, said Weiss. The public health director, Dr Eric Goyer, said these were the 1st cases of measles in the region since 2011. There are about 500 Tosh families in Boisbriand, or 3000 people.
 
No one knows for sure how the infection spread. Weiss said it is thought that a young man from the community who went to New York to take part in a recreational after-school program may have contracted the virus and brought it back to Boisbriand. It appears that he had been vaccinated, but his shots were not up to date.
The community's leaders are informing members about the necessity of vaccinations and trying to dispel any fear about the risk of negative side effects. Unvaccinated children will not be permitted to attend the community's schools until the outbreak is deemed contained, Weiss said, but parents can only be persuaded, not forced, to vaccinate their children.

A father of 5 who asked that his name not be published, said, "We are outraged that there are parents -- a few -- who are so irresponsible as to refuse (vaccination). The rabbis are talking about it, everyone is talking about it, but some are difficult to convince."

Last spring (2019), when there was a serious measles outbreak in New York, Montreal public health authorities stepped up an educational campaign targeting ultra-Orthodox communities. While the rate of vaccination among those communities is believed to be similar to that of the general population, there is frequent contact between the Montreal and New York communities.

At the time, Rabbi Yonasan Binyomin Weiss, who serves as the chief rabbi of Montreal and heads the medical ethics committee of the Jewish Community Council, stated, "From a religious perspective, and also from an ethical and moral perspective, our message is very clear: families are required to follow the directions of the health authorities."

In April (2019), many Montreal doctors were among over 500 medical professionals serving Orthodox Jewish communities throughout North America who signed a public letter confirming the need for everyone to be vaccinated according to US Centers for Disease Control and Prevention guidelines. The doctors rejected "the dangerous misinformation campaign being spread and reject any unproven unscientific statements that contradict all available current science-based studies on vaccinations" against measles and other illnesses.  [byline: Janice Arnold]
Date: Fri, 2 Aug 2019 04:54:00 +0200 (METDST)
By Julien BESSET

King's Point, Canada, Aug 2, 2019 (AFP) - At dusk, tourists marvel at the sensational collapse of an iceberg at the end of its long journey from Greenland to Canada's east coast, which now has a front row seat to the melting of the Arctic's ice.   While the rest of the world nervously eyes the impact of global warming, the calving of Greenland's glaciers -- the breaking off of ice chunks from its edge -- has breathed new life into the remote coastal villages of Newfoundland and Labrador.

Once a hub of cod fishing, the province now plays host to hordes of amateur photographers and tourists hoping to capture the epic ice melt for posterity. As winter ends, iceberg spotting begins.   "It keeps getting better every year," says Barry Strickland, a 58-year-old former fisherman who now takes tourists in his small boat around King's Point in the north of the province.    "We've got 135, 140 tour buses with older people coming into the town every season so it's great for the economy."   For the past four years, Strickland has taken visitors to bear witness to the death throes of these ice giants, which can measure dozens of meters in height and weigh hundreds of thousands of tons.    Winds and ocean currents bring the icebergs from northwest Greenland, thousands of kilometers (miles) away, to Canada's shores.    In a matter of weeks, ice frozen for thousands of years can quickly melt into the ocean.

- 'Incredible' rise in tourism -
Strickland's boat excursions are often fully booked during the high season from May to July, with tourists coming from all around the world to King's Point, a village of just 600 inhabitants.   The villagers keep track of the icebergs on an interactive satellite tracking map put online by the provincial government.   "There's not much in these small outport towns anymore to keep people around, so tourism is a big part of our economy," said Devon Chaulk, who works in a souvenir shop in Elliston, a small town of 300 on "Iceberg Corridor," as the coastline is now known.   "I've lived here my entire life, and the increase in tourism around here in the past 10 to 15 years has been incredible. It's not surprising to have thousands of people here over the next couple of months," said the 28-year-old.    Last year, a total of 500,000 tourists visited Newfoundland and Labrador, a number roughly equivalent to the province's total population.    Those visitors spent nearly Can $570 million (US $433 million), government figures show.

- Melting ice -
The tourism boom has helped offset the decline in the region's traditional fishing industry, which is in crisis because of overfishing at the end of the last century.   Some are even marketing "iceberg water" as the purest on Earth -- and selling it as a high-end luxury item. The melt is also used in vodka, beer and cosmetics.    But beneath the shiny surface of economic success is the dark truth that the area is in part profiting from accelerated global warming in the Arctic, and that the industry is precarious at best.

