WORLD NEWS

Getting countries ...
Select countries and read reports below or

Andorra

General
************************************
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
**************
*********************
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
***************************************
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
************************************
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
************************************
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
************************************
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
************************************
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]
=====================
[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]
More ...

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.
=====================
[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:
More ...

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 ...

Slovakia

Slovak Republic US Consular Information Sheet
July 09, 2008
COUNTRY DESCRIPTION:
The Slovak Republic is a rapidly developing European nation. Tourist facilities are not as developed as those found in Western Europe, particularly outside th
major cities, and some goods and services taken for granted in other European countries are occasionally unavailable.
Read the Department of State Background Notes on the Slovak Republic for additional information.

ENTRY/EXIT REQUIREMENTS: A passport is required. A visa is not required for stays for tourism or business up to 90 days within six months of the date of first entry into the Slovak Republic/Schengen zone. That period begins when you enter any of the Schengen countries: Austria, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Slovakia, Slovenia, Spain and Sweden.
All foreigners seeking entry into the Slovak Republic must carry proof of a medical insurance policy contracted for payment of all costs for hospitalization and medical treatment in the Slovak Republic.
Border police have the right to request evidence of finances sufficient to pay for the proposed stay in the Slovak Republic in the amount of $50 per person per day.
Current information can be found on the Slovak Embassy’s web site at http://www.slovakembassy-us.org.

All persons in Slovakia over the age of 15 must carry official identification at all times. American citizens staying overnight in Slovakia must register with the local Border and Aliens Police within three working days.
Persons staying hotels are registered automatically.
Visit the Slovak Ministry of the Interior’s web site at http://www.minv.sk for the most current information.

NOTE: On December 21, 2007, Slovakia became a member of a group of countries collectively known as “Schengen countries” or the “Schengen zone.” Americans may enter and remain within the entire Schengen zone without a visa for no more than 90 days in any six-month period. If an American has just spent 60 days in another Schengen country, for example, he or she would be permitted to enter Slovakia only for the remaining 30 days. It is not possible to extend a tourist stay beyond 90 days in the Schengen zone. Once an American has used his/her 90 days, he/she cannot reenter Slovakia until he/she has spent at least three months outside the Schengen zone.

Although European Union regulations require that non-EU visitors obtain a stamp in their passport upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passport may be questioned and asked to document the length of their stay in Schengen countries, and could face possible fines or other repercussions if unable to do so.

Persons wishing to remain in Slovakia longer than 90 days or arriving for purposes other than tourism or business travel may apply for temporary residency and/or work permits shortly after arrival in Slovakia.
However, it is strongly recommended that such persons review the requirements and begin preparing their applications prior to travel, as many documents required of U.S. citizens are more easily obtained in the United States.
For example, U.S. citizens must submit a certificate not older than 90 days showing the result of a fingerprint records check by the FBI.
As authorities in Slovakia cannot take fingerprints for this purpose, it is extremely difficult to obtain this certificate after arrival in Slovakia.
In addition, Slovakia requires all documents (birth certificates, etc) intended for official use in Slovakia to be authenticated (e.g. to have an apostille). See our section on Judicial Assistance for more information.

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

SAFETY AND SECURITY:
Taking photographs of security/military installations (for example, military bases, government buildings, nuclear power plants, etc.) is prohibited. Violation of this law may result in confiscation of the camera, film or memory card, a reprimand or fine, or even expulsion from the country. Serious cases may be reported to and handled by local and/or military police.

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

Up-to-date information on security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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 Slovak Republic has a medium rate of crime. Police forces suffer from a lack of manpower resources and equipment. Local police are not likely to speak English. Western visitors, especially short-term visitors such as tourists and students, are the primary foreign targets of street crime. The majority of street crime is non-violent and ranges from pickpocketing (particularly in the summer) and purse and cellular telephone snatchings to mugging, armed robbery, shooting, drugging and robbing of unsuspecting victims at nightspots and bars. Most reported thefts occur at crowded tourist sites (such as Bratislava’s Old Town area) or on public buses or trains. Thieves in the Slovak Republic often work in groups or pairs. In most cases, one thief distracts the victim, another performs the robbery, and a third person hands off the stolen item to a nearby accomplice. Groups of street children are known to divert tourists’ attention so that a member of their group can pickpocket the tourists while they are distracted. Do not leave personal items in unattended vehicles, even if locked.
Reports of racially motivated incidents against foreigners and minorities, particularly perpetrated by groups with a history of targeting persons of Roma, African, or Asian descent, have occurred in the Slovak Republic. In addition to incidents of assault, persons of Roma, African, or Asian heritage may be subject to various types of harassment, such as verbal abuse.

Both indigenous and foreign organized crime groups are well-established in the Slovak Republic. They do not target U.S. or other foreign individuals and tend to co-exist peacefully in the tourist district so as not to scare away tourist dollars. Though not common, violent incidents sometimes do occur outside of Old Town Bratislava.

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 or Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
The local equivalent to the 911 emergency line in Slovakia is 155.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are available in the Slovak Republic, although the quality and availability varies within the country. Ambulances are only a means of transportation to the hospital; they may not have life support stabilization equipment on board. Only a limited number of doctors speak English.
Doctors and hospitals expect cash payment for health services unless the patient can present an insurance number from the Slovak National Insurance Company. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars or more.

Medical prescriptions issued in the U.S. are not valid in the Slovak Republic. If needed, a local doctor must issue a prescription. Medicines are generally available locally, if not under the American name the doctor can be consulted for a substitute. The Ministry of Health of Slovak Republic administers the use of medicines and medicine brought to the Slovak Republic for personal use may become subject to comparison against the list of those authorized for use in the Slovak Republic.

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 the Slovak Republic is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Roads in the Slovak Republic typically are safe and well maintained. Four-lane highways exist in and around Bratislava. However, most roads outside of built-up areas are two lanes only, and aggressive drivers attempting to pass at unsafe speeds pose a serious hazard. Due to poor lighting and narrow, winding roads, nighttime driving outside of built-up areas is not recommended.

From November through March there is often heavy snowfall, which is not adequately cleared from many rural roads. Roads in the mountainous northern part of the country are particularly prone to hazardous conditions during winter months. Winter tires are recommended and chains are necessary in certain mountainous areas.

In the Slovak Republic, vehicles travel on the right side of the road. Headlights must be used at all times (day and night) from October 15 until March 15. The maximum legal speed on highways is 130 kilometers per hour (78 mph). On smaller roads the maximum speed in 90 kph (54 mph). The limit in towns is 60 kph (36 mph). Use of cellular phones while driving is strictly prohibited. Safety reflection vests and first aid kits are compulsory equipment of each vehicle.

Drivers must yield the right of way to all vehicles with flashing blue lights (police, ambulances, fire trucks, motorcades). Vehicles with yellow or orange lights usually mean that traffic must slow down. Drivers must always be cautious, however, as many slowly moving vehicles, such as agricultural vehicles, are not well marked.

Driving under the influence of alcohol is strictly prohibited. The blood alcohol tolerance level is zero percent.
Penalties for drivers involved in car accidents involving injury of death are decided by a court of law. Penalties for minor offenses are not generally large, but foreigners are sometimes targeted for additional sums. Anyone suspecting this has occurred should ask for a written receipt and note the name and number of the traffic officer imposing the fine.

Gasoline is readily available, although many gas stations are closed on Sunday, especially in rural areas. Gas stations typically do not offer repair service; private mechanics must be found. Most gas stations accept credit cards, but mechanics less frequently accept them, so travelers should expect to pay for these services in cash.

A highway user decal must be purchased for travel on most major roads outside of Bratislava. The decal is valid for the calendar year in which it is purchased, and is available at gas stations, post offices and some newspaper kiosks. The cost is 1100 Sk (Slovak crowns) for all vehicles up to 3.5 tons. A short-term decal valid for 30 days may be purchased for 300 Sk and for 7 days for 150Sk.

Taxi companies provide generally reliable, safe, and economical services. Avoid independent cabs that do not prominently display a company name. Visitors should be alert to the potential for substantial overcharging by taxis, particularly in areas frequented by tourists. Radio-dispatched taxis are often much more reliable.

Buses, trolleys, and trams are mechanically safe, but there have been reports of thefts on city transportation and of harassment by the transport police. On public transportation it is obligatory to have a time-ticket validated after entering the vehicle (valid for 10, 30, or 60 minutes), or a prepaid zone ticket (valid for 24,.48,. or 68-hours, and 1 month, 3 months or 1 year). Children from 6 to 15 years of age pay reduced fares. Passengers who are traveling without a valid ticket will be fined by the ticker inspector. The ticket inspector has to have an identification card and must provide a ticket for the fine. More information is provided in English at www.imhd.sk.

Inter-city travel is widely available by bus, train, or taxi and is generally safe (inquire about taxi fares in advance). There are regular international trains and buses which are mechanically safe. However, there is a danger of theft, even from locked compartments, particularly on international night trains serving Warsaw, Prague and Budapest. Taxi drivers with special permits may provide international taxi service.

A motorcycle driver’s license and helmet are required. Small motorcycles are not allowed on highways. All traffic regulations apply.

Tourists coming to the Slovak Republic are required to have an International Drivers’ Permit. A U.S. driver’s license alone is not sufficient to drive in Slovakia. The U.S. driver’s license must be accompanied by an International Driver’s Permit, obtainable in the United States from the American Automobile Association and the American Automobile Touring Alliance.

A Slovak Driver’s License can be applied for at the Dopravny Inspektorat in the district of the applicant’s place of residence in the Slovak Republic. Completion of the regular driving course and a written examination (in Slovak) are required for issuance of a Slovak driver’s license. For specific information concerning Slovak driver’s permit, vehicle inspection, road tax and mandatory insurance, contact the Slovak Embassy in Washington, DC.

Please refer to our Road Safety page for information.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in the Slovak Republic, the U.S. Federal Aviation Administration (FAA) has not assessed the Slovak Republic’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 www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Slovak customs authorities enforce strict regulations concerning temporary importation into or export from the Slovak Republic of items such as firearms, antiquities, medications, business equipment, etc. It is advisable to contact the Embassy of the Slovak Republic in Washington, D.C, or one of the Slovak consulates in the United States for specific information regarding customs requirements.

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 Slovak laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Slovakia are strict and convicted offenders can expect 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 AND CONSULATE LOCATIONS:
Americans living in the Slovak Republic are encouraged to register with the nearest U.S. Embassy of Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within the Slovak Republic.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy in Bratislava is located at Hviezdoslavovo namestie 4, Bratislava telephone (421) (2)5443 0861; (421) (2) 5443 3338, fax (421) (2) 5441 8861; mailing address: U.S. Embassy, P.O. Box 309, 814 99 Bratislava, Slovak Republic; e-mail: consul@usembassy.gov; web site:http://slovakia.usembassy.gov
* * * *
This replaces the Country Specific Information for Slovakia dated December 17, 2007 without substantive changes.

Travel News Headlines WORLD NEWS

Date: Thu 2 Jun 2016
Source: The Slovak Spectator [edited]
<http://spectator.sme.sk/c/20179834/number-of-people-infected-with-tick-borne-encephalitis-rises.html>

The number of people suffering from tick-borne encephalitis in Košice increased again on 1 Jun [2016]. So far 27 infected patients have been hospitalised at the Infectology and Travel Medicine Department (KICM) of the Louis Pasteur University Hospital (UNLP) while another 5 are being monitored by doctors at outpatient departments. "This number is not necessarily definitive, as the incubation period of the disease (between 7-14 days - ed. note) has not expired yet," said Ladislava Šustova¡, the hospital's spokesperson, as cited by the SITA newswire.

Some patients have been released from the hospital already while doctors have not recorded any complications in treatment so far. Local tick-borne encephalitis broke out in Košice last weekend [28-29 May 2016]. Consumption of cheese produced from unpasteurized sheep's milk is said to have caused the infection. Symptoms of this infectious viral disease come in 2 stages: "The 1st presents as a mild flu, including a loss of appetite and intestinal problems," explained Šustova.

"After 3 or 4 days these problems fade and the so-called asymptomatic phase occurs, which can last up to 20 days. Then a 2nd phase sets in abruptly, featuring high fever, persistent headaches, vomiting, sensitivity to light, a stiff neck, and other symptoms characteristic of the involvement of the central nervous system." One of the most serious complications of the disease is meningitis. KICM records 6 cases of tick-borne encephalitis on average per year.

"Such a mass outbreak of tick-borne encephalitis has not been recorded at this hospital for the past 5 years," said Šustová. In total, Slovak doctors diagnosed 88 cases of tick-borne encephalitis in Slovakia last year [2015], 17 of which were found to be contracted via food. So far this year [2016], except for the local epidemic in Košice, 8 people have contracted the disease, none of them via food, Martina Merková from the Public Health Authority (ÚVZ) told the TASR newswire.
=======================
[Central and Eastern Europe countries are endemic for the European subtype of tick-borne encephalitis (TBE) virus and cases occur yearly there. Although castor bean ticks, _Ixodes ricinus_, are the main vectors that transmit TBE virus to people, individuals can become infected by consumption of unpasteurized milk and milk products coming from infected animals -- goats in the situation above.

Presumably, the public will be warned of this risk and advised of measures to avoid tick bites and be vaccinated as people become more active out of doors with the onset of warmer weather. The Standing Commission on Vaccination Recommendations at the Robert Koch Institute recommends vaccination against TBE for people who live or work in areas at risk of TBE and who are at risk of tick bites, and for people in endemic areas for other reasons if they are at risk of tick exposure. - ProMed Mod.TY]

[Maps of Slovakia can be seen at <http://www.ezilon.com/maps/images/europe/Slovakian-political-map.gif> and <http://healthmap.org/promed/p/53556>. - ProMed Sr.Tech.Ed.MJ]
   Date: Tue 14 Oct 2014
Source: Czech News Agency [edited]

Sanitary authorities registered dozens of cases of hepatitis A in southern Slovakia over the past few weeks, and due to the local epidemic, they ordered the suspension of activity at some schools and vaccination in the afflicted localities, the health authority in Nitra said today, 14 Oct 2014.

The hepatitis mainly spread in the Zlate Moravce and Levice districts, afflicting all age groups, the office said. In Zlate Moravce, most of the cases were confirmed with the local Romas and the people living in very poor sanitary conditions. As many as 14 infected persons lived at the same address in the village of caradice, without water and toilets.

"The number of ill is rising," the head of the teaching hospital in Nitra, Jozef Valocky, is quoted as saying. So far, at least 50 people have contracted hepatitis. In the afflicted localities, the sanitary officers have ordered the vaccination of about 1000 people as well as preventative vaccination of the children living in poor sanitary conditions.
====================
[Hepatitis A is a liver infection caused by the hepatitis A virus. The virus is spread by faecal-oral transmission. Hepatitis A is closely associated with inadequate sanitation and poor personal hygiene. Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms. Hepatitis A occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. Waterborne outbreaks are usually associated with sewage contaminated- or inadequately treated water.

Casual contact among people does not spread the virus. In developing countries (where sanitary conditions are poor), most children experience infection in early childhood. As a consequence of poor sanitary conditions and hygienic practices, most children (up to 90 percent) have been infected with the hepatitis A virus before the age of 10. Those infected in childhood do not experience any noticeable symptoms. Consequently, epidemics are uncommon because older children and adults are generally immune. Symptomatic disease rates in these areas are low, and outbreaks are generally rare, although one seems to have occurred here. - ProMed Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sat 10 Nov 2012
Source: NOVINY.SK [in Slovak, trans., edited]

Farm in Staskovce quarantined because of anthrax
------------------------------------------------
In the past few days 4 oxen have died on a farm in the village of Staskovce, Stropkov [district, Presov region]. The diagnosis has been confirmed in one of the animals.

The animals died over a short period of some 3-4 hours and the event took everyone by surprise. The farmers claim that they have seen nothing like this in the previous 20 years. And they take pride in the quality of livestock -- cattle, pigs, horses -- that they produce.

The veterinarians are on the farm and the affected herd has been quarantined in the farm stables. The affected animals had appeared to be healthy and the owner was taken by surprise.

Anthrax had been seen previously in the district of Svidnik 2 years ago.
----------------------------------------
communicated by:
Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach
52385 Nideggen
Germany
=====================
[This report is abstracted from a TV news report and if you go to the site you can hear the full report in Slovak.

In July 2010, 3 farms in Svidnik, Presov region, were reported with outbreaks and 9 animals were affected (see <http://www.oie.int/wahis_2/public%5C..%5Ctemp%5Creports/en_fup_0000010361_20110314_165943.pdf>). From the OIE reports and map they would appear to have been adjoining farms. These 2010 outbreaks were the first since 1995 in Slovakia, which is regarded as essentially free. But they had a human case in 2003, not otherwise explained, which suggests that the their freedom was conditional, that is, there were some unreported background cases. This could hint at the farmer having bought contaminated hay grown in one of those disturbed fields and the hay got soil contaminated -- this can happen if it rains during haymaking and mud gets included in the hay.

These outbreaks out of the blue usually are a result of earth moving activities on the farm, which resulted in an old anthrax grave being disturbed or of a waste-pit at a now closed tannery, which is much the same thing epidemiologically. However a new risk has shown itself latterly of contaminated imported bone meals. If this were the case there will be essentially simultaneous outbreaks on other dairy farms in the area from the same bone meal shipment.

Let us hope that the Slovak veterinarians are investigating this outbreak to discover the source of the infection.

Date: Tue, 18 Sep 2012 15:08:54 +0200 (METDST)

Bratislava, Slovakia, Sept 18, 2012 (AFP) - Slovakia banned alcohol from the Czech Republic Tuesday amid a wave of poisoning from methanol-tainted bootleg spirits that has claimed 21 Czech lives and put four Slovaks in hospital. "As a neighbouring country, which imports a quarter of Czech-made alcohol, we decided to ban the import and sale of Czech alcohol, effective as of 5 pm (1500 GMT) today," Agriculture Minister Lubomir Jahnatek told journalists.  "This is a precautionary measure after we learned that grocery chains were planning a big sale on Czech alcohol for tomorrow," he added. So far Slovakia, a nation of 5.4 million, has not recorded any bootleg-related deaths. Four people were hospitalised on Sunday after drinking a bottle of Czech-made plum brandy ordered over the Internet, but were reported to be in good condition.

The Slovaks had bought the liquor for a 50th birthday party via the Internet and received it in plastic bottles, local media reported. Poland banned the sale of all Czech-made alcohol except for beer and wine on Sunday after five deaths were recorded in the past two weeks, though they were not necessarily linked. On Friday, the Czech health ministry imposed a blanket ban on sales of spirits with over 20 percent alcohol content for the first time in the history of the nation of 10.5 million, which has the world's second highest adult alcohol intake after Moldova.

The ban could last for months, Health Minister Leos Heger said. A health ministry analysis showed most of those affected had drunk one of two types of tainted liquor -- vodka or a local rum dubbed "tuzemak". The Czech Association of Spirits Producers and Importers meanwhile said it estimated the bootleg liquor sold on the black market "made up 20 percent of total Czech alcohol consumption." Czech police were still looking Tuesday for the primary source of the poisonings but 23 suspected bootleggers and their distributors had faced charges as of Tuesday.
Date: Wed, 11 Jul 2012 21:56:23 +0200 (METDST)

BRATISLAVA, July 11, 2012 (AFP) - An 18-year-old Belgian boy scout was killed by a lightning while hiking in the High Tatra mountains in northern Slovakia on Wednesday, local media reported. "A group of Belgian boy scouts were hiking in the High Tatra mountains when a lightning struck one of them" on the summit of Slavkovsky Stit, 2,452 metres (8,045 feet) above sea level, the TASR news agency said. "The scouts called the emergency and started resuscitating him but neither they nor the emergency team that arrived by helicopter succeeded and the boy died," it added.
More ...

