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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Benin - US Consular Information Sheet
April 28, 2008

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

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

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

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

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

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

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

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

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

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

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

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

See our information on Victims of Crime.

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

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

6th December, 2019
HSE Health Protection Surveillance Centre

There is a case of human rabies in Latvia. The case has been clinically and laboratory confirmed (immunofluorescence and PCR). The case is 55 years old female from city Daugavpils, located 35 km from Belarus and Lithuania borders. Symptoms appeared on November, 22, she died on November, 28. 
 
Possible exposures: 
• In May, 2018 she was bitten in both legs (ankles) by puppy travelling in India;
• She worked as volunteer in animal shelter in Daugavpils, in April this year she was bitten/scratched there by a dog, and the dog is healthy now;
• She fed stray cats and dogs in the courtyard of the house in Daugavpils, as well as in a country house outside the city near the forest. Information about bites or other possible exposures is not known.

In none of these cases the person received PEP. Now 61 contacts receive post-exposure treatment (vaccination), mostly as precautions: staff of two hospitals and medical emergency service, and close contacts, including household. In Latvia the last cases of rabies in wild animals were registered in 2010, in 2012 was registered the last case in domestic animals. In 2014, Latvia received the status of a country free of rabies. Latvia continues to implement wild animal’s vaccination progamme. Neighbour countries Belarus and Russian Federation is not rabies free and animals can cross the border.
 
A test report has been received on the results of the rabies virus genotype identification and sequencing reaction (EURL-Rabies Protocol, (AFSSA) P. Meyer, 2009). The rabies virus genotype 1 was detected in the sample. According to the GenBank database, the virus sequence has 99.17% identity to the RV2924 isolate of rabies virus from Nepal. Information and evidence obtained during an epidemiological investigation demonstrated that the human rabies case had a dog bites during her travel in India (Naggar and Manali, state Himachal Pradesh – close to Nepal), in May 2018. No post exposure treatment was received.

No cases of illegally exported pets as the potential source of infection were identified in the relation to this rabies case. According to the literature in rare cases a long (more than one year) incubation period of rabies is observed. Taking into account the epidemiological data and the result of the rabies virus sequencing, the Center for Disease Prevention and Control of Latvia believes that this human rabies case is not epidemiologically linked to Latvia.
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.
More ...

Syria

Syria US Consular Information Sheet
August 13, 2008

COUNTRY DESCRIPTION:
Since March 1963, the Syrian Arab Republic has been ruled by an authoritarian regime dominated by the Socialist Ba'ath Party.
While the ruling Ba'ath party
spouses a largely secular ideology, Islamic traditions and beliefs provide a conservative foundation for the country's customs and practices.
Syria has a developing, centrally-planned economy with large public (30%), agricultural (25%), and industrial (20%) sectors.
Tourist facilities are available, but vary in quality depending on price and location.
Read the Department of State Background Note http://www.state.gov/r/pa/ei/bgn/3580.htm on Syria for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required.
Visas must be obtained prior to arrival in Syria from a Syrian diplomatic mission located in the traveler’s country of residence, although the Syrian visa policy with respect to American diplomats and citizens is currently under review.
Foreigners who wish to stay 15 days or more in Syria must register with Syrian immigration authorities by their 15th day.
Syrian-American men or American men of Syrian origin, even those born in the United States, may be subject to compulsory military service unless they receive a temporary or permanent exemption from a Syrian diplomatic mission abroad prior to their entry into Syria.
(Please see the section on Special Circumstances below.)
Syria charges a departure tax for all visitors except those on diplomatic passports.
As of July 1, 2008, the tax is 1,500 Syrian Pounds if departing from the airport; 500 Syrian Pounds if departing via one of the land borders.

The Syrian government rigidly enforces restrictions on prior travel to Israel, and does not allow persons with passports bearing Israeli visa or entry/exit stamps to enter the country.
Syrian immigration authorities will not admit travelers with Israeli stamps in their passports, Jordanian entry cachets or cachets from other countries that suggest prior travel to Israel.
Likewise, the absence of entry stamps from a country adjacent to Israel, which the traveler has just visited, will cause Syrian immigration officials to refuse admittance.
Entry into Syria via the land border with Israel is not possible.
American-citizen travelers suspected of having traveled to Israel have been detained for questioning.

Syrian security officials are also sensitive about travel to Iraq.
There have been instances in which Americans, especially those of Arab descent, believed to have traveled to Iraq were detained for questioning at ports of entry/exit.
Americans seeking to travel to Iraq through Syria have also on occasion been turned around and/or detained.
On a number of occasions the border between Iraq and Syria has been closed without notice, stranding Americans on either side of the border.
Children under the age of eighteen whose fathers are Syrian or of Syrian descent must have their fathers' permission to leave Syria, even if the parents are separated or divorced and the mother has been granted full custody by a Syrian court.
Women in Syria are often subject to strict family controls.
On occasion, families of Syrian-American women visiting Syria have attempted to prevent them from leaving the country.
This can be a particular problem for young single women of marriageable age.
Although a woman does not need her husband's explicit consent every time she wishes to leave Syria, a Syrian husband may take legal action to prevent his wife from leaving the country, regardless of her nationality.
Once such legal orders are in place, the U.S. Embassy cannot help American citizens leave Syria.
Visit the Embassy of the Syrian Arab Republic, 2215 Wyoming Ave. NW, Washington, DC
20008, telephone (202) 232-6313 or check the Syrian Embassy's home page at http://www.syrianembassy.us for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Syria is included on the Department of State's List of State Sponsors of Terrorism.
A number of the terrorist groups that have offices in Syria oppose U.S. policies in the Middle East.
On September 12, 2006, the U.S. Embassy in Damascus was attacked by assailants using improvised explosives, gunfire, and two vehicles laden with explosives.
On February 4, 2006, mobs protesting caricatures of the Prophet Mohammed destroyed the Norwegian and Chilean embassies and severely damaged the Danish and Swedish diplomatic missions.
On April 27, 2004 there was a violent clash in which three people died in an area of Damascus where many foreign citizens reside.
It has never been clear whether the shootout with Syrian security forces involved common criminals or terrorists.
In 1998 and 2000, mobs attacked the U.S. Ambassador’s Residence and the U.S. Embassy, respectively.
In 1997, twenty-two people were killed when a public bus was bombed in downtown Damascus.
All of these attacks serve as reminders that Syria is not immune from political or purely criminal violence.
Americans traveling through the area should remain aware that U.S. interests and citizens might be targeted.
Security personnel may at times place foreign visitors under surveillance.
Hotel rooms, telephones, and fax machines may be monitored, and personal possessions in hotel rooms may be searched.
Taking photographs of anything that could be perceived as being of military or security interest may result in problems with authorities.
Additionally, Americans should be aware that conversations on the topics of political, religious and other freedoms are not seen as merely healthy debate in Syria and could lead to arrest.
Note that possession of specific-use electronic devices including GPS, short-wave or handheld radio equipment, or similar devices in Syria is illegal.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website at http://travel.state.gov, where the current Travel Warnings, including the Travel Warning for Syria, 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:
While a few cases of theft, burglary and assault have been reported to the Embassy, crime is generally not a serious problem for travelers in Syria.
It is important to note, however, that Syria is not crime free. Specifically, incidents of credit card and ATM fraud, and physical harassment of women, are on the rise.

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 the local police, please contact the U.S. Embassy for assistance.
The Embassy 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 equivalents for the “911” emergency line in Syria are:
110 for ambulance, 113 for fire and 112 for the police.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Basic medical care and medicines are available in Syria's principal cities, but not necessarily in outlying areas.
Serious illnesses and emergencies may require evacuation to a Western medical facility.
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.
Some HIV/AIDS entry restrictions exist for visitors to or foreign residents of Syria.
There are no special immunizations required for entry to Syria.
AIDS tests are mandatory for foreigners’ ages 15 to 60 who wish to reside in Syria.
The AIDS test must be conducted in Syria at a facility approved by the Syrian Ministry of Health.
A residence permit will not be issued until the absence of the HIV virus has been determined.
Foreigners wishing to marry Syrian nationals in Syria must also be tested for HIV.
Syria usually will not give visas or residency permits to students wishing to study religion or Arabic in private religious institutions.
Please verify this information with the Embassy of Syria at http://www.syrianembassy.us/ before you travel.
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 Syria is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Syria is hazardous and requires great caution.
Although drivers generally follow traffic signs and signals, they often maneuver aggressively and show little regard for vehicles traveling behind or to the sides of them.
Lane markings are usually ignored.
Vehicles within Syrian traffic circles must give way to entering traffic, unlike in the United States.
At night, it is very hard to see pedestrians, who often walk into traffic with little warning.
Outside major cities it is common to find pedestrians, animals and vehicles without lights on the roads at night.
Pedestrians must also exercise caution.
Parked cars, deteriorating pavement, and guard posts obstruct sidewalks, often forcing pedestrians to walk in the street.
Vehicles often do not stop for pedestrians, and regularly run red lights or “jump” the green light well before it changes.