In the village of Twillingate, employees at the Auk Island Winery -- which makes its product from iceberg water and locally picked wild berries -- have already seen that business can be unpredictable.   "We see the difference in the number of tourists from year to year, depending on the amount of icebergs in the area," says Elizabeth Gleason, who works at the winery.   "This year was a good year. Last year, we had almost none."   The Arctic is warming three times faster than the rest of the world. In mid-July, record temperatures were recorded near the North Pole.   In recent years, the icebergs have drifted further and further south, posing a threat to shipping on this busy route between Europe and North America.

For now, tourists are enjoying the view and the experience while they can.    "The prevalence of icebergs has good things and bad things about it," says Melissa Axtman, an American traveller.   Laurent Lucazeau, a 34-year-old French tourist, says seeing an iceberg was sobering.   "It is a concrete image of global warming to see icebergs making it to these places where the water is warm," he told AFP.   "There's something mysterious and impressive about it, but knowing too that they are not supposed to be here makes you wonder, and it's a little scary."
More ...

Cuba

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

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

Travel News Headlines WORLD NEWS

Date: Wed 3 Jul 2019
Source: 660 City News [edited]

A Newfoundland woman is warning travellers to do their research before adventurous excursions abroad after she and several other Newfoundlanders became ill from a mysterious disease traced back to a cave she visited in Cuba. The illness was eventually identified as a respiratory infection called histoplasmosis, or "cave disease," caused by spores from bird or bat droppings in damp soil. [She] of Paradise, NL, travelled to Cuba with her husband on 27 Apr [2019], but her fever-like symptoms didn't appear until 21 May [2019], weeks after she returned home. X-rays showed nodules in her lungs and tests showed low blood counts. Her condition baffled local doctors, who initially thought her lung infection could be some form of pneumonia. The clue to her illness came from a chance meeting she'd made on the trip with a family of Newfoundlanders who had a mutual friend. [She] and her husband had travelled with the group on a tour that included cave diving in the Matanzas province of Cuba.

Back in Canada, a number of their new friends had also fallen ill. [She] and the travellers informed their doctors that they knew each other and were experiencing the same symptoms, and their illness was identified as a respiratory infection called histoplasmosis, or "cave disease." [She] said pinpointing the source of her condition offered some relief from what she called a terrible, alarming health issue that she feared might have been cancerous. "You didn't want to be too excited about the fact that somebody else was sick, but at least cancer was off the table," [she] said by phone Wednesday [3 Jul 2019].

Eastern Health, [her] local health authority, has issued an advisory for travellers heading to the Americas, Africa, East Asia and Australia to avoid contracting the disease. Histoplasmosis is a treatable disease, contracted by breathing in airborne spores where bird or bat droppings are disturbed in damp soil. Eastern Health described its symptoms as including "cough and chest pain, shortness of breath, fever and chills, headaches and flu-like illness." The disease is treatable and most people who contract it never show symptoms, but it can be serious for infants or people with compromised immune systems. The health authority said the advisory was issued after a low number of histoplasmosis cases were confirmed in the Eastern Health region. An exact number of cases could not be provided for privacy reasons, but [the patient] said she's heard of at least 5 others.

While the disease is treatable, it is rare in Newfoundland, making treatment more complicated. [The patient] said she's waiting to receive an anti-fungal medication that had to be approved from outside of the province, and she's been told she'll have to take the drug for treatment for the next 3 months to a year. [The patent] said she's still experiencing fatigue and a persistent cough, and her voice is still scratchy and strained from an illness she contracted from what was one of the most breathtaking excursions on her vacation. "It was absolutely amazing," she said of the cave. "It was so pristine and so nice-looking when we went in."

[She] said she'd advise other travellers to do a thorough background check on the regions they're visiting and any planned excursions. "It's without a doubt that you have to go and you have to research the excursion that you're going on," she said. "You have to know the region, the areas, 100%. [She] wrote a Facebook post about her experience that's been shared thousands of times, and she said people as far as France have written to her about experiencing similar, undiagnosed symptoms after travelling abroad.  [Byline: Holly McKenzie-Sutter]
====================
[_Histoplasma capsulatum_, a dimorphic fungus that grows in a mycelial form at ambient temperatures and as yeast at body temperature in mammals, is found worldwide in soil enriched by bird or bat droppings. Contaminated soil can be potentially infectious for years. Fungal spores become airborne during activities that disturb the contaminated soil, such as spelunking, mining, construction, excavation, demolition, roofing, chimney cleaning, farming, or gardening, which can lead to clusters of cases of histoplasmosis that follow inhalation of the aerosolized spores. The spores can travel distances downstream from the source in currents of air. Because of the presence of bats in caves, cave exploration is a known risk factor for histoplasmosis, which is sometimes known as "cave fever" (<https://www.ncbi.nlm.nih.gov/pubmed/10403317>). Physicians should be aware of the association between histoplasmosis and caving when caring for individuals who develop an acute febrile respiratory illness after cave exploration (<http://tinyurl.com/yxjust7x>).

