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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 ...

Timor-Leste

General Information:

The People’s Republic of China is the world’s third largest nation in land mass and shares borders with 16 other countries. It is the worlds most populated country. Nowadays many Irish travellers will b

going to China for business or holiday trips. Much of the country is mountainous or semidesert and the country lies almost entirely in the temperate zone. Only portions of the southern-most area - the provinces of Yunnan and Guangdong, and the Zhuang autonomous region of Guangxi - lie within the tropics. The monsoon climate is a major influence in the south, but the north and west have a typical continental climate.

Weather Profile: 

During the summer, warm moist maritime air masses bring heavy rains to eastern China, and hot humid summer weather is typical. Winter offers a sharp contrast when Siberian air masses dominate. In late winter and spring strong north winds sweep across north China and hazy days caused by dust storms are common. Beijing’s spring is mostly dry. In July and August the weather turns hot and humid. Autumn is the nicest time of the year with many warm, clear days and little wind usually. Chest Complaints  Because of the prevailing dust, increased transportation and the burning of soft coal during the winter, Beijing and other major cities in China have a high rate of pollution. This may exacerbate bronchial and/or sinus complaints. The dust level in Lhasa is also very high and this may lead to respiratory problems.

Safety & Security:

The risk of crime against tourists is low but care of personal belonging should be observed at all times. Maintenance of buildings and general safety precautions may not always be in place and so checking for fire exits (and that they are unblocked) is wise. Use the hotel safety boxes and carry photocopies of any important documents rather than the originals where possible.

Local Medications:

Western brand-name drugs or non-prescription medicines are seldom available locally although some Chinese equivalents are to be found at reasonable prices. Always carry your own medication (well marked) on your person and bring enough for your trip.

Rabies:

Rabies is a serious problem throughout China. Reports indicate that as many as five million people are bitten each year by rabid dogs and that approximately 5,000 of these patients die. Travellers should stay well clear of any warm blooded animals, especially dogs. Any contact (lick, bite or scratch) should be treated seriously and immediately by washing out the wound, applying an antiseptic and then seeking urgent medical attention.

River Boat Travel:

Many of the older river boats in China use untreated river water for washing dishes and in the bathrooms. This increases the risk of illnesses such as traveller’s diarrhoea and a parasitic disease called schistosomiasis (Bilharzia). Also be careful that the ferry is not overcrowded and be aware of any sharp corners or rusty edges due to lack of maintenance.

Altitude Sickness in Tibet:

Virtually all of the Tibetan Autonomous region, much of Quinghai and Xinjiang, parts of Sichuan, Yannan and Gansu are above 13,000 feet in altitude. Some main roads in Tibet, Qinghai and Xinjiand go above 17,000 feet. At these levels the available oxygen is very low and altitude sickness may occur. Travellers may experience severe headaches, nausea, dizziness, shortness of breath or a dry cough. These symptoms usually settle over a few days with rest, but if not travellers should seek medical assistance and, if possible, descend to a lower altitude. Travellers with a history of cardiac problems or respiratory difficulties should avoid such high altitudes where possible.

Insect Bites and Malaria:

During the summer months, carry a supply of insect repellent ointments for your trip and use sensible, light coloured clothing to cover yourself when there are mosquitoes or sandflies about. The risk of malaria in most of China is limited but prophylactic tablets may be prescribed depending on your actual itinerary. Other serious mosquito borne diseases do occur so these will need to be considered.

Sunlight:

The sunlight during the summer months and in Tibet at high elevations can be intense so travellers should bring sun screen and sun-glasses and a sensible wide-brimmed hat.

Acupuncture:

Many tourists are tempted to experience this oriental art in its homeland while visiting China. It is essential to ensure that sterile needles are used at all times as otherwise there may be a risk of transmission of a blood borne disease such as the HIV virus or Hepatitis B.

AIDS risk in China:

Official figures suggest that AIDS is a very limited risk in China. Only 707 cases were reported up to October 2000. These very low figures are very difficult to verify and so all travellers should take care not to place themselves at risk where possible.

Customs Regulations: 

Never carry any medication for another individual unless they are part of your family. The Chinese authorities have strict drug regulations which may be enforced.

Vaccination Requirements: 

 There are no vaccination requirements for entry / exit purposes but travellers on short trips should consider the following ... * Poliomyelitis (childhood booster) * Typhoid (food & water disease) * Tetanus (childhood booster) * Hepatitis A (food & water disease) Those planning to spend a longer time in China should consider additional vaccination against conditions like Rabies, Hepatitis B, Japanese B Encephalitis, Meningococcal Meningitis, Diphtheria and Mantoux Test / BCG vaccination.

Summary: 

China is teeming with people and a culture very different to ours. It is a land of many contrasts. Travellers generally stay healthy if they follow standard commonsense healthcare advice.

Travel News Headlines WORLD NEWS

Date: Thu, 5 Mar 2015 13:53:47 +0100 (MET)

Dili, East Timor, March 5, 2015 (AFP) - An American tourist has returned to the United States after six months trapped in East Timor over the discovery of drugs in a taxi that she was sharing.    Stacey Addison arrived back in Portland, Oregon, on Wednesday, embracing her mother tightly during an emotional reunion at the city's airport, TV reports showed.    "It's a great feeling, it's a relief to finally be back home, be out of there," she told a local station, adding her experience in East Timor, a tiny half-island nation bordering Indonesia, had been an "emotional rollercoaster".   A Facebook group set up to advocate for her release carried a celebratory message on Tuesday announcing that she had left East Timor: "IT'S FINALLY HAPPENED! STACEY IS ON HER WAY HOME!!!!"   Addision was arrested on September 5 after methamphetamine was found in the shared taxi that was en route to the capital Dili, but denied any wrongdoing.

The veterinarian, who had just crossed from Indonesia when she was arrested, wrote on Facebook that another passenger -- who was a stranger -- picked up a package containing the drugs, and police later detained everyone in the car.   She was initially released from jail after several days but was later re-arrested, although no charges were laid against her.    Addison was released again in December, but East Timor authorities hung on to her passport while they continued to investigate her case.    Her lawyer had warned that the probe could take two years but last week the East Timor government announced that prosecutors had decided not to pursue her case and "Ms. Addison is now free to leave".   The State Department had supported Addison and pressed for her release.   East Timor, a poor half-island nation that was occupied by Indonesia for over two decades, imposes tough punishments for drugs cases, including the death penalty for traffickers.
Date: Tue, 4 Feb 2014 00:59:28 +0100 (MET)

JAKARTA, Feb 03, 2014 (AFP) - A strong 6.1-magnitude earthquake hit eastern Indonesia Tuesday but there was no tsunami alert, seismologists said.   The quake struck at 7:36 am local time (2236 GMT Monday), 318 kilometres (197 miles) east-northeast of the East Timor capital Dili in the Banda Sea at a depth of 18 kilometres, the US Geological Survey said.

The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between East Timor and the Maluku islands.   In an initial assessment, the USGS said there was a low likelihood of damage or casualties.

Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity.   A 6.1-magnitude quake struck Indonesia's main island of Java in January, damaging dozens of buildings.   Another 6.1 quake that hit Aceh province on Sumatra island in July 2013 killed at least 35 people and left thousands homeless.
Date: Sun, 1 Dec 2013 04:07:58 +0100 (MET)

AMBON, Indonesia, Dec 01, 2013 (AFP) - A 6.3-magnitude quake hit off eastern Indonesia and East Timor Sunday, seismologists said, but there was no tsunami alert or reports of damage or casualties.   The quake struck at 10:24 am local time (0124 GMT), 351 kilometres (217 miles) east-northeast of the East Timor capital Dili at a relatively shallow depth of 10 km, the US Geological Survey said.

The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between the islands of Timor and New Guinea.   In an initial assessment, the USGS said there was a low likelihood of damage or casualties.   Indonesian officials said they had not received any reports of casualties or damage so far.   "From data, the epicentre is quite a distance from the nearest cities and the intensity of shaking is not destructive," Suharjono, the technical head of Indonesia's geophysics and meteorology agency, told AFP.

An AFP correspondent in Dili said no tremor was felt.   Johanes Huwae, a police official in the Maluku provincial capital Ambon, one of the cities closest to the epicentre, said "there was no shaking, everything's safe", while the national disaster management agency reported "slight shaking for three to five seconds" in Southwest Maluku.   Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity.   A 6.1-magnitude quake that struck Aceh province on Sumatra island in July killed at least 35 people and left thousands homeless.
Date: Tue 20 Mar 2012
From: Helen Hanson <helenjhanson@gmail.com> [edited]

Re: Meng Ling Moi's post from Japan re: DENV-3 in 3 Japanese travelers returning from East Timor in March [see ProMED-mail archives 20120319.1074013 and 20120306.1060914]

I am the Australian Embassy's doctor in Dili, East Timor. Our clinic sees expatriates and some locals.

It is likely that I saw one or more of the travellers concerned prior to their return to Japan.

