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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: 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.
Date: Tue 13 Aug 2019
Source: Outbreak News Today [abridged, edited]

Kenya is reporting a large outbreak of the parasitic disease, visceral leishmaniasis (Kala Azar). Since January through the 1st week of August (2019), a total of 1986 cases of leishmaniasis have been reported from Marsabit, Wajir and Garissa counties. Marsabit County has been hit the hardest, reporting 1716 suspected cases with 19 deaths. Overall in Kenya, 27 deaths have been recorded.

Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. Leishmaniasis has several different forms.

Visceral leishmaniasis (VL) is the most serious manifestation, which affects some of the internal organs of the body (such as the spleen, liver, and bone marrow). VL is predominantly transmitted through the bite of an infected female phlebotomine sand fly, although congenital and parenteral transmissions (through blood transfusions and needle sharing) have been reported.
=====================
[Visceral leishmaniasis in Kenya is caused by _L. donovani_, and transmission is believed to be mainly anthroponotic (Alvar J, Velez ID, Bern C, et al., and the WHO Leishmaniasis Control Team. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 2012;7(5):e35671; supporting information S50: <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0035671>).

A recent study (Al-Salem W, Herricks JR, Hotez PJ. A review of visceral leishmaniasis during the conflict in South Sudan and the consequences for East African countries. Parasit Vectors 2016;9:460. <https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-016-1743-7>) concluded that there was a "strong relationship between civil unrest and VL epidemics".

Marsabit is a town in the northern Marsabit County in Kenya. It is situated in the former Eastern Province and is almost surrounded by the Marsabit National Park and Marsabit National Reserve (<https://en.wikipedia.org/wiki/Marsabit>). - ProMED Mod.EP]

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Chile

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

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

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

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

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

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

For the latest security information, Americans traveling abroad should regularly monitor the Department's web site where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Crime rates are low to moderate throughout Chile and are moderate in Santiago, Valparaiso, and other major cities.
American citizens visiting Chile should be as careful in cities as they would be in any city in the United States.
There have been few violent crimes committed against Americans.
However, American tourists are at a heightened risk for pick-pocketing, purse or camera snatching, and theft from backpacks and rental cars.
Such crimes have been reported in all areas of Chile frequented by tourists.
In Santiago, visitors should be especially alert to the possibility of crime at the Plaza de Armas and the Mercado Central; at major hotels and restaurants in the Las Condes, Vitacura, and Providencia areas, and in the Suecia and Bellavista entertainment districts.
In Valparaiso, visitors should be especially alert in the port and adjoining tourist areas.
Tourists using taxis in Santiago should be alert to possible scams involving currency switching.
Tourists should also be especially alert while using public transportation, such as the Santiago Metro Subway and public buses and while in the vicinity of Metro stations and bus terminals. The emergency number for the police (Carabineros) is 133.

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

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

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

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRI (1-877-394-8747) or from the CDC’s web site http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at www.who.int/en.
Further health information for travelers is available at www.who.int/countries/chl/en/.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Chile.

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

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

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

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

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

Travel News Headlines WORLD NEWS

Date: Mon, 4 Nov 2019 23:47:26 +0100 (MET)

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

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

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

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

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

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

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

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

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

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

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

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

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

- Astronomy heaven -
Benefitting from a totally clear sky for most of the year, northern Chile is home to some of the world's most powerful telescopes.   The construction of the planet's biggest telescope was launched in May 2017 in the Atacama desert by ESO, the European Organisation for Astronomical Research in the Southern Hemisphere.
Date: Sat, 5 Oct 2019 03:30:17 +0200 (METDST)
By Giovanna FLEITAS

Petorca, Chile, Oct 5, 2019 (AFP) - For Erick Hurtado, the worst thing about the drought that has devastated his family farm in Chile is the dead animals.   "Going out and seeing the animals dead on the ground is so horrible," Hurtado says as he gazes across the dusty paddocks of his farm in Petorca, near the coastal city of Valparaiso.

Farmers are counting the cost of one of the driest austral winters in six decades, which has destroyed crops and left tens of thousands of farm animals dead in the fields of central Chile.   Hurtado's farm, owned by his grandfather, has lost half its 60 head of cattle.   So far, 106,000 animals have died due to lack of water and fodder, mostly goats, cattle and sheep, according to the agriculture ministry.   President Sebastian Pinera, who last month announced a $5 billion plan to improve water distribution, this week set up a crisis group of government agencies to tackle the water crisis, which he said had become "more extensive and more intense."

