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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: 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:
Date: Thu, 19 Oct 2017 16:37:27 +0200
By Ricardo ARDUENGO, con Nelson DEL CASTILLO en San Juan y Leila MACOR en Miami

Utuado, Puerto Rico, Oct 19, 2017 (AFP) - It's been a month since Hurricane Maria ripped through Puerto Rico and Samuel de Jesus still can't drive out of his isolated, blacked-out town.   In fact, much of the US territory in the Caribbean is still a crippled mess four weeks after that fierce Category Four storm.

The bridge connecting Rio Abajo to the rest of the island was swept away when Maria slammed the island on September 20. For two weeks Rio Abajo, located in a mountainous region in central-western Puerto Rico, was cut off and forgotten, without power or phone service.   "We didn't know what to do. We were literally going crazy," said de Jesus, 35.   "Those were difficult, desperate days. We could not find a way out, and the hurricane caused extensive damage," he told AFP.

During the two long weeks following Maria, the 27 families living in Rio Abajo saw their supplies quickly deplete.   De Jesus, who has diabetes, needed to keep his insulin refrigerated. The storm blew away the island's already decrepit power grid, so people resorted to emergency generators.   "But I was running out of gasoline to run the generator," he said.   A helicopter now makes regular deliveries of food, water and medicine because with the bridge washed out, there is no other way in or out of town.

People can't wade across the river because it is contaminated with human waste after a pipe broke when the bridge went.   Some brave souls use a precarious ladder rigged to get across the water, but for most people it is too dangerous.   We need a bridge "to take out our vehicles and leave in case of emergency, or if there is a landslide," he said.   Where the bridge once stood, residents set up a system of ropes, pulleys and buckets to move supplies over the river, which has been contaminated with sewer water since the hurricane.   Over the remains of the bridge locals hung the single-star, red, white and blue flag of Puerto Rico and a sign that reads "the campsite of the forgotten."

- Desperate need for electricity -
Puerto Rico Governor Ricardo Rossello visited the surrounding municipality of Utuado on Wednesday to deliver supplies, but he did not stop in Rio Abajo.   "Utuado is certainly one of the most severely affected municipalities in all of Puerto Rico," Rossello said.   "Our commitment is to give it support and aid during the whole road to recovery."   Eighty-one percent of Puerto Rico remains blacked out one month after Maria struck. Clean water for drinking, cooking and bathing is scarce, too.

Puerto Ricans' main obstacle to getting back to some semblance of normality is the slowness of the Puerto Rico Electric Power Authority in getting the power grid back up and running.   The lack of power has paralyzed a key industry -- pharmaceutical production -- and most businesses including restaurants are closed or operating at great cost through the use of diesel powered generators.

This nightmare comes about a year after the US government established an external fiscal control board for the island after it declared bankruptcy because of 73 billion dollars in debt.   Economist Joaquin Villamil told AFP that damage from Hurricane Maria is estimated at 20 billion dollars -- four times that of Hurricane Georges in 1998, when measured in 2016 dollars.

Villamil said reconstruction money provided by the Federal Emergency Management Agency and from insurance companies will have a positive impact on the island's economy in the second half of fiscal 2018 and in fiscal 2019, but this boost will just be temporary.   "From an economic point of view there is not much net gain," said Villamil, who works for a consulting firm called Estudios Tecnicos.   He said the economy has been shrinking since 2006 and Maria will delay any prospect of recovery.   It will take at least until 2026 to get back to the GDP level of 2006, he added.

Making things worse, people are leaving the island for the mainland US. Forecasts are that the population now at 3.4 million will go down to 3.1 million or even less by 2026, said Villamil.   The government of Florida estimates that since October 3 -- the day a state of emergency to deal with an influx of Puerto Ricans was declared -- more than 36,000 people from the island have poured in.
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Western Sahara

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

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

Travel News Headlines WORLD NEWS

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Tunisia

General Information
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Tunisia is situated in Northern Africa and is a common tourist destination for Irish travellers. It is bordered by Algeria to the west and southwest, Libya to the south east and the Medite
ranean Sea to the east and north. It has a Mediterranean climate with mild rainy winters and hot dry summers. Costal temperatures are less extreme than the inland regions ranging from an average daily low in January of 70C to an average daily high in August of 320C. Rainfall throughout the country varies considerably from about 40" in the northwest down to only 4" in the southwest.
Safety & Security
************************************
Most tourists will not have any significant difficulties in this regard but criminals have targeted tourists and business travellers for thefts, pickpocketing, and scams.
Care should be taken with wallets and other valuables kept in handbags or backpacks that can be easily opened from behind in crowded streets or marketplaces.
Harassment of unaccompanied females occurs rarely in hotels, but more frequently elsewhere.
Health Facilities
************************************
The level of health care facilities in Tunisia will usually be found to be below that normally accepted at home in Ireland. In general the larger hotels will have English speaking doctors in attendance. Unfortunately the hospital/clinic backup for these practitioners is usually very limited.
Food & Water Facilities
************************************
The World Health Organisation statistics suggest that close to 35% of all travellers to these regions will develop significant diarrhoea during their stay. In almost all cases this can be traced back to unwise eating and drinking habits by tourists not taking sufficient care. Most significantly, travellers should stay away from cold foods (especially lettuce) and also all undercooked shell fish (mainly prawns, oysters, mussels and shrimps).
Hotel tap water will frequently not be potable and should not be used for drinking or brushing teeth. Sealed mineral water should be used at all times.
Fruit juice drinks sold by street traders should always be avoided as frequently the drink will have been supplemented with straight tap water.
Malaria in Tunisia
************************************
It is fortunate that this disease is not endemic in Tunisia and so travellers do not require to take prophylactic tablets. Nevertheless there are plenty of mosquitoes and sandflys during the hotter summer months and travellers will need to use insect repellents to protect against these uncomfortable bites. (see Protection against Insect Bites - Tropical Medical Bureau )
Jiggers & Chiggers
************************************
These are uncomfortable parasitic diseases which usually occur on the feet and often present looking like an ingrown toenail. Travellers returning home with unexplained skin rashes should always attend for medical assessment.
Rabies
************************************
This viral disease occurs throughout Africa and is evident in Tunisia. The disease can be transmitted by the bite (or lick or scratch) of any infected warm-blooded animal. Dogs will be the main risk animal but cats and monkeys can also transmit the disease. Any contact must be treated seriously and washed out immediately. An antiseptic should then be applied and further medical attention must always be sought.
Leishmaniasis
************************************
This is a parasitic disease transmitted by the bite of an infected sandfly. The disease occurs in Tunisia mainly during the summer and autumn months. Sandflys are much smaller than mosquitoes and are mainly found hovering around your ankles usually first thing in the morning or during the cooler evening hours. In most cases the bites cause little harm but occasionally deep infection can occur with more serious consequences. Again, travellers should wear sensible clothing and use adequate insect repellent. A bite which is slow to heal needs to be medically checked.
Sunbathing
************************************
One of the common health complaints associated with Tunisia relates to travellers becoming sun burnt while there on holidays. This is particularly the case with smaller children and toddlers. It is essential that travellers use high factor protection creams to lessen the risk of burning and to remember that skin cancer is commonly associated with burnt skin.
Anthrax from Leather Goods
************************************
This bacterial disease has been reported in Tunisia and travellers need to be aware that the disease can be transmitted through unprepared leather goods usually bought in the local market places. Even though this will be rare, any unusual sore should be medically checked after you return home.
Vaccinations for Tunisia
************************************
There are no essential vaccinations for Tunisia but travellers from Ireland are strongly recommended to have vaccination cover against
*
Poliomyelitis (childhood booster)
*
Typhoid (food & water borne disease)
*
Tetanus (childhood booster)
*
Hepatitis A (food & water borne disease)
Those spending longer periods in the country, or trekking, may need to consider vaccination cover
against
Rabies
and
Hepatitis B.
Summary
************************************
Be careful of the intense sun during the summer months. Care with food and water consumption will also be essential at all times.
Further Information
************************************
If you require any further information on staying healthy while overseas please contact either of the help lines at the numbers below.

Travel News Headlines WORLD NEWS

Date: Thu, 27 Jun 2019 14:23:48 +0200

Tunis, June 27, 2019 (AFP) - Two suicide bombers attacked security forces in the Tunisian capital on Thursday, killing a police officer and wounding at least eight people including several civilians, the interior ministry said.   One attack on the main street of Tunis wounded three civilians and two police personnel, the interior ministry initially said.   "Five (are) wounded -- three civilians and two police officers", Interior Ministry spokesman Sofiene Zaag told AFP, before later saying that a police officer had died of his wounds.

Body parts were strewn in the road around a police car on Habib Bourguiba avenue near the old city, according to an AFP correspondent.   "It was a suicide attack, which took place at 10:50 (0950 GMT)," Zaag said.   The second attack targeted a base of the national guard in the capital and wounded four security personnel, the ministry said.   "At 11:00 am (1000 GMT) an individual blew himself up outside the back door" of the base, wounding four security personnel, Zaag said.   Civil protection units and police rapidly deployed to Habib Bourguiba avenue, where the interior ministry is located.    People initially fled in panic, before some crowded around the scene of the attack, expressing anger against the authorities. Shops and offices were closed by police.

Tunisia, the cradle of the Arab Spring uprisings, has been hit by repeated Islamist attacks since the 2011 overthrow of longtime dictator Zine El Abidine Ben Ali.   On October 29, 2018 an unemployed graduate blew herself up near police cars on Habib Bourguiba, killing herself and wounding 26 people, mostly police officers, according to the interior ministry.   The Tunisian authorities said the suicide bomber had sworn allegiance to IS.

The attack was the first to rock the Tunisian capital for over three and a half years.   In March 2015, jihadist gunmen killed 21 tourists and a policeman at the National Bardo Museum in Tunis.   And in June that year, 30 Britons were among 38 foreign holidaymakers killed in a gun and grenade attack on a beach resort near the Tunisian city of Sousse.
Date: Thu, 9 May 2019 17:43:55 +0200
By Caroline Nelly Perrot

Tunis, May 9, 2019 (AFP) - As holidaymakers flock to Tunisia once more following a series of attacks, the country's tourism minister has his sights set on diversifying the industry and taking visitors beyond the beach.   "Practically all the big tour operators here have returned," said Rene Trabelsi, six months into his ministerial post.   He credits "huge efforts" for making the country safe for visitors again, after attacks in 2015 targeting tourists.   Gunmen killed 21 foreign visitors and a Tunisian security guard at the capital's Bardo National Museum, followed by a shooting rampage at a Sousse beach resort which left 38 people dead -- mostly British tourists.

Britain, France and other countries have recently eased their travel warnings, deeming most of Tunisia now safe.   Two million holidaymakers have visited Tunisia so far this year, according to government figures touted by the tourism minister.   That marks a 24 percent jump on the same period last year, and a 7 percent increase compared to the 2010 industry reference point.   But despite tourists returning, revenue has so far failed to reach that of nearly a decade ago.

The indebted industry is heavily reliant upon cheap "all-inclusive" holidays and the government is trying to diversify the tourism sector, which accounts for around 7 percent of GDP.   "During the high season, Tunisia will be packed, but we're interested in the low season, from September to March," said Trabelsi, sitting behind his large desk in the capital Tunis.   The minister wants to attract tourists over the winter months who are also interested in activities away from the beach.   "We're negotiating with the tour operators" to offer charter flights after the summer, said Trabelsi who hopes visitors will sign up for golf, spa treatments and cultural activities.   "This year already, a lot of hotels which closed during winter after the crisis, want to stay open," he said.   An electronic music festival in southern Tunisia is due to take place in September, while a jazz festival is planned in Tabarka near the Algerian border.

- No 'right to fail' -
Whereas half the holidaymakers in 2010 were European, they now make up less than a third of visitors amid an increasing number of tourists from other North African countries and further afield.   The government aims to welcome nine million visitors this year, but Trabelsi said Tunisians still need to tackle "environmental terrorism" to avoid scaring tourists away.   "I'm using that word to shock and alert," said the minister, warning that poor environmental standards can put tourists off "like when there's an attack".

Following Tunisia's 2011 revolution, authorities failed to keep atop of waste management. Municipal councils were elected for the first time a year ago but the clean-up is far from complete.   "We also have a cultural problem," said Trabelsi. "If each person swept outside their front door, that would already be huge."   Trabelsi has for years been co-organiser of an annual Jewish pilgrimage to Djerba, where his father is president of the island's synagogue, and in the 1990s he set up his own travel agency.   But months into his first political post, he said he has no intention of staying in government long-term.   "I want to make a mark, and Tunisians expect a lot from me. I come from the private sector, I have a different religion, so I don't have the right to fail," Trabelsi said.   "But once my mission is accomplished, I'll return to my own affairs."
Date: Sun 16 Feb 2019
Source: Realites Online [in French, trans. ProMED Corr.SB, edited]
<https://www.realites.com.tn/2019/02/tunisie-1318-cas-de-leishmaniose-enregistres-a-gafsa>

As of Sat 15 Feb 209, the Metlaoui Regional Hospital in Gafsa governorate has hosted 1318 patients with leishmaniasis, following the proliferation of mosquitoes [actually leishmania is transmitted by sandflies] near the lakes and wastewater. According to Shems Fm, citing its correspondent in the region, the number of leishmaniasis cases has tripled compared to the year 2017.
============================
[We presume these cases are cutaneous leishmaniasis. Cutaneous leishmaniasis, CL, caused by _Leishmania major_ is a major public health problem in Tunisia. It occurs mainly in central and southwestern Tunisia (semi-arid and arid areas), with thousands of cases. There are foci with a permanent active transmission, so, from time to time, outbreaks occur, related to new agricultural projects or large population movements (introduction to a non-immune population).  In some villages, up to 60 percent of the population is infected.

For a detailed discussion of _Leishmania_ in Tunisia please see Alvar J, Valez ID, Bern C, et al. Leishmaniasis worldwide and global estimates of its incidence.
PLoS One. 2012; 7(5): e35671; <https://doi.org/10.1371/journal.pone.0035671> - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Gafsa, Tunisia:
<http://healthmap.org/promed/p/8782>]
Date: Thu, 17 Jan 2019 17:26:14 +0100
By Aymen Jamli

Tunis, Jan 17, 2019 (AFP) - A public sector strike brought Tunisia to a standstill Thursday as workers heeded calls from a powerful trade union to stay home over demands for wage hikes and economic reforms.   Across the country, schools were closed, public offices shuttered and transport paralysed after calls for a 24-hour strike by the Tunisian General Labour Union (UGTT).   The international airport in Tunis was hit hard, with thousands of travellers stranded without flights or information.   The UGTT had addressed its call to the country's 677,000 civil servants and 350,000 employees of state-owned companies, who make up nearly a quarter of the Tunisian workforce. 

Protesters took to the streets of the capital chanting "the Tunisian people do not accept humiliation", criticising Prime Minister Youssef Chahed's for bowing to reforms dictated by the International Monetary Fund (IMF).    Some held portraits of IMF chief Christine Lagarde, with a bright red X painted over her face.    Tunisia is seen as having had a relatively smooth democratic transition since the January 14, 2011 toppling of president Zine El Abidine Ben Ali after 23 years in power.

But price hikes fuelled by the fall of the Tunisian dinar, combined with tax increases and stubborn unemployment, have spurred social discontent.   In 2016, the IMF granted Tunisia a 2.4-billion-euro loan over the span of four years in exchange for a promise to carry out economic reforms and to control civil service salaries to avoid pushing up the public deficit.   "The UGTT will oppose the failure of the liberal choices of these leaders," UGTT head Noureddine Taboubi told the crowd, speaking from a balcony at the union's headquarters.   In Sfax, the second largest city in the country, thousands of demonstrators took to the streets.    The union has called for wage hikes for public sector employees to counter the decline in purchasing power due to inflation, which stands at 7.5 percent.

In a televised speech Wednesday, Prime Minister Chahed said public finances meant he could not accept the union's demands, adding that dialogue would continue after the strike.   "It is the wage increases conceded after the revolution in the absence of real growth that have led to inflation, debt and declining purchasing power," he argued.    Economist Ezzedine Saidane blamed Tunisia's economic problems on a long-term "lack of overall vision".    He told AFP structural reforms rather than a wage hike were needed "to limit inflation and boost job-creating growth".   Thursday's strike was the first to bring together employees from both the public sector and state-owned companies.    In November, Tunisian civil servants staged the biggest general strike in years.
Date: Mon, 14 Jan 2019 18:49:43 +0100

Tunis, Jan 14, 2019 (AFP) - Tunisia's powerful UGTT trade union on Monday called for a strike as the country, grappling with economic hardships, marked the eighth anniversary of the 2011 revolution that toppled its longtime dictator.   The Tunisian General Labour Union, the UGTT, called on public sector employees to observe the strike on Thursday -- the second since November -- to demand a wage rise and economic reforms.   In a speech at the union's headquarters, secretary general Noureddine Taboubi said the strike should go ahead as talks between the UGTT and the government on social and economic reforms remained deadlocked.

Civil servants represent a sixth of Tunisia's workforce and in November the UGTT said it was demanding 673,000 state employees receive salary hikes equal to those granted in 2018 to public companies, which range from 15 to 30 euros ($17-34) a month.   But President Beji Caid Essebsi has urged a boycott of the strike.   "It is necessary to stop or limit" strikes, he said, during a visit at the Bardo National Museum where an exhibit was on display to pay tribute to Tunisian revolution which sparked the 2011 Arab Spring uprisings.   Essebsi added, however, that "we must take into consideration the deteriorating purchasing power of citizens".

The North African country is seen as having had a relatively smooth democratic transition since the January 14, 2011 toppling of president Zine El Abidine Ben Ali after 23 years in power.   At the same time, price hikes fuelled in particular by the fall of the Tunisian dinar, combined with tax increases and stubborn unemployment, have spurred social discontent that escalated into riots across several cities in January last year.

In 2016, the International Monetary Fund granted Tunisia a 2.4-billion-euro loan over the span of four years in exchange for a promise to carry out economic reforms.   The country is grappling with an inflation rate of 7.5 percent and unemployment stands at more than 15 percent, with those worst hit being young university graduates.

Many Tunisians hope there will be change in 2019 when presidential and legislative elections are due to take place.   Meanwhile on Monday, hundreds of Tunisians, including politicians, took to the streets of the capital to celebrate the ousting eight years ago of strongman Ben Ali, gathering in the landmark Habib Bourguiba Avenue in central Tunis.
More ...

World Travel News Headlines

Date: Mon, 19 Aug 2019 03:45:54 +0200 (METDST)

Lomo del Pino, Spain, Aug 19, 2019 (AFP) - A raging wildfire on the Spanish holiday island of Gran Canaria forced the evacuation of some 5,000 people, authorities said Sunday, warning it could take days for the blaze to be brought under control.   The fire, which has spread to the mountainous Cruz de Tejeda region popular with tourists for its breathtaking views, is "extremely fierce" and "unstable", said Canary Islands president Angel Victor Torres in a statement.   No fatalities have been reported.

More than 600 firefighters and 14 aircraft battled to contain the flames, hampered by strong winds and high temperatures.   With the temperature set to rise Monday, authorities estimate it could take days before the blaze is brought under control.   "The next few hours will be very important because the weather forecast for the night is not good," Torres said.   The fire broke out days after another wildfire in the same region forced the evacuation of hundreds.

Gran Canaria is the second most populous of the Canary Islands in the Atlantic off the northwest coast of Africa.   The Canary Islands received 13.7 million foreign visitors last year, over half of them from Britain and Germany.   Spain is frequently plagued by huge forest fires because of its arid summer climate.
Date: Sun, 18 Aug 2019 23:01:00 +0200 (METDST)

Lisbon, Aug 18, 2019 (AFP) - Portuguese fuel tanker drivers whose strike has caused fuel shortages at the summer holiday season on Sunday ended their industrial action.   Drivers have been staging a strike since Monday to demand further wage increases in 2021 and 2022, prompting the government to declare an energy crisis.   "Since all the conditions are now in place to negotiate, we decided to end the strike," Pedro Pardal Henriques, spokesman for the National Union of Dangerous Goods Carriers (SNMMP), told reporters.

A meeting is scheduled for Tuesday, the union President Francisco Sao Bento said, adding that the union did not "rule out new strikes being called if Antram (the employers association) adopts an uncompromising attitude".   Police had launched an operation to escort fuel tankers with extra supplies and Portugal also mobilised about 500 members of the security forces to replace the strikers and drive the trucks.   Despite the shortages, Energy Minister Joao Pedro Matos Fernandes said about two-thirds of the country's 3,000 or so petrol stations had not run dry.
Date: Sun, 18 Aug 2019 11:47:26 +0200 (METDST)
By By Emal Haidary and Mushtaq Mojaddidi

Kabul, Aug 18, 2019 (AFP) - Joy and celebration turned into horror and carnage when a suicide bomber targeted a packed Afghan wedding hall, killing at least 63 people in the deadliest attack to rock Kabul in months, officials and witnesses said Sunday.   The massive blast, which took place late Saturday in west Kabul, came as Washington and the Taliban finalise a deal to reduce the US military presence in Afghanistan and hopefully build a roadmap to a ceasefire.   The groom recalled greeting smiling guests in the afternoon, before seeing their bodies being carried out hours later.

The attack "changed my happiness to sorrow", the young man, who gave his name as Mirwais, told local TV station Tolo News.   "My family, my bride are in shock, they cannot even speak. My bride keeps fainting," he said.   "I lost my brother, I lost my friends, I lost my relatives. I will never see happiness in my life again."   Interior ministry spokesman Nasrat Rahimi said at least 63 people had been killed and 182 injured.   "Among the wounded are women and children," Rahimi said. Earlier he stated a suicide bomber carried out the attack.

Afghan weddings are epic and vibrant affairs, with hundreds or often thousands of guests celebrating for hours inside industrial-scale wedding halls where the men are usually segregated from the women and children.   "The wedding guests were dancing and celebrating the party when the blast happened," recounted Munir Ahmad, 23, who was seriously injured and whose cousin was among the dead.   "Following the explosion, there was total chaos. Everyone was screaming and crying for their loved ones," he told AFP from his bed in a local hospital, where he is being treated for shrapnel wounds.

Images from inside the hall showed blood-stained bodies on the ground along with pieces of flesh and torn clothes, hats, sandals and bottles of mineral water. The huge blast ripped parts of the ceiling off.   The wedding was believed to be a Shia gathering. Shia Muslims are frequently targeted in Sunni-majority Afghanistan, particularly by the so-called Islamic State group, which is also active in Kabul but did not immediately issue any claim of responsibility.

Wedding guest Hameed Quresh told AFP the young couple were saying their vows when the bomb went off.    "We fainted following the blast, and we don't know who brought us to the hospital," sobbed Quresh, who lost one brother and was himself wounded.   Another guest told Tolo that some 1,200 people had been invited. With low security, weddings are seen as easy targets.   The attack sent a wave of grief through a city grimly accustomed to atrocities. President Ashraf Ghani called it "barbaric", while Afghanistan's chief executive Abdullah Abdullah described it as a "crime against humanity".

- Withdrawal deal expected -
The attack underscores both the inadequacy of Afghanistan's security forces and the scale of the problem they face. While the police and army claim they prevent most bombings from ever happening, the fact remains that insurgents pull off horrific attacks with chilling regularity.   On July 28, at least 20 people were killed when attackers targeted Ghani's running mate Amrullah Saleh as he campaigned in presidential elections.    The incident showed how even amid tight security and known threats, insurgents can conduct brazen attacks.   The issue also goes to the heart of a prospective deal between the US and the Taliban that would see Washington begin to withdraw its approximately 14,000 soldiers from Afghanistan.

The deal relies on the Taliban providing guarantees they will stop jihadist groups such as Al-Qaeda and IS from using Afghanistan as a safe haven. Saturday's attack suggests any such promise would be tough to keep.   The "Taliban cannot absolve themselves of blame, for they provide platform for terrorists," Ghani said.   Few believe such a deal will bring quick peace.

Many Afghans fear the Taliban could return, eroding hard-won rights for women in particular and leading to a spiralling civil war.   Meanwhile, in the northern province of Balkh, 11 members of the same family were killed when their car hit a roadside bomb, officials said. The provincial governor blamed the Taliban for planting the device.
Date: Sun, 18 Aug 2019 05:28:47 +0200 (METDST)
By Amélie BOTTOLLIER-DEPOIS

Paris, Aug 18, 2019 (AFP) - Seafood lovers who prize the mussel for its earthy taste and succulent flesh may be unaware of its growing potential in the fight against water pollution.   The mussel is the hoover of the sea, taking in phytoplankton for nourishment along with microplastics, pesticides and other pollutants -- which makes it an excellent gauge.

One day, it may also be pressed into service to cleanse water.   "It's a super-filter in the marine world, filtering up to 25 litres of water a day," says marine biologist Leila Meistertzheim.   "It's a real model of bioaccumulation of pollutants generally speaking."   As they pump and filter the water through their gills in order to feed and breathe, mussels store almost everything else that passes through -- which is why strict health rules apply for those destined for human consumption.

Like canaries in a coal mine, mussels have long been used as "bio-indicators" of the health of the seas, lakes and rivers they inhabit.   Little-known pollutants can turn up to join the usual suspects, with increasing attention paid to microplastics containing bisphenol A and phthalates, both thought to be endocrine disruptors.

Meistertzheim heads a study for France's Tara Ocean Foundation using mussels to gauge the health of the estuaries of the Thames, Elba and Seine rivers.   The mussels, placed in fish traps, are submerged in the waters for a month before researchers dissect them to determine what chemical substances lurk in their tissues.   The idea of deploying mussels across the oceans to absorb ubiquitous microplastics is just a dream for now, but for other pollutants, the bivalves are already at work.   "In some places, mussels are used, as well as oysters, to cleanse the sea of pesticides, for example," Meistertzheim notes.

- E. coli busters -
Richard Luthy, an environmental engineer from California's Stanford University, says that, in most cases, mussels harvested from contaminated waters should not be eaten.   But if the contaminant is E. coli, mussels can be thanked for the "removal and inactivation" of the faecal material, he says, calling the service a "public health benefit".   The mussels are edible because they "excrete the bacteria as faeces or mucus," he says.   Mussels living in waterways affected by eutrophication -- often marked by abundant algae -- are also fit for human consumption, researchers say.   The phenomenon is often the result of waste dumped into the waterway containing phosphates and nitrites, such as detergents, fertilisers and sewage.   The nutrients in these substances encourage the proliferation of algae, which in turn starves the water of oxygen, upsetting the ecosystem.

Mussels "recycle" these nutrients by feeding on the algae, says Eve Galimany, a researcher of the US National Oceanic and Atmospheric Administration's Milford Laboratory who has experimented with mussels in the Bronx River in New York.   The recycling principle is already at work in a pilot project titled Baltic Blue Growth in Sweden, Denmark and the Baltic countries which grows mussels to be fed to animals such as poultry, fish and pigs.   "Eutrophication... is the biggest problem of the Baltic Sea, the most urgent one," says project head Lena Tasse. Mussels "could be part of a solution".   Why feed them to animals if they are safe for humans? Because Baltic mussels are too small to be of interest to seafood lovers, says Tasse, adding: "Swedes like big mussels."

Meanwhile, the jury is still out on the effects of microplastics on human health.   A recent report by WWF said that humans ingest an average of five grammes of microplastics a week -- about the weight of a credit card.   A 2018 study published in the journal Environmental Pollution, based on samples from British coastlines and supermarkets, estimated that every 100 grammes (3.5 ounces) of mussels contained 70 tiny pieces of plastic.   Should we be worried? Meistertzheim thinks not.   "I eat them," she says. "A dish of mussels is not necessarily worse than organic hamburger meat wrapped in plastic."
Date: Sat, 17 Aug 2019 20:51:48 +0200 (METDST)
By Ricky Ombeni and Marthe Bosuandole

Kinshasa, DR Congo, Aug 17, 2019 (AFP) - Measles has killed 2,758 people in the DR Congo since January, more than the Ebola epidemic in a year, medical NGO Doctors Without Borders said, and called Saturday for a "massive mobilisation of funds."   The disease, preventable with a vaccine, has infected over 145,000 people in the Democratic Republic of Congo between January and early August, it said in a statement.   "Since July, the epidemic has worsened, with a rise in new cases reported in several provinces," said the NGO that goes by its French acronym MSF.   "Only $2.5 million has been raised out of the $8.9 million required for the Health Cluster response plan  -- in stark contrast with the Ebola epidemic in the east of the country, which attracts multiple organisations and hundreds of millions of dollars in funding," it added.

MSF tweeted that without a "massive mobilisation of funds and response organisations, the current measles outbreak in #DRCongo could get even worse."   The NGO said it has vaccinated 474,860 children between the ages of six months and five years since the beginning of the year, and provided care to more than 27,000 measles patients.   In the country's east, Ebola has claimed more than 1,900 lives since erupting last August.

Measles is a highly-contagious diseased caused by a virus that attacks mainly children. The most serious complications include blindness, brain swelling, diarrhoea, and severe respiratory infections.   Last year, cases more than doubled to almost 350,000 from 2017, according to the World Health Organization, amid a rise in "anti-vaxxer" sentiment in some countries that can afford the vaccine, and lagging resources for the preventative measure in poor nations.   The DR Congo declared a measles epidemic in June.
Date: Sat, 17 Aug 2019 12:12:19 +0200 (METDST)

Toulouse, France, Aug 17, 2019 (AFP) - Nine people were injured during a fireworks display in a popular resort in southern France when one rocket misfired close to onlookers on the beach, firefighters said Saturday.   Three of those hurt in the incident in on Friday night in Collioure were taken to hospital after the device "exploded very low" and rained down sparks on some of the 80,000 crowd, firefighters and the local prefecture said.

One person remained in hospital after surgery for a shoulder fracture.   The misfiring rocket was part of a show on a barge just off the port of Collioure, a small picturesque seaside town near the Spanish border whose 3,000 population mushrooms around 30-fold with summer tourists.   Three doctors on site swiftly intervened to treat those injured, the local prefecture said, adding local police have opened an investigation into the incident.
Date: Fri, 16 Aug 2019 21:37:39 +0200 (METDST)
By Ricky Ombeni and Marthe Bosuandole

Bukavu, DR Congo, Aug 16, 2019 (AFP) - A woman has died of Ebola and her infant son was diagnosed with the virus in the first confirmed cases in DR Congo's South Kivu province, reviving fears Friday the highly contagious disease could spread through the region.

The Democratic Republic of Congo's Ebola epidemic has claimed more than 1,900 lives since erupting last August.   "Two cases which tested positive for Ebola were confirmed overnight in South Kivu, in Lwindi district in the Mwenga region," the provincial government said in a statement.   A woman in her twenties died while her seven-month-old child tested positive for the virus and is receiving treatment, the vast central African nation's pointman on Ebola, Jean-Jacques Muyembe, said in a statement.

The woman had been staying with a family in the North Kivu town of Beni, the epicentre of the outbreak, and was identified as a "high-risk contact" of one of the family members infected with Ebola, the statement said.   She then "escaped" movement controls in the area, changing identities four times and travelling from Beni through the North Kivu cities of Butembo and Goma to South Kivu's Bukavu and Mwenga, the statement added.    She died on Wednesday.   "We reassure neighbouring countries that all steps are being taken to strengthen surveillance at points of entry as well as sanitary control," the statement said.    South Kivu shares borders with Rwanda, Burundi and Tanzania.

World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus tweeted that the outbreak in South Kivu "has sparked a rapid response... to provide treatment, identify all contacts, raise community awareness & begin vaccinating".   The International Federation of Red Cross and Red Crescent Societies (IFRC) said it was "rapidly deploying an expert team" to the area.   And South Kivu Governor Theo Ngwabidje told reporters: "Teams from the national anti-Ebola coordination campaign arrived yesterday to provide support."

- Risk of crossing border 'enormous' -
The outbreak of the haemorrhagic virus began in neighbouring North Kivu province on August 1, 2018 and spread to Ituri province.   The WHO declared the epidemic a "public health emergency of international concern" last month after cases were confirmed in the densely-populated North Kivu capital Goma.   The city's proximity to Rwanda and many transport links sparked fears of cross-border spread.    "Beni, Butembo and Goma are still containable," a Congolese professor and epidemiologist said of the three North Kivu cities.   "But with the disease in South Kivu, the risks of it spreading to (the eastern DR Congo town) of Kalemie, Tanzania and Burundi are enormous."

Residents in South Kivu's capital Bukavu said they were worried.   "At this time of year, we rarely have running water -- how are we going to avoid this disease if we have to frequently wash our hands?" asked mother-of-five Martine Mushagalusa.   Anselme Kangeta, 35, said: "Given the crowded way we live, movement is uncontrolled, people go from one place to another without taking precautions. The authorities must get involved otherwise we will all die."   South Kivu experienced an Ebola scare on July 31 when doctors briefly quarantined 15 people in the town of Birava over fears they were infected, but tests came back negative.

- Drug breakthrough -
Ebola is named after a river in northern DR Congo, formerly named Zaire, where the virus was first identified in 1976.   The latest outbreak is the second-deadliest on record after more than 11,000 people were killed in Guinea, Sierra Leone and Liberia between 2014-2016.   The pathogen causes fever, vomiting and severe diarrhoea, often followed by kidney and liver failure, and internal and external bleeding.   The disease is spread by contact with infected bodily fluids and is fought with the time-honoured but laborious techniques of tracing contacts and quarantining them.

The cases in South Kivu come on the heels of researchers announcing a possible breakthrough in the quest for drug to treat Ebola. Two prototype drugs, REGN-EB3 and mA114, slashed mortality rates among Ebola patients in a
trial in eastern DR Congo.   The authorities have also deployed a US-made vaccine called rVSV-ZEBOV, which is unlicensed but has been widely tested for safety.    Muyembe, appointed by President Felix Tshisekedi to coordinate the campaign against Ebola, predicted Thursday that with the new drugs and vaccine "we can manage to completely control the epidemic in three to four months".    Nearly 200,000 people have been vaccinated to date.   Burundi said Wednesday it had begun vaccinating frontline workers at its border with DR Congo.
Date: Fri 16 Aug 2019
Source: CBS Boston [edited]

The Massachusetts Department of Public Health has confirmed a 2nd human case of eastern equine encephalitis [EEE] in the state on Friday [16 Aug 2019]. Officials also raised the risk level for EEE to "critical" in 10 more towns in central and eastern Massachusetts.

The department said the new EEE case is in a man between the ages of 19-30 in Grafton. As a result, Grafton, Hopkinton, Northbridge, Shrewsbury, Southboro, Upton, and Westboro are all at "critical risk" for EEE.  The wife of the Grafton man diagnosed with EEE says he is in his late 20s and lives near a farm. The couple asked not to be identified but told WBZ he was diagnosed after having a seizure.  A goat in Bristol County has also tested positive for EEE, leading officials to put Easton, Norton and Raynham at critical risk as well. A total of 19 communities across the state are at critical risk now, and 18 are at high risk.

The department said it is working with local boards of health and mosquito control experts to work on "appropriate public health response activities."  "The most intense level of EEE activity is still being seen in Bristol and Plymouth Counties," said Public Health Commissioner Monica Bharel in a statement. "However, in active EEE years, the virus may move outside of southeastern Massachusetts. This is evidence of that movement, and residents in the area of increased risk should use mosquito repellent and avoid outdoor activities at night."  Less than a week ago, the department confirmed the 1st human case of EEE in Massachusetts since 2013. The infected man is over 60 and lives in southern Plymouth County.

So far, EEE has been found in 288 mosquito samples.  "[The] history here in Massachusetts [is that] the mosquitos test positive, but the people don't, so this is a little bit unusual," said Dr. Michael Hirsh of the Worcester Division of Public Health.  He said weather may be to blame. "Whenever there is a winter that doesn't have a really hard frost, if it's much more mild, the mosquitoes don't really ever knock off from last year."  Residents should make efforts to avoid mosquito bites, which can spread EEE, including using insect repellent, being aware of peak mosquito hours (dusk to dawn), wearing long sleeve shirts and pants when outside, draining standing water from around your home, replacing window screens, and protecting your animals from mosquitos.

EEE symptoms can range from a stiff neck, headache and lack of energy to dangerous complications like inflammation and swelling of the brain.  The risk of EEE will remain until the 1st killing frost.
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[There was a recent human eastern equine encephalitis (EEE) case in Massachusetts, the 1st human case that ProMED-mail has posted this year (2019), and now a 2nd case in that state and the 3rd in the eastern USA.

So far this year (2019), all of the EEE cases other than in humans posted on ProMED-mail have been in horses, indicating that this has been an active EEE virus transmission season. The case above again reminds us that human cases occur as well. As usual, the equine cases have occurred in the eastern states and a midwestern state in the USA. There is a vaccine available for equine animals, and their owners are wise to have them vaccinated. There is no commercially available vaccine for humans, so avoidance of mosquito bites is the best preventive measure.

Additional information on EEE is available on the CDC website at
<https://www.cdc.gov/EasternEquineEncephalitis/>. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Massachusetts, United States: <http://healthmap.org/promed/p/224>]
Date: Sun 18 Aug 2019
Source: Taipei Times [abridged, edited]

The Centers for Disease Control (CDC) yesterday [17 Aug 2019] confirmed 5 new measles cases associated with a cluster outbreak in Taipei, saying that 1981 people who had come into direct contact with the patients would be monitored for symptoms until 6 Sep 2019.

The cases are likely associated with a man in his 30s living in northern Taiwan who was infected with measles in Viet Nam, returned home on 29 Jul 2019, transmitted the disease to his flat-mate, and was confirmed to have measles on Wed 31 Jul 2019, the centres said.

One of the 5 cases confirmed yesterday [17 Aug 2019] is a man in his 30s who was on the same flight with the index case on 29 Jul 2019 and was in Viet Nam from 5 Aug to Wed 14 Aug 2019, so he might have been infected by the index case or by other people in Viet Nam, it added.

The other 4 patients are nurses who work at Cathay General Hospital's emergency room who had come into contact with the index case, the CDC said.

The nurses started experiencing symptoms between Friday last week [9 Aug 2019?] and Thursday this week [15 Aug 2019?], CDC Deputy Director-General Chuang Jen-hsiang said, adding that one of them was vaccinated for measles, mumps and rubella (MMR) in 2013, and 2 were vaccinated last year [2018], but the other has not been vaccinated.

The hospital held an emergency response meeting to discuss prevention measures and asked the medical practitioners who have had direct contact with the index case to have their measles antibody levels measured and receive an MMR vaccine if no antibodies are found, hospital deputy superintendent Lee Chia-long said. The hospital also asked medical practitioners with higher antibody levels to help screen patients with a fever, control the personnel who are allowed to enter the emergency room, take disinfection measures, and put up posters to warn people about clustered measles cases, he said.

One 119 measles cases have been confirmed this year [2019] -- 72 domestic cases, among whom 51 had come into contact with confirmed cases, and 47 imported -- the CDC said.  [Byline: Lee I-chia]
Date: Fri 16 Aug 2019
Source: 1 News Now [abridged, edited]

A spike in measles cases this week is the worst since the outbreak started, Auckland Regional Public Health Service said.

In the past week, there have been 81 new cases.

As of midday [16 Aug 2019], the total number of cases in Auckland this year [2019] was 456.