Please refer to our Road Safety page for more information.
For specific information concerning Syrian driving permits, vehicle inspection, road tax and mandatory insurance, contact the Syrian Embassy in Washington, D.C. at 2215 Wyoming Avenue NW, Washington, DC
20008, tel. 202-232-6313.
AVIATION SAFETY OVERSIGHT:
Sanctions resulting from the passage of the Syria Accountability Act prohibit aircraft of any air carrier owned or controlled by the Syrian government to take off from or land in the United States.
As there is no direct commercial air service to the United States by carriers registered in Syria, the U.S. Federal Aviation Administration (FAA) has not assessed Syria'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.
The U.S. Embassy in Damascus has advised its employees to avoid travel on Syrian Arab Airlines (Syrian Air or SAA) whenever possible due to concerns regarding the airline's ability to maintain its airplanes.
SAA has, on its own initiative, grounded individual aircraft with significant maintenance or service issues; however, concerns persist that some planes still being flown may lack certain safety equipment or may have undergone repairs that have not been reviewed by the manufacturer.

SPECIAL CIRCUMSTANCES:
Syrian customs authorities may enforce strict regulations concerning temporary importation into or export from Syria of items such as weapons, narcotics, alcohol, tobacco, cheese, fruits, pharmaceuticals, modems, cosmetics, and some electrical appliances.
It is advisable to contact the Embassy of Syria in Washington, D.C. for specific information regarding customs requirements.
Please see our Customs Information.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times so that, if questioned by local officials, they will have proof of identity and U.S. citizenship readily available.
Although Syria is a signatory to the Vienna Convention on Consular Relations, Syrian officials generally do not notify the American Embassy when American citizens are arrested. When the American Embassy learns of arrests of Americans and requests consular access, individual police officials have, on their own initiative, responded promptly and allowed consular officers to visit the prisoners.
However, security officials have also in the past denied Embassy requests for consular access, especially in the case of dual citizens.
Foreign currencies can be exchanged for Syrian pounds only at government-approved exchange centers and licensed private banks.
Syrian pounds cannot be changed back into foreign currency.
Very few places in Syria accept credit cards.
Foreigners visiting Syria are required to pay hotel bills in US dollars or Euros.
Travelers’ checks are not accepted for payment in Syria, and banks will not cash them unless the traveler has an account at the bank in question.
There are no US-based banks operating in Syria.
There are six private banks operating in Syria, with branches and ATMs in most major cities.
These ATMs usually honor major debit/credit systems.
Funds may be transferred into Syria through Western Union.
Wiring of funds through private banks is possible only if the traveler already holds an account with the bank in Syria;, transferring funds through the Commercial Bank of Syria is not possible due to U.S. sanctions.
Syrian-American and Palestinian-American men who have never served in the Syrian military and who are planning to visit Syria are strongly urged to check with the Syrian Embassy in Washington, D.C. prior to traveling concerning compulsory military service. American men over the age of 18, even those who have never resided in or visited Syria, whose fathers are of Syrian descent, are required to complete military service or pay to be exempted.
Possession of a U.S. passport does not absolve the bearer of this obligation.
The fee for exemption from military service ranges from $5,000 to $15,000 USD, depending upon circumstances, for Syrian-American and Palestinian-American men who live abroad.
In January 2005 the Syrian government reduced mandatory military service from 30 months to 24 months.
It also announced that Syrians born outside of Syria and residing abroad until the age of 18 have the option of being exempted from their service by paying $2,000 USD.
Those born in Syria who left the country before reaching the age of 11, and have resided abroad for more than 15 years can be exempted by paying $5,000 USD.
Contact the Syrian Embassy in Washington, DC, for more information (See Entry/Exit Requirements section above).
President Bush signed an executive order on May 11, 2004, implementing sanctions in accordance with the Syria Accountability Act.
These sanctions prohibit the export to Syria of products of the United States other than food or medicine, and prohibit any commercial aircraft owned or controlled by the Syrian government from taking off from or landing in the United States.
Under the authority provided in Section 5(b) of the Act, the President has determined that it is in the national security interest of the United States to waive the application of these sanctions in certain cases and for certain products, as specified in the Department of Commerce's General Order No. 2.
For additional information about implementation of the Syria Accountability Act, consult the Department of Commerce web site at (http://www.bis.doc.gov/).
Since 1979, the United States has designated Syria a State Sponsor of Terrorism due to its support for groups such as Hizbollah and Palestinian terrorist groups.
The Terrorism List Government Sanctions Regulations prohibit U.S. persons from receiving unlicensed donations from the Syrian government.
Additionally, U.S. persons are prohibited from engaging in financial transactions which a U.S. person knows or has reasonable cause to believe pose a risk of furthering terrorists' acts in the United States.
For additional information about the Terrorism List Government Sanctions Regulations, consult the terrorism brochure on the U.S. Department of the Treasury, Office of Foreign Assets Control (OFAC) home page on the Internet at http://www.treas.gov/offices/enforcement/ofac/ or via OFAC's info-by-fax service at (202) 622-0077.
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 Syrian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Syria are strict and convicted offenders can expect prison sentences and heavy fines.
Penalties for possession of even small amounts of illegal drugs for personal use are severe in Syria.
Persons convicted in Syria for growing, processing, or smuggling drugs face the death penalty, which may be reduced to a minimum of 20 years’ imprisonment.
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 Syria 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 Syria.
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 2 Al-Mansour St., Abu Roumaneh, Damascus.
The international mailing address is PO Box 29, Damascus.
Mail may also be sent via the U.S. Postal Service to: American Embassy Damascus, Department of State, Washington, DC
20521-6110.
Telephone numbers are (963) (11) 3391-4444, fax number is (963)(11) 3391-3999, e-mail: acsdamascus@state.gov.
The government workweek in Syria is Sunday through Thursday; the private sector generally works Saturday through Thursday.
The U.S. Embassy is open Sunday through Thursday.
Additional information may be found on the Embassy web site at http://damascus.usembassy.gov
*

*

*
This replaces the Country Specific Information dated November 20, 2007 to update the sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu 5 Dec 2019 6:11 PM EET
Source: Enab Baladi [edited]

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

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

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

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

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

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

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

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

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

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

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

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

[Maps of Syria:
Date: Mon, 2 Dec 2019 11:19:53 +0100 (MET)

Beirut, Dec 2, 2019 (AFP) - Regime air strikes Monday killed 10 civilians in Syria's last major opposition bastion, where deadly clashes between regime forces and armed groups have escalated in the past two days, a monitor said.   The raids also wounded 15 civilians in a market in the town of Maaret al-Numan in the jihadist-run province of Idlib, the Britain-based Syrian Observatory for Human rights said.
Date: Fri 21 Jun 2019
Source: WHO/EMRO (Regional Office for the Eastern Mediterranean) [edited]