Our small one-doctor clinic saw 45 test-confirmed cases of dengue in February [2012] alone, mostly expatriates. These are not included in the 161 test confirmed cases for East Timor quoted in the previous post. Serotyping is not available in Dili, however reports from my colleagues at the ASPEN military medical facility, where blood samples have been sent to Australia for analysis, have also shown DEN-3 to be the circulating serotype.
-------------------------------------------------
Dr Helen Hanson
Australian Embassy Clinic
Dili, East Timor
helenjhanson@gmail.com
=========================
[ProMED-mail thanks Dr Helen Hanson for this 1st hand report. These types of reports from health professionals in the field who are dealing with outbreaks are especially valuable sources of reliable, current information. Her report confirms the circulation of dengue virus 3 in East Timor.

A HealthMap/ProMED-mail interactive map of East Timor can be accessed at
<http://healthmap.org/r/1KlU>. - ProMed Mod.TY]
Tuesday 6th March 2012
A ProMED-mail post
<http://www.promedmail.org>

- East Timor (national). 2 Mar 2012. As of 24 Feb [2012], the Ministry of Health had received 563 reports of dengue (161 confirmed by laboratory tests) in every district except one, including 192 reports of DHF that causes severe abdominal pain, vomiting, and in worst cases, death. This is a 36 per cent increase over reports for the 1st 2 months of 2011. As of 1 Mar [2012], 10 people had died from dengue, according to the government.
=====================
[A HealthMap/ProMED-mail interactive map of East Timor can be accessed at <http://healthmap.org/r/1KlU>. - ProMed Mod.TY]
More ...

Chad

Chad - US Consular Information Sheet
March 29, 2007
COUNTRY DESCRIPTION: Chad is a developing country in north central Africa with one of the lowest per capita incomes in the world. Chad faces challenges in the areas of political stability and
conomic development. Years of war, drought, and lack of economic growth have severely damaged the country's institutions and its infrastructure. Facilities for tourism are limited. The capital is N'Djamena. French and Arabic are the primary languages. Read the Department of State Background Notes on Chad for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport and visa are required. Visitors must check in with the National Police and obtain a registration stamp within 72 hours of arrival. Further entry information may be obtained from the Embassy of the Republic of Chad, 2002 R St. N.W., Washington D.C. 20009, telephone (202) 462-4009. Overseas, inquiries should be made at the nearest Chadian embassy or consulate. Some travelers originating in countries with no Chadian embassy or consulate can arrange for airport entry visas. This process is generally limited to business or official travelers, and arrangements must be made by the traveler’s local contact in Chad several days in advance of arrival. The U.S. Embassy is not in a position to assist private U.S. citizens with their visa application for travel to Chad.

See our Foreign Entry Requirements brochure for more information on Chad and other countries.

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

SAFETY AND SECURITY: See the Department of State’s Travel Warning for Chad.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s website where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.

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

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

CRIME: Americans and Europeans are perceived to be wealthy and certain precautions should be taken. Travelers are advised not to leave cash or valuables unsecured in their hotel room and not to wear expensive jewelry or show large amounts of cash. Travelers are also advised to dress modestly, not to walk outside after dark, and to lock their car doors. Petty crimes such as purse snatching, pick-pocketing and theft from vehicles do occur, particularly in areas frequented by expatriates. Violent crime is somewhat rare, but does occur. Burglary and vehicle thefts increase during times of political instability. Expatriate residences have been targeted for armed robbery, and some foreigners have been assaulted in the process. Travelers to northern Cameroon should contact the U.S. Embassy’s Regional Security Officer in N'Djamena prior to crossing the Chad/Cameroon border because of a high incidence of road attacks there.

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

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Chad are extremely limited. Medicines are in short supply or unavailable, including many over-the-counter preparations sold in the United States. Travelers should carry any needed, properly labeled, medicines with them. In the event of major injury or illness, visitors generally will require medical evacuation.

There are two medical clinics in the capital of N’Djamena, International SOS and the Centre Medico-social de l’Ambassade de France. Advance membership is required to access these two clinics.

Malaria is a serious and sometimes fatal disease.
Plasmodium falciparum malaria, the type that predominates in Chad, is resistant to the antimalarial drug chloroquine.
Because travelers to Chad are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam - TM), doxycycline, or atovaquone/proguanil (Malarone -TM).
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, including protective measures, visit the CDC Travelers’ Health web site at http://www.cdc.gov/travel/malinfo.htm.

Other widespread diseases in Chad include diarrhea and upper respiratory infections. AIDS is becoming an increasingly serious problem as infection rates have risen to alarming levels (up to 25 percent in high-risk groups). Meningitis outbreaks usually occur annually and several other diseases (cholera, diphtheria, chicken pox, typhoid) periodically appear.

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

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

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

Roads are in poor condition and dangerous. In the capital city of N'Djamena, only the main roads are paved; the rest of the roads are either hard-packed dirt or looser dirt and sand. During the summer rainy season (mid-June to mid-September) many roads become impassable or are restricted by rain barriers, while during the drier season, clouds of dust rising from the roads reduce visibility.

Visitors should take great care while driving. Both paved and unpaved roads are poorly maintained, and often have large ruts and potholes. All drivers should adjust their speed accordingly. At night, streets are not lit; it is imperative to watch for pedestrians, bicyclists, motorcyclists, and livestock, as they may not become visible until they are in very close proximity.

Driving in Chad tends to be erratic both in cities and in rural areas. In cities, particularly N'Djamena, motorists share the roads with bicycles, motor scooters, pedestrians, and non-motorized wheelchairs. Lanes are not marked, and it is not uncommon for a normally two-lane thoroughfare to become a four-lane road during rush hours (generally 7:00 a.m.-9:00 a.m. and 3:00 p.m.-6:00 p.m. Monday-Thursday; 7:00 a.m.-9:00 a.m. and 11:00 a.m.-12:30 p.m. on Friday). Drivers are urged to be particularly observant at these times because motorists often attempt to overtake slower traffic by moving into oncoming lanes, usually at high speeds.There are only a few traffic lights in N'Djamena, and these are often out of service. Drivers yield to traffic on their right, particularly when entering the many traffic circles.

In rural areas, drivers should watch for livestock crossing the roads, and for large hawks that rest on the roads. These birds can be fearless, and cause damage by smashing into drivers' windshields; drivers may avoid this by slowing down when approaching the hawks, and allowing them sufficient time to fly away. Finally, drivers should be alert to older transport trucks traveling between cities, which do not always have functioning headlights.

No emergency services exist, so drivers should exercise extreme caution. Travelers should always wear seat belts. When traveling by car, be sure to carry a spare tire. Roadside service is limited to good Samaritans and children who will help push cars to the side or out of holes. When traveling outside the capital, it is imperative to carry sufficient quantities of drinking water. Drivers should ensure that their gas tanks are at least half-full at all times, as gas stations are not widely available. Gas may be purchased in an emergency in bottles from roadside stands, but it is generally of poor quality.

Travelers on roads in all areas of the country are subject to attack by armed bandits.
Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES: All photography requires a government permit. Taking photos of military sites, official buildings, and airports is strictly prohibited, even with a permit. Such sites are not always clearly marked. Film and cameras may be confiscated, often by undercover police.

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 Chadian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Chad 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 onCriminal Penalties.

CHILDREN'S ISSUES: Embassy N’Djamena does not issue immigrant visas. Therefore, American citizens who adopt children in Chad are required to travel to the U.S. Embassy in Yaounde, Cameroon, or another Embassy for visa processing before return to the United States.

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 Chad are encouraged to register with the U.S. Embassy in Chad through the State Department’s travel registration website , Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy in Chad is located in N'Djamena on Avenue Felix Eboue; mailing address is B.P. 413; telephone (235) 51-62-11, 51-70-09, 51-77-59, 51-90-52, 51-92-18 and 51-92-33, fax (235) 51-56-54.
* * *
This replaces the Country Specific Information dated July 10, 2006 with no updates.

Travel News Headlines WORLD NEWS

Date: Thu 30 Jan 2020
Source: ReliefWeb [abridged, edited]

A provisional total of 53 cases of Guinea worm disease were reported in 2019, The Carter Center announced Wednesday [29 Jan 2020].  Intensified surveillance and reporting incentives in endemic areas in recent years have produced expected fluctuations in the small number of Guinea worm cases. When The Carter Center assumed leadership of the program in 1986, about 3.5 million human cases occurred annually in 21 countries in Africa and Asia.

The campaign against the disease, also called dracunculiasis, has taken on additional complexity in recent years with the rise of infections in animals, primarily dogs in Chad. The world's foremost experts and partner governments are responding vigorously.  "The time to eradicate Guinea worm is now," said Adam Weiss, director of The Carter Center Guinea Worm Eradication Program. "To prevent unnecessary suffering, the remaining endemic countries are going all out with every intervention available."

For example, in Chad, the national program intensified surveillance and broadly promoted cash incentives for reporting suspected infections. As a result, in 2019, rumors of human cases rose 137% and rumours of animal infections rose 268% compared with 2018. The program investigated 95% of those rumors within 24 hours. Additionally, the larvicide Abate was applied to water sources in 408 villages in 2019, compared with 72 villages the previous year [2018].

During 2019, 47 human cases of the disease were reported in Chad, 4 in South Sudan, one in Angola, and one in Cameroon that is believed to have been imported from Chad. No human cases have been reported for 2 years in Ethiopia or 4 years in Mali, but the 2 countries are still considered endemic. As for Guinea worm infections in animals (mainly dogs but also a handful of cats and baboons), 1973 were detected in Chad, 9 in Mali, 8 in Ethiopia, and one in Angola; none [were reported] in South Sudan or Cameroon. (All 2019 figures are provisional until officially confirmed in March 2020. Further details can be found in the latest issue of Guinea Worm Wrap-Up.)

Interventions to stop transmission include community-based health education, filtering all drinking water, keeping people and animals with emerging Guinea worms from entering water sources, and targeted use of Abate in stagnant water sources.

Only one human disease has ever been eradicated; that was smallpox, 40 years ago. For a disease to be declared eradicated, every country in the world must be certified free of human and animal infection, even those where transmission has never taken place. To date, 199 countries have been certified free of Guinea worm; only 7 have not.

Wednesday's [29 Jan 2020] announcement comes on the eve of the inaugural World Neglected Tropical Disease (NTD) Day, created to draw attention to a group of little-known conditions, including Guinea worm, that disproportionately affect the world's poorest and most marginalized people.

In late 2019, the World Health Organization and the NTD community agreed to adjust and accelerate elimination targets for NTDs to align with the United Nations' 2030 Sustainable Development Goals. The Carter Center, the WHO, and the independent International Commission for the Certification of Dracunculiasis Eradication all agreed that Guinea worm's goal could fit into the adjusted plan. As a result, the target date for eradication of Guinea worm disease -- including for the 1st time the certification process, which takes at least 3 years -- now is by 2030. The WHO is the only body that can certify disease eradication.

"The Carter Center's goal is to end the human suffering caused by the disease as soon as possible, and the revised target of 2030 would include that goal," said Dr. Donald R. Hopkins, a veteran of the campaign to eradicate smallpox who is The Carter Center's special advisor for Guinea worm eradication.

"The fight against Neglected Tropical Diseases is long and difficult, but so is every battle worth fighting," added Dr. Mwelecele Ntuli Malecela, director of the WHO Department of Neglected Tropical Diseases. "Victory cannot be achieved merely by dreaming. The way to victory is marked by honest goals, good science, and focused work. We are bringing all of these to bear against Guinea worm disease."

The Carter Center Board of Trustees announced in September 2019 a USD 40 million fundraising campaign, including a USD 20 million Carter Center Challenge Fund, toward the eradication of Guinea worm disease. The Challenge Fund will match donations up to USD 10 million per year in 2019 and 2020, for a total of USD 20 million in matching funds.

"Our successes are a testament to the fierce persistence of people on the front lines and our committed partners," Jason Carter, chair of The Carter Center Board of Trustees, said. "We are grateful for every ally standing with us as we seek to eradicate the 1st parasitic disease in human history, and we are so committed that we are investing our own endowment funds into the effort."

Considered a neglected tropical disease, Guinea worm disease (dracunculiasis) is usually contracted when people consume water contaminated with tiny crustaceans (copepods) that carry Guinea worm larvae. The larvae mature and mate inside the patient's body. The male worm dies. After about a year, a meter-long female worm emerges slowly through a painful blister in the skin. Contact with water stimulates the emerging worm to release its larvae into the water and start the process all over again. Guinea worm disease incapacitates people for weeks or months, reducing individuals' ability to care for themselves, work, grow food for their families, or attend school.

Without a vaccine or medicine, the ancient parasitic disease is being wiped out mainly through community-based interventions to educate people and change their behavior, such as teaching them to filter all drinking water and preventing contamination by keeping patients from entering water sources.
==========================
[This is a timely update from The Carter Center (<https://www.cartercenter.org/health/guinea_worm/index.html>), which has been leading efforts in Guinea worm eradication for many years. The review discusses in detail the challenges and the results. The finding of a reservoir in dogs has complicated the efforts in Chad. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Date: Wed, 14 Aug 2019 15:14:41 +0200 (METDST)

N'Djamena, Aug 14, 2019 (AFP) - A female suicide bomber killed six people after blowing herself up in western Chad early Wednesday, a senior army officer said, in an attack attributed to Nigeria's Boko Haram jihadists.   "Six people died, including a soldier," in the attack in Kaiga-Kindjiria district, said the source, speaking on condition of anonymity.    A number of people were also injured, the officer said, without giving figures.   A provincial security official said a woman wearing an explosives-laden belt "blew herself up near the home of a traditional chief".   Four guards as well as a soldier were among the dead, and five people were wounded, the official said.   The death toll of six was confirmed by Chadian army spokesman Colonel Azem Bermandoa, and by a local NGO.   There was no immediate claim of responsibility.

Kaiga-Kindjiria lies in Lac province, which abuts the vast Lake Chad -- a region shared by Chad, Cameroon, Niger and Nigeria.   Boko Haram launched an insurgency in northeastern Nigeria a decade ago that has since spilled over into neighbouring countries.   It has carried out at least 10 cross-border attacks in Chad since 2018, mainly targeting army positions.   In March, 23 troops were killed when their forward position on the northeastern side of the lake came under attack.   In June, 11 soldiers were killed and six were wounded in clashes at Tchoukoutalia, according to the authorities, who said 26 jihadists were killed.   Boko Haram's campaign has left some 27,000 people dead and displaced around two million in Nigeria alone, according to some estimates.   In 2015, the four Lake Chad countries, together with Benin, set up a combined force to fight Boko Haram with the help of local groups of armed citizens.
Date: Sun, 26 May 2019 12:12:06 +0200

N'Djamena, May 26, 2019 (AFP) - Four Chadian soldiers and a television reporter were killed when their vehicle hit a mine on a road in eastern Chad, security sources said Sunday.   The victims were headed towards an army position that had been attacked by elements of the Boko Haram Islamist group overnight Friday, the sources said.   "This delegation of the Chadian army was headed to Ngounboua (on Lake Chad), where elements of Boko Haram had attacked an army position overnight, illing at least one on our side," a security source told AFP. 

The source said 23 Boko Haram fighters were killed, confirming a toll given by Chadian army spokesman Azem Bermandoa on national television.   Dimouya Soiapebe, the head of Lake Chad Province, said soldiers and a journalist for the national broadcaster had gone to the scene to "raise the morale of the troops" when the bomb went off.   "Terrorists often lay explosive devices on the roads leading to positions they have attacked," Soiapebe said.

In March, 23 soldiers were killed in the Lake Chad region in the deadliest attack yet on the Chadian army by Boko Haram, which launched an insurgency in Nigeria a decade ago.   The revolt has claimed more than 27,000 lives and uprooted some 1.8 million people.
Date: Thu, 11 Apr 2019 05:29:58 +0200
By Amaury HAUCHARD

Adré, Chad, April 11, 2019 (AFP) - Dinar Tchere is fighting time and the sun, and he fears he may be losing.   This morning, the health worker is expected in a remote village of eastern Chad, where he will administer the measles, mumps and rubella vaccine to poor children.   But he's behind schedule -- and there is limited time before his enemy, the blistering Sahelian heat, will destroy his precious drugs.  Tchere takes his gear and the ice-packed cooler that shields the vaccines, puts them in an NGO pickup and heads out from his clinic in Hilouta, in Ouaddai province, on the dusty untarmacked road.

Twenty minutes later he is in Agang, a village of 400 people, and there, another private dread has turned to reality. No-one is there to be vaccinated.   "It's just what I feared -- most of the mums have gone off to the market to do their shopping," groans Tchere, a stocky, shaven-headed man in his fifties.    There is nothing to do but hope that the mothers and their children will return. He stretches out a mat on the soil, under a mango tree.   His luck starts to turn. One by one, mothers with their children make their way to the spot, and soon there is no room on his mat for youngsters waiting for their jab.

- Cold chain -
Always worried by the heat -- the thermometer now reads 40 degrees Celsius (104 degrees Fahrenheit) -- Tchere dips his finger into the cooler to check that the ice has not melted, and starts the vaccination.   "Our biggest headache is ensuring that the vaccines are always kept cold," says Tchere, who heads one of 21 health centres in the region.   "Since the troubles of 2007, we no longer have a solar panel or fridge."   The "troubles" refer to years-long violence by armed groups on the tense border between Sudan and Chad.   Hilouta, which lies less than two kilometres (one mile) from the border, became a combat zone.   With no power, how does Tchere keep his vaccines cool?   "I stock them in Sudan, in a clinic on the other side of the border. They've got a fridge," he explains.

But there's a problem: because of security concerns, Sudan refuses to let people cross the border by motorbike -- Tchere's only form of transport when he cannot use the pickup.   So on the eve of every immunisation session, Tchere walks into Sudan, carrying his cooler, fills it up with vaccines, and walks back into Chad.   His clinic administers to about 60 villages. He says e does four vaccination sessions per month -- two in the clinic, and two in the villages.   Most often, he does the outside trips on his motorbike, always taking care never to take the same route back home, in order to avoid holdups.

The state no longer pays the running costs of his health centre -- a French NGO, Premiere Urgence Internationale (PUI), has stepped in, using financial help provided by the European Union.   In Arkoum, about 50 kilometres (30 miles) from Hilouta, Felix Djembonoudji, a nurse who runs the health centre, says that the stockpile of vaccines -- held in the district's main town of Adre, several hours away by road -- has run out.   "The people (in Adre) sometimes don't receive any -- we've been without MMR (vaccine) for five days," he says.

- Measles threat -
Measles is often dismissed by so-called anti-vaxxers who oppose immunisation as a disease of the past or non-threatening.   Experts say that it is neither -- measles is on the comeback trail.    And out of every 20 children who catch measles, as many as one will suffer from pneumonia, according to the US Centers of Disease Control (CDC). Blindness, encephalitis and severe diarrhoea are also serious complications.   Only one child in five in Chad is fully vaccinated against measles, according to a 2017 survey.   "Measles can also cause malnutrition in non-vaccinated children, which in itself is a cause of premature death," said PUI's mission chief in Chad, Fabienne Mially.

According to UN figures, more than one child in 10 in Chad will die before their fifth birthday.   In Agang, the measles vaccination session comes to an end, and Tchere is packing up his gear when a horse appears on the horizon, its hooves kicking up dust, bearing a man and his six-month-old baby.   The infant needs his second MMR vaccine. "It's important!" pleads the father. The child will get his jab.   Tchere returns to his clinic in Hilouta. There is no water or electricity. Two local people are awaiting him in the gloom, desperate for a medical consultation.    "The working day is long," he sighs, as he welcomes them in.
Date: Tue, 9 Apr 2019 04:47:15 +0200
By Amaury HAUCHARD

Hadjer Hadid, Chad, April 9, 2019 (AFP) - "I've already earmarked a customer for this drum -- I need to get a move on!"   Ali Ahmat,12, flicks his whip to persuade a hard-driven horse to press on with his cart, laden with 200 litres (44 imperial gallons) of freshly-fetched water.   The young entrepreneur is one of the informal but indispensable links in a chain to supply people in Ouaddai, eastern Chad, with water, the stuff of life.

Scorching temperatures, an open sky, a shortage of deep wells and lack of water purification system make this a thirsty part of the world indeed.   "After the rainy season, water becomes scarce," says Mahamat Adoum Doutoum, chief of the Guerri region, where only two deep wells exist for 86,000 inhabitants. "So people go to look for water in the wadi."   Wadis -- "riverbeds" in Arabic -- are watercourses that run strong and fast during the rains and are often dangerous to cross, but largely dry up for the rest of the year. When there is no more rain, people dig wells in the wadis and install pumps to extract groundwater.

Ali and dozens of other water carriers flock to the pumps to collect supplies they plan to sell to people who have no access to the source, often in dusty settlements.   Each refill of his 200-litre drum costs Ali 100 CFA francs (0.15 euros / $0.17), but he can sell the water for five times as much in town. "We do between seven or eight return trips each day, roughly," he says.     Towards the end of a hot Sunday, the blazing sun has set and Ali's cart is heading towards Hadjer Hadid.

The town harbours a refugee camp for people who fled conflict and mass killings in the Darfur region of western Sudan, the far side of the border.   Pascal, a Sudanese refugee and father of five in his 50s, is also used to the return trips between the town, the bed of the wadi and the muddy wells.    He first came to Chad about 15 years ago and says that he "suffered" to be able to buy his own donkey.   The beast of burden was an investment that has paid off, however, enabling Pascal to deliver water to the townsfolk over the past two years and bring a small sum home to his family.

- Add bleach -
But he remains concerned about the quality of the water.   "To drink the water, you also have to add bleach," Pascal says.   While water has become as rare as it is valuable, the kind to be found around wadis is unsafe. Traditional wells dug into the earth at the wadis provide water that is often the same colour as the soil.   "The water can be contaminated at various points, either at the source, which may be unprotected, or during transport, using receptacles which are inappropriate, dirty or uncovered, and during storage and distribution," says Fabienne Mially, mission chief in Chad for the French aid group Premiere Urgence Internationale (PUI).

The NGO supports 11 health centres in the Ouaddai region, where awareness sessions on the importance of proper drinking water are regularly organised.   In Borota, a village several hours' drive from Hadjer Hadid, the head of the local health centre has no illusions. Of the six standpipes in the village, none is working any more.   "They were installed by NGOs," says the official, Koditog Bokassa, who says that wadi water is the only available source of water locally.   He hands out sachets of bleach to dilute in untreated water.   But Bokassa lacks the means to satisfy everybody and PUI has become the sole supplier of bleach in central parts.    The state used to deliver some, but has not done so for more than a year, he says. It is quite common to see young people at the wadis drink directly from their cans.

- 'Barely enough' -
The town has holding basins and water towers designed to retain water during the rainy season.   "But the holding basins are insufficient and the two water towers broke down several years ago," says local resident Hassan.   One trader has bought two barrels of 200 litres apiece, which he leaves in the courtyard of his house. "It's barely enough for the children, but it's better than nothing."   The water deliverer Pascal does not have the money to buy a drum of such munificence. For the seven members of his household, there are seven 20-litre cans on the stoop.    "I haul water every day, but I have the same problem as everyone else," he said.
More ...

Grenada

Grenada US Consular Information Sheet
March 30, 2007
COUNTRY DESCRIPTION:
Grenada is a developing Caribbean island nation.
The capital is St. George’s. Tourism facilities vary, according to price and area. Read the Department of Sta
e Background Notes on Grenada for additional information.
ENTRY/EXIT REQUIREMENTS: Although Grenada has its own entry requirements, the Intelligence Reform and Terrorism Prevention Act of 2004 requires all U.S. citizen travelers to and from the Caribbean to have a valid, unexpired passport to depart or enter the United States by air. Effective January 23, 2007, U.S. citizens, including infants and children, must have a valid, unexpired U.S. passport, or a “passport card” (which is now under development) when departing or entering the U.S. by air.
IMPORTANT NEW INFORMATION:The new passport requirement will be extended to all land border crossings as well as sea travel no later than June 1, 2009.
We strongly encourage all American citizen travelers to apply for a U.S. passport or “passport card” well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports. Until the passport requirement is in place for sea travel, U.S. citizens traveling by ship to Grenada may refer to our Foreign Entry Requirements brochure for documentation that is acceptable for travel to and from Grenada.
There is no visa requirement for stays up to three months. There is an airport departure fee of US$20 for adults and US$10 for children between the ages of five and twelve.
See our Foreign Entry Requirements brochure for more information on Grenada and other countries.

For additional information concerning entry/exit requirements, travelers may contact the Embassy of Grenada, 1701 New Hampshire Avenue, N.W., Washington, D.C. 20009, telephone: (202) 265-2561, Fax: (202) 265-2468: e-mail: grenada@oas.org, or the Consulate of Grenada in New York.
Read our information on dual Nationality and the prevention of international child abduction. Also, please see 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. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Street crime occurs in Grenada.
Tourists have been victims of armed robbery especially in isolated areas and thieves frequently steal credit cards, jewelry, U.S. passports and money.
Mugging, purse snatching and other robberies may occur in areas near hotels, beaches and restaurants, particularly after dark.
Visitors should exercise appropriate caution when walking after dark or when using the local bus system or taxis hired on the road.
It is advisable to hire taxis to and from restaurants.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care is limited.
U.S. citizens requiring medical treatment may contact the U.S Embassy in St. George’s for a list of local doctors, dentists, pharmacies and hospitals.
Serious medical problems requiring hospitalization and/or medical evacuation to the U.S. can cost thousands of dollars.
Doctors and hospitals often expect immediate cash payment for health services.
Pharmacies are usually well stocked, and prescription medicine is available, but travelers are advised to bring with them sufficient prescription medicine for the length of their stay as occasionally there are temporary shortages of medicines; most pharmacies will check with others in the area to see if they can get what is needed.

Grenada chlorinates its water, making it generally safe to drink.
However, during especially heavy rains, quality control can slip, particularly in the city of St. George’s.
It is recommended that visitors to Grenada request bottled water, which is widely available and relatively inexpensive.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s Internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Grenada is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic moves on the left in Grenada; the majority of vehicles are right hand drive. Grenada’s roads, paved and unpaved, are mostly narrow and winding, with many blind corners and narrow or no shoulders.
Road surfaces often deteriorate; especially in the rainy season (June –November) before maintenance work begins.
Driving conditions in Grenada, including road conditions, increasing numbers of vehicles, and sometimes undisciplined minibus drivers all require caution and reduced speed for safety.
The Government of Grenada has a seat belt law; drivers and passengers found not wearing seat belts are subject to a fine of EC$1,000 (US$400).
Getting a local temporary drivers license, based on valid U.S. drivers license plus EC$30 (US$12), is highly recommended.
In the event of an accident, not having a valid local driver’s license may result in a fine, regardless of who is at fault.
Rental vehicle companies are widely available; most of them will assist in applying for temporary driving licenses.
The adequacy of road signage varies, but is generally poor to nonexistent.
For specific information concerning Grenada driver’s permits, road safety, vehicle inspection, road tax and mandatory insurance, please contact the Grenada Board of Tourism in New York at 317 Madison Avenue, Suite 1704, New York, N.Y. 10017, telephone 1-800-927-9554, (212) 599 0301; Fax: 212-573-9731; e-mail: gbt@caribsurf.com or www.grenadagrenadines.com
Please refer to our Road Safety Page for more information.
Visit the website of the country’s national tourist office at www.grenadagrenadines.com.
Additional general information can be found on Grenada’s Internet website at: http://www.grenadaconsulate.org.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Grenada’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Grenada’s air carrier operations.
For more information, travelers may visit the FAA’s internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Recovery efforts have been made from the damage caused by Hurricane Ivan in September 2004 and Hurricane Emily in July 2005.
All utilities have been restored.
Cruise ships have returned and all the main shopping areas are open.
While the majority of hotels are up and running, there is still one major resort (Le Source), which remain closed.
The resort’s management hopes to have the hotel open by the time Cricket World Cup 2007 Super Eight games take place in Grenada (alternate days April 10-21).

The February 1 merger of Liat and Caribbean Star airlines has reduced the number of daily flights between Grenada and the other Eastern Caribbean islands from six to three.
Travelers coming into the region from the U.S. and elsewhere should verify in advance directly with Liat that they have a valid reservation.
Some travelers making reservations from outside the region have arrived in the Eastern Caribbean and discovered that the reservation they thought they had on Liat, is not recognized by the airline, resulting in delayed travel as well as additional hotel costs.

Grenada experiences tropical storms during the hurricane season, from June through November. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.
It is difficult to cash personal U.S. checks in Grenada.
If accepted, they will take approximately six weeks to clear by a local bank. Major credit cards are widely accepted, and ATM facilities are available at most banks.
Most hotels and restaurants take U.S. currency; however, change will be in local currency.
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 Grenada laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Grenada 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.
For more information, 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 Grenada are encouraged to register with the U.S. Embassy through the State Department’s travel registration website , and to obtain updated information on travel and security within Grenada.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located on the main road to Lance Aux Epines after the Christian Scientist Church, and is approximately 15 minutes from the Point Salines International Airport. Telephone: 1-(473) 444-1173/4/5/6; Fax: 1-(473) 444-4820; Internet e-mail: usemb_gd@caribsurf.com. Embassy hours are 8:00 am to 12:30 pm, Monday to Friday except local and American holidays.
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This replaces the Consular Information Sheet dated October 13, 2006, to update all sections.

Travel News Headlines WORLD NEWS

Date: Mon 7 Mar 2016
Source: Outbreak News Today [edited]

Two weeks ago, health officials in Grenada reported on a chickenpox outbreak that affected 17 students at St. George's Anglican Junior School. The school was closed for the week to monitor and treat affected students.

This pustulovesicular rash represents a generalized herpes outbreak due to the Varicella-zoster virus (VZV) pathogen/CDC.

Last week, the Ministry of Health screened over 400 students from the St. George's Anglican School. The exercise saw a team of qualified nursing personnel conducting screening and evaluation of students at the St. George's Anglican Junior and Senior Schools.

A total of 255 and 183 students from the junior and senior schools respectively were examined on the compound as the institution reopened its doors following the completion of sanitation and cleaning operations.

During the screening/examination at the school, several students with skin lesions, fever, cold, headaches and skin rashes were identified and were not given clearance for a return to the classroom. Some of the students were referred to the doctor, and others were requested to be observed at home.

Meanwhile, the ministry will undertake a daily monitoring of the school, conduct education sessions with teachers and undertake another medical evaluation of students, in particular the ones that are to be observed at home and referred.

Chickenpox is a common, usually benign childhood disease caused by the varicella-zoster virus (VZV), a member of the herpes family. This virus causes 2 distinct diseases; varicella (chickenpox) is the primary infection, and later when VSV reactivates, herpes zoster (shingles).

Chickenpox is highly contagious and is spread by coughing and sneezing, by direct contact and by aerosolization of the virus from skin lesions. You can also get it by contact with the vesicle secretions from shingles.

The disease is characterized by fever and a red, itchy skin rash that usually starts on the abdomen, back or face and then spreads to nearly all parts of the body. The rash begins as small red bumps that appear as pimples or insect bites. They then develop into thin-walled blisters that are filled with clear fluid which collapse on puncture. The blisters then break, crust over, and leave dry brown scabs.

The chickenpox lesions may be present in several stages of maturity and are more abundant on covered skin rather than exposed. Lesions may also be found in the mouth, upper respiratory tract and genitals.

Chickenpox is contagious from 1-2 days before the rash forms and continues until all the lesions are crusted over (usually about 5 days).

This disease is more serious in adults than in children. Complications of chickenpox are rare, but include pneumonia, encephalitis and secondary bacterial infections.

Infection with this virus usually gives lifelong immunity, although 2nd attacks have been documented in immunocompromised people. The viral infection remains latent, and disease may recur years later as shingles.

According to the Centers for Disease Control and Prevention (CDC), the chickenpox vaccine is the best protection against chickenpox. The vaccine is made from weakened varicella virus that produces an immune response in your body that protects you against chickenpox. The chickenpox vaccine was licensed for use in the United States in 1995.  [Byline: Robert Herriman]
===================
[A map of Grenada can be found at <http://healthmap.org/promed/p/34>. - ProMED Mod.LK]
Date: Sat 28 Aug 2010
Source: Spice Grenada.com, The New Today [edited]
<http://www.spicegrenada.com/index.php?option=com_content&view=article&id=2505:dengue-fever-is-present&catid=546:august-28th-2010&Itemid=143>

After weeks of speculation among the population that there are dengue cases on the island, the officials within the Ministry of Health confirmed last week that 39 people in Grenada had come down with the fever. Head of the Epidemiology Unit within the Ministry of Health, Dr Alister Antoine, told reorters last week Tuesday [24 Aug 2010] that every parish, including Carriacou, has been affected by dengue fever, with the youngest case being a 2 year old and the oldest being 72.

He said: "In total, we have 20 males and 19 females. The figures we have now are what we have just confirmed with the lab, meaning that there were 17 new cases diagnosed during the 1st week in August [2010]." According to Dr Antoine, there was a noted increase in infection during the months of July and August. As compared to only one case in February, 6 by June, and with the number jumping to 15 in July.

"People should be making it difficult for the mosquitoes to breed, just make it difficult by cleaning up the place," he said. Presently there are 2 types of [dengue virus] strains recorded in Grenada -- type 1 and type 2, and there have been 2 cases of DHF both of which were mild and were treated successfully.
========================
[A HealthMap/ProMED-mail interactive map showing the location of Grenada in the southern Caribbean can be accessed at <http://healthmap.org/r/05Pe>. - ProMed Mod.TY]
Date: Mon, 3 Sep 2007 11:53:29 +0200 (METDST) MIAMI, Sept 3, 2007 (AFP) - A potentially catastrophic class-five Hurricane Felix ripped across the warm waters of the Caribbean early Monday towards Honduras and Belize after damaging homes and power lines in Grenada. The storm was so powerful that it tossed around a US 'hurricane hunter' data gathering airplane and forced it to abort its mission, the Miami Herald reported. At 0900 GMT the center of Felix was located some 445 kilometers (275 miles) south-southeast of Kingston, Jamaica, packing winds of 270 kilometers (165 miles) per hour, with higher gusts, the Florida-based National Hurricane Center said in its latest advisory. The hurricane was moving west at around 33 kilometers (21 miles) per hour, and "on this track the center of Felix will be near the coasts of extreme northeastern Nicaragua and northeastern Honduras early on Tuesday morning," the Hurricane Center said. Felix is then forecast to head for Belize and Mexico's Yucatan peninsula, where it could make landfall on Wednesday. No casualties were reported since Felix became the second hurricane of the Atlantic storm season on Saturday, though one person was reported missing in northern Venezuela. In just 15 hours on Sunday, Felix jumped from a Category Two storm with winds at 160 kilometers (100 miles) per hour to a rare Category Five hurricane, the most powerful on the Saffir-Simpson scale. The speed at which Felix reached maximum strength was one of the fastest ever recorded, Hurricane Center specialists said. Felix was so powerful that one of the US National Oceanic and Atmospheric Administration's 'hurricane hunter' airplanes was caught in a rapid updraft-downdraft cycle as it gathered data, the Miami Herald reported. The violent cycle placed four times the weight of gravity on those aboard the plane. "Four Gs can put a fair strain on the aircraft, and it also got some very heavy hail that can rip the paint off the plane," Hurricane Center forecaster James Franklin told the newspaper. The airplane, a modified Orion P-3 that normally carries 14 people, was ordered backto its base at Saint Croix, one of the US Virgin Islands, Franklin said. The storm, nourished by the warm Caribbean ocean, was expected to maintain its strength as it followed the general path that another Category Five storm, Hurricane Dean, took just last week. Though extremely powerful, Felix "has a very small wind field," the Hurricane Center said. "Hurricane force winds extend outward up to 45 kilometers (30 miles) from the center, and tropical storm force winds extend outward up to 185 kilometers (115 miles)," the Hurricane Center said. The Honduran government early Monday warned officials along its Caribbean coast to prepare for the hurricane. Hurricane conditions "are also possible over extreme northeastern Nicaragua," the Hurricane Center said. In Venezuela civil defense officials said a person went missing as beaches were evacuated in Puerto Cabello, 120 kilometers (75 miles) west of Caracas, where Felix generated high winds, heavy rains and up to three meter (10 foot) swells. There were no immediate reports of damage as the storm skimmed just north of the Paraguana peninsula, site of Venezuela's main oil refineries. Meanwhile Jamaica, which lay well to the north of Felix's track, was under a tropical storm watch as it prepared to hold elections Monday, already postponed from one week ago by Hurricane Dean. Warnings for Aruba, Bonaire and Curacao were discontinued as Felix swiped the popular tourist destinations in the Netherlands Antilles after wreaking some damage in Grenada, ripping roofs, downing power lines and knocking radio and TV stations off the air. Last week, Dean, also reaching category five, swept through the Caribbean with severe winds and rains, leaving a wide swathe of damage and a death toll of 30 from Martinique to Mexico.
Date: Thu, 14 Jul 2005 17:59:59 +0200 (METDST) MIAMI, July 14 (AFP) - Hurricane Emily, the Atlantic's second big storm of the season, headed west, gathering strength Thursday, the National Hurricane Center said, just after its predecessor Dennis carved a trail of death and destruction across the region. Packing 100-mile-per-hour (160-kilometer-per-hour) winds and growing stronger, Emily -- now a Category Two hurricane on the Saffir-Simpson intensity scale, on which five is the top-force storm -- lashed Grenada and headed toward Hispaniola island. Shared by the Dominican Republic and Haiti, Hispaniola's southern coast was grazed last week by Dennis, leaving at least 40 people dead in Haiti. Dennis went on to kill 16 in Cuba and one man in Jamaica. Emily was expected to produce heavy rain across much of the southern Caribbean and northern Venezuela, as well as the Netherlands Antilles. "These rains could produce life-threatening flash floods and mudslides," the center warned. In Grenada, where 30,000 people -- one-third of the permanent population -- remain homeless 10 months after Hurricane Ivan, there were widespread fears about the new storm. There were no immediate reports of fatalities in Grenada Thursday, though authorities said they were inspecting damage. At 1500 GMT, the storm's center was about 560 miles (905 kilometers) southeast of Santo Domingo in the Dominican Republic, moving west-northwest near 18 miles (30 kilometers) per hour, the US center said. "Additional strengthening is forecast during the next 24 hours," the center added. The government of the Dominican Republic has issued a tropical storm watch from Punta Salinas westward to the Haitian border. And the government of Haiti has issued a tropical storm watch from the border with the Dominican Republic to Port-au-Prince. In Haiti, civil protection agency spokesman Jeffe Delorges said after Dennis roared past last Thursday that 23 bodies were found in the southwestern town of Grand-Goave. Most were killed when a bridge collapsed. Another 10 were killed in the Grande-Anse region, also in the southwest, along with five in the southeast and two in the southern city of Cayes. The agency estimates that about 15,000 people are without homes or means to feed themselves, with hundreds of houses completely destroyed. It said there had been widespread flooding and damage to plantations. The Haitian government announced emergency aid totaling the equivalent of 30,000 dollars. Cuban President Fidel Castro said in a televised address late Monday that the toll from Dennis had climbed to 16 and that Dennis destroyed or damaged 120,000 homes and caused more than 1.4 billion dollars in damage. Castro also read from a lengthy list of agricultural devastation: "The entire crop of citrus fruits was lost -- 200,000 tonnes of grapefruit fell from the trees, as did 160,000 tonnes of oranges. "At hundreds of dollars per tonne, that's a huge loss for our exports," he said. Dennis, the first hurricane of the season, was estimated to have caused a further one billion to five billion dollars in insured losses in the United States, according to Risk Management Solutions.
Date: Thu, 7 Oct 2004 03:19:49 +0200 (METDST) by Laura Bonilla POINT SALINES, Grenada, Oct 6 (AFP) - US Secretaty of State Colin Powell flew over the Caribbean island state of Grenada on Wednesday to survey the damage caused by Hurricane Ivan and vowed to bring more help to this devastated spice island. The hurricane killed 39 people and destroyed 90 percent of the tiny island's buildings when it blasted across the Caribbean on September 7, causing an estimated 800 million dollars in damage. This island of 90,000 people is heavily dependent on tourism and nutmeg production, which together account for 40 percent of the economy. The United States has given one million dollars in aid to Grenada and pledged an additional 3.6 million, US officials said. The island will receive additional help in a 100-million-dollar emergency aid package that US President George W. Bush has requested from Congress for Caribbean nations hit by a wave of hurricanes this storm season, Powell said. "We'll do everything we can to expedite the flow of that money," Powell said in a news conference at the airport in Point Salines, the island's southernmost point, after surveying the destruction from his plane's cockpit. "There's an urgent need to reconstruct the economy as well as rebuilding houses and rebuilding schools," Powell said, noting that Grenada's schools, homes, farms and power system were hit by the hurricane. Residents are receiving food and water, "but it'll be a continuing challenge," he said. Shelters need to be built for people who remain homeless, the infrastructure needs to be repaired and power needs to be restored, he said. Only one-third of the island has electricity. Grenada's Prime Minister Keith Mitchell said his government's priority is to reopen schools, which remain closed. "After the devastation arrived we've gone through quite a lot in every respect," Mitchell said. He told Powell: "You understood what was happening, you had a good grasp of the problems that we've faced." From an airplane, much of the island appeared still in ruins. Some areas appeared deserted, while some buildings looked as if they had been eaten up by a raging blaze and palm trees stood leafless. "When those roofs went away, there was water damage done in all of these homes, in some cases destroying a family's entire possessions, all that they owned," Powell said. "What makes this situation so difficult for Grenada is that not only was their infrastructure hit -- schools, housing, roads, the power system -- but their means of production and the economic base of the country," he said. The nutmeg industry -- Grenada is world's second producer of the aromatic seed -- was devastated, and it takes five to 10 years for its evergreen trees to regrow, Powell said. "We want to see if there are things we can do to help with that or perhaps diversify the agricultural sector," he said.
More ...

World Travel News Headlines

Date: Wed, 19 Feb 2020 11:20:59 +0100 (MET)

Dhaka, Feb 19, 2020 (AFP) - Bangladesh on Wednesday kicked off a drive to vaccinate more than a million people against cholera, which infects tens of thousands a year, as part of an international campaign to eliminate transmission by 2030.   The delta nation has sought to reduce the impact of the disease -- which causes acute diarrhoea and spreads through contaminated food and water -- through vaccines and by setting up a dedicated treatment hospital.   "We have brought down the mortality rate in cholera to almost zero in Bangladesh," said senior scientist Firdausi Qadri at the Dhaka-based International Centre for Diarrhoeal Disease Research.   But she admitted that the number of infections was still very high.   According to the World Health Organisation, cholera infects about 1.3 to five million people every year, and kills an estimated 21,000 to 143,000.

Bangladesh has an estimated 100,000 cases a year, according to authorities, but plans to immunise half its 168 million people in the next decade.   Daisy Akter, who lost two sisters and a brother to cholera in the 1970s, was one of the first recipients of the oral vaccine at a Dhaka neighbourhood on Wednesday.   "No villager came to offer funeral prayers for them fearing they might get the disease," she told AFP.   "We had to bury them in the front yard of our home."   UN agencies and Bangladesh authorities have already carried out a massive cholera vaccination drive in the country's southeast, where nearly one million Rohingya refugees have lived in overcrowded camps since 2017.   Some 800,000 Rohingya and 600,000 locals were vaccinated in that campaign.
Date: Tue, 18 Feb 2020 17:16:35 +0100 (MET)

Juba, Feb 18, 2020 (AFP) - Swarms of locusts which are wreaking havoc across East Africa have now arrived in South Sudan, the government said Tuesday, threatening more misery in one of the world's most vulnerable nations.   Billions of desert locusts, some in swarms the size of Moscow, have already chomped their way through Ethiopia, Somalia, Kenya, Djibouti, Eritrea, Tanzania, Sudan and Uganda.   Their breeding has been spurred by one of the wettest rainy seasons in the region in four decades.

Experts have warned the main March-to-May cropping season is at risk. Eggs laid along the locusts' path are due to hatch and create a second wave of the insects in key agricultural areas.    The arrival of the locusts could be catastrophic in South Sudan, where war  followed by drought and floods has already left six million people -- 60 percent of the population -- facing severe hunger.   Agriculture Minister Onyoti Adigo Nyikiwec said the locusts had crossed the eastern border with Uganda on Monday.   "The report came that these are matured. As you know locusts are like human beings, they send their reconnaissance ahead of time to make sure that whether there is food or not and if the area is good for breeding."

Meshack Malo, the Food and Agriculture Organization (FAO) representative in South Sudan, said about 2,000 locusts had been spotted so far, and if not controlled quickly, could have a devastating impact.   "These are deep yellow which means that they will be here mostly looking at areas in which they will lay eggs."    He said the FAO was training locals and acquiring sprayers and chemicals to try and combat the locusts. It is the first locust invasion in 70 years in the country.   Other countries have employed aircraft to spray the swarms, while desperate locals have employed tactics like banging pots and pans or shooting at them.    Nyikiwec said the government had prepared a contingency plan.   "We are training people who will be involved in spraying and also we need chemicals for spraying and also sprayers. You will also need cars to move while spraying and then later if it becomes worse, we will need aircraft."

Earlier this month Somalia declared a national emergency over the invasion.   The FAO says the current invasion is known as an "upsurge," the term for when an entire region is affected.   However, if the invasion cannot be rolled back and spreads, it becomes known as a "plague" of locusts.   There have been six major desert locust plagues in the 1900s, the last of which was in 1987-89. The last major upsurge was in 2003-05.
Date: Tue, 18 Feb 2020 15:26:41 +0100 (MET)
By Ismail BELLAOUALI

AIT-BEN-HADDOU, Morocco, Feb 18, 2020 (AFP) - Millions worldwide may have seen the desert fortress in the hit fantasy series "Game of Thrones", but fewer know they can visit the Moroccan village of Ait-Ben-Haddou.   The fortified old settlement at the foot of the majestic Atlas mountains enchanted audiences in the HBO series and also served as a dusty backdrop in Ridley Scott's epic swords-and-sandals film "Gladiator".

But unlike other famous locations from movie and television history, this UNESCO World Heritage Site has so far missed out on a mass influx of tourism -- something some of its inhabitants are eager to change.    "Several people have told me that they came here to see the filming location of 'Game of Thrones'," said Ahmed Baabouz, a local tour guide. "There is tourism linked to cinema here but frankly we have not developed it to the extent it could be."   Ait-Ben-Haddou is southern Morocco's most famous fortress. Time seems to have stopped at the site overlooking a valley some 30 kilometres (18.6 miles) from the town of Ouarzazate.

After passing through the imposing entrance way, visitors navigate a labyrinth of winding alleys that eventually lead onto a public square where the settlement's inhabitants once gathered.    There is a mosque and two cemeteries -- one for Muslims and one for Jews. Most inhabitants have long since departed though, with a few homes converted into stalls selling handicrafts.    The fortress is an ideal film setting, located a short distance from the studios of Ouarzazate, the "Mecca" of Moroccan cinema. Productions ranging from "Lawrence of Arabia" to "The Mummy" have been filmed here.

More recently, scenes from the cult series "Game of Thrones" were shot at Ait-Ben-Haddou, with the site standing in for the fictional Yellow City of Yunkai which is conquered by Daenerys Targaryen, a key character in the "GOT" universe.   Hammadi, 61, is a privileged witness to the location's cinematic history.   "All of these productions have contributed to the reputation of the region," he said, grinning widely.    Hammadi himself has appeared as an extra in a number of films. And while like most people he lives in a more modern home in a village on the other side of the valley, he continues to return to Ait-Ben-Haddou to welcome tourists.

-'House of the Dragon' -
On a wall at the entrance to Hammadi's former home, photos bear witness to the projects he has worked on.    One shows him dressed as an ancient Roman with director Ridley Scott on the set of "Gladiator".    "We have a very rich cinematic heritage that we hope to use to attract tourists," said tour guide Baabouz, who is 29.   But "nothing indicates that 'Game of Thrones' was shot here," he added.    On Morocco's Atlantic coast, the city of Essaouira also formed the backdrop to scenes from the series.    But there too, Moroccan tourism promoters are yet to capitalise on the connection.

In comparison, Northern Ireland, Malta and Dubrovnik in Croatia have attracted hordes of fans from around the world, drawn by their links to the franchise.    To remedy this, Baabouz and other young people in the village are pooling their limited resources towards an ambitious project: a museum in the fortress, gathering photography from the productions that have been filmed here.    US channel HBO has commissioned a prequel to "GOT", called "House of the Dragon". George R.R. Martin, the author of the books on which the series is based, wrote on his blog that shooting would also take place in Morocco.
Date: Tue, 18 Feb 2020 09:44:12 +0100 (MET)

Macau, Feb 18, 2020 (AFP) - Macau's casinos will reopen Thursday after authorities lifted a city-wide two-week closure aimed at stopping the spread of the deadly new coronavirus.    The resumption of the lynchpin industry comes after the city reported no new infections in the last two weeks, with the number confirmed cases at just ten people.

The former Portuguese colony took the unprecedented step of shutting down almost all of its lucrative entertainment sector earlier in the month, including casinos, nightclubs and many bars.   The vast majority of Macau's tourists are mainland Chinese travellers, drawn to the city's casinos.

As the only place in China where casinos are allowed, Macau's gambling houses account for about 80 percent of government revenue.   But arrivals tanked as the epidemic spread.   Authorities said casinos that don't want to reopen because of low tourist numbers could apply to extend the closure, but they must be up and running within 30 days.

Macau's government has been keen to ensure the casinos keep employing staff through the downturn and are trying to avoid lay-offs.   Officials said all gamblers and casino staff must wear face masks.   First found in the city of Wuhan in central China, the new coronavirus has infected over 72,000 people on the mainland and 60 in Hong Kong.    It has also taken over 1,800 lives on the mainland and one in Hong Kong.
Date: Tue, 18 Feb 2020 09:07:42 +0100 (MET)

Athens, Feb 18, 2020 (AFP) - Greece was hit with a 24-hour strike Tuesday over a pension reform encouraging people to stay longer in the workforce.   The labour action paralysed public transport in Athens, intercity trains and ferry ship services.   Civil servants are also walking off the job and journalists will stage a three-hour work stoppage against the pension reform.   "This bill is practically the continuation of (austerity) laws introduced in 2010-2019," civil servants' union ADEDY said.

Unions will hold street protests in Athens, Thessaloniki and other major cities later in the day.   The new conservative government says the reform, to be voted by Friday, will make the troubled Greek pension system viable to 2070.   The labour ministry says the overhaul -- the third major revamp in a decade -- will contain pension increases and reduce penalties for pensioners still working.

Successive governments have attempted to reform the pension system, whose previously generous handouts are seen as one of the causes of the decade-long Greek debt crisis.   Chronic overspending and the inaccurate reporting of the budget deficit spooked creditors in 2010, and required three successive bailouts by the European Union and the International Monetary Fund to avert a Greek bankruptcy.   In return for billions of euros in rescue funds, Greece had to adopt unpopular austerity reforms and pension cuts.
Date: Tue, 18 Feb 2020 08:50:55 +0100 (MET)

Peshawar, Pakistan, Feb 18, 2020 (AFP) - A policeman was killed and two others wounded Tuesday by a roadside bomb aimed at polio vaccination workers in Pakistan's restive northwest, officials said.    The attack came a day after Islamabad launched a nationwide anti-polio drive, aiming to immunise tens of millions of children in Pakistan -- one of only three countries, along with Afghanistan and Nigeria, where the crippling disease remains endemic.

Opposition to inoculations grew after the CIA organised a fake vaccination drive to help track down Al-Qaeda's former leader Osama Bin Laden in the Pakistani city of Abbottabad.   According to Captain Wahid Mehmood, a district police chief, a police van monitoring the polio team was hit on the outskirts of the north-western city of Dera Ismail Khan.   "It was an IED (improvised explosive device) explosion in which one of our policemen got martyred while two others were wounded", Mehmood told AFP.   Sadaqat Khan, a local police official, confirmed the toll.   There was no immediate claim of responsibility, but the Pakistani Taliban and other militants have targeted polio vaccinators in the past.

The nationwide polio vaccination campaign aims to vaccinate some 39 million children.  Tuesday's attack follows a devastating year in Pakistan's long fight against polio, with at least 17 cases reported in 2020 so far.   In 2019, the number of polio cases jumped to 144 from just 12 in 2018.

Even as Pakistan has tried to eliminate polio, a new challenge has emerged in the form of a growing global movement against vaccinations.   The phenomenon has attracted adherents worldwide, fuelled by medically baseless claims and proliferated on social media resulting in a resurgence of once-eradicated, highly contagious diseases.
Date: Mon, 17 Feb 2020 21:19:05 +0100 (MET)
By Joe JACKSON

London, Feb 17, 2020 (AFP) - Britain on Monday battled the fallout from Storm Dennis after the second severe storm in seven days left one woman dead over the weekend.   Winds of more than 90 miles (140 kilometres) an hour, along with more than a month's worth of rain in 48 hours in some places, led officials to issue rare "danger to life" warnings.   A 55-year-old woman was found dead after being swept away by near the flood-prone town of Tenbury Wells in western England.   "We are all devastated," her family said in a statement after a body was discovered.

James Bevan, chief executive of the Environment Agency, which is responsible for flood protection, said more than 400 homes in England had been flooded while at least 1,000 agency staff were working "to protect and support those communities which have been hit".   "This is not yet over," he told BBC radio.   "We still have many flood warnings in force and we may still see significant flooding in the middle of this week from larger rivers."   The storm also pummelled much of France, with some 20,000 people without electricity on Monday after suffering power cuts in the northwest.

- 'More extreme' -
In Britain, more than 600 warnings and alerts -- a record number -- were issued on Sunday, extending from the River Tweed on the border of England and Scotland to Cornwall in the southwest.   After a day of torrential rain, major flooding incidents were declared in south Wales and parts of west central England.  In northern England, the defence ministry deployed troops in West Yorkshire, which had also been hit by flooding from last weekend's Storm Ciara.   There were fears that rivers there could burst their banks.

Newly appointed environment secretary George Eustice said the government had done "everything that we can do with a significant sum of money" to combat increased flooding.    "We'll never be able to protect every single household just because of the nature of climate change and the fact that these weather events are becoming more extreme," he said.   Youth climate activists gathering for a national conference in Staffordshire, west central England, were forced to cancel the event because of the storm.   "There's a bleak irony in our being beaten back by climate change," 15-year-old attendee Sophia said in a statement released by organisers.

- 'Supercomputer' announced -
Two rivers in south Wales burst their banks on Sunday, prompting rescue workers to launch operations to evacuate hundreds of people and their pets trapped in their homes.   Police said a man in his 60s died after entering the River Tawe, north of the Welsh city of Swansea, but later clarified that the death was not "linked to the adverse weather".

Meanwhile the bodies of two men were pulled from rough seas off the south coast of England on Saturday as the storm barrelled in.   Britain's Coastguard said it had sent a helicopter and rescue team to join navy and other search vessels after receiving reports of a man overboard in the sea near Margate, Kent.   "After many hours of searching, a body was sadly found in the water... and was brought to shore," it added.

Around the same time in nearby Herne Bay, emergency responders discovered another dead man following reports a person had been pulled from the sea, according to Kent police.   In a timely announcement the Met Office, Britain's national weather service, said Monday it would invest £1.2 billion ($1.6 billion) in a state-of-the-art supercomputer to improve forecasting.   The government claims it is the world's "most powerful weather and climate supercomputer".
Date: Sun 16 Feb 2020, 5:00 PM
Source: WHO, Weekly Bulletin on Outbreaks and Other Emergencies, page 9 [abridged, edited]

During week 4 [week ending 26 Jan 2020], a total of 73 suspected cases including one death were reported across the country, compared to 46 suspected cases and no deaths in the previous week. The majority of cases in week 4 were reported from Sankuru province (78%).

In the past 4 weeks (weeks 1 to 4 of 2020) a total of 222 suspected cases with 4 deaths (CFR: 1.8%) were notified in the country, with the majority of cases being reported from the provinces of Sankuru (31%), Bas-Uele (18%), Equateur (15%) and Mai-Ndombe (9%). There has been an increase in the weekly case incidence since week 2 of 2020.

Between weeks 1 and 52 of 2019 a cumulative total of 5288 monkeypox cases, including 107 deaths (CFR 2%) were reported from 133 health zones in 19 provinces.
======================
[Monkeypox (MPX) virus is endemic and widespread geographically in the DR Congo, with cases occurring sporadically in several provinces. January 2020 is off to a similar start with 222 suspected cases and 4 deaths reported in 4 provinces. The 2% CFR is relatively low for the clade of MPX that occurs in the DRC, which can reach 10% or more. The 222 cases are suspected, and there is the possibility that without laboratory confirmation some of them may be varicella cases misdiagnosed as MPX. There is no additional information about the circumstances under which these cases acquired their infection. Monkeys are not the reservoirs of the virus, despite the name that the virus has received. Studies of prevalence of MPX virus in populations of rodent hosts are not mentioned in this or previous reports. The main reservoirs of MPX virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp., an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_. Halting the bushmeat trade and consumption of wild animals to halt MPX virus exposure will be culturally and economically difficult, so continued occurrence of cases can be expected. MPX virus can be transmitted between people but not readily. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Fri 31 Jan 2020
Source: Nigeria CDC Situation report, yellow fever [edited]

Highlights
----------
In this reporting period:
- A total of 139 suspected cases were reported in 90 LGAs across 27 states
- All 139 suspected cases had blood samples collected
- 2 presumptive positive and 1 inconclusive case were reported; the inconclusive case was reported from Katsina State
- No confirmed case was recorded from Institute Pasteur Dakar
- No death was recorded from all the cases reported

Yellow fever response activities are being coordinated by the multi-agency yellow fever Technical Working Group (YF TWG).

Off-site support is being provided to all states.

Yellow fever preventive mass vaccination (PMVC) campaigns are planned for implementation in Oyo, Delta, Benue, Osun, Bauchi and Borno in the 3rd and 4th quarters.

Graphs and a map accessible at the above URL;
Figure 1 [graph]: Epidemic Curve of All Cases of Yellow Fever in Nigeria from Week 1 - Week 5, 31 Jan 2020
Figure 2 [graph]: Trends of Confirmed Cases in Nigeria - 2018, 2019 and January 2020
Figure 3 [graph]: Yellow fever Attack rate by State in Nigeria from Week 1 - Week 5, 31 Jan 2020
Figure 4: Map of Nigeria Showing States with Suspected and Presumptive confirmed Cases from Week 1 - Week 5, 31 Jan 2020
====================
[This report is not clear about the number of confirmed yellow fever (YF) cases that there have been in Nigeria this year (2020). The above report indicates that there are 139 suspected cases and all have had blood samples taken but does not state if all samples have been tested for YF by the Institute Pasteur in Dakar. The report does state that no confirmed case was recorded by the Institute Pasteur Dakar. The report states that 2 cases are presumptive and 1 is inconclusive. The graph in Figure 2 shows no confirmed cases in 2020.

It is curious that a 19 Jan 2020 report indicated that there were 141 suspected yellow fever cases in Jos North, Wase, Bassa, Kanam and Riyom Local Governments of Plateau State, of which 25 cases had been confirmed (see Yellow fever - Africa (02): Nigeria (PL) http://promedmail.org/post/20200121.6903167). A 29 Dec 2019 The World Health Organization (WHO) report confirmed 13 cases of yellow fever (YF), with 3 deaths in 4 local government areas of Plateau State (see Yellow fever - Africa (01): Nigeria (PL) http://promedmail.org/post/20200101.6862783). It is possible that all of these Plateau state cases occurred in 2019 and, hence, are not included in the above 2020 report which does not mention any cases in Plateau state. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Sat 15 Feb 2020 2:34:10 PM AFT
Source: MENAFN, Afghanistan Times News report [edited]

At least 35 people including women and children have died in the past few weeks due to pneumonia outbreak in Badakhshan Province in the north-western mountainous area, the provincial health department confirmed.

Dr Noor Khawari, head of the provincial public health department, said [Sat 15 Feb 2020] that the people had died in the Wakhan district, a remote area surrounded by high and impassable mountains.

He said that 15 of the dead were children, calling malnutrition and cold weather as the main reasons for the fatalities. A medical team had been dispatched to Wakhan to prevent further outbreak of the disease, according to Dr Khawari.

The provincial council had earlier said that at least 10 people had lost their lives since an unknown disease had broken out in the Yomgan district [Badakhshan Province].

The report caused panic and concerns among the residents as coronavirus [infection, COVID-19] in China that borders Badakhshan takes the lives of people every day.

But the ministry of public health denied outbreak of any unknown disease in Badakhshan, saying that the recent deaths happened only due to pneumonia and pertussis (whooping cough) as well as malnutrition. Badakhshan is one of the provinces where seasonal diseases like pneumonia and whooping cough break out during winter. The diseases claim the lives of people in the remote areas behind high mountains as the roads connecting them to the provincial capital are blocked by heavy snowfalls.

The provincial health department has deployed medical teams to the borders with China and Tajikistan to examine those entering from the neighbouring states and to prevent coronavirus [infection, COVID-9].
===========================
[We are told in the news report above that at least 35 people, including 15 children, died in the past few weeks due to a "pneumonia" outbreak in Wakhan district, a remote area surrounded by high and impassable mountains, with a population of about 14 000 residents. Wakhan is a narrow strip about 350 km (220 mi) long and 13-65 km (8-40 mi) wide that extends from Badakhshan Province in Afghanistan in the west to Xinjiang Autonomous Region in China in the east, separating the Pamir Mountains and Tajikistan to the north and the Karakoram Mountains and Pakistan to the south  (<https://en.wikipedia.org/wiki/Wakhan_Corridor>).

A trade route through this valley has been used by travellers since antiquity
(<https://caravanistan.com/afghanistan/wakhan-corridor/>).

A map of this region can be found at

The local residents are concerned that the novel coronavirus infection, COVID-19, may be the cause of the outbreak of pneumonia in Wakhan district. There are about 70 500 total cases of COVID-19 in China, mainly concentrated in Hubei Province in Central China.

Although Xinjiang in Western China has reportedly 75 confirmed cases of COVID-19 and 1 death (assessed 16 Feb 2020 at 9:43 PM EST) (<https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6>), spread of COVID-19 to this very remote region in Afghanistan, that is easily cut off from the rest of the world especially in winter, seems unlikely. Also, 43% of deaths (15/35) occurred in children, which would be unusual for COVID-19. However, we are not told the clinical presentation of the illness, nor how a diagnosis of "pneumonia" was made in this undeveloped region. Other diagnoses, such as influenza, are also possible. More information from knowledgeable sources would be appreciated. - ProMED Mod.ML]

[Maps of Afghanistan: