WORLD NEWS

Getting countries ...
Select countries and read reports below or

Andorra

General
************************************
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
**************
*********************
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
***************************************
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
************************************
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
************************************
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
************************************
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
************************************
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]
=====================
[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]
More ...

Puerto Rico

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Gibraltar

United Kingdom and Gibraltar (England, Wales, Scotland, Northern Ireland) US Consular Information Sheet
June 03, 2008
COUNTRY DESCRIPTION:
The United Kingdom of Great Britain and Northern Ireland is a highly developed constitutional monarc
y comprised of Great Britain (England, Scotland and Wales) and Northern Ireland.
Read the Department of State Background Notes on the United Kingdom for additional information.
Gibraltar is a United Kingdom Overseas Territory bordering Spain and located at the southernmost tip of Europe at the entrance to the Mediterranean Sea.
It is one of thirteen former British colonies that have elected to continue their political links with London.
Tourist facilities are widely available.

ENTRY/EXIT REQUIREMENTS:
A visa is not required for tourist or business visits to the UK of less than six months in duration.
Visitors wishing to remain longer than one month in Gibraltar should regularize their stay with Gibraltar immigration authorities.
Those planning to visit the UK for any purpose other than tourism or business, or who intend to stay longer than six months, should consult the website of the British Embassy in the United States at http://britainusa.com for information about current visa requirements.
Those who are required to obtain a visa and fail to do so may be denied entry and returned to their port of origin.
The British government is currently considering reducing the visa-free period from six months to 90 days.
Travelers should be alert to any changes in legislation.
The U.S. Embassy cannot intervene in UK visa matters.
In addition to the British Embassy web site at http://britainusa.com, those seeking current UK visa information may also contact UK consular offices via their premium rate telephone service at 1-900-656-5000 (cost $3/minute) or 1-212-796-5773 ($12 flat fee).
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
The United Kingdom is politically stable, with a modern infrastructure, but shares with the rest of the world an increased threat of terrorist incidents of international origin, as well as the potential, though significantly diminished in recent years, for isolated violence related to the political situation in Northern Ireland (a part of the United Kingdom).
On July 7, 2005, a major terrorist attack occurred in London, as Islamic extremists detonated explosives on three underground trains and a bus in Central London, resulting in over 50 deaths and hundreds of injuries.
Following the attacks, the public transportation system was temporarily disrupted, but quickly returned to normal.
A similar but unsuccessful attack against London’s public transport system took place on July 21, 2005.
UK authorities have identified and arrested people involved in these attacks.
Similarly, those involved in terrorist incidents in London and Glasgow during the summer of 2007 were identified and arrested.
Like the US, the UK shares its national threat levels with the general public to keep everyone informed and explain the context for the various increased security measures that may be encountered. UK threat levels are determined by the UK Home Office and are posted on its web site at http://www.homeoffice.gov.uk/security/current-threat-level/.
Information from the UK Security Service, commonly known as MI5, about the reasons for the increased threat level and actions the public can take is available on the MI5 web site at http://www.mi5.gov.uk/.
On August 10, 2006, the Government of the United Kingdom heightened security at all UK airports following a major counterterrorism operation in which individuals were arrested for plotting attacks against US-bound airlines.
As a result of this, increased restrictions concerning carry-on luggage were put in place and are strictly enforced.
American citizens are advised to check with the UK Department for Transport at http://www.dft.gov.uk/transportforyou/airtravel/airportsecurity/ regarding the latest security updates and carry-on luggage restrictions.
The British Home Secretary has urged UK citizens to be alert and vigilant by, for example, keeping an eye out for suspect packages or people acting suspiciously at subway (called the “Tube” or Underground) and train stations and airports and reporting anything suspicious to the appropriate authorities.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.
For more information about UK public safety initiatives, consult the UK Civil Contingencies Secretariat web site at http://www.ukresilience.gov.uk.
The political situation in Northern Ireland has dramatically improved since the signing of the Good Friday Agreement in 1998, the announcement by the Irish Republican Army (IRA) on July 28, 2005, that it would end its armed campaign, and the agreement to set up a power-sharing government on May 8, 2007.
The potential remains, however, for sporadic incidents of street violence and/or sectarian confrontation. American citizens traveling to Northern Ireland should therefore remain alert to their surroundings and should be aware that if they choose to visit potential flashpoints or attend parades sporadic violence remains a possibility. Tensions may be heightened during the summer marching season (April to August), particularly during the month of July around the July 12th public holiday.

The phone number for police/fire/ambulance emergency services - the equivalent of "911" in the U.S. - is “999” in the United Kingdom and “112” in Gibraltar.
This number should also be used for warnings about possible bombs or other immediate threats.
The UK Anti-Terrorist Hotline, at 0800 789 321, is for tip-offs and confidential information about possible terrorist activity.
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, Travel Alerts, as well as the Worldwide Caution can be found.
Recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the U.S. Embassy's American Citizens' Services web site at http://london.usembassy.gov/cons_new/acs/index.html.
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:
The United Kingdom and Gibraltar benefit from generally low crime rates and rates decreased slightly in 2007 in significant categories, including violent crime.
The crime situation in the UK is similar to the United States, with typical incidents including pick-pocketing; mugging; “snatch and grab” thefts of mobile phones, watches and jewelry; and theft of unattended bags, especially at airports and from cars parked at restaurants, hotels and resorts.
Pickpockets target tourists, especially at historic sites, restaurants, on buses, trains and the London Underground (the “Tube,” or subway).
Thieves often target unattended cars parked at tourist sites and roadside restaurants, looking for laptop computers and hand-held electronic equipment, especially global positioning satellite equipment.
Walking in isolated areas, including public parks, especially after dark, should also be avoided, as these provide advantageous venues for muggers and thieves.
At night or when there is little foot traffic, travelers should be especially careful using the underground pedestrian tunnels.
As a general rule, either walk the extra distance to use a surface crossing or wait until there are other adult pedestrians entering the tunnel.

In London, travelers should use only licensed “black taxi cabs,” or car services recommended by their hotel or tour operator.
Unlicensed taxis or private cars posing as taxis may offer low fares, but are often uninsured and may have unlicensed drivers.
In some instances, travelers have been robbed and raped while using these cars.
You can access 7,000 licensed “Black Cabs” using just one telephone number – 0871 871 8710. This taxi booking service combines all six of London’s radio taxi circuits, allowing you to telephone 24 hours a day if you need to “hail a cab.” Alternatively, to find a licensed minicab, text “HOME” to 60835 on your mobile phone to get the telephone number to two licensed minicab companies in the area. If you know in advance what time you will be leaving for home, you can pre-book your return journey.
The “Safe Travel at Night” partnership among the Metropolitan Police, Transport for London, and the Mayor of London maintains a website with additional information at http://www.cabwise.com/.
Travelers should not leave drinks unattended in bars and nightclubs.
There have been some instances of drinks being spiked with illegal substances, leading to incidents of robbery and rape.
Due to the circumstances described above, visitors should take steps to ensure the safety of their U.S. passports.
Visitors in England, Scotland, Wales, Northern Ireland, and Gibraltar are not expected to produce identity documents for police authorities and thus may secure their passports in hotel safes or residences.
Abundant ATMs that link to U.S. banking networks offer an optimal rate of exchange and they preclude the need to carry a passport to cash travelers’ checks.
Travelers should be aware that U.S. banks might charge a higher processing fee for withdrawals made overseas.
Common sense personal security measures utilized in the U.S. when using ATMs should also be followed in the UK.
ATM fraud in the UK is becoming more sophisticated, incorporating technologies to surreptitiously record customer ATM card and PIN information.
Travelers should avoid using ATMs that look in any way “temporary” in structure or location, or that are located in isolated areas.
Travelers should be aware that in busy public areas, thieves use distraction techniques, such as waiting until the PIN number has been entered and then pointing to money on the ground, or attempting to hand out a free newspaper.
When the ATM user is distracted, a colleague will quickly withdraw cash and leave.
If distracted in any way, travelers should press the cancel transaction button immediately and collect their card before speaking to the person who has distracted them.
If the person’s motives appear suspicious, travelers should not challenge them but remember the details and report the matter to Police as soon as possible.
In addition, travelers should not use the ATM if there is anything stuck to the machine or if it looks unusual in any way.
If the machine does not return the card, report the incident to the issuing bank immediately.

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 at the opening of the next business day.
The U.S. Embassy or Consulate only issues replacement passports during regular business hours.
If you are the victim of a crime while overseas, report it to local police.
The nearest U.S. Embassy or Consulate will also be able to assist by helping you to find appropriate medical care, contacting family members or friends, and explaining 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.

Visit the “Victim Support” web site, maintained by an independent UK charity to helps people cope with the effects of crime: http://www.victimsupport.org.uk/
See our information for Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
While medical services are widely available, free care under the National Health System is allowed only to UK residents and certain EU nationals.
Tourists and short-term visitors will be charged for medical treatment in the UK.
Charges may be significantly higher than those assessed in the United States.
Hiking in higher elevations can be treacherous.
Several people die each year while hiking, particularly in Scotland, often due to sudden changes in weather.
Visitors, including experienced hikers, are encouraged to discuss intended routes with local residents familiar with the area, and to adhere closely to recommendations.
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.

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.
If your medical insurance policy does not provide overseas coverage, you may want to purchase a short-term policy for your trip.
The Department of State provides a list of travel insurance companies that can provide the additional insurance needed for the duration of one’s trip abroad in its online at medical insurance overseas.
Remember also that most medical care facilities and medical care providers in the UK do not accept insurance subscription as a primary source of payment.
Rather, the beneficiary is expected to pay for the service and then seek reimbursement from the insurance company.
This may require an upfront payment in the $10,000 to $20,000 range

Please see our information on medical insurance overseas.

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

UK penalties for driving under the influence of even minimal amounts of alcohol or drugs are stiff and often result in prison sentences.
In contrast to the United States and continental Europe, where traffic drives on the right side of the road, in the UK, it moves on the left.
The maximum speed limit on highways/motorways in the UK is 70MPH.
Motorways generally have a hard shoulder (breakdown lane) on the far left, defined by a solid white line.
It is illegal to stop or park on a hard shoulder unless it is an emergency.
In such cases, you should activate your hazard lights, get out of your vehicle and go onto an embankment for safety.
Emergency call boxes (orange telephone booths with “SOS” printed on them) may be found at half-mile intervals along the motorway.
White and blue poles placed every 100 yards along the motorway point in the direction of the nearest call box.
Emergency call boxes dial directly to a motorway center.
It is best to use these phones rather than a personal cell phone, because motorway center personnel will immediately know the location of a call received from an emergency call box.
Roadside towing services may cost approximately £125.
However, membership fees of automotive associations such as the RAC or AA (Automobile Association) often include free roadside towing service.
Visitors uncomfortable with, or intimidated by, the prospect of driving on the left-hand side of the road may wish to avail themselves of extensive bus, rail and air transport networks that are comparatively inexpensive.
Roads in the UK are generally excellent, but are narrow and often congested in urban areas.
If you plan to drive while in the UK, you may wish to obtain a copy of the Highway Code, available at http://www.highwaycode.gov.uk.
Travelers intending to rent cars in the UK should make sure that they are adequately insured.
U.S. auto insurance is not always valid outside the U.S., and travelers may wish to purchase supplemental insurance, which is generally available from most major rental agents.
The city of London imposes a congestion charge of £8 (eight pounds sterling, or approximately U.S. $16.00) on all cars entering much of central London Monday through Friday from 7:00 a.m. to 6:30 p.m.
Information on the congestion charge can be found at http://www.cclondon.com.
Public transport in the United Kingdom is excellent and extensive.
However, poor track conditions may have contributed to train derailments resulting in some fatalities.
Repairs are underway and the overall safety record is excellent.
Information on disruptions to London transportation services can be found at http://www.tfl.gov.uk and information about the status of National Rail Services can be found at http://www.nationalrail.co.uk.
Many U.S. pedestrians are injured, some fatally, every year in the United Kingdom, because they forget that oncoming traffic approaches from the opposite direction than in the United States.
Extra care and alertness should be taken when crossing streets; remember to look both ways before stepping into the street.
Driving in Gibraltar is on the right-hand side of the road, as in the U.S. and Continental Europe.
Persons traveling overland between Gibraltar and Spain may experience long delays in clearing Spanish border controls.
Please refer to our Road Safety Overseas page for more information.
For specific information concerning United Kingdom driving permits, vehicle inspection, road tax and mandatory insurance, refer to the United Kingdom’s Department of Environment and Transport web site at http://www.dft.gov.uk, the Driving Standards Agency web site at http://www.dsa.gov.uk or consult the U.S. Embassy in London’s web site at http://london.usembassy.gov/.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the UK’s air carrier operations.
For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
The legal drinking age in the UK is generally lower than in the U.S. and social drinking in pubs is often seen as a routine aspect of life in Britain. Parents, organizers of school trips, and young travelers should be aware of the impact that this environment may have when combined with the sense of adventure that comes with being abroad.
Please see our Students Abroad web site as well Studying Abroad to help students plan a safe and enjoyable adventure.
The UK has strict gun-control laws, and importing firearms is extremely complicated. Travelers should consider leaving all firearms in the United States.
Restrictions exist on the type and number of weapons that may be possessed by an individual.
All handguns, i.e. pistols and revolvers, are prohibited with very few exceptions.
Licensing of firearms in the UK is controlled by the Police.
Applicants for a license must be prepared to show 'good reason' why they require each weapon.
Applicants must also provide a copy of their U.S. gun license, a letter of good conduct from their local U.S. police station and a letter detailing any previous training, hunting or shooting experience. Background checks will also be carried out.
Additional information on applying for a firearm certificate and/or shotgun certificate can be found on the Metropolitan Police Firearms Enquiry Teams web site at http://www.met.police.uk/firearms-enquiries/index.htm.
A number of Americans are lured to the UK each year in the belief that they have won a lottery or have inherited from the estate from a long-lost relative.
Americans may also be contacted by persons they have “met” over the Internet who now need funds urgently to pay for hospital treatment, hotel bills, taxes or airline security fees.
Invariably, the person contacted is the victim of fraud.
Any unsolicited invitations to travel to the UK to collect winnings or an inheritance should be viewed with skepticism.
Also, there are no licenses or fees required when transiting a UK airport, nor is emergency medical treatment withheld pending payment of fees.
Please see our information on International Financial Scams. Please read 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 British law, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the UK 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.
Many pocketknives and other blades, and mace or pepper spray canisters, although legal in the U.S., are illegal in the UK and will result in arrest and confiscation if detected.
A UK Metropolitan Police guide to items that are prohibited as offensive weapons is available at http://www.met.police.uk/youngpeople/guns.htm.
A UK Customs Guide, detailing what items visitors are prohibited from bringing into the UK, is available at http://customs.hmrc.gov.uk/channelsPortalWebApp/downloadFile?contentID=HMCE_CL_001734.
Air travelers to and from the United Kingdom should be aware that penalties against alcohol-related and other in-flight crimes (“air rage”) are stiff and are being enforced with prison sentences.
Please also see our information on customs regulations that pertain when returning to the US.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the United Kingdom are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within the United Kingdom.
By registering, Americans make it easier for the Embassy or Consulate to contact them in case of emergency, and to relay updated information on travel and security within the United Kingdom.
The Embassy and Consulates regularly send security and other information via email to Americans who have registered.
As noted above, recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the embassy’s web site.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
The Consular Section also disseminates a newsletter every month.
Those wishing to subscribe to the monthly consular newsletter in London should send a request by email to SCSLondon@state.gov.
The U.S. Embassy is located at 24 Grosvenor Square, London W1A 1AE; telephone: in country 020-7499-9000; from the U.S. 011-44-20-7499-9000 (24 hours); Consular Section fax: in country 020-7495-5012; from the U.S. 011-44-20-7495-5012, and on the Internet at http://london.usembassy.gov.
The U.S. Consulate General in Edinburgh, Scotland, is located at 3 Regent Terrace, Edinburgh EH7 5BW; Telephone: in country 0131-556-8315, from the U.S. 011-44-131-556-8315.
After hours: in country 01224-857097, from the U.S. 011-44-1224-857097.
Fax: in country 0131-557-6023; from the U.S. 011-44-131-557-6023.
Information on the Consulate General is included on the Embassy’s web site at http://london.usembassy.gov/scotland.
The U.S. Consulate General in Belfast, Northern Ireland, is located at Danesfort House, 228 Stranmillis Road, Belfast BT9 5GR; Telephone: in country 028-9038-6100; from the U.S. 011-44-28-9038-6100.
Fax:
in country 028-9068-1301; from the U.S. 011-44-28-9068-1301.
Information on the Consulate General is included on the Embassy’s web site at: http://london.usembassy.gov/nireland.
There is no U.S. consular representation in Gibraltar.
Passport questions should be directed to the U.S. Embassy in Madrid, located at Serrano 75, Madrid, Spain, tel (34)(91) 587-2200, and fax (34)(91) 587-2303.
The web site is http://madrid.usembassy.gov.
All other inquiries should be directed to the U.S. Embassy in London.
* * *
This replaces the Consular Information Sheet dated December 12, 2007, to update the sections on Entry Requirements, Safety and Security, Crime, Victims of Crime, Medical Facilities, Medical Insurance, Traffic Safety and Road Conditions, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu 24 Aug 2017
Source: Gibraltar Chronicle [edited]
<http://chronicle.gi/2017/08/tiger-mosquito-found-in-gibraltar-but-no-cause-for-concern-officials-say/>

An aggressive species of mosquito known to transmit viral diseases has been detected in Gibraltar, but public health officials insist there is no cause for alarm. Public Health Gibraltar and the Environmental Agency confirmed that the mosquito of the species _Aedes albopictus_, also known as the tiger mosquito, has been found in Gibraltar.

Last June [2017] after 9 months of intensive surveillance, officials said no tiger mosquito had been found in Gibraltar. But this has now changed after the 1st tiger mosquito was found in the urban dome   stic environment within Gibraltar. "This finding alone does not however materially alter any health risks in Gibraltar and there is no immediate cause for public concern," the government said in a statement. Public Health Gibraltar was first alerted in January 2016 to the discovery of the mosquito in Malaga and Algeciras [in Andalusia, Spain]. Since then, together with the Environmental Agency, it began working with international experts to mount surveillance in Gibraltar.

World Health Organization experts visited Gibraltar and gave advice on setting traps and monitoring locations, but no tiger mosquito had been detected until now. The tiger mosquito is not native to Gibraltar and has not been previously found here. It is common in other countries where it transmits viral diseases like Zika, dengue, and chikungunya. It is a domestic species, breeds in water in urban areas -- water butts, blocked drains, rainwater gullies -- and is able to reach high abundance around residential areas.

It is also a day-time mosquito, that aggressively bites humans. "Health risks to the public only arise if the virus causing these diseases is also present, which is not the case in Gibraltar," the government said.  "The virus can, however, be imported by travellers returning from an overseas country and if this happens, there is a risk of spread, but only if the mosquito bites within a small window period of about a week after the fever starts."

Public Health Gibraltar has been raising awareness of travel risk amongst travellers through its publication A Factsheet for Travellers and recommends the following precautions:
- before travelling to affected areas, consult your doctor or seek advice from a travel clinic, especially if you have an immune disorder or severe chronic illness;
- if you are pregnant or are considering pregnancy, consider postponing non-essential travel;
- when staying in a mosquito-prone area, wear mosquito repellents and take mosquito bite prevention measures;
- if you have symptoms within 3 weeks of return from an affected country, contact your doctor;
- if you have been diagnosed with any of the diseases Zika, dengue, or chikungunya, take strict mosquito bite prevention measures for 10 days after the fever starts.
========================== 
[The appearance of _Aedes albopictus_ in Gibraltar is not surprising. A map of the distribution of this species as of April this year (2017) shows it present around the Mediterranean Basin and up to Gibraltar on the west (<https://ecdc.europa.eu/en/publications-data/aedes-albopictus-current-known-distribution-europe-april-2017>).

Now it has been found in Gibraltar. The concerns are real about transmission of dengue, chikungunya, and Zika viruses should populations of _Ae. albopictus_ become established. In 2015 there were a few locally acquired cases of dengue in the south of France. This also happened on a larger scale in Emilia Romagna, Italy, when a viraemic man introduced chikungunya virus into Italy and sparked an outbreak.

One hopes that mosquito surveillance will continue in Gibraltar, perhaps be intensified, and help guide vector control efforts. - ProMED Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/517>.]
Date: Wed, 1 Jun 2011 01:46:48 +0200 (METDST)

GIBRALTAR, June 1, 2011 (AFP) - A fuel tank exploded and caught fire near a cruise ship in the British territory of Gibraltar Tuesday, injuring at least 15 people, most of them on the vessel, local officials and the ship's owners said. The blast was probably caused by a spark from welding operations, Chief Minister Peter Caruana told Radio Gibraltar. But police were not ruling out any possibility including that of an attack, he added. Flames several metres high could be seen coming out of the tank with dense black smoke billowing across the port as firefighters directed jets of water at the blaze from tugboats. The fire continued late into the night, with Radio Gibraltar reporting more explosions were heard. The tank was close to the giant cruise ship, Independence of the Seas, which had arrived in Gibraltar Tuesday morning. The ship made an emergency departure immediately after the blast Tuesday afternoon.

The Gibraltar government and the ship's owners, Royal Caribbean International, both said 12 people on the ship had been hurt. Gibraltar officials said one of the passengers had suffered a fractured arm. Two Spanish welders working on the tank were injured, including one who was in critical condition in a burns unit at a hospital in the southern Spanish city of Seville, Radio Gibraltar said. A police officer was also slightly injured in the rescue attempt, police said. "The lid of the tank was blown off by the blast," a police spokesman said. The statement from Royal Caribbean International said: "Immediately after the explosion, the ship retracted the gangway and moved a safe distance from the dock. "Twelve guests sustained minor injuries and have received medical treatment onboard." The boat was on a two-week cruise, having left the southern English port of Southampton on Saturday, the company added.

Air services to Gibraltar were suspended and offices in the port area evacuated. The police spokesman said the possibility of adjacent tanks overheating and exploding could not be ruled out. Caruana described it as a serious incident but said there was "no cause for concern". "Once it was established that there were welding operations going on, on top of the very tank at the time it exploded, (that) makes that a frontrunner for a likely explanation, but all possibilities are being kept open," he told Radio Gibraltar. "The police are obviously keeping their minds open to the possibility of maybe a security incident. It's looking unlikely but all possibilities are being looked into if only to be excluded."

"The plan is to allow it to carry on burning itself off," he said later Tuesday, but warned that the wind was due to change during the night, which could bring the smoke over land. Spanish tugs from a private company were helping the local fire services, he added. One witness said he was in his office nearby when he heard three loud explosions. "We started running out and saw one of the main tanks set alight. My concern was the poor people who were working there," he told Radio Gibraltar. The public was being advised to keep away from the area and keep windows closed due to the smoke. Gibraltar is a 6.5-square-kilometre (2.6-square-mile) British territory of around 30,000 people off the tip of southern Spain. Madrid ceded it to London in 1713 under the Treaty of Utrecht, but it has long fuelled tensions between the two countries.
Date: Tue, 10 Aug 2010 20:08:15 +0200 (METDST)

GIBRALTAR, Aug 10, 2010 (AFP) - Gibraltar on Tuesday condemned as "illegal" a proposal by the neighbouring Spanish town of La Linea to impose a tax on cars entering or leaving the tiny British territory by road.   The decision comes amid thorny relations between Madrid and London over the disputed British possession off the tip of southern Spain.

La Linea mayor Alejandro Sanchez on Monday announced the "congestion charge" of no more than five euros (6.5 dollars) on cars crossing into and out of Gibraltar, saying the measure will be imposed in October once it is passed by the town council.   He said lorries carrying debris and other materials used in Gibraltar to reclaim land from the sea will pay more, but the exact amount has not yet been determined.   Sanchez, a member of Spain's conservative opposition Popular Party, said the tax is needed partly to compensate the municipality for austerity measures imposed by the socialist government in Madrid.   La Linea residents would be exempt, but it was not clear if Gibraltarians would also have to pay.

The Gibraltar government reacted angrily and said it has contacted the Spanish authorities over the decision.   "The confused statements by the mayor of La Linea in respect of the proposed toll describe a litany of illegalities under EU Law and probably also under Spanish law," it said in a statement.   "The mayor of La Linea is clearly engaged in a political manoeuvre with his central government, which is unlikely to allow the proposal.

"The mayor's proposals are wholly unacceptable both legally and politically and in the unlikely event that these measures should be introduced, the (Gibraltar) government will take appropriate steps."   Spain ceded Gibraltar to Britain in 1713 under the Treaty of Utrecht but has retained first claim on the tiny peninsula should Britain renounce sovereignty.

"The Rock" has long fuelled tensions between Spain and Britain, with Madrid arguing the 6.5-square-kilometre (2.6-square-mile) territory that is home to roughly 30,000 people should be returned to Spanish sovereignty.   But its people overwhelmingly rejected an Anglo-Spanish proposal for co-sovereignty in a referendum in 2002.   In recent months British and Spanish naval and police boats have engaged in a series of cat and mouse games in the waters off Gibraltar, which lies at the strategic western entrance to the Mediterranean.
Date: Thu 23 Oct 2008
Source: Panorama.gi [edited]
---------------------------------
During the last 10 weeks, Gibraltar has experienced an outbreak of measles. "We have so far been notified of over 250 cases and notifications are still coming in at around 4-6 cases per day," said the Gibraltar Health Authority [GHA], who believe that the actual numbers are greater as many people with mild attacks have chosen not to report them. While the majority of infections in the outbreak have been mild, some have been severe and a few patients including babies have needed intensive care.  Measles is an unpleasant disease with fever, sore throat, streaming eyes, diarrhoea, and rash. Most people recover within a week or so, but complications like fits, bacterial infection, or pneumonia can develop. Long-term complications can also arise in very young children.

Says the GHA: It is important that all persons with symptoms suggestive of measles should report the illness to their doctor to enable complications to be detected at an early stage. In addition to medical advice, persons with the illness should follow general hygiene practices such as limiting contact with other people, carefully discarding soiled tissues, and washing their hands. Anyone who has had measles infection is immune for life and cannot get measles again. There is no basis for the rumour that some people have had measles twice. It is possible that infection with rubella (German measles, a different disease) may have caused the confusion. Vaccination with the MMR [measles, mumps, and rubella] vaccine is the only way to prevent measles infection.

[So far], the 250 cases have been in persons who are unvaccinated or partly vaccinated (one dose only). Not a single case has occurred in a person who has had a full course of MMR vaccine. MMR vaccine has been available free to children [from] Gibraltar's health service since 1989, although the boosters were only introduced in 2002. It is also a very safe and effective vaccine, with an impressive track record," they say. Gibraltar Health Authority adds that it is continuing to advise all parents of children who have not had the MMR vaccine to immunise their children. There had been some difficulties in obtaining vaccine recently due to an international shortage, but fresh supplies have now been received. The course consists of 2 injections, approximately 3 months apart. Please note that BOTH the doses are needed for adequate immunity. They add: If your child has received only one dose, either now or in the past, he or she could still be at risk. Arrangements have been made to offer additional  vaccination to all unimmunised children as follows: During October and November [2008], the Child Welfare Clinics (primary care centre) will be open on Mondays (2:00 pm to 4:00 pm), Wednesdays (9:00 am to 11:00 am) and Fridays (9:00 am to 11:00 am) for immunisations. Appointments are not necessary.
-------------------------------
[The Rock of Gibraltar is located at the entrance of the Mediterranean. Gibraltar is connected to Spain by a sandy isthmus, by a ferry to Morocco, and by flights to London. By virtue of its geographical position and political status Gibraltar is vulnerable to introduction of infectious disease from diverse sources. No information has been provided regarding the source of the measles virus responsible for this outbreak. In this respect it will be relevant to determine the genotype of the measles virus involved (see comment in ProMED-mail "Measles - Gibraltar 20080814.2529"). The outbreak has escalated from the 17 cases reported on 14 Aug 2008 to the current 250 cases. Despite the availability of free MMR vaccination it is clear that there is an appreciable number of unimmunised individuals in the community who remain susceptible to measles virus infection. It is encouraging that efforts are underway to expand vaccine coverage.


and the HealthMap/ProMED-mail interactive map at <http://healthmap.org/promed?g=2411586&amp;v=36.133,-5.35,7>. - ProMed Mod.CP]
Date: Wed, 16 Apr 2008 14:56:40 +0200 (METDST) GIBRALTAR, April 16, 2008 (AFP) - Animal rights groups have expressed outrage over a plan by Gibraltar's government to cull its famous Barbary Apes, which are posing a hazard as they roam the town in search of food. The government of the tiny British territory off Spain's southern coast plans to cull 25 of the simians, whose population has exploded to around 200. The mischievous primates climb over cars and pull out antennas, open rubbish bags and rifle through handbags left unattended in the popular tourist destination. Officially, the management of the apes is the responsibility of the Gibraltar Ornithological and Natural History Society (GONHS), on contract from the government. But the society said it has not approved the cull. "Our policy is that culling can be a population management solution but only in extreme cases when there is no other more suitable option," GONHS general secretary Dr. John Cortes said on Tuesday. "We would only ever recommend a cull after very careful assessment of the situation from a veterinary and a genetic point of view." However, Environment Minister Ernest Britto said a licence has been issued for the cull and two of the apes have already been given lethal injections. Helen Thirlway, the head of Britain's International Primate Protection League, said the government was failing to manage the apes "in a responsible manner." "There have been many advances and pilot studies in recent years on different methods of controlling free-roaming monkeys," she was quoted as saying in the local media Wednesday. "We are more than happy to work with the government of Gibraltar and with GONHS to help them develop more efficient, alternative solutions, but this needless slaughter has to stop." According to legend, if the apes disappear, Britain will lose control of Gibraltar. When wartime British prime minister Winston Churchill heard their population was low, British consuls in North Africa -- from where the apes originally came -- were tasked with sending new young simians to the Rock. At one time, the apes were looked after by the British army stationed in Gibraltar, which selected a place up the Rock where they were fed daily to keep them from loitering downtown. Spain ceded Gibraltar to Britain in 1713, but has retained a constitutional claim should Britain renounce sovereignty. The vast majority of the 30,000 people want to retain their links with Britain.
More ...

Afghanistan

Afghanistal US Consular Information Sheet March 03, 2009


COUNTRY DESCRIPTION:


Afghanistan has made significant progress since the Taliban were deposed in 2001, but still faces daunting challenges, including de

eating terrorists and insurgents, recovering from over three decades of civil strife, dealing with years of severe drought and rebuilding a shattered physical, economic and political infrastructure. Coalition and NATO forces under ISAF work in partnership with Afghan security forces to combat Taliban and al-Qa’ida elements who seek to terrorize the population and challenge the government. Violence in 2008 reached unprecedented levels, as both ISAF/Afghan forces and the Taliban initiated more battles than ever before. President Hamid Karzai was sworn in as President of the Islamic Republic of Afghanistan on December 7, 2004 and the Afghan Parliament was subsequently convened in late 2005. The government is working to develop a more effective police force, a more robust legal system, and sub-national institutions that work in partnership with traditional and local leaders to meet the needs of the population. The U.S. works closely with the international community to provide coordinated support for these efforts. An Afghanistan-hosted Peace Jirga with Pakistan resulted in a commitment to cooperate in combating terrorism, facilitate the return of Afghan refugees, and support regional economic activity. Read the Department of State Background Notes on Afghanistan for additional information.


ENTRY/EXIT REQUIREMENTS:


 A passport and valid visa are required to enter and exit Afghanistan. Afghan entry visas are not available at Kabul International Airport or any other ports of entry in Afghanistan. American citizens who arrive without a visa are subject to confiscation of their passport and face heavy fines and difficulties in retrieving their passport and obtaining a visa, as well as possible deportation from the country. Americans arriving in the country via military air usually have considerable difficulties if they choose to depart Afghanistan on commercial air, because their passports are not stamped to show that they entered the country legally. Those coming on military air should move quickly after arrival to legalize their status if there is any chance they will depart the country on anything other than military air. Visit the Embassy of Afghanistan web site at http://www.embassyofafghanistan.org for the most current visa information. The Consular office of the Embassy of Afghanistan is located at 2233 Wisconsin Avenue NW, Suite 216, Washington, DC 20007, phone number 202-298-9125. Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.


SAFETY AND SECURITY:


The latest Travel Warning for Afghanistan emphasizes that the security situation remains critical for American citizens. The Taliban and associated insurgent groups, al-Qaida network terrorist organizations, and narco-traffickers oppose the strengthening of a democratic government. These groups aim to weaken or bring down the Government of Afghanistan and to drive Westerners out of the country. They do not hesitate to use violence, including targeting civilians. Terrorist activities may include, but are not limited to bombings -- including improvised explosive devices and car bombs -- assassinations, carjackings, rocket attacks, assaults and kidnappings. There were over 120 suicide attacks in 2008. There is an ongoing threat to attack and kidnap U.S. citizens and Non-Governmental Organization (NGO) workers throughout the country. In 2008,, more than 30 NGO workers were killed (six foreigners) and at least 78 NGO staff members (seven foreigners) were abducted. Over 25 other foreign civilians, including journalists, were kidnapped. Kabul continues to experience suicide bombings against Afghan government personnel and installations, Afghan and coalition military assets, and international civilians. Riots -- sometimes violent -- have occurred in response to various political or other issues. Crime, including violent crime, remains a significant problem. Official Americans' use of the Kabul-Jalalabad, Kabul-Kandahar highways and other roads throughout the country is often restricted or completely curtailed because of security concerns. Insurgents continue to use roadside and car bombs to conduct attacks and abductions along major highways. Millions of unexploded land mines and other ordinance present a constant danger. The country faces a difficult period in the near term, and American citizens could be targeted or placed at risk by unpredictable local events. Americans should not come to Afghanistan unless they have made arrangements in advance to address security concerns. The absence of records for ownership of property, differing laws from various regimes and the chaos that comes from decades of civil strife have left property issues in great disorder. Afghan-Americans returning to Afghanistan to recover property, or Americans coming to the country to engage in business, have become involved in complicated real estate disputes and have faced threats of retaliatory action, including kidnapping for ransom and death. Large parts of Afghanistan are extremely isolated, with few roads, mostly in poor condition, irregular cell phone signals, and none of the basic physical infrastructure found in Kabul or the larger cities. Americans traveling in these areas who find themselves in trouble may not even have a way to communicate their difficulties to the outside world. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.


CRIME:


 A large portion of the Afghan population is unemployed, and many among the unemployed have moved to urban areas. Basic services are rudimentary or non-existent. These factors may directly contribute to crime and lawlessness. Diplomats and international relief workers have reported incidents of robberies and household burglaries as well as kidnappings and assault. Any American citizen who enters Afghanistan should remain vigilant for possible banditry, including violent attacks.


INFORMATION FOR VICTIMS OF CRIME:


The loss or theft abroad of a U.S. passport should be reported immediately to the local police and to the U.S. Embassy in Kabul. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy in Kabul for assistance. The Embassy 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 provide a list of attorneys if needed. The local equivalent to the "911" emergency line in Afghanistan is: 119 Please see our information on Victims of Crime, including possible victim compensation programs in the United States.


CRIMINAL PENALTIES:


While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Afghanistan’s laws, even unknowingly, may be expelled, arrested or imprisoned. During the last several years, there have been incidents involving the arrest and/or detention of U.S. citizens. Arrested Americans have faced periods of detention—sometimes in difficult conditions—while awaiting trial. Penalties for possession or use of, or trafficking in illegal drugs in Afghanistan are severe, and convicted offenders can expect long jail sentences and heavy fines. Another sensitive activity is proselytizing. Although the Afghan Constitution allows the free exercise of religion, proselytizing is often viewed as contrary to the beliefs of Islam and considered harmful to society. Proselytizing may lead to arrest and/or deportation. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.


SPECIAL CIRCUMSTANCES:


Because of the poor infrastructure in Afghanistan, access to banking facilities is limited and unreliable. Afghanistan's economy operates on a "cash-only" basis for most transactions. Credit card transactions are not available. International bank transfers are limited. Some ATM machines exist at Standard Charter Bank and Afghan International Bank (AIB) in the Wazir Akbar Khan neighborhood of Kabul, but some travelers have complained of difficulties using them. International communications are difficult. Local telephone networks do not operate reliably. Most people rely on satellite or cellular telephone communications even to make local calls. Cellular phone service is available locally in Kabul and some other cities, but can be unreliable. Injured or distressed foreigners could face long delays before being able to communicate their needs to family or colleagues outside of Afghanistan. Internet access through local service providers is limited. In addition to being subject to all Afghan laws, U.S. citizens who are also citizens of Afghanistan may also be subject to other laws that impose special obligations on Afghan citizens. U.S. citizens who are also Afghan nationals do not require visas for entry into Afghanistan. The Embassy of Afghanistan issues a letter confirming your nationality for entry into Afghanistan. However, you may wish to obtain a visa as some Afghan-Americans have experienced difficulties at land border crossings because they do not have a visa in their passport. For additional information on dual nationality in general, see the Consular Affairs home page for our dual nationality flyer. U.S. citizens are encouraged to carry a copy of their U.S. passport with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. As stated in the Travel Warning, consular assistance for American citizens in Afghanistan is limited. Islam provides the foundation of Afghanistan's customs, laws and practices. Foreign visitors -- men and women -- are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts. Women in particular, especially when traveling outside of Kabul, may want to ensure that their tops have long sleeves and cover their collarbone and waistband, and that their pants/skirts cover their ankles. Almost all women in Afghanistan cover their hair in public; American women visitors should carry scarves for this purpose. Afghan customs authorities may enforce strict regulations concerning temporary importation into or export from Afghanistan of items such as firearms, alcoholic beverages, religious materials, antiquities, medications, and printed materials. American travelers have faced fines and/or confiscation of items considered antiquities upon exiting Afghanistan. It is advisable to contact the Embassy of Afghanistan in Washington for specific information regarding customs requirements. Travelers en route to Afghanistan may transit countries that have restrictions on firearms, including antique or display models. If you plan to take firearms or ammunition to another country, you should contact officials at that country's embassy and those that you will be transiting to learn about their regulations and fully comply with those regulations before traveling. Please consult http://www.customs.gov for information on importing firearms into the United States. Please see our Customs Information sheet.


MEDICAL FACILITIES AND HEALTH INFORMATION:


Well-equipped medical facilities are few and far between throughout Afghanistan. European and American medicines are available in limited quantities and may be expensive or difficult to locate. There is a shortage of basic medical supplies. Basic medicines manufactured in Iran, Pakistan, and India are available, but their reliability can be questionable. Several western-style private clinics have opened in Kabul: the DK-German Medical Diagnostic Center (www.medical-kabul.com), Acomet Family Hospital (www.afghancomet.com), and CURE International Hospital (ph. 079-883-830) offer a variety of basic and routine-type care; Americans seeking treatment should request American or Western health practitioners. Afghan public hospitals should be avoided. Individuals without government licenses or even medical degrees often operate private clinics; there is no public agency that monitors their operations. Travelers will not be able to find Western-trained medical personnel in most parts of the country outside of Kabul, although there are some international aid groups temporarily providing basic medical assistance in various cities and villages. For any medical treatment, payment is required in advance. Commercial medical evacuation capability from Afghanistan is limited and could take days to arrange. Even medevac companies that claim to service the world may not agree to come to Afghanistan. Those with medevac insurance should confirm with the insurance provider that it will be able to provide medevac assistance to this country. There have been outbreaks of Avian Influenza in poultry in Afghanistan, to include the areas of Nangahar, Laghman, and Wardak provinces, and in the city of Kabul, however, there have been no reported cases of the H5N1 virus in humans. Updates on the Avian Influenza situation in Afghanistan are published on the Embassy’s web site at http://kabul.usembassy.gov/information_for_travelers.html. For additional information on Avian Influenza, please refer to the Department of State's Avian Influenza Fact Sheet available at http://travel.state.gov/travel/tips/health/health_1181.html Tuberculosis is an increasingly serious health concern in Afghanistan. For further information, please consult the CDC's Travel Notice on TB. http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx| The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Afghanistan. However, if one has questions, please inquire directly with the Embassy of Afghanistan at http://www.embassyofafghanistan.org before you travel. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site. For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site. Further health information for travelers is available from the WHO.


MEDICAL INSURANCE:


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


SAFETY AND ROAD CONDITIONS:


 While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Afghanistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance. All drivers face the potential danger of encountering improvised-explosive devices and land mines that may have been planted on or near roadways. An estimated 5-7 million landmines and large quantities of unexploded ordinance exist throughout the countryside and alongside roads, posing a danger to travelers. Robbery and kidnappings are also prevalent on highways outside of Kabul. The transportation system in Afghanistan is marginal, although the international community is constructing modern highways and provincial roads. Vehicles are poorly maintained, often overloaded, and traffic laws are not enforced. Vehicular traffic is chaotic and must contend with numerous pedestrians, bicyclists and animals. Many urban streets have large potholes and are not well lit. Rural roads are not paved. Please refer to our Road Safety page for more information.


AVIATION SAFETY OVERSIGHT:


As there is no direct commercial air service to the United States by carriers registered in Afghanistan, the U.S. Federal Aviation Administration (FAA) has not assessed Afghanistan’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. U.S. Government personnel are not authorized to travel on Ariana Afghan Airlines or any other airline falling under the oversight of the Government of Afghanistan’s Civil Aviation Authority, owing to safety concerns; however, U.S. Government personnel are permitted to travel on international flights operated by airlines from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA’s International Aviation Safety Assessment (IASA) program.


CHILDREN'S ISSUES:


 For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. R


EGISTRATION / EMBASSY LOCATION:


Americans living or traveling in Afghanistan are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site and to obtain updated information on travel and security within Afghanistan. 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 in Kabul on Great Massoud (Airport) Road, local phone number 0700-108-001 or 0700-108-002, and for emergencies after hours 0700-201-908. The web site is http://kabul.usembassy.gov/ * * * * * This replaces the Country Specific Information dated June 16, 2008 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties, Special Circumstances, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sun 1 Sep 2019
Source: MENAFN - Afghanistan Times [edited]

Two new polio cases have surfaced separately in capital city of Tirinkot and Chora district of southern Uruzgan [Oruzgan] province, a statement from the relevant ministry said [Sun 1 Sep 2019].

A 30-month-old child and another 6-month-old infant were permanently paralyzed as a result of the polio virus.

According to a statement issued by the Ministry of Public Health (MoPH), the total number of polio cases in 2019 reached 15 with the 2 new cases, saying all of these cases had been reported from inaccessible areas.

"Of the 15 polio cases this year [2019], 14 have been reported from the southern region of Afghanistan,' the statement said, adding "7 positive cases came from [Oruzgan], 5 from Helmand, and 2 other from Kandahar."

Only 1 out of 12 polio cases was reported from eastern Kunar province while the rest happened in the southern zone.

"Access to health services is the right of every citizen of the country," said Dr Ferozuddin Feroz, the Minister of Public Health. "We are deeply concerned about the increasing polio cases and the number of children who still don't have consistent and proper access to vaccination," he added.

He said the virus could spread further in the country and more children would be affected and paralyzed by polio virus.

He called upon people to 'work together and protect innocent children against polio and facilitate a safe and secure environment for our frontline workers in order to enable them administer vaccine drops to children in every nook and cranny of the country."

Polio is a crippling and potentially fatal infectious disease. There is no cure and the vaccine is the only safe and effective way to protect children.

The polio vaccine is safe and harmless for new-born children whether they are sick or not. It is very important that new-borns and sick children get the vaccine because they may have lower immunity which makes them more susceptible to the virus.

Polio vaccination has also been strongly endorsed by national and global Islamic scholars.
========================
[As I mentioned in the moderator comment of the last post (Poliomyelitis update (71): global (Pakistan, Congo DR) http://promedmail.org/post/20190901.6651501), "While there have been no newly confirmed cases reported from Afghanistan this week nor have there been positive environmental samples reported from either Pakistan or Afghanistan, it doesn't mean the virus is not still circulating, just that there aren't new confirmations." Unfortunately there were cases under investigation.

As correctly stated in the media report above, the addition of these 2 newly confirmed cases brings the number of confirmed WPV1 cases reported by Afghanistan during 2019 to date to 15.

Oruzgan is located in the central part of Afghanistan, sharing southern and southwestern borders with Kandahar and Helmand provinces where other polio cases have been reported this year (2019) as well (<http://www.lib.utexas.edu/maps/middle_east_and_asia/afghanistan_admin-2009.jpg>).

HealthMap/ProMED-mail map of Afghanistan:
Date: Mon, 19 Aug 2019 13:26:06 +0200 (METDST)

Jalalabad, Afghanistan, Aug 19, 2019 (AFP) - Scores of people including children were wounded Monday after a series of explosions shook the eastern Afghan city of Jalalabad, as the country's independence day was marred by bloodshed.

As many as 10 blasts were reported in and around the city in Nangarhar province, authorities said, and casualty numbers rose as the day wore on.   "The explosions were caused by IEDs in different parts of the city and as groups of people were celebrating independence day," the Nangarhar governor's spokesman Attaullah Khogyani said, referring to improvised explosive devices.   Jalalabad is the scene of frequent bomb attacks, and the surrounding terrain is home to both Taliban fighters and the Islamic State group's local affiliate.

At least 52 people were wounded, Khogyani said. Zaher Adel, a spokesman for a local hospital, said 66 wounded people had been brought in. An AFP correspondent saw children among the victims.   This year's August 19 celebrations mark 100 years of Afghan independence from British influence.   The day was supposed to be one of national pride and unity, but was overshadowed by an IS suicide attack Saturday on a crowded Kabul wedding hall that killed at least 63 people.

In Kabul, locals took to the streets to wave the black-red-and-green Afghan flag, but several public events to commemorate the date were scrapped as Kabul mourns and due to fears of a fresh attack.    "We postponed the celebrations to honour the victims, but we will definitely take revenge for our people," Afghan President Ahraf Ghani said.   "We will avenge the blood of our people, every drop of it."

Mayhem from Afghanistan's war continues to wreak havoc on Afghans every day, even though the US and the Taliban are in final negotiations for a deal that would see US troops begin to quit Afghanistan and could potentially lead to a reduction in violence.
Date: Sun, 18 Aug 2019 11:47:26 +0200 (METDST)
By By Emal Haidary and Mushtaq Mojaddidi

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

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

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

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

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

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

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

Many Afghans fear the Taliban could return, eroding hard-won rights for women in particular and leading to a spiralling civil war.   Meanwhile, in the northern province of Balkh, 11 members of the same family were killed when their car hit a roadside bomb, officials said. The provincial governor blamed the Taliban for planting the device.
Date: Mon, 1 Jul 2019 11:19:17 +0200

Kabul, July 1, 2019 (AFP) - At least one person was killed and dozens wounded in a Taliban-claimed attack which saw a powerful car bomb rock Kabul early Monday, followed by gunmen who battled special forces in an area housing military and government buildings.   Many children were among the wounded, according to a hospital statement, after the rush-hour explosion sent a plume of smoke into the air above the Puli Mahmood Khan neighbourhood of the Afghan capital and shook buildings up to two kilometres (1.2 miles) away.

AFP reporters could hear gunshots and multiple smaller explosions as fighting between the gunmen and special forces continued more than four hours after the attack began.   "At first, a car bomb took place and then several attackers took over a building. The area is cordoned off by the police special forces and (they) are bringing down the attackers," interior ministry spokesman Nasrat Rahimi said.    He later said that at least one attacker had been killed.   Health ministry spokesman Wahidullah Mayar said that at least one person had been killed and 65 wounded -- including nine children -- and warned that casualties could rise.   "Among the wounded, many children who were going to school," said the Twitter account of the Emergency Hospital in Kabul, where many victims were taken.   Some social media images purportedly taken at the hospital showed wounded, stunned children in school uniforms, still clutching books as they arrived for treatment.

The Taliban claimed the attack, which came just two days after the insurgents began a seventh round of talks with the US in Qatar as Washington eyes a breakthrough before Afghanistan's September presidential election.   Militant spokesman Zabiullah Mujahid released a statement saying the insurgents had targeted a defence ministry building in the area, which was quickly blocked off by Afghan forces and ambulances, with helicopter gunships seen overhead as firing continued.   Authorities have not confirmed the target.    "We were sitting inside the office when the world turned upside down on us," Zaher Usman, an employee at a branch of the culture ministry, which he said stands just 150 metres (yards) from the blast.

- Brief lockdown -
"When I opened my eyes, the office was filled with smoke and dust and everything was broken, my colleagues were screaming," Usman told AFP by telephone.   Shams Amini, a spokesman for the Afghan Football Federation, told AFP that the blast occurred near their HQ gates, and said some colleagues had been injured.   Nearby Shamshad TV station, which was attacked in 2017, aired images of broken glass and damage to its offices. "I was terrified," Shamshad anchor Hashmat Stanikzai told AFP.

The explosion came as the US was set to begin a third day of negotiations with the militants in Doha. There was no immediate confirmation if they would go ahead after the blast.   With the attack still ongoing, the Taliban spokesman in Doha again insisted that the insurgents will not negotiate with Kabul.   "Once the timeline for the withdrawal of foreign forces is set in the presence of international observers, then we will begin the talks to the Afghan sides, but we will not talk to the Kabul administration as a government," Suhail Shaheen tweeted. 

The insurgents have long refused to negotiate with the Western-backed government, whom they deem puppets.   The talks have so far centred on four issues -- counter-terrorism, the foreign troop presence, an intra-Afghan dialogue and a permanent ceasefire.   A potential deal would see the US agree to withdraw its troops after more than 17 years in Afghanistan, igniting deep concerns among Afghans who fear Washington will rush for the exits and allow the militants to return to some semblance of power.   In return, the Taliban would guarantee the country would never again become a safe haven for violent extremism, as happened with Al-Qaeda before the September 11, 2001 attacks.   However, US officials have insisted that "nothing is agreed until everything is agreed", including intra-Afghan talks.
Date 24 Jun 2019
Source: Mena FN [edited]

The number of polio positive cases in Afghanistan has reached 10 so far in 2019, with 4 cases reported from Uruzgan [Oruzgan] province and 1 new case detected in the Mehr Abad area of Tirinkot, the provincial capital.

According to Ministry of Public Health, a 21-month-old girl is permanently paralyzed in Tirinkot, making 10 cases of polio in Afghanistan so far [in 2019].

The Health ministry in a statement said that last week, another polio case was reported from Trinkot, which paralyzed a 30-month-old boy [see Poliomyelitis update (50): Afghanistan (OZ) http://promedmail.org/post/20190619.6528976].

House-to-house polio campaigns have been banned in this area since May 2018. This means children under [5 years of age] living in the area have not been vaccinated and protected from the virus since then, the ministry added.

Only one out of 10 polio cases were reported from Eastern Kunar province, while the rest have been reported from the southern region: 4 cases in Urozgan [Oruzgan], 3 in Helmand and 2 cases in Kandahar.

"Access to health services is the right of every citizen of the country," said Dr. Ferozuddin Feroz, the Minister of Public Health of Afghanistan. "We are deeply concerned about the increasing polio cases and the number of children who still don't have consistent access to vaccination. The virus could spread, and more children will be affected and paralyzed by polio virus in Afghanistan. I ask everyone to work together and protect innocent children against polio, to provide a safe and secure environment for our frontline workers to vaccinate children in every corner of the country."

The polio vaccine is safe, even for sick and new-born children. It is very important that new-borns and sick children get the vaccine, because they may have lower immunity, which makes them more susceptible to the virus.

Polio vaccination has also been strongly endorsed by national and global Islamic scholars, the statement added.
======================
[In last week's report on the 30-month-old male child from Oruzgan, there was mention that the vaccination teams were unable to enter the zone where the child lived due to security concerns. The media report above mentions there haven't been vaccinations provided through household visits in this zone since May 2018.

Oruzgan is located in the central part of Afghanistan, sharing southern and southwestern borders with Kandahar and Helmand provinces where other polio cases have been reported this year (2019) as well (<https://www.afghana.com/GetLocal/Afghanistan/Provinces.htm>).

With the addition of this newly confirmed case, there have now been 10 cases of confirmed poliomyelitis reported from Afghanistan since the beginning of 2019. Add these to the 27 cases confirmed in Pakistan, and there are now 37 cases reported this year (2019), 4 more than the total number of cases reported during 2018.

HealthMap/ProMED-mail maps:
Oruzgan Province, Afghanistan: <http://healthmap.org/promed/p/1257>  - ProMED Mod.MPP]
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.
*

*

*
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 ...

Lebanon

Lebanon - US Consular Information Sheet
August 20, 2008
COUNTRY DESCRIPTION:
The Republic of Lebanon is a parliamentary republic. Political power is concentrated in the office of the President, Prime Minister and Speaker of Parliament, eac
representing one of Lebanon's three largest religious sects (Maronite Christians, Sunni and Shi'a Muslims). Since 1973, Lebanon has been in a state of war with Israel. Read the Department of State Background Notes on Lebanon for additional information.

ENTRY/EXIT REQUIREMENTS: Passports and visas are required.
American citizens coming to Lebanon for tourism can purchase a short-term visa at the border.
Travelers holding passports that contain visas or entry/exit stamps for Israel will likely be refused entry into Lebanon.
Travelers whose passports contain Israeli stamps or visas and who also hold an "Arab nationality" may be subject to arrest and imprisonment.
Travelers who have overstayed their entry visa validity in Lebanon have to adjust their status with the Central Department of Surete General (Department of Passport and Immigration) prior to their departure.

Further information on entry/exit requirements can be obtained from the Embassy of Lebanon, 2560 28th Street NW, Washington, DC, 20008, tel. (202) 939-6300.
Travelers may also contact one of the following Consulates General:
1959 E. Jefferson, Suite 4A
Detroit, MI 48207
(313) 567-0233
2400 Augusta, Suite 308
Houston, TX 77057
(713) 268-1640
7060 Hollywood Blvd., Suite 510
Los Angeles, CA 90028
(323) 467-1253
6600 S.W. 57th Avenue, Suite 200
Miami, FL 33143
(305) 665-3004
(Honorary Consul, for Florida residents only)
9 E. 76th Street
New York, NY 10021
(212) 744-7905
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:
A Department of State Travel Warning advises U.S. citizens against travel to Lebanon.
Recent events underscore the need for caution and sound personal security precautions.
U.S. citizens who are in Lebanon despite this Travel Warning should exercise particular caution when traveling in parts of the southern suburbs of Beirut, portions of the Bekaa Valley and areas south of the Litani River in South Lebanon.
Hizballah maintains a strong presence in many of these areas, and there is the potential for action by other extremist groups.
The situation remains tense and a resumption of sporadic violence remains a possibility.
On May 7, 2008, Hizballah militants blocked the road to Rafiq Hariri International Airport.
The action rendered the airport inaccessible and travelers were unable to enter or leave the country via commercial air carriers.
Armed Hizballah and other opposition members proceeded to enter areas of Lebanon not traditionally under their control resulting in heavy fighting and a number of casualties.
While there is now full access to the airport, widespread hostilities have subsided, and the government of Lebanon has successfully elected a president and formed a cabinet, the United States remains concerned about Hizballah's willingness to use violence to achieve political ends with little or no warning.
Since the May hostilities there have been violent outbreaks in Tripoli that left over ten dead and dozens wounded.

Americans have been the targets of numerous terrorist attacks in Lebanon in the past.
The perpetrators of many of these attacks are still present and retain the ability to act.
On January 15, 2008, a U.S. Embassy vehicle was involved in a bomb attack that killed three Lebanese bystanders.
American citizens should thus keep a low profile, varying times and routes for all required travel.
Americans should also pay close attention to their personal security at locations where Westerners are generally known to congregate, and should avoid demonstrations and large gatherings.
Unofficial travel to Lebanon by U.S. Government employees and their family members requires prior approval by the Department of State.
Palestinian groups hostile to both the Lebanese government and the U.S. operate largely autonomously inside refugee camps in different areas of the country.
Intra-communal violence within the camps has resulted in violent incidents such as shootings and explosions.
Travel by U.S. citizens to Palestinian camps should be avoided.
Asbat al-Ansar, a terrorist group with apparent links to Al-Qaida, has targeted Lebanese, U.S. and other foreign government interests.
It has been outlawed by the Lebanese government but continues to maintain a presence in Ain al-Hilweh refugee camp.
Americans traveling to Lebanon should also be aware that personnel from the U.S. Embassy are not able to travel in all areas of Lebanon.
In the case of an emergency involving a U.S. citizen in areas where it is unsafe for Embassy personnel to travel, the Embassy may not be able to render assistance.
In addition, dangers posed by landmines and unexploded ordnance throughout south Lebanon are significant and also exist in other areas where civil war fighting was intense.
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, including the Travel Warning for Lebanon, 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 overseas 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: The crime rate in Lebanon is moderate, but both car theft and home break-ins occur.
Violent crime and sexual assault are rare, although petty theft -- such as pick pocketing and purse snatching -- is common in crowded public areas.
Police are responsive but often unable to effect a positive outcome.
There are no special concerns with regard to targeted victimization of Americans or to scams or confidence schemes.
There have, however, been recent kidnappings of Lebanese-American women by their Lebanese relatives in an effort to force these women into marriage.

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 http://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, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
The local equivalent to the “911” emergency line in Lebanon is 112.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: In Beirut and the surrounding areas, modern medical care and medicines are widely available.
Such facilities are not always available in outlying areas, although no location in the country is more than three hours from the capital.
Doctors and hospitals often expect immediate cash payment for services, and without such payment, may deny service even in emergency cases.
A list of doctors who speak English and a list of hospitals are available from the U.S. Embassy and at the Embassy's web site at http://lebanon.usembassy.gov/
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Lebanon.

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 Lebanon is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Drivers in Lebanon often maneuver aggressively and pay little regard to traffic lights and stops signs.
Lanes are generally unmarked and roads outside of the capital may be poorly lit.
Pedestrians, especially, should exercise great caution.
Inter-city directional signs are improving throughout the country, but side roads are often not signposted at all.
Public transportation is generally safe.
Emergency services in Lebanon are adequate.
In case of a road accident, emergency numbers are “140” for the Red Cross and “125” for the emergency civil police.
Please refer to our Road Safety page for more information.
Visit the website of Lebanon's national tourist office at http://www.destinationlebanon.gov.lb.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Lebanon, the U.S. Federal Aviation Administration (FAA) has not assessed Lebanon’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: In addition to being subject to all Lebanese laws, U.S. citizens who also possess Lebanese nationality may also be subject to other laws that impose special obligations on them as Lebanese citizens.
Lebanese citizens who are discovered to have associated with or traveled through Israel, are subject to arrest and detention.

Military Service:
Mandatory military service in Lebanon was abolished on February 4, 2007.
However, travelers with questions about prior military service, desertion, or failure to register in the past should contact the Military Office of the Embassy of Lebanon, 2560 28th Street, N.W., Washington, D.C. 20008, or call (202) 265-2335 or fax (202) 667-0063 for details prior to traveling to Lebanon. Information about military service can also be found at the Lebanese government web site at http://www.lebarmy.gov.lb/English/FlagService.asp
Lebanese Customs authorities may enforce strict regulations concerning import and export of such items as firearms or antiquities.
It is advisable to contact the Embassy of Lebanon in Washington, D.C., or one of Lebanon's consulates in the United States for specific information regarding customs requirements. Please see our information on customs regulations.
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 Lebanese laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Lebanon 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 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 Lebanon are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, and to obtain updated information on travel and security within Lebanon.
Americans without Internet access may register directly with the U.S. Embassy in Beirut.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in Awkar, near Antelias, Beirut, Lebanon.
Public access hours for American citizens are Monday, Tuesday, and Thursday, 8:00 a.m. to 11:00 am for regular consular services.
Consular Report of Births Abroad (birth certificates for newborns) are handled Wednesdays only from 8:00 a.m. to 11:00 a.m.
The telephone numbers are (961-4) 542-600, 543-600, and fax 544-209, and American citizens who require emergency services outside of these hours may contact the Embassy by telephone at any time.
American citizens registering at the embassy can receive updated information and warden messages via e-mail by subscribing to join-wardenmessagebeirut@mh.databack.com.
Information on consular services and registration can be found at http://lebanon.usembassy.gov or by phone at the above telephone numbers between 2:00 p.m. and 4:00 p.m. Monday through Friday local time.
* * * * * *
This replaces the Country Specific Information dated December 27, 2007 to update the sections on Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information and Aviation Oversight.

Travel News Headlines WORLD NEWS

Date: Sat, 9 Nov 2019 14:18:27 +0100 (MET)

Beirut, Nov 9, 2019 (AFP) - Several petrol stations in protest-hit Lebanon stopped services Saturday, as reserves ran dry due to a shortage of US dollars to pay suppliers, a syndicate head said.   The shuttering of petrol stations came as demonstrators again took to the street across the country, keeping up their three-week-long movement against a political class regarded as inefficient and corrupt.    "The petrol stations that opened today are the ones that still have reserves. They will close down as soon as supply runs out," said Sami Brax, the head of the Syndicate of Gas Station Owners.   He said if officials do not facilitate access to dollars by Tuesday, "we will be forced to stop imports and close down all petrol stations."

Petrol stations receive payment from customers in Lebanese pounds but have to pay importers and suppliers in dollars.    For two decades, the Lebanese pound has been pegged to the US dollar, with both currencies used interchangeably in daily life.   But banks have been reducing access to dollars since the end of the summer, following fears of a shortage in central bank dollar reserves.   In recent days, banks halted all ATM withdrawals in dollars and severely restricted conversions from Lebanese pounds.   Many Lebanese have had to instead buy dollars from money changers at a higher exchange rate, in what amounts to a de-facto devaluation of the local currency that has sparked price hikes.

The official exchange rate has remained fixed at 1,507 Lebanese pounds to the dollar, but the rate in the parallel market has surpassed 1,800.   "The banks are under pressure from people, both inside Lebanon and abroad," said economist Naseeb Ghabreel, after many rushed to withdraw their dollar savings or convert Lebanese pound accounts.   Since September, petrol station owners have accused banks of failing to provide them with the dollars they need and threatened strikes.    In response, the central bank last month pledged to facilitate access to the greenback for importers of petroleum products, wheat and medicine.   But the measure has not yet gone into effect.

Lebanon has since October 17 witnessed an unprecedented popular uprising against everything from power cuts and poor social security to alleged state corruption.   The government yielded to popular pressure and stepped down last month, with the World Bank urging for the quick formation of a new cabinet to prevent the economy from further deteriorating.
Date: Tue 22 Oct 2019
Source: WHO Disease outbreak news [abridged, edited]

Health authorities in Lebanon are responding to an outbreak of measles. From 1 Nov 2018 through 12 Oct 2019, a total of 1171 cases have been reported, of which 675 (57.6%) were laboratory confirmed, 8 (0.7%) epidemiologically linked cases, and 488 (41.7%) were clinically diagnosed. No associated deaths have been reported as of now.

Measles cases have been reported in all 8 Lebanese governorates, with Aakar, Baalbek-El-Hermel, Bekaa North, and Mount Lebanon governorates most affected. A total of 90% of suspected measles cases were Lebanese nationals, while 10% were Syrians living in informal settlements and in residential areas. The cumulative incidence of measles among Lebanese was higher than that of Syrians (22.4 versus 11.1 per 100,000 population, respectively).

The most affected age group among the 1123 cases with known age was children under the age of 5 years with 705 cases (63%), followed by cases of 5-9 years of age (271 cases; 24%), 10-14 (31 cases; 3%), 15-24 (19 cases; 2%), and people over 24 years of age 97 cases (9%). In addition, children below 5 years old have the highest cumulative incidence (124.6 per 100 000 population) followed by children in the age group of 5-9 years (41.4 per 100 000 population).

The immunization strategy employed by the Lebanon public health sector includes both measles vaccine given at 9 months of age (introduced in 1987) and measles mumps rubella (MMR) vaccine given to children as 2 doses at 12 and 18 months of age (MMR, introduced in 1996). The private sector implements MMR vaccination, at 12 months and 4-5 years of age.

In Lebanon, between 2000 and 2018, the WHO-UNICEF coverage estimations for 2nd dose of measles-containing vaccine ranged from 15-75% with a median coverage of 63%.

Public health response
The Ministry of Health (MoH) in Lebanon is coordinating the response activities, with the support of WHO and UNICEF. Public health response measures include:

- Epidemiological investigations, contact tracing, and monitoring of close contacts;
- Sensitization of clinicians on measles surveillance, reporting, case investigation, and management;
- Social mobilization and distribution of information, education, and communication (IEC) materials;
- Measles assessment mission, conducted in May 2019, recommended a national measles campaign and support to the epidemiological surveillance unit;
- Localized accelerated immunization activities in areas of measles clusters; and
- Planning of a national measles campaign targeting 1,170,000 children in the age group of 6 months to less than 10 years of age.

WHO risk assessment
Based on the available information, the risk at the national level is considered to be high for the following reasons: nationwide case distribution and low vaccination coverage at national level with immunity gaps; the country host around 1 million displaced Syrians with limited access to healthcare; limited funding for supplementary immunization activities to improve measles vaccination coverage and for the epidemiological surveillance unit to support surveillance activities and capacity building; and measles cases being reported throughout the country.

The overall risk at regional level was assessed as moderate due to porous boundaries allowing free movement between Lebanon and Syria, the low vaccination coverage, and recent measles outbreaks reported in neighbouring countries. The overall risk at global level was assessed as low.

WHO advice
While there is no specific antiviral treatment for measles, the provision of Vitamin A is recommended by WHO for all children infected with measles, as it is associated with reduced mortality and severity of complications. In populations with high levels of malnutrition and a lack of adequate health care, up to 10% of measles cases result in death, and in the most vulnerable groups, deaths can reach up to 30%. Among malnourished children and people with greater susceptibility, measles can also cause serious complications, including blindness, encephalitis, severe diarrhea, ear infection, and pneumonia.

In countries with low vaccination coverage, epidemics typically occur every 2-3 years and usually last between 2 and 3 months, although their duration varies according to population size, crowding, and the population's immunity status.

WHO urges all member states to do the following:
- Vaccinate to maintain high coverage (greater than or equal to 95%) with 2 doses of measles-containing-vaccine, in every district;
- Vaccinate at-risk populations (without proof of vaccination or immunity against measles and rubella), such as healthcare workers, people working in tourism and transportation, and international travellers;
- Maintain a reserve of MCV for control of imported cases;
- Strengthen epidemiological surveillance for "fever with rash cases" for timely detection of all suspected cases of measles in public and private healthcare facilities;
- Ensure that collected blood samples from suspect measles cases are received by laboratories within 5 days;
- Provide a rapid response to imported measles cases through the activation of rapid response teams to prevent the establishment or re-establishment of endemic transmission;
- Administer Vitamin A supplementation to all children diagnosed with measles to reduce the complications and mortality (2 doses of 50 000 IU for a child less than 6 month of age, 100 000 IU for children between 6 and12 months of age, or 200 000 IU for children 12-59 months, immediately upon diagnosis and on the following day).
Date: Tue, 15 Oct 2019 19:33:58 +0200 (METDST)

Beirut, Oct 15, 2019 (AFP) - Lebanon has turned to its neighbours for help battling forest fires that have ravaged homes and killed a volunteer firefighter in the Mediterranean country, its premier said on Tuesday.   Heavy rain fell on parts of the country including Beirut in the evening, after Cyprus dispatched help and as Greece and Jordan vowed to follow suit.   "We have contacted the Europeans who will send means of help," Prime Minister Saad Hariri said earlier in comments carried by national news agency NNA.

Dozens of blazes have hit Lebanon in recent days, fire chief Raymond Khattar told NNA, amid unusually high temperatures and strong winds.   Thick smoke had been seen drifting over the outskirts of Beirut, the mountainous Chouf region to its southeast, and the southern city of Saida.   In the Chouf, an area famed for its forests, a volunteer firefighter lost his life trying to put out the flames, his family said.   In an area south of Beirut, firefighters have for two days been unable to stop the blaze, which has burnt four homes to the ground and caused dozens to suffer breathing difficulties, NNA said.

Interior Minister Raya El-Hassan said nearby Cyprus and Greece had responded to Lebanon's call for help.   "Two Cypriot planes have been working to put out the fires since yesterday," she said on Twitter.   "Greece has responded to our request and will send two planes to help us," she added.   Jordan's army said the king had ordered two firefighting planes to be dispatched.   NNA said the army was working together with helicopters and the Cypriot planes to fight the blaze, with access sometimes impeded by thick smoke and high-voltage power lines.   Personnel from UN peacekeeping force UNIFIL, who usually patrol the country's southern border with Israel, have also joined in the efforts, the agency said.   Lebanese on social media criticised the government's apparent inability to respond fast enough on its own.

In neighbouring war-torn Syria, fires also killed two people, Syrian state media said.   Flames have ripped through parts of the coastal provinces of Latakia and Tartus, as well as the central province of Homs but most have been brought under control, state news agency SANA said.   Two members of the Latakia forestry department were killed while fighting the blaze, it added.   In Tartus, the fires -- mostly stamped out -- coincided with the olive harvest, the governor told SANA.   In Homs, trees were burnt and electricity networks disrupted in mountainous areas, the agency reported.
Date: Mon, 26 Aug 2019 18:29:25 +0200 (METDST)

Beirut, Aug 26, 2019 (AFP) - Lebanese authorities on Monday detained the owner of a travel agency accused of having left thousands of travellers stranded with fake flight and hotel reservations.   Fawaz Fawaz, the Lebanese owner of New Plaza Tours, was captured in Syria and transferred to Lebanon, the General Security agency said in a statement, without elaborating.

The security agency accused Fawaz of committing "fraud and embezzlement" through a travel agency, by selling fake flight tickets and hotel reservations.   This left "thousands of Lebanese" stranded in Turkey, Georgia and other countries without accommodation or return flights, it said.   Local media was rife with stories last week of Lebanese travellers forced to sleep on airport and hotel floors because of the scandal.   New Plaza Tours is reportedly not licensed by the tourism ministry.   On Friday, Lebanon's Middle East Airlines said it had filed a lawsuit against Fawaz in 2015 over outstanding debts owed by one of his several travel agencies.
Date: Mon 26 Nov 2018 (accessed)
Source: Epidemiology and Infection, 1st view, published online 15 Nov 2018 [edited]
<https://doi.org/10.1017/S095026881800300X>

Citation: Kassir MF, El Zarif T, Kassir G, Berry A, Musharrafieh U, Bizri AR (2018).
Human rabies control in Lebanon: a call for action.

Epidemiology and Infection 1-8.
------------------------------------------------------------------------------------------------------------------------------------------------------------
Abstract:   The status of rabies as a neglected disease has made its eradication rather challenging in different parts of the world despite the availability of a successful vaccine. Lebanon, in particular, is a country endemic to the disease with several cases of rabies deaths reported over the past 30 years. The risk of rabies, however, has taken a new turn over the past few years in Lebanon with 2 emerging situations that have made the control of the disease rather challenging: the neighbouring Syrian war and the local garbage crisis.

Both of these milestone events might have contributed to an increase in the number of disease vectors as well as individuals at risk, thus nourishing the cycle of disease transmission. In this observational study, the effects of these 2 events are investigated, with an update on the status of this preventable, yet often neglected, disease in the country. Both events were found to be concomitant with a notable increase in the number of dog bites and thus possible rabies exposure.

Current regulations are explored through interviews with veterinarians, and customs recommendations, ranging from policies to control of dog populations to awareness campaigns in high-risk individuals, are then proposed to help control the disease.
===========================
[According to information included in the paper, between 2005 and 2016, a total of 7369 animal bites were reported to the LMOPH (Lebanese Ministry of Public Health), with an annual average of 614 bites per year. About 91 percent of the bites were caused by dogs, of which 53 percent were by domestic dogs and 47 percent by stray dogs. The remaining 9 percent involved cats, bats and rodents. It may be assumed that some events involved farm animals as well, not mentioned in the paper.

In 2013, a steep increase in numbers was observed and was sustained up to 2016. The yearly average of animal bites post-2013 was, reportedly, 1004 ± 272 bites per year, which is significantly higher than the average of 355 ± 145 bites per year prior to 2013 (span from 1991 to 1996 and 2001 to 2013). The highest number of bites (per 100 000 individuals) was observed in the northern governorate and in the (southern) Nabatieh governorate (Lebanon's administrative map at <https://en.wikipedia.org/wiki/List_of_cities_and_towns_in_Lebanon>).

Counting bites does not necessarily reflect the incidence of rabies in animals; it may serve as suggestive of increased rabies incidence in the vector animals. Unfortunately, no information about clinically suspected and/or lab confirmed rabies in animals is included in the paper. Lebanon has reported a rabies case in a dog to the OIE in March 2018 (http://promedmail.org/post/20180314.5687339); this was the 1st reported animal rabies case from Lebanon since 1995(!).

As suggested by the authors, the Syrian war and the local garbage crisis are plausible explanations for increased rabies incidence in Lebanon. A wide circulation of the virus in Lebanon's canines/fauna, particularly in the Nabatieh governorate bordering northern Israel, was suggested in the past, most recently in http://promedmail.org/post/20180321.5701731 (item 4) and in ref 1.

It could also be deduced from the data presented in Israel's rabies map of 2015 at <http://www.moag.gov.il/vet/Yechidot/Machon/maabada_kalevet/airueim%20kalevet/kalevet_2015/PublishingImages/rabiesmap272016.jpg>.

Reference 1.
D David, N Devers, BA Yakobson, I Davidson. Emergence of dog rabies in the Northern region of Israel. Epidemiol Infect 2009; 137(4): 544-8; DOI:10.1017/S0950268808001180. - ProMED Mod.AS]

[HealthMap/ProMED map available at: Lebanon: <http://healthmap.org/promed/p/85>]
More ...

Yemen

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

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

On March 18, 2008, three mortar rounds landed in the vicinity of the U.S. Embassy in Sanaa. Yemeni students at a nearby school and Yemeni government security personnel posted outside the embassy were injured in the attack. On April 6, 2008, an expatriate residential compound in the Hadda neighborhood of southwestern Sanaa was attacked by mortar fire, and on April 30, 2008, suspected extremists fired two mortar rounds that exploded near the Yemen Customs Authority and the Italian Embassy. No injuries were reported in either incident. A group calling itself al-Qa'ida in Yemen may be responsible for all three attacks. Following the attacks against the Embassy and the residential compound, the Department of State ordered the departure of all American non-emergency embassy staff and family members on April 7, 2008.
On January 18, 2008, suspected al-Qa’ida operatives ambushed a tourist convoy in the eastern Hadramout Governorate, killing two Belgians. On July 2, 2007, suspected al-Qa’ida operatives carried out a vehicle-borne explosive device attack on tourists at the Belquis Temple in Marib, which resulted in the deaths of eight Spanish tourists and two Yemenis. The targeting of tourist sites by al-Qa’ida may represent an escalation in terror tactics in Yemen. On February 3, 2006, 23 convicts, including known affiliates of al-Qa’ida, escaped from a high-security prison in the capital city, Sanaa. Among the al-Qa’ida associates were individuals imprisoned for their roles in the 2000 bombing of the USS Cole and the 2002 attack on the French oil tanker Limburg. In the weeks following the escape, some prisoners voluntarily turned themselves in to authorities; to date, however, some escapees remain at large. Two of the escapees were killed in vehicle-based suicide attacks on oil facilities near Mukalla and Marib on September 15, 2006. Those attacks were followed by the arrest the next day in Sanaa of four suspected al-Qa’ida operatives, who had stockpiled explosives and weapons. On December 5, 2006, a lone gunman opened small arms fire outside of the Embassy compound during the early morning hours. The assailant, wounded by host-nation security personnel and subsequently arrested, was the sole casualty. It appears that, although the gunman was influenced by extremist ideology, he worked alone in planning and executing the attack.
Americans should avoid areas where demonstrations are taking place. A 2005 demonstration against an increase in the fuel price led to two days of widespread demonstrations and rioting throughout Sanaa and other cities. Those demonstrations resulted in a large amount of property damage, looting, and several roadblocks.
In late 2007 and throughout 2008, there has been an increase in anti-government demonstrations in southern Yemen, including the cities of Aden, Taizz, Ibb, and Mukalla, as well as surrounding regions. Some of these demonstrations have resulted in injuries and deaths. Americans should be aware of the potential for further demonstrations when traveling in these areas.
Throughout the country, U.S. citizens are urged to exercise particular caution at locations where large groups of expatriates have gathered. From time to time, the U.S. Embassy in Sanaa may temporarily close or suspend public services as necessary to review its security posture and ensure its adequacy.
In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of such objects to local authorities. Vehicles should not be left unattended and should be kept locked at all times. Americans in Yemen are urged to register and remain in contact with the American Embassy in Sanaa for updated security information (see section on Registration/Embassy location below).
Yemeni government security organizations have arrested and expelled foreign Muslims, including Americans, who have associated with local Muslim organizations considered to be extremist by security organs of the Yemeni government. Americans risk arrest if they engage in either political or other activities that violate the terms of their admission to Yemen.
Travel on roads between cities throughout Yemen can be dangerous. Armed carjacking, especially of four-wheel-drive vehicles, occurs in many parts of the country, including the capital. Yemeni security officials advise against casual travel to rural areas. The U.S. Embassy sometimes restricts the travel of its own personnel to rural areas, while the Government of Yemen also sometimes places restrictions on Americans traveling outside Sanaa. Please check with the Embassy for the latest restrictions.
Travel is particularly dangerous in the tribal areas north and east of Sanaa. Armed tribesmen in those areas have kidnapped a number of foreigners in attempts to resolve disputes with the Yemeni government. Hostilities between tribesmen and government security forces in the Sadah governorate north of Sanaa have flared up on several occasions since 2005. Serious fighting occurred in the city of Benni Hashish from late May through early June 2008. Americans are urged to avoid this region during periods of conflict.
Travel by boat through the Red Sea or near the Socotra Islands in the Gulf of Aden presents the risk of pirate attacks. If travel to any of these areas is necessary, travelers may reduce the risk to personal security if such travel is undertaken by air or with an armed escort provided by a local tour company.
Other potential hazards to travelers include land mines and unexploded ordnance from the 1994 civil war. This is of particular concern in areas where fighting took place in the six southern provinces. However, most minefields have been identified and cordoned off.
Americans are most vulnerable to terrorist attacks when they are in transit to and from their residences or workplaces, or visiting locations where large groups of expatriates have gathered. All Americans are reminded to vary their routes and times, remain vigilant, report suspicious incidents to the Embassy, avoid areas where large groups of expatriates have gathered, lock car windows and doors, and carry a cell phone.
Based on previous abductions of foreigners in Iraq, Afghanistan and Kuwait, the Embassy recommends that Americans with doubts about the identity of security or police personnel on the roads remain in their vehicles, roll up their windows, and contact the Embassy. For additional information on travel by road in Yemen, see the Traffic Safety and Road Conditions section below.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, including the Travel Warning for Yemen, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: The most serious crime problem affecting travelers to Yemen is carjacking. Travelers have rarely been victims of petty street crime.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends, and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

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

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

Travel News Headlines WORLD NEWS

Date: Tue 15 Oct 2019
Source: Yemen Online [edited]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[HealthMap/ProMED-mail map:
Date: Wed 29 May 2019
Source: World Health Organization [edited]

Outbreak update - Cholera in Yemen, 27 May 2019
-----------------------------------------------
The Ministry of Public Health and Population of Yemen reported 16,827 suspected cases and 18 associated deaths during epidemiological week 20 (13-19 May 2019). 15 per cent of cases were severe. The cumulative total number of suspected cholera cases from 1 Jan 2018 to 28 Apr 2019 is 704 986, with 1114 associated deaths (case fatality rate [CFR] 0.16%). Children under 5 represent 22.6% of total suspected cases during 2019. The outbreak has affected 22 of 23 governorates and 295 of 333 districts in Yemen.

>From week 8 in 2019, the trend of weekly reported suspected cholera cases started increasing and peaked at more than 29 500 cases in week 14. During weeks 15 to 20, case numbers declined, although it is too early to conclude a downward trend. The decline may be attributed to enhanced outbreak control efforts such as community engagement and WaSH [water, sanitation, and hygiene] activities, and scaling up WHO and partners' response, including establishing additional DTCs [diarrhea treatment centres] and ORCs [oral rehydration corners].

The governorates reporting the highest number of suspected cases of cholera in 2019 are Amanat Al Asimah (55 065), Sana'a (41 094), Al Hudaydah (34 814), Ibb (31 725), Dhamar (29 889) and Amran (27 727).

Of a total 6144 samples tested since January 2019, 3264 were confirmed as cholera-positive by culture at the central public health laboratories. During this reporting period, the governorates reporting the highest number of positive cultures are Amanat Al Asimah (995), Taizz (741) and Sana'a (367).

WHO continues to provide leadership and support for activities with health authorities and partners to respond to this ongoing cholera outbreak, including case management, surveillance and laboratory investigations, hotspot mapping and oral cholera vaccination campaign planning, water sanitation and hygiene (WaSH), and risk communication.
===================
[The numbers reported in this continuing catastrophe are difficult to wrap one's head around. Given the low case fatality rate reported, it is likely that many of the cases of diarrhoea are not cholera. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
More ...

Iceland

Iceland US Consular Information Sheet
November 17, 2008
COUNTRY DESCRIPTION:
Iceland is a highly developed, stable democracy with a modern economy.
The national language is Icelandic, but English is widely spoken, especially in the ca
ital city of Reykjavik.
Read the Department of State Background Notes on Iceland for additional information.

ENTRY/EXIT REQUIREMENTS:
Iceland is a party to the Schengen agreement.
As such, U.S. citizens may enter Iceland for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our fact sheet.
For further information in English concerning entry requirements for Iceland, please contact the Icelandic Directorate of Immigration via their web site at www.utl.is.

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:
There have been no terrorist attacks and very few criminal attacks affecting Americans in Iceland.
However, like other countries in the Schengen area, Iceland’s open borders with its Western European neighbors allow the possibility of terrorists or other criminals entering/exiting the country with anonymity.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

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 United States and Canada, or, for callers outside the United States and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Iceland has a relatively low crime rate, but minor assaults, automobile break-ins and other street crimes do occur, especially in the capital city of Reykjavik.
Tourists should be aware that downtown Reykjavik can become especially disorderly in the early morning hours on weekends.
Violent crime is rare, but it does occasionally occur.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft of a U.S. passport abroad 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.
Iceland maintains a limited crime victim’s assistance program through the Ministry of Justice.
Please contact the U.S. Embassy in Reykjavik for further details.
Those suffering psychological trauma or who are victims of rape may receive psychological assistance by contacting the University of Iceland’s Hospital Psychological Trauma Center at 354-543-2000. For further information about possible U.S. compensation, see our Information for Victims of Crime
The local equivalent to the “911” emergency line in Iceland is:112.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Excellent medical facilities are available in Iceland.
To obtain emergency medical assistance anywhere in the country, dial 112.
To obtain non-emergency medical assistance in the Reykjavik metropolitan area dial 544-4114 during business hours and outside of normal business hours, dial 1770.
The nurse who answers will offer advice on how to handle the problem, suggest that the patient come to an after-hours clinic, or send a physician to make a house call.
For information on after-hours dental care, call 575-0505.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Iceland.
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 web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith
MEDICAL INSURANCE:
Most medical services in Iceland, including emergency care, require full payment at the time of service.
Payment to the medical facility must be paid in full before an individual will be able to leave the country.
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.
Additional travel insurance to cover the price of medical evacuations is also strongly recommended.
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 Iceland is provided for general reference only, and may not be completely accurate in a particular location or circumstance.

Less than a third of Iceland’s total road network is paved (2,262 miles of paved road vs. 5,774 miles of gravel or dirt road).
Most of the 900-mile ring road (Highway 1) that encircles the country is paved, but many other roads outside the capital, especially those that run through the center of the country, are dirt or gravel tracks.
Even those roads that are paved tend to be narrow and lack a shoulder or margin.
Most bridges are only one lane wide, requiring drivers to be cognizant of oncoming traffic.
Extreme care should be taken when driving in rural areas during the winter (October through March), when daylight hours are limited and the weather and road conditions can change rapidly.
Many routes in the interior of the country are impassable until July, due to muddy conditions caused by snowmelt.
When driving in the interior, consider traveling with a second vehicle and always inform someone of your travel plans.
For information on current road conditions throughout the country, please call the Public Roads Administration (Vegagerdin) at 1777 or consult its web site at http://www.vegagerdin.is/english/.

For recorded weather information in English, call the Icelandic Weather Office (Vedurstofa Islands) at 902-0600, press 1 for English.

Icelandic law requires drivers to keep headlights on at all times.
Talking on cell phones while driving is prohibited and is subject to a 5000 Icelandic Kronur fine, except when using a hands-free system.
Unless otherwise posted, the speed limit is 50 km/h in urban areas and 30 km/h in residential areas.
In rural areas, the speed limit depends on the type of road.
On dirt and gravel roads, the speed limit is 80 km/h.
On paved highways, the speed limit is 90 km/h.
It is illegal to turn right on a red light.
At four-way intersections, the right of way goes to the driver on the right; in traffic circles, to drivers in the inside lane.
Many intersections in the capital have automatic cameras to catch traffic violators.

The use of seatbelts is mandatory in both the front and rear seats, and children under the age of six must be secured in a special car seat designed for their size and weight.
Drivers are held responsible for any passenger under the age of 15 who is not wearing a seatbelt.
No one who is less than 140 centimeters tall, weighs less than 40 kilograms, or is under the age of 12 is allowed to ride in a front seat equipped with an airbag.

Driving under the influence of alcohol is considered a serious offense in Iceland.
The threshold blood alcohol test (BAT) level is very low.
Drivers can be charged with DUI with a BAT as low as .05%.
Drivers stopped under suspicion of DUI are usually given a ``balloon’’ or Breathalyzer test.
If the test is positive, a blood test is routinely administered.
Under Icelandic law, a blood test cannot be refused and will be administered by force if necessary.
The minimum punishment for a first offense is a fine of 50,000 Icelandic Kronur and the loss of driving privileges for two months.
U.S. citizens spending less than 90 days in Iceland may drive using their U.S. licenses.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.vegagerdin.is/english/road-conditions-and-weather/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Iceland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Iceland’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:
Extreme care should be exercised when touring Iceland's numerous nature attractions, which include glaciers, volcanic craters, lava fields, ice caves, hot springs, boiling mud pots, geysers, waterfalls, and glacial rivers.
There are few warning signs or barriers to alert travelers to potential hazards.
Several tourists are scalded each year because they get too close to an erupting geyser, or because they fall or step into a hot spring or boiling mud pot.
High winds and icy conditions can exacerbate the dangers of visiting these nature areas.
Hikers and backpackers are well advised to stay on marked trails, travel with someone, notify a third party about their travel plans and check weather reports, as there are often no means of communication from remote locations.
This is especially important as weather conditions in Iceland are subject to frequent and unexpected changes.
Those planning visits to dangerous or remote locations in Iceland are strongly encouraged to register with the U.S. Embassy before beginning their journey and to leave a travel itinerary with local guides/officials if planning to trek through remote parts of the country.
See below for information on how to register.

Please see our information on customs regulations.

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 Icelandic laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Iceland are strict, 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.

DISASTER PREPAREDNESS:
Iceland is subject to natural disasters in the form of earthquakes, volcanic eruptions, avalanches, and violent storms.
Travelers should learn how to prepare for and react to such events by consulting the web site of Iceland's National Civil Defense Agency at http://www.almannavarnir.is.
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.

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 in or visiting Iceland 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 Iceland.
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 Laufasvegur 21, tel. +354-562-9100; fax +354-562-9110.
Information about consular services can be found in the Consular section of the Embassy home page at http://iceland.usembassy.gov
* * *
This replaces the Country Specific Information sheet dated May 7, 2008 to update the sections on Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat 13 Jul 2019
Source: Food Safety News [edited]

At least 3 children have developed kidney failure after being diagnosed with _Escherichia coli_ infections that are linked to eating ice cream from a farm. A cluster of infections due to Shiga toxin producing enterohemorrhagic _E. coli_ (EHEC) O26:H11 has been traced to the tourist attraction Efstidalur II farm in Blaskogabyggd in the south of Iceland.

The 17 ill children are aged between 14 months and 12 years. At least 3 of them developed haemolytic uremic syndrome (HUS), a severe condition associated with _E. coli_ infections that causes kidney failure. Around one-third of employees at the farm have also been investigated, but none tested positive for the bacterium.

It was initially suspected that children who fell ill after visiting the farm were infected because of contact with calves, but further investigation found some children had no contact with this animal while 9 had eaten ice cream and the 10th child was infected by a sibling.

Product testing of ice cream did not find the outbreak strain, but samples were not the same as what the children had eaten, as new product was being sold. An investigation found the _E. coli_ strain that infected the children was also detected in faeces from calves.

Officials from the Directorate of Health urged anyone who had visited the farm between 10 Jun 2019 and 4 Jul 2019, and developed diarrhoea within 10 days, to contact a doctor to be tested for the bacterium. "After contact with animals, before eating or preparing food and especially after caring for individuals with diarrhoea, hand-washing with soap and water is strongly recommended. Alcohol-based hand-sanitizer is an optional addition but may not be sufficient on its own against many causes of diarrhoea," added the agency.

The Icelandic Food and Veterinary Authority (Matvaelastofnun) recently detected EHEC in 30% of lamb samples and 11.5% of beef samples it tested. Of 148 samples of Icelandic sheep meat, 44 samples were positive for EHEC, and in the 148 samples of domestic and foreign beef, 17 samples were contaminated.

Symptoms of infections caused by EHEC include abdominal cramps and diarrhoea. The incubation period can range from 3 to 8 days and many people recover within 10 days.  [byline: Joe Whitworth]
=======================
[It may well be that contact with the calves was the initial transmission event and the ice cream eating using unwashed hands facilitated transfer. Alternatively, since the outbreak strain was found in calves, were there milk-producing cows present, and, if the ice cream was made there, was the milk used to make the ice cream pasteurized?

Three of 17 cases developing HUS is a high proportion. Some strains seem to produce a higher risk of HUS, but the use of antimicrobials early in the infection can increase the risk of HUS. In episodes of diarrhoea (with or without blood) with significant abdominal pain and little or no fever, EHEC must be suspected and antimicrobials withheld. - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Iceland:
Date: Thu 4 Jul 2019
Source: Outbreak News Today [edited]

Iceland health officials have reported 4 paediatric Shiga toxin-producing E. coli (also called enterohemorrhagic E. coli [EHEC]) cases. Officials say all the children are from the capital of Reykjavik; however, all have probably been infected in Arnessysla county or, more specifically, in Blaskogabyggd.

The source of the infection is unknown at this time. The Icelandic Food and Veterinary Authority and the South Iceland Health Inspectorate are now working to analyse the origin of the infections and stop further spread.

Health officials say individuals who have been in Arnessysla (Blaskogabyggd) in the past 2 to 3 weeks and sickened with bloody diarrhoea are encouraged to seek medical advice so that they can check whether they have been infected with [EHEC].

The symptoms of [EHEC] infections vary for each person but often include severe stomach cramps, diarrhoea (often bloody), and vomiting. If there is fever, it usually is not very high (less than 101 deg F/less than 38.5 deg C). Most people get better within 5 to 7 days. Some infections are very mild, but others are severe or even life-threatening.

The Icelandic Food and Veterinary Authority recently analysed the presence of pathogenic bacteria in meat in the Icelandic market. It was found that [EHEC] bacteria are found in 30% of lamb and 11.5% of beef. In addition, the bacteria can be found in unpasteurized milk.
========================
[The serotype of EHEC involved is not stated, and it is not entirely clear whether the cases are related to the same food or are even the same serotype. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Thu, 14 Mar 2019 18:17:56 +0100

Reykjavik, March 14, 2019 (AFP) - Iceland has blocked the millions of tourists who descend upon the volcanic island each year from visiting a canyon that has been overrun since it was featured in a Justin Bieber music video.   An influx of tourists and a humid winter have disrupted the Fjadrargljufur canyon's fragile ecosystem, so the Environment Agency of Iceland has closed the site to the public until June 1.   "During periods of thaw, the path is completely muddy and is practically unusable for hikers," agency advisor Daniel Freyr Jonsson told AFP on Thursday.   "Because the mud is so thick, visitors step over the fences and walk parallel to the path, which rapidly damages the plant life," he added.

Fjadrargljufur is a gorge about 100 meters (yards) deep and two kilometres (1.25 miles) long, with steep green walls and a winding riverbed. The canyon was created by progressive erosion from water melting from glaciers 9,000 years ago.   The canyon was little known to foreigners until the end of 2015, when Canadian singer Justin Bieber featured the site in his song "I'll Show You".   "Visits to the site have risen by 50 to 80 percent per year since 2016," said Daniel Freyr Jonsson, estimating that around 300,000 people visited the canyon in 2018.   A growing number of tourist sites in Iceland have been closed in a bid to
preserve them.

The popular Reykjadalur valley and its hot springs were temporarily closed in April 2018 and a hiking trail overlooking the Skogafoss waterfall is currently shut.   "The infrastructure is not set up to accomodate so many visitors," said Daniel Freyr Jonsson.    "Tourism in winter and spring, the most sensitive periods for wildlife in Iceland, (was previously) almost unheard of in Iceland."   Since 2010 and the eruption of the Eyjafjallajokull volcano -- which generated a lot of publicity for the island -- the number of visitors has grown by 25 percent per year on average.   Last year, a record 2.3 million people visited Iceland.
Date: Wed, 27 Dec 2017 18:20:14 +0100

Reykjavik, Dec 27, 2017 (AFP) - A coach carrying Chinese tourists visiting Iceland overturned on Wednesday, killing one person and leaving 12 others seriously injured, local authorities said.   The 44 passengers in the coach were all Chinese nationals, a police spokesman told AFP.   The most seriously injured were taken by helicopter to the capital Reykjavik, around 250 kilometres (340 miles) from the scene of the accident in Kirkjubaejarklaustur.

It happened in the heart of the Icelandic winter with harsh weather conditions and icy roads.   The coach crashed into the back of a car carrying Lithuanian tourists, before going off the road and overturning, authorities said in a statement.   Tourism is a growing sector in Iceland, which welcomed a record number of 1.8 million visitors in 2016.   The number of tourists coming from china have tripled between 2014 and 2016 when 67,00O visited the small volcanic island nation of 335,000.
Date: Fri, 31 Mar 2017 17:26:19 +0200

Reykjavik, March 31, 2017 (AFP) - Tourists keen to explore Iceland's natural beauty will have to pay more from next year, after Reykjavik announced a tax hike Friday on the sector, which has exploded in recent years.   The island nation announced the end of an 11 percent reduced rate of value-added sales tax, saying it will make a typical holiday there about 4 percent more expensive.

Tax on hotels, campsites, travel agents' services, pools and spas and such like will rise to the regular rate, which was itself reduced to 22.5 percent.   The government said the reduced rate was no longer justified since tourism in Iceland, which was badly hit by the 2008 global economic near-meltdown, has exploded seven-fold in the last seven years.

Some 1.77 million visitors came last year, with 2.2-2.3 million expected to make the trip in 2017.   "Most types of tourism will be classified under the general value-added tax bracket," said the finance ministry, announcing the end or the lower rate from July 1, 2018.   Reykjavik estimates the move will reduce tourist numbers by 1 or 2 percent, saying that cost was not the decisive factor for visitors to the country.   According to an opinion poll last year by the national tourism office, 83 percent of visitors cited Iceland's natural beauty as a reason they chose to come, against only 19 percent who said low prices were a factor.
More ...

World Travel News Headlines

Date: Mon, 18 Nov 2019 08:37:15 +0100 (MET)

Jakarta, Nov 18, 2019 (AFP) - An endangered Sumatran Tiger has mauled to death an Indonesian farmer and seriously injured a domestic tourist, a conservation official said Monday.   The fatal attack happened Sunday at the farmer's coffee plantation on Sumatra island where the 57-year-old wrestled with the big cat before it killed him, according to Genman Hasibuan, head of the South Sumatra conservation agency.   "The farmer was attacked while he was cutting a tree at his plantation," he told AFP on Monday.   The mauling came a day after the same tiger attacked a group of Indonesian tourists who were camping at a local tea plantation in South Sumatra's Mount Dempo region.

One of the tourists was rushed to hospital for wounds to his back after the cat stormed into his tent, Hasibuan said.   The animal, which remains loose in the protected-forest area, is believed to be one of just 15 critically endangered tigers in South Sumatra, which has seen five tiger attacks this year, including two fatal incidents, Hasibuan said.

Human-animal conflicts are common in the vast Southeast Asian archipelago, especially in areas where the clearing of rainforest to make way for palm oil plantations is destroying animals' habitats and bringing them into closer contact with people.   In March last year, a man was killed by a tiger in Sumatra's Riau province while several months earlier a tiger also killed a plantation worker in the area.   Sumatran tigers are considered critically endangered by protection group the International Union for Conservation of Nature, with 400 to 500 remaining in the wild.
Date: Fri, 15 Nov 2019 17:12:24 +0100 (MET)

Karachi, Nov 15, 2019 (AFP) - Pakistan has become the first country in the world to introduce a new typhoid vaccine, officials said Friday, as the country grapples with an ongoing outbreak of a drug-resistant strain of the potentially fatal disease.   The vaccine, approved by the World Health Organization (WHO), will be used during a two-week immunisation campaign in southern Sindh province.

Sindh is where most of Pakistan's 10,000 cases of typhoid have been documented since 2017.    "The two-week campaign beginning from today would target over 10 million children of nine months to 15 years of age," Azra Pechuho, the health minister in Sindh province, said in Karachi on Friday.   The new vaccines have been provided by Gavi, the Vaccine Alliance, to the Pakistani government free of cost.

After the two-week campaign, it will be introduced into routine immunisations in Sindh, and in other areas of Pakistan in the coming years.   Pakistan spends a meagre amount of its national resources on public health and a majority of its population remains vulnerable to contagious diseases such as typhoid.   In 2017, 63 percent of the typhoid cases documented and 70 percent of the fatalities were children, according to a joint press release from the Pakistani government, WHO and Gavi.
Date: Sat, 16 Nov 2019 05:50:25 +0100 (MET)
By Abhaya SRIVASTAVA

New Delhi, Nov 16, 2019 (AFP) - A thick grey smog choked New Delhi for the fifth day Saturday, adding to a mounting pollution health crisis, but retired naval commander Anil Charan is one of the vast majority of the city's 20 million inhabitants who do not wear a mask.   Indian media is packed with warnings about the risk of premature death, lung cancer and particular danger to children from PM2.5 -- tiny particles that get into the bloodstream and vital organs -- carried in the smog.   But the smartly-dressed Charan was among shoppers in Delhi's upmarket Khan Market district browsing the luxury clothes and jewellery stores without a mask, seemingly oblivious to the risk.   Many are too poor to afford protection but others simply do not like the way a pollution mask looks.

Charan, wearing aviator sunglasses, said it did not fit his "rough and tough" image.   "I have been brought up in this kind of atmosphere, the smog and all, so I am kind of used to it. And being a naval officer I think if I wear a mask I will think I am a sissy," he said.   Doctors say face masks must be worn and air purifiers used at home and in offices.   There are a variety of masks to choose from. A basic cloth version can cost as little as 50 rupees (70 US cents) but the protection they offer is debatable.    More reputable types start from 2,500 rupees ($34) while some Khan Market stores charge more than 5,500 rupees ($75) for top of the range imported models.

- Bare-faced bravado -
The mask-look worried a lot of the Khan Market shoppers and diners however. Some said the danger had been overblown.   "I know I am risking my health but I am not very comfortable wearing them (masks)," said Ritancia Cardoz, who works for a private company.   "I don't find it appealing," she told AFP.   Lopa Diwan, on a visit to the capital from the provinces, said the Delhi air was "not as bad as it is being made out to be."   "So many people advised me not to go to Delhi because of the pollution but I don't think it's that bad. I don't see people dying," she said.

Pollution -- blamed on industrial and car emissions mixed with stubble fires on thousands of farms surrounding the city -- has been building up each winter for the past decade. The past five years have been particularly bad.   The toxic air cuts short the lives of one million people in India every year, according to government research published earlier this year.    Concentrations of the most harmful airborne pollutants in Delhi are regularly about 20 times the World Health Organisation safe limit. That rams home the city's reputation as the world's most polluted capital.   Some foreign companies and embassies now do not let families move to Delhi, or at least give strong warnings about the pollution.

The Delhi government has given out hundreds of thousands of masks to children and closed schools for four of the past five days. Construction is banned and cars can only go on the roads on alternate days.   But still only a tiny number of inhabitants follow medical advice when outside. Rickshaw drivers who earn about $7 a day on an average say they cannot afford masks.   Chand Babu, a car park attendant at Khan Market, said he could buy one of the cheaper masks but it was too much of a hassle to wear.   "I have to blow the whistle all the time so it's inconvenient."   Babu does worry, however, about his three children who also do not have masks. "They go outside to play. The problem is real, but what do we do, tell me?"
Date: Sun, 17 Nov 2019 14:28:44 +0100 (MET)
By Filippo MONTEFORTE with Charles ONIANS in Rome

Venice, Nov 17, 2019 (AFP) - Venice's St Mark's Square was closed on Sunday as the historic city suffered its  third major flooding in less than a week, while rain lashing the rest of Italy prompted warnings in Florence and Pisa.   Venice's latest "acqua alta", or high water, hit 150 centimetres (just under five feet) on Sunday, lower than Tuesday's 187 centimetres -- the highest level in half a century -- but still dangerous.   "The water has stopped rising," tweeted mayor Luigi Brugnaro, who has estimated damage so far from the invading salt water at over one billion euros (dollars).   "High of 150 centimetres... Venice is working to restart," Brugnaro said after the sea water swamped the already devastated city where authorities have declared a state of emergency.   To the south, Tuscany president Enrico Rossi tweeted a warning of a "flood wave" on the Arno and said boards were being installed on the swollen river's banks in Pisa "as a precautionary measure".

The Italian army tweeted photos of paratroopers helping to bolster river defences in Pisa, with authorities monitoring the same river in Florence after heavy rain made it rise dramatically overnight.   Arno flooding devastated Renaissance jewel Florence in 1966, killing around 100 people and destroying thousands of priceless works of art. Civil protection units in Florence advised citizens "not to stand near the Arno's riverbanks".   Firefighters tweeted footage of a hovercraft being deployed to rescue stranded citizens in southern Tuscany's Grossetano province.

- Brief respite -
The renewed threat from exceptionally high tides in Venice came after a brief respite on Saturday.   Emergency workers removed temporary walkways from St Mark's Square as the water started to rise on Sunday, with only police and soldiers visible at around midday.   The top tourist site had already been shut for several hours on Friday as strong storms and winds battered the region, leaving it submerged by sea surges.

Churches, shops and homes have also been inundated in the Renaissance city, a UNESCO World Heritage site.   A massive infrastructure project called MOSE has been under way since 2003 to protect the city, but the multi-billion euro project has been plagued by cost overruns, corruption scandals and delays.   "We weren't expecting the high waters to be so exceptionally high," said Guido Fulgenzi, who had planned to open his cafe on St Mark's square this week.   "We're paying the price" for the MOSE project not being completed, he said, sloshing around in his flooded kitchen and pointing to Tuesday's high water mark on the wall.   The crisis has prompted the government to release 20 million euros ($22 million) in funds to tackle the devastation.   Culture Minister Dario Franceschini has warned that the task of repairing the city, where more than 50 churches have suffered damage, will be huge.

- Hotel reservations cancelled -
Residents whose houses have been hit are eligible for up to 5,000 euros in immediate government aid, while restaurant and shop owners can receive up to 20,000 euros and apply for more later.   Most of the city's cash machines were no longer working, making life even more difficult for tourists and Venetians.   "We didn't expect there to be so much water, now we're soaked," said French tourist Magali Mariolou, visiting Venice for her wedding anniversary.   "We'll come back another year when it's a bit drier. The boots are heavy, they're full of water!"

Older residents who remember the infamous "acqua alta" of 1966, when the water rose to 1.94 metres, say they have not seen such frequent flooding before.   Hotels reported cancelled reservations, some as far ahead as December, following the widespread diffusion of images of Venice underwater.   Tuesday's high waters submerged around 80 percent of the city, officials said.   Many, including Venice's mayor, have blamed the disaster on global warming and warned that the country prone to natural disasters must wake up to the risks posed by ever more volatile seasons.   The Serenissima, as the floating city is called, is home to 50,000 residents but receives 36 million visitors each year.
Date: Mon, 18 Nov 2019 06:41:11 +0100 (MET)

Wellington, Nov 18, 2019 (AFP) - Samoa finalised plans for a compulsory measles vaccination programme Monday, after declaring a state of emergency as a deadly epidemic sweeps the Pacific nation.   At least six fatalities, including five children, have been linked to the outbreak of the virus, which has also hit other island states such as Tonga and Fiji.   Samoa is the worst affected with more than 700 cases reported from across all areas of the country, prompting the government on Friday to invoke emergency powers.

Declaring a state of emergency, the government said plans for compulsory measles, mumps and rubella (MMR) immunisations would be published on Monday.   "MMR vaccinations for members of the public who have not yet received a vaccination injection is now a mandatory legal requirement for all of Samoa," it said.   A national emergency operations centre to coordinate the measles response in the nation of 200,000 people was opened on Monday, with children aged six months to 19 years and non-pregnant females aged 20-35 given priority.

However, no information was immediately available on how the vaccinations would be administered or whether those who were not immunised would face sanctions.   Children are the most vulnerable to measles, which typically causes a rash and fever but can also lead to brain damage and death.   Samoa has closed all schools, kindergartens and the country's only university in a bid to halt the spread of the virus.   New Zealand, which is experiencing its own measles outbreak in the Auckland region, will this week send 30 nurses, 10 doctors and 3,000 MMR doses to Samoa.

University of Auckland immunologist Helen Petousis-Harris said even though measles was already widespread, the mass rollout of vaccinations could help limit the number of cases and reduce the death count.   She said it was also important to boost Samoa's low levels of immunisation and help prevent future outbreaks.   "In Samoa, the proportion of people who are immune to measles is very, very low, one of the lowest in the world," she told AFP.   "So if they aren't able to improve that, this is going to happen again."   The country's vaccination programme was briefly suspended last year when two babies died shortly after being given the MMR vaccine.   Subsequent investigations found the problem was not the widely used vaccine but the fact that nurses had prepared it incorrectly.

Neighbouring Tonga last week announced government primary schools and kindergartens would be closed until later this month as the number of measles cases in the kingdom approaches 200.   Fiji has reported four cases but says they are contained to a township west of the capital Suva.
Date: Sun, 17 Nov 2019 18:10:23 +0100 (MET)

Johannesburg, Nov 17, 2019 (AFP) - South African unions on Sunday called on all aviation workers to join striking South African Airways (SAA) staff after the cash-strapped airline failed to meet their demands.   The country's embattled flag carrier has been losing 52 million rand ($3.5 million) per day since more than 3,000 workers started an open-ended strike on Friday -- forcing the airline to cancel hundreds of flights.   Talks with the two unions representing the striking workers ended without resolution on Saturday, prompting threats of further action.   "In response to this deliberate provocation by the SAA board and its executive management, (the) NUMSA (metalworkers' union) is in the process of consulting workers for a secondary strike in aviation," NUMSA spokeswoman Phakamile Hlubi-Majola told reporters outside the SAA headquarters in Johannesburg.

NUMSA and the South African Cabin Crew Association (SACCA) first threatened to strike after SAA announced this week that almost 1,000 employees could lose their jobs as part of a restructuring process.   Initial talks with management deadlocked after they failed to agree on wage hikes, prompting the unions to press on with their threats.   SAA is offering a 5.9 percent pay rise, while unions are demanding an eight percent across-the-board hike and a three-year guaranteeof job security.   They are also asking the airline to in-source more jobs.    "We are fighting against retrenchment, corruption and privatisation," Hlubi-Majola told journalists.   She said discussions with SAA subsidiaries, South Africa's airport management company and airline service providers were under way.   Two transport unions have also been called on to join the action.   "This secondary strike will have the impact of shutting down the entire aviation sector," NUMSA and SACCA said in a joint statement.   SAA CEO Zuks Ramasia voiced "concern" about the unions' intentions and urged them to "reconsider".   "The intent of a secondary strike is to cause disruption, bring all airport operations to a halt and create huge damage to the South African economy," Ramasia said in a statement on Sunday.

- Embattled airline -
The CEO added that SAA could not "afford to pay any salary increases" and reiterated the 5.9 percent rise offer.   "The company has repeatedly communicated the precarious financial position of the company," Ramasia said.      More than 300 SAA flights have been grounded as a result of the open-ended strike.   International flights started slowly resuming on Sunday, while regional and domestic flights remain grounded.   "We hope all our customers understand that the cancellations have been beyond our control," Ramasia said.   South Africa is struggling to get its state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.   SAA -- one of Africa's biggest airlines -- is deep in debt and has not posted a profit since 2011, despite several government bailouts.   Finance Minister Tito boweni announced in February that the government would reimburse the company's 9.2 billion rand ($620 million) debt over the next three years.   Ramasia said discussions with unions would resume once the airline had considered "options on the way forward".
Date: Tue, 12 Nov 2019 13:10:01 +0100 (MET)
By Holly ROBERTSON, Andrew BEATTY, with Daniel De Cartert in Hillville

Sydney, Nov 12, 2019 (AFP) - Bushfires raging across eastern Australia singed Sydney's suburbs on Tuesday, with firefighters scrambling planes and helicopters to douse a built-up neighbourhood with water and red retardant.   Experts have described the conditions as the worst on record, as spring temperatures climbed toward 40 degrees Celsius (104 Fahrenheit) and winds topped 80 kilometres (50 miles) per hour across a zone which has been plagued by persistent drought.   Although the bushfire season is in its infancy, scientists predict it to be one of Australia's toughest ever, with climate change and unfavourable weather cycles helping created a tinderbox of strong winds, low humidity and high temperatures.

Twin blazes in the north shore suburb of Turramurra -- around 15 kilometres (nine miles) from the centre of Australia's largest city -- tore through a eucalypt forest park and sparked spot fires in homes, before eventually being brought under control.   As night fell, authorities said they were bringing another "clearly suspicious" blaze in a national park in the city's southern suburbs under control.    Throughout the day, more than 300 bushfires burned up and down Australia's east coast, fanned by gale-force winds, scorching temperatures and tinder-dry bushland that has brought some of the most dangerous conditions the country has seen.

In Turramurra, gardens smouldered, thick smoke hung heavy in the air and cars, houses and roads were caked in raspberry-red retardant as if hit by a giant paintball.   "It was the embers that floated up that actually went across and set off spot fires in the front yards" resident Nigel Lush told AFP, adding that one roof had been set alight.   Another resident, Julia Gretton-Roberts, said the blaze spread shockingly quickly.   "Next thing I know the fire was opposite our house and it was massive and the police came and grabbed our kids and took them away," she said.   "My daughter is pretty freaked out."   Firefighter Andrew Connon told AFP "a number of homes were threatened but it was contained by the aerial bombing".

- 'Catastrophic conditions' -
From early morning thousands of firefighters spread out across New South Wales in anticipation of what they called "off the scale" fire risk and "catastrophic" conditions.   They were unable to prevent several bushfires from breaching containment lines and trapping residents who had not already evacuated.   New South Wales Rural Fire Service Commissioner Shane Fitzsimmons said so far only a dozen buildings had been damaged Tuesday and a handful non-life-threatening injuries were reported, but the crisis was far from over.

Firefighters will be "working on these fires for days and weeks given the enormity of the firegrounds," he said.    Even before unfavourable weather hit, days of fires had killed three people and destroyed at least 150 homes.   "The conditions are expected to get worse," Fitzsimmons said, warning residents in adjacent areas to stay alert.   "Complacency kills," he added.   Up to 600 schools were closed, as well as many national parks, a total fire ban was introduced for the affected area and Rally Australia -- due to be held in Coffs Harbour at the weekend -- was cancelled.   The military pitched in, helping firefighters with logistics and water-dropping sorties using more than 100 aircraft.

- 'We'll fight it first' -
In the town of Hillville a fire that has ripped through an area the size of 25,000 soccer fields approached the home of Daniel Stevens.   Like many, his family -- including his mother nursing a broken leg -- have packed their bags, but have resisted leaving their house and everything they own.    "We'll fight it first," he told AFP, "but if it jumps the fence line into the paddock, we'll go."

In the nearby town of Taree, dozens of people have already moved to a showground that has become a makeshift evacuation centre.   Fifty-nine-year-old Caroline Watson arrived last night with her husband and their dog.    "The fires are just rife. They are absolutely everywhere" she told AFP. "They didn't ask us to get out, but we figured it was coming."

Further south in the Blue Mountains on the outskirts of Sydney, veteran Winmalee firefighter Alan Gardiner said locals were "terrified and on edge".    The town still bears the scars of a 2013 blaze that destroyed 200 homes, and residents are acutely aware that with few roads in and out of the mountains, a decision to leave late can be fatal.   Efforts to burn fuel in a controlled way have been limited by months of drought-like conditions that made it too dangerous.
Date: Tue, 12 Nov 2019 10:03:07 +0100 (MET)

Denpasar, Indonesia, Nov 12, 2019 (AFP) - An Australian tourist who fly-kicked a motorcyclist and assaulted a man in his own home during a drunken rampage was jailed for four months on Tuesday.   The ruling comes after Nicholas Carr's antics were caught in a viral video that saw him carry out a campaign of destruction in Seminyak, a popular tourist area on the Indonesian holiday island.   "The defendant Nicholas Carr is found guilty and is sentenced to four months" in jail, presiding judge Soebandi, who goes by one name, told the Denpasar District Court.    A lawyer for Carr, charged with assault and property damage, said the 26-year-old would not appeal the ruling.    He is expected to be released next month because of time already served.   In August, Carr ran barefoot on to a street and shouted expletives before the apprentice builder slammed into the bonnet of a moving car and then fly-kicked an unsuspecting motorcycle rider.

The biker, who was thrown from the moving scooter, sustained minor injuries -- later the pair embraced during a court hearing as Carr apologised to the victim.   Carr also shattered a convenience store's glass door before stealing a motorcycle.   Later, he broke into a house where he assaulted the sleeping homeowner, leaving him with injuries, police said earlier.    He was eventually caught by locals and police and taken to hospital.    Pictures that circulated on social media showed at the time showed Carr bloodied and bruised, and trussed with hosepipe and rope.   Shortly after his arrest, Carr apologised and admitted drinking more than 10 small bottles of vodka as well as other alcohol.

After a string of embarrassing incidents by tourists, Bali officials recently warned that boorish visitors may be kicked off the island, which attracts millions annually to its palm-fringed beaches, colourful nightlife and ancient temples.   Australian professional rugby league player David Fifita returned home this week after he was briefly arrested in Bali for assaulting a nightclub security guard.   Several days after Carr's arrest, a Czech couple who were slammed for disrespecting a Balinese temple took part in a ritual purification ceremony.
Date: Mon, 11 Nov 2019 16:19:54 +0100 (MET)

Lyon, Nov 11, 2019 (AFP) - An unusually strong earthquake hit south-eastern France on Monday, injuring four people, one of them seriously, authorities said.   A physicist at a geophysics institute the IPGP said that quakes of this strength are rare in that region, but warned of possible aftershocks and said people should leave fragile buildings.   The quake, with a magnitude of 5.4, was felt in a vast area between the cities of Lyon and Montelimar which are about 150 kilometres (93 miles) apart, the national seismological office said.   "I was leaning against the oven in my mother's bakery when I felt the tremor," said Victoria Brielle, a resident in Privas, some 25 kilometres from the quake's epicentre.   "A customer said her sideboard had moved and all her crockery was broken,"  she said.

Another resident in the area, Didier Levy, who lives in a 15th century castle, told AFP that "chandeliers were still trembling" several minutes after the quake.   Levy, who said his dog starting barking even before humans felt the tremors, added: "I have never experienced anything like it, I could feel the trembling even though these wall are one metre thick."   One person was seriously hurt when some scaffolding collapsed, the regional prefect's office said.   Three other people in the neighbouring Ardeche region were slightly injured.

Quakes in this region are rarely higher than Magnitude 5, said Mustapha Meghraoui of the IPGP's office in Strasbourg.   "We can say that this is a rare one," he added. But he said there might be an aftershock of around 4.5.   "If people are in a fragile house, they would be better leaving it" for something more robust for a while, he said.   The scale of the damage suggested the quake happened at a depth of between five and 10 kilometres, he added. But they were working on a more accurate reading.
Date: Mon, 11 Nov 2019 13:19:54 +0100 (MET)

Goma, DR Congo, Nov 11, 2019 (AFP) - A local radio station that has been involved in the fight against Ebola in eastern DR Congo said Monday it was closing down after one of its broadcasters was murdered.   Joel Musavuli, head of Lwemba radio in Mambasa in Ituri province, told AFP that the station had been targeted by armed groups hostile to the campaign to roll back the Ebola epidemic.

"Each of us have received threats since last month. We have now decided to stop broadcasting, Musavuli said, adding that he himself had escaped two kidnap attempts.   "We are victims of our commitment to the awareness campaign about the spread of Ebola virus disease. We don't know why the militiamen are targeting us."   Nearly 2,200 people have died since the notorious haemorrhagic disease erupted in eastern Democratic Republic of Congo in August 2018, according to the latest official figures.

The fight against the outbreak has been hampered by local fears and superstititions, exploited by militia groups that are rampant in the remote region.   Several health workers have been killed and media that have supported the campaign have received threats.

Several radio stations in the Mambasa area say they have stopped broadcasting anti-Ebola messages because of intimidation.   On November 2, Lwemba broadcaster Papy Mahamba was killed at his home by unidentified men. His wife was injured and their house set ablaze.    The station said the authorities had failed to take action against the threats. It said it would resume broadcasts after "the state has restored authority in the area".