Situation reports on Al-Hol camp, Al-Hasakah
--------------------------------------------
- Over the past 2 weeks, a total of 633 people have left the camp. This number includes 107 people who returned to their homes in north-east Syria. There were no new arrivals during the reporting period.
- 9 medical points are reporting regularly to the disease Early Warning And Response System (EWARS). Leishmaniasis, acute diarrhoea, bloody diarrhoea, and severe acute malnutrition (SAM) remain the most commonly reported diseases.
- 38 new cases of leishmaniasis were detected. All patients are being treated by a WHO-supported mobile team in coordination with the Al-Hasakeh Directorate of Health.
- 7 suspected cases of measles were reported. No new cases of tuberculosis were detected during the reporting period.
- 30 children with severe acute malnutrition with medical complications were admitted to Al-Hikmah hospital during the reporting period, of whom 22 were discharged, one died, and the remainder are still under treatment. Mortality rates related to severe acute malnutrition remain below the emergency threshold.
- 2 new static health care points have been established, bringing the total number to 12. There is still an acute shortage of health care points in the Foreign Annex.
- 35 water sources were tested for microbial contamination in Al-Hasakeh water national laboratory during the reporting period. All 35 samples tested negative for contamination. WHO continues to test the quality of water from different sources in the camp.
- Stool samples from patients with diarrhoea were tested for
_Salmonella_, _E. coli_, and cholera, with all samples testing negative. Blood samples from patients with suspected measles were also sent for testing, and all samples tested negative.
- Following intensive negotiations by WHO, the local authorities have given their approval in principle to evacuate a patient requiring advanced mental health treatment
===================
[Leishmaniasis has surged throughout Syria during the civil war on all sides and continues to be a health problem in the refugee population. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Syria:
Date: Wed, 22 May 2019 16:52:39 +0200
By Nazeer al-Khatib with Hashem Osseiran in Beirut

Maaret al-Numan, Syria, May 22, 2019 (AFP) - Syrian government air strikes killed 18 civilians, including a dozen people at a busy market, as fierce fighting raged for the jihadist-held northwest, a war monitor said on Wednesday.   Regime forces battled to repel a jihadist counteroffensive around the town of Kafr Nabuda that has left 70 combatants dead in 24 hours, the Syrian Observatory for Human Rights said.   The Hayat Tahrir al-Sham alliance, led by Syria's former Al-Qaeda affiliate, controls a large part of Idlib province as well as adjacent slivers of Aleppo, Hama and Latakia provinces.   The jihadist-dominated region is nominally protected by a buffer zone deal, but the government and its ally Russia have escalated their bombardment in recent weeks, seizing several towns on its southern flank.   At least 12 people were killed and another 18 wounded when regime warplanes hit the jihadist-held Idlib province town of Maarat al-Numan around midnight (2100 GMT) on Tuesday, the Observatory said.

The market was crowded with people out and about after breaking the daytime fast observed by Muslims during the holy month of Ramadan.   The bombardment blew in the facades of surrounding buildings, and ripped through the flimsy frames and canvas of stalls in the market square, an AFP photographer reported.    The bodies of market-goers were torn apart.   "Residents are still scared," stallholder Khaled Ahmad told AFP.   Three more civilians were killed on Wednesday by air strikes in the nearby town of Saraqib, the Observatory said.    Two others were killed in strikes on the town of Maaret Hermeh, it added.    Another civilian was killed in air raids on the town of Jisr al-Shughur, the monitor said.   The Britain-based Observatory relies on a network of sources inside Syria and says it determines whose planes carried out strikes according to type, location, flight patterns and munitions.

- 'Worst fears'-
The strikes came as heavy clashes raged in neighbouring Hama province after the jihadists launched a counterattack on Tuesday.   Fresh fighting on Wednesday took the death toll to 70 -- 36 regime forces and militia and 34 jihadists, the Observatory said.   It said the jihadists had recaptured most of Kafr Nabuda from government forces, who had taken control of the town on May 8.   State news agency SANA on Wednesday however said the army repelled a jihadist attack in the area, killing dozens of insurgents.

Russia and rebel ally Turkey inked the buffer zone deal in September to avert a government offensive on the region and protect its three million residents.   But President Bashar al-Assad's government upped its bombardment of the region after HTS took control in January.   Russia too has stepped up its air strikes in recent weeks.   The Observatory says nearly 200 civilians have been killed in the flare-up since April 30.   The United Nations said Wednesday that Idlib's civilian population once again faced the threat of an all-out offensive.   "A full military incursion threatens to trigger a humanitarian catastrophe for over 3 million civilians caught in the crossfire, as well as overwhelm our ability to respond," said David Swanson, a spokesman for the UN humanitarian office.   Swanson said more than 200,000 people have been displaced by the upsurge of violence since April 28.   A total of 20 health facilities have been hit by the escalation -- 19 of which remain out of service, Swanson said.   Collectively they served at least 200,000 people, he added.

- 'Break the status quo' -
The September deal was never fully implemented as jihadists refused to withdraw from a planned buffer zone around the Idlib region.   But it ushered in a relative drop in violence until earlier this year, with Turkish troops deploying to observation points around the region.   The Syrian government has accused Turkey of failing to secure implementation of the truce deal by the jihadists.   But Turkish Defence Minister Hulusi Akar accused the Syrian regime late Tuesday of threatening the ceasefire deal.   "The regime is doing all that it can to break the status quo including using barrel bombs, land and air offensives," Akar told reporters.   "Turkish armed forces will not take a step back from wherever they may be", he however added.   Earlier, the US State Department said it was assessing indications that the government had used chemical weapons on Sunday during its offensive in Idlib.   HTS accused government forces of launching a chlorine gas attack on its fighters in the northern mountains of Latakia.   But the Observatory said Wednesday it had "no proof at all of the attack".

7 May 2019, Cairo, Egypt: The World Health Organization (WHO) strongly condemns continuing attacks on health facilities in north-western Syria. Since 29 April, in just nine days, twelve health structures have been hit. 

On 5 May, three facilities were struck in one day alone, including two major hospitals that provide secondary healthcare in the area.  One of the structures, a surgical unit, was supported by WHO. Three health care workers lost their lives as a result of these attacks.  There are now no functioning hospitals in northern Hama, and emergency care is provided by only three surgical units supported by WHO.  Close to 300,000 civilians are affected.   

“These attacks against health facilities and other civilian infrastructure are a grave and totally unacceptable development,” said Dr. Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean Region. “International humanitarian law safeguards civilians, even in the most violent of conflicts. And according to the Geneva Convention, health facilities and civilians – especially the most vulnerable – must be protected.  Parties to the conflict in northern Hama and in Idleb are flagrantly disregarding those rules; and it is women, children, the elderly and other vulnerable groups who are suffering as a result.”   

The health facilities that were hit in northern Hama and southern Idleb provided a total of 30,000 consultations, 860 hospital admissions and 700 surgeries per month to a highly vulnerable population. 

“We are also deeply concerned about the people who have had to flee their homes and now have no access to basic health services. Over 150,000 people were displaced from northern Hama and southern Idleb in between 29 April and 4 May, doubling the total number of people displaced in the area in the last three months. Saving their lives is our main priority and this requires further strengthening available health services. What is of particular concern is the increasing risk for infectious disease outbreaks due to overcrowding in temporary settlements,” Dr Al-Mandhari added.

WHO continues – with health partners – to ensure the provision of key primary and secondary healthcare and has released emergency health supplies for almost 92,200 treatment courses, including for surgical and trauma care, secondary healthcare, and primary healthcare.

As the conflict in north-western Syria intensifies, WHO reminds all parties to the conflict that attacks on health facilities are a blatant violation of international humanitarian law. Health facilities must never be attacked or damaged, and health workers should be allowed to provide medical treatment and services to all people in need wherever they are.

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Yemen

Yemen - US Consular Information Sheet
July 21, 2008
COUNTRY DESCRIPTION:
The Republic of Yemen was established in 1990 following unification of the former Yemen Arab Republic (North) and the People's Democratic Republic of Yemen (South). I
lamic and traditional ideals, beliefs, and practices provide the foundation of the country's customs and laws. Yemen is a developing country and modern tourist facilities are widely available only in major cities. Read the Department of State Background Notes on Yemen for additional information.

ENTRY/EXIT REQUIREMENTS: Passports and visas are required for travel to Yemen. Visas may be obtained at Yemeni Embassies abroad; all travelers to Yemen can also potentially obtain entry visas at ports of entry. Travelers to Yemen are no longer required to have an affiliation with and arrange their travel through a Yemeni-based individual or organization to enter Yemen. However, individuals may be asked for supporting evidence of their character, purpose of visit and length of stay. Upon arrival at ports of entry, travelers may be issued a visa valid for a maximum of three months.
Yemeni law requires that all foreigners traveling in Yemen obtain exit visas before leaving the country. In cases of travelers with valid tourist visas and without any special circumstances (like those listed below), this exit visa is obtained automatically at the port of exit as long as the traveler has not overstayed the terms of the visa.
In certain situations, however, foreigners are required to obtain exit visas from the Immigration and Passport Authority headquarters in Sanaa. These cases may include, but are not limited to, foreigners who have overstayed the validity date of their visa; U.S.-citizen children with Yemeni or Yemeni-American parents who are not exiting Yemen with them; foreigners who have lost the passport containing their entry visa; foreign residents whose residence visas are based on their employment or study in Yemen, marriage to a Yemeni citizen, or relationship to a Yemeni parent; or foreign residents who have pending legal action (including court-based "holds" on family members' travel). The loss of a passport can result in considerable delay to a traveler because Yemeni law requires that the traveler attempt to recover the passport by placing an advertisement in a newspaper and waiting a week for a response. All minor/underage U.S. citizens should be accompanied by their legal guardian(s) and/or provide a notarized letter in Arabic of parental consent when obtaining exit visas to depart Yemen. In all of these more complex cases, obtaining an exit visa requires the permission of the employing company, the sponsoring Yemeni family member, the sponsoring school or the court in which the legal action is pending. Without this permission, foreigners -- including U.S. Citizens -- may not be allowed to leave Yemen.
American women who also hold Yemeni nationality and/or are married to Yemeni or Yemeni-American men often must obtain permission from their husbands for exit visas. They also may not take their children out of Yemen without the permission of the father, regardless of who has custody (see Special Circumstances section below).
For more details, travelers can contact the Embassy of the Republic of Yemen, Suite 705, 2600 Virginia Avenue NW, Washington, DC 20037, telephone 202-965-4760; or the Yemeni (Mission to the U.N., 866 United Nations Plaza, Room 435, New York, NY 10017, telephone (212) 355-1730. Visit the Yemeni Embassy home page for more visa information at http://www.yemenembassy.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: The Department of State is concerned that al-Qa‘ida and its affiliates are actively engaged in extremist-related activities in Yemen and the Arabian Peninsula. The Department remains concerned about possible attacks by extremist individuals or groups against U.S. citizens, facilities, businesses and perceived interests.

On March 18, 2008, three mortar rounds landed in the vicinity of the U.S. Embassy in Sanaa. Yemeni students at a nearby school and Yemeni government security personnel posted outside the embassy were injured in the attack. On April 6, 2008, an expatriate residential compound in the Hadda neighborhood of southwestern Sanaa was attacked by mortar fire, and on April 30, 2008, suspected extremists fired two mortar rounds that exploded near the Yemen Customs Authority and the Italian Embassy. No injuries were reported in either incident. A group calling itself al-Qa'ida in Yemen may be responsible for all three attacks. Following the attacks against the Embassy and the residential compound, the Department of State ordered the departure of all American non-emergency embassy staff and family members on April 7, 2008.
On January 18, 2008, suspected al-Qa’ida operatives ambushed a tourist convoy in the eastern Hadramout Governorate, killing two Belgians. On July 2, 2007, suspected al-Qa’ida operatives carried out a vehicle-borne explosive device attack on tourists at the Belquis Temple in Marib, which resulted in the deaths of eight Spanish tourists and two Yemenis. The targeting of tourist sites by al-Qa’ida may represent an escalation in terror tactics in Yemen. On February 3, 2006, 23 convicts, including known affiliates of al-Qa’ida, escaped from a high-security prison in the capital city, Sanaa. Among the al-Qa’ida associates were individuals imprisoned for their roles in the 2000 bombing of the USS Cole and the 2002 attack on the French oil tanker Limburg. In the weeks following the escape, some prisoners voluntarily turned themselves in to authorities; to date, however, some escapees remain at large. Two of the escapees were killed in vehicle-based suicide attacks on oil facilities near Mukalla and Marib on September 15, 2006. Those attacks were followed by the arrest the next day in Sanaa of four suspected al-Qa’ida operatives, who had stockpiled explosives and weapons. On December 5, 2006, a lone gunman opened small arms fire outside of the Embassy compound during the early morning hours. The assailant, wounded by host-nation security personnel and subsequently arrested, was the sole casualty. It appears that, although the gunman was influenced by extremist ideology, he worked alone in planning and executing the attack.
Americans should avoid areas where demonstrations are taking place. A 2005 demonstration against an increase in the fuel price led to two days of widespread demonstrations and rioting throughout Sanaa and other cities. Those demonstrations resulted in a large amount of property damage, looting, and several roadblocks.
In late 2007 and throughout 2008, there has been an increase in anti-government demonstrations in southern Yemen, including the cities of Aden, Taizz, Ibb, and Mukalla, as well as surrounding regions. Some of these demonstrations have resulted in injuries and deaths. Americans should be aware of the potential for further demonstrations when traveling in these areas.
Throughout the country, U.S. citizens are urged to exercise particular caution at locations where large groups of expatriates have gathered. From time to time, the U.S. Embassy in Sanaa may temporarily close or suspend public services as necessary to review its security posture and ensure its adequacy.
In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of such objects to local authorities. Vehicles should not be left unattended and should be kept locked at all times. Americans in Yemen are urged to register and remain in contact with the American Embassy in Sanaa for updated security information (see section on Registration/Embassy location below).
Yemeni government security organizations have arrested and expelled foreign Muslims, including Americans, who have associated with local Muslim organizations considered to be extremist by security organs of the Yemeni government. Americans risk arrest if they engage in either political or other activities that violate the terms of their admission to Yemen.
Travel on roads between cities throughout Yemen can be dangerous. Armed carjacking, especially of four-wheel-drive vehicles, occurs in many parts of the country, including the capital. Yemeni security officials advise against casual travel to rural areas. The U.S. Embassy sometimes restricts the travel of its own personnel to rural areas, while the Government of Yemen also sometimes places restrictions on Americans traveling outside Sanaa. Please check with the Embassy for the latest restrictions.
Travel is particularly dangerous in the tribal areas north and east of Sanaa. Armed tribesmen in those areas have kidnapped a number of foreigners in attempts to resolve disputes with the Yemeni government. Hostilities between tribesmen and government security forces in the Sadah governorate north of Sanaa have flared up on several occasions since 2005. Serious fighting occurred in the city of Benni Hashish from late May through early June 2008. Americans are urged to avoid this region during periods of conflict.
Travel by boat through the Red Sea or near the Socotra Islands in the Gulf of Aden presents the risk of pirate attacks. If travel to any of these areas is necessary, travelers may reduce the risk to personal security if such travel is undertaken by air or with an armed escort provided by a local tour company.
Other potential hazards to travelers include land mines and unexploded ordnance from the 1994 civil war. This is of particular concern in areas where fighting took place in the six southern provinces. However, most minefields have been identified and cordoned off.
Americans are most vulnerable to terrorist attacks when they are in transit to and from their residences or workplaces, or visiting locations where large groups of expatriates have gathered. All Americans are reminded to vary their routes and times, remain vigilant, report suspicious incidents to the Embassy, avoid areas where large groups of expatriates have gathered, lock car windows and doors, and carry a cell phone.
Based on previous abductions of foreigners in Iraq, Afghanistan and Kuwait, the Embassy recommends that Americans with doubts about the identity of security or police personnel on the roads remain in their vehicles, roll up their windows, and contact the Embassy. For additional information on travel by road in Yemen, see the Traffic Safety and Road Conditions section below.
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, including the Travel Warning for Yemen, 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: The most serious crime problem affecting travelers to Yemen is carjacking. Travelers have rarely been victims of petty street crime.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends, and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the "911" emergency line in Yemen is 199, but operators do not speak English.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Lack of modern medical facilities outside of Sanaa and Aden and a shortage of emergency ambulance services throughout the country may cause concern to some visitors. Doctors and hospitals often expect immediate cash payment for health services. An adequate supply of prescription medications for the duration of the trip is important. While many prescription drugs are available in Yemen, a particular drug needed by a visitor may not be available.
The U.S. Embassy in Sanaa strongly advises all American citizens residing in or traveling to Yemen to ensure that they have received all recommended immunizations (see below).
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en/.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Yemen.

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 Yemen is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Based on previous abductions of foreigners in Iraq, Afghanistan and Kuwait, the Embassy recommends that Americans with doubts about the identity of security or police personnel on the roads remain in their vehicles, roll up their windows, and contact the Embassy. For additional information addressing security concerns for Americans in Yemen, please see the Safety and Security section above.
Travel by road in Yemen should be considered risky. Within cities, minivans and small buses ply somewhat regular routes, picking up and dropping off passengers with little notice or regard for other vehicles. Taxis and public transportation are widely available but the vehicles may lack safety standards and equipment. Embassy personnel are advised to avoid public buses for safety reasons. Despite the presence of traffic lights and traffic policemen, drivers are urged to exercise extreme caution, especially at intersections. While traffic laws exist, they are often not enforced, and/or not adhered to by motorists. Drivers sometimes drive on the left side of the road, although right-hand driving is specified by Yemeni law. No laws mandate the use of seat belts or car seats for children. The maximum speed for private cars is 100 kilometers per hour (62.5 miles per hour), but speed limits are rarely enforced. A large number of under-age drivers are on the roads. Many vehicles are in poor repair and lack basic parts such as functional turn signals, headlights and taillights. Pedestrians, especially children, and animals on the roads constitute a hazard in both rural and urban areas. Beyond the main inter-city roads, which are usually paved and in fair condition, the rural roads in general require four-wheel-drive vehicles or vehicles with high clearance.
Yemeni security officials advise against casual travel to rural areas. The U.S. Embassy sometimes restricts the travel of its own personnel to rural areas, while the Government of Yemen also sometimes places restrictions on Americans traveling outside Sanaa. Please check with the Embassy for the latest restrictions.
Travelers should take precautions to avoid minefields left over from Yemen's civil wars. Traveling off well-used tracks without an experienced guide could be extremely hazardous, particularly in parts of the south and the central highlands.
Penalties for driving under the influence of alcohol or drugs, and reckless driving which causes an accident resulting in injury, are a fine and/or prison sentence. If the accident results in death, the driver is subject to a maximum of three years in prison and/or a fine. Under traditional practice, victims' families negotiate a monetary compensation from the driver proportionate to the extent of the injuries -- higher if it is a fatality.
Please refer to our Road Safety page for more information and visit the web site of Yemen’s national tourism office at http//yementourism.com.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Yemen, the U.S. Federal Aviation Administration (FAA) has not assessed Yemen’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: Photography of military installations, including airports, equipment, or troops is forbidden. In the past, such photography has led to the arrest of U.S. citizens. Military sites are not always obvious. If in doubt, it is wise to ask specific permission from Yemeni authorities.
Travelers should be aware that automated teller machines (ATMs) are being introduced in major cities but are still not widely available in Yemen. Credit cards are not widely accepted. The Government of Yemen may not recognize the U.S. citizenship of persons who are citizens of both Yemen and the United States. This may hinder the ability of U.S. consular officials to assist persons who do not enter Yemen on a U.S. passport. Dual nationals may also be subject to national obligations, such as taxes or military service. For further information, travelers can contact the nearest embassy or consulate of Yemen.
American citizens who travel to Yemen are subject to the jurisdiction of Yemeni courts, as well as to the country's laws, customs, and regulations. This holds true for all legal matters including child custody. Women in custody disputes in Yemen may not enjoy the same rights that they do in the U.S., as Yemeni law often does not work in favor of the mother. Parents planning to travel to Yemen with their children should bear this in mind. Parents should also note that American custody orders might not be enforced in Yemen.
American women who also hold Yemeni nationality, and/or are married to Yemeni or Yemeni-American men, are advised that if they bring their children to Yemen they may not enjoy freedom of travel should they decide they want to leave Yemen. Such women often must obtain permission from their husbands for exit visas. They also may not take their children out of Yemen without the permission of the father, regardless of who has custody (See Entry/Exit Requirements section above).
American students and workers in Yemen sometimes report that the sponsors of their residence permits seize their U.S. passports as a means of controlling their domestic and international travel. While the sponsors say they seize the passports on behalf of local security services, there is no law or instruction from Yemeni passport or security offices requiring that passports be seized.
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 Yemeni laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession or use, or trafficking in illegal drugs in Yemen are severe, and convicted offenders can expect long jail sentences and heavy fines. The use of the mild stimulant "qat” or “khat" is legal and common in Yemen, but it is considered an illegal substance in many other countries, including the United States. 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 Yemen 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 Yemen. 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 Dhahr Himyar Zone, Sheraton Hotel District, PO Box 22347. The telephone number of the Consular Section is (967)(1) 755-2000, extension 2153 or 2266. The fax number is (967) (1) 303-175. The after-hours emergency number is (967) (1) 755-2000 (press 0 for extension) or (967) 733213509. The Embassy is open from Saturday through Wednesday.
* * *
This replaces the Country Specific Information for Yemen dated December 27, 2007, to update the sections on Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

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

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

[HealthMap/ProMED-mail map of Yemen:
Date: Tue 15 Oct 2019
Source: Yemen Online [edited]

The cumulative number of suspected cholera cases reported in Yemen between October 2016 and August 2019 is 2,036,960, including 3716 related deaths (fatality rate of 0.18%). The 5 governorates with the highest attack rate per 10 000 are: Amran (1602.13), Al Mahwit (1474.79), Sana'a (1295.78), Al Bayda (1027.14) and Dahamar (957.61).

The national average attack rate is 713.99 per 10 000. The highest numbers of deaths are reported in the Hajjah (559), Ibb (486), Al Hudaydah (380) and Taizz (304) governorates. Cholera patients are often unable to afford transportation to supported health facilities, which contributes to the spread of disease and to deaths at community level.

Acute fuel shortages are causing critical disruption of water and sanitation services in Yemen given the reliance on fuel for extracting water. Limited access to water increases the risk of epidemic diseases, acute malnutrition, and triggers additional population displacement. Up to 16 million Yemenis may fall into acute need of humanitarian assistance and WASH services.
========================
[The calculated case fatality rate from this is quite low, strongly suggesting that many of the cases are not cholera. Even with that, the numbers reported in this continuing catastrophe are difficult to wrap one's head around. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Thursday 22nd August 2019
World Health Organisation

Sana’a, 21 August 2019 — A 6-day oral cholera vaccination campaign reached almost 400 000 people, including almost 65 000 children under the age of 5 in Aden, Al Dhale’e and Taiz, where high numbers of suspected cholera and acute watery diarrhoea cases have been recorded.

The first few months of 2019 saw an increase of reported acute watery diarrhoea cases in over 95% of districts across Yemen. Between January and the end of July 2019, there have been nearly 536 000 suspected cases and 773 associated deaths. Children under 5 represent one quarter of all suspected cases.

The vaccination campaign, run by local health authorities, UNICEF and WHO, was made possible thanks to GAVI, the Vaccine Alliance, and to the World Bank’s ‘Emergency Health and Nutrition Project.’

“Amid the fighting in surrounding areas, over 800 health workers, brave men and women, risked their lives to reach communities from cholera — these are the real heroes,” said Altaf Musani, WHO Representative in Yemen.

“Thanks to the extraordinary commitment and dedication of Yemen’s local health workforce, hundreds of thousands of people from these priority districts were reached with vaccination against cholera,” said Sara Beysolow Nyanti, UNICEF Country Representative in Yemen. 

Since April 2017, the cholera and acute watery diarrhoea epidemic in Yemen has caused an estimated 2 million suspected cases and 3500 associated deaths. Almost one third have been in children under 5, including 711 associated deaths. The outbreak in Yemen remains the largest cholera in the world. 

Health partners throughout Yemen joined forces to control and prevent any future cholera outbreaks. UNICEF and WHO are working closely with the relevant health authorities and other humanitarian partners to respond.

Date: Fri 2 Aug 2019
Source: Outbreak News Today [edited]

The Global Alliance to Eliminate Lymphatic Filariasis (GAELF) reported this week that Yemen has eliminated lymphatic filariasis as public health problem, making them the 2nd country in the Eastern Mediterranean Region of the World Health Organization (WHO) to achieve this.

Yemen's success comes after almost 2 decades of tremendous efforts of sustained elimination measures as recommended by WHO of the 2 pillars -- mass drug administration (MDA) and morbidity management and disease prevention (MMDP) of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) strategy. After several rounds of MDA implementation, surveys since 2011 have validated that infection has been reduced to below transmission thresholds.

Transmission assessment surveys (TAS) conducted in 2013 and 2016 confirmed that Yemen had met all criteria for achieving elimination as a public health problem while, at the same time, management of morbidity in affected patients continued. Yemen will continue to improve its morbidity management programme treating patients with clinical symptoms as well as [maintaining] the appropriate level of surveillance to ensure continued zero transmission.

Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The infection impairs the lymphatic system triggering abnormal enlargement of body parts, causing pain, severe disability and social stigma.

The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

The achievements of the Yemen PELF were made possible through the generous support and funding from the World Health Organization (WHO), the integration with the national leprosy programme (NLEP), the generous drug donations from the Mectizan Donation Program and GSK and the generous technical guidance of GPELF-WHO and GAELF.
=====================
[The problem of lymphatic filariasis in Yemen was realised around 2000, and in 2002 an initial pilot mass drug administration was implemented in Wisab subdistrict, Dhamar governorate (about 12,800 inhabitants) and 2 subdistricts on Socotra island, Hadramout governorate (about 29 000 inhabitants; El Setouhy M, Ramzy RM. Lymphatic filariasis in the Eastern Mediterranean Region: current status and prospects for elimination. East Mediterr Health J 2003;9:534-41.  <http://applications.emro.who.int/emhj/0904/9_4_2003_534_541.pdf>).

The location of Dhamar governorate can be found here:
<https://en.wikipedia.org/wiki/Dhamar_Governorate>.

Thus, filariasis was limited to the Dhamar governorate in central eastern Yemen and the Socotra island. Currently the Dhamar governorate is under control of the Houthi-led government in Sanaa (see <https://www.ecfr.eu/mena/yemen>), and Socotra is controlled by the United Arab Emirates.

Onchocerciasis, which is also considered a variant of filariasis, is still found in Yemen along the coastal areas toward the Red Sea (Al-Kubati A-S, et al. Onchocerciasis in Yemen: moving forward towards an elimination program. Int Health 2018;10 Suppl 1:i89-i96. <https://academic.oup.com/inthealth/article/10/suppl_1/i89/4868662>). - ProMED Mod.EP]

[HealthMap/ProMED-mail map:
Date: Tue 25 Jun 2019
Source: Urdu Point News [edited]

A cholera outbreak in Yemen has killed 686 people since the start of 2019, the SABA news agency reported on Monday [24 Jun 2019], citing Houthi health ministry spokesman Youssef Hadri.

Over 418 000 cholera cases have been reported in the country since January 2019, in addition to hundreds of malaria, dengue, diphtheria, meningitis, and chicken pox cases, Hadri said. The WHO said the number of suspected cholera cases between 1 Jan 2018 and 9 Jun 2019 had gone up to 759 464 in Yemen, with 1163 associated deaths.

This year's [2019's] outbreak, the 3rd major flare-up since the war began in Yemen in 2015, has affected 22 of 23 regions. Children under 5 represented a fifth of suspected cholera cases.  [Byline: Mohammad Ali]
======================
[The cumulative reported cholera total in Yemen from 27 Apr 2017 to 7 Jan 2018 was 1,029,717 suspected cholera cases and 2241 associated deaths. Adding in this information, in about 27 months, the total number of reported cholera cases in this war-torn country has reached about 1 790 000 with about 3300 fatalities. The calculated case fatality rate from this is quite low, strongly suggesting that many of the cases are not cholera. Even with that, the numbers reported in this continuing catastrophe are difficult to wrap one's head around. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
More ...

World Travel News Headlines

Date: Fri, 13 Dec 2019 16:41:23 +0100 (MET)
By Mariëtte Le Roux and Joseph Schmid

Paris, Dec 13, 2019 (AFP) - French commuters gritted their teeth for a ninth day of public transport strikes Friday, with unions vowing to keep up their protest against a pension overhaul through the holidays unless the government backs down.   Officials have said they are ready to negotiate, with Education Minister Jean-Michel Blanquer meeting teachers' representatives on Friday to try and stave off another day of class shutdowns.   "It was an intense and frank meeting... but we still need details, and maintain our call to strike on Tuesday," Stephane Crochet of the SE-Unsa union said.

Unions are hoping for a repeat of 1995, when they forced a rightwing government to back down on pension reforms after three weeks of metro and rail strikes just before Christmas.   The prospect of a protracted standoff has businesses fearing big losses during the crucial year-end festivities, and travellers worried that their Christmas plans may be compromised.   "Right now it's a catastrophe here, but we're hoping there will be a solution before Christmas," Frederic Masse, a foie gras producer at the huge Rungis wholesale food market south of Paris, told AFP on Friday.

The capital city was again choked by huge traffic jams as most metro lines remained shut, only a handful of buses and trams were running, and one in four TGV trains were cancelled.   "I'm sick of this, and I won't be able to keep working if it goes on," Zigo Makango, a 57-year-old security agent, told AFP onboard a bus in the Bobigny suburb northeast of Paris.   To get home at night Makango said he has to use taxis, but "my boss doesn't reimburse me for that".

- 'Historic reform' -
President Emmanuel Macron on Friday expressed his "solidarity" with people impacted by the strike, "but I want the government to continue its work" in forging a single pension system, a key campaign promise.   "It's a historic reform for the country," he told journalists at an EU summit in Brussels. 

The overhaul unveiled by Prime Minister Edouard Philippe would do away with 42 separate regimes, some of which offer early retirement and other benefits to public-sector employees such as train drivers, dockers and even Paris Opera employees.   But Philippe angered unions further by proposing a reduced payout for people who retire at the legal age of 62 instead of a new, so-called "pivot age" of 64.

They have called for new mass demonstrations for next Tuesday, the third since the action started on December 5 in the biggest show of strength in years by France's notoriously militant unions.   Philippe insisted on Twitter that "My door is open and my hand outstretched".   But Laurent Brun of the hard-line CGT union, the largest among public-sector workers including those at rail operator SNCF, has already warned "There won't be any Christmas truce" unless the government drops the plan entirely.

- France divided -
A poll released Thursday by the Elabe institute found France evenly divided on Philippe's plan, with 50 percent for and 49 percent against.  But 54 percent rejected the mooted 64-year cutoff for a full pension, and 54 percent supported the protest.

Staff at four of France's eight oil refineries were on strike Friday, affecting output and raising fears of shortages down the line.   And both Paris operas, the Garnier and the Bastille, again cancelled Friday performances and others through the weekend.   Macron's government insists the changes will make for a fairer system and help erase pension system deficits forecast to reach as much as 17 billion euros ($19 billion) by 2025.   The average French person retires at just over 60, years earlier than most in Europe or other rich OECD countries.
Date: Fri, 13 Dec 2019 14:05:22 +0100 (MET)

Milan, Dec 13, 2019 (AFP) - More than 300 flights were cancelled Friday in Italy due to a planned one-day strike by workers from Alitalia and Air Italy.   Alitalia said in a statement that 315 flights were cancelled on Friday, with another 40 cancelled Thursday night and Saturday morning. It was not immediately clear how many flights were cancelled at Air Italy.   The 24-hours strike, which involves pilots, flight attendants and ground personnel, was called by three unions to draw attention to what they called "the ongoing crisis at Alitalia and Air Italy."

The strike was felt most in Sardinia, with about 30 flights cancelled.    Money-losing Alitalia has been under special administration since 2017 when employees rejected a restructuring plan that would have laid off 1,700 workers out of an approximately 11,000.   The government has so far looked for buyers without success.    Unions plan to meet on Tuesday with Economy Minister Stefano Patuanelli.    A potential consortium of buyers for the ailing carrier fell apart last month after Atlantia, which operates Rome's airports, pulled out.
Date: Fri, 13 Dec 2019 05:24:44 +0100 (MET)
By Neil SANDS

Wellington, Dec 13, 2019 (AFP) - Adventure tourism is a key part of New Zealand's international appeal but the White Island volcano eruption is a tragic reminder that such activities carry genuine risk that must be better explained to travellers, experts say.   The South Pacific nation offers a wealth of adrenaline-fuelled pursuits, from heli-skiiing on snow-capped mountains to ballooning and blackwater rafting through caves.

Some, such as bungee-jumping, jet-boating and zorbing -- where you hurl yourself down a hill inside an inflatable ball -- were invented or popularised in a country that prides itself on catering to intrepid visitors.   The tourism industry as a whole is among New Zealand's biggest earners, generating about NZ$16.2 billion ($10.7 billion) and attracting 3.8 million international visitors annually.     "Adventure tourism is a massive sector in New Zealand. We are promoting ourselves as the adventure capital of the world," professor Michael Lueck, a tourism expert at Auckland University of Technology, told AFP.

New Zealand is also renowned for its rugged landscapes, which feature prominently films such as Kiwi director Peter Jackson's "Lord of the Rings".   Day-trips to White Island combined both, taking tourists including cruise ship passengers to a desolately beautiful island off the North Island coast where they could experience the thrill of standing on an active volcano.   Instead, at least 16 people are believed to have died and dozens suffered horrific burns when 47 tourists and guides were caught on the island during Monday's eruption.

The disaster has raised questions about why tourists were allowed on a volcano where experts had recently raised threat levels, as well as broader issues about the regulation of risky activities in the tourism sector.   "There will be bigger questions in relation to this event," Prime Minister Jacinda Ardern told parliament after the eruption.   "These questions must be asked, and they must be answered."

- 'Slapdash' or world's best? -
The disaster on White Island -- also known as Whakaari -- is not the first mass-fatality accident to affect tourists in New Zealand.   In 2015, seven people were killed when a scenic helicopter flight crashed into Fox Glacier. Two years earlier, a hot-air balloon claimed 11 lives and in 2010 nine died when a plane carrying skydivers plunged into a paddock.

Briton Chris Coker's son Brad, 24, died in the skydive plane crash and since then he has campaigned from afar for tighter regulations in New Zealand's adventure tourism sector.   "In my opinion, the New Zealand authorities... are still slapdash about tourist safety," Coker told news website stuff.co.nz after the White Island eruption.   "To run tourists there is insane. I know they signed a waiver and so on, but it's not really taking care of people."

Trade body Tourism Industry Aotearoa disputes such assessments, saying operators are "working within a world's best regulatory framework", but could not eliminate risk completely.   "Operators put safety first, but adventure activity inherently carries some risk and it's critical that 'adventure' remains in adventure tourism," TIA chief executive Chris Roberts told AFP.   "Operators take all practical actions to minimise the risks and the safety culture of individual operators remains the key factor in preventing accidents."

Roberts said the issue was not tourism operators, but the alert system they relied on at volcanic destinations such as White Island, which attracts about 17,000 visitors a year.   The GeoNet monitoring agency raised White Island's threat level in the week before the eruption but also advised current activity "does not pose a direct hazard to visitors".   "The reviews need to look at the science and specifically the guidance provided about volcanic activity, and whether the operating practices followed for the past 30 years need to change," Roberts said.

- 'Understand the risks' -
Travel companies such as White Island Tours brief customers before setting off and require them to sign a waiver declaring they understand the risk, as well as supplying equipment such as hard-hats and gas masks.   However, some relatives of those affected by the eruption have expressed scepticism that their loved ones truly appreciated the potential danger they faced.   Options for legal redress are limited under New Zealand's Accident Compensation Commission scheme, which covers victims' medical bills and provides modest compensation but does not allow civil suits for damages.

Neither Roberts nor Lueck expected the White Island eruption to hit international arrivals in New Zealand, which have continued to climb despite major earthquakes in 2011 and 2016.   The nature of any review arising from White Island remains uncertain, but Lueck said at the very least tourists needed to be better informed about any risks.   "Operators and tourism boards should have tourists understand what these risks are, and not brush over quickly signing a waiver," he said.   "Only then can tourists make an informed decision and decide whether or not they want to take that particular risk."
Date: Thu, 12 Dec 2019 21:25:36 +0100 (MET)

Kinshasa, Dec 12, 2019 (AFP) - Twenty-three cases of Ebola have been recorded in four days in eastern Democratic Republic of Congo, where deadly violence is hampering efforts to end the 16-month-old epidemic, authorities said on Thursday.   Ten cases were recorded on Tuesday alone in Mabalako in North Kivu province, after six on Monday, according to the Multisectoral Committee for Epidemic Response (CMRE).   Three out of the six were practitioners of traditional medicine, it said.

On Wednesday, three cases were recorded in North Kivu, including one in the Biena neighbourhood -- which has had no new Ebola cases for the last 85 days.   More than 2,200 people have died since the epidemic was declared on August 1, 2018.   As of November 22, the rate of new cases had fallen to 10 per week.   CMRE said "security reasons" -- attacks on Ebola health workers and sites by armed groups and angry youths -- had "paralysed" work in the key zones of Beni, Biakato and Mangina.   The attacks led to a pullout of locally-employed Ebola workers in Biakato by the UN's World Health Organization (WHO) and Doctors Without Borders (MSF).
Date: Thu, 12 Dec 2019 15:59:23 +0100 (MET)

Juba, Dec 12, 2019 (AFP) - Devastating flooding in South Sudan following a fierce drought could tip parts of the country into famine in the next few months, the World Food Programme (WFP) warned on Thursday.   According to the UN refugee agency nearly one million people were affected by floodwaters that submerged entire towns, compounding an already dire humanitarian situation after six years of war.

The WFP said that 5.5 million people are expected to be going hungry in early 2020 -- the time at which the population is generally benefiting from their harvest in October and November of the previous year.   An earlier harvest failed due to drought. This time crops have been washed away.    "The number of people in need is likely to increase because of the catastrophic level of destruction caused by floods since October following a drought that hammered parts of the country earlier in the year," the agency said in a statement.

The floods wiped out 73,000 metric tons of potential harvests as well as tens of thousands of cattle and goats, said the WFP.   "We know the problems that we've been having in South Sudan, but the rains and the floods have led to a national disaster and are much worse than anyone could have anticipated," said WFP Executive Director David Beasley.    "In fact, if we don't get funding in the next few weeks and months, we are literally talking about famine. We need support, we need help and we need it now."   The agency estimated its needs at $270 million (242 million euros) for the first half of 2020.   South Sudan declared a "man-made" famine affecting around 100,000 people in 2017. 

The term "famine" is used according to a scientific system agreed upon by global agencies, when at least 20 percent of the population in a specific area has extremely limited access to basic food; acute malnutrition exceeds 30 percent; and the death rate exceeds two per 10,000 people per day for the entire population.   "Famine in South Sudan was defeated after four months in 2017 by a concerted large-scale humanitarian response," said the WFP.   "Experts now say the country's food security outlook has never been so dire."   Political instability is also high as President Salva Kiir and his rival Riek Machar have again delayed their formation of a power-sharing government, this time by 100 days until February 2020.
Date: Wed, 11 Dec 2019 09:33:13 +0100 (MET)
By Holly ROBERTSON

Sydney, Dec 11, 2019 (AFP) - Up to 20,000 protesters rallied in Sydney on Wednesday demanding urgent climate action from Australia's government, as bushfire smoke choking the city caused health problems to spike.   Sydney has endured weeks bathed in toxic smoke as hundreds of blazes have raged across the countryside, with hospitals recording a 25 percent increase in the number of people visiting emergency departments last week.   On Tuesday smoke alarms rang out across Australia's biggest city, with thick haze triggering smoke alarms and forcing buildings to be evacuated, school children to be kept indoors, and ferries to be cancelled.   The devastating fires have focused attention on climate change, with scientists saying the blazes have come earlier and with more intensity than usual due to global warming and a prolonged drought.   Police estimated the crowd size at 15,000, organisers put the figure at 20,000.

Many of the protestors voiced anger at the government's silence in the face of the crisis.   "The country is on fire" said 26-year-old Samuel Wilkie attending his first climate protest. He described politicians' response as "pathetic".    "Our government is not doing anything about it," said 29-year-old landscape gardener Zara Zoe. "No one is listening, no one is doing anything."   Prime Minister Scott Morrison -- a staunch backer of Australia's vast coal industry -- has said little about the smoke since the crisis began, preferring to focus on fire-hit rural communities.   Organiser Chloe Rafferty said that had created anger at the conservative government's inaction.   "I think the wider public can see that we are not expecting the climate crisis in the future but we are facing the climate crisis now," she told AFP.   "People are experiencing it in their day-to-day lives."   As well as a rise in people visiting hospitals with smoke-related health symptoms, the number of emergency calls for ambulances spiked 30 percent last week.    "For most people, smoke causes mild symptoms like sore eyes, nose and throat," top health department official Richard Broome said.   "However, people with conditions like asthma, emphysema and angina are at greater risk because the smoke can trigger their symptoms."

Smoke from bushfires is one of the biggest contributors to air pollution in Australia, releasing fine particles that can lodge deep within people's lungs and cause "severe" health impacts over time, according to scientist Mick Meyer from government-funded scientific research agency CSIRO.   "The impact of smoke on people remote from the fires may, on occasion, substantially exceed the direct injury to people within the fire zone," he wrote in The Conversation.   "But we currently lack the operational tools to understand the extent of these impacts or to manage them."   Six people have been killed and more than 700 houses destroyed in bushfires this fire season.   Though the human toll has been far lower than the deadliest fire season in 2009 -- when almost 200 people died -- the scale of this year's devastation has been widely described as unprecedented.   Three million hectares (7.4 million acres) of land has been burnt -- the size of some small countries -- and vast swathes of koala habitat scorched.   Official data shows 2019 is on track to be one of the hottest and driest years on record in Australia.
Date: Tue 3 Dec 2019
Source: Trinidad Express [abridged, edited]

The number of local deaths from the influenza virus has risen to 24. At the Health Ministry's update last week, 16 fatalities were reported from the flu, with Health Minister Terrence Deyalsingh appealing to citizens -- especially those considered at-risk -- to get vaccinated.
Date: Sat 30 Nov 2019
Source: The New Indian Express, Express News Service [edited]

According to official data, 14 swine flu [influenza A/H1N1] deaths across the state were recorded this year [2019] till [17 Nov 2019]. The figure is slightly less than the previous year's [2018] toll of 17. The total number of H1N1 swine flu-positive cases [has] also come down this year [2019] compared with 2018 from 402 to 325. Health officials are setting up isolation wards in hospitals as a preventive measure.

As the winter season has set in and the minimum temperatures are coming down, health officials are instructing the public to take precautions in order to stay away from being infected by swine flu. The health department has initiated steps to set up district-[wide] swine flu testing facilities and isolation wards in every district hospital, area hospital, and community health centre.

As per the requirement of treatment procedure, the government has to set up special isolation wards in all government hospitals and provide protection kits to the healthcare staff, especially to those who will attend to the patients suffering from the flu. Across the state, Visakhapatnam registered the highest number of positive swine flu cases and deaths. Out of 325 positive cases, 180 alone were reported from Visakhapatnam, of which 8 died. West Godavari district registered 3 deaths, and Anantapur, East Godavari, and Srikakulam registered one death case each.

All the district health officials have been instructed to intensify awareness camps and screening centres. As part of the action plan, isolation wards with 5-10 beds are to be set up in every teaching, district, and area hospital. A sufficient stock of drugs, masks, and PPE [personal protective equipment] kits are to be made available. Currently, there are 18 labs eligible for conducting confirmation test in the state. "We are creating awareness by distributing pamphlets and putting up screening centres at bus stops and railway stations," DMHO [district medical and health officer] Dr. TSR Murthy said.

Symptoms of swine flu are generally similar to that of seasonal flu. These include cough, fever, sore throat, stuffiness, runny nose, body aches, headache, chills, fatigue, diarrhoea, and vomiting. Later on, breathlessness, chest pain, drowsiness, low blood pressure, sputum mixed with blood, and bluish discoloration of nails also develops.
Date: Thu 28 Nov 2019
Source: GDN Online [edited]

Two expatriates living in Oman died after contracting the seasonal influenza (H1N1) or swine flu in the governorate of Dhofar -- the 1st in July and the 2nd in August [2019]. They were among 78 confirmed cases of swine flu registered at the Sultan Qaboos Hospital over the first 9 months of 2019 in the governorate.

The hospital authorities reported a total of 599 registered suspected cases of H1N1 between January and last September [2019]. Doctors working at Sultan Qaboos Hospital dealt overall with 1779 cases of respiratory infections during the same period.

Patients most vulnerable to the respiratory viruses are those over 18 years, particularly pregnant women; those suffering from chronic illnesses, kidney and heart diseases, liver problems, diabetes, asthma, blood disorders, and HIV/AIDS; and even health workers, according to Muscat Daily.
Date: Wed 11 Dec 2019
Source: UNICEF/WHO Situation report 11 Dec 2019 [edited]

Highlights
- 5 new human cases reported in the past week
- In response to 1st human vaccine-derived poliovirus type 1 (VDPV1) case from the island province of Basilan, in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), outbreak immunization was conducted
in Maluso, Basilan, with bivalent oral polio vaccine (bOPV) against polio type 1, vaccinating 13 547 children under 10 years old (102% of the target).
- Currently 9 human cases confirmed with circulating VDPV type 2 (cVDPV2), 1 case with VDPV1, 1 case with cVDPV1, and 1 case with immunodeficiency-related VDPV type 2 (iVDPV2).
- A case with VDPV1 from Sultan Kudarat is pending genetic analysis; 1 case of cVDPV1 from Malaysia was confirmed as genetically linked to the Basilan case.
- Synchronized polio vaccination campaign conducted on [25 Nov 2019 - 10 Dec 2019] (including 2 days of extension) vaccinated 4 309 566 children under 5, which is 98% of the target total of 4.4 million children under 5. A total of 1 395 365 children under 5 were vaccinated in National Capital Region (NCR), which is 109% of the target, and 2 914 201 (94%) in Mindanao.
- DOH planning to conduct outbreak immunization with bOPV targeting 710,296 children under 10 in the Sulu Archipelago, Zamboanga City, and Lambayong, Sultan Kudarat, on [6-12 Jan 2020].
- Current polio outbreak resulting from persistently low routine immunization coverage, and poor sanitation and hygiene.
- Philippines is affected by both cVDPV1 and cVDPV2. cVDPV is considered a public health emergency of international concern (PHEIC).

cVDPV1
---------
- In response to the 1st human case confirmed with VDPV1 from Maluso, Basilan (BARMM), outbreak immunization was conducted in the area with bOPV for children under 10 years old, vaccinating 13,547 children under 10 years of age (102% of the target).
- A cVDPV1 case in Sabah state, Malaysia, was confirmed to be genetically linked to the Basilan case by the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Australia. Since the 2 viruses are genetically linked, they are both classified as circulating.
- A new VDPV1 case from Sultan Kudarat (Region XII) was confirmed on [6 Dec 2019] and is pending further genetic analysis.
- All 13 cVDPV1 environmental samples found in Manila are genetically linked.

cVDPV2
---------
- All 9 human cases and 17 environmental samples confirmed with cVDPV2 are genetically linked. All human cases were reported from Mindanao (BARMM and Region XII), whereas environmental samples were found in NCR and Davao.
- All samples were tested by the National Polio Laboratory at the Research Institute for Tropical Medicine (RITM), whereas sequencing and genetic analysis is done at the NIID in Japan, and additional genetic characterization is provided by the United States Centers for Disease Control and Prevention (CDC).
=======================
[Given the identification of the cVDPV1 case in Malaysia that is genetically related to the VDPV1 case in Basilan, it is now clear there are at least 2 separate cVDPV outbreaks in the Mindinao region of the Philippines: one of the outbreaks is associated with cVDPV2, and the other with cVDPV1 and one outbreak of cVDPV1 in the Manila Metropolitan area (although only environmental samples have been positive without AFP (acute flaccid paralysis) cases as yet.) What all these areas have in common is pockets of populations with suboptimal vaccination coverages. Clearly, we await further information on the genetic profiling of the newly identified VDPV1 case in Sultan Kudarat, also located in southern Philippines. Note that Basilan Island, Sultan Kudarat, and Sabah state in Malaysia, while all in the same general area, are not contiguous, each being on a different island. In. total, there are 11 cases of AFP in the Philippines that are attributable to infection with a VDPV.

A map showing the provinces in the Philippines can be found at

HealthMap/ProMED-mail map of the Philippines: