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Andorra

General
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This small country is situated between France and Spain. Because of its elevation and proximity to the Pyrenees the climate is generally pleasant throughout the year.
Climate
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During the summer months the temperatures can rise to 30c but there is usually a cooling breeze. Lightening storms can occur during the summer months associated with torrential rain.
Sun Exposure and Dehydration
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Those from Northern Europe can develop significant sun exposure and so remember to use a wide brimmed hat when necessary. The altitude can also lead to significant tiredness and dehydration so take sufficient initial rest and drink plenty of fluids.
Safety & Security
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The level of crime throughout the country directed at tourists is very low. Nevertheless take care of your personal belongings at all times and use hotel safety boxes where possible.
Local Customs
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There are strict laws regarding the use of illegal drugs. Make sure you have sufficient supplies of any medication you required for your trip and that it is clearly marked. The European E111 form is not accepted in Andorra and so it is essential that you have sufficient travel insurance for your trip.
Winter Sports
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Andorra is one of the regions where many travel to partake of their winter sport facilities. Generally this is well controlled and one of the safer regions. Nevertheless, make certain your travel insurance is adequate for the activities you are planning to undertake.
Vaccination
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The only standard vaccine to consider for Andorra would be tetanus in line with many other developed countries of the world.

Travel News Headlines WORLD NEWS

Date: Thu, 12 Jul 2018 15:24:06 +0200

Andorra la Vella, Andorra, July 12, 2018 (AFP) - The tax haven of Andorra has long been a favourite destination for smokers looking to stock up on cheap cigarettes, but the enclave said Thursday that it would soon stop advertising the fact.   The government said it had signed up to the World Health Organization's (WHO) anti-tobacco convention, which aims to encourage people to quit smoking and combat contraband sales.   "The goal is to contribute to public health and pursue the fight against trafficking," government spokesman Jordi Cinca said at a press conference.

The tiny principality of Andorra, perched in the Pyrenees on the border between France and Spain, attracts millions of shoppers each year to duty-free stores, where prices of alcohol, cigarettes, electronics and clothes can be up to 20 percent cheaper than elsewhere in the EU.   High taxes on tobacco imposed by many countries to help people kick smoking make Andorra's cigarettes a particularly good deal.   The average pack costs just three euros ($3.50) compared with eight euros in France, which has said it will gradually raise the price to 10 euros a pack by November 2020.

Tobacco sales bring in some 110 million euros a year for Andorra, whose economy is otherwise based almost entirely on tourism.   It is also an enticing destination for smugglers, with French and Spanish border agents regularly seizing cartons from people trying to sneak them out, either by car or by hiking down the mountain trails which criss-cross the Pyrenees.   No date has been set for the advertising ban, which will come into effect three months after the ratification of the WHO accord is voted by parliament.
Date: Fri, 16 Mar 2018 02:41:51 +0100

Andorra la Vella, Andorra, March 16, 2018 (AFP) - The tiny principality of Andorra is witnessing a once in a generation phenomenon -- a widespread strike.   Around a third of civil servants across the mountainous micro-state have walked out to protest proposed reforms to their sector in what has been described as Andorra's first large-scale strike since 1933.

With no negotiation breakthrough in sight, picket lines are expected to be manned again on Friday with customs officers, police, teachers and prison staff among those taking part.   The first major strike in 85 years was sparked by plans from the government of Antoni Marti to reform civil servant contracts.   He has assured officials "will not do an hour more" work under the reforms and that 49 million euros would be allocated for the next 25 years to supplement civil servant salaries.   But government workers are unconvinced with unions warning the reforms could risk their 35 hour working week and pay.

Customs officers involved in the strike interrupted traffic on the Andorran-Spanish border this week, according to unions, while some 80 percent of teachers have walked out of classes.   Strikers have occupied the government's main administrative building and held noisy protests outside parliament calling for Marti's resignation.    "We have started collecting signatures to demand the resignation of the head of government and now nobody will stop us," Gabriel Ubach, spokesman for the public service union, told reporters.
Date: Mon 27 Sep 2017
Source: Contagion Live [edited]

A recent Dispatch article published in the Centers for Disease Control and Prevention (CDC)'s Emerging Infectious Diseases journal, offers insight into a large norovirus outbreak that sprung up in Spain in 2016 that had been linked with bottled spring water. The Public Health Agency of Catalonia (ASPCAT) reported a staggering 4136 cases of gastroenteritis from 11-25 Apr 2016. Of the 4136 cases, 6 individuals required hospitalization. The CDC defines a "case-patient" as an "exposed person who had vomiting or diarrhoea (3 or more loose stools within 24 hours)," as well as 2 or more of the following symptoms: nausea, stomach pain, or fever.

ASPCAT investigators traced back the outbreak to contaminated bottled spring water in office water coolers. The water came from a source in Andorra, a small independent principality located between Spain and France. Norovirus is a "very contagious virus," according to the CDC, and it is common for individuals to become infected by eating contaminated food. Although it is possible to be infected by consuming contaminated drinking water, this mode of transmission is "rare in developed countries," according to the article.

The investigators collected water samples from a total of 4 19-L water coolers in 2 different offices located in Barcelona, "from which affected persons had drunk; samples 1 and 2 came from 2 water coolers in one office, while samples 3 and 4 came from 2 water coolers in another office. Using "positively charged glass wool and polyethylene glycol precipitation for virus concentration," the investigators tested the samples.

"We detected high RNA levels for norovirus genotype I and II, around 103 and 104 genome copies/L, in 2 of the 4 water cooler samples concentrated by glass wool filtration and polyethylene glycol precipitation," according to the article. The investigators noted that a drawback of using molecular methods is that they are not able to differentiate between particles that are infectious and those that are not. Therefore, they "predicted the infectivity of norovirus in the concentrated samples by treating the samples with the nucleic acid intercalating dye PMA propidium monoazide and Triton X surfactant before RT-qPCR," which allowed them to "distinguish between virions with intact and altered capsids."

In those 2 water samples, they found high genome copy values -- 49 and 327 genome copies/L for norovirus genotype I and 33 and 660 genomes copies/L for norovirus genotype II. This was not an unexpected finding, due to the large number of infected individuals associated with the outbreak. Through "PMA/Triton treatment before RT-qPCR assays," the investigators found that the proportion of infected virions accounted for 0.3% to 5.6% of the total number of physical particles in the water samples, "which was enough to cause gastrointestinal illness."

The investigators also analyzed faecal samples collected from infected individuals who worked at the office in which the 1st 2 water samples were collected. They detected the following genotypes in those faecal samples: GI.2 and GII.17. In the faecal samples collected from the other office, they isolated the following genotypes: GII.4/Sydney/2012, GI.2, GII.17, and GII.2.

"We hypothesize that the spring water was contaminated by all 4 strains (GI.2, GII.2, GII.4, and GII.17) but levels of viral contamination for each genotype were not homogeneous in all bottled coolers," the investigators wrote. "We may have detected only the GII.4 genotype in water samples 1 and 2 because of a higher concentration of this specific genotype or because of bias caused by the sampling, concentration, and molecular detection procedures."

The investigators admit one limitation to their study: the small number of water samples collected and analyzed. They attribute this to the fact that on 15 Apr 2016, 4 days after the onset of the outbreak, the company that produced the drinking water recalled over 6150 containers of water "of suspected quality" as a precautionary measure. The recall prevented the investigators from collecting more samples to assess, according to the article.

Although the exact cause of the contamination has not yet been identified, the investigators posit that "the high number of affected persons from 381 offices that received water coolers, and the many different genotypes found in some patients' faecal specimens" suggest that the spring aquifer had been contaminated by "sewage pollution," and the Andorra Ministry of Health and Welfare banned further use of the spring.

The investigators suggest that assessing commercially-produced mineral waters for different harmful pathogens, such as norovirus would be beneficial. They note, however, that creating, enhancing, and managing such "virus surveillance systems" would be costly. Thus, the investigators suggest taking a "balanced approach to keep both the cost and the time required for the analyses within feasibility limits."  [Byline: Kristi Rosa]
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[The interesting article published in the September 2017 issue of Emerging Infectious Diseases is:
Blanco A, Guix S, Fuster N, et al: Norovirus in bottled water associated with gastroenteritis outbreak, Spain, 2016. Emerg Infect Dis. 2017; 23(9): 1531-34; https://wwwnc.cdc.gov/eid/article/23/9/16-1489_article. - ProMED Mod.LL]

[Catalonia and Andorra can be located on the HealthMap/ProMED-mail map at http://healthmap.org/promed/p/1341. - ProMED Sr.Tech.Ed.MJ]
Date: Thu, 26 Dec 2013 22:25:05 +0100 (MET)

ANDORRA LA VELLA, Andorra, Dec 26, 2013 (AFP) - A Spanish skier and a French snowboarder have died in avalanches in different mountain ranges in Europe, officials said Thursday.

The 27-year-old skier, a woman from Barcelona, died Wednesday while going off-piste alone in the Soldeu resort in Andorra, in the Pyrenees mountains between France and Spain, a resort manager told AFP.   Although she was rescued within 10 minutes, after her glove was spotted on the surface, she was unable to be revived despite a helicopter dash to hospital.

In the Italian Alps, close to the border with France, a 24-year-old Frenchman who was snowboarding with three friends on a closed run died Thursday when an avalanche swept over him in the resort town of Les Arnauds.   Local officials said he succumbed to multiple injuries, asphyxia and hypothermia.

Avalanches are common in Europe's ski resorts at this time of year, when early snows are heavy with moisture, and several deaths occur each winter.   Last Sunday, a 35-year-old Frenchman died in an avalanche in the Alps near the Italian border while on a three-day trek with a friend.
Date: Fri 7 Feb 2003 From: Jaime R. Torres Source: EFE Salud, Thu 6 Feb 2003 (translated by Maria Jacobs) [edited] -------------------------------------------------- Close to 300 students in one school and 173 tourists staying in 7 hotels in the Principality of Andorra have been affected by outbreaks of gastroenteritis that, according to local authorities, are not related to each other. Monica Codina, Minister of Health, stated that the outbreak that has affected almost 300 children and 8 adults in the San Ermengol school was detected last Monday [3 Feb 2003] but that it may have started Wednesday or Thursday of the previous week. The epidemiological surveys of a group of pre-school and grammar school students that may also be affected have not been performed yet. Also pending are the results of the microbiological tests of the food and water served in the school dining room, but the minister has indicated that the probable cause of the outbreak is the fact that water pitchers were filled with hoses directly from the faucet. The Minister stated that this outbreak of gastroenteritis is not related to the one that affected 173 tourists, most of them young people on holiday, who where staying in 7 hotels of the Principality. The government is also investigating the cause of this outbreak and has indicated that an anomaly in the system that supplies water to the hotels was detected, requiring a process of chlorination, which has not been carried out due to the heavy snowfall of the past few days. * * * * * * * * * * [The suspicion that defective water supplies may be responsible for all of these independent outbreaks suggests that the etiologic agent may be an enterovirus, hepatitis A virus, or non-viral, rather than one of the noroviruses associated with sudden-onset viral gastroenteritis. Information on the outcome of diagnostic tests in progress would be welcomed. - ProMed Mod.CP]
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Puerto Rico

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Belgium

Belgium - US Consular Information Sheet
October 03, 2008
COUNTRY DESCRIPTION:
Belgium is a highly developed and stable democracy with a modern economy. Tourist facilities are widely available.
Read the Department of State Background N
tes on Belgium for additional information.
ENTRY/EXIT REQUIREMENTS: Belgium is a party to the Schengen agreement. As such, U.S. citizens may enter Belgium 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. Sufficient funds and a return airline ticket are required. For further details about travel into and within Schengen countries, please see our fact sheet. For further information concerning entry requirements, contact the Embassy of Belgium at 3330 Garfield Street NW, Washington, DC 20008, telephone (202) 333-6900; or one of the Belgian Consulates General in Atlanta, Los Angeles, or New York.Visit the Belgian Embassy web site at http://www.diplobel.org/usa for the most current visa information.
Belgian law requires that everyone carry some form of official identification at all times, which must be displayed upon request to any Belgian police official. A U.S. passport suffices for these purposes.
See the section on Special Circumstances for information on new business visitor and employee registration requirements.
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: Belgium remains largely free of terrorist incidents. Belgian law enforcement and security officials, in close cooperation with neighboring countries, maintain a solid anti-terrorism effort and a peaceful environment for tourists and business. However, like other countries that are members of the Schengen Agreement on free cross-border movement, Belgium’s open borders with its European neighbors allow the possibility for terrorist groups to enter/exit the country with anonymity.
Prior police approval is required for public demonstrations in Belgium, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, situations may develop that could pose a threat to public safety. U.S. citizens are advised to avoid areas where public demonstrations are taking place.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: Belgium remains relatively free of violent crime, but low-level street crime is common. Visitors should always be watchful and aware of their surroundings, however, because muggings, purse snatchings, and pickpocketing occur frequently, particularly in the major cities. Transportation hubs like the Metro (subway) and train stations are also frequented by thieves who take advantage of disoriented travelers. In Brussels, pickpocketing, purse snatching, and theft of light luggage and laptops are common at the three major train stations -- the North Station (Noordstation or Gare du Nord), the Central Station (Centraal Station or Gare Central) and especially at the South Station (Zuidstation or Gare du Midi). The latter is a primary international train hub, and travelers are advised to pay very close attention to their personal belongings when in the station. Common ploys are to distract the victim by spraying shaving cream or another substance on his or her back or asking for directions while an accomplice steals the luggage. It is a good idea to remain in physical contact with hand luggage at all times, and not to place carry-on luggage on overhead racks in trains.
Another growing problem, especially in Brussels, is theft from vehicles, both moving and parked. Do not leave valuables in plain sight where a thief may spot them. Thieves will sometimes position themselves at stop lights to scan for valuables in stopped cars. If they see a purse or other valuable item they break the window and steal the item before the victim can even react. Expensive car stereos and GPS navigational devices left in plain sight are often stolen from parked cars. Always drive with windows up and doors locked.
Travelers to Brussels should be aware that small groups of young men sometimes prey on unwary tourists, usually at night and often in Metro stations. Items such as expensive mobile phones and MP3 players are often the target. Travelers should carry only a minimum amount of cash, credit cards, and personal identification. Wearing expensive jewelry and watches is discouraged.
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: Good medical facilities are widely available in Belgium. The large university hospitals can handle almost every medical problem. Hospitals in Brussels and Flemish-speaking Flanders will probably have English-speaking staff. Hospitals in French-speaking Wallonia may not have staff members who are fluent in English, however. The Embassy Consular Section maintains a list of English-speaking doctors, which can be found on the Embassy web site at http://brussels.usembassy.gov/medical_facilities.html.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Belgium is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Belgian urban highways are generally well built and maintained with extensive lighting systems, but rain and fog often reduce visibility. Rural roads are less likely to be illuminated at night. Belgian rules for right-of-way differ from those in the U.S., and new drivers should thoroughly understand these rules before driving in Belgium. For instance, traffic coming from the right generally has priority at uncontrolled intersections and roundabouts, even if coming from a smaller street. The maximum speed limit on Belgian highways is 120 kilometers (72 miles) per hour, but is not always posted except at Belgium’s borders and on roads leaving major airports. The maximum speed in urban areas is normally 50 km (30 miles) per hour. While Belgian authorities strictly enforce speed limits, many Belgians still drive significantly faster than the posted limit. Claims of ignorance may not prevent a significant fine for speeding, which can also lead to the vehicle’s being impounded if the driver is unable to pay the fine on the spot. Belgian police also conduct breath analysis checks for alcohol use, particularly at night and during major holidays.
Roadside assistance and information on road conditions are available in English from Touring Mobilis, tel: 0900 10280. Belgian police will also provide information on road conditions, tel: 02-642-6666. Emergency services are efficient and responsive. By phone within Belgium, for police emergencies dial 101 and for all other emergencies,112.

Please refer to our Road Safety page for more information. Visit the website of Belgium’s national tourist office at http://www.visitbelgium.com/.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Belgium’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Belgium’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: While most forms of monetary transactions are available (cash, credit cards), U.S. money orders cannot be negotiated in Belgium. Personal checks may only be cleared through a bank at which a person holds an account and clearance can take from two to four weeks. Banks and exchange facilities may refuse U.S. dollar denominations of $50 and $100 if they are not equipped with devices to identify counterfeit currency. Automated Teller Machines (ATMs) are widespread in Belgium and accept most U.S. ATM cards to withdraw funds. Travelers seeking to purchase Euros are more likely to find a more favorable exchange rate at banks than at money exchange facilities located at tourist locations, train stations, and airports. Please see our Customs Information.
Non-EU citizens visiting Belgium and staying in a private residence are required by Belgian law to register with local Commune authorities within three days of their arrival. Any change in visa or resident status must also be requested through Commune authorities and must be completed prior to the expiration of the current status. Given the requirements to change status in Belgium, it is nearly impossible to do so within the 90 days permitted to remain in Belgium without a visa under the Visa Waiver Program.
BUSINESS VISITOR AND EMPLOYEE REGISTRATION REQUIREMENT: Since April 1, 2007 non-Belgian employers and self-employed persons or their employees who carry out short term assignments in Belgium must declare these activities in advance.
This mandatory "Limosa" declaration applies to: (1) Employees and apprentices, who come to Belgium to execute certain temporary work and who, because of the nature of their short term assignment, are not subject to the Belgian social security system; (2) Self-employed people and self-employed apprentices who come to work in Belgium temporarily, irrespective of whether they are subject to the Belgian social security system.
Some exceptions to this general obligation exist. Certain persons may be exempted, especially for short-term assignments. For more information about the Limosa declaration, visit http://www.limosa.be.
For more information about working in Belgium, please see http://www.employment.belgium.be/home.aspx.
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 Belgian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Belgium are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Belgium 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 Belgium. 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 in Brussels is located at 25 Boulevard du Regent. The telephone number from the U.S. is 011-32-2-508-2111. Within Belgium, the telephone number is 02-508-2111. The Embassy’s fax number is 02-511-2725. The Consular Section’s fax number is 02-513-0409. The American Citizen Services Unit of the Consular Section is open from 1:30 to 3:30 p.m. Monday through Friday, except for American and Belgian holidays. Further information can be obtained at the Embassy’s web site at http://belgium.usembassy.gov/
* * *
This replaces the Country Specific Information for Belgium dated March 13, 2008, to update sections on Entry/Exit Requirements.

Travel News Headlines WORLD NEWS

Date: Tue 22 Oct 2019
Source: The Brussels Times [abridged, edited]

Students from the UCLouvain [Catholic University of Leuven] have received an email warning of increased cases of mumps on the campus of Sint-Lambrechts-Woluwe and in the colleges in the municipality [of Brussels-Capital Region].

This information -- widely reported in Belgium -- was confirmed by the spokesperson for the University Isabelle Decoster to Belga.

The total number of infected is currently not known as students can go to doctors across the city. Sick students are asked to stay at home.  [Byline: Jules Johnston]
====================
[HealthMap/ProMED-mail map of Belgium:
Date: Thu 24 Oct 2019
Source: Brussels Times [edited]

Two people in Belgium have been infected with _Listeria_ bacteria that lead to the death of 3 people and a miscarriage over a 2-year period in the Netherlands, a sampling by a federal health centre showed. [See ProMED-mail post Listeriosis - Europe (15): (Netherlands) fatal, WGS, cold cuts http://promedmail.org/post/20191005.6711608, which described a listeriosis outbreak that affected 20 people, 3 of whom died and one woman had a miscarriage, over the past 2 years after eating cold cuts produced by Offerman, a Netherland-based producer. - ProMED Mod.ML]

The cases in Belgium affected a 97-year-old woman and a Dutch national who recently gave birth in Antwerp [Belgium], a study by federal health research centre Sciensano confirmed. Both women were infected with the bacteria in 2018, according to the study, which compared samples of bacteria in the Netherlands with those of Belgian patients infected, HLN reports.

The centre's study comes after three people died and one woman had suffered a miscarriage in the Netherlands after eating meat contaminated with _Listeria_ over a 2-year period, which was reportedly linked to Dutch meat producer Offerman.

In Germany, 2 _Listeria_-related deaths were also reported in the central state of Hesse. [See ProMED-mail post Listeriosis - Europe (16): (Germany) fatal, WGS, meat, healthcare facilities http://promedmail.org/post/20191019.6736570, which described a listeriosis outbreak that affected 40 people, 3 of whom have died, in 12 German states between 2014 and 2019, due to _Listeria_-contaminated meat products manufactured at a processing facility in the German state of Hesse and widely distributed to more than 20 European countries. This German outbreak associated with the Hesse-based meat processing facility is unrelated to the Netherlands/Belgium outbreak associated with the Netherlands-based meat processing facility. - ProMED Mod.ML]

News of the deaths led supermarkets in Belgium to issue recalls for pre-packaged meat, a move they said at the time was precautionary. Offerman, a subsidiary of Belgian food group Ter Beke, has since been shut down in the Netherlands.

The Sciensano study could not identify the cause of the infections in Belgium, since isolated cases, unlike outbreaks, are not subject to follow-ups, Het Nieuwsblad reports.  [Byline: Gabriela Galindo]
==================
[The incriminated meat is refrigerated cold cuts that are not cooked before eating (i.e., ready-to-eat). Cold cuts are well-recognized sources for listeriosis. Even if initial contamination adds only a few _Listeria_ organisms to the food, the contamination can be significant for refrigerated foods because _L. monocytogenes_ can subsequently multiply at refrigerator temperatures to a sufficient number to cause disease. People at increased risk for disseminated listeriosis, which include pregnant women (and their new-borns), adults aged 65 years or older, and people with weakened immune systems, should avoid eating food potentially contaminated with _Listeria_. - ProMED Mod.ML]

[HealthMap/ProMED maps available at:
Date: Wed 25 Sep 2019
Source: Food Safety News (FSN) [edited]

A _Salmonella_ outbreak that sickened almost 200 people at a Belgian school was likely caused by eggs used to make a tartar sauce, according to authorities. The Agency for Care and Health (Zorg en Gezondheid) and Federal Agency for the Safety of the Food Chain (FASFC) investigation detected _Salmonella_ in the freshly prepared tartar sauce. Findings from an online survey of students and teachers also reached the same conclusion on the source.