In Colina, north of the capital Santiago, the drought has been hard on small farmers. Scrawny cattle pick at sprigs of strawy grass on pastures that have turned to dust. Cows, goats and horses roam hungry on hills have turned to a dry muddy brown.   "The drought has been disastrous for us," said Sandra Aguilar. Her family owned about a hundred head of cattle. Today, only half survive thanks to a trickle of water provided by a neighbor who still has some reserves.   "The situation is complicated," said Javier Maldonado, governor of the province of Chacabuco, where several agricultural areas have been hit particularly hard by the drought.    "We have to be realistic, climate change is here to stay," he said.

- Water shortages -
Dominga Mondaca points out the deep fissures that run through the garden behind her house in the village of La Ligua near Valparaiso. The garden used to be full of strawberries and citrus trees; now it's cracked earth.    "We have had many years with little water. But the last year, it didn't rain at all," said the 73-year-old, one of more than 600,000 people the government is supplying by tanker trucks as part of emergency measures.   She says she has had to give up raising chickens, in order to keep what little water she and her husband receive for their own consumption, washing and cleaning. Whatever is left, she uses to sprinkle on herbs in a small kitchen garden.   The agriculture ministry says 37,000 family farms need assistance in the central Chile.

- Thirsty avocados? -
In Petorca, some rivers have run dry, and the landscape has been left parched, but lush avocado and citrus plantations are nevertheless thriving.   Locals in Petorca say the real, long-term problem is the mismanagement of water resources.    "There is an excess of monoculture plantations that consume all the water," said Diego Soto of the Movement for the Defense of Access to Water, Land and Environmental Protection (MODATIMA) told AFP.   Avocados need a lot of water to grow, said Soto.   "An avocado tree needs 600 liters of water per week, whereas humans consume 50 liters a day, or 350 liters a week," he said.   Producers refute these figures and say the real problem is a lack of infrastructure to store water, both above and below ground.    "The avocado is not a crop that needs more water," insisted Francisco Contardo, chairman of the local producers' committee.   Avocados are a key export for Chile, mostly to the US and China, but drought has reduced exports by 25 percent.

- Less snow -
For many though, the changes being wrought by climate change are overwhelmingly obvious. Snow in the highlands of central Chile was relatively scarce this year.    Scientists predict an average decrease of between five and 10 percent snowfall every 10 years in almost the entire Andes mountains, one of the country's main sources of water.   "The central zone of Chile is highly dependent on the summer melt season, its snow and glaciers, which means that if the snow cover is reduced, there is also a reduction in the availability of water resources," said Paul Cordero, climate change expert at the University of Santiago.   Weak snowfall forced the country's main ski resorts to use artificial snow machines much earlier and more often this season than in previous years.    "Chile has been living as if it were a country with an abundance of water," said Pinera.   "Climate change and global warming have changed this situation probably forever."
Date: Sun, 29 Sep 2019 19:26:18 +0200 (METDST)

Santiago, Sept 29, 2019 (AFP) - A 6.8 magnitude earthquake struck in the Pacific off the coast of Chile on Sunday, the United States Geological Survey (USGS) said.   "There is a low likelihood of casualties and damage," the USGS said of the earthquake, which it earlier reported as a magnitude 7.2, and which occurred 41 miles (66 kilometres) west-southwest of Constitucion, Chile.   Chile's National Seismological Center (CSN) put the quake at 6.6 magnitude.

Despite the tremor's strength, there were no reports of injuries, impacts to basic services or damage to infrastructure, according to Chile's National Emergency Office (ONEMI).   There were also no tsunami warnings, advisories, watches or threats in the wake of the earthquake, according to the US Tsunami Warning System.   Chile is one of the world's most earthquake-prone countries.   The 1960 Valdivia earthquake in Chile was, at 9.5, the strongest ever recorded on the magnitude scale, according to the USGS.   Chile lies on the Ring of Fire -- an arc of fault lines that circles the Pacific Basin and is prone to frequent earthquakes and volcanic eruptions.
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Bahrain

Bahrain - US Consular Information Sheet
June 27, 2008
COUNTRY DESCRIPTION:
Bahrain is a hereditary kingdom governed by the Al-Khalifa family. In 2002, the country adopted a new constitution that reinstated a parliament, which consists of o
e elected and one appointed chamber. Islamic ideals and beliefs provide the conservative foundation of the country's customs, laws and practices. Bahrain is a modern, developed country and tourist facilities are widely available. The capital is Manama. Read the Department of State Background Notes on Bahrain for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required. Passports should be valid for at least six months after the date of arrival. U.S. passport holders outside of Bahrain may apply and pay for a two-week tourist visa online through the Bahraini government web site at http://www.evisa.gov.bh, or may obtain it upon arrival at the airport. U.S. diplomatic passport holders receive a no-fee two-week visa. Prior to travel, visitors may obtain five-year multiple-entry visas valid for stays as long as one month from Bahraini embassies overseas. Bahrain assesses heavy fines on visitors who fail to depart Bahrain at the end of their authorized stay. The amount of the fine is determined by a formula related to the visa type, duration, and location of issuance. An exit tax is included in the ticket price for flights out of Bahrain, and no additional exit fees are required upon departure. Residents of Bahrain who intend to return must obtain a re-entry permit before departing. For further information on entry/exit requirements, travelers may contact the Embassy of the Kingdom of Bahrain, 3502 International Drive NW, Washington, DC 20008, telephone (202) 342-1111; or the Bahrain Permanent Mission to the U.N., 2 United Nations Plaza, East 44th St., New York, NY 10017, telephone (212) 223-6200. Visit the Embassy of Bahrain web site at www.bahrainembassy.org for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Americans in Bahrain should maintain a high level of security awareness. Spontaneous demonstrations take place in Bahrain from time to time in response to world events or local developments. We remind American citizens that even demonstrations intended to be peaceful can turn confrontational and possible escalate into violence. American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations. American citizens should stay current with media coverage of local events and be aware of their surroundings at all times. Information regarding demonstrations in Bahrain can be found on the U.S. Embassy Manama’s web site at http://bahrain.usembassy.gov/information_for_travelers.html.

Visiting U.S. citizens should register with the U.S. Embassy in Manama upon arrival. The Department of State remains concerned about the possibility of terrorist attacks against U.S. citizens and interests throughout the world. Americans should maintain a low profile, vary routes and times for all required travel, and treat mail and packages from unfamiliar sources with caution. In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of the objects to local authorities. Please report any security concerns to the U.S. Embassy's Regional Security Office at telephone (973) 1724-2700 during office hours or (973) 1727–5126 after hours.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. 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 security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
The crime rate in Bahrain is low and violent crime is rare. However, burglary, petty theft, and robberies do occur. Visiting Americans are urged to take the same security precautions in Bahrain that one would practice in the United States. Hotel room doors should be locked when visitors are in their rooms, and travelers are encouraged to store valuables in hotel room safes when they are available. Women are encouraged to keep their purses firmly under their arms, and men should avoid keeping their wallets in their hip pockets while in the old market area. The U.S. Embassy in Manama recommends that travelers using local taxis insist on the use of a meter since unexpectedly high fares may otherwise be charged. Bahrain has a professional police force, and visitors are encouraged to contact the police if problems are encountered.

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 U.S. Embassy. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy for assistance. The Embassy staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how to transfer funds. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Bahrain is 999.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Basic modern medical care and medicines are available in several hospitals and health centers in Bahrain. Two government hospitals, several private hospitals, and numerous private clinics located throughout the country offer a wide range of medical services. Cardiac care, general surgery, internal medicine, obstetrics, gynecology, pediatrics, orthopedics and dentistry services are readily available, as are x-rays, CT-scan and MRI testing. The government hospitals house both trauma and ICU units. Pharmacies are common throughout Bahrain and carry a wide range of medications. Prescriptions are normally required.
Payment at all medical facilities is due at the time of service. Some hospitals have limited direct billing capability for certain insurance carriers. Billing and insurance practices vary among the medical facilities.

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

Travel by road in Bahrain is generally safe although unsafe driving practices are common. Highways and major roads in the northern third of Bahrain are four to six lanes wide and well maintained; roads in villages and older parts of Manama and Muharraq are narrow and twisting. As in the United States, traffic in Bahrain moves on the right. Roundabouts (traffic circles) follow the British system, with those automobiles within the traffic circle having right of way over those attempting to enter. Although the Bahraini penal code calls for fines of up to 100 dinars ($270.00) or imprisonment of up to six months for driving above posted speed limits, it is not uncommon for drivers to drive well over the posted speed limits of 50-120 km per hour. The law allows the police to detain drivers for traffic violations until they can appear before a magistrate. It is illegal to use a cell phone while driving.

Under Bahraini law, any sign of having consumed alcohol may be taken as prima facie evidence of driving under the influence, which can lead to imprisonment and/or fines of up to 1,000 Bahraini Dinars (2,700 U.S. dollars). Except for minor accidents, drivers may not move their vehicles after an accident until a report has been filed with the traffic police. This is true even in cases of single-car accidents. Insurance companies may not provide coverage if the cars are moved. However, drivers involved in minor, non-injury accidents no longer need to wait at the scene for the police. Individuals should get their vehicles off the road to avoid further accidents. Drivers can call the accident hotline at 199 (if there are no injuries) or 999 (when someone is injured) where they will be directed to one of five centers to file the accident report. This report must be filed within 24 hours of the accident. Both drivers may be prohibited from leaving the country until the matter is resolved if an accident results in legal proceedings. The main switchboard at the traffic department is 1787-2222.
Emergency numbers are as follows:
Fire/Ambulance/Police: 999
Traffic/Accidents: 199 (no injuries) OR 999 (injuries)
Please refer to our Road Safety page for more information. Visit the web site of Bahrain’s national authority responsible for road safety at http://www.traffic.gov.bh/main.htm.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bahrain, the U.S. Federal Aviation Administration (FAA) has not assessed Bahrain’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Individuals subject to Bahraini court orders arising from indebtedness, labor disagreements, or other legal disputes may be prevented from departing Bahrain until their cases are resolved. Instances have occurred in which departure was prohibited for several years, since the legal process can be both lengthy and complex. The Consular Section of the U.S. Embassy in Manama maintains a list of local attorneys capable of representing Americans.
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. Persons violating Bahrain’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for breaking the law can be more severe than in the United States for similar offenses. Disrespect to officials in word or deed can result in heavy fines. Travelers who are driving should be aware that one drink may be sufficient grounds for a DUI arrest. Penalties for possession, use, or trafficking in illegal drugs in Bahrain 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 Bahrain 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 Bahrain. 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 Bldg. 979, Road no. 3119, Zinj District (next to Al Ahli Sports Club). The mailing address is P.O. Box 26431, Manama, Bahrain. The telephone number is (973) 1724-2700. The after-hours number is (973) 1727-5126. The Consular Section’s fax number is (973) 1725-6242. The Embassy's web site, which includes consular information and the most recent messages to the American community in Bahrain is at http://bahrain.usembassy.gov/. The workweek in Bahrain is Sunday through Thursday.
* * *
This replaces the Country Specific Information for Bahrain dated November 23, 2007 without substantive changes.

Travel News Headlines WORLD NEWS

Date: Mon, 2 Oct 2017 19:26:47 +0200

Dubai, Oct 2, 2017 (AFP) - A "terrorist explosion" during a Shiite procession commemorating Ashura lightly wounded five policemen on Monday, the interior ministry in Sunni-ruled Bahrain announced.   "A terrorist explosion caused five light injuries among policemen deployed as security for a procession along Budaiya Avenue" in western Manama, a tweet from the ministry said.

Shiites in the tiny Gulf kingdom mark Ashura with processions in Manama and in villages around the capital.   The annual Ashura commemorations mark the killing of Imam Hussein by the forces of the Caliph Yazid in 680 AD -- a formative event in Shiite Islam.   Imam Hussein's death was part of a dispute over who should succeed the Prophet Mohammed, which eventually developed into a bitter schism between the Sunni and Shiite branches of Islam.

Bahrain, home to the US Fifth Fleet, has seen sporadic violence since the repression in 2011 of a protest movement by the Shiite majority, demanding a constitutional monarchy and an elected prime minister.   Hundreds of protesters, mainly but not all Shiites, were arrested and sentenced to lengthy prison terms for their role in the demonstrations.   Bahrain says it does not discriminate towards the country's Shiites, and regularly accuses Shiite Iran of meddling in its internal affairs, an allegation Tehran denies.
Date: Sun, 26 Feb 2017 20:11:48 +0100

Dubai, Feb 26, 2017 (AFP) - Four Bahraini policemen were wounded in a bomb attack Sunday near the village of Jaw, south of the capital Manama, the interior ministry said.   "Terrorist blast in police bus near Jua village. 4 policemen injured and they are in a stable condition. Necessary steps are being taken," the ministry said on its Twitter account.   It gave no further details.

On January 1, gunmen attacked the prison in Jaw, killing a policeman and allowing 10 inmates to escape.   Shiites convicted over anti-government protests in Sunni-ruled Bahrain were held at Jaw.   Tiny but strategic Bahrain, home to the US Fifth Fleet, has been rocked by unrest since the authorities crushed Shiite-led protests in 2011 demanding a constitutional monarchy and an elected prime minister.

Hundreds of Shiites have been arrested and many have faced trials over their role in the demonstrations.   One of those on trial is Sheikh Issa Qassem, the country's Shiite spiritual leader.   He was stripped of his citizenship last year for "serving foreign interests" -- a reference to Shiite Iran.   On Sunday, clashes broke out between security forces and protesters in several Shiite villages as a new hearing in Qassem's case was underway, witnesses said.   Protesters chanted anti-government slogans and carried portraits of Qassem, they said.
Date: Wed, 15 Feb 2017 11:55:11 +0100

Dubai, Feb 15, 2017 (AFP) - An explosion wounded two civilian passers-by in Bahrain, the interior ministry said early Wednesday, as demonstrators were marking the sixth anniversary of an anti-government uprising that was bloodily suppressed.   The ministry did not say what caused Tuesday evening's blast in a village outside the capital Manama but demonstrators sometimes throw petrol bombs during the sporadic protests that still grip the Sunni-ruled but Shiite-majority kingdom.   "Terrorist blast in Sitra causes minor injuries to a married couple passing the site. Police at the scene," the ministry said on its Twitter account without elaborating.   It also tweeted a picture of a black 4X4 with a shattered windscreen and significant damage to the front bonnet.   The blast came as demonstrators clashed with police in Manama and several nearby villages.   The demonstration in the capital ended when police fired tear gas and stun grenades, witnesses said.

Activists posted pictures of injured protesters online, but the interior ministry has not published any official statements about the reported demonstrations.   The Shiite-led protests of February 2011 sought a constitutional monarchy and an elected prime minister to replace the current government dominated by the ruling Al-Khalifa family.   Authorities crushed them the following month with the support of Saudi-led forces who secured key installations.   Since then, the authorities have banned the Shiite opposition and handed long jail terms to many of its leaders. Some have been stripped of their citizenship.   Tiny but strategic Bahrain lies just across the Gulf from Iran and is home to the US Navy's Fifth Fleet.
Date: Thu, 19 May 2016 21:53:48 +0000
From: Dr Manaf Alqahtani <drmanaf@gmail.com> [edited]
BDF Hospital, Bahrain
-----------------------------------
Measles is a highly infectious virus that spreads easily from person to person through the air, through breathing, coughing and sneezing. Although measles is largely considered a disease of children, we have noticed increasing numbers of adults infected. Since 9 May 2016, we had a total of 7 cases with measles. 4 were adults (30-40 years old) and 3 children (less than 12 months old). All adults were Bahraini (3 originally born in Yemen and one in Pakistan). All of the adults either have no documentation of MMR or received one dose MMR only.

Regarding the 3 children with measles, all were non-vaccinated and got infected from their infected adult family member.

3 out of 7 cases needed to be admitted for hydration and symptomatic treatment. Luckily, all our HCWs [health care workers] have documented 2 doses of MMR.

In the 2014 measles outbreak in Bahrain, 32 cases were registered, of which 27 were among children under 15 years and 5 among adults. Of the total, 14 cases were detected among expatriates.

Bahrain and the other member states of the EMR [Eastern Mediterranean Region] adopted a resolution for elimination of measles from the region by 2010. In 1996, the Ministry of Health (MOH) developed a plan for measles elimination that included a revised measles immunization schedule, introduction of case-based surveillance, and annual immunization campaigns of school children.

Most of recent measles cases are imported.
------------------------------
Dr. Manaf Alqahtani
BDF Hospital
Bahrain
=================
[ProMED thanks Dr. Alqahtani for sending this information.

Also see: JS Jawad et al. Toward Measles Elimination in Bahrain -- A Middle East Country Experience. The Journal of Infectious Diseases 2011;204:S299-S304

"Abstract
---------
Measles was a leading cause of infant and child morbidity and mortality in Bahrain before the introduction of measles vaccine in 1974. With the establishment of the Expanded Program on Immunization (EPI) in 1981 and the introduction of a 2nd dose of measles vaccine in 1985, coverage for 1st and 2nd doses of measles vaccine increased to 94 percent by 1997 and has been sustained greater than 97 percent since 2001. Measles, mumps, and rubella (MMR) immunization campaigns targeting 12-year-old students were conducted annually during 1998-2006 and achieved coverage of greater than 95 percent. As a result, the incidence of measles in Bahrain has declined markedly over the past 4 decades, to 2.7 cases per million persons in 2009. Recent confirmed measles cases have occurred sporadically, in under-vaccinated children or in infants too young or adults too old to receive measles vaccine. Bahrain has made significant progress toward measles elimination by sustaining high immunization coverage and strengthening case-based measles surveillance activities. Further success will depend on improved identification and immunization of under-vaccinated expatriate workers and their families."

A map of Bahrain can be accessed at <http://healthmap.org/promed/p/127>.
Bahrain is an archipelago in the middle of the Arabian Gulf encompassing 33 islands, the largest of which is Bahrain Island. - ProMED Mod.LK]
Date: Fri 6 Nov 2015
Source: Reuters [edited]

A cholera outbreak in Iraq has spread to Kuwait and Bahrain, and risks turning into a region-wide epidemic as millions of pilgrims prepare to visit the country, UNICEF's Iraq director has said. The disease, which can lead to death by dehydration and kidney failure within hours if left untreated, was detected west of Baghdad in September 2015 and has since infected at least 2200 people in Iraq and has killed 6.

"It [the outbreak] already has a regional dynamic and the risk of that can only be increased by people from all over the region coming into Iraq," UNICEF country director, Peter Hawkins, said on Thu 5 Nov 2015. Hawkins said cholera had spread to Bahrain, Kuwait and Syria, but in a later statement, UNICEF said the cases in Syria were not confirmed: "However, given the scale of the outbreak in Iraq the risk of cholera spreading across Iraq's borders remains high," it said.

Millions of Shi'ite Muslims are due to visit Iraq in December for Arbaeen, a religious ritual marking the end of an annual mourning period for the Prophet Mohammad's grandson Hussein, whose death in 680 AD entrenched the schism between Shi'ites and Sunnis.

Hawkins said UNICEF was working with clerics in the Shi'ite shrine cities of Najaf and Kerbala to convey information about how to guard against cholera, which is endemic in Iraq and the wider region. The outbreak can be traced to a number of factors including low water levels in the Euphrates and winter flooding that has contaminated the river and shallow wells with sewage water.

The war against [the so-called] Islamic State militants who control large swathes of territory in northern and western Iraq has also contributed to the outbreak. The conflict has displaced more than 3 million people, with many living in camps where conditions are conducive to the spread of cholera -- a bite of contaminated food or a sip of contaminated water is enough to cause infection.

Hawkins said UNICEF has only limited access to areas controlled by Islamic State, which swept across the Syrian border in mid-2014 in a bid to establish a modern caliphate.

Higher military expenditure and other costs associated with the battle against Islamist militancy has aggravated a cash crunch for Iraq, a major OPEC oil producer that has suffered from the drop in global crude prices over the past year. A higher proportion of the government budget is also being spent on security at the expense of other services and infrastructure such as water supply, Hawkins said.

1 in 5 of the confirmed cases in Iraq is among children, and in large parts of the country the start of the school year was delayed by a month as a precaution, UNICEF said in a statement. In response to the outbreak, UNICEF is providing bottled water, oral rehydration salts and installing community water tanks, but like most humanitarian operations in Iraq it is severely underfunded.  [byline: Isabel Coles]
=====================
[The conflicts in the Middle East have exacerbated the endemic cholera in Iraq, and it has spread beyond Iraq's borders. The number of cases of cholera in Kuwait and Bahrain are not reported, nor is it clear whether the cases were acquired in these countries or imported. UNICEF has not confirmed any cases in war-torn Syria, but there are informal reports circulating. - ProMED Mod.LL]

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

World Travel News Headlines

Date: Tue, 12 Nov 2019 13:10:01 +0100 (MET)
By Holly ROBERTSON, Andrew BEATTY, with Daniel De Cartert in Hillville

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Several radio stations in the Mambasa area say they have stopped broadcasting anti-Ebola messages because of intimidation.   On November 2, Lwemba broadcaster Papy Mahamba was killed at his home by unidentified men. His wife was injured and their house set ablaze.    The station said the authorities had failed to take action against the threats. It said it would resume broadcasts after "the state has restored authority in the area".
Date: Mon, 11 Nov 2019 11:38:15 +0100 (MET)

Kuwait City, Nov 11, 2019 (AFP) - Hundreds of workers at Kuwait's international airport held a one-hour strike Monday to demand better working conditions, threatening to stage longer walkouts in the coming days.    Ahmed Mohammed al-Kandari, a union representative, said workers were calling for improved treatment and to be compensated for daily exposure to pollution and noise.  Monday's strike by Kuwaiti staff did not affect flights, officials said.   The right to strike is guaranteed for citizens in Kuwait, but such actions remain rare in the Gulf country.

Foreign workers do not have the right to strike.  "Airport traffic is very normal," Sheikh Salman Al-Hamoud Al-Sabah, head of the General Directorate of Civil Aviation, told AFP.    Another official, Saleh Al-Fadaghi, the airport's director of operations, also said flights were not affected. "During the one-hour strike, 19 flights were operated as scheduled. There were five departures and 14 arrivals," he told AFP.

Kandari said the purpose of the strike was not to disrupt operations but "to make our voices heard". He added that Kuwaiti workers would hold a further two-hour strike on Wednesday and a 24-hour strike on Sunday if their demands are not met.    Of 4,500 civil aviation employees, 1,500 took part in Monday's strike, he said.
Date: Mon, 11 Nov 2019 10:39:09 +0100 (MET)

La Jonquera, Spain, Nov 11, 2019 (AFP) - Catalan separatist activists blocked traffic on Monday on a motorway linking Spain and France, in a fresh protest against the sentencing last month of nine of their leaders to lengthy jail terms.   Demonstrators cut the AP7 motorway at La Jonquera near the city of Girona in eastern Spain, a day after a repeat general election in which Prime Minister Pedro Sanchez's Socialist emerged as winners but weakened, while far-right party Vox surged to third place on the back of its hardline stance against separatism.   Dozens of vehicles blocked the motorway near the border with France while some 300 people set up a barricade, according to an AFP photographer at the scene.   Some demonstrators began to set up a stage and speakers which they brought to the scene in vans.   Catalonia's regional road department confirmed the motorway was cut in both directions at La Jonquera.

The protest was called by a new, mysterious organisation called "Democratic Tsunami" which last month sent thousands of people to block access to Barcelona airport in a protest which ended in clashes between demonstrators and police.   "This mobilisation is a cry to the international community so that it makes the Spanish state understand that the only possible path is to sit down and talk," the group said in a message sent to its followers on encrypted messaging service Telegram.   Radical separatist group CDR also called on its supporters to head to La Jonquera to block the highway.   Catalonia was rocked by days of mass, sometimes violent, pro-independence rallies after Spain's Supreme Court on October 14 sentenced nine politicians and activists to jail for up to 13 years for their role in a failed secession bid in 2017.   Demonstrators have frequently cut road and rail links between Spain and France while many shops in downtown Barcelona have been shut during the rallies and there are growing concerns about the impact of the unrest on business in Spain's second largest city.
Date: Sat, 9 Nov 2019 18:59:25 +0100 (MET)

MOUSOUNI ISLAND, India, Nov 9, 2019 (AFP) - Cyclone Bulbul hit India and southern Bangladesh on Saturday, leaving two dead as authorities in the countries ordered more than two million people to get out of the path of the storm.   The cyclone, packing winds of up to 120 kilometres (75 miles) per hour, has "weakened" and "started crossing" India's West Bengal and Bangladesh's Khulna coast at about 9:00 pm (1500 GMT), Dhaka's Meteorological Department said in a special bulletin.   "It is likely to move in a northeasterly direction" and "weaken gradually, and may complete crossing West Bengal-Khulna coast by midnight tonight," the department said.     Airports and ports were shut down and the deaths were reported before the full force of the cyclone had hit.   One person was killed by an uprooted tree in Kolkata and another by a wall that collapsed under the force of the winds in Odisha state, authorities said.

More than 60,000 people were moved away from the coast on the Indian side of the border.   Bangladesh disaster management secretary Shah Kamal told AFP that "2.028 million" have been evacuated and moved to more than 5,500 cyclone shelters.   He said there was no reports of casualties and rejected reports in local media that dozens of local fishermen were missing on the southern coast.    Bangladeshi troops were sent to some villages, while about 55,000 volunteers went door-to-door and making loudspeaker announcements in the streets to get people away from the danger zone in villages, many of which were below sea level.

- Ports closed, flights halted -
A storm surge up to two metres (seven feet) was predicted along the coast, Bangladesh's Meteorological Department said.   About 1,500 tourists were stranded on the southern island of Saint Martin after boat services were suspended due to bad weather.   Bangladesh's two biggest ports, Mongla and Chittagong, were closed because of the storm, and flights into Chittagong airport were halted.   In India, flights in and out of Kolkata airport were suspended for 12 hours because of the storm.   On the West Bengal island of Mousouni, which lies in the path of the storm, frightened residents took shelter in schools and government buildings because they had not been able to escape.   Military planes and ships have been put on standby to help in emergencies, Indian authorities said.

Bulbul hit the coast at the Sundarbans, the world's largest mangrove forest, which straddles Bangladesh and part of eastern India, and is home to endangered species including the Bengal tiger and the Irrawaddy dolphins.   Bangladesh's low-lying coast, home to 30 million people, is regularly battered by cyclones that leave a trail of destruction.   Hundreds of thousands of people have been killed in cyclones in recent decades.   While the frequency and intensity have increased, partly due to climate change, the death tolls have come down because of faster evacuations and the building of 4,000 cyclone shelters along the coast.   In November 2007, Cyclone Sidr killed more than 3,000 people. In May this year, Fani became the most powerful storm to hit the country in five years, but the death toll was about 12.
Date: Sat, 9 Nov 2019 14:18:27 +0100 (MET)

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

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

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

Lebanon has since October 17 witnessed an unprecedented popular uprising against everything from power cuts and poor social security to alleged state corruption.   The government yielded to popular pressure and stepped down last month, with the World Bank urging for the quick formation of a new cabinet to prevent the economy from further deteriorating.
Date: Fri, 8 Nov 2019 19:25:02 +0100 (MET)

Madrid, Nov 8, 2019 (AFP) - Spanish health authorities confirmed Friday a case of a man spreading dengue through sex, a world first for a virus which until recently was thought to be transmitted only by mosquitos.   The case concerns a 41-year-old man from Madrid who contracted dengue after having sex with his male partner who picked up the virus from a mosquito bite during a trip to Cuba, said Susana Jimenez of the Madrid region's public health department.

His dengue infection was confirmed in September and it puzzled doctors because he had not travelled to a country where the disease, which causes severe flu-like symptoms such as high fever and body aches, is common, she added.   "His partner presented the same symptoms as him but lighter around ten days earlier, and he had previously visited Cuba and the Dominican Republic," Jimenez said.   "An analysis of their sperm was carried out and it revealed that not only did they have dengue but that it was exactly the same virus which circulates in Cuba."

A "likely' case of sexual transmission of dengue between a man and a woman was the subject of a recent scientific article in South Corea, Jimenez said.   In an e-mail sent to AFP, the Stockholm-based European Centre for Disease Prevention and Control (ECDC), which monitors health and disease in Europe, said this was "to our knowledge, the first sexual transmission of the dengue virus among men who have sex with men."

According to the World Health Organization's website, dengue is transmitted mainly by the Aedes Aegypti mosquito, which thrives in densely-populated tropical climates and breeds in stagnant pools of water.    It is most serious -- and deadly -- in children, especially young girls though scientists don't know why.

Dengue is most commonly caught by people travelling to hotter climates such as southeast Asia, Africa, Australia, the Caribbean and South and Central America.
Date: Sun 10 Nov 2019
Source: The News [abridged, edited]

Another young man is awaiting death in an isolation ward of the Jinnah Postgraduate Medical Centre (JPMC) after developing full-blown rabies, as he was bitten by a rabid dog some 3 months ago but was not administered the rabies vaccine, officials said on Saturday [9 Nov 2019].

"18-year-old Z.K., a resident of Jeva Khan Goth in the Nooriabad area of District Jamshoro, has been brought to the casualty ward of the JPMC with full-blown rabies," Dr Seemin Jamali, the hospital's executive director, told The News.

"According to his family members, the teenager was bitten by a stray dog on the leg around 3 months ago. Unfortunately, neither did the family know about vaccination nor did anybody tell them to get the teenager vaccinated, which resulted in the development of the lethal disease."

Sindh Health Department officials said that this is the 22nd case of rabies in the province this year [2019].

M.K., the ill-fated youngster's father, said that after his son was bitten on the leg, he was taken to a local doctor, who had dressed the wound and given him some medicines but had not asked for the teenager to be vaccinated or referred him to a tertiary-care hospital.

Officials said that right now, dog-bite incidents are on the rise in Karachi as well as in other districts of Sindh, with so far more than 200 000 people falling victim to canine attacks.

They added that the population of rabid dogs is also on the rise, and the animals are not only transmitting the disease to their own species but also attacking humans throughout the province.

Dr Seemin said: "These days any person who is bitten by a dog should be given immunoglobulin as well as the full course of the rabies vaccine to prevent the victim from a painful death. Once rabies is developed in a person, there is no cure for their condition."

She deplored the fact that on the one hand incidents of dog-bite are on the rise and on the other, hospitals in the entire province are facing a shortage of the rabies vaccine, due to which the cases are being referred to the JPMC in Karachi.

"Even the Abbasi Shaheed Hospital, which is considered to be a tertiary-care hospital, is referring dog-bite victims to the JPMC after administering one dose of the vaccine," she said.

"As we don't know the status of their vaccination, we have to vaccinate these patients from zero, but this practice is extremely unprofessional, and it can result in the loss of a precious life."

On the other hand, the shortage of rabies vaccine is becoming a serious issue in Pakistan, especially in Sindh, which requires hundreds of thousands of doses to prevent the people from developing rabies encephalitis.

Pakistan used to get most of its rabies vaccine supplies from Indian biotechnology giants and pharmaceutical companies, but after the deterioration of relations between the 2 countries, Pakistan's next-door neighbour reduced those supplies, while production at the NIH is insufficient to meet the local requirements.

In this scenario, experts say there is an urgent need to control the population of stray dogs in the country by hook or by crook. They believe that at a time when there is not enough rabies vaccine available, the authorities should take measures to save people from canine attacks by reducing the dog population by any means.  [Byline: M. Waqar Bhatti]
=====================
[We have received recently several reports from Pakistan, describing human rabies cases; e.g.
(published 7 Nov 2019),
(published 3 Nov 2019),
(published 15 Oct 2019].

Hopefully, this post will help the professionals involved in getting due attention and required means from the health and municipal authorities for immediate measures undertaken, including timely supply of the required medical preparations.

According to Pakistan's Health Minister, Dr Azra Fazal Pechuho, (on Fri 8 Nov 2019), dog-bite cases were "mishandled" by citizens, as the victims were often brought to hospitals quite late, and the delay caused their deaths (see <https://www.dawn.com/news/1515803>).

WHO's most recent available position paper addressing rabies vaccines and immunoglobulins is available at

[HealthMap/ProMED map available at: