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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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Cook Islands

No Profile is available at present

Travel News Headlines WORLD NEWS

8 Aug 2019

Dengue-type1 outbreak was declared on the 27 Feb 2019 following a laboratory (NZLabPlus) confirmation of 7 dengue type 1 cases. From 28 Jan-4 Aug 2019, a cumulative number of 78 dengue cases have been reported (22 confirmed, and 56 probable-NS1Ag positives). Rarotonga and Aitutaki are the only islands affected and most of the cases have been from the main island of Rarotonga. Aitutaki has managed to contain its number of cases to 3. The last case was reported on 18 Apr 2019. A total of 42 cases have been hospitalised and given free mosquito nets to take and use at home. Apart from some severe cases, the hospitalisation was also an effort to contain and minimise the spread of the infection into the community. Unfortunately, some cases refused to be admitted but were given some health advice and mosquito precautionary measures. No deaths reported.

- Cook Islands. 17 Aug 2019. 78 dengue cases have been reported in Cook Islands since the outbreak began early in the year [2019]. The Cook Islands News reports the Ministry of Health saying 22 were confirmed cases while 56 have been deemed probable positives.

HealthMap/ProMED-mail map of Cook Islands:
- Cook Islands. 12 Apr 2019

As of Wednesday [10 Apr 2019], the Ministry for Health has 18 confirmed and 12 probable dengue fever cases. This is a total of 30 cases compared to 24 previously identified.
Date: Thu, 2 Jul 2015 05:34:35 +0200 (METDST)

Wellington, July 2, 2015 (AFP) - Airport authorities in the Cook Islands on Thursday warned thrill seekers to stay away from their runway's jet blast zone after three tourists were injured when a plane was taking off.   The main road in the tiny Pacific nation passes by the bottom of the runway and daring plane-spotters often stand in the wash of jet engines, clinging to the airport's fence as aircraft hit maximum thrust for ascent.   "If you don't hang onto anything, you'll be knocked over," Cook Islands Airport Authority chief executive Joe Ngamata told AFP.   "You get the young people and tourists looking for thrills going down there."

Ngamata said three tourists were blown over by the power of the jet blast last Thursday and were lucky to only receive cuts and bruises.   "It can be dangerous," he said, adding that the area was clearly marked with red danger signs to deter the practice.    "We might need to look at extra barriers or fences to keep people away."   However, stopping it may be difficult, with the national tourism authority including the jet blast in a recent marketing video showing "the top 10 reasons to come to the Cook Islands".
Date: Tue 1 Apr 2014
From: Dr Alyssa Pyke <Alyssa.Pyke@health.qld.gov.au> [edited]

A female patient in Townsville, Queensland, Australia has been diagnosed with Zika virus infection following a recent trip to the Cook Islands, where the virus is currently circulating. A serum sample collected in March 2014 was positive by 2 separate Zika virus TaqMan real-time RT-PCRs and a pan-Flavivirus RT-PCR. Nucleotide sequencing and phylogenetics revealed 99.1 per cent homology with a previous Cambodia 2010 sequence within the Asian lineage. Flavivirus IgG and IgM antibodies were also detected in the serum sample.

This is the 1st known imported case of Zika virus infection into northern Queensland, where the potential mosquito vector _Aedes aegypti_ is present, and only the 2nd such case diagnosed within Australia.
----------------------------------------------------
Dr Alyssa Pyke
Public Health Virology
Forensic and Scientific Services
Coopers Plains, Queensland
Australia
==============================
[As of 25 Mar 2014, there were 49 confirmed cases of Zika virus infection in the Cook Islands, the source of the virus in the case above. Concern for Zika virus introduction into northern Queensland where vector mosquitoes are present is a serious concern. Transport of this virus by viremic individuals has been the mechanism for its introduction into several Pacific islands. Dengue viruses have been introduced into Townsville, northern Queensland, by infected individuals and started small outbreaks there. Since that has happened with dengue viruses, it can happen with Zika virus as well.

ProMED thanks Alyssa Pyke for sending in this report.

A HealthMap showing the location of Queensland state can be accessed
at <http://healthmap.org/promed/p/285>, and the Cook Islands at
<http://healthmap.org/promed/p/4035>. - ProMed Mod.TY]
Date: Tue 25 Mar 2014
Source: Radio New Zealand [edited]

There are now 49 confirmed cases of Zika virus [infection] in the Cook Islands, and as many as 630 people are believed to have suffered from the mosquito-borne disease.

Last month [February 2014], health authorities 1st thought they were dealing with dengue fever, but the 1st batch of test results confirmed 18 cases of Zika [virus infection].

The Director of Community Health Services, Dr Rangi Fariu, says further results from French Polynesia, where the disease 1st broke out in the region, take the number to 49.

He says scientists there are still determining the exact nature of the strain. "Tahiti just asked for those who were already shown positive; they wanted more samples to find out if the Zika [virus] strain that we have here is similar to the one that they have in Tahiti."

Dr Rangi Fariu says doctors have reported about 630 cases of suspected Zika virus [infection] in the Cook Islands and says the real number would be much higher.
========================
[This is the 1st report of Zika virus infections in the Cook Islands. The virus has been circulating in the islands of French Polynesia, New Caledonia and Easter Island. Although the distances between these islands is significant, the virus is being moved by viraemic people who travel between them. One can expect further spread to localities where there are populations of vector mosquitoes that can initiate new outbreaks. Zika virus is a flavivirus. Symptoms of Zika fever may include fever, headache, red eyes, rash, muscle aches, and joint pains. The illness is usually mild and lasts 4-7 days. No fatalities caused by Zika virus infection have been reported.

A HealthMap/ProMED-mail map showing the location of the Cook Islands in the Pacific can be accessed at
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New Caledonia

New Caledonia US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
New Caledonia is a French overseas territory located in the Southwest Pacific near Australia. It consists of the large island of New Caledonia, the Loyalty Is
ands, the Isle of Pines, and several smaller island groups. The capital is Noumea. New Caledonia's moderately developed economy is based on mining and, to a lesser degree, tourism. Tourist facilities can be found throughout New Caledonia, the Loyalty Islands, and the Isle of Pines. The French Government Tourism Office, which has a wide range of information available to travelers, can be contacted by telephone at (212) 838-7800.
ENTRY/EXIT REQUIREMENTS: A passport valid for six months beyond duration of stay is required. Visas are not required for stays of up to one month. Extensions for up to three months may be granted locally by applying to the Haut Commissionaire (The French High Commissioner). For longer stays, you must apply for a visa at your nearest French Embassy or Consulate well beforehand, as the processing time is quite long. For further information about entry requirements, travelers, particularly those planning to enter by sea, may contact the French Embassy at 4101 Reservoir Road NW, Washington, DC 20007, telephone 202 944-6200, fax 202-944-6212, or visit the Embassy of France web site at http://www.info-france-usa.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:
Marches highlighting labor or political issues take place in the greater Noumea area from time to time. Demonstrations in January 2008 resulted in clashes between demonstrators and the police. American citizens are advised to avoid large public gatherings and to exercise caution if within the vicinity of any demonstrations, as they could turn violent at any time.
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: The crime rate in New Caledonia is low; however, petty crime such as pick-pocketing and purse-snatching does occur. Visitors should be aware that fights and assaults sometimes occur outside discotheques and bars, especially over weekends and holidays and at closing time.
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 equivalents to the “911” emergency lines in New Caledonia are 17 for police (gendarmes), 18 for fire, 15 for ambulance and medical emergencies, and 16 for rescue at sea.

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical treatment on the main island is generally good, but it is more limited on the outer islands. The Centre Hospitalier Territorial in Noumea provides emergency and outpatient services, as does the smaller Centre Hospitalier Nord in Koumac in the northern part of the main island of New Caledonia and the Centre Hospitalier Est in Poindimie on the east coast of the main island. Patients with more serious illnesses are often referred to Noumea, Australia or France for treatment. In the event of a medical evacuation to Australia, before issuing a visa, Australian visa authorities will require a referral from a doctor in New Caledonia, proof of acceptance by an Australian doctor, and proof of the patient's ability to pay for the medical treatment. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Doctors and hospitals often expect immediate cash payment for health services.
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 New Caledonia.

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 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 New Caledonia is provided for general reference only, and may not be totally accurate in a particular location or circumstance:
Roads are generally well maintained except in remote areas. Animals and unwary pedestrians walking in the road make night driving on unlit secondary roads hazardous. To obtain information on operation of motor vehicles or for specific information concerning New Caledonian driving permits, vehicle inspection, road tax and mandatory insurance in New Caledonia, contact the New Caledonia Southern Province Tourism Office at www.new-caledoniatourism-south.com and go to the e-mail address provided for specific inquiries.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: Civil aviation operations in New Caledonia fall under the jurisdiction of French authorities. The U.S. Federal Aviation Administration (FAA) has assessed the Government of France’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of France’s air carrier operations. For further 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 encouraged to carry a copy of their U.S. passports with them at all times, so that if questioned by local officials, proof of identity and U.S. citizenship are readily available. If detained, U.S. citizens are encouraged to request that a consular officer at the U.S. Embassy in Suva, Fiji, be notified.
Customs authorities may enforce strict regulations concerning temporary importation into or export from New Caledonia of items such as agricultural products. It is advisable to contact the Embassy of France in Washington or one of the French consulates in the United States for specific information regarding customs requirements.
The cyclone season is November through April. The Fiji Meteorological Service maintains a Tropical Cyclone Warning Center (TCWC) in Nadi serving the Southwest Pacific Region. It collaborates with the French Meteorological Service and the French High Commission, which in turn alert the press and general public when necessary. General information about natural disaster preparedness is available via the Internet at http://travel.state.gov/crisismg.html, and from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
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 those in the United States for similar offences. Persons violating New Caledonia’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession of, use of, or trafficking in illegal drugs in New Caledonia 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 page on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
There is no U.S. Embassy or Consulate in New Caledonia. The U.S. Embassy in Fiji provides assistance for U.S. citizens in New Caledonia. Americans living or traveling to New Caledonia are encouraged to register with the U.S. Embassy in Suva, Fiji, or through the State Department’s travel registration web site, and to obtain up-to-date information on travel and security within New Caledonia. Americans without Internet access may register directly with the nearest 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 Fiji is located at 31 Loftus Street in the capital city of Suva, telephone (679) 331-4466; fax (679) 330-2267. Information may also be obtained by visiting the Embassy’s home page at http://suva.usembassy.gov/.
* * *
This replaces the Country Specific Information for New Caledonia dated February 26, 2008, to update sections on Crime, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Thu, 27 Jun 2019 14:09:43 +0200

Noumea, June 27, 2019 (AFP) - A boat carrying Australian tourists was attacked by a gang armed with rifles and machetes off the French Pacific territory of New Caledonia, authorities said on Thursday.    Two Australian holidaymakers and three guides were exploring tropical waters and a coral atoll near the island of Ouvea on Monday afternoon when raiders approached their boat and opened fire, public prosecutor Alexis Bouroz said. 

"A boat from Ouvea came to meet them with seven to eight people on board, some of them apparently armed with guns and machetes," he said.   The attackers fired shots in the air, at the windshield and a fender of the boat before five or six of them boarded.    Although the tourists were only "lightly injured", the skipper was knocked to the deck by a blow to the face, Bouroz said.    The boat was then looted while one of its engines and electronic equipment was destroyed.

New Caledonia, which boasts the world's largest enclosed lagoon, with magnificent coral, is a popular tourist destination.   New Caledonia's tourism department condemned the violence, which it said targeted the very kind of small scale but high-yield tourism it wants to encourage.   "These tourists were staying on a luxury yacht, a trend with high growth potential... which respects the wishes of local people looking to develop responsible tourism", it said.

The president of the assembly in New Caledonia's southern province, Sonia Backes, said the attack was "highly detrimental" to tourism.   The "main perpetrator" has been identified and an investigation has been launched, Bouroz said.    A spokesperson from the Australian department of foreign affairs said it was "aware of media reports that a number of Australians were involved in an incident in New Caledonia", adding: "We stand ready to offer consular assistance."
17th February 2019

- Tahiti ex New Caledonia. 13 Feb 2019. A health alert has been issued in French Polynesia after one case of dengue type 2 was diagnosed. A man who had arrived from New Caledonia has come down with the mosquito-borne illness in Mahina. He has been transferred to the main hospital in Tahiti. The neighbourhood of Mahina he stayed in is being sprayed in the hope of eliminating mosquitoes that could transmit the virus. French Polynesia has been spared a dengue type 2 epidemic for about 2 decades, which means that the public has low immunity to the disease. Last year, 2 cases were diagnosed in Raiatea, but the outbreak was contained.
Date: Wed, 5 Dec 2018 10:55:37 +0100
By Claudine WERY

Noumea, Dec 5, 2018 (AFP) - A powerful 7.5-magnitude earthquake struck near New Caledonia Wednesday, triggering a tsunami alert and emergency evacuations across a swathe of the South Pacific, but there were no reports of serious damage or injuries.   Authorities said the quake, followed by at least 20 strong aftershocks, was centred about 170 kilometres (100 miles) southeast of New Caledonia's Loyalty Islands at a depth of just 10 kilometres.

Island residents said the initial quake shook the walls of buildings and in places turned the sea foamy.   Tsunami waves were recorded moving out from the epicentre, prompting people to flee to high ground.   The Pacific Tsunami Warning Center initially warned surges of up to three metres (10 feet) could be expected and shallow quakes of that magnitude can be devastating.   But the centre later reported waves measured by its monitors around the region only reached about 72 centimetres (2.4 feet) on the island of Tanna, Vanuatu.

Civil defence officials in Noumea said tsunami waves hit parts of the Loyalty Islands and the Isle of Pines, but caused no damage.   "Reports from the area confirm that the strength of the tsunami has fallen significantly and there is no longer a major risk for the population," said a spokesman for the civil defence department.   "There have been no injuries or damage," he said.

Almost three hours after the quake, the Hawaii-based Pacific Tsunami Warning Center reported the threat stemming from the initial quake "has now passed".   Multiple aftershocks of up to magnitude 6.6 hit the area in the hours following the initial quake, according to the US Geological Survey.   The quake triggered emergency warning systems in New Caledonia, where residents received an urgent text message directing them to go to refuges immediately.

- Ring of fire -
Basile Citre, a municipal official on the Loyalty Island of Mare, said he had been in a meeting at the town hall when he felt a small tremor followed by a bigger shock.   "The building shook, but there was no damage," he told AFP. "When the sirens sounded, the population headed for higher ground for safety. For now, nothing serious has happened."

A spokesman for the Vanuatu geohazards observatory said the sparsely populated island of Tanna was expected to be most affected but no evacuations had been ordered.   "There are no sirens on Tanna but the people on the island are familiar with these situations and they will have taken precautions and gone to higher ground," he told AFP.   CCTV footage showed bathers still frolicking in crystalline seas off Noumea, seemingly unaware of the seriousness of the threat on the other coast, just 50 kilometres away.

New Caledonia, with a population of 269,000 people, is a French Pacific territory.   It sits along the so-called Pacific "Ring of Fire", where tectonic plates collide and many of the world's volcanic eruptions and earthquakes occur.   The island's citizens last month rejected independence in a referendum, though the vote revealed lower-then-expected support for remaining part of France.   New Caledonia is home to a quarter of the world's known supplies of nickel -- a vital electronics component -- and is a foothold for France in the Pacific, with French troops stationed on the island.
Date: Wed, 29 Aug 2018 07:21:01 +0200

Sydney, Aug 29, 2018 (AFP) - A 7.1 magnitude earthquake struck off the eastern coast of New Caledonia on Wednesday and generated small tsunami waves, seismologists said, but there were no immediate reports of damage.   The tremor hit at a depth of 27 kilometres (16 miles) in the southern Pacific Ocean, some 231 kilometres from the nearest town Tadine in the lightly populated Loyalty Islands, the US Geological Survey said.

The Pacific Tsunami Warning Center said "small tsunami waves have been observed".   "Persons along coastal areas near the earthquake should be observant and exercise normal caution. Otherwise, no action is required," it added.   Geoscience Australia said shaking would have been felt throughout New Caledonia, but it put the damage radius at 103 kilometres -- well away from land.   New Caledonia, a French overseas territory, is located within the "Ring of Fire", a zone of tectonic activity around the Pacific that is subject to frequent earthquakes and volcanic eruptions.
22nd March 2018

- New Caledonia.16 Mar 2018. Since start of March [2018], 134 cases [of Dengue] diagnosed and 1 death.
More ...

Turkmenistan

Turkmenistan - US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Turkmenistan is a Central Asian nation roughly the size of California.
It shares borders with Kazakhstan, Uzbekistan, Afghanistan, and Iran.
Turkmen
stan gained its independence in 1991 during the dissolution of the Soviet Union.
Primarily a desert country, it has a population of around six million people. Tourist facilities, especially outside of the capital city of Ashgabat, are not highly developed.
Many of the goods and services taken for granted in North American and Western European countries are not yet available. Travel within the country can be difficult due to limited infrastructure and government-imposed internal travel restrictions.
Read the Department of State Background Notes on Turkmenistan for additional information.
ENTRY/EXIT REQUIREMENTS:
American citizens must have a valid passport and visa and/or letter of invitation from the Government of Turkmenistan to enter and exit Turkmenistan.
To apply for a visa, all U.S. citizens must complete an application and have a letter of invitation approved by the State Migration Service (SMS), formerly known as the State Service for the Registration of Foreigners (SSRF), in Ashgabat.
An individual or organization in Turkmenistan must submit the letter of invitation on behalf of an American citizen to the SMS accompanied by a copy of the traveler's passport ID page.
Each traveler’s passport must be valid for at least 6 months following the date of the application.
The SMS requires at least 15 working days for approval.
The U.S. Embassy in Ashgabat does not issue letters of invitation to citizens interested in private travel to Turkmenistan.
Applications for a visa can be submitted to the Embassy of Turkmenistan in Washington, D.C., or directly to the SMS in Ashgabat.
Under local law, a traveler with a stamped and approved invitation letter may also obtain a visa at the Ashgabat International Airport upon arrival in Turkmenistan; however, some travelers have reported difficulties with airlines not boarding passengers who only have approved invitation letters in lieu of a visa for onward travel to Turkmenistan.
Travelers are strongly recommended to obtain a visa before traveling.

The price for the visa will vary according to the intended length of stay.
For an additional charge, the SMS can extend a visa in Ashgabat beyond its initial validity.
Any traveler arriving without a visa or without the documents necessary to obtain a visa will be denied entry and may be held at the airport or border until the traveler has secured transportation out of Turkmenistan.
Based on past incidents, the Embassy discourages travelers from planning to use transit visas in lieu of obtaining tourist visas through a travel agency.
The U.S. Embassy in Ashgabat is unable to intervene with Turkmenistani authorities regarding the admission of private travelers to Turkmenistan.
Travelers departing Turkmenistan must have a current valid visa or they will be denied exit until they have extended the validity of the visa through their departure date.
In addition, U.S. citizens traveling in Turkmenistan should be aware that they need special permission from the SMS to travel to areas of the country that have been restricted by the Government of Turkmenistan, including almost all border areas.

Upon arrival at an airport or border entry point, foreigners will be charged approximately $12 for an immigration card issued by Turkmen authorities.
All foreigners are required to carry this immigration card for the duration of their stay in Turkmenistan.
Authorities will collect the immigration card upon departure.
Those departing Turkmenistan from the Ashgabat airport and flying with a non-Turkmenistani flagged carrier are required to pay a $25 departure fee.

In addition to the immigration requirements mentioned above, foreigners are subject to local registration requirements.
Americans who plan to stay more than three working days in Turkmenistan must register with the SMS.
SMS offices are located in all of Turkmenistan's five major cities: Ashgabat, Dashoguz, Mary, Turkmenabat and Turkmenbashy.
Foreigners who plan to travel outside of the city in which they will register must inform the SMS in advance; otherwise travelers will face fines or deportation.
One day prior to their departure from Turkmenistan foreigners must return to an SMS office to register the departure.
Foreigners should be registered and deregistered at the SMS in the city in which their sponsoring organization is located.
Foreigners who fail to register their departure may be prevented by immigration authorities from leaving the country until they have done so.
The penalties for remaining in Turkmenistan with an expired visa or for failing to register with SMS include fines, arrest, and/or deportation.
Foreigners who are deported for these violations may be prohibited from returning to Turkmenistan for up to five years.
American citizens in Turkmenistan are strongly urged to ensure that their visas do not expire and that they register with SMS upon arrival and upon departure.

Visitors holding tourist visas organized by a travel agency must stay in hotels; other visitors may stay in private accommodations whose owner must register the visitor's presence.
Visit the Embassy of Turkmenistan web site for the most current visa information.

Several popular travel guides discuss traveling by “ferry” across the Caspian Sea from Baku, Azerbaijan, to the port of Turkmenbashy in western Turkmenistan.
Some travelers have faced problems attempting to travel to Turkmenistan by boat.
Travelers should be aware that these “ferries” are in fact cargo ships that take on some passengers incidental to their primary function.
Passengers are generally not provided food or water on these ships, and sleeping and sanitary facilities are likely to be rudimentary.
Travelers should be aware that ships arriving at the port of Turkmenbashy often wait days offshore for outgoing ships to vacate the dock to allow incoming ships to disembark.
Some travelers have spent more than a week offshore while their ship awaited permission to enter the port, and they have run out of stores of food and water, or had their Turkmen visas expire before they could be used.
For this and other reasons travelers, especially those who plan to enter Turkmenistan by boat, are discouraged from using transit visas to enter Turkmenistan.

At Ashgabat International Airport, most airlines do not accept payment for tickets by credit card, or in any currency other than US dollars or Turkmen manat.
Travelers planning direct transit through Turkmenistan en route to another country should be aware that if they are stranded due to a missed connection, they will not be allowed to leave the arrival detention area until they are able to buy a ticket for an onward flight out of Turkmenistan.
For this reason, the Embassy discourages travelers from planning to directly transit through Ashgabat International Airport.

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:
Those considering travel to Turkmenistan should take the country's proximity to regions of past and current instability into account before making any plans.
The Government of Turkmenistan has designated many areas throughout the country as “restricted zones,” particularly the border areas next to Iran, Uzbekistan, and Afghanistan, the entire region of Dashoguz (including Dashoguz city), and areas of the Caspian coast.
Travel to these areas by foreigners is forbidden without special permission from the Government of Turkmenistan.
Turkmenistan Airlines, the national airline, will not sell a ticket to any traveler who intends to travel to a “restricted zone” without proof of permission from the government.
Travelers who wish to visit a “restricted zone” must have a valid passport and visa and must apply to the Ministry of Foreign Affairs for a special permit.
There is a minimum processing time of 10 working days for these permits.

Visible police and military presence in Turkmenistan is common.
Both uniformed and plainclothes officials frequently ask to see passports, visas, migration cards, and SMS registrations.
Travelers should ask to see identification if they are not certain that the person requesting the information is an official.
These documentation checks, and residence and vehicle searches, are common.
Security personnel maintain checkpoints on major roads.

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, such as government buildings, may result in problems with authorities.
Visitors should ask whether buildings may be photographed.

Supporters of extremist groups such as the Islamic Movement of Uzbekistan, Al-Qaeda, and the Eastern Turkistan Islamic Movement remain active in Central Asia.
These groups have expressed anti-U.S. sentiments and may attempt to target U.S. Government or private interests in the region, including in Turkmenistan.
Terrorists do not distinguish between official and civilian targets.
Because of increased security at official U.S. facilities, terrorists are seeking softer civilian targets such as residential areas, clubs, restaurants, places of worship, hotels, schools, outdoor recreation events, resorts, beaches, maritime facilities, and commercial aircraft.

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

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

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

CRIME:
Although the government's official policy is to report that there is no violent crime, there are incidents of assault, rape, and murder sometimes directed at foreigners.
Prostitution, heroin use, and economic conditions are all factors contributing to the incidence of violent crimes.
Petty theft is common in crowded public places such as the local bazaars.
Visitors should take appropriate measures to safeguard their passports and valuables in such areas.
Also, visitors should not leave their valuables in plain view within a parked vehicle.
Several recent cases suggest that there has been an increase in theft from parked vehicles.

Foreign visitors, including American citizens, present an attractive target for criminals.
Travelers should exercise the same common sense, good judgment, and caution as they would in any major U.S. city.
For instance, one should avoid carrying large sums of money in public.
Travelers should avoid walking alone after dark, and women specifically should avoid being alone in isolated areas.
Most taxis are not regulated by any government licensing agency and drivers are usually private citizens looking to make money.
The majority of cars will not have seat belts or other safety devices, and drivers may not have had any formal driver training.
For safety reasons, visitors should strongly consider hiring a private car and driver through their travel agency or hotel.
There is one government-owned and regulated taxi company, operating in Ashgabat, which charges a flat fee of 45,000 Old Turkmen Manat/9 Denominated Turkmen Manat (about $3.25 at the February 2009 exchange rate) for a one-way trip within Ashgabat city limits.
Its telephone number is: (993 12) 32-97-75.
If using local unregulated taxis, passengers should always negotiate fares with taxi drivers in advance, and extreme caution should be used when using taxis after dark, especially when there are other passengers in the vehicle.

Prostitution is illegal, and prostitutes have been known to accompany men to their residences or hotel rooms in order to steal from them, sometimes with the help of an accomplice.
The authorities will generally consider any woman leaving a discotheque with a foreign man late at night to be a prostitute, and on that basis, the foreigner may be detained.
In recent years, at least one foreigner was kept in jail for fifteen days on charges of soliciting prostitution.
Travelers should be aware that U.S. law provides for criminal prosecution in U.S. federal courts of American citizens who have solicited a prostitute under the age of 18 while traveling abroad.

Police can ask anyone to present identity papers at any time, but authorities are especially aggressive late at night.
Even if valid papers are presented, the police may ask for a bribe.
For this reason, those going from place to place late at night should consider using a trusted driver.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing these products back to the United States may result in forfeitures and/or fines. More information on this serious problem is available from the U.S. Department of Justice, Computer Crime & Intellectual Property Section.

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, help you 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 Turkmenistan is 03.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

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 Turkmenistan’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Turkmenistan 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.

SPECIAL CIRCUMSTANCES:
Turkmenistan has a cash-only economy.
However, several new hotels accept credit cards.
Vnesheconombank and the National Bank of Pakistan cash traveler’s checks and personal checks for a fee, although cashing a personal check is a lengthy process that could require up to two months.
Vnesheconombank also accepts Visa for cash advances, for a fee.

Although the manat is the official currency, U.S. dollars are widely accepted and are required as payment for certain goods and services.
Travelers may wish to bring sufficient U.S. currency to exchange into manat to cover expenses not payable in U.S. Dollars.
Old U.S. dollar bills (issued before 1990) and/or those in poor condition (with tears, writing or stamps) are not acceptable forms of currency in Turkmenistan.
Banks frequently do not have small bills for change.
In 2008, the government of Turkmenistan unified its dual currency exchange rate by bringing the commercial and governmental exchange rates together.
This change occurred incrementally, contributing to wild currency speculation by average citizens, many of whom keep their savings in U.S. dollars in their homes, rather than in bank accounts.
As a result, the banks, at times, have imposed limits on the amount of currency that could be exchanged by an individual on a particular day.
Travelers should check with their travel agencies to discuss options for currency exchange if a limitation should happen during their visit to Turkmenistan.

Turkmenistan customs authorities may enforce strict regulations concerning temporary importation into or export from Turkmenistan of items such as carpets, jewelry, musical instruments, pieces of art, archaeological artifacts, antiques, protected animals, etc.
It is advisable to contact the Embassy of Turkmenistan in Washington for specific information regarding customs requirements.
Travelers who wish to take carpets out of Turkmenistan must obtain a certificate from the Carpet Museum in central Ashgabat indicating that the carpet is not of historical value.
Some private shops may have carpets for sale for which they have already obtained certificates; buyers should be sure to ask about customs certificates before purchasing any carpet.
In addition, buyers may have to pay a tax calculated according to the size of the carpet.
Travelers who have purchased other items that could be perceived to be of historical value, such as jewelry, have also reported difficulties in taking these items out of Turkmenistan.
Turkmenistan's indigenous dog, the Alabay, is considered a national treasure and is banned for export without prior permission.
American citizens should also check to ensure that any item they intend to bring into the United States is permitted by U.S. customs regulations.

U.S. citizens are encouraged to carry a copy of their U.S. passports and visas with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship, are readily available.

Travelers to Turkmenistan should be aware that there are several types of poisonous snakes and insects indigenous to the country. Even in cities, it is common to encounter cobras and scorpions, especially in areas covered with tall grass.
Travelers are advised to be alert to these dangers to avoid being bitten or stung. Please see our Customs Information sheet.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Turkmenistan is limited and well below North American and Western European standards.
All visitors are strongly advised to purchase medical evacuation insurance to cover costs associated with transporting them to adequate medical facilities in the event of serious illness or injury.
Such travel can be expensive if undertaken under emergency conditions, and absent this insurance, medical evacuation travel may be logistically impossible on an emergency basis.
Travelers with medical conditions should consult their regular physician to determine whether travel to Turkmenistan is advisable in light of the level of available health care.
Resident American citizens travel to Western Europe or North America for treatment of any serious medical condition.
The U.S. Embassy maintains a list of public hospitals and English-speaking physicians in the country, however the standard of care at these hospitals cannot be considered comparable to Western standards.
Basic medical supplies, including disposable needles, anesthetics, and antibiotics are often in short supply.
Two private clinics have foreign medical practitioners (generally Turkish) who may be available for consultations and treatment; these clinics, however, have refused in some cases to admit patients with serious conditions, regardless of the patient’s ability to pay for treatment.
Even at these hospitals, the standard of care is low compared to Western standards.
Travelers requiring prescription medications should bring sufficient supplies of all necessary medications and appropriate documentation to ensure no problems with customs officials upon arrival.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Turkmenistan.
Currently, HIV tests are not required for applicants requesting tourist visas; however, should an individual be discovered to be HIV positive, that status would be grounds for denial of a visa or deportation.
All individuals requesting residence visas are required to submit to an HIV test.
Please verify this information with the Embassy of Turkmenistan before you travel.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Turkmenistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road conditions in Turkmenistan make driving difficult and sometimes dangerous.
Most roads outside of major cities are narrow, riddled with potholes, unlit at night, and without proper road signs.
Driving at night on these roads should be avoided.
City roads are better in comparison to rural routes but may be hazardous due to potholes, uncovered manholes, poor lighting, and heavy pedestrian traffic.
Pedestrians frequently cross against traffic and create dangerous conditions.
Traffic accidents involving serious injury to drivers, passengers, and pedestrians are common.

In general, visitors should use caution when driving in Turkmenistan.
Drivers pay little attention to lanes and other road markings, with weaving and sudden lane changes a common occurrence (usually without use of a turn signal).
Drivers will often encounter cars going the wrong way on one-way streets or divided highways.
Cars also frequently make left-turns from the right lane and vice-versa.
Pedestrians regularly walk or stand in the middle of busy streets during the day and night, often without paying attention to oncoming traffic.

Roadside assistance does not exist in Turkmenistan, where vast stretches of highway are often unmarked.
Police checkpoints (where cars are required to stop and register) are a common feature on major routes between cities.
The U.S. Embassy in Ashgabat has received reports that police stationed at checkpoints may arbitrarily fine motorists.
Local law requires that traffic fines be paid within 12 hours.
If a fine is not paid within that period, the amount may double every 12 hours up to 72 hours, after which time the vehicle in question may be seized.

Travelers who wish to drive in Turkmenistan must have a valid international driving permit.
Foreigners who plan to reside in Turkmenistan must apply for a local driver's license with the Road Police Department of the Ministry of Internal Affairs of Turkmenistan.
American citizens who want more specific information about driving in Turkmenistan should contact the Embassy of Turkmenistan at 2207 Massachusetts Ave. NW, Washington DC
20008, telephone (202) 588-1500.
Please refer to our Road Safety page for more information.
For specific information concerning Turkmenistan driving permits, vehicle inspection, road tax and mandatory insurance, contact the Turkmenistan National Tourist Organization offices at its Permanent Mission in New York.
The address is: 136 East 67th Street, NY, NY 10021.
The phone number is 1-212-472-5921.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Turkmenistan, the U.S. Federal Aviation Administration (FAA) has not assessed Turkmenistan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.

Travelers may experience significant delays, unexpected re-routing, and sudden cancellations of flights, including those of Turkmenistan Airlines (Turkmenhowayollary), the national airline.
Travelers have reported difficulties securing reservations and purchasing tickets from Turkmenistan Airlines on both domestic and international flights, which are routinely overbooked.

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 Turkmenistan are encouraged to register with the U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Turkmenistan.
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 9 1984 (Pushkin Street), off Magtymguly Street, tel. (993-12) 35-00-45; fax (993-12) 39-26-14.
The Consular Section can also be contacted by e-mail.
The Consular Section is open for American Citizens services every Monday through Friday afternoon, excepting holidays.
American Citizens are requested to call for an appointment for services except in cases of emergency.
*

*

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This replaces the Country Specific Information for Turkmenistan dated September 2, 2008 without substantive changes.

Travel News Headlines WORLD NEWS

Date: Fri, 9 Sep 2016 19:53:02 +0200

Avaza, Turkmenistan, Sept 9, 2016 (AFP) - Turkmenistan strongman President Gurbanguly Berdymukhamedov on Friday opened a giant five-star hotel worth over $100 million, shaped like a cruise ship, at the country's main Caspian Sea resort.   The 13-floor, 350-room hotel is the biggest in Turkmenistan's Avaza tourist zone, which the government is trying to promote despite an incredibly restrictive visa regime for foreigners.

"The purpose of this resort is to create the best conditions for interesting recreation time for the Turkmen people," Berdymukhamedov said of Avaza, adding that the hotel was called "Gami", or "Boat" to symbolise "the boat of our friendship."    "And since we are on a boat, we will be having nautical pasta -- a cheap Soviet pasta dish with minced pork and beef -- for lunch," he joked, before the dish was served to officials, diplomats and journalists at the ceremonial lunch.   The Central Asian country's leader, 59, also quoted a nautically-themed poem by Russian wordsmith Mikhail Lermontov.   The 90-metre by 200 metre (300 by 650 feet) white marble-clad hotel was built to echo a "snow-white ocean ship" a representative of the state company that ordered it built, told AFP.

A giant portrait of Berdymukhamedov spanned three floors of the building as dancers performed in front of it.   The hotel was built by the Turkish construction and logistics firm Ekol.   Hydrocarbon-rich Turkmenistan's secretive government has a reputation for lavish spending on frivolous architectural projects, even in times of economic crisis.   The country devalued its manat currency by around twenty percent in early 2015 under pressure from low prices for hydrocarbons, which account for practically all of the country's exports.

On the black market the currency's value can fetch up to 6 manats to the dollar against an official rate of 3.5 to the dollar, down from 2.8 to the dollar in 2014.    Despite Berdymukhamedov officially encouraging belt-tightening, the country has continued to spend heavily on infrastructure ahead of the 2017 Asian Indoor and Martial Arts Games it will host in the capital Ashgabat.

In 2013 Ashgabat earned a Guinness World Record as the city with the highest density of white marble-clad buildings.    "If the marble was laid out flat, there would be one square metre of marble for every 4.87 m³ of land," Guinness said at the time.   The city also hosts a golden statue of Berdymukhamedov and a similar statue of predecessor Saparmurat Niyazov, which once rotated with the movements of the sun.
Date: Wed, 6 Apr 2016 16:21:20 +0200

Ashgabat, Turkmenistan, April 6, 2016 (AFP) - Turkmenistan has passed a law making HIV tests mandatory prior to marriage, state media reported on Wednesday, in a sign the reclusive Central Asian state fears the spread of a disease it has always downplayed.    The law is the closest the highly secretive state of 5 million has come to acknowledging a public health threat from the disease which is prevalent throughout the former Soviet Union.

The law, which aims to "create conditions for healthy families and prevent the birth of HIV-infected children" was published in the state newspaper on Wednesday and is effective immediately.    An official from the country's national AIDS Center, speaking on condition of anonymity, told AFP that the new law was "very necessary" given the "high risk" of the spread of the virus.   The official cited use of intravenous drugs, mostly sourced from neighbouring Afghanistan, and prostitution as the main means of transmission.

Other than "persons entering marriage", the legislation also enforces HIV tests for blood donors, "persons suspected of narcotics use", prisoners, citizens of foreign countries applying for work visas and stateless persons.    According to the law signed by President Gurbanguly Berdymukhamedov, the government will guarantee anonymity and free treatment for sufferers of the disease.

Turkmenistan, which remains largely closed to the outside world, has always downplayed the prevalence of HIV, a disease that attacks the human immune system and is transmitted from person to person via bodily fluids.   In 2002, the health ministry, which does not publish data on infectious diseases, claimed the country had only two cases of HIV and that both patients had been infected outside Turkmenistan.
Date: Tue, 21 Jul 2015 17:03:00 +0200 (METDST)

Ashgabat, Turkmenistan, July 21, 2015 (AFP) - Health-obsessed former Soviet Turkmenistan is the country with the world's lowest proportion of smokers, World Health Organisation chief Margaret Chan said during a visit to the isolated nation on Tuesday.    Chan said that  just 8 percent of the population smoked, according to WHO figures.   "Recently a WHO overview showed that in Turkmenistan only 8 percent of the population smokes," Chan told the country's authoritarian President Gurbanguly Berdymukhamedov, who is a dentist by training.   "This is the lowest national indicator in the world. I congratulate you on this achievement," she said at a health forum in the capital Ashgabat.

Cited by state media, Chan noted that the country ratified the Framework Convention on Tobacco Control in 2011 by which time it had already banned smoking in public places.   Also speaking at the forum, Vera Luiza da Costa e Silva, Head of the Convention Secretariat, challenged the Central Asian state to drive smoking down to five per cent of the population in the coming years.   In 1990, 27 percent of Turkmen males over 15 and 1 percent of females smoked.

A decade later Turkmenistan banned smoking in public places, state buildings and the army, as well as all forms of tobacco advertising.   By comparison, 31.1 percent of the global male population over the age of 15 smoked in 2012, while 6.2 percent of females were smokers.   President Berdymukhamedov, in power since the death of eccentric predecessor Saparmurat Niyazov in 2006, is a keen equestrian, while Niyazov campaigned against smoking and built a 36-kilometre "path of health" into the mountains surrounding Ashgabat which government officials were forced to walk.   This April the gas-rich country of more than five million held a month of public exercises and sporting events under the slogan "health and happiness."
Date: Wed, 1 Jul 2015 17:54:35 +0200 (METDST)

Ashgabat, Turkmenistan, July 1, 2015 (AFP) - Turkmenistan reported its hottest June on record Wednesday, as a heat wave envelops former Soviet Central Asia.   "June 2015 was the hottest June since 1891 when records began. Daytime temperatures exceeded 40 degrees Celsius in the shade 16 times," a spokeswoman at Turkmenistan's state meteorological service in the capital Ashgabat told AFP Wednesday.   She noted that Tuesday, when temperatures reached 47.2 degrees Celsius, was the hottest June day in Ashgabat in the recorded history of the energy-rich country.   Many Muslims fasting for the Ramadan holy month in the secluded Caspian state have taken time off work and are shutting themselves away in air conditioned rooms, one observant Muslim who did not wish to be named told AFP.

In Kazakhstan temperatures, while set to vary in the coming week, remain very high in the southern regions of the country.   "In the afternoon the streets are empty," said Shafarat Sataeva, 72, from the southern region of Kyzylorda, where temperatures reached 42 degrees Celsius in the shade on Wednesday, the highest anywhere in the country.   In Tajikistan over 50 people including three Russian soldiers stationed at Russia's military base in the country drowned in mountain rivers and lakes as they sought to cool themselves.   The country's meteorological service said temperatures are expected to pass 40 degrees Celsius in the capital Dushanbe and warned of mudflows from high levels of glacial melt in the mountainous country.
Date: Tue, 15 Jul 2014 05:22:34 +0200 (METDST)
by Igor Sasin

AVAZA, Turkmenistan, July 15, 2014 (AFP) - Better known for its inhospitable desert plains than beach breaks, isolated ex-Soviet Turkmenistan this month welcomed an unlikely group of visitors: a sun-tanned crop of the world's top windsurfers.   Bordering Iran and Afghanistan, the energy-rich Central Asian country played host to a leg of the windsurfing World Cup at a sparkling new Caspian Sea resort that authorities hope can turn the once hermit state into a water sports hub.

International competitors bobbed and weaved through the foaming surf as their sails glistened in the sweltering heat -- an unfamiliar sight in a nation that until 2006 was cut off from the rest of the world by the eccentric two-decade rule of former dictator Saparmurat Niyazov.   "This is such a chance for me!" said a joyous Orazmyrat Arnamammedov, one of only a handful of windsurfers in Turkmenistan.   "It's happiness for me to take part in a competition with sportsmen who are known around the world," the 32-year-old sports instructor told AFP.

Turkmenistan is on a drive to promote itself as a destination for sports, adventure travel and even beach holidays in a bid to boost tourist numbers from the current 15,000 visitors per year.   "Holding world-class windsurfing competitions will be a significant step, taking Turkmenistan to a new level," President Gurbanguly Berdymukhamedov said at the opening of the Turkmenistan PWA World Cup windsurfing event.

Turkmen officials said holding sporting championships is part of the government's plan to develop tourism.   Next year the country will host the world championship in belt wrestling -- a traditional form of the sport -- in November and the 2017 5th Asian Indoor-Martial Arts Games.   "Sports and travel are the new trend for international tourism in Turkmenistan," said an official in the state tourism committee who asked not to be named.

- Resort rising from desert -
The sprawling Caspian Sea town of Avaza, which hosted the windsurfing competition from its 16 kilometres of beach, is a key part of that plan.    By 2020 Ashgabat hopes to transform the desert resort, whose name means "singing wave" in Turkmen, into a vast complex that can compete with Turkey's huge southwestern sea resort of Antalya.   "Avaza has every chance of becoming a major attraction for tourists, both from neighbouring countries and also from overseas," Berdymukhamedov said recently.   "In this part of the Caspian, the water is exceptionally clean and there are good beaches and a mild climate."   Since work started in 2007, six hotels and other accommodation for some 7,000 visitors has been built by mainly Turkish firms at a cost of around $2 billion (1.5 billion euros). 

But the resort -- where US pop star Jennifer Lopez was jetted in to perform last summer -- is set to grow into a vast complex with at least 60 hotels, as well as sanatoriums, rest homes, cottages and camp sites, that the the state tourism committee boasts will be "up to world standards".   An artificial river runs through the town and a new airport has been opened in the nearby city of Turkmenbashi.    A winter sports stadium with an ice rink and a 2,000 seat Palace of Congress are also in the pipeline, with the total price tag for the development expected to hit $7 billion.

- 'Why go to Avaza?' -
But some locals are not convinced that the Turkmen resort can bring in the crowds.   A week's package holiday for international visitors costs around $1,500, said Mukhamet Begliyev, who works at a private travel agency.   "Even if someone rich enough turns up, what do we have to offer except the sea and the hotels? The entertainment sphere isn't developed at Avaza at the moment," Begliyev said.   The "international" airport in Turkmenbashi so far only accepts domestic flights and getting a visa to the country is still a major hurdle.

For the moment that means the resort is largely attracting domestic holidaymakers, although Turkmenistan's low wages mean it is beyond the means of many.    For 28-year-old Gozel Akhundova from Dashoguz, a city in the country's north, even a brief stay in an Avaza hotel at $70 a night was an expensive treat.   "We'll only spend three days here. If it was cheaper, we'd stay longer," she said.   And the fledgling resort still has a long way to go to compete with more established holiday spots.     "Why should I go to Avaza, when there is Antalya?" asked Akhmet, a 22-year-old student in Ashgabat who said he planned to holiday in Turkey this summer.   "The service is good, there's plenty of fun activities and it's cheap," he said.
More ...

World Travel News Headlines

Date: Tue, 10 Dec 2019 10:50:09 +0100 (MET)

Sydney, Dec 10, 2019 (AFP) - The death toll from New Zealand's White Island volcano eruption rose to six late Tuesday, after an injured person died in an Auckland hospital, police said.   "Police can confirm a further person has died following the eruption on Whakaari/White Island, bringing the official toll to six," a police statement said.   Eight more people who remain missing are presumed dead after the volcano erupted Monday.
Date: Tue, 10 Dec 2019 09:27:57 +0100 (MET)
By Andrew BEATTY, with Daniel de Carteret in Gosford

Sydney, Dec 10, 2019 (AFP) - Toxic haze blanketed Sydney Tuesday triggering a chorus of smoke alarms to ring across the city and forcing school children inside, as "severe" weather conditions fuelled deadly bush blazes along Australia's east coast.   Fire engines raced office-to-office in the city centre with sirens blaring, as inland bushfires poured smoke laden with toxic particles into commercial buildings.   Emergency services responded to an "unprecedented" 500 automatic call-outs inside a few hours according to New South Wales Fire and Rescue's Roger Mentha.

A regional fire headquarters miles from the nearest blazes was itself evacuated while throngs of mask-wearing commuters choked their way through thick acrid air and the organisers of a harbour yacht race declared it was unsafe to proceed.   "The smoke from all the fires is just so severe here on the harbour that you just can't see anything, so it's just too dangerous," said spokeswoman Di Pearson of an event that normally foreshadows the famed Sydney-Hobart yacht race. "The vision is just so poor."   Some of the city's commuter ferries were also cancelled "due to thick smoke" and school kids were kept inside at breaktime and sent home early as pollution levels soared far above "hazardous" levels.

For weeks the east of the country has been smothered in smoke as drought and climate-fuelled bushfires have burned. But the scale of the problem on Tuesday shocked even hardened residents.   Bruce Baker -- an 82-year-old who lives in Gosford, north of Sydney -- said he was skipping his daily morning walk because of the smoke.   "This is the worst it's been, for sure," he told AFP. "It dries your throat. Even if you're not asthmatic, you feel it."   Authorities recommended that the vulnerable cease outdoor activity altogether and that everyone stay inside as much as possible, although one couple braved the toxic air to get married on the waterfront in front of Sydney Harbour Bridge shrouded in smog.

A cricket match between New South Wales and Queensland also went ahead, despite a barely visible ball.   Tuesday had been expected to bring strong winds and high temperatures that made for "severe conditions where embers can be blown ahead of the fire into suburbs and threaten properties."   But New South Wales Rural Fire Service said "deteriorating fire conditions have been delayed by a thick blanket of smoke" over the east of the state.   As the day developed there were nearly 100 bushfire incidents in the state of New South Wales alone and dozens more in Queensland.   Total fire bans were put in place across much of the east of the country and in large parts of western Australia.   Temperatures in some inland areas eased past 44 degrees Celsius (111 Fahrenheit).

- The 'big dry' -
To the northwest of Sydney, several fires already burning for weeks have combined to create a "megafire" that has already destroyed 319,000 hectares (788,000 acres) of land, mostly inside national parks.   Prime Minister Scott Morrison  -- who for weeks has not commented on the smoke haze -- defended his government's handling of the fires and said there were no plans to professionalise the countryside's largely volunteer force.    "Our policy is sensible when it comes to addressing and taking action on climate change. Our actions on climate change are getting the results they're intended to get," he said.   Morrison's conservative coalition has been criticised by former fire chiefs for failing to heed warnings about climate change.   The crisis has been propelled by a prolonged drought that has made vegetation tinder dry.

The Bureau of Meteorology has reported that Australia experienced its driest November on record this year.   The "big dry" has left farmers desperate and small towns facing the prospect of running out of water completely.   A swathe of the east of the country has seen "rainfall deficiencies" since early 2017 -- almost three years.   Many dams in New South Wales are empty and almost all are well below capacity.   Firefighters south of Brisbane recently reported 1,000 litres of water were stolen from tanks at their station.   Amid the shortage, Tuesday also saw the toughest water restrictions in a decade being introduced for Sydney -- with curbs on everything from hosepipe use to washing cars.
Date: Tue, 10 Dec 2019 03:09:17 +0100 (MET)
By Allison JACKSON

Sao Paulo, Dec 10, 2019 (AFP) - Gripping the deadly snake behind its jaws, Fabiola de Souza massages its venom glands to squeeze out drops that will save lives around Brazil where thousands of people are bitten every year.   De Souza and her colleagues at the Butantan Institute in Sao Paulo harvest the toxin from hundreds of snakes kept in captivity to produce antivenom.    It is distributed by the health ministry to medical facilities across the country.

Dozens of poisonous snake species, including the jararaca, thrive in Brazil's hot and humid climate.    Nearly 29,000 people were bitten in 2018 and more than 100 died, official figures show.   States with the highest rates of snakebite were in the vast and remote Amazon basin where it can take hours to reach a hospital stocked with antivenom.   Venom is extracted from each snake once a month in a delicate and potentially dangerous process.

Using a hooked stick, de Souza carefully lifts one of the slithering creatures out of its plastic box and maneuvers it into a drum of carbon dioxide.    Within minutes the reptile is asleep.    "It's less stress for the animal," de Souza explains.    The snake is then placed on a stainless steel bench in the room where the temperature hovers around 27 degrees Celsius (80 degrees Fahrenheit).    De Souza has a few minutes to safely extract venom before the snake begins to stir.      "It's important to have fear because when people have fear they are careful," she says.

- Antivenom 'crisis' -
The snakes are fed a diet of rats and mice that are raised at the leafy institute and killed before being served up once a month.   After milking the snake, de Souza records its weight and length before placing it back in its container.    The antivenom is made by injecting small amounts of the poison into horses -- kept by Butantan on a farm -- to trigger an immune response that produces toxin-attacking antibodies.

Blood is later extracted from the hoofed animals and the antibodies harvested to create a serum that will be administered to snakebite victims who might otherwise die.   Butantan project manager Fan Hui Wen, a Brazilian, says the institute currently makes all of the country's antivenom -- around 250,000 10-15 millilitre vials per year.

Brazil also donates small quantities of antivenom to several countries in Latin America.    There are now plans to sell the life-saving serum abroad to help relieve a global shortage, particularly in Africa.    About 5.4 million people are estimated to be bitten by snakes every year, according to the World Health Organization (WHO). 

Between 81,000 and 138,000 die, while many more suffer amputations and other permanent disabilities as a result of the toxin.   To cut the number of deaths and injuries, WHO unveiled a plan earlier this year that includes boosting production of quality antivenoms.   Brazil is part of the strategy. It could begin to export antivenom as early as next year, Wen says.   "There is interest for Butantan to also supply other countries due to the global crisis of antivenom production," she says.
Date: Mon, 9 Dec 2019 14:14:15 +0100 (MET)

Dec 9, 2019 (AFP) - New Zealand, struck by a deadly volcanic eruption Monday, lies in a zone where Earth's tectonic plates collide, making it a hotspot for earthquakes and volcanic activity.   In one of its worst natural disasters, a huge mass of volcanic debris from the eruption of Mount Ruapehu triggered a mudslide in 1953 that washed away a bridge and caused a passenger train to plunge into a river with the loss of 151 lives.  After Monday's eruption on New Zealand's White Island, here is a recap of some of the deadliest volcanic eruptions around the world in the past 25 years.

- 2018: Indonesia -
In December the Anak Krakatoa volcano, a small island in the Sunda Strait between Java and Sumatra, erupts and a section of its crater collapses, sliding into the ocean and generating a tsunami. More than 420 people are killed and 7,200 wounded.

- 2018: Guatemala -
The June eruption of the Fuego volcano, about 35 kilometres (22 miles) from the capital, unleashes a torrent of mud and ash that wipes the village of San Miguel Los Lotes from the map. More than 200 people are killed.

- 2014: Japan -
The sudden eruption in September of Mount Ontake, in the central Nagano region, kills more than 60 people in Japan's worst volcanic disaster in nearly 90 years. The mountain is packed with hikers at the time. In 1991 an eruption of the southwestern Unzen volcano kills 43.

- 2014: Indonesia -
At least 16 people are killed on the island of Sumatra in February by a spectacular eruption of Mount Sinabung, which had lain dormant for 400 years before roaring back to life five months earlier. In 2016 villages are scorched and farmland devastated after another eruption kills seven.

- 2010: Indonesia -
Indonesia's most active volcano, Mount Merapi on Java island, starts a series of explosions in October, eventually killing more than 320 people. An 1930 eruption of the volcano killed 1,300 people and one in 1994 claimed more than 60 lives.

- 2002: DR Congo -
The eruption in July of Mount Nyiragongo in the eastern Democratic Republic of Congo destroys the centre of Goma town, along with several residential areas, and kills more than 100 people.

- 1997: Montserrat -
The capital of the small British colony, Plymouth, is wiped off the map and 20 are killed or left missing in avalanches of hot rock and ash clouds when its volcano erupts in June.

- 1995: The Philippines -
At least 70 are killed and another 30 missing after the crater of the Parker volcano in the south of the island of Mindanao collapses. Five years earlier the eruption of Mount Pinatubo, 80 kilometres north of the capital Manila, kills more than 800 people.

- Worst ever -
The explosion of Indonesia's Krakatoa volcano in 1883 is considered the worst ever seen. The eruption sent a jet of ash, stones and smoke shooting more than 20 kilometres (12 miles) into the sky, plunging the region into darkness, and sparking a huge tsunami that was felt around the world. The disaster killed more than 36,000 people.

The most famous eruption in history is that of Mount Vesuvius in modern-day Italy in 79 AD, which destroyed the towns of Herculaneum, Stabiae and Pompeii, wiping out an estimated 10 percent of the population of the three cities.
Date: Mon 9 Dec 2019
Source: Fox 29 Philadelphia [edited]

A total of 31 people have been sickened by salmonellosis at 4 health care facilities in south-eastern Pennsylvania. A majority of those cases occurred after individuals ate pre-cut fruit from New Jersey-based Tailor Cut Produce. The Food and Drug Administration (FDA) announced the salmonellosis outbreak in conjunction with the Pennsylvania Department of Health (DOH) on [Fri 6 Dec 2019]. The North Brunswick distributor has recalled its fruit mix with cantaloupe, honeydew, pineapple and grapes as a result.

Tailor Cut Produce reports that its products may be found in restaurants, banquet facilities, hotels, schools and institutional food service establishments in Pennsylvania, New Jersey and New York. "We recommend that any facility who use Tailor Cut Produce pre-cut fruit to immediately stop and throw it away," Pennsylvania Secretary of Health Dr. Rachel Levine said.

Salmonellosis is an infection caused by _Salmonella_ bacteria that generally affects the intestinal tract. People usually become infected by either eating or drinking contaminated food or water, by contact with infected people or animals, or through contact with contaminated environmental sources.
Date: Mon 9 Dec 2019
Source: Sixth Tone [edited]

Dozens of researchers in northwestern China's Gansu province have been infected with brucellosis, an animal-borne disease that causes flu-like symptoms and, potentially, lingering problems. In a statement [Fri 6 Dec 2019], the Lanzhou Veterinary Research Institute, an affiliated institute of the Chinese Academy of Agricultural Sciences, said that the 1st few grad students from the institute's foot-and-mouth disease prevention team tested positive for brucellosis antibodies on [28 Nov 2019]. The labs affected have been closed, the institute said, and national and local health authorities have assembled a team to investigate the outbreak.

Li Hui, an official at the health commission in Lanzhou, the provincial capital, told Sixth Tone on [Mon 9 Dec 2019] that the total number of brucellosis cases at the institute had climbed to 96. None have shown clinical symptoms, according to domestic media, and it remains unclear how they were exposed to the bacteria.

Brucellosis -- also known as Malta, Mediterranean, or undulant fever -- is a zoonotic disease that mainly affects animals, including livestock and dogs, which can in turn transmit the bacteria to humans through direct contact. Symptoms include fever, chills, sweating, lethargy, and aches and pains, according to the WHO. In the absence of early diagnosis and treatment, brucellosis can become a chronic condition that is difficult to cure.

In China, brucellosis is a Class B disease, ranking below a more serious category that includes cholera and plague. Human-to-human transmission has only been known to occur between lactating mothers and their babies. According to state broadcaster China National Radio, the brucellosis outbreak at the Gansu veterinary institute has prompted health checks among local students and staff who fear that they may have come into contact with infected animals.

One of the last brucellosis outbreaks in China occurred in 2011, when an agricultural university in the northeastern Heilongjiang province reported 28 cases stemming from infected goats being used in lab research. The school publicly apologized, fired 2 administrators, and offered each of the students' affected monetary compensation.

Scientific labs are subject to different experimental standards depending on their biosafety level, according to a researcher surnamed Yang at the Shanghai Institutes for Biological Sciences, an affiliate of the Chinese Academy of Sciences.

"If the protection levels don't keep pace (with biosafety levels), there will be a risk of infection," Yang, who studies viruses and works in a Biosafety Level 2+ lab, told Sixth Tone. As a result, labs generally require researchers to undergo safety training or even pass an exam to earn a certification, said Yang, who only used her surname because she was not authorized by her employer to speak to media.

The Lanzhou Veterinary Research Institute describes itself as "China's only authorized research center for working with the live virus that causes foot-and-mouth disease," a highly contagious disease affecting livestock. The institute is reportedly also one of the few in China with Biosafety Level 3 labs, which are required for _brucella_ pathogen studies, according to the National Health Commission.

As the local agriculture department tries to ascertain the source of the recent infections, Lanzhou's health commission said [Fri 6 Dec 2019], it is implementing precautionary measures so that brucellosis does not pose a threat to neighbouring communities. [Byline: Yuan Ye]
=================
[An earlier report suggested that 4 persons were clinically ill but this is not confirmed here.  Brucellosis (<http://www.medicinenet.com/brucellosis/article.htm>) is a disease that is thought to have existed since ancient times, as it was 1st described more than 2000 years ago by the Romans and Hippocrates. It was not until 1887 that a British physician, Dr. David Bruce, isolated the organism that causes brucellosis from several deceased patients from the island of Malta. This disease has had several names throughout its history, including Mediterranean fever, Malta fever, Crimean fever, Bang's disease, and undulant fever (because of the relapsing nature of the fever associated with the disease).

The symptoms and signs of brucellosis may develop from days to months after the initial exposure to the organism. While some individuals may develop mild symptoms, others may go on to develop long-term chronic symptoms. The signs and symptoms of brucellosis are extensive, and they can be similar to many other febrile illnesses, so recognition of potential exposure -- from ingestion of unpasteurized milk or cheese, employment as a veterinarian or veterinary student, in a slaughter house or meat processing plant, or working in a microbiology lab -- is vital. In this outbreak, it is not clear what symptoms the students had or whether they were just seropositive. ProMED would like more information about this episode. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Gansu Province, China: <http://healthmap.org/promed/p/333>]
Date: Tue 3 Dec 2019
Source: Outbreak News Today [edited]

In late November [2019], Uganda health authorities notified the World Health Organization of a fatal Rift Valley fever (RVF) case from Obongi district.  The case was a 35-year-old man from South Sudan who was living in the Palorinya Refugee camp in Obongi district, Uganda. The case had travel history to South Sudan between 12 and 19 Nov 2019 to harvest cassava. While in his home country, he developed fever and other symptoms and was treated for malaria; however, his condition got worse.  He later returned to the refugee camp in Uganda and his symptoms progressed and he was hospitalized. Viral hemorrhagic fever was suspected. Samples were collected and sent to the Uganda Virus Research Institute; however, the patient died. A safe and dignified burial was performed on 22 Nov 2019. As of 24 Nov 2019, a total of 19 contacts were recorded during the active case search including 10 healthcare workers.
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[The circumstances and specific location under which the man became infected with Rift Valley fever (RVF) virus in South Sudan is not mentioned. It is worth noting that there was an RVF outbreak in the Eastern Lakes region of South Sudan during the 1st 3 months of last year (2018). At the end of that outbreak, the OIE's follow-up report no. 3 reported: "The event cannot be considered resolved, but the situation is sufficiently stable. No more follow-up reports will be sent. Information about this disease will be included in the next 6-monthly reports."

There were more human cases than animal ones in that outbreak, prompting Mod.AS to comment: "Unfortunately, during the recent South Sudan RVF event, as in most -- if not all -- previous RVF events in other African countries, humans served as sentinels. Improved surveillance in animals is desperately needed in Africa, to allow timely measures applied, predominantly preventive vaccination, before the development of a full-blown epizootic involving secondary infection in humans." Intensified surveillance is needed in South Sudan in those localities where the affected man had been prior to his return to Uganda.

It is likely that RVF virus has persisted in this area in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods of time and hatch when flooded during future rain events, with the subsequent emergence of infected females ready to transmit the virus. This risk provides justification for maintaining livestock of the area well vaccinated into the future. This may have accounted for the reappearance of RVF in South Sudan in 2018, after nearly 2 years without additional reported cases in humans or livestock and again with this human case in 2019. - ProMED Mod.TY]

Obongi district, Uganda is located approximately 50 km (30 mi) from the South Sudan border.
HealthMap/ProMED-mail maps:

According to OIE's data, a total of 2 outbreaks of RVF affecting animals have been reported from Sudan during the event. The 1st outbreak started in the Arabaata dam area, Red Sea state, on 25 Sep 2019, affecting goats. The 2nd (and, so far, last) outbreak started 10 Oct 2019 in the River Nile state, affecting sheep and goats. Both outbreaks have been declared as 'resolved' on 14 Nov 2019.

Outbreak summary:
Total outbreaks = 2 (Submitted)
Species / Susceptible / Cases / Deaths / Killed and disposed of / Slaughtered
Goats / 1700 / 37 / 7 / 0 / 0
Sheep / 1550 / 37 / 5 / 0 / 0

According to the recent (5 Dec 2019) OCHA (UN Office for the Coordination of Humanitarian Affairs) update, the (human) RVF situation in Sudan, as of 26 Oct 2019, was the following: "a total of 345 suspected RVF cases -- including 11 related deaths -- reported in the states of Red Sea (128), River Nile (212), Khartoum (1), White Nile (1), Kassala (2), and Gedaref (1). The most affected age group is 15 to 45 years, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5 per cent). RVF is endemic in Sudan and 3 outbreaks affecting people have been documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths."

Egypt suffered its 1st RVF outbreak in 1977/78 with serious human disease and death as well as severe losses in livestock; several additional events have been recorded since. A recent historical review paper [1] concluded: "due to the availability and abundance of the potential vectors, the suitability of environmental conditions, continuous importation of livestock's from Sudan, and the close association of susceptible domestic animals with humans, the RVF virus could possibly occur and circulate in Egypt."   (https://tinyurl.com/whz3pz5)

Reference
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1. Kenawy MA, Abdel-Hamid YM, Beier JC. Rift Valley fever in Egypt and other African countries: Historical review, recent outbreaks, and possibility of disease occurrence in Egypt. Acta Trop. 2018; 181: 40-49; <https://doi.org/10.1016/j.actatropica.2018.01.015>  - ProMED Mods.AS/TY]
Date: Fri 6 Dec 2019 5:53 PM MST
Source: CTV News [edited]

A syphilis outbreak is worsening in Alberta [Canada], and the majority of new cases are in the Edmonton zone. Edmonton saw 1186 of the 1753 infectious syphilis [primary, secondary and early latent syphilis] cases reported in Alberta in 2019, a total of 68 per cent.

Alberta Health Services [AHS] declared an outbreak in July 2019, saying cases had 'increased dramatically' in the province since 2014. The number increased again in July [2019]  [<https://edmonton.ctvnews.ca/alberta-declares-province-wide-syphilis-outbreak-1.4510737>].

AHS sent a new public health alert to doctors on [27 Nov 2019], asking for their help to control the outbreak [<https://www.albertahealthservices.ca/assets/info/hp/phys/if-hp-phys-moh-ez-syphilis-outbreak.pdf>]. "It's very significant," said Dr Ameeta Singh, a clinical professor in infectious diseases. "That's an alarming rise in new syphilis cases in Alberta." She said it's the highest number of cases the province has seen since the 1940s.

According to Dr Singh, the increase in cases being reported is partially due to a greater number of people getting tested. "We know more people are coming in to get tested, but if we look a bit closer at the data we have, we do see there's, in fact, a [bigger] rise in the number of cases than we would expect to see," said Singh.

Another factor could be the rise in methamphetamine use in Edmonton. "I believe this is a major factor. Meth also stimulates risky sexual behaviour and increases the chance people will engage in multiple, usually casual or anonymous partners as well and not use precautions such as condoms to protect themselves during sex," she said.

What's also alarming, Singh said, is the spike in cases of congenital syphilis, where the disease is passed on to newborns. According to AHS, there have been 38 cases of congenital syphilis in 2019, 31 of which were in the Edmonton area. That accounts for more than half of the 61 cases of congenital syphilis reported since 2014.

"Those are not numbers we should be talking about in Canada ever...in a country that has universal access to health care, in a major city in Canada where syphilis testing is offered to all pregnant women who access prenatal care," she said. "What we're seeing with the congenital syphilis cases is many of the women are not accessing prenatal care until they come into the hospital to deliver and then the tests are being done."
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[A recent ProMED-mail post (Syphilis - Canada (04): (AB) RFI http://promedmail.org/post/20190718.6574300) reported a rise in "infectious syphilis" cases over a 4-year period: from 2014 to 2018 but made no mentioned of contributing factors. As illicit drug use has been cited as a contributing factor to recent increases in syphilis cases in the Canadian provinces of Ontario and Manitoba, I questioned in this prior ProMED-mail post if use of illicit drugs, in particular, methamphetamine, could similarly be contributing to the rise of syphilis cases in Alberta. The news article above reports that the rise in methamphetamine use in Edmonton, as well as increased testing for syphilis, are thought to be contributing factors in Alberta.

Methamphetamine can be swallowed, snorted, smoked or injected by needle and syringe

When methamphetamine is injected, transmission of syphilis may occur as a consequence of sharing a needle/syringe contaminated with infected blood from somebody who has primary or secondary syphilis (<https://ucsdnews.ucsd.edu/archive/newsrel/health/04-28TransmissionSyphilis.asp>); but syphilis can also be acquired by direct contact with an infected lesion during oral, vaginal, or anal sex when the drug is taken by any route of administration. Methamphetamine use is associated with sexual behaviors that increase the risk for acquiring syphilis and other sexually transmitted diseases, including having multiple sex partners, inconsistent condom use, and exchange of sex for drugs or money (<https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a4.htm>).

The linkage of methamphetamine use and syphilis transmission is reminiscent of the increase in syphilis among heterosexuals during the crack cocaine epidemic of the 1980s and 1990s, when the practice of trading sex with multiple partners for drugs, especially crack cocaine, played a major role in the transmission of syphilis. Under these circumstances, the identities of sex partners are often unknown, which weakens the traditional syphilis-control strategy of partner notification.

Bacteremia due to _Treponema pallidum_, the cause of syphilis, which occurs during primary, secondary, and latent syphilis, can result in transplacental transmission of this organism to the fetus during pregnancy and cause congenital syphilis. An increase in the incidence of syphilis in women in the population is commonly accompanied by increasing rates of congenital syphilis.

Edmonton, with a population of 932 546 residents in 2016, is the capital of the Canadian province of Alberta
(<https://en.wikipedia.org/wiki/Edmonton>).

A map showing the location of Edmonton can be found at
<https://goo.gl/maps/Rfq6XC2vvwi19ypb6>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Alberta, Canada:
9 December 2019
https://www.who.int/bangladesh/news/detail/09-12-2019-cholera-vaccination-campaign-launched-to-protect-635-000-people-in-cox-s-bazar

Cox’s Bazar, Bangladesh
Over 635,000 Rohingya refugees and Bangladeshi host community will be vaccinated against cholera in a 3-week-long campaign beginning today at the refugee camps in Cox’s Bazar and nearby areas, to protect vulnerable population against the deadly disease amidst increasing number of cases of acute watery diarrhoea (AWD).

The Oral Cholera Vaccination (OCV) campaign will be implemented in the refugee camps from 8-14 December to reach 139,888 Rohingya aged 1 year and less than 5 years. In the host community, the campaign will take place from 8-31 December and aims to reach any person older than 1 year (495,197). In total, 635,085 people are expected to be reached.

Led by the Ministry of Health and Family Welfare, with support of the World Health Organization (WHO), UNICEF and other partners, the campaign aims to reach people who missed some or all previous cholera vaccination opportunities. The campaign, including operational costs, is funded by Gavi, the Vaccine Alliance.

“We want to equip these populations with more protection against diarrheal diseases. Despite the progresses made to ensure access to quality water and sanitation, such diseases remain an issue of concern: approximately 80% of host community living near the camps have not been targeted in previous OCV campaigns and are still vulnerable”, says Dr Bardan Jung Rana, WHO Representative in Bangladesh.

Earlier rounds of cholera vaccination, which have taken place since the beginning of the emergency response in 2017, have helped prevent outbreaks of the disease. To this date, over 1 million people were vaccinated against cholera.
6th December 2019
https://www.theguardian.com/world/2019/dec/06/flooding-hits-new-zealand-tourist-hubs-of-wanaka-and-queenstown

Heavy rain has led to rivers bursting their banks, forcing the closure of shops and restaurants

Streets in the South Island tourist towns of Wanaka and Queenstown were slowly going under water on Friday, after Lake Wanaka and Lake Wakatipu burst their banks earlier in the week, flooding businesses and sewerage systems.

Water and large debris closed the main street of Wanaka, a popular spot with Instagrammers thanks to its famous tree that appears to have grown out of the lake. On Friday businesses were sandbagging as heavy rain continued to fall.

Sewerage systems in the town were also at risk of contaminating the lake, with the Queenstown Lakes District council taking the precautionary measure of shutting down the sewer connection to a handful of premises.

Wanaka residents were told to be on “high alert” with heavy rain predicted all weekend.

The streets of the usually bustling tourist town were largely empty, and the popular cafes and restaurants on the lake shore were closed.