Another disease that has also acquired the name "cave fever" is tick-borne relapsing fever (TBRF). See ProMED-mail posts Tick-borne relapsing fever - Israel: spelunkers, tourists http://promedmail.org/post/20180422.5761531 and Tick-borne relapsing fever - USA: (TX) cave workers, 2017 http://promedmail.org/post/20180420.5759542.

Although birds cannot be infected by the _H. capsulatum_ and do not transmit the disease, bats can become infected by _H. capsulatum_ and may harbor the fungus in their gut (<https://academic.oup.com/jtm/article/15/2/133/1801173>).

In the US, histoplasmosis is endemic in the Ohio, Missouri, and Mississippi River valleys, where it is caused by _H. capsulatum_ var. _capsulatum_. Histoplasmosis has also been reported in Mexico, Central and South America, Oceania, Asia, Africa, and Europe (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535725/>). In Africa, histoplasmosis occurs most commonly in west and central Africa, where it is caused by the _duboisii_ variety, which has yeast cells that average about twice the size of _H. capsulatum_ var. _capsulatum_  (<http://www.reviberoammicol.com/1997-14/155159.pdf>).

Most individuals with histoplasmosis are asymptomatic. Those who develop clinical manifestations are usually immunocompromised or are exposed to a large number of spores. Disseminated disease is especially more common in HIV/AIDS co-infected cases. - ProMED Mod.ML]

[HealthMap/ProMED-mail maps:
Newfoundland, Newfoundland and Labrador, Canada:
Date: Wed, 5 Jun 2019 03:22:19 +0200
By Paul HANDLEY

Washington, June 5, 2019 (AFP) - The Trump administration clamped down on US tourist visits to Cuba Tuesday, aiming to cut the flow of dollars to a country that Washington accuses of helping prop up Venezuelan President Nicolas Maduro.

The Treasury Department banned group educational travel, cruise ship and private yacht visits by Americans, taking aim at the most common ways US tourists and Cuban-Americans visit the Caribbean island.   The move could constitute a heavy hit on Cuba, which saw more than a quarter-million US visitors in the first four months of 2019, almost double the figure from a year earlier.   "The United States holds the Cuban regime accountable for its repression of the Cuban people, its interference in Venezuela, and its direct role in the man-made crisis led by Nicolas Maduro," the State Department said in a news release.   "Empowered by Cuba, he has created a humanitarian disaster that destabilizes the region."

White House National Security Advisor John Bolton said the aim was to end what the administration considers "veiled tourism" to Cuba.   "We will continue to take actions to restrict the Cuban regime's access to US dollars," Bolton said on Twitter.   The Cuban government condemned the move, which could cost the country's economy tens of millions of dollars a year in lost income.   "They seek to stifle the economy and damage the standard of living of Cubans to wrest political concessions," said Foreign Affairs Minister Bruno Rodriguez in a tweeted statement. "They'll fail again."

- Reverses Obama's historic opening -
American tourism in Cuba took off after then-president Barack Obama moved to ease the half-century trade embargo against the communist government in 2014 -- even though continuing restrictions kept visits nominally in the realm of cultural and artistic exchanges and business dealings.   Cuba and the US restored ties in 2015 and Obama himself visited Havana in a historic presidential trip in March 2016, meeting with then-president Raul Castro. Weeks later, the ban was lifted on US commercial ship visits, opening the door for the Caribbean cruise ship industry to expand stops in Cuba.

But President Donald Trump came into office attacking the Obama opening, and within months began tightening relations, first by banning individual visits and limiting commercial interactions.   The State Department tied the new ban directly to Havana's support for Maduro -- whose embattled regime faces a direct challenge from US-backed opposition leader Juan Guaido, the self-declared acting president of Venezuela.  "Veiled tourism has served to line the pockets of the Cuban military, the very same people supporting Nicolas Maduro in Venezuela and repressing the Cuban people on the island," the State Department said.

- 'Political grandstanding' -
Collin Laverty, president of Cuba Educational Travel, one of the US agencies which arranges visits to Cuba, accused the Trump administration of playing politics by trying to appease conservative anti-Havana Cuban immigrants in Florida, an important election swing state where they carry significant political weight.   "This political grandstanding aimed at Florida in the run up to the 2020 elections is so unfortunate for the millions of Cubans that will feel the crunch from less US visitors," said Laverty.   "This has nothing to do with empowering the Cuban people and has everything to do with empowering a handful of people in Florida that have never even been to Cuba."   Travel industry officials said that people who are booked on tours now will be able to go, ensuring that advanced-booked cruise ships will likely be operating from Florida to Havana throughout this year.   But Royal Caribbean Cruises said ships leaving Wednesday and Thursday of this week will skip previously scheduled stops in Cuba as the company examines the new US policy.

Norwegian Cruise Lines said they are seeking additional information on the new policy to see how it will affect future travel.   Tessia Aral, the owner of ABC Charters in Miami, said it could have a huge impact on her business, which arranged trips to Cuba for about 10,000 people last year.   She said it will hurt not only companies like hers but also those of the many entrepreneurs in Cuba who have built businesses to serve tourists.   "The people making the rules have never been to Cuba. They don't know how things have changed" in recent years, she said.   "What they are doing is counter-productive. I believe it's really going to hurt the private entrepreneurs in Cuba -- all the private restaurants, all the private homes" who serve tourists.
Date: Sun, 10 Mar 2019 04:13:11 +0100
By Katell ABIVEN

Havana, March 10, 2019 (AFP) - In Havana, there's a shop selling a camera for more than $25,000 -- roughly 850 times the average monthly wage in Cuba.   The eye-popping sum earned predictable scorn on social media, but it begins to make sense when seen through the lens of the island's fledgling bid to tap into the luxury tourism market.

The exclusive camera store and other boutiques featuring A-list brands like Versace and Armani are located in a shopping gallery on the ground floor of the swanky Gran Hotel Manzana.   The mere existence of the shops certainly seems incongruous in a country that has been governed as a one-party communist state since 1959, and where the average wage is $30 a month.   But the hotel isn't exactly looking for locals to buy in -- it attracts "a clientele of private airplanes... princes and celebrities," according to general manager Xavier Destribats.

The Gran Hotel Manzana, the first ever five-star establishment in Havana, opened in 2017 in a sumptuous historic building that was, at the beginning of the 20th century, the island's first shopping mall.   The property run by Swiss group Kempinski is "the first genuine luxury hotel in Havana," said Destribats.   "It's the first hotel with a 1,000-square-meter spa," he said. All the rooms are at least 40 square meters (430 square feet), with prices ranging from $370 for a basic room in low season to $5,000 for the presidential suite.   "There was a certain type of clientele that didn't travel to Havana, or Cuba, because there wasn't the standard of luxury five-star hotel like in cities such as Paris or London," Destribats added.

- 'Feels like Miami' -
The hotel terrace offers stunning views over Havana's colorful historic neighbourhood, where many Cubans live in dilapidated buildings that have fallen into disrepair or have vegetation sprouting from them.   "It really doesn't feel like Cuba, clearly not -- it feels like being in the United States, Miami or Puerto Rico," said Celia Liegeois, a 26-year-old tourist from Paris.   Having traveled around the island nation for three weeks, she and a friend had decided to spend their last few days relaxing by the hotel's rooftop pool.

Nearby, Suki Lu, a recently arrived 28-year-old Chinese television presenter, is impressed at what she sees.   "It's beautiful. Look at the sunset! It's truly addictive," she said.   "I live in Dubai so when you talk about luxury hotels, the level there is really high, but I think I'll like this hotel," she said, while her friend used a drone to get an aerial view of the building.   The largest single group of visitors to the Gran Hotel Manzana -- one-fifth of the total -- are tourists from the United States, although there are plenty of visitors from Europe, Asia and the Middle East.

The Kempinski group, which hopes to open two or three more hotels in Cuba, is of course not the only chain to show an interest in the ultra-luxury market.   In September 2018, Spain's Iberostar opened its second five-star hotel, the Grand Packard.   French hotel giant Accor is planning on opening its own luxury establishment on the Malecon, Havana's famous seaside boulevard, in September.   It will include a chocolate shop on its ground floor and a restaurant and concert space on its roof.   The employees' outfits will be designed by Spanish fashion designer Agatha Ruiz de la Prada.

- US blacklist -
However, there is a slight catch: in every case, the hotels are owned by Gaviota, the Cuban army's branch dedicated to tourism.   The foreign hotel groups are only allowed to run the establishments, all built by French group Bouygues, which has a long-standing local presence.   Authorities don't publish the army's revenues, but this alliance between hoteliers and the military landed the luxury hotels on Washington's blacklist.

US tourists are technically banned from staying in the hotels -- but the restriction can be easily circumvented by either paying in cash or booking through travel agents.   Beyond hotels, developers have more ideas to entice those with deep pockets.   "There's a plan to build golf courses in partnership with real estate groups," said industry expert Jose Luis Perello.   The opening of a luxury hotel means Cuba has turned a corner, he said.   "Since it opened up to international tourism more than 20 years ago, Cuba has focused all its plans and strategies" on "sun and beach tourism" for the masses, Perello said.   That category currently accounts for 73 percent of the 70,000 hotel rooms on offer in Cuba. And those who rent them usually don't spend much money.

The same goes for cruise ship tourists -- while the number of cruises docking in Cuba has exploded, passengers only spend an average of $15 a day on land.   That isn't great news for Cuba, which welcomed 4.7 million tourists in 2018 -- it needs the cash.   The government, which has been subjected to US sanctions since 1962, used to depend on aid from its oil-rich ally Venezuela.   But with Venezuela in turmoil, Cuba is scrambling for other sources of hard currency and its economic growth has stagnated at around one percent -- not enough to cover the population's basic needs.   Opening luxury hotels is "a new stage," but also "a necessity," Tourism Minister Manuel Marrero Cruz says.
Date: Mon, 4 Feb 2019 03:08:04 +0100

Havana, Feb 4, 2019 (AFP) - The number of people killed in the powerful tornado that ripped through part of Havana last week has risen to six, authorities said Sunday.    Public Health Minister Jose Angel Portal Miranda said in state media that "sadly, two people have died among the 13 who were in critical condition." The earlier death toll was four.

The storm which hit Havana area towns including Regla, Guanabacoa, San Miguel de Padron and 10 de octubre late January 27, has been confirmed as a F4 storm, with F5 the strongest.    Its powerful winds overturned trees and homes and cars, and several areas a number of blocks wide were all but wiped off the map.
Date: Mon, 28 Jan 2019 19:01:10 +0100

Havana, Jan 28, 2019 (AFP) - A rare and powerful tornado has devastated sections of Havana, overturning cars, uprooting trees and leaving homes in shambles. Three people were killed and 172 injured, Cuban President Miguel Diaz-Canel said Monday.   A shaken resident, recalling a night of terror, said she clutched her daughter and crouched down in her kitchen as the tornado came roaring in Sunday night.   "It was as if rocks were falling -- it was hail -- and I felt things beginning to fall. It lifted my entire roof, and took everything away," Canaima Hernandez, 36, said, sobbing.   Hernandez's Havana neighborhood, Regla, was one of the hardest hit by the tornado, which state media said was comparable in strength to the most powerful hurricanes.

Residents picked their way through overturned vehicles, collapsed walls, overturned lampposts, and uprooted trees on Monday morning.   Diaz-Canel, who toured the city's darkened streets visiting emergency crews, wrote on Twitter that damage was "severe."   In the city's Luyano neighborhood storm debris -- including parts of a balcony ripped off an old building --  blocked the streets, AFP photographers reported.   As emergency sirens blared across the city, firefighters and ambulances rushed about on rescue missions, their flashing lights giving light to blacked out areas.   "As of now we mourn the loss of three human lives and 172 injured people are receiving aid," Diaz-Canel tweeted.    He added that several emergency teams were working hard to restore power to blacked-out areas.

At the Hijas de Galicia maternity hospital staff were forced to evacuate the building due to storm damage.   The tornado, spawned by a powerful storm that originated in the Gulf of Mexico, hit western Cuba with winds of up to 100 kilometers (60 miles) per hour.   "Islanders are used to these warnings, but they did not suspect the magnitude of what was approaching," said Granma, the Communist Party daily.     People described the tornado as having "the sound of a jet engine," and reported feeling changes in the environmental pressure when it arrived, Armando Caymares with the Institute of Meteorology said.

The tornado "caught me in the street, in the car with my wife and children," actor Luis "Panfilo" Silva wrote on his social media account.   "I had to dodge fallen trees, flooded areas and strong winds until I managed to get home. We experienced great fear," he wrote.   Francisco Sotolongo said it was a good thing the tornado's impact only lasted seconds. "Because if it lasted a minute there would be nothing left here."   High winds sent sea water surging over the city's famed Malecon esplanade and several meters into the city. The western provinces of Pinar del Rio, Artemisa and Mayabeque also were affected by the storm.
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World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
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.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline 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.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."