Latvia

Latvia US Consular Information Sheet
October 02, 2008
COUNTRY DESCRIPTION:
Latvia is a stable democracy with a developing economy. Most tourist facilities found in a western European city are available in the capital city of Riga. However,
some of the goods and services taken for granted in other countries are not yet available in other parts of the country. Read the Department of State Background Notes on Latvia for additional information.
ENTRY/EXIT REQUIREMENTS: Latvia is a party to the Schengen agreement. As such, U.S. citizens may enter Latvia 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. Travelers remaining in Latvia for more than 90 days, including 180 day periods that cross over two half-calendar years, must apply for temporary residence. All travelers must have a valid insurance policy, covering medical expenses while in Latvia. Repatriation costs, including funeral and disposition of remains costs also have to be covered by the policy. In addition, upon entering or exiting the country, travelers must declare cash in excess of 10,000 euros to Latvian customs. For more information, travelers may contact the Latvian Embassy, at 2306 Massachusetts Avenue NW, Washington, DC 20008, tel. (202)328-2840, fax (202) 328-2860. For further information, visit http://www.latvia-usa.org. Within Latvia, contact the Ministry of Interiors Office of Citizenship and Migration Affairs at Ciekurkalna 1, linija 1,k,3,Riga, LV 1026. Tel. (371)67219645, (371)67219679, (371)80007657, fax (371)67219654, e-mail: pmlp@pmlp.gov.lv, web site http://www.ocma.gov.
Any traveler to Russia, even in transit, is advised to obtain a visa prior to entry into Latvia. The process of obtaining a visa at the Russian Embassy in Riga can be lengthy, and involve surrender of the passport for an undetermined period of time. Visit the Embassy of Latvia web site at http://www.latvia-usa.org for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information.
SAFETY AND SECURITY:
Civil unrest is not a problem in Riga. Nonetheless, in the past, Riga has seen large, peaceful demonstrations related to internal political issues. While demonstrations have been peaceful, American citizens are nevertheless cautioned to avoid any large public demonstrations. There have been no incidents of terrorism directed toward American interests. Incidents of anti-Americanism are rare. However, instances of racially motivated verbal harassment, and on occasion, physical assaults on non-Caucasian foreigners, have occurred in Riga. There have also been reports of non-Caucasian foreigners being subjected to extra scrutiny by security guards in shops and malls in Riga. Additionally, individuals displaying alternative lifestyles have experienced harassment.

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, as well as the Worldwide Caution can be found.
Up-to-date information on security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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 notice A Safe Trip Abroad.
CRIME: Crime in Riga is generally non-violent. The majority of non-violent crime tends toward acts of pickpocketing, identity theft, and personal scams. However, there have been instances of serious violent assaults and robberies. Street crime is a serious problem, particularly for tourists. In addition to pickpockets in all public areas, there are numerous scam artists targeting foreigners in the tourist pubs and restaurants. There have been a number of reports recently of foreign tourists being charged xorbitant prices for drinks in bars. Some have then been assaulted or forced to withdraw money from an ATM to pay the bill. You can avoid situations like this by ensuring that you check the price of drinks before ordering, pay for one round at a time and seek recommendations for bars from trustworthy sources. There have also been a few cases of tourists and residents being drugged in bars and restaurants and then taken outside or to their residences and robbed. In any public area, one should always be alert, particularly to being surrounded by two or more people at once. It is not uncommon for groups of pickpockets to attempt to overwhelm their victim. Gangs of professional pickpockets are specifically targeting foreigners, particularly those carrying backpacks. In addition, Riga has one of the highest rates of car theft in the world.
Internet crime is a growing concern in Latvia. Common fraudulent schemes involve both Internet auction sites and Internet job search sites. In the first scam, criminals offer valuable items for sale at low prices on Internet auctions and request that payments be sent by wire transfer to a bank in Latvia or through a fraudulent escrow site that they have created themselves. In this scheme, the money passes through a bank in Latvia and is quickly withdrawn by ATM or transferred to a bank in another country. It is very difficult in these cases to discover the identities of the account holders or recover the funds.
The second common scam involves identity theft through false job offers. In this scheme, a company claiming to be located in Latvia, but which has a non-existent address, offers the victim employment as a U.S. – based agent or freight forwarder. When the victim responds to the job offer, commonly posted on one of several popular Internet job sites, a Social Security Number and other identifying information needed for the identity theft is required under the guise of conducting a background check.

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 or Consulate staff can, for example, assist you to find appropriate medical care, to 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. For more information, see Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Latvia is steadily improving, but remains limited in several important respects. There are a few private clinics with medical supplies and services, including disposable needles and basic modern diagnostics, which are nearly equal to Western Europe or U.S. standards. However, because of the lack of equipment and resources, most major invasive procedures or surgeries in Latvia are not recommended. Hospital services have shown good progress but are still not equal to Western standards. Elderly travelers and those with existing health problems may be at risk due to inadequate medical facilities. Most, but not all, antibiotics and prescription medications are available but as they are generally produced in Europe or Latvia, they often have different names and instructions are usually not printed in English. Diphtheria, hepatitis and tick-borne encephalitis are present. According to the World Health Organization, tuberculosis is a significant problem in Latvia, with 9% of all cases being multi-drug resistant. For further information, please consult the CDC’s Travel notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx. State ambulance service for emergencies is available by dialing 112 anywhere in Latvia. However, response time is poor in rural areas. Air ambulance service is available for medical evacuations. In general, private air ambulance services are very expensive and require advance payment before the patient is transported.
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
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 Latvia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Foreign visitors to Latvia planning to operate a motor vehicle are required to obtain an International Driving Permit. These may be obtained through the American Automobile Association (AAA) or the American Automobile Touring Alliance for a small fee. A U.S. state driver’s license is not sufficient. These requirements apply to those operating rental cars as well, whether or not the rental company chooses to enforce the requirement as a condition of rental. Individuals driving without an International Driving Permit may have their vehicle confiscated by the police. Americans resident in Latvia for more than six months are required to apply for a Latvian driver’s license. Upon receipt of a Latvian driver’s license, American citizens are required to surrender their US driver’s license to the Latvian authorities. The licenses are then returned to their respective states of issuance. For more information, visit the Latvian Road and Traffic Safety Department at http://www.csdd.lv
Latvia has one of the highest rates of automobile accidents and fatalities in Europe. While recent reports show a decrease in the number of traffic accident fatalities, there are still a number of hazards to watch out for. Drivers should be alert for pedestrians and slow moving vehicles in traffic. Additionally, violation of traffic rules is common, and it is not unusual to be overtaken by other automobiles traveling at high speeds, even in crowed urban areas. Drivers do not always yield to pedestrians, even at marked intersections. During winter, most major roads are cleared of snow. However, drivers should be alert for fog, snow, and ice while driving. Driving while intoxicated is a very serous offense and carries heavy penalties. Local authorities use roadblocks and Breathalyzer tests as enforcement tools. Drivers and pedestrians should be alert to the possibility of drunk drivers and drunken pedestrians wandering on the road. Drivers must use their headlights at all times. Speed limits are usually 50 km/hr in the city and 90 km/hr on the highways. Public transportation is generally considered safe, but travelers are encouraged to select well-marked taxis. Emergency services are fair but improving (See section on Medical Facilities above); response time may be especially slow in traffic or in rural settings. Dial 112 for ambulance service.
Please refer to our Road Safety page for information. Visit the website of Latvia’s national tourist office at http://latviatourism.lv/info.php and the national authority responsible for road safety at http://www.csdd.lv/
AVIATION SAFETY OVERSIGHT:As there is no direct commercial air service to the United States by carriers registered in Latvia, the U.S. Federal Aviation Administration (FAA) has not assessed Latvia’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 www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Banks and currency exchange counters may refuse to accept U.S. currency that is crumpled, torn, discolored or defaced (even small pen stokes, hand written numbers and letters are considered defacing). If such notes are accepted for exchange, an additional processing fee, based on the size of the transaction, may be charged. ATMs are widely available in Riga and in major towns. For security purposes, it is recommended that visitors use ATMs located inside major hotels or shopping malls, versus those located on the street, in high-volume tourist areas. Telephone connections with the United States are reliable. However, 1-800 numbers cannot be accessed from Latvia. Please check with your long distance carrier before departure to see if they offer service in Latvia. Local Internet cafés offer computer access, and fax machines are widely available.
Latvian customs authorities may enforce strict regulations concerning temporary importation into or export from Latvia of items such as firearms, religious materials, antiquities, medications, business equipment, drugs, etc. It is advisable to contact the Embassy of Latvia in Washington or one of the Latvian consulates in the United States for specific information regarding customs requirements at http://www.latvia-usa.org.
Please see our information on Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Latvian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Latvia are strict and convicted offenders can expect 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 web pages on intercountry adoption and international parental child abduction.
REGISTRATION/EMBASSY AND CONSULATE LOCATIONS: Americans living or traveling in Latvia are encouraged to register with the nearest U.S. Embassy of Consulate through the State Department’s travel registration website, https://travelregistration.state.gov/ibrs/ui/ and to obtain updated information on travel and security within Latvia. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is located at 7 Raina Blvd. Riga, LV-1510, and may be reached by dialing +371-703-6200. The fax number for the Consular American Citizen Services section is+371-781-4088. You can find the ACS section online at http://riga.usembassy.gov/
* * * * * *
This replaces the Consular Information Sheet dated March 12, 2008 with updated information on Entry Requirements.

Travel News Headlines WORLD NEWS

Date: Thu, 7 Nov 2019 17:11:10 +0100 (MET)

Riga, Nov 7, 2019 (AFP) - Thousands of doctors and nurses rallied Thursday in front of the Latvian parliament in Riga calling for better pay in what was the Baltic state's largest protest in over a decade.   Police said more than 5,000 people, including patients, turned out for the protest, which featured coffins and signs with slogans such as "United for health", "I only want to work one job" and "Patients supporting doctors and nurses".   The LVSADA medical labour union organised the rally to condemn lawmakers for planning to increase their own salaries next year while reneging on a promise to boost wages in the chronically underfunded medical profession.   "We won't allow the healthcare system to be starved again," LVSADA chief Valdis Keris said at the rally, which state hospital employees attended by taking a day of unpaid leave.

Some doctors also participated in the protest by only performing emergency surgery and tending to emergency patients on Thursday while rescheduling everything else.    "The average monthly wage for a doctor at a Latvian public hospital is only between 1,000-3,000 euros ($1,100-$3,300)," protester and doctor Roberts Furmanis said in a statement sent to media.    "I work my daily shift at one hospital, at night I also work overtime driving around in an ambulance, plus sometimes I lecture at medical schools on my rare days off," he added.   "I get less than 3,000 euros a month for those jobs combined. How am I supposed to support my family?"   Last year, lawmakers voted to raise wages for almost all employees of the government-run healthcare system, but now say that they are unable to find the necessary funds in the 2020 state budget.    "I express deep regret for last year's promise, which we cannot carry out," speaker of parliament Inara Murniece told the rally.

Those protesting, however, point out that the 2020 state budget exceeds 10 billion euros for the first time ever in the country of just 1.9 million people -- or 700 million more euros than this year.    Medical workers are upset that while there is no room for better healthcare wages in the new budget, the country's lawmakers and ministers plan to increase their own salaries next year and have also earmarked taxpayer money for their respective political parties.    Thursday's rally was Latvia's largest since some 10,000 people attended a January 2009 protest against government cuts, which grew violent and resulted in dozens of arrests.
Date: Sat 21 Sep 2019
Source: Food Safety News [edited]
<https://www.foodsafetynews.com/2019/09/latvian-officials-investigate-salmonella-and-e-coli-illnesses/>

Officials in Latvia are investigating 40 _Salmonella_ and Shiga toxin-producing _E. coli_ illnesses with mostly children affected. A total of 36 children and 4 employees of educational institutions are ill, according to the Latvian Centre for Disease Prevention and Control (SPKC). Salmonellosis has been laboratory confirmed in 9 children with symptoms of acute intestinal infection thought to have occurred from [9 to 11 Sep 2019]. Patients have been recorded at Levina and Tornisi kindergartens. Shiga toxin-producing also called enterotoxigenic _E. coli_ (EHEC) infections have been linked to schools identified as Levina, Saulite and Piladzitis in Sigulda, a town in the country.

At least 4 children aged 3 to 6 years old have developed hemolytic uremic syndrome (HUS) after EHEC infection from early September 2019 in Sigulda. HUS is a type of kidney failure associated with EHEC infection. It can occur in people of any age but is most common in children under 5 years old. The SPKC has surveyed parents of sick children, visited preschools to obtain information on absent children and staff and the cause, analysed food menus and possible risk factors. A total of 19 infections at 3 other pre-school facilities in Ikskile, Garkalne and Ogre are not thought to be related to those ill in Sigulda.

The Latvian Food and Veterinary Service (PVD) has been investigating catering units at the 3 sites linked to _E. coli_ infection where catering comes from one company. Initial suspicions pointed to contaminated watermelons. Inspections at the catering units did not reveal violations of hygiene requirements that could contribute to the spread of infection. The sites also underwent cleaning and disinfection. PVD suspended operations of a vegetable processing firm called "Jelgavas Augļi" due to violations of hygiene requirements, product traceability and inadequate storage temperature for pre-packed vegetables that were stored at 13 deg. C [approx. 55 deg. F] instead of the required 6 deg. C [approx. 42 deg. F].

The company, through Baltic Restaurants Latvia, supplies fresh fruits and vegetables to Sigulda educational institutions but a connection to the outbreak has not been established. Testing at the firm so far has not found _E. coli_. Other results are pending but the company will be allowed to resume operations if they are negative and when it corrects the deficiencies identified by authorities. Authorities have also found issues with transportation of food by the company "Point to Point" Ltd between educational institutions.
=================
[These are two outbreaks of enteric pathogens that appear to be related to food supplied to schools. The EHEC outbreak has been possibly linked to watermelon. With 9 cases of EHEC and 4 of them developing HUS, it is possible that the strain is a hyperproducer of Shiga toxin but most likely related to use of antimicrobials early in the infection which increases the risk of HUS. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Latvia: <http://healthmap.org/promed/p/119>]
Date: Wed, 15 May 2019 19:20:02 +0200

Riga, May 15, 2019 (AFP) - A second Albanian soldier has died of his injuries from a World War II landmine blast last week during a NATO exercise in Latvia, the Baltic state's defence minister said Wednesday.   Klodian Tanushi, who held the rank of major, died following surgery at a Riga hospital over the weekend, days after the landmine explosion that also killed another soldier.    "I would like to express my deepest sympathy to the soldiers' relatives and friends, to their fellow service members and to the people of Albania," Latvian Defence Minister Artis Pabriks told AFP.    "Latvia is very grateful to our ally Albania for contributing to NATO's expanded presence in Latvia."

In 2016, NATO deployed four multinational battalions to Poland and the Baltic states to guard against possible Russian adventurism.   The defence group's rotating battalion in Latvia is led by Canada and also includes soldiers from Albania, the Czech Republic, Italy, Montenegro, Poland, Slovakia, Slovenia and Spain.   Tanushi, a father-of-three, was the commanding officer of the Albanian contingent stationed at the NATO base in the central village of Adazi.    Both world wars left Latvia littered with many unexploded sea and landmines as well as artillery shells, which continue to be found on a daily basis.    Clearing areas of such explosives is a frequent focus of NATO military exercises in the region.
Date: Sun, 22 Jul 2018 18:58:20 +0200

Riga, July 22, 2018 (AFP) - Fires raging for five days have destroyed more than 800 hectares (2,000 acres) of western Latvia, authorities said Sunday, with continuing extreme temperatures hampering firefighters' efforts.   Satellite images showed the fires have wiped out 170 acres of forest, 257 hectares of scrubland and nearly 400 hectares of peatland.

A peat fire in the Courland region broke out last Tuesday and spread eastwards, with the smoke noticeable in the resort town of Jurmala, more than 100 kilometres (60 miles) away in the neighbouring Riga region.   "Peatland fires burn downward, but when there's wind, which brings oxygen, the fires can erupt into flames," Latvian fire services spokesman Inta Palkavniece told reporters.   "The main goal is to prevent the fires from spreading," he added.   The fire services said on its website that firefighting efforts would be "long and troublesome".    "The weather is unfavourable to firefighting and will remain so over the next days," it said.

The Courland region is sparsely populated, with few roads and many areas inaccessible because of its vast marshes.   Residents of Stikli, a village that was evacuated because of the fire, began to return home after the wind changed "of their own accord", the mayor of its municipality Ventspils, Aivars Mucenieks, told reporters.   Pupils of a school for disabled children in Stikli will not return until the situation is fully under control, he added.

Meteorologists warned that the high temperatures are persisting and no rain is expected for the next two weeks.   Latvia has experienced severe drought over the last few months, prompting authorities to declare a natural catastrophe in the agricultural sector.   The Baltic country has not yet asked for help from other European countries and has no proposals to do so for the time being.   But other countries in Europe have been in the grip of an unusually long heatwave for recent weeks with little prospect of rain for the time being.

In Sweden, where temperatures are the highest for a century, farmers are even sending their animals to slaughter because there is no hay left to feed them.   It has asked for help from other European countries, because of the lack of manpower and capacity to tackle such natural catastrophes.   Poland has asked the EU for financial aid after more than 91,000 farms were affected by an unusual spring drought, according to the agriculture ministry.   In Germany, which suffered a drought in May and June, agricultural producers warned the harvest this year will be down by between 20 and 50 percent.
Date: Wed, 18 Jul 2018 19:41:17 +0200

Riga, July 18, 2018 (AFP) - Latvian authorities on Wednesday ordered the evacuation of a village threatened by a wildfire in the west of the Baltic state as firefighters struggled to control the blaze.   Clouds of smoke and ash from the fire choked the small community of Stikli, forcing the evacuation of dozens of residents including handicapped children from a boarding school, the state fire and rescue service said.   The fire broke out in a peat bog in the Kurzeme region on Tuesday before quickly engulfing bone-dry forests nearby.

The blaze covers an area of nearly 200 football pitches (180 hectares, 444 acres), according to firefighters.   "Firefighting is very problematic, as this part of Kurzeme is only sparsely populated, the roads are few and narrow and many areas are inaccessible due to vast marshlands," said Zigmunds Jaunkirkis, an official with the State Forestry Department.   The army and national guard deployed a specialised helicopter on Wednesday to help firefighters fight the flames.

Neighbouring Lithuania has also sent a helicopter while residents from the nearby port city of Ventspils have started to form volunteer units.   Daytime temperatures of up to 30 degrees Celsius (86 Fahrenheit) and strong winds have fanned the flames amid a long heatwave.   No substantial rain is forecast for the next two weeks.    An EU and NATO member of 1.9 million people, Latvia has suffered from severe drought in recent months, forcing its government to declare a national disaster in the farm sector in June.
More ...

Antigua and Barbuda

Antigua and Barbuda - US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
Antigua and Barbuda is a dual island nation known for its beaches, and is a favorite destination for yachtsmen.
Tourist facilities are widely avai
able.
English is the primary language.
Banking facilities and ATMs are available throughout the island.
Read the Department of State Background Notes on Antigua and Barbuda for additional information.

ENTRY/EXIT REQUIREMENTS:
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
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.

Immigration officials are strict about getting exact information about where visitors are staying, and will often request to see a return ticket or ticket for onward travel, as well as proof of sufficient funds to cover the cost of the visitor’s intended stay.
There is a departure tax payable when departing the country.
For further information on entry requirements, travelers can contact the Embassy of Antigua and Barbuda, 3216 New Mexico Avenue NW, Washington, DC
20016, telephone (202) 362-5122, or consulates in Miami.
Additional information may be found on the home page of the Antigua and Barbuda Department of Tourism at http://www.antigua-barbuda.org.

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 at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings, and Travel Alerts 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:
Petty street crime does occur, and valuables left unattended on beaches, in rental cars or in hotel rooms are vulnerable to theft.
There has been an increase in crime in Antigua, including violent crimes, in the last six months.
However, this increase has not, for the most part, affected visitors to the island.
The Government of Antigua and Barbuda has taken steps to improve the effectiveness of the police in responding to crimes.
As everywhere, visitors to Antigua and Barbuda are advised to be alert and maintain the same level of personal security used when visiting major U.S. cities.

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:
There are many qualified doctors in Antigua and Barbuda, but medical facilities are limited to a public hospital and a private clinic and are not up to U.S. standards.
The principal medical facility on Antigua is Holberton Hospital, on Hospital Road, St. John's (telephone (268) 462-0251).
There is no hyperbaric chamber; divers requiring treatment for decompression illness must be evacuated from the island, to either Saba or Guadeloupe.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals often expect immediate cash payment for health services, and U.S. medical insurance is not always valid outside the United States.
U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States.

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

Traffic in Antigua and Barbuda moves on the left.
Major roads are generally in good condition, but drivers may encounter wandering animals and slow moving heavy equipment.
There is relatively little police enforcement of traffic regulations.
Buses and vans are frequently crowded and may travel at excessive speeds.
Automobiles may lack working safety and signaling devices, such as brake lights.

Please refer to our Road Safety page for more information.
For specific information concerning Antigua and Barbuda driving permits, vehicle inspection, road tax, and mandatory insurance, contact the Antigua and Barbuda national tourist organization offices in New York via e-mail at info@antigua-barbuda.org.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Antigua and Barbuda’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Antigua and Barbuda’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:
Like all Caribbean countries, Antigua can be affected by hurricanes. The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
Please see 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 Antigua and Barbuda laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Antigua and Barbuda 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 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 Antigua and Barbuda are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov/, and to obtain updated information on travel and security within Antigua and Barbuda.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy in Bridgetown in located in the Wildey Business Park in suburban Wildey, south and east of downtown Bridgetown.
The main number for the Consular Section is (246) 431-0225; after hours, the Embassy duty officer can be reached by calling (246) 436-4950.
The web site for Embassy Bridgetown is http://barbados.usembassy.gov/. Hours of operation are 8:30 a.m. - 4:00 p.m., Monday-Friday, except local and U.S. holidays.

The U.S. Consular Agent, Rebecca Simon, in Antigua provides passport, citizenship and notarial services, and assists Americans in distress.
The Consular Agency is located in Suite #2, Jasmine Court, Friars Hill Rd, St. John’s, Antigua.
Contact information is as follows: telephone 1-268-463-6531, cellular 1-268-726-6531, or e-mail ANUWndrGyal@aol.com. The mailing address is P.O. Box W-1562, St. John’s, Antigua. The Consular Agent is available by appointment only.
The office is closed for local and U.S. Holidays.
*

*

*
This replaces the Country Specific Information for Antigua and Barbuda dated April 2, 2007, to update sections on Entry/Exit Requirements, Safety and Security, Medical Facilities and Health Information, Traffic Safety and Road Conditions, and Crime.

Travel News Headlines WORLD NEWS

Date: Wed, 21 Mar 2018 18:14:27 +0100
By Gemma Handy

St. John's, Antigua and Barbuda, March 21, 2018 (AFP) - Voters in the hurricane-wracked twin island nation of Antigua and Barbuda headed to the polls Wednesday to elect a new government after Prime Minister Gaston Browne called snap elections.   Browne's Antigua Barbuda Labour Party, which has led the eastern Caribbean country since 2014, is widely expected to secure a second consecutive term.   The prime minister announced general elections on February 24, 15 months before a constitutionally mandated deadline, giving opposition parties less than four weeks to prepare.

And there will be no polling stations on Barbuda, which was battered by Hurricane Irma in September.    As a result, the estimated 400 Barbudans who have since returned home will have to travel to Antigua to cast their ballot. The government has promised to pay for related transport, accommodation and meal expenses.   Just over 51,000 Antiguans and Barbudans are eligible to vote. Voter turnout was around 90 percent in 2014.

Browne says the government wants to protect half a billion US dollars worth of developments currently under construction in the tourism-dependent country, and provide investors with stability.    One of the most prominent -- and controversial -- projects is a $250 million mega resort being built by Hollywood star Robert De Niro on Barbuda which was devastated by Hurricane Irma in September.   Lowering the cost of living in the country of 100,000 people is high on the
agenda.

- Ruling party dominates -
Browne, a former businessman and banker, has pledged to reduce electricity bills, along with the cost of land, and provide more affordable housing, under the slogan "Rebuilding Together." His wife Maria is also running for a seat on an ABLP ticket.   On Sunday, thousands of Browne's supporters donned the party's red colours and walked alongside a motorcade in an event that culminated in a public rally.   The "Delivering Hope" campaign of the main opposition group, the United Progressive Party (UPP), cites revitalization of the tourism and agricultural sectors as key priorities.

Fifty-three candidates will vie for seats in the 17 single-member constituencies -- of which the ABLP currently holds 14 -- in a first-past-the-post system.    The ruling party is alone in presenting a full slate of 17 candidates. The UPP, led by former finance minister Harold Lovell, has put forward 16.    A new party, the Democratic National Alliance, headed by current lawmaker and former UPP representative Joanne Massiah has registered 13 candidates.    There is a handful of smaller parties, a single independent runner and one representing the Barbuda People's Movement (BPM) contesting the small island's sole seat.

Polling stations opened at 6:00 am (1000 GMT) and are due to close at 6:00 pm. Alcohol sales are restricted during those hours and all public schools are closed, as many are serving as polling stations.   Teams representing the Caribbean Community (CARICOM) are observing the elections.   On its path through the Caribbean in September, Irma caused "absolute devastation" on Barbuda where up to 30 percent of properties were demolished, and 95 percent damaged, Browne had said at the time.    After a 10-year hiatus, voters returned Browne's Labour Party to power during the last ballot four years ago, when he pledged to economically transform the country.   The country became fully independent from Britain in 1981.
Date: Sun, 25 Feb 2018 08:04:27 +0100

Georgetown, Guyana, Feb 25, 2018 (AFP) - Antigua and Barbuda, a hurricane-ravaged Caribbean tourist destination, will go to the polls next month more than a year earlier than scheduled, the prime minister said on Saturday.   The two-island nation's parliamentary elections were scheduled for June 2019, but will now be held on March 21, Gaston Browne said.   Voters will select the 17 members of Antigua and Barbuda's House of Representatives, its lower house. Members of the Senate are appointed.   "Our primary focus for calling elections early is not about politics but is about your development. God forbid for there to be change in government," Browne said on radio.

After a 10-year hiatus, voters returned Browne's Labour Party to power during the last ballot in 2014, when he pledged to economically transform the country.   On Saturday, Browne said there had been "significant gains" since and that the government wanted to guard against unpredictability in the investment climate.   He cited cheaper housing for ordinary people, better roads, two Marriott-branded hotels, as well as a new airport on the island of Barbuda, which was battered last year by Hurricane Irma.   On its path through the Caribbean in September, Irma caused "absolute devastation" on Barbuda where up to 30 percent of properties were demolished, and 95 percent damaged, Browne had said at the time.    Labour has ruled Antigua and Barbuda almost continuously since 1949. The country became fully independent from Britain in 1981.
Date: Sat, 9 Sep 2017 18:35:21 +0200
By Gemma Handy

Codrington, Antigua and Barbuda, Sept 9, 2017 (AFP) - Homes, shops and government buildings were destroyed when Hurricane Irma slammed the Caribbean island of Barbuda this week, while a huge stretch of its once glorious 11-mile west coast beach has been wiped out.   Destruction was so widespread that authorities have ordered the entire population of 1,800 to evacuate as Hurricane Jose approached the island over the weekend. 

By mid-day Saturday Jose, a Category Four hurricane, was tracking towards the north-west and no longer expected to hit Barbuda, but it remained under a Tropical Storm warning.   Authorities on Barbuda -- one of the two islands that make up the nation of Antigua and Barbuda -- have only begun to measure the damage caused when Irma struck the island as a powerful Category Five hurricane overnight Tuesday to Wednesday.   "Terrifying," "horrific" and the "worst damage seen in a lifetime" were some of the descriptions from residents as they emerged from their shelters after Irma's passage.    A child died when Irma, the strongest storm ever recorded to form in the Atlantic, struck the island.   Authorities said 30 percent of properties were demolished by the monster storm.

- Surviving in a wardrobe -
Barbudans swapped tales of hiding in wardrobes and showers as 157 mile (252 kilometer) per hour wind from Irma ripped off roofs, uprooted trees and knocked down walls.   Sira Berzas, 40, spent more than an hour huddled in a wardrobe with a friend after Irma tore the roof off the home they were hiding in.   "I have never been so scared in my life. Jackie and I were holding on to each other and basically saying our goodbyes," Berzas told AFP.

When the eye of the hurricane came, she said, "we ran outside in our underwear screaming for help. Luckily there was a police truck which took us to a safer building."   In the rush to safety "we had to leave Jackie's kitten behind," said Berzas, who lost her Pink Sand Beach home, bar and restaurant to the disaster.   Thankfully Houdini lived up to his name. The kitten was later found crouched in a corner of the ruined house, trembling but alive.

- Fleeing Hurricane Jose -
Hundreds of Barbudans were transported on Friday to Antigua via a Venezuelan military plane for safety ahead of Hurricane Jose.   Many have family to visit on the sister island, but others had no idea where they would stay when they arrived.   "I don't know where we are going when we get to Antigua -- or how we will get there," said Beautymey John, who was on a dock waiting to board a boat to safety with her five children.   "I would rather stay here, it doesn't feel right to leave. We have to try and start again," she told AFP.

Other Barbudans also said they were determined to rebuild their homes and livelihoods.   Teacher Maurice George, 30, said the small bag he was taking to Antigua contained the bare essentials, but vowed to return as soon as the secondary school he works in reopens.   "It is heart-breaking to see our island looking like this," he said.   "But where some people see devastation, I see an opportunity to rebuild," he added.
Date: Sat, 19 Mar 2016 13:18:00 +0100

Washington, March 19, 2016 (AFP) - A 6.0-magnitude earthquake hit off the coast of the Caribbean island nation of Antigua and Barbuda Saturday, US experts said, but caused no tsunami warning or immediate reports of damage or injury.   The strong quake, which hit at 1126 GMT, struck at a depth of 24 kilometres (15 miles) with its epicentre located 153 kilometres northeast of the capital of Saint John's, according to the US Geological Survey.
Date: Mon 14 Dec 2015
Source: Antigua Observer [edited]

Prison sources are still complaining that, despite the alleged outbreak of chicken pox at Her Majesty's Prison (HMP), not much has been done to ensure that the virus does not affect more people who either work there or are in custody. A source said since Observer media reported on the incident, last Thu 10 Dec 2015 that there has been another suspected case, bringing the number of affected persons to 19.

The source explained that this occurred even while the other 18 infected persons were already in isolation in the chapel in the prison yard. That source is suggesting that health authorities should to go into the jail to "clean it and spray out the cells" because the virus, according to research, can be picked up from contaminated surfaces.

An official at HMP, who is not authorized to speak with the media, said although the affected inmates are being housed in the chapel away from the rest of the prison population, they are still able to come and go to other parts of the jail, including the washroom and for breaks. Another source indicated that most of the affected persons are on remand and it is highly likely they will be released at any time, and then the virus would likely spread to communities outside the prison walls.

Observer media was unable to reach the prison boss, Superintendent Albert Wade, for comment.

In the meantime, Attorney General Steadroy "Cutie" Benjamin, who has responsibility for the prison, has given assurance that prison authorities have taken adequate steps to control the spread of chickenpox.
======================
[Outbreaks of chickenpox are not uncommon in closed communities where contagious virus can spread rapidly. Chickenpox is a very contagious disease caused by varicella-zoster virus (VZV), a herpes virus. It causes a blister-like rash, itching, tiredness, and fever. Chickenpox can be serious, especially in babies, adults, and people with weakened immune systems. It spreads easily from infected people to others who have never had chickenpox or received the chickenpox vaccine. Chickenpox spreads in the air through coughing or sneezing. It can also be spread by touching or breathing in the virus particles that come from chickenpox blisters and can be transmitted by touching surfaces that have recently be contaminated by open lesions as well. Chickenpox most commonly causes an illness that lasts about 7-10 days.

The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may 1st show up on the face, chest, and back, then spread to the rest of the body, including inside the mouth, eyelids, or genital area. It usually takes about a week for all the blisters to become scabs. Some people who have been vaccinated against chickenpox can still get the disease. However, the symptoms are usually milder with fewer blisters and mild or no fever. About 25 to 30 percent of vaccinated people who get chickenpox will develop illness as serious as chickenpox in unvaccinated persons.

Chickenpox vaccine is safe and effective at preventing the disease. Most people who get the vaccine will not get chickenpox. If a vaccinated person does get chickenpox, it is usually mild -- with fewer blisters and mild or no fever. The chickenpox vaccine prevents almost all cases of severe disease (for further information, see: <http://www.cdc.gov/chickenpox/index.html>). - ProMed Mod.LL]

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

Suriname

Suriname - US Consular Information Sheet
December 19, 2008
COUNTRY DESCRIPTION:
The Republic of Suriname is a developing nation located on the northern coast of South America. Tourist facilities are widely available in the capital city of
aramaribo; they are less developed and in some cases non-existent in the country's rugged jungle interior. English is widely used, and most tourist arrangements can be made in English. Please read the Department of State Background Notes on Suriname for additional information.

ENTRY/EXIT REQUIREMENTS: A passport, valid visa, and, if traveling by air, return ticket are required for travel to Suriname. There is a processing fee for business and tourist visas, and visas must be obtained before arrival in Suriname. A business visa requires a letter from the sponsoring company detailing the reason for the visit. There is an airport departure charge and a terminal fee, normally included in the price of airfare. Travelers arriving from Guyana, French Guiana, and Brazil are required to show proof of a yellow fever vaccination. For further information, travelers can contact the Embassy of the Republic of Suriname, 4301 Connecticut Avenue, NW, Suite 460, Washington, DC 20008, telephone (202) 244-7488, email: embsur@erols.com, or the Consulate of Suriname in Miami, 7235 NW 19th Street, Suite A, Miami, Fl 33126, telephone (305) 593-2697.
Visit the Embassy of Suriname web site at www.surinameembassy.org for the most current visa information.

Important information for foreigners who have the intention of staying longer than three months:
s of October 1, 2008, persons who intend to stay longer than three months in Suriname must apply for an Authorization for Temporary Stay (MVK) before travel to Suriname. The above implies that foreigners who need a visa (with the exception of foreigners of Surinamese origin) who have traveled to Suriname on a tourist or business visa will not be able to apply for residence during their stay in Suriname.

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

SAFETY AND SECURITY:
Demonstrations do occur, primarily in the capital or second cities, and are usually peaceful, but American citizens traveling to or residing in Suriname should take common-sense precautions and avoid large gatherings or other events where crowds have congregated to demonstrate or protest. Travelers proceeding to the interior may encounter difficulties due to limited government authority. Limited transportation and communications may hamper the ability of the U.S. Embassy to assist in an emergency situation.

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 United States and Canada, or for callers outside the United States and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Criminal activity throughout the country is on the rise and foreigners, including Americans, may be viewed as targets of opportunity. Burglary, armed robbery, and violent crime occur with some frequency in Paramaribo and in outlying areas. Pick-pocketing and robbery are increasingly common in the major business and shopping districts of the capital. Visitors should avoid wearing expensive or flashy jewelry or displaying large amounts of money in public.
There have been several reports of criminal incidents in the vicinity of the major tourist hotels and night walks outside the immediate vicinity of the hotels are therefore to be avoided.
Visitors should avoid the Palm Garden area (“Palmentuin” in Dutch) after dark, as there is no police presence and it is commonly the site of criminal activity.

Theft from vehicles is infrequent, but it does occur, especially in areas near the business district. Drivers are cautioned not to leave packages and other belongings in plain view in their vehicles. There have been reports of carjackings within Paramaribo, particularly in residential areas. When driving, car windows should be closed and doors locked. The use of public minibuses is discouraged, due to widespread unsafe driving and poor maintenance.
Travel to the interior is usually trouble-free, but there have been reports of tourists being robbed. Police presence outside Paramaribo is minimal, and banditry and lawlessness are occasionally of concern in the cities of Albina and Moengo and the district of Brokopondo, as well as along the East-West Highway between Paramaribo and Albina and the Afobakka Highway in the district of Para. There have been reports of attempted and actual carjackings committed by gangs of men along the East-West Highway. Travelers proceeding to the interior are advised to make use of well-established tour companies for a safer experience.

The emergency number 115 is used for police, fire, and rescue and normally does not provide English-language services.
Fire and rescue services provide a relatively timely response, but police response, especially during nighttime hours, is a rarity for all but the most serious of crimes.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
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 are 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 care, including emergency medical care, is limited and does not meet U.S. standards. There is one public emergency room in Paramaribo with only a small ambulance fleet providing emergency transport with limited first response capabilities. The emergency room has no neurosurgeon, and other medical specialists may not always be available. As a rule, hospital facilities are not air-conditioned, although private rooms with individual air-conditioning are available at extra cost and on a space-available basis. Emergency medical care outside Paramaribo is limited and is virtually non-existent in the interior of the country.

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 Suriname is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic moves on the left in Suriname; left-hand-drive cars are allowed on the road. Excessive speed, unpredictable movements by vehicles, and motorcyclists/bicycles, unusual right of way patterns, poorly maintained roads, and a lack of basic safety equipment on many vehicles are daily hazards on Surinamese roads. As of January 2007, seatbelts are required for all passengers of automobiles, and drivers must use a hands-free device if using a mobile phone while driving. Visitors are encouraged to use automobiles equipped with seat belts and to avoid the use of motorcycles or scooters. An international driver's license is necessary to rent a car.
The major roads in Paramaribo are usually paved, but not always well maintained. Large potholes are common on city streets, especially during the rainy seasons, which last from approximately mid-November to January, and from April to July (rainy seasons can differ from year to year by as much as six weeks). Roads are often not marked with traffic lines. Many main thoroughfares do not have sidewalks, forcing pedestrians, motorcycles, and bicycle traffic to share the same space.
The East-West Highway, a paved road that stretches from Nieuw Nickerie in the west to Albina in the east, runs through extensive agriculture areas; it is not uncommon to encounter slow-moving farm traffic or animals on the road. Travelers should exercise caution when driving to and from Nieuw Nickerie at night due to poor lighting and sharp road turns without adequate warning signs.
There are few service stations along the road, and western style rest stops are non-existent.
The road is not always well maintained, and during the rainy season, large, sometimes impassable, sink holes develop along the road.
Police recommend that travelers check with the police station in Albina for the latest safety information regarding travel between Paramaribo and Albina.
Roads in the interior are sporadically maintained dirt roads that pass through rugged, sparsely populated rain forest. Some roads are passable for sedans in the dry season, but they deteriorate rapidly during the rainy season. Interior roads are not lit, nor are there service stations or emergency call boxes. Bridges in the interior are in various states of repair. Travelers are advised to consult with local sources, including The Foundation for Nature Conservation in Suriname, or STINASU, at telephone (597) 421-683 or 476-579, or with their hotels regarding interior road conditions before proceeding.

For specific information concerning Suriname driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Embassy of Suriname in Washington, D.C., or the Consulate of Suriname in Miami.
Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.suriname-tourism.org/cms/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Suriname’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Suriname’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:
Credit cards are not widely accepted outside the major hotels and upscale restaurants. Travelers should contact their intended hotel or tour company to confirm that credit cards are accepted. Currently, only one bank, Royal Bank of Trinidad and Tobago (RBTT), has Automatic Teller Machines (ATMs) accepting foreign ATM cards. In order to withdraw money from the ATM machines of other banks, you must have a local Surinamese bank account and ATM card. Visitors can exchange currency at banks, hotels, and official exchange houses, which are called “cambios.” Exchanging money outside these locations is illegal and can be dangerous. Telephone service within Suriname can be problematic, especially during periods of heavy rains. 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 Surinamese laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Suriname 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 residing or traveling in Suriname are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Suriname.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Dr. Sophie Redmondstraat 129, telephone (011) (597) 472-900, web site http://suriname.usembassy.gov. The Consular Section hours of operation for routine American citizen services are Mondays and Wednesdays from 8:00 to 10:00 AM, or by appointment, except on American and Surinamese holidays. U.S. citizens requiring emergency assistance on evenings, weekends, and holidays may contact an Embassy duty officer by cell phone at (011) (597) 088-08302. The U.S. Embassy in Paramaribo also provides consular services for French Guiana.
* * *
This replaces the Country Specific Information for Suriname dated April 11, 2008, to update the sections on Entry/Exit Requirements, Crime, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue 28 Mar 2017
Source: WHO Disease Outbreak News [edited]

On Thu 9 March 2017, the National Institute for Public Health and the Environment (RIVM) in the Netherlands reported a case of yellow fever to WHO. The patient is a Dutch adult female traveller who visited Suriname from the middle of February until early March 2017. She was not vaccinated against yellow fever.

The case was confirmed for yellow fever in the Netherlands by RT-PCR in 2 serum samples taken with an interval of 3 days at the Erasmus University Medical Center (Erasmus MC), Rotterdam. The presence of yellow fever virus was confirmed on Thu 9 Mar 2017 by PCR and sequencing at Erasmus MC, and by PCR on a different target at the Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.

While in Suriname, the patient spent nights in Paramaribo and visited places around Paramaribo, including the districts of Commewijne (Frederiksdorp and Peperpot) and Brokopondo (Brownsberg), the latter is considered to be the most probable place of infection. She experienced onset of symptoms (headache and high fever) on Tue 28 Feb 2017 and was admitted to an intensive care unit (University Medical Center) in the Netherlands on Fri 3 Mar 2017 with liver failure. The patient is currently in critical condition.

Suriname is considered an area at risk for yellow fever and requires a yellow fever vaccination certificate at entry for travellers over one year of age arriving from countries with risk of yellow fever, according to the WHO list of countries with risk of yellow fever transmission; WHO also recommends yellow fever vaccination to all travellers aged 9 months and older. This is the 1st reported case of yellow fever in Suriname since 1972.

Public health response

This report of a yellow fever case in the Netherlands with travel history to Suriname has triggered further investigations. Following this event, health authorities in Suriname have implemented several measures to investigate and respond to a potential outbreak in their country, including:
 - Enhancing vaccination activity to increase vaccination coverage among residents. Suriname will continue with its national vaccination programme and will focus on the district of Brokopondo. A catch-up vaccination campaign is also being conducted to increase coverage in Brownsweg.
 - Enhancing epidemiologic and entomologic surveillance including strengthening laboratory capacity.
 - Implementing vector control activities in the district Brokopondo.
 - Carrying out a survey of dead monkeys in the suspected areas.
 - Conducting social mobilization to eliminate _Aedes aegypti_ breeding sites (e.g. by covering water containers/ barrels).
 - Issuing a press release to alert the public.
 - Mapping of the suspect area of Brownsweg, as well as the Peperpot Resort.
================
[This case would suggest local transmission of yellow fever in Suriname which isn't surprising given the on-going outbreak in Brazil. This case would also suggest travelers to the area consider getting vaccinated for yellow fever prior to entering the country. One wonders if perhaps the local wildlife may be acting as a reservoir as well based on the outbreaks seen in monkeys in Brazil. - ProMED Mod.JH]

[A HealthMap/ProMED-mail map can be accessed at:
Eurosurveillance, Volume 22, Issue 11, 16 March 2017
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22744

A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient’s condition deteriorated and she developed hepatic encephalopathy requiring transfer to the intensive care. Although yellow fever has not been reported in the last four decades in Suriname, vaccination is recommended by the World Health Organization for visitors to this country.

Yellow fever virus (YFV) is known to be enzootic in South America, causing periodic outbreaks of disease in monkeys and humans in some countries. In Brazil, there has been an outbreak of yellow fever ongoing since December 2016 with 1,500 cases as at 9 March [1,2]. Here we report an imported case of human infection with YFV in a traveller returning from Suriname, on the north-eastern coast of South America, from where the last case of yellow fever was reported 45 years ago.

Case description

In March 2017, a Dutch Caucasian female in her late 20s from the Netherlands was referred to the University Medical Center Groningen in the Netherlands because of high fever and signs of severe acute liver injury after returning from a two-week stay in Suriname. She had no co-morbidities apart from obesity (body mass index around 40 kg/m2, norm: 18.5–25 kg/m2). During her visit she stayed in the capital of Suriname, Paramaribo, and she made several daytrips by boat and car, of which two in the tropical rainforest (Figure).

Figure

Timeline of events and diagnostic results, case of yellow fever in a traveller returning from Suriname to the Netherlands, March 2017

/images/dynamic/articles/22744/17-00187-f1

P: Paramaribo; RNA: ribonucleic acid; UMCG: University Medical Center Groningen; YFV: yellow fever virus.

She recalled having been bitten by mosquitoes during her hike at Brownsberg, a nature resort in the rainforest with wildlife. Before her travel, she did not visit a travel clinic and did not receive yellow fever vaccination. On day 12 of her visit in Suriname, she experienced mild muscle pain, headache and nausea and she developed a high-grade fever. She returned to the Netherlands on day 15 and visited the emergency department of a secondary care centre, from where she was referred to our University hospital. At physical examination she was not icteric. Except for a temperature of 39.9 °C, vital parameters were normal. The results of the remaining physical examination were unremarkable. Laboratory testing revealed leukopenia (leukocytes 0.9x109/L, norm: 4.0–10.0x109/L) and massive liver injury (aspartate aminotransferase 5,787 U/L, norm: <31 U/L; alanine aminotransferase 4,910 U/L, norm: <34 U/L), with mildly elevated bilirubin levels (total bilirubin 20 µmol/L, norm: <17 µmol/L). Liver synthesis was impaired as revealed by increased clotting times (activated partial thromboplastin time (APTT): 49s, norm: 23–33s; prothrombin time (PT): 26.6s, norm: 9.0–12.0s) and reduced antithrombin (49%, norm: 80–120%). Fibrinogen was diminished suggestive of diffuse intravascular coagulation. Renal function was normal apart from severe albuminuria (up to 22.6 g/24h, norm: 0g/24h). Malaria, viral hepatitis (A, B, C, E, Epstein Barr virus, cytomegalovirus, herpes simplex virus), dengue, chikungunya and Zika were ruled out (Table). Diagnostic tests to exclude leptospirosis performed on day 6 post onset of symptoms (dps 6) were inconclusive (Table) and a convalescent serum was going to be tested at the time of publication. Because of the combination of fever, leukopenia, thrombocytopenia, liver injury and travel history, yellow fever was included in the differential diagnosis. Real-time reverse transcriptase PCR (qRT-PCR) was positive for YFV in serum taken on dps 3. On dps 7 the patient’s condition deteriorated due to hepatic encephalopathy (ammonia 149 µmol/L, norm: 15–45 µmol/L). Cerebral oedema and bleeding was ruled out by computed tomography (CT)-scan. The patient was transferred to the intensive care unit for close observation of vital parameters. Vitamin K was administered. Hepatic encephalopathy was treated with rifaximin and lactulose. Ceftriaxone (2g per day intravenously) was given for 7 days as antibiotic prophylaxis. Consequently, possible leptospirosis was also treated. Her neurological condition stabilised on dps 10 together with the coagulation parameters. On dps 13 the patient was transferred back to the ward.

Table

Pathogens for which laboratory tests were performed, yellow fever case, the Netherlands, March 2017


Pathogen Blood (day 3 post onset of symptoms)
Plasmodium spp. Thick smear negative, antigen test negative
Hepatitis A virus IgM and IgG negative
Hepatitis B virus Serological screening negative
Hepatitis C virus Serological screening negative
Hepatitis E virus PCR negative
Epstein Barr virus IgM and IgG negative
Cytomegalovirus IgM and IgG negative
Herpes simplex virus type 1 and 2 PCR negative
Dengue virus PCR negative, IgM and IgG negative
Chikungunya virus PCR negative, IgM and IgG negative
Zika virus PCR negative, IgM and IgG negativea
Leptospira spp. PCR negative, microscopic agglutination test negative, IgM 1:80b

a Performed on day 5 post onset of symptoms (dps 5).

b ELISA (in-house ELISA Dutch Leptospirosis Reference Center) performed on dps 6 showed IgM 1:80 (cut-off positive IgM ≥1:160). IgM results were negative on dps 3 and dps 7 using Leptocheck-WB (Zephyr Biomedicals, Goa, India).

Virology findings

qRT-PCR and/or pan-flavivirus RT-PCR on blood samples on dps 3 did not detect chikungunya virus (CHIKV), dengue virus (DENV), or Zika virus (ZIKV) (Table) [3,4]. In four consecutive samples of dps 3–6, YFV-RNA was detected (Figure) [4-6], with increasing Ct values (from 23 to 31 from dps 3 to dps 5 [5] and 39 on dps 6 [6]). Sequencing of a 176 bp pan-flavivirus hemi-nested RT-PCR product, targeting part of the NS5 genomic region confirmed YFV infection [4]. The sequence was deposited in the GenBank database under the following accession number: KY774973.

On dps 3, indirect immunofluorescence assays (IFA) was negative for IgM and IgG against YFV (Flavivirus Mosaic, Euroimmun AG, Luebeck, Germany). A convalescent sample of dps 6 was clearly positive for YFV IgM (titre 1:10, Figure), with non-reactive IgG. This anti-YFV IgM response on dps 6 is in line with literature stating that IgM antibodies usually appear during the first week of illness. Neutralising IgG antibodies are likely to appear towards the end of the first week after onset of illness and will be tested for in convalescent serum [7].

Background

YFV is a mosquito-borne virus in the genus Flavivirus, family Flaviviridae, related to DENV, ZIKV, tick-borne encephalitis virus and West Nile virus. YFV is maintained in a sylvatic cycle between non-human primates and so-called ‘jungle’-mosquitoes (Hemagogus and Sabethes spp. in South America) [8]. Sporadic infection of humans with sylvatic YFV can occur when unprotected humans are exposed while entering the habitats where the viruses circulate. Subsequent introduction of a viraemic human case to urban areas with high population densities and Aedes aegypti mosquitoes can initiate an urban transmission cycle [9]. YFV is endemic in (sub)tropical areas of South America and Africa. The risk for YFV infection in South America is the highest in tropical regions and during the rainy season (January–May) when mosquito population densities peak [10]. In 2011, Suriname was identified by the World Health Organization (WHO) as one of 14 South American countries at risk for YFV transmission based on current or historic reports of yellow fever, plus the presence of competent mosquito vectors and animal reservoirs [11].

Since December 2016, an outbreak of sylvatic YFV is ongoing in Brazil; as at 9 March 2017, there were 371 confirmed and 966 suspected human cases, while a total of 968 epizootics in non-human primates have been reported, of which 386 were confirmed [2]. So far, there has been no evidence for a change from sylvatic to an urban transmission cycle [1]. In addition, Bolivia, Colombia and Peru have reported suspected and confirmed yellow fever cases in 2017 [2].

A subclinical infection with YFV is believed to occur in most infected people. In symptomatic cases, symptoms of general malaise occur after an incubation period of 3–6 days (range 2–9 days), followed by remission of the disease in the majority of patients. However, 15-25% of symptomatic persons develop a complicated course of illness, in which symptoms recur after 24–48 hours, with a reported mortality of 20-60% [7,12]. This phase is characterised by fever, abdominal symptoms, severe hepatic dysfunction and jaundice, multi-organ failure and haemorrhagic diathesis. As no specific antiviral treatment is currently available, treatment consists of supportive care [7,12].

Discussion

Although Suriname is considered to be endemic for YFV, no human cases have been officially reported since 1971 [13]. With a population of ca 570,000 people, Suriname has a YFV vaccination coverage of 80–85% in infants [14]. Although WHO recommends vaccination for travellers to countries with risk of YFV transmission like Suriname, sporadic cases of imported yellow fever in returning travellers have been reported for example in Europe, the United States and Asia [15-17], with three reported cases related to the ongoing YFV outbreaks in South America in European travellers since 2016 [18,19]. The establishment of ongoing YFV circulation in Suriname extends the current YFV activity in South America to five countries [2]. However, despite the presence of competent Ae. albopictus mosquitoes in France [20] and Ae. aegypti in Madeira, the risk for YFV transmission in Europe is currently considered to be very low due to the lack of vector activity [18]. An effective, safe live-attenuated YFV vaccine is available for people aged ≥ 9 months and offers lifelong immunity [7]. Vaccination is advised by the WHO for all travellers to Suriname, for the coastal area as well as the inlands [21]. With regard to yellow fever, pre-travel health advice should take into account destination, duration of travel, season and the likelihood of exposure to mosquitoes (in rural areas, forests versus urban areas), and potential contraindications for vaccination with a live-attenuated vaccine.

The multi-country YFV activity might reflect current, wide-spread ecological conditions that favour elevated YFV transmissibility among wildlife and spill-over to humans. Thorough sequence analysis of currently circulating strains in Brazil, Bolivia, Colombia, Peru and Suriname should provide insight whether the human cases in these countries are epidemiologically linked or represent multiple, independent spill-over events without extensive ongoing community transmission. Because of its potential public health impact, our case of yellow fever was notified to the WHO and the European Union Early Warning and Response System on 9 March 2017, according to the international health regulations [22].

Conclusion

Clinicians in non-endemic countries should be aware of yellow fever in travellers presenting with fever, jaundice and/or haemorrhage returning from South America including Suriname. This case report illustrates the importance of maintaining awareness of the need for YFV vaccination, even for countries with risk of YFV transmission that have not reported cases for decades.

Date: Fri 11 Dec 2015
From: Abraham Goorhuis, MD <a.goorhuis@amc.nl> [edited]

We report a confirmed case of Zika virus infection in a 60-year-old and otherwise healthy female patient, who had returned from Suriname on 29 Nov 2015, following a 3-week holiday. She had visited Paramaribo, Carolina Kreek, Klaaskreek and the Commewijne province. On the day of return to the Netherlands, she developed fever, itching in the hands and a red skin rash on the face, neck, trunk and extremities. The skin was painful upon touch and the joints of her fingers and ankles felt stiff. She also reported swelling of both lower legs. She reported multiple insect bites. She presented at our outpatient clinic at the AMC in Amsterdam, the Netherlands, on 2 Dec 2015, the 3rd day of her illness.

Physical examination showed an afebrile patient who was not acutely ill. She had a pronounced macular skin rash of her trunk, extremities, neck and face, as well as a marked conjunctival injection. In addition, she had pitting oedema on both lower legs.

Laboratory investigation showed a normal red and white blood cell count, with atypical lymphocytes in the differential. Renal function and liver enzymes were normal, except for a slightly elevated LDH of 297 IU/l.

One day after her initial presentation, the skin rash had improved markedly. She recovered quickly. Upon follow-up on 11 Dec 2015, her only complaints were arthralgias that seemed to further improve.

The clinical diagnosis of Zika virus infection was confirmed by PCR (Erasmus MC, Rotterdam), on a sample taken on 2 Dec 2015 (the 3rd day of illness).

To date, Zika virus infection has been rarely reported as cause of febrile illness among returned travellers and this is the 1st confirmed case in the Netherlands. Because symptomatology and clinical course are often mild, it is likely that the diagnosis is easily missed. Given the expanding base of information regarding complications possibly associated with this disease (such as neurologic manifestations and the reported increase of infants born with microcephaly in endemic areas), it is important to facilitate diagnostic capacities. This case underscores the fact that changing epidemiology of infectious disease also affects the spectrum of disease in returned travelers. Among other arboviral infections, such as dengue and chikungunya, Zika virus infection should be included in the differential diagnosis of any febrile traveler who has returned from an endemic area, such as Suriname.
------------------------------------
Abraham Goorhuis, MD, on behalf of the medical team
Center of Tropical and Travel Medicine
Academic Medical Center
Amsterdam
The Netherlands
=====================
[Although ProMED does not normally post case reports of arboviruses imported into countries with no possibility of ongoing mosquito transmission unless there is something unusual about them, this case is important for the very reasons noted above. With Zika virus expanding its geographic range in the Americas, we are likely to see more cases imported into a variety of localities where it has not occurred before. The sound advice of Dr. Goorhuis and colleagues to include Zika virus, along with dengue and chikungunya viruses in differential diagnoses when patients with histories of travel to Zika-endemic countries seek medical attention for febrile disease with rash is prudent. This case also illustrates the need to obtain patient travel histories. And clinicians should not forget that there was good evidence of sexual transmission when an infected man infected in Africa returned to his home in a country where Zika virus was not present ((see ProMED-mail archive no.  http://promedmail.org/post/20150516.3367156).

ProMED thanks Dr. Goorhuis and colleagues for submitting this case report.

It was not surprising that Zika virus arrived in Suriname, since 2 other countries in northern South America -- adjacent Brazil and somewhat more distant Colombia -- have reported ongoing cases. Transmission of the virus is continuing there.

A map showing the location of Suriname in northeastern South America can be accessed at
<http://healthmap.org/promed/p/37>. - ProMed Mod.TY]
Date: Tue 3 Nov 2015
Source: Loop [edited]

There are 2 confirmed cases of the Zika virus, also known as Zik-V.

These cases were confirmed by the AZP [Academisch Ziekenhuis Paramaribo, a scientific research center in Paramaribo, Suriname]. The Bureau of Public Health (BOG) has made it known that it requires external confirmation of these results. This stance has dismayed AZP Lab director John Codrington, who stated that it shows a lack of confidence in local authority.

The BOG has made it clear why they have come to this decision. They will conduct further tests through the CARPHA [Caribbean Public Health Agency] because this is the 1st possible instance of the virus locally; the virus is similar in presentation to other ailments such as dengue fever and chikungunya, also known as Chik-V; and the positive test cases may have brought it back from foreign travels.

The call for further study will not disrupt any preventative measures as doctors have been armed with the necessary information that the public requires regarding the nature and procedures surrounding the virus. Its similarity to dengue and Chik-V means that a similar approach to prevention is required.

People need to ensure that their homes and communities are free of mosquito-friendly breeding grounds. As with the chikungunya virus, there is no vaccine or preventive drug for Zik-V, and only treatment of symptoms is possible. Usually non-steroid anti-inflammatories and/or non-salicylic analgesics are used.

While there is no cure or vaccine for the virus, health officials urge people to reduce the risk of contracting Zika virus infection by using the following measures:

Use anti-mosquito devices (insecticide-treated bed nets, coils, smudge pots, spray, repellents) and wearing long sleeves and clothes with long legs, especially during the hours of highest mosquito activity (morning and late afternoon).

Mosquito repellent based on a 30 per cent DEET concentration is recommended -- for new-born children under 3 months, repellents are not recommended; instead, insecticide-treated bed nets should be used.

Before using repellents, pregnant women and children under the age of 12 years should consult a physician or pharmacist.

Unlike Chik-V, Zik-V can also be transmitted through sexual contact.

[byline: Jonathan Stuart]
=================
[It would not be surprising if Zika virus has arrived in Suriname, since 2 other countries in northern South America -- adjacent Brazil and somewhat more distant Colombia -- have reported ongoing cases. The report does not indicate if these 2 cases are locally acquired or are imported cases of Zika virus infection. Sending samples to an outside international reference laboratory is prudent in situations when a new pathogen appears. The AZP laboratory should welcome confirmation of their test results.

A map showing the location of Suriname in north eastern South America can be accessed at
<http://healthmap.org/promed/p/37>. - ProMED Mod.TY]
Monday 30th January 2012
A ProMED-mail post
<http://www.promedmail.org>

- Suriname. 25 Jan 2012. "Up to now more than 300 dengue cases have been registered at the Academic hospital lab, while other labs also confirm cases," the health ministry said in a press release. With the dengue outbreak now a month old, health authorities said they believe cases of the mosquito-borne disease are peaking. Due to overcrowding in hospitals, patients were being treated in the army's health facilities.
======================
[A HealthMap/ProMED-mail interactive map of Suriname can be accessed at <http://healthmap.org/r/1GZ2>. - ProMed Mod.TY]
More ...

Croatia

Croatia US Consular Information Sheet
January 16, 2008
COUNTRY DESCRIPTION:
Croatia is an increasingly well-developed nation in the process of accession to the EU. Facilities for tourism are available throughout the country, and the Adriat
c coast is an increasingly popular tourist destination. Read the Department of State Background Notes on Croatia for additional information or go to http://www.hr/english.

ENTRY/EXIT REQUIREMENTS:
A passport is required for travel to Croatia. A visa is not required for U.S. passport holders for tourist or business trips of fewer than 90 days within a six-month period. All foreign citizens must register with the local police within 24 hours of arrival and inform the office about any change in their address. Registration of foreign visitors staying in hotels or accommodations rented through an accommodation company is done automatically by the hotelier or accommodation company. Failure to register is a misdemeanor offense; some Americans have been fined as a result of their failure to register. U.S. citizens already in Croatia who wish to remain in Croatia for more than 90 days must obtain a temporary residence permit from the local police having jurisdiction over their place of residence in Croatia. With their residency application, applicants will need to provide a copy of their birth and marriage certificates (obtained within 90 days before application) and a police report authenticated for use abroad from their state of residence in the U.S. or from the country where they permanently reside. All documents should have an “apostille” stamp certifying their authenticity. Information regarding apostilles and authentication of documents is available at http://travel.state.gov/law/info/judicial/judicial_701.html.

For information on obtaining FBI or local police reports, please see http://travel.state.gov/tips/emergencies/emergencies_1201.html.
If an extension of the approved temporary stay is needed, the request should be submitted no later than 30 days in advance of the last day of authorized stay. For more information on obtaining residence or work permits, please see http://www.usembassy.hr/acs/entry.htm.

For further information on entry requirements for Croatia, including information regarding requirements for residency and work permits, travelers may contact the Embassy of Croatia at 2343 Massachusetts Avenue NW, Washington, DC 20008, tel. (202) 588-5899, the Croatian Consulates in New York City, Chicago, and Los Angeles or the Croatian Ministry of Internal Affairs/Office for Foreigners, tel. (385) (1) 4563-111 or http://www.mup.hr and http://www.mvpei.hr/MVP.asp?pcpid=1123. Visit the Embassy of Croatia web site at www.croatiaemb.org for the most current information.

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

SAFETY AND SECURITY:
Although hostilities in all parts of the country ended in 1995, de-mining of areas along former confrontation lines is not complete. It is estimated that de-mining operations will continue at least until 2010. Mine-affected areas are well-marked with the Croatian-language warning signs using the international symbol for mines. Travelers in former conflict areas, including Eastern Slavonija, Brodsko-Posavska county, Karlovac county, areas around Zadar, and in more remote areas of the Plitvice Lakes National Park should exercise caution and not stray from known safe roads and areas.
Mine clearance work may lead to the closure of roads in former conflict areas. For more information about mine-affected areas and de-mining operations in Croatia, please see the Croatian Mine Action Center’s web site at www.hcr.hr/en/minskaSituacija.asp.

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., 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:
Croatia has a relatively low crime rate, and violent crime is rare. Foreigners do not appear to be singled out. However, in tandem with increased numbers of American tourists visiting Croatia, the Embassy is receiving increased reports of thefts. Travelers are advised to safeguard their belongings in public areas, especially in bus or railroad stations, airports and on public transportation. As in many countries, outward displays of wealth may increase a traveler’s chances of being targeted by thieves.

While violent crime is rare, there have been isolated attacks targeted at specific persons or property, which may have been racially motivated or prompted by lingering ethnic tensions from Croatia’s war for independence.

Additionally, American citizens are cautioned to be mindful that Croatia is predominantly Catholic and, in some regions, quite conservative. Behavior that may be generally acceptable by American standards may offend local sensitivities and be met with hostility and, in a few cases, even violence.

American citizens are urged to be cautious when frequenting so called "gentlemen's clubs." A few such establishments have presented foreign patrons with grossly inflated bar bills, sometimes in the thousands of dollars, and threatened those customers who refuse to pay.

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:
Health facilities in Croatia, although generally of western caliber, are under severe budgetary strains. Some medicines are in short supply in public hospitals and clinics. The number of private medical and dental practitioners is substantial, and private pharmacies stock a variety of medicines not readily available through public health facilities. Croatian health care facilities, doctors and hospitals may expect immediate cash payment for health services and generally will not accept credit cards. Tick-borne encephalitis, a disease preventable with a three-shot vaccination series, is found throughout inland Croatia but is not prevalent along the coast. Travelers to Croatia may obtain a list of English-speaking physicians and dentists at the Embassy’s web site at www.usembassy.hr/acs/medical.htm or by calling: (385) (1) 661-2376 during working hours, or (385) (1) 661-2400 after working hours. Ambulance services can be reached by dialing 94. Ambulance services are effective; however, response times may be longer to more isolated areas.

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. Americans who plan to stay in Croatia for more than 90 days may be required by Croatian authorities to pay into the Croatian health insurance system for the period of their stay in Croatia, regardless of whether they hold private American insurance or not.

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

Road conditions and maintenance in Croatia vary widely. Two modern highways linking Zagreb with Rijeka and Split opened in 2004. Construction is complete between Zagreb and Split and Zagreb and Rijeka, but work is still ongoing between Split and Dubrovnik; This work may cause delays and road closures. Additionally, there are stretches of highway, with average travel speeds up to 130km/hour, which are still only one lane in each direction. Opposing traffic may not be separated by a divider. Highway tolls are higher than in the United States. Primary roads, including roads along the coast, are generally adequate, but most have only one lane in each direction. Coastal roads are narrow and congested, and tend to be slippery when wet. Rock slides are also possible on roads along the coast as well as through the mountain regions of Lika and Gorski Kotar. There is heavy congestion on major routes on weekends (towards the coast, for example) and in major cities during rush hours. Congestion on coastal routes, at border crossings and at tunnels is especially heavy in the summer months. Drivers should be prepared for sudden slowdowns when approaching tunnels at any time of year. Drivers tend to be aggressive in Croatia. Passing on curves or in oncoming lanes is common on highways and poses a higher risk of accidents. Drivers traveling though former conflict areas should stay on paved roads to reduce the risk of encountering unmarked mines and unexploded ordnance left over from the 1991-1995 war. In Zagreb, motorists and pedestrians alike should also pay special attention to trams (streetcars), which in downtown areas may travel at a high rate of speed through the narrow, congested streets.

Right turns on red lights are strictly forbidden in Croatia, unless an additional green light (in the shape of an arrow) allows it. At unmarked intersections, right of way is always to the vehicle entering from the right. The use of front seat belts is obligatory and passengers in vehicles equipped with rear seat belts are required to use them. Special seats are required for infants, and children under age 12 may not sit in the front seat of an automobile. The use of a cellular phone while operating a motor vehicle is prohibited unless the driver is using a hands-free device. Cars must have headlights on while in operation.

Croatia has adopted a policy of zero tolerance to driving under the influence of alcohol. It is illegal for a driver to have blood alcohol level greater than 0.00. Police routinely spot-check motorists for drinking and driving and will administer breath-analyzer tests at even the most minor accident. Drivers who refuse to submit to a breath-analyzer are automatically presumed to have admitted to driving while intoxicated. In case of accidents resulting in death or serious injury, Croatian law requires police to take blood samples to test blood alcohol levels.

Within Croatia, emergency road help and information may be reached by dialing 987, a service of the Croatian Automobile Association (HAK), staffed by English speaking operators. The police can be reached by dialing 92 and the ambulance service by dialing 94. Additional road condition and safety information may be obtained from HAK at tel. (385-1) 464-0800 ext. 0 (English speaking operators available 24 hours), or (385-1) 455-4433 or (385-1) 661-1999, or via their web site, www.hak.hr. During the tourist season, traffic information in English is also available at 98.5 FM on Croatian radio thirty minutes past the hour between 6:30 a.m. and 8:30 p.m.

According to Croatian law, U.S. citizens in Croatia for tourism or business may use a U.S. driver’s license for up to three months. U.S. citizens in Croatia with an approved extended tourist visa or permit for permanent residence may continue to use a U.S. driver’s license for up to twelve months, after which a Croatian driver’s license must be obtained. Please see http://www.usembassy.hr/acs/driver_license.htm for more information on obtaining a Croatian driver’s license. For specific information concerning Croatian driver’s permits, vehicle inspection, road tax and mandatory insurance, please contact the Croatian National Tourist Office, 350 Fifth Avenue, Suite 4003, New York, NY 10118; phone 1-800-829-4416 or 212-278-8672; fax 212-279-8683.

In cases of traffic accidents involving a foreign-registered vehicle, the investigating police officer on the scene is required to issue a vehicle damage certificate to the owner of the foreign-registered vehicle. This certificate is necessary to cross the state border. Upon written request, the police station in the area where the accident occurred will issue a Traffic Accident Investigation Record. For further information, please visit http://www.mup.hr/1266.aspx.

Please refer to our Road Safety page for more information.

For travelers arriving by private marine craft, please refer to the nautical information and regulations available at www.mmtpr.hr.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by Croatian carriers, the U.S. Federal Aviation Administration (FAA) has not assessed the Government of Croatia’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Croatia’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:
With numerous automated teller machines and ever-wider acceptance of credit cards in Croatia, traveler’s checks are accepted less frequently or exchanged at an unfavorable rate. Western Union money transfer is available. For information on money transfers, call (385)(1) 4839-166 or fax (385)(1) 4839-122.

Recreational Boating:
The Government of Croatia adopted a law (effective January 1, 2006) requiring all recreational skippers chartering Croatian flagged vessels to have a certificate of competence. Under the law, the Ministry of Sea, Tourism and Transport will only recognize licenses issued by national authorities of other states. As no such national licensing regime exists in the U.S., Americans wishing to charter and pilot a Croatian-flagged vessel may be required to pass a certification test at the Ministry in Zagreb or a designated harbormaster's office on the coast.

Tourists can be certified in Croatia at harbormasters' offices in Pula, Rijeka, Senj, Zadar, Sibenik, Split, Ploce and Dubrovnik, as well as at the Ministry in Zagreb. Candidates need to contact the harbormaster's office or the Ministry to schedule the test. Please note that the test will be administered only to groups, so individuals may need to wait until a sufficient number of interested applicants apply. The certification costs 850 kuna (roughly $165) and is valid indefinitely. A study guide is available and the test can be taken in Croatian, English, German, and Italian.

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 Croatian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Croatia 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 also 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 Croatia 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 Croatia.Americans withoutInternet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy in Zagreb is located at ul. Thomasa Jeffersona 2, 10010 Zagreb, tel. (385) (1) 661-2200. The Embassy is located in the southern outskirts of Zagreb near the airport. For emergencies on weekends, holidays and after hours, an embassy duty officer can be reached at tel. (385) (1) 661-2400 or (385) (91) 455-2247.
* * *
This replaces the Consular Information Sheet dated July 6, 2007, to update sections on Traffic and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Tue, 16 Jul 2019 10:44:51 +0200

Zagreb, July 16, 2019 (AFP) - Some 10,000 tourists were evacuated from a popular party beach on a Croatian island after a forest fire erupted early Tuesday, police said.

Police ordered visitors to night clubs on Zrce beach on the northern island of Pag to leave after the blaze erupted in a pine forest at around 1:00 am (2300 GMT Monday), a police statement said.   No one was injured in the fire which was brought under control, the mayor of the nearby town of Novalja, Ante Dabo, told national radio.  The cause was not immediately known.   Three firefighting planes were rushed to the scene to help extinguish the blaze which spread to a local road that had to be closed.

The island of Pag and its Zrce beach are popular with young tourists, notably British, who party there.  Tourism is a pillar of Croatia's economy, with visitors flocking to hundreds of islands and islets along its stunning Adriatic coast.   Last year the country of 4.2 million people welcomed more than 19 million tourists.
Date: Tue, 25 Sep 2018 19:50:04 +0200

Zagreb, Sept 25, 2018 (AFP) - A forest fire erupted Tuesday in Croatia's southern Peljesac peninsula, prompting the evacuation of dozens of villagers and tourists and destroying four houses, officials said.   The blaze broke out near the town of Orebic. It threatened the hamlet of Mokalo whose 40 inhabitants were evacuated, the national rescue and protection directorate (DZUS) said.   Tourists from two nearby camps were also evacuated, it added.

Meanwhile, strong winds hampered firefighting efforts and prevented the use of two water-bombing planes, they said.   "The situation in the Orebic area is pretty serious," national firefighting commander Slavko Tucakovic told state-run television.   "Unfortunately four houses were burned down but there are no casualties," he said.   This summer Croatia did not see major forest fires which mainly namely threaten its Adriatic coast.   But in 2017, summer fires were among the worst in several years, with 83,000 hectares (205,000) of forests damaged.
Date: Mon 3 Sep 2018, 11:43 PM
Source: Xinhua [edited]

A total of 26 people in Croatia have been diagnosed with the West Nile virus (WNV) this year [2018] and one has died, the Croatian Institute of Public Health announced on [Mon 3 Sep 2018].

Since last week, the institute has received 10 new reports of the disease, which is most often transmitted by infected mosquitoes and birds. The victims all came from the northwest and eastern parts of the country.

According to the European Center for Disease Prevention and Control, by [30 Aug 2018] there were 710 cases of WNV infections in Europe. Most of them in were in Italy (327), Serbia (243) and Greece (147).

Croatian news portal index.hr reported on [Mon 3 Sep 2018] that at least 20 people in Croatia who have been diagnosed with the virus were infected in Croatia.

WNV can cause neurological disease and death. The virus 1st appeared in Croatia in 2012 and since then 38 people have been infected. However, only a small percentage of the infected has been recorded, as the disease is usually mild and goes without any symptoms.

It is estimated that 80 percent of infected people have no symptoms while others develop a disease with flu-like symptoms such as high temperature, headache, sickness, and vomiting. Only 1 percent of infected people are hit by a heavy fever that usually leads to meningitis or encephalitis.  [Byline: Mu Xuequan]
======================
[In 2012, the 1st outbreak of human WNV neuroinvasive disease was reported in Croatia with 7 confirmed cases in 3 north-eastern counties [1]. In addition, acute asymptomatic infections in horses were noted in the same counties where human cases occurred [2].

All the cases of the West Nile virus infection in 2018 have been reported in the north-western and eastern regions of the country [3]

Vector surveillance and control measures can be helpful in reducing the burden of WNV and other vector borne diseases such as Dengue and Chikungunya.

References
1. Pem-Novosel, Vilibic-Cavlek T, Gjenero-Margan I, et al. First outbreak of West Nile virus neuroinvasive disease in humans, Croatia, 2012. Vector Borne Zoonotic Dis. 2014 Jan;14(1):82-4. doi: 10.1089/vbz.2012.1295, available at:

[HealthMap/ProMED map available at:
Date: Thu, 28 Jun 2018 12:57:23 +0200

Zagreb, June 28, 2018 (AFP) - Croatian authorities arrested a young British man Thursday on suspicion of stabbing to death another Briton on a popular party island in the Adriatic, in what local media said was a drug-related brawl between British gangs.   "We have identified the person suspected of committing the killing ... and the suspect was arrested this morning at the airport in Split", on the central Adriatic coast, Interior Minister Davor Bozinovic told reporters.   A police statement identified the suspect as a 25-year-old British man.   The victim was a 26-year-old British tourist who was killed at dawn Wednesday on the resort island of Pag.   Two other Britons were hurt in the alleged brawl on a beach, famous for parties. One of them suffered life-threatening stab wounds and was hospitalised while a third British tourist sustained minor injuries, hospital sources said.

The Jutarnji List paper -- which identified the victim as Ugo W. and said surveillance cameras recorded the fight -- reported Thursday that the "young men clashed over an area where they were selling drugs."   Croatia's northern island of Pag, particularly the town of Novalja and Zrce beach, is well known as a summer party destination for young tourists, many of them British.   Tourism is a major industry for Croatia where visitors flock to its stunning Adriatic coast, with more than 1,000 islands and islets.   Last year the country of 4.2 million people welcomed more than 17 million tourists. Among them were more than 750,000 British visitors.
Date: Wed, 27 Jun 2018 18:12:03 +0200

Zagreb, June 27, 2018 (AFP) - A British tourist was stabbed to death outside a nightclub on a popular Croatian party island at dawn on Wednesday in what the local media said was a brawl between British gangs.

Two other Britons were hurt in the fight on a beach on the Adriatic resort island of Pag, one of them suffering life threatening injuries.   Police said they were questioning several people over the incident, which occurred on Zrce beach at around 05:35 am (0335 GMT).   Surveillance cameras recorded the "fight between two British gangs" and police have identified those involved, the Jutarnji List paper reported online.

Police did not give further details about the brawl or the British tourists, although the state-run HINA news agency reported that the dead man was 26 years old.   "Unofficially, it was a fight between a group of young Brits," it said.   Another 26-year-old Briton suffered several stab wounds.   "He is stable now but his life is still in danger," said Edi Karuc, deputy head of a hospital in the coastal town of Zadar, quoted by HINA.    A third British tourist sustained minor injuries.

The northern island of Pag, particularly the town of Novalja and Zrce beach, is well known as a summer party destination for young tourists, many of them British.   Tourism is a major industry for Croatia where visitors flock to its stunning Adriatic coast, with more than 1,000 islands and islets.   Last year the country of 4.2 million people welcomed more than 17 million tourists. Among them were more than 750,000 British visitors.
More ...

Cote d'Ivoire

Cote d'Ivoire - US Consular Information Sheet
May 21, 2007
COUNTRY DESCRIPTION: Cote d'Ivoire (Ivory Coast) is a developing country on the western coast of Africa.
The official capital is Yamoussoukro, but Abidjan is the largest city, the
ain commercial center, and where the Ivorian government and the U.S. Embassy are located.
Cote d'Ivoire is a republic whose constitution provides for separate branches of government under a strong president.

The country has been divided since a 2002 coup attempt developed into a civil war.
Despite several peace agreements and the establishment of a transitional government, key issues remain unresolved, elections have been delayed, and tensions persist throughout the country.

Tourist facilities in and near Abidjan, the commercial capital, are good; accommodations in many other locations are limited in quality and availability.
Read the Department of State Background Notes on Cote d’Ivoire for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required, but U.S. citizens traveling to Cote d'Ivoire for business or tourism do not require visas for stays of 90 days or less.
To stay longer than 90 days, the visitor may still enter without a visa, but then must apply for a "carte de sejour" within 90 days of arrival.
(Note: "Cartes de sejour" are not issued to children under the age of 16, who are documented on their parents' visas).
An international health certificate showing current yellow fever immunization is required for entry into Cote d'Ivoire.
Without it, the traveler may be required to submit to vaccination at the airport health office before clearing immigration, at a cost of 5,000 CFA (a little less than $10).

Travelers may obtain the latest information and details on entry requirements from the Embassy of the Republic of Cote d'Ivoire, 3421 Massachusetts Avenue, NW, Washington, D.C. 20007, telephone (202) 797-0300.
There are honorary consulates for Cote d'Ivoire in San Francisco, Stamford, Orlando, Houston and Detroit.
Overseas, travelers should inquire at the nearest Ivorian embassy or consulate.
See our Foreign Entry Requirements brochure for more information on Cote d’Ivoire and other countries.
Visit the Embassy of Cote d'Ivoire web site at http://www.cotedivoireembassy.com/ for the most current visa information.

Foreign travelers are sometimes approached at ports of entry by individuals with offers to expedite passport control and customs, and are then asked to pay an exorbitant fee, both for the service and for the passport and customs officers.
Travelers to Cote d'Ivoire are advised that there is no need to pay a police officer or customs officer at the airport for any service rendered during an arrival or departure, and they should not surrender their passports or other important documents to anyone except easily identifiable government officials in uniform.

See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction.
Please refer to our Customs Information to learn more about customs regulations.

SAFETY AND SECURITY:Cote d'Ivoire has been unstable since the coup in 1999, and territorially divided since 2002.
The New Forces control the northern and some western parts of the country.
There are many road checkpoints manned by security forces and militia in both the government-controlled and New Forces-controlled portions of the country.
Soldiers and militia members check documents and frequently demand cash for permission to pass.
Cote d'Ivoire's border with Liberia is open, but border controls are extensive.

Political instability has contributed to economic stagnation and high unemployment, exacerbating social tensions and creating the potential for labor unrest and civil disorder.
There have been recurring episodes of violence, some of them severe.
In November 2004, there was a brief resumption of hostilities between the two sides followed by widespread attacks against people and property in Abidjan and elsewhere.
Many of these attacks were directed against French and other expatriates, and thousands fled the country.
Americans should avoid crowds and demonstrations, be aware of their surroundings, and use common sense to avoid situations and locations that could be dangerous.
While diplomatic efforts to end the crisis are ongoing, further civil unrest, coup attempts or the resumption of hostilities are possible.

Swimming in coastal waters is dangerous and strongly discouraged, even for excellent swimmers.
The ocean currents along the coast are powerful and treacherous, and numerous people drown each year.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, 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., 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 U.S. citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Crime continues to be a major security threat for Americans living in Cote d'Ivoire.
Grab-and-run street crime and pick pocketing in crowded areas are widespread.
Armed carjacking, robberies of businesses and restaurants, and home invasions are common, and they often target expatriate residents who are perceived as wealthy.
Armed criminals use force when faced with resistance.
Travelers displaying jewelry and carrying cameras are especially at risk.
Travelers are advised to carry limited amounts of cash and only photocopies of key documents.
While there have been relatively few reported cases of sexual assault, given the general climate of criminality, the actual rate of assault may be much higher than that which is reported.
There were allegations of sexual assaults during the November 2004 civil strife.
Given the strong anti-French sentiment, people of non-African appearance may be specifically targeted for violence.
Avoid large gatherings and political demonstrations, as they can turn violent quickly.

Travel outside of Abidjan or at night is strongly discouraged, and it is particularly dangerous to visit Abidjan's Treichville, Adjame, Abobo, and Plateau districts after dark.
The DeGaulle and Houphouet-Boigny bridges in Abidjan are dangerous areas for pedestrians.
Inadequate resources and training limit the ability of the police to combat crime.
Many hotels, restaurants, nightclubs and supermarkets provide security guards to protect clients and vehicles.

Travelers should take the same common sense precautions in Abidjan that they would in any metropolitan area in the United States.
Travelers should stay in well-lit areas and walk confidently at a steady pace on the side of the street facing traffic close to the curb.
Travelers should avoid crowds, mass transit, doorways, bushes, alleys and sparsely populated areas.
Travelers who need transportation at night should take an Orange metered taxi.
Travelers should be discreet about your transactions, especially in sight on the street.
Normal spending habits of Westerners appear extravagant.

Credit card use in Cote d'Ivoire is limited, particularly outside Abidjan, but credit card fraud is an increasing problem.
Travelers should not use credit cards in paper transactions unless the credit card transaction is electronically performed in view of the individual.

Business fraud is rampant and the perpetrators often target foreigners, including Americans.
Schemes previously associated with Nigeria are now prevalent throughout West Africa, including Cote d'Ivoire, and pose a danger of grave financial loss.
Typically these scams begin with unsolicited communication (usually e-mails) from strangers who promise quick financial gain, often by transferring large sums of money or valuables out of the country, but then require a series of "advance fees" to be paid, such as fees for legal documents or taxes.
Of course, the final payoff does not exist; the purpose of the scam is simply to collect the advance fees.
A common variation is the scammer’s claim to be a refugee or émigré of a prominent West African family, or a relative of a present or former political leader who needs assistance in transferring large sums of cash.
Still other variations appear to be legitimate business deals that require advance payments on contracts.
Sometimes victims are convinced to provide bank account and credit card information and financial authorization that drains their accounts, incurs large debts against their credit, and takes their life savings.

The best way to avoid becoming a victim of advance-fee fraud is common sense — if a proposition looks too good to be true, it probably is a scam, particularly if one has never met the correspondent.
Travelers should carefully check and research any unsolicited business proposal before committing any funds, providing any goods or services, and undertaking any travel.
A good clue to a scam is the phone number given to the victim; legitimate businesses and offices provide fixed line numbers, while scams typically use only cell phones.
In Cote d'Ivoire, all cell phone numbers start with zero.

It is virtually impossible to recover money lost through these scams.
For additional information please consult the Department of State's brochure Advance Fee Business Scams.

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:
Abidjan has privately-run medical and dental facilities that are adequate but do not fully meet U.S. standards.
Good physician specialists can be found, though few speak English.
While pharmacies are well stocked with medications produced in Europe, newer drugs may not be available.
Medical care in Cote d'Ivoire outside of Abidjan is extremely limited.
Malaria is a serious health problem in Cote d’Ivoire.
For more information on malaria, including protective measures, see the Centers for Disease Control Travelers’ Health web site at http://www.cdc.gov/malaria/.

The avian influenza or “Bird Flu” virus (H5N1) has been confirmed in animals in Cote d’Ivoire as of June 2006.
For more information regarding Avian Influenza, please visit the CDC’s internet site at http://www.cdc.gov/travel/other/avian_flu/ and the State Department’s Avian Influenza Fact Sheet.

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 internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.

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 Cote d’Ivoire is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Serious traffic accidents, one of the greatest threats to U.S. citizens in Cote d’Ivoire, occur regularly in Abidjan.
Unsafe road conditions, unskilled drivers, and poorly maintained and overloaded vehicles create very poor driving conditions.
Speed limits, signals, and yielding for pedestrians and cyclists are not respected.
Travelers should drive defensively, watch out for public transportation vehicles that stop and start without warning, and be especially cautious at intersections because traffic lights often malfunction.
Travelers who must travel at night should beware of vehicles without headlights and/or taillights, and pedestrians and bicycles along the roadside.
In case of an accident, travelers are advised not to move their vehicle until a police officer authorizes.
Travelers should go to the nearest hospital or police station if there is no other vehicle to take the injured to a hospital, or if there is reason to believe that their life is in danger from others at the site of the accident.

Abidjan has a poor public transportation system; if traveling by bus, use only the “Express” line.
In Abidjan, taxis are readily available, inexpensive (metered), but poorly maintained and notorious for not respecting the rules of the road.
Communal taxis (“woro-woros”), used only within the limits of each commune, are not metered and are dangerous.
Local vans ("Gbaka") should not be used because they are frequently involved in accidents.

Criminals usually steal vehicles when the driver is in or near the vehicle, so car doors and windows should be kept locked.
While stopped in traffic, travelers should remember to allow enough room between your car and the one in front to maneuver out if needed.
Travelers should look around to see if there is anyone paying unusual attention or if someone appears to be watching, before entering their vehicles. Travelers should not attempt to enter their vehicles, and should go get assistance.
Travelers should enter and exit their vehicles as quickly as possible, to limit their vulnerability to carjacking.

Victims of carjacking should not resist.
Victims should try to remain calm and give the carjackers what they want, which is usually the vehicle and any valuables.
Experience shows that criminals usually don’t use violence unless they are confronted with resistance.
Furthermore, it is not uncommon to take an occupant, usually a woman or child, as hostage to ensure their safe escape; the hostage is usually released unharmed.
This is a very difficult situation; victims should use their best judgment in deciding a course of action.

A newer phenomenon is the staged accidental "bumping" accident.
If your vehicle is "bumped" from the rear or the side, stay locked inside because this ruse is used to get the driver out and leave the vehicle free for carjacking.
Travelers with cell phones should call for assistance.
Victims should report the accident at the nearest police station as soon as possible if they feel their safety is in jeopardy and try to get the license number for any other vehicle involved.

Emergency services such as ambulance service (SAMU) exist in Abidjan and larger towns.
Call 185 or 22-44-55-53.
In smaller towns there is usually no ambulance service available, but ambulances will be dispatched from larger towns

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 Cote d'Ivoire’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Cote d'Ivoire's air carrier operations.
For more information, travelers may visit the FAA’s internet web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Ivorian 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, at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States.
For additional information, call (212) 354-4480, e-mail atacarnet@uscib.org, or visit http://www.uscib.org.

If traveling to another West African Economic and Monetary Union (WAEMU) country, expatriate residents leaving Cote d’Ivoire must declare the amount of currency being taken out of the country; if going to any other country, tourists are prohibited from taking more than 500,000 CFA francs (approximately $1,000), and business operators two million CFA francs (approximately $4,000), without government approval.
Even with authorization, there is a cash limit of $4,000 for tourists and $5,500 for business people, with any surplus in travelers or bank checks.

Travelers should carry a photocopy of your U.S. passport, visa, and entry stamps.
Travelers should also, carry their international driver's licenses if planning to drive.

Government corruption remains a serious problem in Cote d'Ivoire, and has an impact on judicial proceedings, contract awards, customs, and tax issues.
Security forces (police, military, gendarmes) routinely stop vehicles for traffic violations and security checks. Travelers should politely present identification if stopped.
Travelers who are stopped at one of these check points for any reason and asked to pay a "fine" to these uniformed officials, should politely refuse and present a photocopy of their U.S. passport, visa, and entry stamp.

Taking pictures is prohibited near sensitive installations, including military sites, government buildings such as the radio and television stations, the Presidency building, the airport, and the DeGaulle and Houphouet-Boigny bridges in Abidjan.

Cote d’Ivoire recognizes dual nationality if acquired at birth.
Americans who also are Ivorian nationals may be subject, while in Côte d'Ivoire, to certain aspects of Ivorian law that impose special obligations on citizens of that country.
Please see our information on Customs Regulations.
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 Cote d'Ivoire's laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Cote d'Ivoire 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 Criminal Penalties.

CHILDREN'S ISSUES:
For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web site.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Cote d'Ivoire are urged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website and to obtain updated information on travel and security within Cote d’Ivoire.
Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in the Riviera Golf neighborhood of the Cocody section of Abidjan, east of the downtown area.
The Embassy's postal address is 01 B.P. 1712 Abidjan 01, and the main telephone number is 22-49-40-00.
The Consular Section fax number is 22-49-42-02, and more information is on the Consular pages of the Embassy's web site at http://Abidjan.usembassy.gov/
*

*

*
This replaces the Consular Information Sheet dated November 21, 2006, with no major changes.

Travel News Headlines WORLD NEWS

Date: Thu, 24 Oct 2019 11:46:08 +0200 (METDST)
By David ESNAULT

Bouake, Ivory Coast, Oct 24, 2019 (AFP) - Once the bane of sub-Saharan Africa, sleeping sickness is agonisingly close to being wiped out, but only if countries -- and donors -- keep up their guard, say scientists.   The disease, transmitted to humans by the tsetse fly, was once a curse in 30 countries.   But a coordinated global fight to eradicate it has borne fruit, leading to a 95-percent fall in cases over the past 15 years, according to the World Health Organization (WHO).

Last year, the agency recorded only 977 cases, compared to a peak of some 300,000 in the 1990s. Its hope is that sleeping sickness will enter the history books by 2030.   Sleeping sickness -- human African trypanosomiasis -- is caused by the trypanosoma parasite, which is transmitted to humans by the tsetse when it takes a blood meal.   The disease is fatal unless diagnosed and treated rapidly. Early symptoms are severe headaches and muscle aches and fever.

Sufferers feel lethargic and sleepy by day then awake and exhausted at night. Neuropsychiatric and sensory disorders follow, then a coma before death ensues within months or sometimes even years later.   "Sleeping sickness is scary -- when someone has it, it makes them mad," said Emile Gouribitiali, 56, a villager in central Ivory Coast whose mother and younger brother both fell ill.   But scientists say this dreaded disease is on the ropes.   "After a century of fighting it, sleeping sickness is on the verge of being eradicated," said Dr Dramane Kaba, an entomologist and director of the Pierre Richet Institute (IPR) at Bouake in central Ivory Coast.   "Sleeping sickness has almost stopped being a public health problem in Africa," he said. "But we have to maintain our efforts."   The institute, founded in 1970, specialises in insect-transmitted diseases including malaria, dengue, zika and chikungunya.

- Meticulous task -
Despite the progress, "pockets of resistance" remain, says Kaba.   They include the Democratic Republic of Congo -- home to 80 percent of cases -- and Guinea, where health programmes have been ravaged by the Ebola crisis.   It is also difficult to gain an accurate assessment in areas of armed conflict.   If the overall outlook is relatively favourable, there must be no let-up towards eradication, Kaba insists.

He points to the fact that, after a campaign against the illness from the 1920s through to the 1960s "vigilance then dropped off and the illness returned".   Combatting the spread of the disease requires meticulous work to break the chain of transmission and kill the parasite, said Vincent Jamonneau at France's Research Institute for Development (IRD).   Teams on the ground, working with lab-based researchers, comb rural areas to uncover possible cases of the disease and beef up control of the tsetse fly, which favours a hot, humid habitat.

- Fly traps -
They log symptoms that point to a possible infection and then carry out a quick diagnostic blood test, obtaining results confirmed in a lab.   Patients identified in this way can be cured through hospitalisation of seven to 10 days, which the WHO provides free of charge across Africa. A revolutionary treatment, which involves taking a one-off pill, is being tested.

Ironically, as the disease is rolled back, it becomes more and more difficult to encourage villagers to come forward and get tested, said Jammoneau.   "People no longer feel that the disease is a threat," he said.   The researchers also test cattle, another tsetse target who suffer a different strain of the virus -- animal trypanosomiasis. They lose weight, their milk production slumps, then they die.   IPR teams set tsetse traps in villages where they operate. The traps comprise blue screens impregnated with insecticide -- the flies find the colour attractive. 

Another trap variant permits capture to assess their number and then dissection to determine if they are infected.   The IPR hosts research at its lab as the scientific community hones its battle to eradicate sleeping sickness.    The lab can draw on some state-of-the-art equipment as well as some 100 employees, including 16 researchers, but needs renovating, said Kaba.    For Jamonneau, "the means to eradicate trypanosomiasis are there.   "But this disease raises scant interest among fundraisers. So we still need their support as the challenge is to track down and treat the last cases in order to finish off the illness."
Date: Tue, 22 Oct 2019 16:24:07 +0200 (METDST)

Abidjan, Oct 22, 2019 (AFP) - Ivory Coast announced Tuesday that Arab investors had pledged $5 billion to support its programme to attract foreign tourists to the West African nation.   The tourism ministry said "a round table of investors in Dubai" on Sunday and Monday expressed interest In Ivory Coast and in total, the minister for tourism and leisure, Siandou Fofana, "enlisted from them pledges worth just over $5 billion" (4.49 billion euros).   Ivory Coast's charm offensive in the United Arab Emirates included a delegation with recently retired star footballer Didier Drogba and A'Salfo, lead singer with the pop group Magic System, who gave two concerts.

The initiative, dubbed "Sublime Cote d'Ivoire" (Magnificent Ivory Coast), was launched in May.   "Our goal is to become the fifth biggest destination for tourism in Africa by 2025," Fofana said in the ministry's statement.   If objectives are reached, tourism would account for 12 percent of GDP compared with 5.5 percent today, and jobs in the tourism sector would grow from 270,000, as of 2016, to 365,000.   The economy today is hugely dependent on rural earnings, especially cacao and coffee. The plan is to attract tourists to the remote west of the country, a region of unspoiled mountains and beaches.
Date: Tue, 27 Aug 2019 15:33:42 +0200 (METDST)

Bouake, Ivory Coast, Aug 27, 2019 (AFP) - The main market in Bouake, Ivory Coast's second biggest city, was largely destroyed Tuesday in an overnight blaze, although there were no known casualties, an AFP correspondent reported.   The fire broke out around 2:00 am (0200 GMT) and spread fast, market watchmen said.   It took around seven hours to bring under control, mobilising several hundred firefighters, police and troops, partly to put out the blaze but also to secure the area.   "This tragedy has most fortunately caused no loss of life," Bouake mayor Nicolas Djibo said, adding though that he was "dumbstruck by the scale of the damage".

Djibo said the fire had begun in the butchers' area of the market, which hosts hundreds of stalls and is a hub of social activity in Bouake, a city of one million people in the centre of Ivory Coast.   Some traders had been able to remove their wares in time but others wept at the sight of their loss.   Koffi Rachelle, who sold children's toys and various gadgets, told AFP she had lost everything. "I can"t even get into my shop, the fire has destroyed everything over there," she said in tears.

An inquiry into the fire has been opened, according to a police source who asked not to be named.   The market, which had an area of between eight and nine hectares (about 22 to 22 acres), had been razed by a fire in 1998.   Experts had been studying a proposal to house the stalls in a large modern building before the latest blaze.
Date: Tue, 30 Jul 2019 21:28:27 +0200

Abidjan, July 30, 2019 (AFP) - Eighty-nine people have contracted yellow fever and one person has died in recent weeks during an outbreak in Ivory Coast, the health ministry said Tuesday.   Most of the confirmed cases were in the West African country's economic capital Abidjan, the ministry said in a statement.

It recommended that any unvaccinated people be vaccinated against yellow fever.   "The outbreak occurs in the context of a dengue outbreak," the ministry said, adding that dengue and yellow fever are viral diseases transmitted by the same mosquito.    "The vector control measures that have been implemented to deal with dengue also work for the yellow fever outbreak."   In early June, 130 cases of dengue were reported including two deaths, with the authorities launching a major mosquito-control campaign.   Abidjan is going through the end of its rainy season, which spurs mosquito breeding.

Symptoms of yellow fever -- including high fever, vomiting and muscle aches -- usually manifest themselves three to six days after a person is bitten by an infected mosquito.   The infection caused by yellow fever is usually mild, but in some cases can be life-threatening and result in kidney and liver failure.   Yellow fever is found only in parts of South America and Africa.
Date: Tue 30 Jul 2019
Source: Medical Xpress [edited]

In recent weeks, 89 people have contracted yellow fever, and one person has died during an outbreak in Ivory Coast, the health ministry said Tuesday [30 Jul 2019].

Most of the confirmed cases were in the West African country's economic capital Abidjan, the ministry said in a statement. It recommended that any unvaccinated people be vaccinated against yellow fever.  "The outbreak occurs in the context of a dengue outbreak," the ministry said, adding that dengue and yellow fever are viral diseases transmitted by the same mosquito.

"The vector control measures that have been implemented to deal with dengue also work for the yellow fever outbreak."  In early June [2019], 130 cases of dengue were reported, including 2 deaths, with the authorities launching a major mosquito-control campaign.  Abidjan is going through the end of its rainy season, which spurs mosquito breeding.

Symptoms of yellow fever -- including high fever, vomiting and muscle aches -- usually manifest themselves 3-6 days after a person is bitten by an infected mosquito.  The infection caused by yellow fever is usually mild, but in some cases can be life-threatening and result in kidney and liver failure.  Yellow fever is found only in parts of South America and Africa.
=====================
[Yellow fever (YF) is a serious disease and has a case fatality rate of about 30%. It is surprising that there has been only one death so far among the 89 infected individuals. It is not stated that all 89 individuals were laboratory confirmed YF cases. The above report does not indicate the proportion of the population that has been vaccinated against YF.

YF virus can spread rapidly in a largely unvaccinated population, as it did in Angola in 2016. _Aedes aegypti_ vector control is of limited effectiveness in the face of a YF outbreak. Vaccination is the best preventive measure.

There have been YF cases in Cote d'Ivoire in the past, the most recent in 2011. At that time, more than 700 000 people were vaccinated against yellow fever [YF] in an emergency campaign in the country. There were YF cases in Abidjan in 2008, when the estimated vaccination coverage of the population was around 60 percent after a vaccination campaign. Now, time is of the essence to quickly halt the spread of YF, as it rapidly did in Angola and the DR Congo in that large outbreak. - ProMED Mod.TY]

[Maps of Cote d'Ivoire can be accessed at <http://bit.ly/2uHz53s>
and <http://healthmap.org/promed/p/52>.]
More ...

Saint Kitts and Nevis

St. Kitts and Nevis - US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
St. Kitts and Nevis is a developing Caribbean nation consisting of two islands.
Tourist facilities are widely available.
Read the Department
f State Background Notes on St. Kitts and Nevis for additional information.

ENTRY/EXIT REQUIREMENTS:
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.

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.

Visitors may be asked to present an onward/return ticket and proof of sufficient funds to cover the cost of their visit.
Stays of up to three months are granted at immigration.
Anyone requiring an extension must apply to the Ministry of National Security.
There is an airport departure tax and environmental levy charged when leaving the country.

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 at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings, and Travel Alerts 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:
Petty street crime occurs in St. Kitts and Nevis, as well as the occasional burglary; visitors and residents should take common-sense precautions.
Avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents.
Do not leave valuables unattended on the beach or in cars.
Exercise caution when walking alone at night.

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 care is limited.
The main hospitals are Joseph N. France General Hospital (telephone (869) 465-2551) on St. Kitts and Alexandria Hospital (telephone (869) 469-5473) on Nevis.
St. Kitts has two additional hospitals and both islands have several health clinics.
Neither island has a hyperbaric chamber.
Divers suffering from decompression illness are transported to the island of Saba, in the Netherlands Antilles.
Serious medical problems requiring hospitalization and/or medical evacuation to the U.S. can cost thousands of dollars.
Doctors and hospitals expect immediate cash payment for health services.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) 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 St. Kitts and Nevis is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic in St. Kitts and Nevis moves on the left-hand side of the road.
Roads are reasonably well paved but narrow and sometimes poorly marked.
Drivers often stop on the side of or in the middle of the road to visit with other drivers, blocking one lane of traffic.
Honking one's horn is a common form of greeting, not a warning.
Travelers are required to obtain a visitor's drivers license, which may be obtained from the Traffic Department or the Fire Station for a small fee on presentation of a valid home or international license.
Public Transportation consists of mini-buses and taxis.
Established fares are available from airport dispatchers and local hotels.
Complaints regarding taxi or minibus services may be lodged with The Department of Tourism or with your hotel.

More detailed information on roads and traffic safety can be obtained from the Ministry of Tourism, Culture and the Environment, Bay Road, Pelican Mall, P.O. Box 132, Basseterre, St. Kitts, telephone (869) 465-4040.
For specific information concerning St. Kitts and Nevis driving permits, vehicle inspection, road tax and mandatory insurance, contact the St. Kitts and Nevis national tourist organization via the Internet at http://www.stkitts-tourism.com/index.asp.
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 St. Kitts and Nevis’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of St. Kitts and Nevis’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:
There is no U.S. Embassy or Consulate in St. Kitts and Nevis.
The U.S. Embassy in Bridgetown, Barbados, is responsible for American citizen services in these islands.
U.S. citizens are encouraged to carry a copy of their U.S. passports or other proof of citizenship with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship are readily available.

All Caribbean countries can be affected by hurricanes.
The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

Please see 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 St. Kitts and Nevis laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in St. Kitts and Nevis 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 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 St. Kitts and Nevis 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 St. Kitts and Nevis.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in Barbados in the Wildey Business Park, Wildey, St. Michael, telephone 1-246-436-4950, web site http://barbados.usembassy.gov/.
The Consular Section telephone number is 1-246-431-0225. The Consular Section fax number is 1-246-431-0179. Hours of operation are 8:30 a.m. to 4:00 p.m. Monday-Friday, except Barbados and U.S. holidays.
In certain circumstances, the U.S. Consular Agency in Antigua can be of assistance.
Persons seeking assistance should call the Consular Agent, Rebecca Simon, at 1-268-463-6531 to schedule an appointment.
*

*

*
This replaces the Country Specific Information for St. Kitts and Nevis dated June 6, 2006, to update sections on Entry/Exit Requirements, Safety and Security, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed 21 May 2014
Source: West Indies News Network (WINN) FM [edited]

There are now 20 confirmed cases of chikungunya disease in St Kitts, according to Acting Chief Environmental health Officer Alexander Riley. Mr Riley made this confirmation Tuesday [20 May 2014] during an edition of WINN FM's Talking Trash programme.

Chikungunya is a mosquito-borne disease that causes fever and joint pain in humans. Other symptoms of the disease include rash, muscle pain, and fatigue.

As the hurricane season approaches Mr Riley lists measures that the environmental health department will be taking to prevent the spread of chikungunya [virus] include fogging beginning this Wednesday [20 May 2014].

Meanwhile, Mr Riley sought to allay fears and concerns about the health and environmental health department risks of fogging, noting that the chemicals used are environmentally friendly.  [Byline: Andre Huie]
===================
[Fogging will provide only temporary vector mosquito control. Elimination or treatment of breeding sites is necessary for significant vector mosquito population reduction. This same report was also sent in by Roland Hubner.

Maps of St Kitts and Nevis can be accessed at
and <http://healthmap.org/promed/p/31>. - ProMed Mod.TY]
Date: Thu 20 Feb 2014
Source: Winn FM [edited]

The Federation [St. Kitts and Nevis] has recorded its 1st confirmed case of the chikungunya virus [infection]. A statement from the Ministry of Health Thursday morning [20 Feb 2014] indicated that the 30-year-old male resident of St. Kitts was hospitalized and discharged without complications 2 weeks ago. Confirmation testing was done by the Trinidad-based Caribbean Public Health Agency (CARPHA).

Speaking to WINN FM Thursday morning, Chief Medical Officer Dr. Patrick Martin assured that there was no need to panic. "There is no need for travel or trade restrictions, no need for alarm, no need to panic. If you have the fever and pain, Paracetamol, lots of fluids... don't tire out yourself," Dr. Martin said Thursday.

Like dengue, chikungunya is characterized by fever and pain which appear up 3-7 days after being bitten by an infected mosquito. Other symptoms include headache, nausea, vomiting, fatigue and rash.

Acute chikungunya fever typically lasts a few days to a few weeks, but as with dengue, some patients have prolonged fatigue lasting several weeks. There is no risk of bleeding complications with chikungunya which distinguishes it from dengue.

Dr. Martin advised that persons exhibiting symptoms can be treated at, and use over the counter medications except for aspirin and ibuprofen.

Dr. Martin said Thursday [20 Feb 2014] that in all likelihood the virus has been in the Federation [St. Kitts and Nevis] for several weeks and that there have been other cases.   [Byline: Toni Frederick]
-----------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===================
[This report does not indicate whether the chikungunya virus infection was acquired locally on St. Kitts or in another locality where transmission is going on. No mention was made of the individual's travel history off of St. Kitts island, and the Chief Medical Officer mentioned that it is likely that the virus has been present in the Federation for several weeks with occurrence of other cases; these factors suggest that the infection was, in fact, acquired locally.

A HealthMap/ProMED-mail map showing the location of St. Kitts can be accessed at
<http://healthmap.org/r/1E3K>. - ProMed Mod.TY]
Wednesday 15th February 2012

WASHINGTON, Feb 14, 2012 (AFP) - US Supreme Court Justice Stephen Breyer was robbed at his Caribbean island vacation home last week by a masked, machete-wielding bandit, a court spokeswoman said Tuesday.  The incident took place February 9 at the justice's home in Nevis, with about $1,000 cash taken, the spokeswoman said.  "No one was hurt," said the official, noting that the 73-year-old Breyer was "robbed by an armed intruder" and that "the individual was armed with a machete."  Breyer was on vacation during a break from the schedule of the top US court, which resumes hearings Friday.

St Kitts and Nevis

Flag of St Kitts and Nevis
Still current at: 30 November 2011
Updated: 29 November 2011

This advice has been reviewed and reissued, with an amendment to the Entry Requirements - Passport Validity section (updated). The overall level of the advice has not changed; there are no travel restrictions in place in this travel advice for St Kitts and Nevis.

(see travel advice legal disclaimer)


  • There is no British High Commission in St Kitts and Nevis. British nationals requiring emergency consular assistance may contact the British Honorary Consul, Sarah Percival, on +1 (869) 764 4677 begin_of_the_skype_highlighting +1 (869) 764 4677 end_of_the_skype_highlighting. If the Honorary Consul is not available and for all other non-consular related matters please contact the British HighCommission in Bridgetown, Barbados.
  • Around 4,700 British nationals visited St Kitts and Nevis in 2008 (Source: Ministry of Tourism). Most visits to St Kitts and Nevis are trouble-free. The main type of incidents for which British nationals required consular assistance in St Kitts and Nevis in 2008 were replacing lost and stolen passports and dealing with hospitalisations. Over the past year, there has been an overall increase in crime in St Kitts, including gun crimes although these tend to occur within the local community.
  • There is a low threat from terrorism. But you should be aware of the global risk of indiscriminate terrorist attacks which could be in public areas, including those frequented by expatriates and foreign travellers.
  • The hurricane season in St Kitts and Nevis normally runs from June to November. See the Natural Disasters section of this Travel Advice.
  • You should take out comprehensive travel and medical insurance before travelling. See General - Insurance.

Safety and Security - Terrorism
There is a low threat from terrorism. But you should be aware of the global risk of indiscriminate terrorist attacks which could be in public areas, including those frequented by expatriates and foreign travellers. For more general information see our Terrorism Abroad page.

Safety and Security - Crime
Around 5,000 British nationals visit St Kitts and Nevis each year (Source: Ministry of Tourism) and the vast majority of visits are trouble-free. St Kitts and Nevis is a friendly and welcoming country but incidents of violent crime including murder do occur. Gun crime is increasingly problematic; there have been more than 25 murders in 2011, the majority as a result of shootings. Although these tend to occur within the local community, there have been a number of recent incidents involving British nationals in the Half Moon Court area, including a double murder and violent attack.

You should maintain vigilance at all times even when staying with family or friends. Avoid walking alone in isolated areas, including beaches, after dark. Do not carry large amounts of cash or jewellery. Valuables and travel documents should be left, where possible, in safety deposit boxes and hotel safes.

For more general information see our Victims of Crime Abroad page.

Safety and Security - Local Travel

Safety and Security - Local Travel - Road Travel
In order to be able to drive a car in St Kitts and Nevis you must purchase a local driving licence, usually from the car hire company, at a cost of EC$ 100. You must show your current driving licence to obtain this. Motorists drive on the left in St Kitts and Nevis. Main roads are generally well maintained but many follow winding routes so careful driving is necessary. Roads are not well lit at night. You must be alert for stray livestock and speed bumps in some areas that are not well marked. Hiring of scooters is popular amongst visitors but safety equipment is not included in the hire price; despite the additional cost this is highly recommended for your own protection. You should be cautious when driving a scooter, as other road users do not always give them due consideration.

For more general information see our Driving Abroad page.

Safety and Security - Local Travel - Air Travel
You will have to pay a departure tax when leaving St Kitts and Nevis. Departure tax is EC$58 (per adult) and EC$25 (child under 12).

Safety and Security - Political Situation
St Kitts and Nevis Country Profile

You should note that there are severe penalties for all drug offences. Pack all luggage yourself and do not carry anything through customs for anyone else. You should be aware that it is an offence for anyone, including children, to dress in camouflage clothing. Certain homosexual acts are illegal under the laws of St Kitts and Nevis. For more general information for different types of travellers see our Your Trip page.

Entry requirements - Visas
British Passport holders do not require visas to visit St Kitts and Nevis. On entry you are granted a one month stay. If you wish to stay longer you must apply and pay for an extension of stay through the St Kitts and Nevis Immigration Department. It is an offence to overstay the entry period granted or to work without a work permit.

Entry requirements may change from time to time and should be checked with the High Commission of St Kitts and Nevis in London.

Entry requirements - Passport validity
You must hold a valid passport to enter St Kitts & Nevis. Your passport must be valid for a minimum period of six months from the date of entry into St Kitts & Nevis.

The medical facilities on the islands are limited to one hospital, which can deal only with routine medical cases. More serious cases will need to be dealt with in Puerto Rico, USA once the patient is in a stable condition.

Dengue fever is common across the Caribbean and can occur throughout the year. Dengue is a mosquito-borne infection that can cause a feverish illness associated with headache, muscle aches and pains, and rash. Some cases of dengue are severe. Dengue can be prevented by avoiding being bitten by the disease-carrying mosquitoes that feed predominately during daylight hours. For more information on prevention, see the National Travel Health Network and Centre website.

You should exercise normal precautions to avoid exposure to HIV/AIDS. For more general information on how to do this see our HIV and AIDS page.

You should seek medical advice before travelling to St Kitts & Nevis and ensure that all appropriate vaccinations are up-to-date. For further information on vaccination requirements, health outbreaks and general disease protection and prevention you should visit the websites of the National Travel Heath Network and Centre (NaTHNaC) and NHS Scotland's Fit For Travel or call NHS Direct on 0845 46 47.

For more general health information see our Travel Health and Swine Flu page.


The hurricane season in St Kitts and Nevis normally runs from June to November. You can also access the World Meteorological Organisation for updates and the US National Hurricane Centre. For more general information see our Tropical cyclones page.

General - Insurance

You should take out comprehensive travel and medical insurance, which includes medical evacuation, before travelling. Check for any exclusions and that your policy covers you for all the activities you want to undertake. Be especially careful about cover for recurring illnesses as they may not be include in all insurance policies. For more general information see our Travel Insurance page.

If things do go wrong when you are oversees see our When Things Go Wrong page.

General - Registration

Register with our LOCATE service to tell us when and where you are travelling abroad or where you live abroad so our consular and crisis staff can provide better assistance to you in an emergency. More information about registering with LOCATE can be found here.

General - Package Holidays

If you are on a package holiday, you must travel on the specified return date. If you fail to do so it is likely that you will have to pay for a return ticket yourself.

General - Passports


Keep a copy of the photo page of your passport and relevant entry stamp in case your documents are stolen.

The passport service for British nationals in St Kitts and Nevis has now moved from Barbados to the UK Passport Service Centre for the Americas and Caribbean in Washington D.C. (http://ukinusa.fco.gov.uk/passports).

If you are applying for a renewal of your UK passport and you are in St Kitts and Nevis your application, with the appropriate passport fee plus a return courier fee of US $21, should be sent direct to:

The UK Passport Service for the Americas and Caribbean
British Embassy
19 Observatory Circle, NW
Washington, DC 20008

The British High Commission in Bridgetown will continue to issue Emergency Passports for people who have lost their passports and who have an urgent need to travel to the UK.

Date: Fri 15 Jan 2010
Source: Institut de Veille Sanitaire: Le point epidemiologique - N2 [in French, trans. & summ. ProMed Mod.TY, edited]
<http://www.invs.sante.fr/surveillance/dengue/points_sbsm/2009/pe_sb_2009_14_dengue.pdf>

Surveillance of cases clinically suggestive of dengue
-----------------------------------------------------
After reaching very high values between mid-Nov and mid-Dec [2009], the number of cases clinically suggestive of dengue fever has abruptly decreased in week 2009-52 without, however, running below the epidemic threshold. Since then, there has been a gradual increase in new cases, with an estimated 40 cases in the 1st week of Jan [2010]. The number of suggestive [dengue] cases has been well above the epidemic threshold for the past 2 months. It is estimated that during this period, 340 cases suggestive of dengue were seen by general practitioners on the island, averaging over 40 per week. The number of cases clinically suggestive of dengue fever is an estimate for the entire population of the island, based on the number of people who consulted a general practitioner for a clinical syndrome suggestive of dengue. This estimation is performed using data collected from the network of sentinel physicians.

Monitoring of laboratory confirmed cases
----------------------------------------
The number of laboratory confirmed cases of dengue fever follows a dynamic similar to that of suggestive cases. After a sharp decline in week 2009-52, there was a further increase in the number of confirmed cases during the last week of Dec (2009-53), then an equally high number of laboratory confirmations during the past week (2010-01). Since the 3rd week of Nov (2009-47), 239 laboratory confirmed cases were recorded, and the number of weekly cases has far exceeded the epidemic threshold.

Positivity rate of requests for laboratory confirmation and circulating [dengue virus, DENV] serotypes
-------------------------------------------------------
As in the previous week, the positivity rate has been very high in the week 2010-01, since 26 of the 41 samples analyzed have been positive (66 per cent). This is the 2nd consecutive week for this rate, so it is increasing during the upswing of the epidemic. Since mid-Nov 2009 (week 2009-47), DENV-1 has constituted the vast majority [of isolates], accounting for 95 per cent of viruses isolated (73 of 77 samples analyzed). DENV-2 has also been identified but only 4 times.

Hospitalized cases
------------------
Since early Dec [2009], no new confirmed cases of dengue have been hospitalized for more than 24 hours. The number of laboratory confirmed hospitalized cases has been constant since October 2009, with 2 hospitalizations occurring each month.

Spatial distribution
--------------------
The geographical distribution of laboratory confirmed cases indicates their presence on all sectors of the island, indicating that there still is widespread circulation of the virus.

Situation analysis
------------------
At Saint Barthelemy, the epidemic continues. Virus circulation is still important and widespread on the island. The number of hospitalized cases remains very low. The epidemiological situation is still in Phase 3 of PSAG of the Northern Islands as an epidemic phase.
======================
[A map of Saint Barthelemy (St. Barts) in the Caribbean can be accessed at
<http://www.worldatlas.com/webimage/countrys/namerica/caribb/stbarts.htm>. - ProMed Mod.TY]
More ...

World Travel News Headlines

Date: Tue, 12 Nov 2019 13:10:01 +0100 (MET)
By Holly ROBERTSON, Andrew BEATTY, with Daniel De Cartert in Hillville

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

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

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

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

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

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

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

Further south in the Blue Mountains on the outskirts of Sydney, veteran Winmalee firefighter Alan Gardiner said locals were "terrified and on edge".    The town still bears the scars of a 2013 blaze that destroyed 200 homes, and residents are acutely aware that with few roads in and out of the mountains, a decision to leave late can be fatal.   Efforts to burn fuel in a controlled way have been limited by months of drought-like conditions that made it too dangerous.
Date: Tue, 12 Nov 2019 10:03:07 +0100 (MET)

Denpasar, Indonesia, Nov 12, 2019 (AFP) - An Australian tourist who fly-kicked a motorcyclist and assaulted a man in his own home during a drunken rampage was jailed for four months on Tuesday.   The ruling comes after Nicholas Carr's antics were caught in a viral video that saw him carry out a campaign of destruction in Seminyak, a popular tourist area on the Indonesian holiday island.   "The defendant Nicholas Carr is found guilty and is sentenced to four months" in jail, presiding judge Soebandi, who goes by one name, told the Denpasar District Court.    A lawyer for Carr, charged with assault and property damage, said the 26-year-old would not appeal the ruling.    He is expected to be released next month because of time already served.   In August, Carr ran barefoot on to a street and shouted expletives before the apprentice builder slammed into the bonnet of a moving car and then fly-kicked an unsuspecting motorcycle rider.

The biker, who was thrown from the moving scooter, sustained minor injuries -- later the pair embraced during a court hearing as Carr apologised to the victim.   Carr also shattered a convenience store's glass door before stealing a motorcycle.   Later, he broke into a house where he assaulted the sleeping homeowner, leaving him with injuries, police said earlier.    He was eventually caught by locals and police and taken to hospital.    Pictures that circulated on social media showed at the time showed Carr bloodied and bruised, and trussed with hosepipe and rope.   Shortly after his arrest, Carr apologised and admitted drinking more than 10 small bottles of vodka as well as other alcohol.

After a string of embarrassing incidents by tourists, Bali officials recently warned that boorish visitors may be kicked off the island, which attracts millions annually to its palm-fringed beaches, colourful nightlife and ancient temples.   Australian professional rugby league player David Fifita returned home this week after he was briefly arrested in Bali for assaulting a nightclub security guard.   Several days after Carr's arrest, a Czech couple who were slammed for disrespecting a Balinese temple took part in a ritual purification ceremony.
Date: Mon, 11 Nov 2019 16:19:54 +0100 (MET)

Lyon, Nov 11, 2019 (AFP) - An unusually strong earthquake hit south-eastern France on Monday, injuring four people, one of them seriously, authorities said.   A physicist at a geophysics institute the IPGP said that quakes of this strength are rare in that region, but warned of possible aftershocks and said people should leave fragile buildings.   The quake, with a magnitude of 5.4, was felt in a vast area between the cities of Lyon and Montelimar which are about 150 kilometres (93 miles) apart, the national seismological office said.   "I was leaning against the oven in my mother's bakery when I felt the tremor," said Victoria Brielle, a resident in Privas, some 25 kilometres from the quake's epicentre.   "A customer said her sideboard had moved and all her crockery was broken,"  she said.

Another resident in the area, Didier Levy, who lives in a 15th century castle, told AFP that "chandeliers were still trembling" several minutes after the quake.   Levy, who said his dog starting barking even before humans felt the tremors, added: "I have never experienced anything like it, I could feel the trembling even though these wall are one metre thick."   One person was seriously hurt when some scaffolding collapsed, the regional prefect's office said.   Three other people in the neighbouring Ardeche region were slightly injured.

Quakes in this region are rarely higher than Magnitude 5, said Mustapha Meghraoui of the IPGP's office in Strasbourg.   "We can say that this is a rare one," he added. But he said there might be an aftershock of around 4.5.   "If people are in a fragile house, they would be better leaving it" for something more robust for a while, he said.   The scale of the damage suggested the quake happened at a depth of between five and 10 kilometres, he added. But they were working on a more accurate reading.
Date: Mon, 11 Nov 2019 13:19:54 +0100 (MET)

Goma, DR Congo, Nov 11, 2019 (AFP) - A local radio station that has been involved in the fight against Ebola in eastern DR Congo said Monday it was closing down after one of its broadcasters was murdered.   Joel Musavuli, head of Lwemba radio in Mambasa in Ituri province, told AFP that the station had been targeted by armed groups hostile to the campaign to roll back the Ebola epidemic.

"Each of us have received threats since last month. We have now decided to stop broadcasting, Musavuli said, adding that he himself had escaped two kidnap attempts.   "We are victims of our commitment to the awareness campaign about the spread of Ebola virus disease. We don't know why the militiamen are targeting us."   Nearly 2,200 people have died since the notorious haemorrhagic disease erupted in eastern Democratic Republic of Congo in August 2018, according to the latest official figures.

The fight against the outbreak has been hampered by local fears and superstititions, exploited by militia groups that are rampant in the remote region.   Several health workers have been killed and media that have supported the campaign have received threats.

Several radio stations in the Mambasa area say they have stopped broadcasting anti-Ebola messages because of intimidation.   On November 2, Lwemba broadcaster Papy Mahamba was killed at his home by unidentified men. His wife was injured and their house set ablaze.    The station said the authorities had failed to take action against the threats. It said it would resume broadcasts after "the state has restored authority in the area".
Date: Mon, 11 Nov 2019 11:38:15 +0100 (MET)

Kuwait City, Nov 11, 2019 (AFP) - Hundreds of workers at Kuwait's international airport held a one-hour strike Monday to demand better working conditions, threatening to stage longer walkouts in the coming days.    Ahmed Mohammed al-Kandari, a union representative, said workers were calling for improved treatment and to be compensated for daily exposure to pollution and noise.  Monday's strike by Kuwaiti staff did not affect flights, officials said.   The right to strike is guaranteed for citizens in Kuwait, but such actions remain rare in the Gulf country.

Foreign workers do not have the right to strike.  "Airport traffic is very normal," Sheikh Salman Al-Hamoud Al-Sabah, head of the General Directorate of Civil Aviation, told AFP.    Another official, Saleh Al-Fadaghi, the airport's director of operations, also said flights were not affected. "During the one-hour strike, 19 flights were operated as scheduled. There were five departures and 14 arrivals," he told AFP.

Kandari said the purpose of the strike was not to disrupt operations but "to make our voices heard". He added that Kuwaiti workers would hold a further two-hour strike on Wednesday and a 24-hour strike on Sunday if their demands are not met.    Of 4,500 civil aviation employees, 1,500 took part in Monday's strike, he said.
Date: Mon, 11 Nov 2019 10:39:09 +0100 (MET)

La Jonquera, Spain, Nov 11, 2019 (AFP) - Catalan separatist activists blocked traffic on Monday on a motorway linking Spain and France, in a fresh protest against the sentencing last month of nine of their leaders to lengthy jail terms.   Demonstrators cut the AP7 motorway at La Jonquera near the city of Girona in eastern Spain, a day after a repeat general election in which Prime Minister Pedro Sanchez's Socialist emerged as winners but weakened, while far-right party Vox surged to third place on the back of its hardline stance against separatism.   Dozens of vehicles blocked the motorway near the border with France while some 300 people set up a barricade, according to an AFP photographer at the scene.   Some demonstrators began to set up a stage and speakers which they brought to the scene in vans.   Catalonia's regional road department confirmed the motorway was cut in both directions at La Jonquera.

The protest was called by a new, mysterious organisation called "Democratic Tsunami" which last month sent thousands of people to block access to Barcelona airport in a protest which ended in clashes between demonstrators and police.   "This mobilisation is a cry to the international community so that it makes the Spanish state understand that the only possible path is to sit down and talk," the group said in a message sent to its followers on encrypted messaging service Telegram.   Radical separatist group CDR also called on its supporters to head to La Jonquera to block the highway.   Catalonia was rocked by days of mass, sometimes violent, pro-independence rallies after Spain's Supreme Court on October 14 sentenced nine politicians and activists to jail for up to 13 years for their role in a failed secession bid in 2017.   Demonstrators have frequently cut road and rail links between Spain and France while many shops in downtown Barcelona have been shut during the rallies and there are growing concerns about the impact of the unrest on business in Spain's second largest city.
Date: Sat, 9 Nov 2019 18:59:25 +0100 (MET)

MOUSOUNI ISLAND, India, Nov 9, 2019 (AFP) - Cyclone Bulbul hit India and southern Bangladesh on Saturday, leaving two dead as authorities in the countries ordered more than two million people to get out of the path of the storm.   The cyclone, packing winds of up to 120 kilometres (75 miles) per hour, has "weakened" and "started crossing" India's West Bengal and Bangladesh's Khulna coast at about 9:00 pm (1500 GMT), Dhaka's Meteorological Department said in a special bulletin.   "It is likely to move in a northeasterly direction" and "weaken gradually, and may complete crossing West Bengal-Khulna coast by midnight tonight," the department said.     Airports and ports were shut down and the deaths were reported before the full force of the cyclone had hit.   One person was killed by an uprooted tree in Kolkata and another by a wall that collapsed under the force of the winds in Odisha state, authorities said.

More than 60,000 people were moved away from the coast on the Indian side of the border.   Bangladesh disaster management secretary Shah Kamal told AFP that "2.028 million" have been evacuated and moved to more than 5,500 cyclone shelters.   He said there was no reports of casualties and rejected reports in local media that dozens of local fishermen were missing on the southern coast.    Bangladeshi troops were sent to some villages, while about 55,000 volunteers went door-to-door and making loudspeaker announcements in the streets to get people away from the danger zone in villages, many of which were below sea level.

- Ports closed, flights halted -
A storm surge up to two metres (seven feet) was predicted along the coast, Bangladesh's Meteorological Department said.   About 1,500 tourists were stranded on the southern island of Saint Martin after boat services were suspended due to bad weather.   Bangladesh's two biggest ports, Mongla and Chittagong, were closed because of the storm, and flights into Chittagong airport were halted.   In India, flights in and out of Kolkata airport were suspended for 12 hours because of the storm.   On the West Bengal island of Mousouni, which lies in the path of the storm, frightened residents took shelter in schools and government buildings because they had not been able to escape.   Military planes and ships have been put on standby to help in emergencies, Indian authorities said.

Bulbul hit the coast at the Sundarbans, the world's largest mangrove forest, which straddles Bangladesh and part of eastern India, and is home to endangered species including the Bengal tiger and the Irrawaddy dolphins.   Bangladesh's low-lying coast, home to 30 million people, is regularly battered by cyclones that leave a trail of destruction.   Hundreds of thousands of people have been killed in cyclones in recent decades.   While the frequency and intensity have increased, partly due to climate change, the death tolls have come down because of faster evacuations and the building of 4,000 cyclone shelters along the coast.   In November 2007, Cyclone Sidr killed more than 3,000 people. In May this year, Fani became the most powerful storm to hit the country in five years, but the death toll was about 12.
Date: Sat, 9 Nov 2019 14:18:27 +0100 (MET)

Beirut, Nov 9, 2019 (AFP) - Several petrol stations in protest-hit Lebanon stopped services Saturday, as reserves ran dry due to a shortage of US dollars to pay suppliers, a syndicate head said.   The shuttering of petrol stations came as demonstrators again took to the street across the country, keeping up their three-week-long movement against a political class regarded as inefficient and corrupt.    "The petrol stations that opened today are the ones that still have reserves. They will close down as soon as supply runs out," said Sami Brax, the head of the Syndicate of Gas Station Owners.   He said if officials do not facilitate access to dollars by Tuesday, "we will be forced to stop imports and close down all petrol stations."

Petrol stations receive payment from customers in Lebanese pounds but have to pay importers and suppliers in dollars.    For two decades, the Lebanese pound has been pegged to the US dollar, with both currencies used interchangeably in daily life.   But banks have been reducing access to dollars since the end of the summer, following fears of a shortage in central bank dollar reserves.   In recent days, banks halted all ATM withdrawals in dollars and severely restricted conversions from Lebanese pounds.   Many Lebanese have had to instead buy dollars from money changers at a higher exchange rate, in what amounts to a de-facto devaluation of the local currency that has sparked price hikes.

The official exchange rate has remained fixed at 1,507 Lebanese pounds to the dollar, but the rate in the parallel market has surpassed 1,800.   "The banks are under pressure from people, both inside Lebanon and abroad," said economist Naseeb Ghabreel, after many rushed to withdraw their dollar savings or convert Lebanese pound accounts.   Since September, petrol station owners have accused banks of failing to provide them with the dollars they need and threatened strikes.    In response, the central bank last month pledged to facilitate access to the greenback for importers of petroleum products, wheat and medicine.   But the measure has not yet gone into effect.

Lebanon has since October 17 witnessed an unprecedented popular uprising against everything from power cuts and poor social security to alleged state corruption.   The government yielded to popular pressure and stepped down last month, with the World Bank urging for the quick formation of a new cabinet to prevent the economy from further deteriorating.
Date: Fri, 8 Nov 2019 19:25:02 +0100 (MET)

Madrid, Nov 8, 2019 (AFP) - Spanish health authorities confirmed Friday a case of a man spreading dengue through sex, a world first for a virus which until recently was thought to be transmitted only by mosquitos.   The case concerns a 41-year-old man from Madrid who contracted dengue after having sex with his male partner who picked up the virus from a mosquito bite during a trip to Cuba, said Susana Jimenez of the Madrid region's public health department.

His dengue infection was confirmed in September and it puzzled doctors because he had not travelled to a country where the disease, which causes severe flu-like symptoms such as high fever and body aches, is common, she added.   "His partner presented the same symptoms as him but lighter around ten days earlier, and he had previously visited Cuba and the Dominican Republic," Jimenez said.   "An analysis of their sperm was carried out and it revealed that not only did they have dengue but that it was exactly the same virus which circulates in Cuba."

A "likely' case of sexual transmission of dengue between a man and a woman was the subject of a recent scientific article in South Corea, Jimenez said.   In an e-mail sent to AFP, the Stockholm-based European Centre for Disease Prevention and Control (ECDC), which monitors health and disease in Europe, said this was "to our knowledge, the first sexual transmission of the dengue virus among men who have sex with men."

According to the World Health Organization's website, dengue is transmitted mainly by the Aedes Aegypti mosquito, which thrives in densely-populated tropical climates and breeds in stagnant pools of water.    It is most serious -- and deadly -- in children, especially young girls though scientists don't know why.

Dengue is most commonly caught by people travelling to hotter climates such as southeast Asia, Africa, Australia, the Caribbean and South and Central America.
Date: Sun 10 Nov 2019
Source: The News [abridged, edited]

Another young man is awaiting death in an isolation ward of the Jinnah Postgraduate Medical Centre (JPMC) after developing full-blown rabies, as he was bitten by a rabid dog some 3 months ago but was not administered the rabies vaccine, officials said on Saturday [9 Nov 2019].

"18-year-old Z.K., a resident of Jeva Khan Goth in the Nooriabad area of District Jamshoro, has been brought to the casualty ward of the JPMC with full-blown rabies," Dr Seemin Jamali, the hospital's executive director, told The News.

"According to his family members, the teenager was bitten by a stray dog on the leg around 3 months ago. Unfortunately, neither did the family know about vaccination nor did anybody tell them to get the teenager vaccinated, which resulted in the development of the lethal disease."

Sindh Health Department officials said that this is the 22nd case of rabies in the province this year [2019].

M.K., the ill-fated youngster's father, said that after his son was bitten on the leg, he was taken to a local doctor, who had dressed the wound and given him some medicines but had not asked for the teenager to be vaccinated or referred him to a tertiary-care hospital.

Officials said that right now, dog-bite incidents are on the rise in Karachi as well as in other districts of Sindh, with so far more than 200 000 people falling victim to canine attacks.

They added that the population of rabid dogs is also on the rise, and the animals are not only transmitting the disease to their own species but also attacking humans throughout the province.

Dr Seemin said: "These days any person who is bitten by a dog should be given immunoglobulin as well as the full course of the rabies vaccine to prevent the victim from a painful death. Once rabies is developed in a person, there is no cure for their condition."

She deplored the fact that on the one hand incidents of dog-bite are on the rise and on the other, hospitals in the entire province are facing a shortage of the rabies vaccine, due to which the cases are being referred to the JPMC in Karachi.

"Even the Abbasi Shaheed Hospital, which is considered to be a tertiary-care hospital, is referring dog-bite victims to the JPMC after administering one dose of the vaccine," she said.

"As we don't know the status of their vaccination, we have to vaccinate these patients from zero, but this practice is extremely unprofessional, and it can result in the loss of a precious life."

On the other hand, the shortage of rabies vaccine is becoming a serious issue in Pakistan, especially in Sindh, which requires hundreds of thousands of doses to prevent the people from developing rabies encephalitis.

Pakistan used to get most of its rabies vaccine supplies from Indian biotechnology giants and pharmaceutical companies, but after the deterioration of relations between the 2 countries, Pakistan's next-door neighbour reduced those supplies, while production at the NIH is insufficient to meet the local requirements.

In this scenario, experts say there is an urgent need to control the population of stray dogs in the country by hook or by crook. They believe that at a time when there is not enough rabies vaccine available, the authorities should take measures to save people from canine attacks by reducing the dog population by any means.  [Byline: M. Waqar Bhatti]
=====================
[We have received recently several reports from Pakistan, describing human rabies cases; e.g.
(published 7 Nov 2019),
(published 3 Nov 2019),
(published 15 Oct 2019].

Hopefully, this post will help the professionals involved in getting due attention and required means from the health and municipal authorities for immediate measures undertaken, including timely supply of the required medical preparations.

According to Pakistan's Health Minister, Dr Azra Fazal Pechuho, (on Fri 8 Nov 2019), dog-bite cases were "mishandled" by citizens, as the victims were often brought to hospitals quite late, and the delay caused their deaths (see <https://www.dawn.com/news/1515803>).

WHO's most recent available position paper addressing rabies vaccines and immunoglobulins is available at

[HealthMap/ProMED map available at: