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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: Thu, 16 Jan 2020 02:45:27 +0100 (MET)
By Ivelisse RIVERA, con Leila MACOR en Miami

Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid.   Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.

In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA.  "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning.    "We are living in constant fear of another powerful tremor," he said.

He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said.   Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake.    The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.

Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old.  "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later.   "It's different to a hurricane. What is happening now is much nastier," he said.

As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted.   The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant.    The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.

- Seeking disaster designation -
Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more.   The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said.   On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.

In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster.   It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests.   The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Date: Sat, 11 Jan 2020 15:43:12 +0100 (MET)

Washington, Jan 11, 2020 (AFP) - A 5.9 magnitude earthquake rocked Puerto Rico Saturday, the latest in a series of powerful tremors that have shaken the US territory in recent days, the US Geological Survey reported.

The latest quake occurred at 8:54 am local time (1254 GMT) around 13 kilometres (eight miles) southeast of Guanica, a town on the island's southern Caribbean coastline that was hard hit by earlier quakes.   The USGS revised its initial report of a 6.0 magnitude quake to 5.9.   It follows a 6.4 magnitude quake Tuesday that killed one person, knocked
out electric power and caused widespread damage.

Puerto Rico Governor Wanda Vazquez declared a state of emergency after Tuesday's quake, which forced an automatic shutdown of the power grid.    Puerto Rico's electric power authority reported outages in the towns of Ponce, Lares, Adjuntas and San German after the latest quake.   The Pacific Tsunami Information Center in Hawaii issued a statement saying there was "no significant tsunami threat" but a small possibility of tsunami waves along coasts nearest the epicentre.

The island is still recovering from Hurricane Maria, which came ashore more than two years ago as a devastating Category 4 storm.   Starting December 28, a wave of tremors have swept the island, putting residents on edge.   The 6.4 quake on January 7 came a day after a 5.8 magnitude quake; it was followed by major aftershocks.   Saturday's quakes were also preceded by a string of smaller tremors.
Date: Tue, 7 Jan 2020 23:44:45 +0100 (MET)
By Ricardo Arduengo

Guayanilla, Puerto Rico, Jan 7, 2020 (AFP) - Puerto Rico's governor declared a state of emergency on Tuesday after a powerful 6.4 magnitude earthquake killed at least one person in the south of the island and caused widespread damage.   Governor Wanda Vazquez said the declaration would allow for the activation of National Guard troops in the US territory still recovering from a devastating 2017 hurricane.   The US Geological Survey said the quake struck at 4:24 am (0824 GMT) with the epicenter off the coast of the southern city of Ponce, and was followed by more than a dozen aftershocks.

Tuesday's quake was the most powerful in a series of tremors that have shaken the island since December 28.   Scientists initially sent out an alert about a potential tsunami but it was later canceled.   The island's electricity authority said the quake had forced an automatic shutdown of the power grid, already severely damaged by Hurricane Maria more than two years ago.   The worst damage appeared to be in towns on the southwest coast, including Ponce, Guayanilla and Guanica.   El Nuevo Dia newspaper said a 73-year-old man died after a wall fell in his home in Ponce. Eight others there were reported injured.

Two power plants in Guayanilla sustained major damage, the Puerto Rico Electric Power Authority said. The city could be without power for two weeks, its mayor Nelson Torres Yordan said.   Celebrity chef Jose Andres announced that a charity he runs, World Central Kitchen, had started serving meals and distributing solar-powered lamps in quake-hit areas.   Vazquez announced that $130 million in emergency aid funding will be disbursed.   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep."   "Everybody is awake & scared all over," she posted.   In Guayanilla, the Inmaculada Concepcion church, built in 1841, was heavily damaged.   Volunteers salvaged statues and other valuable items from the ruins as a priest consoled distraught parishioners.

- 'Be safe' -
A 5.8 magnitude quake on Monday toppled some structures, caused power outages and small landslides, but did not result in any casualties.   It also destroyed a popular tourist landmark, Punta Ventana, a natural stone arch that crumbled on the island's southern coast.   Vazquez, the governor, said government employees were being given the day off on Tuesday to take care of their families.   "We want everyone to be safe," she said.   She said ports were undamaged and there are several weeks' supply of gasoline, diesel and natural gas stored so people need not worry about shortages.

The White House said President Donald Trump had been briefed and Pete Gaynor, head of the Federal Emergency Management Agency (FEMA), had been in touch with the governor.   Trump's administration came under severe criticism for its response to Hurricane Maria.   The Category 4 storm destroyed the island's already shaky power grid, overwhelmed public services, left many residents homeless and claimed several thousand lives, according to government estimates.
Date: Tue, 7 Jan 2020 12:52:34 +0100 (MET)

Washington, Jan 7, 2020 (AFP) - A strong earthquake struck south of Puerto Rico early Tuesday, the US Geological Survey said, the latest in a series of tremors that have shaken the island since December 28.   The shallow 6.5 magnitude quake struck 13.6 kilometres (8.5 miles) south of the city of Ponce, the USGS said, revising down its initial reading of 6.6.   The quake struck just off the US territory's southern Caribbean coastline at 4:24 am local time (0824 GMT).   "The whole island is without power," the director of Puerto Rico Electric Power Authority, Jose Ortiz, told local media.

Puerto Rico's governor Wanda Vazquez Garced posted on Twitter that the government's security protocols had been activated.   She said government employees were not expected at work, adding: "We want everyone to be safe."   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep", adding "Everybody is awake & scared all over."

Dramatic images also shared on social media appeared to show widespread damage in the town of Guayanilla, home to around 20,000 people, as well as nearby Guanica.   The mayor of Guayanilla told local news channel NotiUno that the town's church had collapsed in the incident.

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled.   Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake.   That earthquake toppled houses and caused power outages, but there were no reports of casualties.
Date: Mon, 6 Jan 2020 18:04:21 +0100 (MET)

Miami, Jan 6, 2020 (AFP) - A 5.8-magnitude earthquake shook Puerto Rico Monday, toppling houses and causing power outages and small landslides but there were no reports of casualties, the US Geological Survey said.   The quake, just off the US territory's southern Caribbean coastline, was felt throughout much of the island, including the capital San Juan.

Some 250,000 customers were hit by electric power outages after the quake, which struck at 6:32 am local time (1032GMT).   Images posted on social media showed houses tumbled from their supporting pillars, cracks in walls, cars crushed under collapsed houses and small scale landslides.   The quake was the strongest of a series that have rippled through the island since December 28, and it was followed by at least eight aftershocks, officials said.   No tsunami alerts were issued.
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Ghana

Ghana US Consular Information Sheet
23rd September 2008
DESCRIPTION:
Ghana is a developing country on the West Coast of Africa. The capital is Accra. Facilities for tourism are available in the population centers of the greater Accra regio
, Kumasi in the Ashanti region, and in the Cape Coast area of the Central region, but they are limited in the more remote areas of the country. Read the Department of State Background Notes on Ghana for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required, as is evidence of a yellow fever vaccination. Travelers should obtain the latest information and details from the Embassy of Ghana, 3512 International Drive NW, Washington, DC
20008; telephone (202) 686-4520. Consular services are also available at the Ghana Permanent Mission to the UN at 19 East 47th Street, New York, NY
10017, telephone (212) 832-1300, and the Honorary Consulate of Ghana, 3434 Locke Lane, Houston, TX, telephone (713) 960-8806. Overseas, inquiries should be made at the nearest Ghanaian embassy or consulate. Visit the Embassy of Ghana web site at www.ghanaembassy.org for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Due to the potential for violence, U.S. citizens should avoid political rallies and street demonstrations and maintain security awareness at all times. There will be frequent political rallies across Ghana in the run-up to the presidential and parliamentary elections on December 7, 2008.

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 other callers, 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:
Pick-pocketing, purse snatching, and various types of scams are the most common forms of crime confronting visitors. U.S. travelers have reported these types of theft at crowded markets, beaches, parks, and tourist attractions. Incidences of violent crime, such as armed robbery, are on the rise, including reports of armed robberies in expatriate residential areas. Victims who resist attackers run a high risk of serious physical injury. Take security measures, such as traveling in groups and avoiding travel at night. Avoid travel in communal taxis. Travelers who limit their display of jewelry and handle their cash discreetly reduce their vulnerability to crime. Travelers are advised to carry limited amounts of cash and only photocopies of key documents.

Use of credit cards in Ghana should be avoided if possible, as a growing number of travelers have been victims of credit card fraud.

In recent years, U.S. citizens have reported substantial financial losses from questionable transactions involving gold and other precious metals. The Government of Ghana maintains strict regulations on these natural resources. All agents must be licensed and all transactions must be certified. (See Special Circumstances below).

Perpetrators of business fraud often target foreigners, including Americans. Such fraud schemes are now prevalent throughout West Africa, including Ghana.
Please refer to the Country Commercial Guide for Ghana at http://www.buyusa.gov/ghana/en/doing_business_in_ghana.html, for further information.

American citizens frequently consult the Embassy regarding questionable business offers sent by people in Ghana. These are scams and typically begin with an unsolicited communication (usually by e-mail) from an unknown individual who describes a situation that promises quick financial gain, often by assisting in the transfer of a large sum of money or valuables out of the country.
A series of “advance fees” must be paid in order to conclude the transaction, such as fees to open a bank account or to pay certain taxes.
In fact, the final payoff does not exist; the purpose of the scams is simply to collect money from the victim.
The Embassy has also received reports of fraudulent charities soliciting contributions through the Internet or direct mail. If you receive such business offers or charity requests, carefully check them out before you commit any funds, provide any goods or services, or undertake any travel. Check with the U.S. Embassy in Ghana at telephone (233-21) 741-100 for an assessment of the offer’s credibility.

Another type of fraud is committed by persons claiming to live in Ghana or who claim to be traveling to Ghana on business, and who profess friendship or romantic interest over the Internet. Once a relationship has been established, the correspondent typically asks the American to send money for living expenses, travel expenses, or visa costs. Sometimes a “hospital” or “doctor” telephones to say that the friend has suffered an “accident” and needs immediate financial assistance to cover medical bills. There are other variations of this scam, but the common goal is to fraudulently obtain as much money as possible from the victim.
Americans have reported losing thousands of dollars through such scams. The anonymity of the Internet means that the victim cannot be sure of the real name, age, marital status, nationality, or even gender of the correspondent. In most cases reported to the Embassy, the correspondent turned out to be a fictitious persona created to lure Americans into sending money.

Visitors to Ghana should also be wary of overly-friendly locals offering tours, discounted lodging or other services that seem too good to be true.
Tourists are often targeted by touts and scam artists.
Some Americans have been the victims of false criminal accusations and have found themselves separated from time, money and trust as they seek to resolve these difficult situations.

For additional information, please see the Department of State brochure International Financial Scams.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
Ghana maintains a specialized Domestic Violence Victim Support Unit (DOVVSU) within the Ghana Police Service to assist victims of domestic violence, especially women and children. In addition to its law enforcement responsibilities, the Unit can refer victims to medical providers and counselors, as well as to community support services. Further information is available by following the DOVVSU link at www.ghanapolice.org
The local equivalent to the “911” emergency line in Ghana is: 191
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Ghana are limited, particularly outside Accra, the capital. Travelers should carry adequate supplies of any needed prescription medicines, along with copies of their prescriptions, the generic name of the drugs, and a supply of preferred over-the-counter medications. For information on avian influenza (bird flu), please refer to the Department of State's Avian Influenza Fact Sheet.
Documentation of Yellow fever vaccination is required upon arrival from all countries.
There are no HIV/AIDS entry restrictions for visitors to or foreign residents of Ghana.

Motor vehicle accidents, drownings and water-related accidents due to Ghana’s rough surf, muggings and other violent attacks, and the development of sexually transmitted diseases—including HIV—are
health and safety concerns that have been reported by U.S. citizens and can be at least partially mitigated by using common-sense safety precautions.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Ghana is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Primary roads are generally paved and well maintained. However, some side roads within major cities and roads outside of major cities are in poor condition. The road from Accra to the central region tourist area of Cape Coast continues to be the site of many accidents. Travel in darkness, particularly outside the major cities, is extremely hazardous, due to poor street lighting and the unpredictable behavior of pedestrians, bicyclists and farm animals, particularly goats and sheep. Aggressive drivers, poorly maintained vehicles and overloaded vehicles pose serious threats to road safety.

The safety standards of the small private buses that transit roads and highways are uncertain. Travelers are encouraged to consider this when making travel arrangements.

Travelers are routinely stopped at police checkpoints throughout Ghana, and vehicles and passengers may be searched. Drivers must possess an international driver’s license (available from AAA and the American Automobile Touring Alliance). Foreign nationals should carry documentation of their status, such as a passport and visa.

Please refer to our Road Safety page for more information. Visit the website of Ghana’s national tourist office at http://www.touringghana.com/default.asp and the national authority responsible for road safety at http://www.mrt.gov.gh/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ghana’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Ghana’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

Service provided by a number of regional air carriers is reported to be unreliable. The airlines may alter scheduled stops, cancel or postpone flights on short notice, and regularly overbook flights. Travelers may experience unexpected delays even after checking in. Passengers should get the required seat reconfirmation stamped on the ticket, have enough emergency funds for food and lodging in case of unexpected delays, and arrive at the airport at least two hours before the scheduled departure time.

SPECIAL CIRCUMSTANCES:
Effective July 1, 2007, the Government of Ghana redenominated the local currency, the cedi, introducing new banknotes (Ghana Cedi) and coins (Ghana Pesewa). 10,000 cedis = 1 Ghana Cedi = 100 Ghana Pesewas. The old cedi was taken out of circulation on December 31, 2007, and as of January 1, 2008, can be converted only at commercial banks or the Bank of Ghana. Travelers should be alert to persons who may try to defraud them with the old and new bills. The Government of Ghana established a web site in 2007, www.ghanacedi.gov.gh, to inform the public about the redenomination exercise. The web site includes a useful currency converter.

Visitors arriving or departing Ghana with more than $5,000 in cash are required to declare the amount at the border. Currency exchange is available at most banks and at licensed foreign exchange bureaus, but currency transactions with private citizens are illegal. The Government of Ghana also prohibits departing travelers from carrying more than 5,000,000 cedis (500 Ghana Cedis) out of the country. Ghanaian currency must either be spent or exchanged before departure, or it will be confiscated.

Strict customs regulations govern temporary importation into or export from Ghana of items such as gold, diamonds and precious natural resources. Only agents licensed by the Precious Metals and Mining Commission, telephone (233-21) 664-635 or 664-579, may handle import-export transactions of these natural resources. Any transaction without the commission’s endorsement is illegal and/or fraudulent. All transactions must be completed through the commission at the price set daily by the London exchange. Any transaction that discounts this price, or includes a previously negotiated price, is either illegal or fraudulent. Export of gold dust is rare as it encourages dangerous and environmentally destructive practices, and transactions involving the export of gold dust are probably fraudulent. Attempts to evade regulations are punishable by imprisonment. It is advisable to contact the Embassy of Ghana in Washington, DC, or one of the Ghanaian consulates in the United States, for specific information regarding customs requirements.

In rare instances, visitors arriving in Ghana with sophisticated electronic equipment (video cameras and laptop computers) may have to deposit 17.5 per cent of the item's value with the Customs and Excise office at the airport. To get the deposit refunded, visitors must apply to the Customs and Excise Office in central Accra 48 hours before departure.

Taking pictures near sensitive installations, including military sites and some government buildings, is prohibited. These sites are not always clearly marked and application of these restrictions is subject to interpretation. Permission may be obtained from Ghanaian security personnel. Permission should also be obtained before photographing anyone in uniform (e.g., police officers and military officers). In some cases, film and cameras have been confiscated. For security reasons, taking photographs of the U.S. Embassy is also prohibited.

It is strictly prohibited to wear any military apparel such as camouflage jackets or trousers, or any clothing or items that may appear military in nature.

Please see our Customs Information.

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

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Ghana are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Ghana. 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 No. 24 Fourth Circular Road, Cantonments, Accra; telephone (233-21)741-000. The public entrance to the Consular Section is No. 19 Fifth Link Road, Cantonments, Accra; telephone (233-21) 741-100; fax (233-21) 741-362 or 741-426; after-hours (233-21) 741-775.
*

*

*
This replaces the Country Specific Information for Ghana dated February 21, 2008, to update sections on safety and security, crime, information for victims of crime, and medical facilities and health information.

Travel News Headlines WORLD NEWS

Date: Thu 9 Jan 2020
Source: All Africa/Ghanaian Times [edited]

A total of 3 cases of poliomyelitis with 2 deaths have been recorded in the Bono, Bono East and Ahafo regions.

The 1st case reported, in the Bono Region, was a 24-month-old girl from Asiri in Goka, a subdistrict in the Jaman North District. The 2nd case was a 33-month-old girl resident in Sissala line in the Techiman West submunicipality in the Bono East Region, and the 3rd case was a 37-month-old boy from Kwasuso in the Asutifi South District of the Ahafo Region.

Poliomyelitis is highly infectious viral disease that mainly affects young children. The virus is transmitted from person to person, spread mainly through the faecal-oral route or less frequently by a common vehicle (via contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and cause paralysis.

According to the Bono Regional Health Directorate of the Ghana Health Service (GHS), the cases were detected in October and November last year [2019] with the latest one in January 2020.

The Deputy Regional Director of Public Health, Dr. John Ekow Ottoo, who briefed journalists here in Sunyani yesterday [8 Jan 2020], said the 3rd victim, in a critical and paralysed condition, was being treated.

According to Dr. Ottoo, initial symptoms of polio include fever, fatigue, headache, vomiting and stiffness in the neck and pain in the limbs, saying the disease had no cure but could only be prevented by immunisation.

The Deputy Public Health Director stressed the need for the general improvement of sanitation across the country, noting that the virus was in the system due to poor sanitary condition in the affected areas. He said the GHS had deployed staff and volunteers to the affected areas, including the various borders within the jurisdiction for the immunisation exercises.

Dr. Ottoo urged the public to cooperate with the GHS as the immunisation began on Wednesday [8 Jan 2020].  [Byline: Daniel Dzirasah]
====================
[According to the most recent GPEI (Global Polio Eradication Initiative) update, during 2019, Ghana reported 11 cases of cVDPV2 associated disease, with most recent date of onset recorded as 7 Nov 2019 (see Poliomyelitis update (03): global (WPV1 Afghan., Pak., cVDPV2 Zambia), Pakistan http://promedmail.org/post/20200110.6881006). While it is unclear if all 3 of the cases reported in the above media report are newly confirmed cases, this is the 1st report we've seen of a case with onset in January 2020.

More information on these cases would be greatly appreciated with clarification of the situation in Ghana.

A map of Ghana showing new regions after the referendum:

[HealthMap/ProMED-mail maps:
Date: Mon 17 Dec 2019
Source: Peace FM Online [edited]

There has been a surge in the number of polio cases across the country [Ghana] since July this year [2019], and this has been an issue of concern for both the Government and other health partners. Government and donor partners, are therefore, making frantic efforts at addressing the issue while the Ghana Health Service (GHS) and its partners have embarked on a number of measures to contain the situation. In some few years back, the country was nearly declared polio-free as it had chalked a lot of success in eradicating the disease, and so the current trend is disturbing phenomenon for most stakeholders in the health sector.

Briefing journalists on the status of the Polio disease in the country, Dr. Franklin Asiedu-Bekoe, Director, Diseases Control, GHS, "said the new virus started as a case from the environment seen in Tamale and later some cases was seen in humans". He said at now there have been 10 cases reported in humans while some viruses from the environment have been isolated.

Dr. Asiedu-Bekoe was speaking on the side-lines of the 2nd Ghana Field Epidemiology and Laboratory Trainings Programme (GFELTP) and Scientific Conference and Competency Graduation held in Accra where 58 health professionals involving Frontline, Intermediate and Advanced level trainees graduated after going through various levels of training.

He said following the Tamale outbreak, "as an intervention, we have had a number of vaccination exercises in several regions and districts. We have vaccinated the whole of Northern Region, Upper East and Greater Accra and we are going to do some vaccination in Oti and Bono Ahafo Regions come next week." He said hopefully, early next year [2020], the GHS would start a nationwide Polio vaccination campaign to cover the whole country, adding that a lot of work was also being done by the health partners to ensure that there was no complications or minimal effects with the current vaccines. "We are using both the oral and injectable polio vaccines in the country currently."

Explaining the seemingly upsurge in Polio cases, Dr. Asiedu-Bekoe said the world has been polio-free for most countries excerpt for Nigeria, Pakistan and Afghanistan, but until recently, there had been surge of the disease in some African countries including Ghana, Cote d'Ivoire, and Togo. "Apparently, there was a gap that has arisen because some children who were supposed to be vaccinated were not. The thinking was that we thought the global immunity was huge enough to protect us against the disease. Unfortunately some of the children were prone, and they are those who have gotten the disease. And that is why we are going to do this nationwide vaccination campaign to protect all the children who were left out from an earlier planned vaccination exercise, so that the protection will be assured".

He said children from 9 months up to 4 years would be covered in the nationwide campaign while those under 5 would be involved in the oral polio vaccine. He explained that Ghana was now doing a multiple-prone approach to address the threat of Polio, which included "ensuring that our vaccination is intact".

There was also the surveillance system, which was being made very sensitive to be able to comb all the communities and health facilities to detect if the disease was present anywhere while the third approach was ensuring a clean environment.

According to Dr. Asiedu-Bekoe, keeping a clean environment was very important as Polio was a faecal-oral disease and so "we need to make sure that our environment is clean so that children will not go and pick the Polio virus from the soil and put them in their mouths.

"So these are the approach we are to use to make sure that the Polio menace does not get out of hands. But we are certain that we will actually be able to get Polio eradicated globally. He gave the assurance that the combined effort of government and other partners like UNICEF, WHO, Centre for Disease Control and Prevention (CDC) and Rotary Club were all on board in the fight against Polio.

Mr. Fred Osei Sarpong, Immunisation Focal Person, World Health Organisation, said with Polio cases being reported in Angola, Nigeria, Benin and other neighbouring countries, "Ghana isn't safe. The virus is in the sub-region that is why we have to make sure everyone is protected, that is why we will call on all caregivers to make sure they send their kids for vaccination. Once your child is protected you don't have a cause to worry". He said children without protection were going down with the disease so all parents should avail their children to ensure that they were all vaccinated and protected from the virus that was in circulation.
===================
[First, congratulations to Ghana and the FELTP Groups in Ghana for graduating 58 Health Professionals from their Field Epidemiology Training Program initiatives this year (2019).

According to the most recent Global update from the Global Polio Eradication Initiative / WHO data, there had been 9 cases of cVDPV2 associated disease, with a virus genetically related to the Jigawa Nigeria outbreak (Poliomyelitis update (99): global (WPV & cVDPV), Pakistan (KP), Afghanistan (BL) http://promedmail.org/post/20191212.6837355). The above media report mentions there were 10 cases. No further information was provided. More information from knowledgeable sources would be greatly appreciated including verification of this additional case and demographics including age and geographic location of case, and vaccination history as well as virus type.

HealthMap/ProMED map of Ghana: <http://healthmap.org/promed/p/53> - ProMED Mod.MPP]
Date: Fri, 18 Oct 2019 15:43:29 +0200 (METDST)

Accra, Oct 18, 2019 (AFP) - Floods caused by eight days of torrential downpours in north-eastern Ghana have left 28 people dead and displaced hundreds, officials said Friday.     "At the moment the death toll is 28. About 640 people in some six communities have been displaced and we are providing shelters for them," George Ayisi, spokesman for the National Disaster Management Organisation, told AFP.    "We've counted about 286 collapsed houses during this disaster and that is making life difficult for the people."

Relief items were being transported 800 kilometres (500 miles) by road from the capital Accra to the affected region on the border with Burkina Faso as meteorologists warned the rains could last into November.    "We have to just prepare for anything," Ayisi said.   So far this year 46 people have been killed in floods in the West African nation, the disaster relief agency said.   Flooding in northern and other parts of Ghana happens each year during the rainy season.    Last year, 34 people died in northern Ghana during flooding caused by heavy rains and waters spilling from a dam in Burkina Faso.
Date:   August 30th 2019
Received from HPSC (Ireland)
HPSC website: https://www.hpsc.ie/a-z/vaccinepreventable/polio/

HPSC has received an alert through IHR regarding a recent case of cVDPV2 in a 2 year old female in Ghana who presented with AFP. Hence the cVDPV2 outbreak originating in Jigawa state, Nigeria, continues to spread in West Africa.  Given cross-border population movements with Nigeria and across West Africa, subnational immunity and surveillance gaps, Ghana is considered at high-risk for further transmission of the isolated cVDPV2. In Ghana, the last wild poliovirus was reported in 2008 and this is the first ever cVDPV2 outbreak reported in the country.  [Authorities in] G

WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel.

cVDPV2 outbreak originating in Jigawa state, Nigeria, continues to spread in West Africa.  In Ghana, cVDPV2 was isolated from an acute flaccid paralysis (AFP) case in Ando-Nyamanu, Chereponi district, Northern Region, bordering Togo.  The case is a two-year and eight-month old girl who had onset of paralysis on 27 July 2019. Stool samples were taken on 27 and 28 July 2019 and were sent to the National Polio Laboratory at Noguchi Memorial Institute for Medical Research for laboratory investigations. The sample tested positive for cVDPV2 as per result received on 17 August 2019.   The sequencing information of the AFP case revealed 25 nucleotide differences compared to the reference Sabin 2 and 6 nucleotides with the closest matching sequence of the AFP case from Kwara State of Nigeria in 2018. Earlier, a related cVDPV2 had been isolated from an environmental sample, collected on 11 June 2019, from Northern Region in Ghana.  Both isolated viruses are linked to an outbreak originating in Jigawa, Nigeria, in 2018.  This same strain has already spread within Nigeria, and internationally to the Republic of Niger, Benin and Cameroon.

On 25 August 2019, the Polio Laboratory reported the isolation of polio virus type 2 in an environmental surveillance (ES) site at Agbogbloshie in Accra, Greater Accra Region, from routine surveillance. This was confirmed as cVDPV2 on 26 August.

Public health response
The Ministry of Health has declared detection of this virus to be a national public health emergency, in line with temporary recommendations issued by the International Health Regulations Emergency Committee regarding the international spread of poliovirus. The Ministry of Health and its Partners are working tirelessly to contain the situation and to prevent the spread of the disease.

An emergency meeting with key stakeholders and partners of the Global Polio Eradication Initiative (GPEI) was held on the 19 August 2019, to discuss response measures in response to this, the Ministry of Health / Ghana Health Service has taken these immediate actions:

1. A national team made up of the Ghana Health Service and the WHO has been deployed to support the regional and district teams carry out detailed investigations and response measures
2. A full epidemiological and field investigation is ongoing, active surveillance is being strengthened, subnational population immunity levels are being analysed and outbreak response actions are being planned
3. Areas at risk are mapped conduction of reactive vaccination campaign in the affected and adjoining high risk districts and planned following approval from the Polio Advisory Group for monovalent Oral Polio Vaccine Type 2 (mOPV2)

WHO risk assessment
Given cross-border population movements with Nigeria and across West Africa, subnational immunity and surveillance gaps, Ghana is considered at high-risk for further transmission of the isolated cVDPV2.  As the current detected case is in a district sharing international land border with Togo where there is a very low population immunity against type 2 poliovirus (IPV coverage of 20% in 2018), there is an increased risk of further international spread of this outbreak. As this outbreak, originating in Jigawa Nigeria has already spread to Niger, Cameroon and Benin the risk of further international spread across West Africa associated with this virus, remains high.
WHO advice
It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.
As per the advice of an Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC).  Countries affected by poliovirus transmission is subject to Temporary Recommendations.  To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency and consider vaccination of all international travellers.

Further Information:
Polio is a highly infectious disease and can cause permanent paralysis or death. The risk of paralytic polio due to exposure to cVDPV2 remains high due to the low population immunity against polio type-2 virus, after the global switch from trivalent oral poliovirus vaccine (tOPV) to bivalent OPV (bOPV). The national immunization coverage for Inactivated Poliovirus Vaccine (IPV) in Ghana was 55% for 2018 (WHO/UNICEF estimation). Poliovirus is a pathogen slated for global eradication. In July 2019, cVDPV2 has been confirmed in Ghana in an environmental sample and the last wild poliovirus was reported in 2008. Any detected Poliovirus subtype either in humans or the environment after the global synchronized withdrawal of tOPV in April 2016 is unusual and unexpected and remains to be of a huge cause of concern.  Poliovirus spreads easily and across large distances. There is evidence of genetic linkage of polio virus isolated from Ghana with polio viruses originating in, Nigeria which has already spread to Niger, Cameroon and Benin. The Chereponi district from where the case is reported also shares an international border with Togo that has low population immunity to type 2 Polio (IPV coverage was 20% for 2018). The risk of further spread to Togo cannot be ruled out.

WHO does not recommend any restriction on travel and/or trade to Ghana based on the information available for the current polio outbreak.
https://www.hpsc.ie/a-z/vaccinepreventable/polio/
Date: Tue, 30 Apr 2019 16:30:41 +0200
By Stacey KNOTT

Cape Coast, Ghana, April 30, 2019 (AFP) - Ghana on Tuesday rolled out the world's only proven malaria vaccine for infants as part of a landmark campaign against the deadly mosquito-borne disease, one week after Malawi became the first country to do so.   Malaria kills hundreds of thousands of people each year, mainly in Africa, and it is hoped a vaccine will bring down the toll.    Children are especially at risk, and babies were Ghana's first vaccine recipients Tuesday in the town of Cape Coast, 150 kilometres (90 miles) west of the capital Accra.   "I hope this will help us to be able to eliminate malaria, so Ghana can be a malaria-free country," said Justice Arthur, the doctor running the clinic.

The vaccines will be given to children between the ages of six months and two years, in a project run by Ghana's health ministry and the World Health Organization (WHO).   "I am really hopeful that the vaccine is going to help me and my family," said Abigail Aguanyi, a woman waiting to get her child, Blessing, vaccinated. Many of her family members had previously been stricken.   The vaccine, known by its lab initials RTS,S, has passed lengthy scientific trials which found it to be safe and effective at preventing about four in ten cases of malaria in infants -- the best ever recorded.   To achieve this level of partial protection, four successive doses must be administered on a strict timetable -- a challenge for rural Africa.

- 'Exciting' -
The rollout in Ghana, Malawi, and soon also Kenya, will seek to evaluate the vaccine's effectiveness as a complementary tool, augmenting -- but not replacing -- measures such as insecticide-treated bed nets and the use of sprays.   It will also test the feasibility of administering the four required doses in children in areas of the world with limited access to healthcare.   Data from the programme will inform a WHO policy on the broader use of RTS,S.   Malaria is spread to people by mosquitoes, which transfer the parasite while sucking blood from humans. RTS,S is effective against the Plasmodium falciparum parasite most prevalent in Africa.   In Ghana alone, there were 5.5 million confirmed cases of malaria last year, and many more suspected.

Worldwide, the WHO says malaria killed 435,000 people worldwide in 2017.    The number of cases climbed to 219 million in 2017, two million more than in 2016. Over 90 percent of cases occurred in Africa.   "This is an exciting and long-awaited step forward to fight malaria and its devastating effects on the most vulnerable," said WHO boss in Ghana, Owen Kaluwa.
More ...

Chile

Chile US Consular Information Sheet
August 20, 2008
COUNTRY DESCRIPTION:
Chile is a rapidly developing country with a large, educated middle class and a robust free-market economy.
Tourist facilities are generally good and are continu
usly improving.
Read the Department of State’s Background Notes on Chile for additional information.
ENTRY/EXIT REQUIREMENTS:
U.S. citizens entering Chile must have a valid passport.
U.S. visitors will be charged a reciprocity fee at the port of entry, and a small receipt for the fee will be stapled in the last page of the passport.
This visa is valid for multiple entries and remains valid until the expiration of the passport.
In addition, visitors will be issued a tourist visa consisting of a single sheet of paper placed in the passport. This visa is valid for a stay of up to 90 days.
An extension of stay for an additional 90 days is possible, but requires payment of an extension fee.
The visa document must be surrendered to immigration authorities upon departure.

Chilean entry and exit control laws require that a minor child under age 18 traveling unaccompanied must have permission from the parents or legal guardians.
The document must be notarized and, if issued in the United States, authenticated by a Chilean consul in the United States.

If the child is traveling in the company of only one parent or guardian, the non-traveling parent or guardian will also be required to grant permission for travel.
In this case, the document will also need to be notarized and authenticated by a Chilean consul.
The permission to travel may also be notarized by a Chilean notary in Chile.

Parents are required to have documentary evidence of their relationship to the child.
An original birth certificate or certified copy of an original birth certificate is required.
This requirement applies to all foreigners as well as Chileans.
This requirement is increasingly being enforced by Chilean immigration officers.
When traveling with a minor child in Chile on a tourist visa, having such documentation on hand will facilitate entry and departure.

Visit the Embassy of Chile web site www.chile-usa.org for the most current visa information and entry/exit requirements.
Visitors should be aware of the severe Chilean restrictions on the importation of fruit, vegetables & agricultural products.
Check the Ministry of Agriculture web site www.sag.gob.cl for current requirements.

Information about dual nationality and the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
The potential for terrorist activity is low.
There has been some politically-motivated violence among indigenous communities in southern Chile, none of which has affected Americans.
Potential for civil disturbance is low, although demonstrations, sometimes violent, do occur.
Particularly violent days are March 29, the Day of the Young Combatant, and the anniversary of the September 11, 1973, coup against the government of President Salvador Allende.

For the latest security information, Americans traveling abroad should regularly monitor the Department's web site where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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:
Crime rates are low to moderate throughout Chile and are moderate in Santiago, Valparaiso, and other major cities.
American citizens visiting Chile should be as careful in cities as they would be in any city in the United States.
There have been few violent crimes committed against Americans.
However, American tourists are at a heightened risk for pick-pocketing, purse or camera snatching, and theft from backpacks and rental cars.
Such crimes have been reported in all areas of Chile frequented by tourists.
In Santiago, visitors should be especially alert to the possibility of crime at the Plaza de Armas and the Mercado Central; at major hotels and restaurants in the Las Condes, Vitacura, and Providencia areas, and in the Suecia and Bellavista entertainment districts.
In Valparaiso, visitors should be especially alert in the port and adjoining tourist areas.
Tourists using taxis in Santiago should be alert to possible scams involving currency switching.
Tourists should also be especially alert while using public transportation, such as the Santiago Metro Subway and public buses and while in the vicinity of Metro stations and bus terminals. The emergency number for the police (Carabineros) is 133.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at www.cybercrime.gov/18usc2320.htm.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime 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. You will find information about the Chilean legal system at the following website www.ministeriopublico.cl.
Women that are victims of domestic violence will find helpful information at the website www.sernam.cl.

The local equivalent to the “911” emergency line in Chile is:
131 – AMBULANCE (SAMU)
132 – FIRE DEPARTMENT (BOMBEROS)
133 – POL
ICE DEPARTMENT (CARABINEROS)
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care, though generally good, may not meet U.S. standards, especially in remote areas.
Although emergency rooms in some major hospitals accept credit cards, many doctors and hospitals in Chile expect immediate payment in cash.
Prescriptions written by local doctors and over-the-counter medicines are widely available.
Air pollution is a major source of health concern in Santiago, resulting in severe bronchial ailments affecting infants, small children and the elderly.
The most severe air pollution occurs during the winter (May through August). Additional information on air quality levels is available at the National Air Quality Information Service (SINCA) web site - www.sinca.conama.cl.

The ozone layer is especially thin at the bottom of the world.
Travelers should take proper precautions to protect themselves from ultraviolet radiation.

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-TRI (1-877-394-8747) or from the CDC’s web site 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 www.who.int/en.
Further health information for travelers is available at www.who.int/countries/chl/en/.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Chile.

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 Chile is provided for general reference only, and may not be totally accurate in a particular location or circumstance
Driving in Chile is on the right-hand side of the road.
Traffic laws in Chile differ from traffic laws in the United States in some respects.
Right-hand turns are generally prohibited at red lights unless otherwise posted.
Seat belts are mandatory. Several modern toll highways have recently been opened in and around Santiago, dramatically improving transit into and through the city.
Major roads are generally in good condition throughout the country.
Some secondary roads, however, may be poorly maintained.
At night, occasional heavy fog in rural areas may lead to vehicle accidents with occasional deaths and injuries.
Care should be taken while driving in the mountains because the roads tend to have many tight switchbacks and may not have guardrails.
Chains are often required and should be used on mountain roads during the winter.
Many major highways in Chile are toll roads; drivers should carry a sufficient amount of local currency to cover the tolls.
The new major highways in and around Santiago generally collect tolls through use of an electronic transmitter issued by the concessionaire and placed on the vehicle.
“Day passes” may be purchased separately.
Vehicles rented at Santiago airport generally are equipped with the electronic transmitter and the rental car companies charge a surcharge for its use.
Some major arteries remain under construction in Santiago and drivers should be alert for detours and delays. Information on the major highways in the Metropolitan Region requiring an electronic transmitter is found at www.concesiones.cl.
Throughout Chile, care should be exercised when changing lanes or merging because many drivers do not signal lane changes and rarely yield to merging traffic.
Many Chilean drivers exceed posted speed limits, do not maintain safe distances, and do not observe posted road signs.
Buses are especially aggressive in moving between lanes.
Speeding is common, including in urban areas.
Traffic jams and detours in Santiago and other areas are common.
Taxis are plentiful and relatively inexpensive.
Drivers should drive with car doors locked at all times, especially in the southern parts of the city and near the airport, as there have been reports of thieves entering cars stopped at traffic lights or moving in slow traffic.
In Santiago, certain major arteries switch directions during morning and evening rush hours.
Visitors to Santiago should obtain up-to-date information on these changes from their auto rental company or the Chilean Automobile Association (please see below).
Visitors that wish to use the public bus and subway system in Santiago should visit the following websites for information on purchasing a “BIP” card, a prepaid ticket required for public buses, routes and other helpful information regarding the public transportation systems: www.transantiagoinforma.cl; www.metrosantiago.cl and www.micros.cl.
Driving under the influence of alcohol in Chile is severely punished, and can result in incarceration if the driver is involved in an accident. In accidents involving injuries or death, police may detain both drivers for many hours.
Visitors must have an international driver’s permit in order to drive legally in Chile. The international driver’s license must be obtained in the United States before traveling to Chile.
Although car rental firms may rent to customers with only a U.S. driver’s license, the police fine foreigners for driving without a valid international permit.

Please refer to our Road Safety page for more information.
Visit the website of Chile’s national tourist office at www.sernatur.cl and national authority responsible for road safety at www.vialidad.cl.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Chile’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Chile’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Visitors should take care to use only the services of government licensed tour operators throughout Chile as the Embassy is aware of at least one accident involving American fatalities with an unauthorized tour operator.
Special care should be taken by arriving cruise ship passengers if arranging land tours not authorized by the cruise line.
Chile is an earthquake-prone country.
Information on Chilean earthquake preparedness is available from the Oficina Nacional de Emergencia de Chile (ONEMI) at www.onemi.cl.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at www.fema.gov.
Information about emergency preparedness is also available on the Embassy web site at http://santiago.usembassy.gov/.
The U.S. Geological Survey provides earthquake information on Chile at http://earthquake.usgs.gov/regional/world/index.php?regionID=8.
Minefields are found in Chile’s northern border with Peru and Bolivia and on the southern border with Argentina in Patagonia.
Minefields are generally marked, but markers may have been shifted, become obscured or been vandalized.
Travelers should pay attention to markers and follow clearly identified roads and trails when traveling in minefield areas.
Border crossings should only be made at authorized locations.
Persons visiting wilderness areas in the border regions mentioned above should check with park or other local officials concerning minefields and other potential hazards.
Chile is a popular destination for outdoors and adventure sports.
Much of the country is mountain, forest, desert, or glacier.
Despite the best efforts of local authorities, assisting persons lost or injured in such areas can be problematic.
American citizens have been killed in recent years in mountain climbing and whitewater rafting accidents, and seriously injured while skiing.
Persons planning to travel in isolated and wilderness areas should first learn about local hazards and weather conditions.
Information about parks and wilderness areas can be obtained from the Chilean Forestry Service at www.conaf.cl.
Information about mountain climbing in Chile can be obtained from the Federacion de Andinismo de Chile at www.feach.cl.
Current weather forecasts are available from the Chilean Meteorological Service at www.meteochile.cl.
Reports of missing or injured persons should be made immediately to the police so that a search can be mounted or assistance rendered.
Travelers in isolated areas should always inform park rangers, police, or other local authorities of their itinerary before starting off.
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 Chilean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Chile 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.
Just as in the United States, foreigners in Chile must have proper immigration status and pay taxes on income earned in Chile.
Recently, Americans have been deported for working in Chile without authorization.
Please see our information on Criminal Penalties and ensure compliance with all Chilean immigration regulations; consult the web site of the U.S. Embassy in Chile for more information at http://santiago.usembassy.gov/
CHILDREN'S ISSUES:
See our Office of Children’s Issues web pages for information on intercountry adoption and international parental child abduction.
Chile has demonstrated patterns of noncompliance with the Hague Child Abduction Convention. Chile’s patterns of noncompliance fall in its judicial performance. The courts continue to demonstrate a clear bias toward Chilean mothers.

REGISTRATION/ EMBASSY LOCATION:
Americans living or traveling in Chile are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Chile.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located at Avenida Andres Bello 2800, Las Condes, Santiago, Chile.
The telephone number is (56) (2) 330-3000.
The Embassy web site is http://santiago.usembassy.gov, and the email address for the American Citizen Services Unit is SantiagoAMCIT@state.gov.
The Consular Section fax number is (56) (2) 330-3005.
The American Citizen Services Unit is open to the public from 8:30am-11:30am, Monday through Friday, except U.S. and Chilean holidays and the first Friday of each month.
* * *
This replaces the Country Specific Information dated October 23, 2007 to update all sections except Aviation Safety Oversight.

Travel News Headlines WORLD NEWS

Date: Sat 30 Nov 2019
Source: 24 Horas [in Spanish trans. ProMED Mod.TY, edited]

The ISP [Public Health Institute] confirmed the 1st hantavirus [infection] case in the O'Higgins region [of 2019]. The affected individual is a 32-year-old woman, resident of San Vicente. Moreover, the Health SEREMI [Regional Health Ministerial Secretariat] stated that they are studying a suspected case in a minor.

"Chile is an endemic country for hantaviruses in the Coquimbo y Aysen regions. Because of this, the inhabitants of our region must always observe preventive measures," stated the Health SEREMI Dr. Daniela Zavando. The chief of this agency added, "Sadly, the ISP confirmed the 1st case of hantavirus [infection] in our region."

Dr. Zavando added that, "there is a suspected hantavirus [infection] case in a minor, and we await the confirmation or elimination of the case. People who visit the countryside, rivers, mountains, among other sites, must follow the recommendations to walk along established trails, ventilate sheds or cabins before entering them, do not gather and eat wild fruit, protect food materials adequately, and do not kill natural predators of the long-tailed mouse such as owls, foxes etc.," stated the regional sanitary authority.

The SEREMI added that, "Our Epidemiological and Sanitary Action team is currently carrying out monitoring and investigation of the case with the object of preventing new cases in the areas visited by the patient in rural localities in San Vicente."
==================
[An additional report of 1 Dec 2019 indicated that the patient was taken to the intensive care unit in the Hospital del Torax in metropolitan Santiago

A 3rd report of 1 Dec 2019 indicates that although in serious condition, the patient is progressing well

As noted in previous comments, much of central and southern Chile is endemic for Andes hantavirus. The report above provides no information about the circumstances under which the woman acquired her hantavirus infection, but it may have been due to exposure to rodent reservoir hosts of the virus or to virus-contaminated rodent excreta while in contact with the environment where rodents were present. Cases of human hantavirus infections occur fairly frequently in the endemic region.

Although not specified in this or previous reports from the region, the hantavirus involved in these cases no doubt is Andes virus. This virus is endemic in Chile, and cases of hantavirus pulmonary syndrome occur every year. In Chile, Andes virus can be transmitted directly person-to-person but only with very close physical proximity, usually within the family.

Images of the long-tailed pygmy rice rat (_Oligoryzomys longicaudatus_), the sigmodontine rodent host of Andes hantavirus, can be seen at

[HealthMap/ProMED map available at:
Date: Sat 23 Nov 2019
Source: Outbreak News Today [edited]

A salmonellosis outbreak in Maipu commune in Santiago Province has now affected 80 people, according to the Chile news source, T13 (computer translated). This is up from 45 cases reported ill at the El Carmen Hospital with symptoms of salmonella infection on [Tue 19 Nov 2019].

Health officials have linked to outbreak to the consumption of sushi at a Bokado sushi store. "This is an important call for the preparation of these products, they must be cooked. They must not use salmon or raw seafood, they must use cooked products," said health SEREMI [Secretaria Regional Ministerial de Salud; regional ministerial secretariat of health], Rosa Oyarce.
=======================
[Fish are not considered to be reservoirs for salmonellosis but can certainly be contaminated after harvesting. - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Chile:
Date: Mon, 4 Nov 2019 23:47:26 +0100 (MET)

Santiago, Nov 4, 2019 (AFP) - A strong 6.0-magnitude earthquake shook Chile on Monday, rattling buildings in the capital while a big anti-government demonstration was under way.   The quake struck at 6:53 pm (2153 GMT) with its epicentre near the northern town of Illapel, the US Geological Survey said.   A strong and prolonged shaking was felt in the capital.   Chile's National Seismological Center measured the quake at magnitude 6.1, revising down an earlier estimate of 6.3.   There were no immediate reports of damage or casualties.   "There have been no reports of damage to people, disruption of basic services or infrastructure," the National Emergency Office said.   The Army Hydrographic and Oceanographic Service said the quake was unlikely to cause a tsunami on Chile's Pacific coast.

When the quake hit, police in Santiago were dispersing protesters at the start of the third week of anti-austerity protests targeting the conservative government.   Chile is one of the world's most earthquake-prone countries.   The 9.5-magnitude 1960 Valdivia earthquake was the strongest ever recorded on the magnitude scale, according to the USGS.   In 2010 an 8.8-magnitude followed by a tsunami killed more than 500 people.   Chile lies on the Ring of Fire -- an arc of fault lines that circles the Pacific Basin and is prone to frequent earthquakes and volcanic eruptions.
Date: Thu, 24 Oct 2019 02:27:37 +0200 (METDST)
By Miguel SANCHEZ

Santiago, Oct 24, 2019 (AFP) - Thousands of Chileans flooded the streets of Santiago and other cities in a general strike on Wednesday, upping the pressure on beleaguered President Sebastien Pinera after days of social unrest that left 18 dead.   Students, professors and state workers walked off the job at the urging of the country's largest union, ignoring a package of measures announced by Pinera aimed at quelling the violence.   "THE STRIKE IS ON! We say it loud and clear: enough of the increases and abuses," said the Workers' United Center of Chile, which organized the two-day action alongside about 20 other groups.   In the capital Santiago, police used water cannons to disperse protesters.   "Chile has awakened," read the sign of one protester -- a slogan that has been popular since the protests against social and economic woes, and a yawning gap between rich and poor, began last week.

The country, usually one of the most stable in Latin America, has experienced its worst violence in decades since protests against a now-scrapped hike in metro fares escalated dramatically on Friday.   A four-year-old child and a man were killed on Tuesday when a drunk driver rammed into a crowd of demonstrators, Interior Undersecretary Rodrigo Ubilla said.   A third person died after being beaten by police, according to the victim's family.   The armed forces announced a nighttime curfew for the fifth day running, although at just six hours, Wednesday night's is the shortest yet.   In an address to the nation late on Tuesday, Pinera apologized for failing to anticipate the outbreak of social unrest.   "I recognize this lack of vision," Pinera said after a meeting with some of Chile's opposition leaders.   Beyond the dead, another 269 people have been injured and about 1,900 have been arrested, according to the National Institute for Human Rights.

- Pinera's proposals -
Having initially taken a confrontational line -- declaring that Chile was "at war" and imposing a state of emergency in Santiago and most of Chile's 16 regions --  Pinera has rapidly changed tack and sought cross-party support to find a solution.   He says he will increase the universal basic pension by 20 percent, cancel a recent 9.2 percent increase in electricity bills and propose a law that would see the state cover the costs of expensive medical treatment.   He also pledged a state subsidy to increase the minimum wage from 301,000 to 350,000 pesos ($482) a month and said the government would introduce health insurance for medications, which is among the most expensive in the region.

Chileans were unconvinced by the promises.   "It seems like a joke to me. Does he think with this the people will calm down?" protester Ximena Gutierrez told AFP.   "No, they won't calm down, this will continue because we won't be silenced!"   After widespread scenes of violence, destruction, arson and looting last week, protests have become more peaceful this week, particularly in Santiago.   But it's the worst violence to hit Chile since the country returned to democracy after the 1973-1990 right-wing dictatorship led by General Augusto Pinochet.   Some 20,000 police and troops have been deployed.   Strike organizers issued a statement demanding that the government end the state of emergency and send troops back to their barracks.   The country's powerful copper mine workers' unions joined the strike movement, but the state copper company insisted that operations continued nonetheless. 

Chile is the largest producer of copper in the world, much of which is sold to China.   Despite 2.5 percent growth, ordinary Chileans are deeply unhappy.    In a poll by Ipsos, two thirds of respondents said their economic, health and pensions situation was "unequal and unfair."    "Pinera has always been a liar and now... he is asking for forgiveness," said 23-year-old Carlos Morales.   Before Pinera's announcement, one of Chile's largest conglomerates, Quinenco, promised to increase its minimum salaries to 500,000 pesos a month from January 1 -- 60 percent more than the current minimum wage.   Chile's big business conglomerates are one of the major factors in the huge wealth disparity that has angered protesters.

- Back to normal -
Life in the capital has been returning to normal, with three of seven metro lines open on Wednesday.   More than half of Santiago's 136 metro stations suffered heavy damage during last week's protests and remained guarded by soldiers.   Shops and businesses -- even banks -- appeared to be reopening, but some Santiago-area schools were still closed.   LATAM, South America's largest airline, said more than 98 percent of its flights to and from Santiago's international airport took off following dozens of cancelations during days of chaos caused by the curfews.   Chile's Central Bank dropped interest rates from 2.0 percent to 1.75 percent and said the crisis would affect the country's economy.
Date: Mon, 21 Oct 2019 13:34:35 +0200 (METDST)

Santiago, Oct 21, 2019 (AFP) - Chile, reeling from its worst social unrest in decades, has since the 1990s been considered a Latin American hub of political stability and economic growth after 17 years of dictatorship.   Here is some background.

- From dictatorship to democracy -
In 1973 General Augusto Pinochet toppled Socialist President Salvador Allende in a military coup. Allende committed suicide in the presidential palace as troops closed in.   Pinochet imposed a right-wing dictatorship that lasted for 17 years, during which at least 3,200 people were killed or disappeared as a result of political repression. Around 38,000 were tortured.   In 1988 he lost a plebiscite on remaining in power and handed over to democratically elected Patricio Aylwin in 1990, remaining head of the armed forces until 1998.    Pinochet died in 2006 without standing trial for atrocities under his regime.   In 2006 Socialist Michelle Bachelet became Chile's first female president. Re-elected in 2013, she was barred constitutionally from standing again immediately and appointed UN right commissioner in 2018.   The 2017 elections were won by conservative billionaire Sebastian Pinera, who had already been president in 2010-2014.

- Model economy -
Pinochet applied neo-liberal free-market methods, privatising healthcare, education and pensions.   Chile turned to exports and in the 1980s became the preferred Latin American host for foreign investors.   With this economic model still largely in place, growth reached a strong 4% in 2018. The country of 18 million people also has the highest per capita income of Latin America at $20,000.   GDP, however, fell to 1.8% in the first half of 2019 -- due to a challenging external context, adverse climatic conditions and a delay in reforms -- and is expected at 2.5 percent for the year.   Despite slashing poverty from 30% in 2000 to 8.6% in 2019, the country has high social inequalities including in healthcare, education and pensions.   It is the world's biggest producer of copper, with lithium, timber, fisheries, gold, silver, avocados and oil also driving exports.

- Paedophile priests scandal -
The staunchly Roman Catholic country has been rocked by allegations of sexual abuse within the church going back decades.   In May 2018 Pope Francis summoned all 34 Chilean bishops to Rome over the crisis and all tendered their resignations, although only a handful have been accepted.   Since 2000 about 80 priests have been reported to authorities in Chile for alleged sexual abuse, including of children and adolescents.   Prosecutors said in August 2018 they were investigating 158 members of the church, both priests and lay people.   Ultra-conservative Chile allowed divorce only from 2004 and legalised abortion in certain cases in 2017.

- World's most seismic -
Bordered by the Pacific Ocean to the west and the Andes mountain range to the east, long and narrow Chile is the world's most seismic country.   In 1960 it was struck by the most powerful earthquake ever registered which measured 9.5 and struck at Valdivia. More than 5,700 people were killed.   In 2010 a 8.8-magnitude quake in the south and centre unleashed a tsunami that swept away entire villages, leaving around 520 people dead.

- Astronomy heaven -
Benefitting from a totally clear sky for most of the year, northern Chile is home to some of the world's most powerful telescopes.   The construction of the planet's biggest telescope was launched in May 2017 in the Atacama desert by ESO, the European Organisation for Astronomical Research in the Southern Hemisphere.
More ...

French Guiana

French Guiana US Consular Information Sheet
August 14, 2006

COUNTRY DESCRIPTION: French Guiana is an overseas department of France. It is a sparsely populated tropical area located on the northern coast of South America. French is the pred
minant language; English is not widely spoken. Tourist facilities are available, especially in the larger cities such as Cayenne and Kourou, but in some instances are not highly developed.

ENTRY/EXIT REQUIREMENTS: Passports are required of U.S. citizens entering French Guiana. Visitors who arrive by land or on a commercial air carrier with a return ticket may enter for up to 90 days without a visa. See our Foreign Entry Requirements brochure for more information on French Guiana and other countries. Visit the Embassy of France web site at for the most current visa information, or contact the Embassy of France at 4101 Reservoir Road N.W., Washington, DC 20007; telephone (202) 944-6000; or the nearest French Consulate in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, New Orleans or San Francisco.

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction . For further information about customs regulations, please read our Customs Information .

SAFETY AND SECURITY: For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site , where the current Worldwide Caution Public Announcement , Travel Warnings and Public Announcements can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad .
CRIME: Petty street crime occurs throughout the major cities. Individuals should make sure to keep valuables out of sight, especially if left unattended in an automobile.

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

See our information on Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care within French Guiana is limited, and hospital facilities are available only in major urban areas. Patients' rooms in hospitals are primarily open-air facilities; instead of glass panes, hospital windows are fitted with wooden slats.

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

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

Primary roads in French Guiana are well paved and well maintained. Emergency call boxes are available at regular intervals on the main highways. Roads in rural areas are less developed. Roads leading to more remote regions in the interior are often improved dirt roads. French Guiana has a relatively moderate to high volume of traffic and police enforce traffic safety. Night driving can be dangerous, especially in the remote interior regions or on less-developed rural roads. Public transportation in the form of taxis and vans is relatively safe.

Please refer to our Road Safety page for more information. Visit the website of the French National Tourist Organization at http://www.franceguide.com.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of France as being in compliance with ICAO international aviation safety standards for oversight of France's air carrier operations. For more information, travelers may visit the FAA's Internet web site at .
SPECIAL CIRCUMSTANCES: In addition to being subject to all French laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on French citizens. For additional information, please see our Dual Nationality flyer .
French customs authorities may enforce strict regulations concerning temporary importation into or export from French Guiana of items such as firearms, medications, animals, etc. It is advisable to contact the Embassy of France in Washington or one of the many French consulates in the United States for specific information regarding customs requirements.
Customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes. ATA Carnet Headquarters , located at the U.S. Council for International Business , 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States. For additional information call (212) 354-4480, e-mail atacarnet@uscib.org, or visit www.uscib.org for details. Please see our Customs Information .

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating French laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in French Guiana 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 on international adoption of children and international parental child abduction, see the Office of Children's Issues website.

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Suriname are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website and to obtain updated information on travel and security within Suriname. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Dr. Sophie Redmondstraat 129, telephone (011)(597) 472-900, web site http://paramaribo.usembassy.gov. The Consular Section hours of operation for routine American citizen services are Mondays and Wednesdays from 1:30 pm - 3:30 pm, or by appointment, except on American and Surinamese holidays. U.S. citizens requiring emergency assistance evenings, weekends, and holidays may contact an Embassy duty officer by cell phone at (011)(597) 088-08302.
* * *
This replaces the Consular Information Sheet dated November 2, 2005 to update all sections.

Travel News Headlines WORLD NEWS

Date: Tue 14 Aug 2018
Source: France Guyane [in French, trans. ProMED Corr.SB, edited]
<http://www.franceguyane.fr/actualite/education-sante-environnement/un-cas-de-fievre-jaune-contracte-en-guyane-412398.php>

A 47-year-old man of Swiss nationality contracted yellow fever in French Guiana. He was diagnosed last weekend by the Institut Pasteur. The fact that he had been present in French Guiana for 4 months without having apparently left it makes it very likely that he contracted the virus in the department, and more precisely in the area of the County Bridge.

In a message addressed to certain health professionals, the Regional Health Agency (ARS) details the situation: "A new case of yellow fever was confirmed last weekend by the Pasteur Institute of Guyana, and after that diagnosed in France. After a visit to CHAR, the patient was transferred urgently to a liver resuscitation unit in Paris.

This is a 47-year-old man of Swiss nationality who had returned by land from Brazil but who had been in French Guiana for 4 months and who had not left the territory (of Guyana) since his arrival. Therefore, we can consider that this is a local infection. The patient was not vaccinated. According to information available at this stage, he was working on the marking of forest roads in the County Bridge area, and it can be assumed that he was infected in these areas, and investigations are underway to detect associated cases and to trace more closely the movements of the patient.

This new case confirms that yellow fever is present in Guyana. While awaiting more precise information, this also seems to indicate that the virus is present in the littoral zone and justifies the vaccination of the whole department's population.
========================
[Sylvatic yellow fever (YF) is endemic in areas of 13 countries and territories of the South American region, including Argentina, Brazil, Paraguay, Bolivia, Peru, Ecuador, Colombia, Venezuela, Panama, Guyana, Suriname, French Guiana and the island of Trinidad.

A 20 Mar 2018 PAHO/WHO Epidemiological Update on Yellow Fever stated that there were confirmed cases this year [2018] in several South American countries including French Guiana (see Yellow fever - Americas (22): South America http://promedmail.org/post/20180321.5699760). Individuals traveling, working or residing in these areas should be vaccinated against YF.

Unfortunately, the Swiss worker was not. The patient's condition was not mentioned, other than that he was transferred urgently to a liver resuscitation unit in Paris, but was still alive. - ProMED Mod.TY]

[HealthMap/ProMED maps available at: Switzerland:
<http://healthmap.org/promed/p/105>

Region d'outre-mer de French Guiana, France:
<http://healthmap.org/promed/p/577>]
Date: Sun, 26 Mar 2017 22:38:35 +0200
By Marion BRISWALTER

Cayenne, March 26, 2017 (AFP) - French Guiana came to a standstill Sunday on the eve of a major strike which has elbowed its way into France's presidential campaign.   Air France cancelled all flights to the South American territory for Sunday and Monday, when 37 labour unions were to launch a general strike demanding a "Marshall Plan" to improve public services and security.   Barricades have been erected on roads since last week, and the US State Department has warned travellers to stay away, citing the risk of violence.   The protests also led to the indefinite postponement of an Arianespace rocket launch at Europe's Guiana Space Centre in Kourou.

The French government has sent a delegation to negotiate with the strikers, asking them to lay out their demands.   But 13 of the territory's 22 mayors have refused to meet the delegation, demanding along with the strikers that French ministers come in person.   "This has gone on long enough! All we have is plundered, it's time to recognise the people of Guiana," a woman at the barricade blocking access to the airport at Cayenne, the capital, told AFP on Sunday.   "I am listening to the Guianans," said Ericka Bareigts, the minister of overseas territories, though she has ruled out travelling to the territory for now.   "We will be able to go to Guiana once the conditions are right and progress has been made," she said.   The road barricades were temporarily lifted Sunday and some stores opened so that people could stock up on food and other supplies before the strike began.

- 'Failed policies' -
The "Collective to Get Guiana Moving" has called for better access to health services and electricity, economic development and job creation programmes, and renewed efforts to keep children from dropping out of school.   The territory, with about 250,000 inhabitants, relies on huge injections of public funds.   "The government must respond rapidly to these requests," Segolene Royal, the French environment minister, said after a recent visit to the territory.   The visiting delegation has already had a scanner installed at the airport to help stop drug trafficking, and pledged to speed up the arrival of EU aide.   But several of the candidates seeking the French presidency have pounced on the crisis just a month before the first round of voting.   For Francois Fillon, the conservative candidate, "This situation is the consequence of the failed policies of Francois Hollande," the outgoing Socialist president.

Marine Le Pen, the far-right National Front candidate, condemned what she called an "cruel minimum service" of recent governments in Paris toward the territory.   In response, Bareigts, the overseas territories minister, and Interior Minister Matthias Fekl said Sunday after a meeting with Prime Minister Bernard Cazeneuve that "We will not tolerate any exploitation of this social crisis, neither to disrupt public order nor for campaign purposes."   A similar revolt gripped French Guiana in 2008 over soaring fuel prices, shutting down schools and the airport.   The strike ended after 11 days, when the government agreed to cut fuel prices.
Date: Mon, 21 Mar 2016 11:58:00 +0100

Paris, March 21, 2016 (AFP) - Up to a third of flights were cancelled at French airports on Monday as air traffic controllers entered a second day of strikes.    Low-cost airline Ryanair deplored what it said was the 41st strike by French air traffic controllers since 2009.   Around 140 passengers spent the night in Paris's Orly airport where half of flights were cancelled on the first day of strikes on Sunday.

Authorities Monday asked airlines to cut a third of flights at Orly and Marseille airports, and 20 percent at Lyon, Nice and Beauvais near Paris.    The striking union, which represents around a fifth of air traffic controllers, is campaigning against job cuts and the lack of investment in new technology.   Air France said journeys out of Paris's other main airport, Charles De Gaulle, were not facing cancellations, but last-minute delays were possible.    EasyJet said it had cancelled 90 flights and that more disruptions were possible.
Date: Wed 2 Sep 2015
Source: OIE WAHID, weekly disease information 2015; 28 (36) [edited]

Rabies, French Guiana
--------------
Information received on [and dated] 2 Sep 2015 from Dr Loic Evain, Directeur General adjoint, CVO, Direction generale de l'alimentation, Ministere de l'Agriculture, de l'Agroalimentaire et de la Foret, Paris, French Guiana.

Summary:
Report type: Immediate notification
Date of start of the event: 20 Aug 2015
Date of confirmation of the event: 31 Aug 2015
Reason for notification: Reoccurrence of a listed disease
Date of previous occurrence: October 2009
Manifestation of disease: Clinical disease
Causal agent: Lyssavirus (RABV vampire bat rabies types)
Serotype: RABV
Nature of diagnosis: Laboratory (advanced)
This event pertains to a defined zone within the country.

New outbreaks (1)
Summary of outbreaks:
Total outbreaks: 1
Outbreak 1: Cayenne, Cayenne
Date of start of the outbreak: 20 Aug 2015
Outbreak status: continuing (or date resolved not provided)
Epidemiological unit: Not applicable
Affected animals:
Species / Susceptible / Cases / Deaths / Destroyed / Slaughtered
Dogs / 1 / 1 / 1 / 0 / 0

Affected population: On Thu 20 Aug 2015, a 6-month-old dog was taken to the veterinarian since he was showing a decreased appetite without neurological signs and again the next day (Fri 21 Aug) following a deterioration of his general condition with convulsions, aggressiveness, visual loss and difficulties with movement. He was hospitalized and died on the night from Friday to Saturday. A rabies investigation was then launched and the Pasteur Institute confirmed the diagnosis on 31 Aug 2015.

Epidemiology:
Source of the outbreak(s) or origin of infection: unknown or inconclusive

Epidemiological comment: The virus isolated in the dog is a Lyssavirus of RABV species and of "vampire bat rabies" type. It is estimated that the virus excretion phase started on 5 Aug 2015. During this period, the dog was in a fully fenced house. No runaway was reported during the period. He just went out for some walks on a lead in the neighbourhood and some visits to the veterinarian. The dog did not bite but could have chewed or lick wounds or the face. The epidemiological investigation has identified to date 12 contact people and no contact animals. However, there are stray cats near the house where the rabid dog was. Although the origin of the contamination of the dog is still uncertain, the most likely hypothesis is the contact with a bat, since the dog has eaten dead animals found in the garden several times. Following confirmation of the diagnosis, a regulated zone was put in place in order to limit the movements of domestic carnivores, to establish increased surveillance and to strengthen the capture of stray animals. Carnivores improperly vaccinated that could have had contact with the case will be euthanized. Carnivores properly vaccinated that could have had contact with the case will be under clinical monitoring for 6 months.

Control measures
Measures applied: movement control inside the country; screening; quarantine; zoning; no vaccination; no treatment of affected animals Measures to be applied: No other measures.

Diagnostic test results:
Laboratory name and type:
Institute Pasteur (Paris) (National laboratory)Species / Test / Test date / Result
Dogs / direct fluorescent antibody (FAT) test / 28 Aug 2015 / Positive
Dogs / pathogen isolation on cell culture / 31 Aug 2015 / Positive

Future Reporting: The event is continuing. Weekly follow-up reports will be submitted.

The location of the outbreak can be seen on the interactive map included in the OIE report at the source URL above.
====================
[This immediate notification officially confirms the information communicated in the ProMED-mail report archive number 20150903.3620512.

"Rabies transmitted by the common vampire bat (_Desmodus rotundus_) is a major public health concern in subtropical and tropical areas of Latin America. Infected vampire bats can transmit rabies to domestic mammals and humans through their haematophagous behavior."  <https://www.aphis.usda.gov/wildlife_damage/nwrc/publications/12pubs/anderson121.pdf>

Pictures of the common vampire bat (_Desmodus rotundus_) can be seen at

[A HealthMap/ProMED-mail map can be accessed at:
Date: Tue 1 Aug 2015
Source: France-Guyane [in French, trans. ProMED CopyEd.LMI, edited]

Yesterday [31 Jul 2015], the Pasteur Institute in Paris confirmed a case of rabies in a 6-month old puppy living in Cayenne. The animal was hospitalized on 21 Aug 2015 at a veterinary hospital for nervous symptoms. He died the following night. 16 people in contact with the dog were sent to the anti-rabies center at the hospital in Cayenne.

The Director for Food, Agriculture and Forestry (Daaf) continues to investigate to discover the origin of the infection. He reminds people of the following guidelines:
- any sudden death of a domestic animal with no identified cause should be reported to a veterinarian;
- any dog, cat, monkey, bat, or other animal bite should be reported to the Daaf;
- early vaccination (starting at 3 months) of domestic animals, with a yearly booster shot is required.

As a precaution, a lot more will be done to catch stray animals in the neighbourhood and the entire area comprising the Zephyr bypass, Montabo, and Baduel roads, and Saint-Antoine path.
=================
[Cayenne is the capital of French Guiana (FG), an overseas region of France on the northeast coast of South America, bordering, on the west, Suriname and on the east and south, Brazil (the Amapa State). See maps at <http://geology.com/world/french-guiana-map.gif> and <http://healthmap.org/promed/p/3486>.

According to French Guiana's reports to the OIE, rabies has been absent there in domestic animals since 2003 and in wildlife since 2009.

According to Ref 1 below, on 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis.

>From the Author Summary:
"Until 2008, rabies had never been described within the French Guianan human population. Emergence of the 1st case in May 2008 in this French Overseas Department represented a public health event that markedly affected the local population, healthcare workers, and public health authorities. The anti-rabies clinic of French Guiana, located at Institut Pasteur de la Guyane, had to reorganize its functioning to handle the dramatically increased demand for vaccination. A rigorous epidemiological investigation and a veterinary study were conducted to identify the contamination source, probably linked to a bat bite, and the exposed population. Communication was a key factor to controlling this episode and changing the local perception of this formerly neglected disease. Because similar clinical cases had previously been described, without having been diagnosed, medical practices must be adapted and the rabies virus should be sought more systematically in similarly presenting cases. Sharing this experience could be useful for other countries that might someday have to manage such an emergence."

Results of the investigation into the source of infection of the 6-month old domestic dog reported above are anticipated with interest.

The increased incidence of rabies transmission to humans by vampire bats in Latin America, specifically in the Amazon region of Brazil, is discussed in Ref 2 below.

References
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1. Meynard J-B, Flamand C, Dupuy C, et al: First human rabies case in French Guiana, 2008: PLoS Negl Trop Dis. 2012;6(2):e1537. doi: 10.1371/journal.pntd.0001537; available at  <http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0001537>.
2. Schneider MC, Romijn PC, Uieda W, et al: Rabies transmitted by vampire bats to humans: an emerging zoonotic disease in Latin America? Rev Panam Salud Publica. 2009; 25(3): 260-9; available at <http://www.scielosp.org/scielo.php?pid=S1020-49892009000300010&script=sci_arttext>. - ProMED Mod.AS]
More ...

World Travel News Headlines

Date: Fri, 24 Jan 2020 12:26:57 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China has quarantined cities and shut major tourist attractions from Disneyland to the Forbidden City and a section of the Great Wall as it scrambles to stop a deadly SARS-like virus from spreading further.   The drastic moves come as hundreds of millions of people criss-crossed the country in recent days to celebrate the Lunar New Year holiday, which officially started Friday and is typically a joyous time of gatherings and public celebration.   Here is a rundown of the measures taken so far in an unprecedented quarantine effort:

- Cities under lockdown -
Public transport has been stopped in 13 cities in central Hubei province, with train stations shut, events cancelled and theatres, libraries and karaoke bars closed in some locations.   The epicentre of the outbreak is provincial capital Wuhan, the biggest city on lockdown, where the government has halted all travel out of the Yangtze River metropolis of 11 million.   Wuhan residents have been told to stay home and authorities are limiting the number of taxis allowed on roads. There are few flights available to the city, deepening the isolation.   Similar quarantine measures are being taken in the other, smaller cities. These include strict controls on weddings and funerals, temperature screening of people as they arrive and the suspension of online taxi services.   More than 41 million people in total are affected by the city shutdowns.

- Festivities cancelled -
Wuhan and Beijing have cancelled public events that usually attract hundreds of thousands of people to temples during the New Year holiday.   Gao Fu, head of the Chinese Center for Disease Control and Prevention, has asked China's 1.4 billion citizens to forego New Year gatherings and confine themselves at home until all is clear.   To discourage nationwide travel, the government also said all tickets for rail, air, road, or water transport could be refunded.

- Attractions closed -
The historic Forbidden City, a sprawling imperial palace in Beijing that is one of the country's most revered cultural sites, will temporarily close from Saturday.   Other famous landmarks including a section of the Great Wall, the Ming Tombs and Yinshan Pagoda are also not open to visitors.   Shanghai Disneyland said it would shut for an indefinite period "to ensure the health and safety of our guests and cast".   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.

- Temperature checks -
Staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing on Friday.   The country has ordered sterilisation and ventilation at airports and bus stations, as well as inside planes and trains, while travellers are being screened for fever.   Health authorities are urging people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear a mask if they have a cough.   In Wuhan, city authorities have made it mandatory to wear a mask in public places.   In response to skyrocketing demand for masks -- starting to sell out at pharmacies and on some popular websites -- China's industry and information technology ministry said it would "spare no effort in increasing supply".

- A new hospital -
In Wuhan, authorities are rushing to build a new hospital in a staggering 10 days as a rising number of patients are infected by the new coronavirus.   The facility is expected to be in use by February 3 and will have a capacity of 1,000 beds spread over 25,000 square metres, according to state media.   Dozens of excavators and trucks were filmed working on the site by state broadcaster CCTV.   Its construction began after reports surfaced of bed shortages in hospitals designated as dealing with the outbreak, which has now infected 830 people across China.
Date: Fri, 24 Jan 2020 11:22:00 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China announced Friday it will close a section of the Great Wall and other famous Beijing landmarks to control the spread of a deadly virus that has infected hundreds of people across the country.   A range of Lunar New Year festivities have been cancelled to try to contain the virus, and Beijing's Forbidden City and Shanghai's Disneyland have also been closed temporarily.

The Ming Tombs and Yinshan Pagoda will also be closed from Saturday, the authority that oversees the sites said, while the Bird's Nest stadium -- the site of the 2008 Olympic Games -- was shuttered from Friday.   The Great Wall attracts around 10 million tourists a year and is a popular destination for visitors during the New Year holiday.   The Juyongguan section will close, while the Great Wall temple fair was cancelled at the Simatai section of the famous landmark.

Tourists at the Gubei water town by the Simatai section will have their temperature tested, the authority said in a statement on the WeChat social media app.   The Bird's Nest will be closed until January 30 in order to "prevent and control" the spread of the virus, authorities said. An ice and snow show taking place on the pitch will be closed.   The measures in the capital are the latest to try and control the outbreak of the new coronavirus, after authorities rapidly expanded a mammoth
quarantine effort that affected 41 million people in central Hubei province.

The previously unknown virus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.   Although there have only been 29 confirmed cases in Beijing, city authorities have cancelled large-scaled Lunar New Year events this week.   The city government said it would call off events including two popular temple fairs, which have attracted massive crowds of tourists in past years.   Beijing's Forbidden City -- which saw 19 million visitors last year -- is usually packed with tourists during the Lunar New Year festival, when hundreds of millions of people travel across China.
Date: Fri, 24 Jan 2020 10:40:12 +0100 (MET)
By Sébastien RICCI

Wuhan, China, Jan 24, 2020 (AFP) - Chinese authorities rapidly expanded a mammoth quarantine effort aimed at containing a deadly contagion on Friday to 13 cities and a staggering 41 million people, as nervous residents were checked for fevers and the death toll climbed to 26.

While the World Health Organization (WHO) held off on declaring a global emergency despite confirmed cases in half a dozen other countries, China expanded its lockdown to cover an area with a total population greater than Canada's.   A range of Lunar New Year festivities have been cancelled, while temporary closures of Beijing's Forbidden City, Shanghai's Disneyland and a section of the Great Wall were announced to prevent the disease from spreading further.   The previously unknown virus habeis caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.

The WHO said China faced a national emergency but stopped short of making a declaration that would have prompted greater global cooperation, including possible trade and travel restrictions.   The outbreak emerged in late December in Wuhan, an industrial and transport hub of 11 million people in China's centre, spreading to several other countries including the United States.   China is in the midst of its Lunar New Year holiday, a typically joyous time of family gatherings and public festivities.   But on Friday Wuhan was a ghost town, its streets deserted and stores shuttered.

- Worried patients -
Hospitals visited by AFP journalists bustled with worried patients being screened by staff wearing full-body protective suits.   At a temperature-check station, a medical staffer in bodysuit, face mask and goggles took a thermometer from a middle-aged woman, pausing to examine the reading before quickly turning back to the patient.   "Have you registered? Then go and see the doctor," the staffer said.   One 35-year-old man surnamed Li voiced the fears of many.   "I have a fever and cough, so I'm worried that I'm infected," he said.   "I don't know the results yet."

With hundreds of millions of people on the move across China for the holiday, the government has halted all travel out of Wuhan, shut down its public transport and told residents to stay home. Deepening the isolation, there were few flights available to the city.   "This year we have a very scary Chinese New Year. People are not going outside because of the virus," said a taxi driver in the city, who asked not to be named.   But said a prolonged shutdown should not pose food-shortage problems because many Chinese had stocked up for the holiday.

Besides Wuhan, 12 other smaller cities nearby have battened down the hatches, with most of them going public on Friday with various measures ranging from closing public venues and restricting large gatherings to halting public transportation and asking citizens not to leave their cities.   Several of the cities have populations numbering several million, led by Huanggang, which has 7.5 million.    The pathogen -- 2019 Novel Coronavirus (2019-nCoV) -- has caused many outlets in Shanghai, Beijing and other cities to sell out their stocks of face masks.   As reports surfaced of bed shortages in Wuhan hospitals, state media said authorities were rushing to build a new facility devoted to the outbreak in a mind-blowing 10 days.

The Wuhan hospital is targeted to be ready by February 3. Dozens of excavators and trucks were filmed working on the site by state television.   To discourage nationwide travel, the government has said all tickets for rail, air, road, or water transport could be exchanged for a refund.   On Friday, staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing.   Thermal cameras scanned passengers arriving at Beijing's West Railway Station.

- 'Work as one' -
Chinese authorities said the number of cases leapt overnight to more than 800, with 177 in serious condition. There were another 1,072 suspected cases.   Officials also said that a virus patient died in Heilongjiang province in China's far northeast, the second death outside the Wuhan epicentre.   Beijing has been praised for its response in contrast to SARS, when it took months to report the disease and initially denied WHO experts any access.

Gao Fu, head of the Chinese Center for Disease Control and Prevention, asked China's people to forego New Year gatherings this year and confine themselves at home until the all-clear.    "If we all work as one, we can contain the virus in Wuhan and add no more cases exported from Wuhan, so as to stem the virus nationwide," Gao told state TV.   Beijing has cancelled popular New Year public events at temples in the capital, the historic Forbidden City will close from Saturday, and Shanghai Disneyland said it also will shut down for an indefinite period from Saturday to protect visitors and staff.
Date: Fri, 24 Jan 2020 07:46:42 +0100 (MET)

Shanghai, Jan 24, 2020 (AFP) - Shanghai Disneyland will close until further notice this weekend due to a deadly virus outbreak that has infected hundreds of people in China, the amusement park said Friday.   The closure comes as China entered its nearly week-long Lunar New Year holiday, and the home of Mickey Mouse had prepared special "Year of the Mouse" celebrations for its guests.

But the park and resort said on its website it would temporarily close from Saturday "in response to the prevention and control of the disease outbreak and in order to ensure the health and safety" of its guests and staff.   "We will continue to carefully monitor the situation and be in close contact with the local government, and we will announce the reopening date upon confirmation," it said, adding that guests who had purchased tickets or booked a resort hotel would be reimbursed.   The entertainment conglomerate opened its $5.5 billion theme park in Shanghai in June 2016, Disney's sixth amusement park and third in Asia.
Date: Fri, 24 Jan 2020 03:33:13 +0100 (MET)
By Rusmir SMAJILHODZIC with Emmy VARLEY in Belgrade

Sarajevo, Jan 24, 2020 (AFP) - As winter grips the Balkans, the poor are caught in a cruel bind, being forced to light fires at home for heating while fuelling a pollution crisis smothering the region.   In recent weeks, Balkan capitals from Belgrade and Sarajevo to Skopje and Pristina have been ranked among the world's top 10 most polluted major cities, according to the monitoring application AirVisual.

While these are small cities compared to leading Asian polluters like New Delhi and Dhaka, a combination of coal-fired power plants, old cars and fires to heat homes are pumping the air with toxins.   "I know it is polluting. I am not an idiot but my only other choice would be to heat this home with electricity and that is damn expensive," said Trajan Nestorovski, who like many in his working-class Skopje neighbourhood burns wood to stay warm in winter.   His wife Vera added: "There are a couple of factories near our neighbourhood that are burning God knows what in the evenings".

Thanks to the rise of mobile phone apps that measure air quality, like the local Moj Vozduh (My Air) created by a Macedonian developer, citizens are finally grasping the full extent of the crisis.    "Serbia is suffocating, has anyone seen the minister of the environment?", said a recent headline in Belgrade's local Blic newspaper, speaking of the fog and dirty air enveloping the city.   Protests have been erupting around the region in recent days.

In Skopje, the capital of North Macedonia, young people have taken inspiration from Swedish activist Greta Thunberg by holding a spate of protests on Fridays.    "Greta inspired all of us," said 17-year-old Iskra Ilieska.   "In winter, half of my school class is absent because of lung problems. That is not normal," she said.

In neighbouring Bosnia, several hundred people wearing face masks gathered in the city of Tuzla to demand a plan from authorities to tackle pollution and phase out coal-fired plants in the next five years.   "The only recommended measures are that we stay shut up at home... when you go out on the streets, in the playgrounds, you won't see children anywhere," said Alisa Kasumovic, a mother in her forties.

- Silent killer -
According to a recent UN environment report, air pollution causes nearly 20 percent of premature deaths in 19 Western Balkan cities.   The main sources of the dust, soot and smoke are low-grade coal plants and household heating, the report said.    More than 60 percent of people in the region rely on coal and firewood to heat their homes, the report said. Only 12 percent of buildings are connected to district heating systems.

Governments need to make "clean energy more accessible", ban old polluting vehicles and tighten regulations on industry emissions and power plants, the UN urged.    Many people cannot afford cleaner heating options at home in countries where average wages are around 500 euros or less.   Sali Ademi, a 78-year-old in Kosovo's capital Pristina, uses coal.     "There's no worse thing, but what can you do?" he said in a city whose air is already poisoned by two nearby coal-fired power plants running on outdated technology.

- Cable car escape -
Those who warm their homes with fires also bear the brunt of health risks, according to experts.   "Some of the emissions from these stoves stay in the house and poison them," warned Anes Podic, president of an environmental group in Bosnia who has called on the government to replace inefficient wood stoves in the country.

In cities like Sarajevo and Skopje, a circle of mountains helps trap the hazardous air in the valleys where residents live.   Sakiba Sahman, 60, is a Sarajevan taking advantage of a recent reduction on ticket prices for a cable car that rides to the top of the 1,160-metre-high (3,800-foot-high) Mount Trebevic, which peaks above the smog over the Bosnian capital.   "We've come to spend a few hours to ventilate the lungs," she told AFP.   Down below, "the pollution is enormous, there are a lot of cars, everything is dirty, grey and depressing."
Date: Fri, 24 Jan 2020 00:46:15 +0100 (MET)

Lima, Jan 23, 2020 (AFP) - Peru's government promised on Thursday to protect the Machu Picchu sanctuary and other Inca ruins when building a new airport to serve the ancient civilization's capital of Cusco.   Machu Picchu and the Inca road system are UNESCO World Heritage sites, and the UN agency has previously expressed concerns over the proposed airport at Chinchero, less than 60 kilometers from the Inca sanctuary that was built in the 15th century.   "We have made a commitment that before work begins on constructing the Chinchero airport, in June of this year, we will present the heritage impact study that UNESCO demands," Transport Minister Edmer Trujillo, who is responsible for the project, told journalists.

UNESCO has told Peru that even though the airport will be built outside of the archeological areas, it is necessary to study how a potential increase in tourists would affect them.   The new airport will be able to receive six million passengers per year -- 60 percent more than the current Cusco airport, which has a capacity for 3,000 passengers a day but receives 5,000.

The existing airport cannot grow because it is inside Cusco, a major Andean city in southeast Peru.   Machu Picchu -- the most iconic site from the Inca empire that ruled a large swathe of western South America for 100 years before the Spanish conquest in the 16th century -- is Peru's most popular tourist attraction, located about 100 kilometers (60 miles) from Cusco.   Trujillo said construction of the new airport would be constantly monitored
by culture ministry experts in case archeological ruins are found.

The airport will be built at 3,780 meters above sea level in the old Inca Sacred Valley.   Many have criticized the impact it could have not only on the country's national treasures but on rural communities.   "Building an airport in the Sacred Valley will have irreparable effects in terms of noise, increase in traffic and uncontrolled urbanization," historian Natalia Majluf said in August.   But local Cusco authorities say it will bring in vital tourism revenue, which the region depends on.
Date: Tue 21 Jan 2020
Source: Channels TV [edited]

In Ondo state, 16 people have been confirmed killed as a result of a Lassa fever outbreak. The state chief epidemiologist, Dr Steven Fagbemi, disclosed this on Tuesday [21 Jan 2020] at the governor's office in the Government House in Akure, the state capital.

Dr Fagbemi made the disclosure while briefing Governor Oluwarotimi Akeredolu as well as the local government chairmen from Ondo North and Central senatorial districts of the state. He also revealed that 84 cases have been reported so far in the state since 1 Jan 2020.

According to the epidemiologist, 16 of the patients have passed on, as their cases had reached the advanced stage before they were taken to the hospital. He added that 47 patients on admission were responding to treatment, while 21 others had already been treated and discharged.

The outbreak is said to have affected Owo, Akoko South-West, Akure South, and Ondo West LGAs of the state.

Also confirming the outbreak, the commissioner for health, Dr Wahab Adegbenro, noted that the disease has been occurring in the state for some years, especially during the dry season. He therefore advised Nigerians to visit hospitals when they noticed symptoms of fever.

Earlier, Governor Akeredolu advised the local government chairmen in the state to deploy cleaners to markets and public places to prevent the outbreak of diseases. He also called on residents to maintain a high level of hygiene to curtail further spread of the Lassa virus in the state.
====================
[The 81 new confirmed and 159 suspected cases in week 3 of 2020 indicate that Lassa fever (LF) virus transmission is continuing to accelerate. The 1st report above confirms that Ondo state has the majority of cases, tied with Edo state. Nigeria is now entering the period of the year when fewer cases usually occur, as illustrated in the graph in Figure 6 (at the source URL above). There has been a peak in case numbers between weeks 1 and 11 (January-March) over the past 3 years and probably will be the case again this year (2020).

Transmission of LF virus occurs when individuals are in contact with rodent reservoir host excreta or are within healthcare facilities. It would be interesting to know whether the prevalence of Lassa fever virus has been increasing in populations of rodent hosts in areas where human cases are occurring.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_: <https://www.inaturalist.org/taxa/45326-Mastomys-natalensis>
_Mastomys erythroleucus_ and _Hylomyscus pamfi_: <http://punchng.com/nigerias-large-rat-population-threatens-lassa-fever-war/>

The pygmy mouse (_Mus baoulei_) has recently been implicated as a reservoir species in West Africa but not in Nigeria.

There is no specific mention in the plans above of public education for avoidance of contact with these rodents and their excreta. - ProMED Mod.TY]

[Maps of Nigeria:
Date: Tue 21 Jan 2020
Source: Ahora Noticias, Costa Rica [in Spanish, machine trans., edited]
<https://www.ahoranoticiascr.com/2020/01/21/autoridades-cerraron-pizzeria-debido-a-casos-de-hepatitis-a-en-san-ramon/>

As many as 22 people suffered from hepatitis A infection in San Ramon de Alajuela, and consequently the Health authorities closed a pizzeria in the area. A source close to this media confirmed the existence of the cases which were detected since 13 Jan 2020.

The cases were thought to be related to food consumption in that establishment 4 of patients were employees of the pizzeria. In statements to the media La Nación, Azalea Espinoza of the Directorate of Surveillance of the Ministry of Health, said they intervened in the business, issued a closing health order, and proceeded to cleaning and disinfecting it. [Byline: Carlos Miranda]
========================
[Although the eating establishment was identified as a pizzeria, pizza itself is not likely to be the vehicle of transmission as it is cooked before serving unless ingredients are added after the cooking process. It is unclear if the pizzeria employees were the source of, or just part of, the outbreak.

With an incubation period averaging 28 but up to 45 days, more cases may occur. The cases are not broken down in regard to age. In children, most cases of HAV infection are subclinical so it is likely that the cases reported were in adults. In the developing world, HAV is not reported much in adults as most children have been infected, and therefore immune to subsequent infection, by the age of 10. That outbreaks are occurring in the area suggests improvement in potable water so fewer children are infected and therefore still susceptible to HAV as adults. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Costa Rica:
<http://healthmap.org/promed/p/17>]
Date: Thu, 23 Jan 2020 17:57:34 +0100 (MET)
By Eva XIAO

Beijing, Jan 23, 2020 (AFP) - The first fatality of China's new virus would come to represent a common set of traits for those who died to the disease: he was over the age of 60 and in poor health.   Since China reported the emergence of a new coronavirus at the end of December, the SARS-like virus has infected more than 500 and killed 17.   So far, the majority of the victims were elderly individuals with pre-existing health conditions, such as diabetes and liver cirrhosis.   All hailed from central Hubei province, where a local seafood market in the capital city of Wuhan is believed to be the epicentre of the epidemic.   But while older individuals have died from the Wuhan virus, some younger patients -- including a 10-year-old boy -- have since been released from the hospital.   Here's what we know so far about the deaths:

Most victims were over 60
According to details released by China's National Health Commission (NHC) on Thursday, the 17 victims of the virus were between 48 and 89 years old.   Only two were under the age of 60, while the average age of the victims was 73.   Most of them died this week, according to the NHC.   Among those who have been discharged from the hospital were younger patients, including a 35-year-old man from Shenzhen, a bustling tech hub in southern Guangdong province.   He was released from the hospital on Thursday, according to the local health commission, as well as the 10-year-old boy who had visited relatives in Wuhan before falling ill.

Many had pre-existing health conditions
Many of those who died from the virus also had pre-existing health issues before contracting the Wuhan disease, such as diabetes and hypertension.   One man, an 86-year-old who was hospitalised on January 9, had surgery for colon cancer four years prior, on top of suffering from high blood pressure and diabetes.   Another, an 80-year-old woman surnamed Hu, had Parkinson's Disease and more than 20 years of high blood pressure and diabetes in her medical history.

Some were hospitalised for weeks before dying
Several of the 17 victims were hospitalised for weeks before dying -- raising questions on the preparedness of hospitals that may have to treat patients for long periods of time.   The youngest victim of the Wuhan virus, a woman surnamed Yin, was hospitalised for more than a month before succumbing to the virus.   On December 10, the 48-year-old woman reported a fever, coughing, body soreness, and fatigue, and underwent anti-infection treatment for two weeks, according to the NHC.   Later in the end of the month, Yin suffered shortness of breath and chest tightness, and she passed away on January 20.

Not all of them had a fever
Currently, Wuhan authorities are screening passengers for fever at the airport, railway stations, and bus terminals.   At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   But not all those who died after being infected reported a fever before being hospitalised, according to the NHC.   A 66-year-old man surnamed Luo reported a "mainly dry cough" but no fever on December 22 before suffering from shortness of breath more than a week later.

By mid-January, Luo required a ventilator to help him breathe.   "A major concern is the range of severity of symptoms this virus is causing," said Dr Jeremy Farrar, Director of the Wellcome Trust.   "It is clear some people are being affected and are infectious while experiencing only very mild symptoms or possibly without experiencing symptoms at all," he said in an emailed statement.   "This may be masking the true numbers infected and the extent of person to person transmission," he added.
Date: Thu, 23 Jan 2020 16:05:30 +0100 (MET)

Singapore, Jan 23, 2020 (AFP) - Singapore Thursday confirmed its first case of the new SARS-like virus which has killed 17 people in China and spread to multiple countries including the United States.   The Ministry of Health (MOH) said the patient was a 66-year-old man from Wuhan who arrived in Singapore with his family on Monday.    He was immediately isolated after arriving at a hospital with a fever and cough, and test results later confirmed he was infected with the coronavirus.   One of his travelling companions, a 37-year-old man from Wuhan, has also been admitted to hospital as a suspect case.

Prior to admission, they had stayed at a hotel on the resort island of Sentosa, the ministry said.   It added that Singapore was expecting more cases and alarms "given the high volume of international travel".   Singapore's Changi Airport started screening flights from Wuhan at the beginning of the month, and on Wednesday extended the checks to all flights from China.   The travel hub receives over 430 flights from China every week.   The virus has caused alarm in China and abroad because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

Singapore was among the hardest hit by SARS with 33 deaths.   Prime Minister Lee Hsien Loong, who is in Davos for the World Economic Forum, said there was "no need to panic".   Speaking to reporters travelling with him, Lee said Singapore has beefed up its hospital facilities and laid out response measures since the SARS epidemic.   "I think we are much better prepared now," he said in remarks carried by the Straits Times newspaper.