The Agency for Care and Health had previously received information about a number of students from the school complaining of gastrointestinal illness. Since 14 Sep 2019, no new cases of illness have been reported so the Spermalie Hotel and Tourism School in Bruges [West Flanders] has been allowed to resume normal operation. About 200 students and teachers from the school became ill from 6 Sep 2019 onward. Laboratory analyses of stool samples revealed students and teachers had been affected by _Salmonella_.

The Agency for Care and Health handled the online survey part of the investigation, FASFC took samples of meals served on Tuesdays, Wednesdays, and Thursdays at the school restaurant. The samples were sent to the lab of Sciensano, the Belgian Institute for Health. The online survey showed the tartar sauce was the most likely source of the outbreak.

A total of 65 samples were sent to Sciensano and after analysis of the different dishes, _Salmonella_ was detected in the freshly prepared tartar sauce. Bacteria present in the food appeared to be the same as in the stool samples from patients.

Staff and students were asked to pay particular attention to hand hygiene and those sick were encouraged to stay at home. The kitchen of the school restaurant and all kitchens and related equipment have been cleaned and disinfected. The sale of any raw food was also suspended. Control measures have been verified by environmental sampling and no _Salmonella_ has been detected in lab analysis of these samples.

Belgium reported 2698 confirmed salmonellosis cases in 2016 compared to 3050 the year before.
===========================
[Tartar sauce (<https://en.m.wikipedia.org/wiki/Tartar_sauce>) is based on either mayonnaise (egg yolk, mustard or vinegar, bitartrate, oil) or aioli (olive oil, garlic), with certain other ingredients added. In the UK, recipes typically add to the base capers, gherkins, lemon juice, and dill. US recipes may include chopped pickles or prepared green sweet relish, capers, onions (or chives), and fresh parsley. Chopped hard-boiled eggs or olives are sometimes added, as may be Dijon mustard and cocktail onions.

Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with fecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the eggshell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Belgium:
Date: Thu, 25 Jul 2019 15:48:48 +0200

Brussels, July 25, 2019 (AFP) - Belgian meteorologists registered record high temperatures on Thursday as western Europe sweltered under a multi-day heatwave that has disrupted transport and triggered safety warnings.   David Dehenauw, chief forecaster at the Royal Meteorological Institute, said a high of 40.6 degrees Celsius (105 Fahrenheit) had been recorded on the Kleine-Brogel military base, in northeastern Belgium.

"New Belgian national record: 40.6 in Kleine Brogel now and it's not finished yet! Unbelievable!" Dehenauw said on Twitter.   The temperature in Belgium exceeded 40 degrees for the second day in a row after it reached 40.2 degrees in Liege, the previous record, on Wednesday.  Thursday's new record is likely to be temporary as temperatures continued to rise in the middle of the afternoon.

In Brussels, the country's reference station, it was a record 38.8 degrees at 15:00 (1300 GMT), compared to 36.8 degrees an hour earlier in Europe's unofficial capital.  Since the beginning of official temperature records in 1833, it has never been so hot.    The previous record of 36.6 was set on in June, 1947.
Date: Fri 17 May 2019
Source: [in French, trans. Corr.SB, edited]

An additional patient, the 19th, was admitted to the hospital in Flanders, [East Flanders province] suffering from legionellosis.

This case comes in addition to the 18 others who have been exposed to _Legionella_ bacteria in the Evergem area [East Flanders], right next to Ghent, and who developed legionnaires' disease, a lung disease that is not transmitted from human to human.

Of the total of 19 patients, 2 men died: one Monday night [20 May 2019] and the other [Wed 22 May 2019], in 2 different Ghent hospitals.

The exact source of _Legionella_ causing the [legionellosis] outbreak in the region has not yet been located. The bacterium normally contaminates people via inhalation of water vapor or micro-droplets, but many exposed individuals do not develop disease.
========================
[This news report above adds 3 cases since the last report posted by ProMED-mail (Legionellosis - Europe (01): Belgium (OV) http://promedmail.org/post/20190514.6468996) for a total now of 19 cases. At the time of the initial report, cooling towers in the vicinity of the Ghent Canal were suspected to be the source of this outbreak. The Ghent Canal separates the town of Evergem, where 7 cases occurred, from the town of Oostakker, where 2 cases occurred. The Ghent-Terneuzen Canal, links Ghent in Belgium to the port of Terneuzen in the Netherlands, thereby providing Ghent with access to the sea (<https://en.wikipedia.org/wiki/Ghent-Terneuzen_Canal>).

A map showing the location of Evergem and this area can be found at
<https://goo.gl/maps/y9Z1tQzbKJa1NkSm7>.

The news report above fails to state where the new cases reside, if _Legionella_ genotypes of the clinical isolates match each other, which would indicate a common source outbreak, and the results of environmental testing for _Legionella_. We await the results of the ongoing investigation. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Belgium:
More ...

Kenya

General Information:
**************************************
Kenya is situated on the east coast of Tropical Africa and is one of the most popular tourist resorts in the continent. The country is bounded by Ethiopia and Somalia in the north, Ugan
a on the west, Tanzania to the south and the Indian ocean to the east. The country has been regarded as one of the more stable in Africa but nevertheless recent events, as they head towards a multiparty democracy, have led to a spiralling devaluation in their currency and general unease and disturbances.
Climate:
**************************************
Nairobi is situated at approx. 6000' and has a mild climate throughout the year. Malaria prophylaxis is not usually recommended for those visiting Nairobi city alone. The main rains tend to fall in April and May or October and November. The annual rainfall tends to be about 39 inches but significant variations can occur. Mombasa, on the coast, has a much more tropical climate and travellers will need to take more care with regard to personal hygiene and also serious protection against mosquito bites.
Health Care Facilities:
**************************************
In general, travellers to Nairobi find that the level of health care facilities are good. All doctors in Kenya speak English and the level of care they provide is usually excellent for the holiday maker. As in many other countries in central Africa, the screening of blood against various viral agents cannot be assured and so travellers should avoid all but essential of blood transfusions. Sterile needles and syringes are in good supply in the major towns and so a syringe kit is not usually necessary. All of the larger hotels will have their own English speaking medical officer, though travellers are usually asked to pay cash. There are many hotels and restaurants providing excellent menu facilities and food borne disease can usually be traced to eating salads or undercooked bivalve shellfish.
Swimming in Kenya:
**************************************
In all the major tourist resorts throughout Kenya there are swimming pools and these are usually the best places to indulge. On the coast the sand is exceptionally fine and it feels as if you are walking on flour. Just be careful of local strong currents and don't swim out to the coral. Watch out for the sea urchins. Their spines are very uncomfortable and may need to be extracted by medical staff. Keep your children in view at all times and warn them to take care. If you are trekking around Kenya or on Safari don't go swimming in any fresh water rivers or lakes. There is a disease called Schistosomiasis (Bilharzia) which will penetrate through your skin and may cause serious problems in the future.
Rabies in Kenya:
**************************************
This viral disease occurs throughout Kenya and is a significant risk for travellers who are going away from the major tourist areas. Keep clear of all warm blooded animals and if you are bitten (even licked or scratched) wash out the area immediately, apply an antiseptic and get medical attention. Even though the risk of Rabies for the traveller is very small don't ever disregard a contact of this type. The beach hotels near Mombasa are favourite haunts for monkeys. Don’t feed them and stay clear. Report any bite (lick or scratch) immediately. Watch your children at all times.
Trekking through Kenya:
**************************************
Some travellers to Kenya will have no particular itinerary planned and so start their holiday from either Nairobi of Mombasa. Those planning to go off the beaten track should register with the Irish Counsel. Great care should always be exercised as each year too many tourists have significant problems while trekking off the usual routes. The major risks revolve around food and water borne disease, the risk of rabies, altitude sickness on Mount Kenya, being robbed or simply getting lost!

Tips for Trekkers
**************************************
*
Always plan your trip well in advance
*
Make sure that you know about personal health and general food & water hygiene.
*
Check in frequently
*
Never travel alone
*
Make sure you have plenty of clean water
*
Stick to your itinerary
*
If you are in trouble, admit it!
The Risk of Malaria:
**************************************
In Kenya, malaria poses a very real risk outside Nairobi. One of the highest risk areas is Mombasa which is where many travellers will find themselves at some time. Malaria is transmitted by the bite of an infected mosquito and so the first line of defence is to protect yourself against mosquito bites. (see leaflet on Protection against Insect Bites - Tropical Medical Bureau). Also it is essential to take your prescribed malaria tablets on a regular basis. Only stop your tablets under exceptional circumstances. Nevertheless, the traveller must remember that there is no perfect protection against malaria and the disease can still occur even after all the precautions have been taken. So be aware that any peculiar symptoms (especially 'flu) for at least a year after your trip will need to be checked out.
After your Journey:
**************************************
Just remember that some tropical diseases may not become evident for weeks or even months after your trip. If you are ill within a year of your journey always seek medical help.
Further Information:
**************************************
General travel health information may be obtained from the Tropical Medical Bureau at any of our centres. Please remember, every traveller will require a specialised consultation and this leaflet only contains general guideline information.

Travel News Headlines WORLD NEWS

Date: Sat, 23 Nov 2019 16:26:01 +0100 (MET)

Nairobi, Nov 23, 2019 (AFP) - Heavy rains lashing East Africa have caused of dozens of deaths, with 29 buried by landslides in Kenya, and 10 people drowned in a river in Tanzania, officials said Saturday.   The landslides and floods come amid weeks of destructive rains and flooding across the wider East African region.   At least 29 people were killed in Kenya when their homes were swept away in landslides during ferocious overnight rainstorms.   Their homes were hit in the early hours of Saturday amid torrential rains in the Pokot region, 350 kilometres (220 miles) northwest of the capital Nairobi.   "We are saddened to confirm that 12 people from Tapach and Parua in Pokot South, and 17 from Tamkal in Pokot Central lost their lives," Kenya's Interior Minister Fred Matiang'i said in a statement.   "Our profound sympathies go to the families and friends of those who have been affected."

Army and police helicopters have been sent, Matiang'i said, with efforts delayed because roads had been cut and bridges closed after streams turned into raging torrents.   Two children were pulled out alive from the smashed wreckage of their mud-covered homes, and rescue efforts to dig bodies out of the dirt continued.   "Massive landslides reported in various areas of West Pokot County following heavy downpour," Kenya Red Cross said in a message, adding its emergency response teams had deployed to help.

- Extreme weather -
In Tanzania, at least 10 people drowned when they were swept away by a torrential river in the far west, in the Sengerema district of Mwanza.   "We think there is a possibility to find more bodies," said Tanzanian Red Cross official Revocatus Kayanda, part of the team who recovered the victims.   Violent downpours have also displaced tens of thousands in Somalia, submerged whole towns in South Sudan and killed dozens in flash floods and landslides in Ethiopia.    Close to a million people in South Sudan alone are affected with growing fears of disease and starvation.

Floods hit East Africa regularly, but scientists say that it has been exacerbated by a powerful climate phenomenon in the Indian Ocean stronger than any seen in years.   The extreme weather is blamed on the Indian Ocean Dipole -- a climate system defined by the difference in sea surface temperature between western and eastern areas of the ocean.   The ocean off East Africa is currently far warmer than usual, resulting in higher evaporation and consequent rain over the continent.
Date: Thu 31 Oct 2019
Source: Hivisasa [edited]

Nakuru County health executive Dr Gichuki Kariuki has urged Solai residents to visit health facilities in the area for malaria checkup. Addressing the media following reports that 3 people had succumbed to malaria, Dr Gichuki said regular check-up is the only solution. He termed the deaths unfortunate, adding that had the patients visited health facilities on noting the 1st symptoms, they could have been saved. "We urge residents of Solai and Nakuru as a whole to ensure they go for check-ups in our health facilities whenever they spot symptoms" he said.

He acknowledged that the health docket in Nakuru is facing challenges when it comes to malaria, as the national government has not been providing mosquito nets since malaria prevalence is low. According Dr Gichuki, a sensitization campaign on malaria has commenced in Solai to educate residents on the symptoms of the disease. "The other challenge we have is that since our prevalence is low the national government does not distribute mosquito nets in Nakuru. But so far, we have put in place measures," he said.

Earlier this week[week of 28 Oct 2019], panic gripped residents of Arus village in Solai, following the death of 3 people in a week due to malaria.

The symptoms of malaria include; diarrhoea, high fever, chills, headaches, nausea and vomiting, abdominal pain, and profuse sweating. According to the World Health Organization, the early symptoms; fever, headache, and chills may be mild and difficult to recognize as malaria.  [byline: Pristone Mambili]
===================
[Nakuru country is located approximately 1850 m (about 6070 ft) above sea level and is considered a low risk area (see figure 2 in The epidemiology and control profile of malaria in Kenya at <https://pdfs.semanticscholar.org/de6c/664f1723fcf3ed31400b2cb06710a889bedd.pdf>. Ministry of Health, Nairobi, 2016) [Solai is 1952 m (6404 ft) above sea level (https://en.wikipedia.org/wiki/Solai), even higher than the altitude of Nakuru County. - ProMED Sr.Tech.Ed.MJ]. It is unusual to have an outbreak at this altitude but a warmer climate moving the altitude limit of malaria transmission upwards is a possible explanation. - {ProMED Mod.EP]

[Maps of Kenya:
Date: Sat 26 Oct 2019
Source: Outbreak News Today [edited]

During the week ending [13 Oct 2019], officials in Kenya reported an additional 100 new suspected cases, with 85% of cases being reported from Nairobi and Wajir. Since the beginning of 2019, Kenya has seen 4476 cholera cases, including 37 deaths. A total of 12 of the 47 counties of Kenya reported cholera cases, namely: Embu, Garissa, Kajiado, Kisumu, Machakos, Makueni, Mandera, Mombasa, Nairobi, Narok, Turkana and Wajir counties.

The outbreak remains active in 6 counties: Garissa, Kajiado, Kisumu, Mandera, Makueni, Nairobi and Wajir.

Cholera is a disease spread by drinking water or eating food contaminated with cholera bacteria. Severe cholera is characterized by large amounts of watery diarrhea, often described as "rice-water stool" because it can have a pale, milky appearance. It can also be accompanied by nausea and vomiting. If untreated, the loss of fluid can be deadly. But simple treatment, including replacing lost body fluids, can lower the risk of death to less than 1%.
Date: Fri, 13 Sep 2019 16:08:16 +0200 (METDST)

Nairobi, Sept 13, 2019 (AFP) - Kenya on Friday became the third country to start routinely innoculating infants against malaria, using the world's first vaccine to combat a disease that kills 800 children globally every day.   The vaccine -- lab name RTS,S -- targets the deadliest and most common form of malaria parasite in Africa, where children under five account for two-thirds of all global deaths from the mosquito-born illness.

Kenya joins Malawi and Ghana, which commenced their own pilot programs for the vaccine supported by the World Health Organization (WHO) earlier this year.   The vaccine will be introduced in phases across malaria-endemic parts of western Kenya near Lake Victoria, starting with Homa Bay, the country's health ministry said.   "It's an exciting time for Kenya as we roll out this vaccine in parts of the country where the burden of malaria is the highest," Health Minister Sicily Kariuki said in a statement.   RTS,S will be added to the national immunisation schedule in these areas, given alongside other routine shots for children under two.

The health ministry said 120,000 Kenyan children were expected to be vaccinated under the pilot programme.   The country has distributed insecticide-treated mosquito nets, fumigated homes and improved diagnostics in its fight against malaria.   But the disease remains stubborn. The health ministry says malaria claimed more than 10,000 lives in 2016, and infected millions more.   As in the rest of the world, children in Kenya bear the brunt of the disease.    Up to 27 percent of Kenyan children under five have been infected with the disease, the health ministry said.   "This vaccine represents an additional tool that will boost Kenya's efforts in reducing malaria infections and deaths among children," Kariuki said.   WHO says a child dies roughly every two minutes from malaria somewhere in the world.

- 30 years in making -
Known under its commercial name as Mosquirix, the vaccine was developed over 30 years by British pharmaceutical giant GlaxoSmithKline in partnership with nonprofit PATH and African research institutes.   It is the only vaccine to date to show a protective effect against malaria in young children, WHO says.   It acts against Plasmodium falciparum, the deadliest malarial parasite and the most prevalent in Africa, where illness and death from the disease remain high despite some gains.   The shots, administered over four doses, have been shown in clinical trials to significantly reduce cases of malaria, and malaria-related complications, in young children.   The vaccine prevented about four in 10 cases of malaria and three in 10 cases of the most severe, life-threatening form of the disease, within the trial group, WHO says.

Evidence gained from the vaccine pilot schemes could guide decisions about whether RTS,S is rolled out more widely in future, WHO says.   "This is the most advanced malaria vaccine that we have today. It has been in the making for the last almost three decades," Dr Richard Mihigo, WHO's co-ordinator of immunisation and vaccine development programme, told AFP before the Kenyan launch.   "Children are the most vulnerable group to this severe disease that is malaria, so protecting children can make a big impact in preventing malaria."   The disease kills more than 400,000 people around the world every year. Of these about 290,000 are under five.    Most are in Africa, where more than 90 percent of the world's malaria cases -- and fatalities -- occur.
Date: Mon, 2 Sep 2019 09:44:27 +0200 (METDST)

Nairobi, Sept 2, 2019 (AFP) - Kenyan authorities said Monday they have recovered the bodies of six of seven members of a tour group who were killed in a flash flood at the Hell's Gate national park.   "Six bodies of the flash flood victims have been recovered, leaving one tourist missing," the Kenya Wildlife Service (KWS) said on Twitter.   The KWS manages the park, the location of the 2003 film "Tomb Raider: The Cradle of Life".   It said the search and rescue operation was continuing and the authorities have sought to contact the next of kin.   Six tourists - five Kenyans and a foreigner -- and their local guide were swept away in the flash flood as they were visiting the park on Sunday, part of a group of 13.   Two survivors from the group alerted park rangers who sent out a search party.

The deep gorges of the Hell's Gate park are often lashed by heavy rains. In 2012, seven young Kenyans drowned at the same spot in the Ol Jorowa gorge in the south of the park.   The tour guides have "been trained to detect storm water flowing downstream towards the gorge," the KWS said.   "Every group is usually accompanied by experienced guides who are able to alert tourists of impending emergencies and direct them to exit points.   "Since the last similar tragedy in 2012, we have created clearly marked emergency exists along the whole gorge as escape routes in case of danger like the flash floods."   It said on Sunday that the gorges were closed to the public as the rains are continuing.   Hell's Gate, named by 19th-century explorers, is around 100 kilometres (60 miles) northwest of the Kenyan capital Nairobi and just south of Lake Naivasha.   Its spectacular scenery inspired the Disney animation "The Lion King".   The park, established in 1984, is also home to three geothermal stations.
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Albania

Albania US Consular Information Sheet November 04, 2008

 COUNTRY DESCRIPTION

Albania is a parliamentary democracy that is transforming its economy into a market-oriented system. Albania's per capita income is among the lowest in Eu

ope, but economic conditions in the country are steadily improving. Tourist facilities are not highly developed in much of the country, and though Albania's economic integration into European Union markets is slowly underway, many of the goods and services taken for granted in other European countries are not yet available. Hotel accommodations are limited outside of major cities. Read the Department of State Background Notes on Albania for additional information.

ENTRY/EXIT REQUIREMENTS

 A passport is required. All travelers entering or exiting Albania must have six months or more validity on their passport. Customs officers strictly enforce this law. U.S. citizens do not require a visa prior to entering Albania, but those traveling without a visa will be charged a fee for an entry stamp at the point of entry, which is valid for a stay of up to 90 days. This fee is currently 10 Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Travelers without a visa who intend to stay in Albania for more than 90 days should be aware that Albanian law allows a traveler without a visa to remain in Albania for 90 days only within a specific 180-day period. That 180-day period is defined from the first day of entry. For example, a traveler entering without a visa on January 1 may remain in Albania for 90 days total during the period of time between January 1 and June 28. Departing Albania during this time period does not "restart the clock." Travelers attempting to reenter Albania without a visa and within 180 days of a previous entry and after an aggregate stay of 90 days may be denied entry. For stays exceeding 90 days within a 180-day period, those interested must apply for a Residency Permit at the police station with jurisdiction over the city of residence. Information on how to apply for a residency permit is available on the Embassy of Albania web site at http://www.embassyofalbania.org/. There is also a departure fee of ten Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Visit the Embassy of Albania web site at http://www.embassyofalbania.org/consular.html#visa for the most current visa information. Dual Nationality: The Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. If such persons are found guilty of draft evasion in Albania, they are subject to prosecution by the Albanian court. Those who might be affected should inquire at an Albanian Embassy or Consulate outside Albania regarding their status before traveling. In some instances, dual nationality may hamper U.S. Government efforts to provide protection abroad. 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

Although the overall security situation in Albania has improved in recent years, organized criminal activity continues to operate in all regions, and corruption is pervasive. US Government employees need permission to travel to the northern administrative districts of Shkoder, Malesi E Madhe and Tropoje (with the exception of the route along the national road to Montenegro and the city of Shkoder) and to the southern town of Lazarat, with such travel restricted to secure vehicles with escort. Travel restrictions for U.S. Government employees have been lifted for overnight stays in the city of Shkoder. In most cases, police assistance and protection is limited. A high level of security awareness should be maintained at all times. Photographing anything that authorities regard as being of military or security interest may cause travelers problems. All gatherings of large crowds should be avoided, particularly those involving political causes or striking workers. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME

In the latest State Department assessment, Albania’s crime rating is “medium.” Crime against foreigners is rare in Albania, as targeting foreigners is often viewed as too risky. Visitors should maintain the same personal security awareness that they would in any metropolitan U.S. city. Caution should be exercised in bars in Tirana where violent incidents, some involving the use of firearms, have occurred in the past, particularly in the early morning hours. Within the last years there have been fewer cases of carjacking compared with previous years. Anyone who is carjacked should surrender the vehicle without resistance. Armed crime continues to be more common in northern and northwestern Albania than in the rest of the country. Street crime is fairly common in Albania, particularly at night. Criminals do not seem to deliberately target U.S. citizens or other foreigners, but do seek targets of opportunity, and select those who appear to have anything of value. Vehicle theft is still one of the biggest problems in Albania. Pick-pocketing is widespread; U.S. citizens have reported the theft of their passports by pick-pockets. 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 is 129, though coverage is inconsistent at best. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION

Medical facilities and capabilities in Albania are limited beyond rudimentary first aid treatment. Emergency and major medical care requiring surgery and hospital care is inadequate due to lack of specialists, diagnostic aids, medical supplies, and prescription drugs. Travelers with previously diagnosed medical conditions may wish to consult their physicians before travel. As prescription drugs may be unavailable locally, travelers may also wish to bring extra supplies of required medications. Recent electricity shortages have resulted in sporadic blackouts throughout the country, which can affect food storage capabilities of restaurants and shops. While some restaurants and food stores have generators to properly store food, travelers should take care that food is cooked thoroughly to reduce the risk of food-borne illness. Water in Albania is not potable. Visitors should plan to purchase bottled water or drinks while in country. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Albania. 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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en

MEDICAL INSURANCE

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

TRAFFIC SAFETY AND ROAD CONDITIONS

While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Albania is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Major roads in Albania are often in very poor condition. Traveling by road throughout Albania is the most dangerous activity for locals and tourists. Vehicle accidents are the major cause of death, according to police statistics. Electricity shortages have resulted in sporadic blackouts throughout the country that can happen any hour of the day or night. Such outages affect traffic signals and street lights, making driving increasingly treacherous at any time of day. Travel at night outside the main urban areas is dangerous and should be avoided due to deplorable road conditions. During the winter months, travelers may encounter dangerous snow and icy conditions on the roads throughout mountainous regions in northern Albania. Buses travel between most major cities almost exclusively during the day, but they are often unreliable and uncomfortable. Many travelers looking for public transport prefer to use privately owned vans, which function as an alternate system of bus routes and operate almost entirely without schedules or set fares. Please note that many of these privately owned vans may not have official permission to operate a bus service and may not adhere to accepted safety and maintenance standards. Persons wishing to use privately owned vans should exercise caution. There are no commercial domestic flights and few rail connections. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at www.albaniantourism.com.

AVIATION SAFETY OVERSIGHT

As there is no direct commercial air service to the United States by carriers registered in Albania, the U.S. Federal Aviation Administration (FAA) has not assessed Albania's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa SPECIAL CIRCUMSTANCES: Albania's customs authorities may enforce strict regulations concerning temporary importation into or export from Albania of some items. It is advisable to contact the Embassy of Albania in Washington, D.C. or one of Albania's Consulates in the United States for specific information regarding customs requirements. As noted previously, the Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. See our information pertaining to dual nationality. Albania is a cash economy. Credit cards and travelers checks are not generally accepted, except at the major new hotels in Tirana and some international airline offices. Travelers' checks can be changed at banks in larger towns. Automated Teller Machines (ATMs) are available in most cities. 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 Albania’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Albania 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. Under Albanian law, police can detain any individual for up to 10 hours without filing formal charges. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times to show proof of identity and U.S. citizenship if questioned by local officials.

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 Albania 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 Albania. 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 Rruga Elbasanit 103, tel. (355)(4) 2247285; fax (355)(4) 2232222. The U.S. Embassy web site is http://tirana.usembassy.gov/ * * * This replaces the Consular Information Sheet dated June 10, 2008, to update sections on Entry and Exit Requirements, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Tue, 26 Nov 2019 09:28:12 +0100 (MET)
By Briseida MEMA

Tirana, Nov 26, 2019 (AFP) - Six people died and some 150 were injured in Albania after the strongest earthquake in decades rocked the Balkan country early Tuesday, destroying buildings and burying victims in rubble.

The epicentre of the 6.4 magnitude quake was about 34 kilometres (about 20 miles) northwest of the capital Tirana, at a depth of 10 km, according to the European-Mediterranean Seismological Centre.   "We have victims," Prime Minister Edi Rama wrote on Twitter. "We are working to do everything possible in the affected areas."   The quake struck at 3:54 am local time (0254 GMT) and sent panicked residents running out onto the streets of Tirana, with people huddling in the open, an AFP correspondent said.

The worst damage appeared to be around the coastal town of Durres. The quake was the strongest to hit this region since 1926, Albanian seismologist Rrapo Ormeni told local television.   Three bodies were pulled from the ruins of damaged buildings in the port town, where a three-story hotel collapsed and other buildings were damaged, according to the defence ministry.   The bodies of a man and a woman were uncovered in rubble in the nearby town of Thumane, the ministry said.

A man in his fifties died after he jumped out of his building in panic in the town of Kurbin, the defence ministry said.   Some 300 armed forces personnel have rushed to Durres and Thumane for rescue operations, where "there are people trapped under the ruins", defence ministry spokeswoman Albana Qahajaj said.

In Thumane, around a dozen rescuers used an excavator to dig through a mountain of debris in search of possible victims.   At least 150 people with injuries have sought first aid in Tirana and Durres, Health Minister Ogerta Manasterliu said.

- Trapped under rubble -
In Thumane, soldiers, rescuers and families were sifting through the rubble of a collapsed five-storey building as cries of people trapped under debris were heard, an AFP reporter said.   Thoma Nika, a 58-year-old who lived in the building, said there were at least six people under rubble.    Another man, Arben Allushi said with tears in his eyes, that his wife and niece missing after the building collapsed.

A man in Durres told local television that his daughter and niece were trapped in the rubble of a collapsed apartment building.    "I talked with my daughter and niece on the phone. They said they are well and are waiting for the rescue. I could not talk to my wife. There are other families, but I could not talk to them," the man said.

The tremors were felt across the Balkan region, from Sarajevo to Bosnia and even in the Serbian city of Novi Sad almost 700 kilometres away, according to reports in local media and on social networks.   It was followed by several aftershocks, including one of 5.3 magnitude, the European-Mediterranean Seismological Centre said. It was described by authorities as the strongest earthquake in the last 20-30 years.   The Balkans is an area prone to seismic activity and earthquakes are frequent.
Date: Sat, 21 Sep 2019 20:39:17 +0200 (METDST)

Tirana, Sept 21, 2019 (AFP) - Albania was rattled by its strongest earthquake in decades Saturday, officials said, sending people fleeing into the streets in several cities, damaging buildings and triggering power cuts in the capital.   The epicentre of the shallow 5.6-magnitude quake, was near Durres, less than 40 kilometres (25 miles) west of the capital Tirana, according to the US Geological Survey.

Albania's defence ministry said it was the "strongest earthquake in the country in the last 20 to 30 years".   "There are no deaths," defence ministry spokeswoman Albana Qajaj said.   Some 80 people sought medical help in both Tirana and Durres, 21 of whom were hospitalised due to injuries caused by falling objects or parts of walls as well as for panic attacks, Health Minister Ogerta Manasterilu said.   Qajaj told AFP that houses and buildings in Tirana had been damaged but were still standing and that the ministry was accessing damage in other towns and villages.   Prime Minister Edi Rama cancelled his scheduled trip to the United States following the quake, which cut electricity and telephone lines in Tirana and a number of other towns and villages.

Many people remained outside their homes for several hours in the capital, fearful of aftershocks.   "I fear to return because such a strong earthquake could be followed with others," Drita Lohja, a resident in her fifties, told AFP.    Falling debris pulverised parked cars in parts of the city.   AFP reporters and witnesses saw windows broken and deep fissures in the facades of buildings in Durres, as well as in the capital.   Media reported that a large building in Tirana was seriously damaged and that residents were being evacuated.   A University of Tirana building was also damaged, witnesses said.

According to local media reports, at least two people were lightly injured and a dozen houses collapsed in the village of Helmes, 10 kilometres from Tirana.   Two other earthquakes followed the strong one that occurred at around 4:00 pm (1400 GMT) and was felt in neighbouring Montenegro and Italy, but also on the Greek island of Corfu according to some Twitter users.
Date: Fri, 9 Mar 2018 16:28:50 +0100

Tirana, March 9, 2018 (AFP) - The military has been deployed in northern Albania to help hundreds of people trapped by floods following heavy rainfall, authorities said on Friday.   More than 9,230 hectares (22,800 acres) of agricultural land is underwater in the Shkodra region, including villages where the only means of transport is by boat, the defence ministry said.

Army personnel are evacuating residents and securing food supplies in the affected areas, 100 kilometres (60 miles) north of the capital, Tirana.   The torrential rain in recent days has caused landslides damaging dozens of homes and flooding roads, said the transport ministry.   The rain has also forced the Albanian authorities to release excess water from a hydroelectric plant, which has added to the flooding in northern areas of the country.   Weather forecasters say the rain is likely to ease from Saturday.
Date: Sun, 3 Dec 2017 12:29:40 +0100

Tirana, Dec 3, 2017 (AFP) - Thousands of police and soldiers have been deployed in Albania to rescue stranded residents after heavy rainfall triggered major flooding, and caused the death of a utility worker, officials and the power company said Sunday.   The victim, Sabri Vlinga, died while he was working on a electricity pole at Roskovec in the flooded south of the country, the power company said in statement.   Two other people were injured in similar accidents. it added.   Some 6,400 police and soldiers have been sent to help rescue people stranded by the floods, Prime MInister Edi Rama said Saturday, calling the situation "very critical".

Around 1,500 people in the affected areas have been rescued, while several thousand homes were without electricity as many utility poles have been swept away by mudslides, said Shemsi Prenci, head of civil protection.   More than 7,874 hectares (19,450 acres) of farm land as well as 3,193 homes are under water and several roads in the south remained impassable.

Army forces have built a temporary bridge at Darezeze, about 70 kilometres (44 miles) from the capital Tirana, to come to the aid of 2,000 residents stranded by the floods, the defence ministry said.    In neighbouring Macedonia, the heavy rains have also caused flooding as several rivers include the main Vardar river have burst their banks, the MIA news agency reported.
Date: Sat 5 Aug 2017
From: Edmond Puca <edmond_puca@yahoo.com> [edited]

Here in Albania, we have 2 imported cases of haemorrhagic fever with renal syndrome (HFRS), one imported from the north of Greece and another from Macedonia in a village near the border with Albania.

The patient from Macedonia is 25 years old. He presented in the emergency room on 31 Jul [2017]. Right now, he is in good condition and will survive. He presented with fever, nausea and vomiting, abdominal pain, and lower back pain.

The other patient from Greece had been in our service for the previous 2 weeks and now is at home in good condition.

The disease is caused by Dobrava-Belgrade virus infection.
---------------------------------
Dr Edmond Puca
Infectologue
Department of Infectious Disease
UHC "Mother Teresa"
Tirana, Albania
===================
[ProMED-mail thanks Dr Edmond Puca for sending in this report.  This and the previous report are the 1st reports of hantavirus infections in Macedonia that ProMED-mail has posted. There is also evidence of HFRS in Greece, although ProMED-mail has not posted reports previously. Sero-epidemiological investigations conducted in several Balkan countries revealed an overall seroprevalence of 4 per cent in Greece (<http://www.sciencedirect.com/science/article/pii/S0168170213004887#>). There doubtless have been Dobrava-Belgrade virus infections in Greece and the Balkans over the years, given that this virus is known to circulate widely in the Balkans.

The yellow-necked field mouse (_Apodemus flavicollis_) is the principle vertebrate host for Dobrava-Belgrade virus. - ProMED Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at:
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World Travel News Headlines

Date: Fri, 6 Dec 2019 10:30:54 +0100 (MET)

Moscow, Dec 6, 2019 (AFP) - More than 50 polar bears have gathered on the edge of a village in Russia's far north, environmentalists and residents said, as weak Arctic ice leaves them unable to roam.   The Russian branch of the World Wildlife Fund said climate change was to blame, as unusually warm temperatures prevented coastal ice from forming.   The WWF said 56 polar bears had gathered in a one-square-kilometre (0.4-square-mile) area near the village of Ryrkaipy in Chukotka on the north-eastern tip of Russia.

There were concerns they could enter the village, home to fewer than 1,000 people, and patrols had been set up to monitor their movements.   "The number of human and predator encounters in the Arctic is increasing," the WWF said in statement.    "The main reason is the decline of sea ice area due to the changing climate. In the absence of ice cover, animals are forced to go ashore in search of food."

Residents had gathered walrus carcasses in the area to try to keep the bears from wandering into the village.   "We have created a feeding point with walrus carcasses that we gathered along the coast," Tatyana Minenko of the local "Bear Patrol" told news agency RIA Novosti.   "As long as there is no big freeze, the sea ice will not form and the bears will stay on the coast," she said.

Russia's weather service said temperatures in the region should fall from Saturday and that coastal ice should freeze by December 11.    Polar bears regularly visit areas inhabited by humans in Arctic Russia to search for food, often in rubbish tips.   But the number of visits has been growing as the melting of Arctic ice from climate change forces the bears to spend more time on land where they compete for food.
Date: Fri, 6 Dec 2019 10:28:26 +0100 (MET)
By Joseph Schmid

Paris, Dec 6, 2019 (AFP) - Travellers across France endured a second day of chaos on Friday as unions vowed to keep up their strike until President Emmanuel Macron backs down on controversial pension overhauls.   Rail operator SNCF said 90 percent of high-speed TGV trains were again cancelled, and several airlines dropped flights including Air France, EasyJet and Ryanair.

Nine of the capital's 16 metro lines were shut and most others severely disrupted, sparking some 350 kilometres (220 miles) of traffic jams in the Paris region, well above the usual 200 km, the traffic website Sytadin reported.   Many employees were unable to get to work and several schools again provided only daycare, though fewer teachers were on strike compared with Thursday when some 800,000 people demonstrated across the country according to the interior ministry.   Bike paths were crowded with bikes and electric scooters, with metro operator RATP sponsoring special deals for commuters with a range of ride-hailing companies and other transportation alternatives.

The walkout is the latest test for Macron after months of protests from teachers, hospital workers, police and firefighters as well as the "yellow vest" movement demanding improved living standards.   Unions say his "universal" pension system, which would eliminate dozens of separate plans for public workers, forces millions of people in both public and private sectors to work well beyond the legal retirement age of 62.   Health Minister Agnes Buzyn said Friday that the government had "heard" the protesters' anger and would meet with union leaders to discuss the reform on Monday.   The government has yet to lay out the details of its plan, and Buzyn told Europe 1 radio that "there is indeed a discussion going on about who will be affected, what age it kicks in, which generations will be concerned -- all that is still on the table".

- Macron 'determined' -
Yves Veyrier, head of the hardline FO union, warned Thursday the strike could last at least until Monday if the government did not take the right action.   But it remains to be seen if the protests will match the magnitude of the 1995 strikes against pension overhauls, when France was paralysed for three weeks from November to December in an action that forced the government to back down.

Macron, a former investment banker, has largely succeeded in pushing through a series of controversial reforms, including loosening labour laws and tightening access to unemployment benefits.   But this is the first time the various disgruntled groups have come together in protest.   So far Macron has not spoken publicly on the stoppages though a presidential official, who asked not to be named, said Thursday that the president was "calm" and "determined to carry out this reform" in a mood of "listening and consultation".

While most of Thursday's rallies were peaceful, police fired tear gas to disperse dozens of black-clad protesters smashing windows and throwing stones during the Paris march, with one construction trailer set on fire. Sporadic clashes were also reported in some other cities.   Many people were bracing for further disruptions over the weekend, including the prospect of fuel shortages as unions blocked most of the country's eight oil refineries.

The minimum pension age in France is 62, one of the lowest among developed countries, but there are 42 "special regimes" for railway workers, lawyers, opera employees and others offering earlier retirements and other benefits.   The government says a single system will be fairer for everyone while ensuring its financial viability while acknowledging that people will gradually have to work longer.
Date: Fri, 6 Dec 2019 04:23:51 +0100 (MET)

Sydney, Dec 6, 2019 (AFP) - Three hundred animals have been evacuated from a wildlife park north of Sydney as massive bushfires encircled Australia's largest city and foreign firefighters arrived to relieve beleaguered local forces.   Walkabout Wildlife Park said it had shipped out lizards, dingoes, peacocks and marsupials, as firefighters battled more than 100 fires up and down the eastern seaboard.   "This fire has been doing some crazy things, so we have to be prepared," general manager Tassin Barnard told AFP.

Prolonged drought has left much of eastern Australia tinder dry and spot fires have raged every day for the past three months, leaving firefighters struggling to cope.   New South Wales rural fire chief Shane Fitzsimmons said Friday that some US and Canadian firefighters had arrived to help out, easing the strain on the exhausted largely volunteer Australian force.

The incident-management and aviation specialists will help ease "fatigue and crew rotations" he said.   "We are not only appreciative of their presence here today, but of their sacrifice," said Fitzsimmons -- who has become a fixture on Australian television screens for weeks, updating the public on blazes in towns, national parks and backwaters.    "They are volunteering to sacrifice time from loved ones, from families, to give up that special time of the year around Christmas and New Year to come down here and lend us a hand," he said.

More than 600 homes have been destroyed and six people have died since the crisis began in September. That is many fewer than Australia's deadliest recent fire season in 2009 when almost 200 people died, but 2019's toll belies the scale of devastation.    Millions of hectares have burned -- the size of some small countries -- across a region spanning hundreds of kilometres (miles).   Bushfires are common in Australia but scientists say this year's season has come earlier and with more intensity due to a prolonged drought and climatic conditions fuelled by global warming.

The fires have taken a toll in Sydney and other major cities, which have been blanketed in toxic smoke for weeks and occasionally sprinkled with snow-like embers.   Fitzsimmons said he could not "overstate the effect that this profound drought is having" as he warned of a long, painful summer ahead.   "There is an absolute lack of moisture in the soil, a lack of moisture in the vegetation... you are seeing fires started very easily and they are spreading extremely quickly, and they are burning ridiculously intensely."
Date: Fri, 6 Dec 2019 03:03:18 +0100 (MET)
By Pierre-Henry DESHAYES

Half Moon Island, Antarctica, Dec 6, 2019 (AFP) - The swimsuit-clad tourists leap into the icy water, gasping at the shock, and startling a gaggle of penguins.   They are spectators at the end of the world, luxury visitors experiencing a vulnerable ecosystem close-up.   And their very presence might accelerate its demise.   Antarctica, a vast territory belonging to no one nation, is a continent of extremes: the coldest place on Earth, the windiest, the driest, the most desolate and the most inhospitable.   Now, it's also a choice destination for tourists.

All around Half Moon Island, off the Antarctic Peninsula, blocks of ice of all sizes float by on a calm sea, their varying forms resembling weightless origami shapes.    On this strip of land, that juts out of the Antarctic Polar and towards South America, visitors can see wildlife normally only viewed in zoos or nature documentaries along with spectacular icy landscapes.   The ethereal shades of white that play across the pillowy peaks change with the light, acquiring pastel hues at dawn and dusk.   "Purity, grandeur, a scale that's out of this world," says Helene Brunet, an awestruck 63-year-old French pensioner, enjoying the scene.    "It's unbelievable, totally unbelievable. It's amazing just to be here, like a small speck of dust."

AFP joined the 430 passengers on board the Roald Amundsen, the world's first hybrid electric cruise ship, on its maiden voyage in the Southern Ocean.    "It's not your typical beach, but it's awesome to do it," says a numb Even Carlsen, 58, from Norway, emerging from his polar plunge in the three-degree C (37.4 F) water.   When tourists go ashore, bundled up in neon-coloured windbreakers and slathered in SPF50 sunscreen, they have to follow strict rules: clean your personal effects so you don't introduce invasive species, keep a respectful distance from wildlife to avoid distressing them, don't stray from the marked paths and don't pick up anything.   "We mucked up the rest of the world. We don't want to muck up Antarctica too," says an English tourist, as she vacuums cat hair off her clothes before going ashore.

- 'Heart of the Earth' -
The Antarctic peninsula is one of the regions on Earth that is warming the fastest, by almost three degrees Celsius in the past 50 years, according to the World Meteorological Organization -- three times faster than the global average.    In March 2015, an Argentinian research station registered a balmy 17.5 degrees Celsius, a record.    "Every year you can observe and record the melting of glaciers, the disappearance of sea ice... (and) in areas without ice, the recolonisation of plants and other organisms that were not present in Antarctica before," said Marcelo Leppe, director of the Chilean Antarctic Institute.

Antarctica is "like the heart of the Earth," he added, saying that it expands and contracts like a heart beating, while the mighty current which revolves around the continent is like a circulatory system as it absorbs warm currents from other oceans and redistributes cold water.   The Antarctic Treaty, signed 60 years ago by 12 countries -- it now has 54 signatories -- declared the area a continent dedicated to peace and science, but tourism has gradually increased, with a sharp rise in the past few years.   Tourism is the only commercial activity allowed, apart from fishing -- the subject of international disputes over marine sanctuaries -- and is concentrated mainly around the peninsula, which has a milder climate than the rest of the continent and is easier to access.

Cruise ships have roamed the region for around 50 years, but their numbers only started to increase from 1990, as Soviet ice-breakers found new purposes in the post-Cold War era.   Some 78,500 people are expected to visit the region between November and March, according to the International Association of Antarctica Tour Operators (IAATO).   That's a 40-percent increase from last year, due in part to short visits by a few new cruise ships carrying more than 500 passengers, too many to disembark under IAATO regulations.     "Some might say 'Well, 80,000 people, that doesn't even fill a national stadium'... (and that it) is nothing like Galapagos which welcomes 275,000 a year," says IAATO spokeswoman Amanda Lynnes.    "But Antarctica is a special place and you need to manage it accordingly."

- 'Leave Antarctica to the penguins' -
It is Antarctica's very vulnerability that is attracting more and more visitors.   "We want to see this fantastic nature in Antarctica before it's gone," Guido Hofken, a 52-year-old IT sales director travelling with his wife Martina, says.    They said they had paid a supplement to climate compensate for their flight from Germany.

But some question whether tourists should be going to the region at all.   "The continent probably would be better off being left to penguins and researchers, but the reality is, that is probably never going to happen," said Michael Hall, professor and expert on polar regions at the University of Canterbury in New Zealand.   "Vicarious appreciation never seems to be enough for humans. So with that being the case, it needs to be made as low risk to the Antarctic environment and as low carbon as possible," said Hall.    "However, when the average tourist trip to Antarctica is over five tonnes of CO2 emissions per passenger (including flights), that is a serious ask."

Soot or black carbon in the exhaust gases of the scientific and cruise ships going to the region is also of concern, said Soenke Diesener, transport policy officer at German conservation NGO Nabu.   "These particles will deposit on snow and ice surfaces and accelerate the melting of the ice because the ice gets darker and will absorb the heat from the sun and will melt much faster," he told AFP.   "So the people who go there to observe or preserve the landscape are bringing danger to the area, and leave it less pristine than it was," he added.

- Responsible tourism -
Antarctic tour operators insist they are promoting responsible tourism.   The trend is for more intimate, so-called expedition cruises, in contrast to popular giant cruise liners elsewhere which are criticised for being invasive and polluting.   With greener ships -- heavy fuel, the most commonly used for marine vessels, has been banned in Antarctica since 2011 -- cruise companies have sought to make environmental awareness a selling point, occasionally earning them accusations of greenwashing.

Global warming, pollution and microplastics are the result of human activities on other, faraway continents, say tour operators.   Here, their motto is "Take nothing but photographs, leave nothing but footprints, keep nothing but memories".   But before they've even set foot on the cruise ships departing from South America -- the most common itinerary -- visitors to Antarctica will already have flown across the world, causing emissions that harm the very nature they have come so far to admire.

Most visitors hail from the Northern Hemisphere, and almost half are from the United States and China, IAATO says.   "I'm a tourist who feels a little guilty about taking a flight to come here," admits Francoise Lapeyre, a 58-year-old globetrotter om France.   "But then again, there are priorities. There are some trips I just won't take, because they leave a big footprint and they're not worth it.   "Crisscrossing the planet to go to a beach for example," she says.

- Don't mention climate change -
Like other expedition cruises where accessible science is part of their trademark, the Roald Amundsen, owned by the Hurtigruten company, has no dance floor or casino.  Instead, there are microscopes, science events and lectures about whales and explorers like Charles Darwin.   But they steer clear of climate change, which is only mentioned indirectly.   That's a deliberate decision as the subject has proven "quite controversial", said Verena Meraldi, Hurtigruten's science coordinator.   "We held several lectures dedicated specifically to climate change but it leads to conflicts. There are people who accept it as a fact, others who don't," she said.   Onboard, "passengers" are referred to as "guests" and "explorers" rather than "cruisers".   "Explorers" are typically older, well-heeled, often highly travelled pensioners who are handed walking sticks as they step ashore.   "My 107th country," says a Dane, stepping ashore onto Antarctica.

The Roald Amundsen "guests" choose between three restaurants, from street food to fine dining -- a far cry from the conditions endured by the Norwegian adventurer for whom the ship is named, who had to eat his sled dogs to survive his quest to reach the South Pole in 1911.   They have paid at least 7,000 euros ($7,700) each for an 18-day cruise in a standard cabin, and up to 25,000 euros ($27,500) for a suite with a balcony and private jacuzzi.   Other cruises are banking on ultra-luxury, with James Bond-like ships equipped with helicopters and submarines, suites of more than 200 square metres (2,153 square feet) and butler services.   With a seaplane to boot, the mega-yacht SeaDream Innovation will offer 88-day cruises "from Pole to Pole" starting in 2021. The two most expensive suites, with a price tag of 135,000 euros per person, are already booked.
 
- Worlds collide -
Outside, in the deafening silence, wildlife abounds.   All around are penguins, as awkward on land as they are agile in water. Massive and majestic whales slip through the waves, and sea lions and seals laze in the sun.   On Half Moon Island, chinstrap penguins -- so called because of a black stripe on their chin -- strut about in this spring breeding season, raising their beaks and screeching from their rocky nests.   "This is to tell other males 'This is my space' and also, maybe, 'This is my female'," ornithologist Rebecca Hodgkiss, a member of the Hurtigruten's scientific team, explains, as a group of tourists stroll around ashore.   The colony of 2,500 penguins has been gradually declining over the years, but it's not known if that is man's fault or they have just moved away, according to Karin Strand, Hurtigruten's vice president for expeditions.   Invisible to the naked eye, traces of humankind are however to be found in the pristine landscape.   Not a single piece of rubbish is in sight but microplastics are everywhere, swept in on ocean currents.   "We've detected them in the eggs of penguins for example," Leppe told AFP.

- Venice under water -
The Antarctic, which holds the world's largest reserve of freshwater, is a ticking time bomb, warn experts and studies.   They say that the future of millions of people and species in coastal areas around the world depends on what is happening here.   As a result of global warming, the melting ice sheet -- especially in the western part of the continent -- will increasingly contribute to rising sea levels, radically re-drawing the map of the world, says climate scientist Anders Levermann, of the Potsdam Institute for Climate Impact Research.   This meltwater will contribute 50 centimetres (almost 20 inches) to the global sea level rise by 2100, and much more after that, he said.   "For every degree of warming, we get 2.5 metres of sea level rise. Not in this century, but in the long run," he said.

Even if the international community meets its obligations under the Paris Agreement to limit global warming to under two degrees Celsius, sea levels will still rise by at least five metres.   "Which means that Venice is under water, Hamburg is under water, New York, Shanghai, Calcutta," he said.   It's impossible to predict when, but the scenario appears unavoidable, says Levermann.   In the same way that a cruise ship powering ahead at full speed can't immediately stop, sea levels will continue to rise even if all greenhouse gas emissions were to cease immediately, a study has said.

- Changing the world? -
The tourism industry says it hopes to make "ambassadors" out of Antarctica visitors.   "It's good for the animal life and for the protection of Antarctica that people see how beautiful this area is, because you cherish what you know and understand," said Hurtigruten chief executive Daniel Skjeldam.   Texan tourist Mark Halvorson, 72, says he is convinced.   "Having seen it, I am that much more committed to having a very high priority in my politics, in my own inner core convictions to being as environmentally friendly in my life as I can," he said.   So, do Guido and Martina Hofken see themselves as future "ambassadors of Antarctica"?    "Just a little bit, probably. But I don't think I will change the world," Guido Hofken concedes.    "The best thing would be for nobody to travel to Antarctica."
Date: Thu, 5 Dec 2019 16:37:37 +0100 (MET)

Paris, Dec 5, 2019 (AFP) - French rail operator SNCF said Thursday that it had cancelled 90 percent of all high-speed TGV trains and 70 percent of regional trains for Friday due to a strike over the government's pension reforms.   SNCF said that services would "still be very disrupted" on the second day of the biggest transport strike in the country in years, with the Eurostar service to Britain and the Thalys service to northern Europe set to be "very heavily disrupted".   In Paris, where only two of 16 metro lines were operating normally Thursday, public transport workers voted to remain on strike until Monday.

France's civil aviation authority meanwhile told airlines to cut 20 percent of their flights in and out of airports in Paris, Beauvais, Lyon, Marseille, Toulouse and Bordeaux on Friday, the same proportion as on Thursday.   Striking transport workers, air traffic controllers, teachers, fire fighters, lawyers and other groups all fear they will have to work longer or receive reduced pensions under the government's proposal to scrap 42 special pension schemes and replace them with a single plan.   Anticipating the worst travel chaos in years, many employees opted to work from home on Thursday. Those who did venture out travelled mainly by car, bicycle, electric scooter or on foot.
Date: Thu, 5 Dec 2019 12:19:45 +0100 (MET)
By Sofia CHRISTENSEN

Johannesburg, Dec 5, 2019 (AFP) - South African Airways was placed under a state-approved rescue plan on Thursday to avoid the embattled airline's collapse following a costly week-long strike last month.   Thousands of South African Airways (SAA) staff walked out on November 15 after the flag carrier failed to meet a string of demands, including higher wages and job in-sourcing.   The strike was called off the following week after SAA management and unions eventually clinched a deal.

But the walkout dealt a severe blow to the debt-ridden airline, which has failed to make a profit since 2011 and survives on government bailouts.   "The Board of SAA has adopted a resolution to place the company into business rescue," said a statement by South Africa's Public Enterprises Minister Pravin Gordhan, adding that the decision was also supported by the government.   "It must be clear that this is not a bailout," said Gordhan. "This is the provision of financial assistance in order to facilitate a radical restructure of the airline."   The business rescue process will be directed by an independent practitioner. It is meant to prevent a "disorderly collapse of the airline", he added.   Gordhan said the government would provide 2 billion rand ($136 million) to SAA in "a fiscally neutral manner".   Existing lenders will also provide a 2 billion rand loan guaranteed by the government.

- 'Financial challenges' -
South Africa is struggling to get state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.   Its national airline -- which employs more than 5,000 workers and is Africa's second largest airline after Ethiopian Airlines -- had been losing 52 million rand ($3.5 million) a day during the strike.   SAA's board said the business rescue, scheduled to start immediately, was decided after consultations with shareholders and the public enterprises department "to find a solution to our company's well-documented financial challenges".

"The considered and unanimous conclusion has been to place the company into business rescue in order to create a better return for the company's creditors and shareholders," said the SAA board of directors in a statement.   The rescue plan will include a "new provisional timetable" and ensure "selected activities... continue operating successfully".   With a fleet of more than 50 aircraft, SAA flies to over 35 domestic and international destinations.   "SAA understand that this decision presents many challenges and uncertainties for its staff," said the board.   "The company will engage in targeted communication and support for all its employee groups at this difficult time.

- 'Lesser evil' -
Unions told AFP they would comment later on Thursday.   They have agreed to a 5.9-percent wage increase backdated to April, but which would only start to be paid out next March depending on funding.   SAA had initially refused any pay rise.    The cash-strapped airline needs two billion rand ($136 million) to fund operations through the end of March. But it was unable to cover all of its staff salaries last month.    "Business rescue allows for the airline to continue to operate while it is being restructured, as opposed to liquidation," analyst Daniel Silke told AFP.   He said the rescue was a "lesser evil for SAA" and would save more jobs than a "shutdown".

But Silke still expected jobs to be cut as SAA attempted to reduce costs.   "Various divisions that make of SAA could be privatised," he said. "There will be a review of SAA aircraft and routes covered by SAA."   Unions had already demanded a three-year guarantee of job security following an announcement last month that almost 1,000 SAA employees could lose their jobs as part of another restructuring plan.   SAA pledged to defer that process to the end of January as part of the deal that ended the strike.
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Out of the 7 patients who were admitted to the hospital suspecting Nipah virus infection, one has been tested positive while the other 6 have been tested negative.

Kerala health minister K K Shailaja said at a press briefing in Kochi on Thursday [28 Nov 2019] that of "7 patients admitted to the hospital, one patient's result is positive for Nipah virus, while 6 patients' results are negative. No one has been discharged from the isolation ward. The source of the virus is not confirmed yet."

On the other hand, 2 persons suffering from high fever were put under observation at Trivandrum Medical College on Thursday [28 Nov 2019]. Their samples have been sent for examination.

On 4 Jun [2019], a 23-year-old-man had tested positive for Nipah virus infection, which killed 17 people in Kerala last year [2018].

As of now, a total of 15 people are under observation in the state.

Union minister for health and family welfare Dr Harsh Vardhan had said on 4 Jun [2019] that the centre had rushed a team of doctors to Kerala for investigation in the wake of the scare of Nipah virus. Vardhan had asserted that he was "very vigorously" following the situation.

Nipah virus is transmitted from animals [bats] to humans and then spreads through people to people, causing respiratory illness. Its symptoms include fever, muscle pain, headache, fever, dizziness, and nausea.

The Health Department in Karnataka issued a circular asking administration in Chamarajanagar, Mysuru, Kodagu, Dakshina Kannada, Uttara Kannada, Udupi, Shivamogga, and Chikkamagaluru districts to immediately convene interdepartmental coordination committee meetings, including the veterinary department, the Indian Medical Association, and the Indian Academy of Pediatrics.

Authorities in these 8 districts have been directed to identify 2 isolation beds to quarantine suspected human cases. They have been asked to keep all the logistics available at all levels, read the circular. The department has also asked district authorities to direct government and private hospitals to keep an eye on suspected cases.

Once a patient shows symptoms of Nipah, the hospitals have to monitor for acute encephalitis syndrome, check all vital parameters, and take a travel history of the patients.

The district hospitals should have an ICU with ventilator facilities and capacity to receive emergency cases, the circular read.

The department asked the districts to furnish a daily outbreak report regarding Nipah virus. It also directed authorities to sensitise health assistants and ASHA workers.
==================
[This is the 3rd case of Nipah virus infection [NVI] in Kerala state this year (2019). It is prudent that surveillance and patient-care capacity have been increased. Last year (2018), as of 17 Jul 2018, a total of 19 Nipah virus (NiV) cases, including 17 deaths, were reported from Kerala state: 18 of the cases were laboratory confirmed, and the deceased index case was suspected to have NVI but could not be tested. The 2018 outbreak was localized to 2 districts in Kerala state: Kozhikode and Malappuram.

The exact circumstances under which this or the previous confirmed Nipah virus cases this year (2019) acquired their infections are not stated in the above or in previous reports, nor is it stated whether these individuals had contact with flying fox fruit bats (_Pteropus giganteus_), the reservoir hosts of Nipah virus, or fruit that the bats may have contaminated. It is interesting to note that 12 of 36 fruit bats tested at the National Institute of Virology were positive for Nipah virus. Although Kerala health minister KK Shailaja officially had declared Ernakulam district Nipah-free, it may have been free of human cases but is unlikely to have been free of the virus in _Pteropus giganteus_ fruit bats. - ProMED Mod.TY]

[Maps of India:
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Bihar Health Minister Mangal Pandey on [Sat 30 Nov 2019] said the state government is doing its best to save children, as the death toll due to acute encephalitis syndrome [AES] in Muzaffarpur mounted to 73.

Pandey said doctors and nurses are being called in from Patna for additional help. "We are trying everything and anything that can save children's lives. Everything is being made available from medicines to doctors. We have even called doctors and nurses from AIIMS in Patna," he said. "There is a protocol regarding what kind of medicines and facilities should be given and we are doing the same. We are monitoring things regularly and trying to save our children."

Recalling the situation that prevailed 5 years ago, Pandey said a team that was formed to ascertain the cause of this disease concluded that sleeping empty stomach at night, dehydration due to humidity and eating lychee on empty stomach were some of the causes of encephalitis.

"Our government has tried to spread awareness which will be beneficial as well. Advertisement in newspapers, radio jingles, pamphlets and mic [microphone] announcements are going to spread awareness regarding the disease. Health ministry is also working on it," he said.

On being asked about spread of ASE in Gorakhpur last year [2018], he said, "From Gorakhpur to Muzaffarpur region, this disease had spread last year and the Union government had worked on this and we will continue to fight it now."

"This incident in Muzaffarpur is very saddening and we also feel bad when children of our nation die like this. Not the whole district is affected but a large part is suffering from it," he added.

From [1 Jan 2019], until now [5 Dec 2019], 220 children were admitted in Sri Krishna Medical College and Hospital in Muzaffarpur due to AES, out of which 62 lost their lives.

As per the data of SKMCH hospital, 235 children were admitted, of which 89 died; in 2013 - 90 children were admitted, of which 35 died; in 2014 - 334 children were admitted, of which 117 died; in 2015 - 37 children were admitted, of which 15 died; in 2016 - 31 children were admitted, of which 6 died; in 2017 - 44 children were admitted, of which 18 died; and in 2018 - 43 children were admitted, of which 12 died.

Meanwhile, Minister of State for Union ministry for home affairs, Nityanand Rai, visited Sri Krishna Medical College and Hospital to review the situation after the outbreak of AES.

Encephalitis is a viral disease, which causes mild flu-like symptoms such as high fever, convulsions and headaches and has been claiming lives in the district for the past few weeks.
======================
[The dates within which these AES cases have occurred is not stated. The urgency that has prompted Behar health officials to request the aid of physicians and nurses from adjoining Patna suggests that the AES outbreak is going on currently. The uncertainty about the etiology of AES continues. It is curious that the above report makes no mention of negative or positive tests for Japanese encephalitis among the AES patients, although that virus is endemic in northeastern India, including Bihar state. Neighboring Uttar Pradesh state has had JE cases as well this summer (2019) but has intensified its JE vaccination program.

The issue of the aetiology of AES has been under discussion for a long time. Lychee fruit contain toxins. Encephalopathy and hypoglycaemia have been associated with consumption of lychee fruit contains phytotoxins, specifically alpha-(methylenecyclopropyl)glycine (see ProMED-mail archive no. http://promedmail.org/post/20150201.3132842). However, the current cases cannot be due to lychee consumption, since the season for that fruit has passed.

AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in AES, but existing surveillance for AES does not include routine testing for dengue. Until the etiology (or etiologies) of these AES cases is determined, effective and efficient prevention of these cases will not be possible.

Reference:
Ravi V, Hameed SKS, Desai A, et al. Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. Int J Infect Dis 2019;84 Suppl:19-24. <https://doi.org/10.1016/j.ijid.2019.01.008>.

Available at:

[Maps of India:
HealthMap/ProMED maps available
at:<http://healthmap.org/promed/p/364>, and Bihar, India:
Date: Thu 5 Dec 2019 6:11 PM EET
Source: Enab Baladi [edited]

[Leishmaniasis] is spreading widely among residents of Deir ez-Zor, and especially children. Some of the areas affected are controlled by the Kurdish self-administration while others are under the control of the Syrian regime. Medical sources counted hundreds of infected civilians and confirmed the disease's rapid spread.

According to Atef al-Tawil, a manager of the Leishmania & Environmental Health Programme at the Syrian regime's Ministry of Health, most infections in eastern Deir ez-Zor are spread among school children.

In a Facebook comment on a post by Twasol agency, al-Tawil claimed that cases of leishmaniasis were detected, at the end of November [2019], in primary schools in eastern Deir ez-Zor and its surrounding villages (al-Jalaa, al-Salihiyah, al-Tawtha, al-Abbas, al-Mujawdeh, al-Hasarat, al-Saial, al-Ghabrah).

According to al-Tawil, 455 infections of children were detected. A treatment team of 10 members was formed in the affected locations, to help control the disease to aid in early detection.

The Syrian Ministry of Health acted after several appeals by civilians residing in the area as they noticed the disease spreading among their children. Al-Tawil said that this rapid spread was due to the fact that all the infected people have lately returned to their original areas which lack medical centers.

Autonomous administration areas
-------------------------------
According to Euphrates Post network, leishmaniasis is also widely spread in areas controlled by the Syrian Democratic Forces (SDF). In its post on [Sun 1 Dec 2019], the network claimed that the spread of leishmaniasis is mostly concentrated in the eastern countryside of Deir ez-Zor.

According to the network, unofficial statistics by the SDF-affiliated local council shows more than 7000 leishmaniasis infections among children in al-Baghouz, Hajin, Diban, al-Sha'afa, al-Kishkiye, Abu Hamam, and Gharanij. The local councils' attempts of controlling the disease are still substandard, according to the Euphrates Post.

The network also quoted doctors and nurses calling for international organizations to interfere and provide hospitals and clinics with the required vaccine [there is no vaccine for leishmaniasis; ed.], and to train specialized medical staff in each clinic to deal with the disease.

The autonomous-administration-affiliated media center in Deir ez-Zor also confirmed the spread of leishmaniasis and pointed out that the authorities took actions, by the end of November [2019], to provide treatments.

According to the media center, special medical teams and cadres were distributed among the clinics to provide 12,000 ampoules of the required [medicine] to treat leishmaniasis with the support of the World Health Organization.

Leishmaniasis is a parasitic disease transmitted by the bite of infected female phlebotomine sandflies -- a very small yellow fly that is active at night and makes no sound when it bites -- and the main cause for its spread is dirt and lack of hygiene.  [Byline: Enab Baladi]
========================
[Deir ez-Zor is east and south of the locations in the previous ProMED reports (see below), indicating further increase in cases of cutaneous leishmaniasis beyond its historical concentration in western Syria (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861536/>) and beyond the area of the MENTOR initiative in northern Syria (<https://wwwnc.cdc.gov/eid/article/24/11/17-2146_article>).

Cutaneous leishmaniasis is endemic in Syria with its reservoir in rodents. It has been a problem throughout the Syrian civil war and in ISIS controlled areas during the war due to a breakdown in rodent and vector control. - ProMED Mod.EP]

[Maps of Syria:
Date: Tue 3 Dec 2019
Source: Twitter feed in Arabic [machine trans., edited]

Taiz health official: 24 laboratory-confirmed cases of West Nile virus and more than 300 suspected cases. #Republic_Yemen
===================
[Any information on the actual number of WNV cases, their lab confirmation, and public health response activities in this regard will be highly appreciated. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Yemen: