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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: 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:
Date: Thu, 19 Oct 2017 16:37:27 +0200
By Ricardo ARDUENGO, con Nelson DEL CASTILLO en San Juan y Leila MACOR en Miami

Utuado, Puerto Rico, Oct 19, 2017 (AFP) - It's been a month since Hurricane Maria ripped through Puerto Rico and Samuel de Jesus still can't drive out of his isolated, blacked-out town.   In fact, much of the US territory in the Caribbean is still a crippled mess four weeks after that fierce Category Four storm.

The bridge connecting Rio Abajo to the rest of the island was swept away when Maria slammed the island on September 20. For two weeks Rio Abajo, located in a mountainous region in central-western Puerto Rico, was cut off and forgotten, without power or phone service.   "We didn't know what to do. We were literally going crazy," said de Jesus, 35.   "Those were difficult, desperate days. We could not find a way out, and the hurricane caused extensive damage," he told AFP.

During the two long weeks following Maria, the 27 families living in Rio Abajo saw their supplies quickly deplete.   De Jesus, who has diabetes, needed to keep his insulin refrigerated. The storm blew away the island's already decrepit power grid, so people resorted to emergency generators.   "But I was running out of gasoline to run the generator," he said.   A helicopter now makes regular deliveries of food, water and medicine because with the bridge washed out, there is no other way in or out of town.

People can't wade across the river because it is contaminated with human waste after a pipe broke when the bridge went.   Some brave souls use a precarious ladder rigged to get across the water, but for most people it is too dangerous.   We need a bridge "to take out our vehicles and leave in case of emergency, or if there is a landslide," he said.   Where the bridge once stood, residents set up a system of ropes, pulleys and buckets to move supplies over the river, which has been contaminated with sewer water since the hurricane.   Over the remains of the bridge locals hung the single-star, red, white and blue flag of Puerto Rico and a sign that reads "the campsite of the forgotten."

- Desperate need for electricity -
Puerto Rico Governor Ricardo Rossello visited the surrounding municipality of Utuado on Wednesday to deliver supplies, but he did not stop in Rio Abajo.   "Utuado is certainly one of the most severely affected municipalities in all of Puerto Rico," Rossello said.   "Our commitment is to give it support and aid during the whole road to recovery."   Eighty-one percent of Puerto Rico remains blacked out one month after Maria struck. Clean water for drinking, cooking and bathing is scarce, too.

Puerto Ricans' main obstacle to getting back to some semblance of normality is the slowness of the Puerto Rico Electric Power Authority in getting the power grid back up and running.   The lack of power has paralyzed a key industry -- pharmaceutical production -- and most businesses including restaurants are closed or operating at great cost through the use of diesel powered generators.

This nightmare comes about a year after the US government established an external fiscal control board for the island after it declared bankruptcy because of 73 billion dollars in debt.   Economist Joaquin Villamil told AFP that damage from Hurricane Maria is estimated at 20 billion dollars -- four times that of Hurricane Georges in 1998, when measured in 2016 dollars.

Villamil said reconstruction money provided by the Federal Emergency Management Agency and from insurance companies will have a positive impact on the island's economy in the second half of fiscal 2018 and in fiscal 2019, but this boost will just be temporary.   "From an economic point of view there is not much net gain," said Villamil, who works for a consulting firm called Estudios Tecnicos.   He said the economy has been shrinking since 2006 and Maria will delay any prospect of recovery.   It will take at least until 2026 to get back to the GDP level of 2006, he added.

Making things worse, people are leaving the island for the mainland US. Forecasts are that the population now at 3.4 million will go down to 3.1 million or even less by 2026, said Villamil.   The government of Florida estimates that since October 3 -- the day a state of emergency to deal with an influx of Puerto Ricans was declared -- more than 36,000 people from the island have poured in.
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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.
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Ecuador

Ecuador US Consular Information Sheet
November 05, 2008
COUNTRY DESCRIPTION:
Ecuador is a Spanish-speaking country about the size of Colorado.
It has a developing economy and a democratically elected government.
Ecuador is geogra
hically and ethnically diverse.
In general, tourist facilities are adequate but vary in quality.
Ecuador adopted the U.S. dollar in 2000.
Both U.S. coins and Ecuadorian coins, which are equivalent to the value of the U.S. coins, are used.
Read the Department of State Background Notes on Ecuador for additional information.

ENTRY/EXIT REQUIREMENTS:
A U.S. passport with remaining validity of at least six months is required to enter Ecuador. A valid U.S. passport is required to depart Ecuador.
Tourists must also provide evidence of return or onward travel.
U.S. citizens traveling on regular passports for tourism or business do not need a visa for a stay of 90 days or less.
Those planning a longer visit must obtain a visa in advance of arrival.
Travelers who stay in Ecuador beyond the allowed entry time are charged a substantial fee and are barred from re-entering Ecuador for six months from the date of departure.
An airport exit tax is required when departing Ecuador.

U.S. citizens whose passports are lost or stolen in Ecuador must obtain a new passport at the U.S. Embassy in Quito or the U.S. Consulate General in Guayaquil and present it, together with a police report of the loss or theft, to the main immigration offices in those cities prior to arriving at the airport in order to obtain permission to depart.

Ecuador’s exit procedures mandate that minors (under the age of 18) who are citizens or residents of Ecuador and who are traveling alone, with one parent, or with a third party, must present a copy of their birth certificate and written authorization from the absent parent(s) or legal guardian.
When a parent is deceased, a notarized copy of the death certificate is required in lieu of the written authorization.
If documents are prepared in the United States, the authorization and the birth certificate must be translated into Spanish, notarized and authenticated by the Ecuadorian Embassy or an Ecuadorian consulate within the United States.
It is not uncommon for some local authorities to insist these documents be apostilled (authenticated).
Documents must be apostilled by the same State that issued the document.
For a list of State Authentication Authorities go to http://travel.state.gov/about/info/customer/customer_312.html; if documents are prepared in Ecuador, only notarization by an Ecuadorian notary is required.
This paragraph does not apply to children who enter Ecuador with U.S. passports as tourists, unless they hold dual U.S./Ecuadorian citizenship.

For further information regarding entry, exit, and customs requirements, travelers should contact the Ecuadorian Embassy at 2535 15th Street NW, Washington, DC 20009; telephone (202) 234-7166; web page http://www.ecuador.org/; or the Ecuadorian Consulate in Chicago (312) 338-1002/03; fax (312) 338-1004, Houston (713) 572-8731, Jersey City (201) 985-1700, Los Angeles (323) 658-5146; (323) 658-1068; fax (323) 658-1198, Miami (305) 539-8214, New Orleans (504) 523-3229, New York (212) 808-0211, or San Francisco (415) 982-1819.
Visit the Embassy of Ecuador’s web site at http://www.ecuador.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: The U.S. Embassy in Quito advises caution when traveling to the northern border region of Ecuador, to include areas in the provinces of Sucumbios, Orellana and Carchi, northern Esmeraldas, and southern Esmeraldas, south of Atacames.
U.S. government personnel are under limitations with respect to traveling alone and over-nighting in these areas due to the spread of organized crime, drug trafficking, small arms trafficking, and incursions by various Colombian terrorist organizations.
Since 1998, at least ten U.S. citizens have been kidnapped near Ecuador's border with Colombia.
One U.S. citizen was murdered in January 2001 by kidnappers holding him for ransom. Violent crime has significantly increased in 2007 and 2008 with American citizens being victims of crimes, to include but not limited to, homicides, armed assaults, robberies, sexual assaults, and home invasions.
American citizens have also been the victims of violent crime on beaches regardless of whether the beach is a popular tourist destination or remote.

Political demonstrations occur frequently throughout Ecuador for various reasons. Protesters often block city streets and rural highways, including major arteries such as the Pan American Highway. Public transportation is often disrupted during these events. Protesters may burn tires, throw rocks and Molotov cocktails, engage in destruction of property and detonate small improvised explosive devices during demonstrations. Police response may include water cannons and tear gas. U.S. citizens and U.S. affiliated interests are not usually targeted, but U.S. citizens are advised to avoid areas where demonstrations are in progress and to be prepared with backup transportation plans. Although political demonstrations have not been directed at foreigners in the past, visitors are reminded that peaceful demonstrations can turn violent with little or no warning.
Additionally, foreigners are prohibited from protesting in Ecuador and may be subject to arrest for participating in demonstrations of any kind.
Please see the following links for the local information in Quito and Guayaquil's Consular Districts, respectively at http://ecuador.usembassy.gov/security-and-safety/warden-messages.html and http://guayaquil.usconsulate.gov/warden_messages.html . U.S. citizens may also keep informed of daily happenings by following the local news and police reports.

Ecuadorian authorities may declare states of emergency in provinces and regions affected by civil unrest, natural disaster, or other disruptions. During states of emergency, authorities have expanded powers to restore order, including suspension of some constitutional rights, expanded detention powers, and imposition of curfews.

Radicals in various locations in Ecuador, including Quito, Guayaquil, and Cuenca, have occasionally placed small explosive devices that release political literature, known locally as pamphlet bombs. Targets have included local and international businesses and various Government of Ecuador buildings. Although no foreign tourists have been injured in these explosions, American citizens visiting or residing in Ecuador are urged to take common-sense precautions and avoid suspicious looking packages.

U.S. citizens should carry identification at all times, including proof of U.S. citizenship.
Travelers to Ecuador’s beach areas should be aware that strong currents, undertow, and underwater hazards may exist and are not always posted.
Most beaches lack staffed lifeguard stations.

For information on the Galapagos Islands, please see the “Special Circumstances” section of this Country Specific Information.
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:
Crime is a serious problem in Ecuador, and visitors should be alert and cautious.
Non-violent crime is common: hundreds of Americans are robbed every year in Ecuador.
Violent crime has increased in recent years.
Thieves and small gangs armed with guns or knives are now sometimes active even in smaller cities such as Otavalo, Manta, and Cuenca.
Tourists have been robbed at gunpoint on beaches and along hiking trails, including on the well-populated trail to the summit of Pichincha Volcano in Quito.
Incidents of rape have increased, even in well-traveled tourists areas and when the victims traveled in groups for safety. Shootings, kidnappings, and carjackings are still relatively rare, but American citizens have been victimized by those crimes.
The Ecuadorian government has increased police patrols in tourist areas, but travelers should remain alert to their surroundings and maintain constant control of personal belongings.

Travelers should avoid wearing expensive-looking jewelry and watches.
Avoid deserted beaches, hiking trails, and infrequently traveled roads, as well as the interior regions of large city parks, particularly at night. Robberies on public buses are a continuing problem.
The Embassy recommends that visitors use legitimate taxicabs (yellow, with meters) to travel around the larger cities.
Public buses can be dangerous – from both a traffic safety and a personal security point of view.

Pickpockets and other petty thieves are particularly active in public markets, airports, bus terminals, restaurants, and crowded streets.
Backpackers are frequently targeted for robbery and “snatch and grabs”; business travelers carrying laptop computer bags are similarly targeted.
Many travelers who travel by bus store their luggage below the bus, where it is sometimes stolen.
Therefore, we recommend that you do not store your passport in your luggage. Always be aware of your surroundings, and try to not travel alone.
Thefts from vehicles are common.
Do not leave anything of value in plain view in a car, including sunglasses or sports equipment.
Carjackings have occurred in both rural and urban areas.
Visitors are advised to drive with doors locked and windows rolled up.

In Quito, travelers should be particularly alert on the crowded streets of south Quito, at the Panecillo, in Old Quito, and in the areas of El Tejar, Parroquia San Sebastian, Avenida Cristobal Colon, and Gonzalez Suarez.
The U.S. Embassy strongly discourages hiking to the summit of Pichincha as violent crime is sharply rising.
Groups as large as eight have been robbed at gunpoint by masked men; female hikers have been sexually assaulted.
The Mariscal Sucre District is a popular tourist area in Quito with numerous restaurants, bars, hotels, and shopping sites.
Since 1999, U.S. government employees and private U.S. citizens have been victimized there, prompting the U.S. Embassy to put certain bars off-limits and to declare a nighttime curfew in the area for its employees.
Increased police presence and better lighting in prime tourist squares of Old Quito have improved safety, but similar measures in the Mariscal district have not been as effective.

In Guayaquil, take extra caution in the downtown area at night, in the street market area of La Bahia, at the Christ Statue (Sagrado Corazon de Jesus) on Cerro del Carmen, in the airport area, and in the southern part of the city.
The riverfront park area called the Malecon 2000 and the passage up to the lighthouse in the Las Penas area are generally safe and well patrolled although at night caution should be observed.
There have been repeated instances of travelers followed from the airport and intercepted by robbers using two vehicles to cut off the traveler.
There is some evidence that those most at risk are people who appear to be returning from family visits laden with gifts and large amounts of cash.
There have been armed robberies of restaurants and their patrons, including in the fashionable areas of Guayaquil.
Guayaquil has also experienced an increase in kidnappings for ransom, often in connection with hijackings, although tourists have not been targeted.

Criminals sometimes use incapacitating drugs such as scopolamine on unsuspecting tourists in order to rob them.
These so-called date rape drugs are put into drinks in order to drug the unsuspecting victim.
This drug can render the victim disoriented and can cause prolonged unconsciousness and serious medical problems.
Never allow a stranger to “buy” you a drink and never leave your drink unattended.
Several American citizens have reported thefts of property following ingestion of such substances.

Every year, 15 to 20 American citizens are arrested for attempting to traffic drugs between Ecuador and the United States, or between mainland Ecuador and the Galapagos.
Suitcases with false bottoms and other packages are common methods of transporting illegal substances. Many of these citizens claim to have been unaware that they were transporting drugs.
As in any other country, do not accept gifts, packages, or suitcases from other persons; even trusted travel companions have been known to take advantage of their friends and family to traffic drugs through Ecuador’s airports. See the Criminal Penalties section below for more details about Ecuador strict laws and sentences regarding illegal drug trafficking.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm .

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, 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.
Female victims of crime may receive assistance from the Comisaria de la Mujer at Ave. 24 de Mayo y Calle Loja, telephone 593 2 228 4016 or the Oficina de Derechos de la Mujer, Guayanas E-331 y Inglaterra, Quito 593 2 252 9909.
The local equivalent to the emergency line in Ecuador is the same as the U.S., dial “911”. The operators typically speak Spanish only. Victims should also call the Embassy or Consulate to report the crime and for assistance.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical and dental care can be readily obtained in the major cities of Ecuador.
In smaller communities and in the Galapagos Islands services are limited, and the quality is variable and generally below U.S. standards.
Ambulances, with or without trained emergency staff, are in critically short supply.
Acute surgical and cardiac services are not available on the Galapagos Islands.
Serious cases must be evacuated to the Ecuadorian mainland or the United States for treatment.
Pharmacies are readily available in any city.
However, the availability of some medications is sporadic, and formulations and brand names will differ from products available in the U.S.
Narcotics and tranquilizers are extremely limited in availability.
“Pharmacists” sometimes prescribe and dispense medications.
These individuals often have little training and prescribe broad-spectrum antibiotics and other inappropriate medications.
Travelers should not seek their advice.
Folk healers and traditional markets offer herbal and folk remedies which should be avoided as formulations are questionable and some components may interact with other prescription medications.

Travelers to Quito (close to 10,000 feet) and other highland areas may require some time to adjust to the altitude, which can adversely affect blood pressure, digestion, and energy level.
Travelers are encouraged to consult with their personal health care providers before undertaking high-altitude travel.
In particular, travelers with heart or lung problems and persons with sickle cell trait may develop serious health complications at high altitudes.

Scuba divers in the Galapagos Islands should be aware of limited facilities for decompression.
A privately owned decompression chamber is available on Santa Cruz Island in the Galapagos Islands.
The Ecuadorian Navy operates a second decompression chamber at the San Eduardo Naval Base in Guayaquil.
Due to the high costs for these services and associated emergency transportation, divers are advised to obtain adequate medical evacuation and divers insurance.

Travelers should be aware of the presence of malaria, dengue fever, and yellow fever in areas of Ecuador below 4,500’ elevation.
Historically there has not been dengue or malaria in the Galapagos archipelago, and yellow fever has only occurred in the Amazon Basin.
Travelers who are on an appropriate anti-malarial drug have a greatly reduced chance of contracting malaria, while vaccine can provide protection against yellow fever.
Avoiding mosquito bites is the only effective prevention for dengue and personal protective measures, such as the use of insect repellents, help to reduce the risk of contracting all of these illnesses.
Travelers who become ill with a fever or flu-like illness while traveling in a high-risk area, and for up to one year thereafter, should seek prompt medical attention.
For additional information on malaria or dengue, protection from insect bites, and anti-malarials, consult the Center for Disease Control and World Health Organization web sites listed below.

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

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

Road travel throughout Ecuador can be dangerous, especially at night.
Many roads are poorly maintained or unmarked.
Heavy rains and mudslides often close or wash out roads.
Heavy fog is common in mountainous areas.
Driving practices differ from U.S. standards.
Inter-urban and inter-provincial bus passengers are often targets of crime, including robbery and sexual assault.

Highways are often unmarked and do not have signs indicating destinations.
Road safety features such as crash barriers and guardrails along steep mountainsides are rare.
In the countryside livestock are often herded along roads or graze on roadsides.
Many roads are used for pedestrian and animal traffic as well as vehicular traffic.
Driving habits vary from region to region.
In general, drivers in Quito and the mountain areas and the Oriente (eastern jungle) drive more slowly, observe traffic signals, and slow down for speed bumps.
Vehicles are reasonably well maintained.
On the coast, drivers have a more liberal approach to vehicle maintenance and traffic regulations.
In all areas buses, both intra-city and intercity, will stop at any point on their route to pick up or drop off passengers.
Speed bumps abound, even on major highways such as the Pan American Highway, to slow traffic.
Drivers turn right and left from any lane and do not yield for pedestrians and cyclists.

Intoxicated drivers can be encountered at any time, but they are especially prevalent on weekends and holidays.
Ecuador’s frontier regions are largely rural, poor, and lack police presence.
Because drug traffickers, criminal organizations, and smugglers of all types use clandestine border crossings to move their goods, the U.S. Embassy advises against driving on all but the most traveled highways.

If you are the driver of a vehicle involved in an automobile accident, you will likely be taken into police custody, especially if injuries are involved.
You are almost certain to spend some time in jail until all parties are satisfied that responsibility has been assigned and adequate financial satisfaction received.
Drivers may face criminal charges if injuries or damages are serious.
When driving your own vehicle or a rented vehicle, be sure to have proper vehicle registration papers with you.
Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office at http://www.turismo.gov.ec/ and the Ministerio de Transporte y Obras Publicas, the national authority responsible for road safety, at http://www.mtop.gov.ec/ .

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ecuador's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Ecuador'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
GALAPAGOS ISLANDS: A significant number of Ecuadorian tour vessels operating in the Galapagos Islands are neither inspected nor operated in accordance with U.S. regulations, and do not meet U.S. safety standards.
The Government of Ecuador requires that vessels carrying more than sixteen passengers comply with the International Safety Management (ISM) code established by the International Maritime Organization.
However, the quality of inspections, oversight, crewmember proficiency evaluation, and other requisites for safe vessel operation may vary substantially.
Tour boat accidents are more frequent among small vessels (those carrying fewer than sixteen passengers), but travelers should inquire about safety features of any vessel, regardless of size. When boarding vessels be sure to look for the life boats, floatation devices and if possible take a moment to inspect the life vest you would be using if there were an accident.

There have been at least three cases in 2004-2006 in which small quantities of drugs have been placed by unknown persons in unsecured pockets of tourists' checked bags, including backpacks, en route to the Galapagos.
Upon arrival, these drugs have been detected by police canine units, and the owners of the bags have been arrested and detained for months while the cases are resolved.
Travelers are advised to secure all parts of their bags thoroughly before checking them on flights to the Galapagos.

Strikes and disturbances by local fisherman in the Galapagos Islands have become violent on occasion.
While tourists have not been targeted, the incidents affected their movement and access to some sites.
Such disturbances have been minimal since April 2004, but the issue remains unsettled and could resurface at any time.

The islands are over 600 miles from the mainland and help may be slow in arriving in case of emergency.
The Government of Ecuador has very limited search and rescue capabilities.
Travelers to the Galapagos are encouraged to contact tour operators and visit the Bureau of Consular Affairs' web site for the most recent information when planning their trips to the Galapagos.

OTHER LEGAL ISSUES: Under Ecuadorian law, business disputes that normally would be handled by civil litigation in the United States may be converted into criminal proceedings.
This provision of the law has been used to impose travel prohibitions against resident U.S. citizens, and it also has led to the arrest and incarceration of U.S. business people while they were awaiting a hearing on the civil matter.

When considering purchasing property in Ecuador, Americans should be aware that competing claims to property might only surface after an apparently legal sale has been made.
Deficiencies in the Ecuadorian system for surveying and registering property and weaknesses in the judicial system mean that these disputes can last years.
The Mission is aware of several cases of American citizen land owners in Ecuador being threatened with physical harm and/or confiscation of their property by individuals claiming rights to the land, and, in at least one case, buildings have been razed.
American citizens considering buying property in Ecuador should engage a competent attorney and carefully research land title issues before making a purchase.

DISASTER PREPAREDNESS: Ecuador has 19 potentially active volcanoes, including nine that have shown recent activity.
Earthquakes occur frequently.
Three active volcanoes within 50 kilometers of Quito pose a significant threat to the city: Guagua Pichincha, Cotopaxi, and Reventador.
The primary threat is from failures of transportation, water, communications, and power systems due to heavy ash fall and damage to infrastructure outside the city.
Air transportation is especially vulnerable.
Potentially serious respiratory problems are caused by inhalation of ash.

The town of Banos, a popular tourist destination approximately 120 kilometers south of Quito, is at the base of the Tungurahua Volcano.
Tungurahua has erupted explosively several times since 1999, most recently in February of 2008, causing deaths and forcing thousands to evacuate their homes.
Explosive eruptions can occur with little warning.
The resulting flows of mud and lava could pose a significant and immediate threat to Banos and other population centers in the vicinity.
Travelers should to be aware of these conditions when choosing to stay overnight in Banos, especially on the western side of the town, and should be ready to evacuate on short notice.

Other volcanoes active in Ecuador include Reventador, 100 kilometers east of Quito, and Cotopaxi, 50 kilometers south of Quito.
In 2002, lava and mudflows caused by Reventador volcano closed a major Quito/northern-border highway and volcanic ash blanketed Quito, shutting down the Quito airport for several days.

The Quito City Government and the Ecuadorian Geophysical Institute monitor these volcanoes and issue regular reports on their activity.
In the event of eruptions, travelers should pay close attention to the news media for updates on the situation.
Other volcanoes in Ecuador may also exhibit increased activity at any time.
Further information is available via the Internet from the Ecuadorian Geophysical Institute at http://www.igepn.edu.ec/ and the National Oceanic and Atmospheric Administration at http://www.ssd.noaa.gov/VAAC/guag.html .

CUSTOMS REGULATIONS:
Ecuadorian customs authorities may enforce strict regulations concerning temporary importation into or export from Ecuador of items such as firearms, religious materials, antiquities, medications, electronic equipment, and currency.
Contact the Embassy of Ecuador in Washington, D.C., or one of Ecuador’s consulates in the United States for specific information regarding customs requirements. Please see our customs information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Ecuadorian laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Ecuador 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.

The Ecuadorian government is required by international law to notify the U.S. Embassy or the nearest U.S. Consulate promptly when an American citizen is arrested and requests such notification.
Delays in notification can limit the assistance the U.S. Government can provide an arrested American citizen.
Therefore, Americans should promptly identify themselves as such to arresting officers and request that the U.S. Embassy in Quito or the U.S. Consulate in Guayaquil be notified immediately.

Prison conditions in Ecuador are extremely poor.
In many facilities food is insufficient in both quantity and quality, and prisoners must pay for adequate nutrition from their own funds.
Most Ecuadorian prisons provide poor medical care, and urgent medical conditions may receive only minimal attention.
The Guayaquil penitentiary medical clinic does not have medicine but is staffed with medical personnel. Prisoners must personally pay to have someone outside of the prison obtain medicine and prescriptions. Those accused of crimes in Ecuador can expect lengthy delays before trial and sentencing.
The accused are usually incarcerated while awaiting trial and sentencing, and in the case of serious crimes, bail is generally not an option.

CHILDREN'S ISSUES:
For information on 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 Ecuador 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 Ecuador.
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 Quito is located at Avigiras E12-170 y Eloy Alfaro.
The telephone during business hours (8:00a.m. to 5:00 p.m.) is (011) 593 2 398 5000.
For after-hours emergencies use (011) 593 2 398 5000. Within the same city use the last seven digits.
Add the city code for intercity telephone calls.
The Embassy's web site is http://ecuador.usembassy.gov/
The U.S. Consulate General in Guayaquil is located at the corner of 9 de Octubre and Garcia Moreno (near the Hotel Oro Verde); telephone (011-593-4) 232-3570 during business hours (8:00 a.m. to 5:00 p.m.) or 232-1152 for after-hours emergencies; fax (011-593-4) 232-0904.
The Consulate General's web site is http://guayaquil.usconsulate.gov/.

Consular services for U.S. citizens in the Galapagos Islands are provided by the Consulate General in Guayaquil with assistance from a U.S. Consular Agent in Puerto Ayora, Galapagos, at (05) 2526-330 or (05) 2526-296.

The Consular Section in Quito is open for American Citizen Services, including registration, from 1:30 to 4:00 p.m., Monday through Thursday, excluding U.S. and Ecuadorian holidays.
In order to provide better customer service and reduce waiting times, the American Citizen Services section in Guayaquil uses an online appointment system. Appointments are available from 12:00 noon to 4:00 p.m., Monday through Thursday. Notary appointments are Friday, 8:00 a.m. to 12:00 p.m., excluding U.S. and Ecuadorian holidays. Walk-in service remains available, but customers with appointments take precedence.
To make an appointment, go to http://guayaquil.usconsulate.gov/online_appointments.html
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This replaces the Country Specific Information for Ecuador dated March 28, 2008, to update the sections on Entry/Exit Requirements, Information for Victims of Crime, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Sun, 31 Mar 2019 11:14:25 +0200

Washington, March 31, 2019 (AFP) - A strong 6.2 magnitude earthquake struck just off the coast of Ecuador early Sunday, the US Geological Survey said, but there were no immediate reports of damage and there was no tsunami warning.   The quake occurred at a shallow depth of 18.5 kilometres (11.5 miles), in the Pacific Ocean west of Guayaquil and 27 kilometres north of Santa Elena, the agency reported.
Date: Fri, 7 Sep 2018 12:17:58 +0200

Quito, Sept 7, 2018 (AFP) - A deep 6.2 magnitude earthquake struck Ecuador on Thursday night, causing damage to buildings and injuring two people.   The quake hit at 9:12 pm local time (0212 GMT on Friday) at a depth of 93.5 kilometres, near the center of the South American country.   It was felt across several provinces, according to Twitter users. Two people were injured in the town of Cumanda.

The walls of homes cracked and ceilings caved in, mayor Marco Marquiasca said.   Local authorities recorded its magnitude as 6.5.   Ecuador suffered a 7.8 magnitude earthquake on April 16, 2016, which devastated villages in the coastal provinces of Manabi and Esmeraldas and killed 673 people.   The losses amounted to more than $3 billion, according to authorities.    Located on the boundary of the Nazca and South America tectonic plates, Ecuador is very prone to seismic activity.
Date: Thu, 16 Aug 2018 03:58:11 +0200

Quito, Aug 16, 2018 (AFP) - Colombia's government said Wednesday that 19 of the victims of a deadly bus crush in Ecuador were its citizens, as Quito lowered the overall death toll from the accident.   Ecuador's foreign ministry said in a statement that 23 people were killed in the Tuesday crash, instead of 24 as previously announced.   Twelve Colombians, four Venezuelans and two Ecuadorans who died in the accident have been identified, the statement said.

The bus, which had foreign license plates, overturned and crashed into three houses after a collision with an all-terrain vehicle near Quito.   Ecuador transport colonel Julio Barba said the driver "probably overused the brakes... which produced an overheating of the brake system leading to a loss of control of the vehicle."   Colombia's Transport Ministry had said on Tuesday that the bus was not authorized to carry tourists.  One of the two drivers, who was injured in the crash, has been arrested.

Traffic accidents are among the leading causes of death in Ecuador. According to the watchdog group Justicia Vial, on average seven people are killed and some 80 people injured each day in traffic accidents.   And 96 percent of those accidents are due to human error, according to the group's figures.   On Sunday, 12 people were killed and 30 injured when a bus carrying fans of Barcelona SC, Ecuador's most popular football club based in Guayaquil, ran off the highway and flipped.
Date: Mon, 11 Jun 2018 22:10:52 +0200

Quito, June 11, 2018 (AFP) - A Lebanese man has been stuck in immigration purgatory at an airport in Ecuador for 42 days after losing his passport and being returned there from Spain.   Nizam Hussein Shalak, 56, who does not speak Spanish, has been residing in the international terminal of the Jose Joaquin de Olmedo airport in Guayaquil, El Universo newspaper reported.   "It is a case of inadmissibility because he has no documents," a foreign ministry source said.   "The only legal body to issue a travel document is the Lebanese consulate in Bogota," which has not responded to requests that it do so, the source said.   "We are closely following the case and are working with the interior (ministry) to get Lebanon to issue him a travel document so he can return to his country."   The situation resembles that of an Iranian refugee who lived in a Paris airport from 1988 to 2006 and was portrayed in the film "The Terminal" starring Tom Hanks.

Shalak visited Guayaquil two months ago and stopped on the way back to Lebanon in Lima, Peru, and Barcelona, Spain, where he was detained after losing his passport as well as his credit cards, El Universo newspaper reported.   He stayed in Barcelona for 10 days and Lima for another 11 before being returned to Guayaquil, where he had to make a makeshift a bed on the seats of the terminal.   "He eats with the coupons that the airline... gives him from time to time" and showers "every three or four days, when they take him to a bathroom in another part of the terminal," the newspaper said.   The foreign ministry source said that while Shalak left with a passport, he did not have one upon his return and could not pass immigration.   Therefore, "he is not legally in the country."
Date: Fri, 6 Apr 2018 03:41:33 +0200

Quito, April 6, 2018 (AFP) - An Ecuadoran soldier died Thursday from wounds sustained in a roadside bomb blast two weeks ago on the border with Colombia, Ecuadoran President Lenin Moreno said, calling the explosion a "terrorist act."   He said on Twitter that the corporal was being treated in a military hospital when he succumbed to his grievous injuries, which had resulted in both his legs being amputated.   "A hug of solidarity to his family," Moreno tweeted.   The death took to four the number of soldiers killed in the March 20 blast, which occurred near the border town of Mataje. A dozen others were wounded.

Ecuador has since January been confronted with an unusual wave of attacks directed at its security forces.    The government blames dissident rebels with Colombia's former FARC guerrilla group which has disbanded and become a political party following a landmark 2016 peace deal.   An Ecuadoran media team comprising a reporter, a photographer and a driver were abducted last week in Mataje.   Quito has stepped up the military presence in the region, and has reinforced cooperation with Colombia to try to quell the border violence. But the task is a difficult one, with dense jungle providing cover to insurgents.
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Montserrat

Montserrat US Consular Information Sheet
June 04, 2007
COUNTRY DESCRIPTION: Montserrat is a British overseas territory and part of the British West Indies.
The island rises in a series of mountain slopes to a high point of over 3,000 feet
t the Soufriere Volcano in the exclusion zone.
Montserrat is a highly active volcanic island.
The Government of Montserrat has issued several recent proclamations and warnings urging residents and visitors to be vigilant and to be prepared to move at short notice.
For further information, see "Special Circumstances" in this Information Sheet.

ENTRY/EXIT REQUIREMENTS: Proof of citizenship and identity, in addition to an onward/return ticket and sufficient funds to cover the expected stay, are required for entry into Montserrat.
However, U.S. citizens are now required to present a valid passport to travel by air between the United States and the Caribbean.
As early as January 1, 2008, a valid passport will also be required for travelers by sea.There is a departure tax payable upon leaving Montserrat.

See our Foreign Entry Requirements brochure for more information on Montserrat and other countries.
For further information, travelers may contact the British Embassy, 19 Observatory Circle N.W., Washington, D.C. 20008; telephone (202) 588-7800; or the nearest consulate of the United Kingdom in Atlanta, Boston, Chicago, Dallas, Los Angeles, New York, Denver, Houston, Miami, Orlando, Seattle, or San Francisco.
Visit the British Embassy's web site at http://www.britainusa.com/ for the most current visa information.

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

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

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

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

CRIME: The crime rate in Montserrat is low.
However, travelers should take normal, common sense precautions.
Travelers should avoid carrying large amounts of cash and displaying expensive jewelry.
Travelers should also use hotel safety deposit facilities to safeguard valuables and travel documents.

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: St. John’s Hospital, Montserrat’s main hospital, can handle most routine and surgical emergencies.
However, there is no hyperbaric chamber in Montserrat.
Doctors in private practice are also available.
Arrangements can be made quickly to transfer more serious problems off island by helicopter to Antigua or Guadeloupe.

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

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

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

In Montserrat, vehicles are operated on the left-hand side of the road.
There is no organized government roadside assistance, but local residents are often willing to aid those with car trouble.
Roads are narrow, winding and steep.
For specific information concerning Montserrat driving permits, vehicle inspection, road tax and mandatory insurance, please contact the Montserrat Tourist Board in Montserrat at tel. 1 (664) 491-2230 or 491-8730.
You may also email them at info@montserrattourism.ms.
The web address for the Tourist Board is http://www.visitmontserrat.com/.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
Ongoing volcanic activity from the Soufriere Hills Volcano has led to the evacuation and relocation of residents from the southern half of the island’s so called ‘exclusion zone' since 1995.
Additional evacuations occurred as recently as early 2007, when volcanic activity increased.
Because the volcano is still active and dangerous, access to the southern part of the island and a surrounding maritime exclusion zone is restricted.
Persons entering restricted areas without authorization are subject to fine and/or imprisonment.

In early 2007, Montserrat government authorities warned residents and visitors of volcanic activity and an increase of pyroclastic flows in Tyres Ghaut, Gages Valley and behind Gages Mountain.
Authorities also evacuated people living in the potential impact areas in and near the Belham Valley - Isles Bay Hill, Old Towne (south of Loblolly Lane), Isles Bay Plantation, lower Happy Hill, Water Works junction and Water Works Estate - due to the volcano’s activity.

When in Montserrat, citizens are advised to monitor Radio Montserrat (Radio ZJB) for the latest official guidance.
In addition to the hazards posed by the Soufriere Hills Volcano as outlined above, Montserrat can be affected by hurricanes.
The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.

The official Montserrat Volcano Observatory website, http://mvo.ms/, is helpful for updates on volcanic activity.
Updates on volcano activity can also be found on the website of the Caribbean Disaster Emergency Response Agency at http://www.cdera.org/.
Please see our Customs Information.

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

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

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Montserrat are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, and to obtain updated information on travel and security within Montserrat.
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 in the Wildey Business Park, Wildey, St. Michael, telephone 1-246-436-4950, web site http://bridgetown.usembassy.gov.

Hours of operation are 8:30 a.m. to 4:00 p.m. Monday through Friday, except Barbados and U.S. holidays.
Assistance may also be provided by the U.S. Consular Agency in Antigua, located at Suite #2, Jasmine Court, Friars Hill Rd, St. John’s, Antigua.
Contact information is as follows: telephone 1-268-463-6531, cellular 1-268-726-6531, or e-mail ANUWndrGyal@aol.com.
The mailing address is P.O. Box W-1562, St. John’s, Antigua.
The Consular Agent is available by appointment only.
The office is closed for local and U.S. Holidays.
* * *
This replaces the Consular Information Sheet dated January 9, 2007, to update the Entry/Exit Requirements, Aviation Safety Oversight and Embassy Location sections.

Travel News Headlines WORLD NEWS

Date: Sat, 13 Feb 2010 21:42:24 +0100 (MET)
by Colin James

ST JOHN'S, Feb 13, 2010 (AFP) - Resilient residents of the tiny Caribbean island of Montserrat Saturday shrugged off clouds of ash spewing out of a volcano, and donned masks to go about their daily business.   "It is makes you sneeze a lot," Gregory Willock, the president of the Montserrat Cricket Association, told AFP in the nearby island of Antigua by telephone.

Life has continued as normal since the Soufriere Hills volcano erupted Thursday, throwing up a plume of smoke and volcanic ash 10 kilometers (six miles) into the air, he said.   "All I know is it can create problems for people who have sinus" problems, Willock added, saying many residents had taken to wearing masks while schools and government offices have been operating as normal.   Thursday's eruption came almost 15 years after the volcano, which had lain dormant throughout recorded history, first rumbled into life in July 1995.

The 1995 eruption threw up a huge plume of ash and molten lava into the sky, which in coming weeks rained down on the British overseas territory.   The island's capital city Plymouth was buried in ash and volcanic debris in a further massive eruption a month later and destroyed. Two-thirds of the island's population were forced to flee abroad.   This time islanders are praying for rain to clear away the blanket of dust, which has even stopped the cricket team practicing.   "We cannot practice because Salem Park is not accessible. We need rain to get rid of ash on the ground," Willcock said Saturday.

Another resident, who asked not to be named, said his only complaint so far had to do with his medical condition. He's asthmatic.   "It has not worried me but because of my complaint I'm being ultra-careful. I'm talking to you with a mask over my mouth," he told AFP.   "However, life goes on beautifully. It is just like normal life. We are a resilient people," he said.   Many flights around the Caribbean remained cancelled Saturday due to clouds of ash spewed up into the skies.   "The continued ash hanging in the atmosphere presents a risk to planes and to the security of passengers," the police in the nearby island of Guadeloupe said in a statement.

The airport in Guadeloupe, which lies just 80 kilometers (50 miles) south of Montserrat, would remain closed until Sunday, it said.   "The dispersion of these ashes will depend on today's weather conditions," it added in a statement, after fire engines were deployed late Friday to try clear the airport's runways of a thick layer of ash.   Some 300 people were stranded on Guadeloupe waiting to leave, the director of the islands' tourism office Thierry Gargar told AFP. He added they were all being accommodated in hotels on the islands.

Flights to other Caribbean tourist hotspots including Anguilla, St. Kitts and Nevis and St. Maarten also remained disrupted.   The ash has also forced LIAT, the region's biggest airline, to temporarily suspend flights in and out of the V.C. Bird International airport in nearby Antigua, although flights resumed Saturday to Dominica.

Montserrat, settled by English and Irish colonizers in 1632, has been dubbed "The Emerald Isle of the Caribbean" for its lush vegetation. It has been trying to rebuild its tourism industry since the 1995 eruption.   The buried capital Plymouth, which has been compared to a modern-day Pompeii, now lies in an exclusion zone, but can be visited with organized tours.
Date: Sat, 13 Feb 2010 03:16:13 +0100 (MET)

ST. JOHN'S, Feb 12, 2010 (AFP) - Ash from a volcanic eruption on the Caribbean island of Montserrat hung in the air around Antigua and Barbuda Friday, causing difficult driving conditions and forcing flight suspensions.   Montserrat's Soufriere Hills volcano erupted Thursday, sending a plume of ash 10 kilometers (six miles) high into the sky, the Montserrat Volcano Observatory said.

The ash forced LIAT, the region's biggest airline, to temporarily suspend flights in and out of Antigua's V.C. Bird International airport.   The airline said in a statement late Friday it had resumed flights to and from Antigua, but added that the "continued presence of airborne ash clouds over Dominica and Guadeloupe has forced LIAT to suspend all remaining flights to both destinations."   Flights to other Caribbean islands including Anguilla, St. Kitts and Nevis and St. Maarten were also disrupted on Thursday.

Montserrat is about 35 kilometers south of Antigua and Barbuda, but residents on the southern side of Antigua said heavy ash had fallen on their homes and made driving conditions difficult at times.   Yvonne McMillan, a resident of the southern village of Jennings, told an Antiguan radio station that "it was pretty rough" on Friday morning.   "Visibility was extremely poor. Coming off a hill you don't see what's below. I had to switch (my lights) to low beam all the time because high beam confused me even more," she said.   Meteorological officials described the ash fall as "quite bad."   Senior forecaster Lorne Salmon said cooling meant the air had become heavier, sinking into valley and low-lying areas.   "When this happens a lot of the ash becomes more concentrated," she said.
Date: Fri, 12 Feb 2010 16:08:48 +0100 (MET)

POINTE-A-PITRE, Guadeloupe, Feb 12, 2010 (AFP) - Ash from a volcano that has erupted on the Caribbean island of Montserrat has spread to neighbouring islands, forcing authorities to close schools in the French territory of Guadeloupe.

The Soufriere Hills volcano on Montserrat erupted on Thursday sending ash 10 kilometers (six miles) high into the sky, according to French weather experts, and forcing other islands to take precautions.   Montserrat is about 80 kilometers (50 miles) north of Guadeloupe.   Point-a-Pitre airport on Guadeloupe was closed straight away and French state representative Jean Fabre ordered schools to close on Friday. He said there was a risk of eye irritation and breathing problems.

Buildings and cars were covered in a layer of grey ash on Friday while flights to Guadeloupe were still diverted to Martinique about 250 kilometers (160 miles) to the south.   The Soufriere volcano has been active since 1995 when a major eruption buried half of Montserrat's capital, Plymouth. Two thirds of the island's 12,000 people have since left.
January 10, 2007 This Public Announcement is being issued to alert American citizens of increasing volcanic activity on the island of Montserrat, and to provide new information from the Government of Montserrat regarding sections of the island that are prohibited to visitors. Travelers are strongly advised to thoroughly consider the risks of travel to Montserrat, and to take adequate precautions to ensure their safety if they do travel. This Public Announcement expires April 9, 2007. U.S. citizens traveling to and residing in Montserrat should be aware that renewed volcanic activity at the Soufriere Hills Volcano has led to evacuations from certain areas of the island. The Government of Montserrat has identified unsafe restricted areas, which include the south and eastern parts of Montserrat adjacent to the active volcano. Remaining or attempting to enter these zones is prohibited by the Government of Montserrat. All Americans currently living or traveling in Montserrat are advised to make arrangements to depart on short notice if requested to do so by the Government of Montserrat. U.S. citizens in affected regions should immediately head to safe ground and/or identify shelter, monitor local media reports, and follow the instructions of local emergency officials. Visitors should be familiar with their hotel evacuation plans. U.S. citizens should carry their travel documents (i.e. U.S. Passport, Birth Certificate, picture IDs, etc.) with them at all times or secure them in a safe location. Additionally, all American citizens in the area are reminded to stay in contact with friends and family in the United States to keep them apprised of their current whereabouts. Lastly, residents and travelers can obtain official guidance and information by monitoring Radio Montserrat (Radio ZJB) or by checking the status of the volcano's activity at the Global Volcanism Program's website located at http://www.volcano.si.edu/reports/usgs. Americans living or traveling in Montserrat are encouraged to register with the U.S. Embassy Bridgetown, Barbados, through the State Department's travel registration website, https://travelregistration.state.gov. 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. For additional information on Montserrat, please consult the Department of State's latest Consular Information Sheet for Montserrat at http://travel.state.gov. American citizens may also obtain up-to-date information on the situation in Montserrat by calling 1-888-407-4747 toll free in the United States or Canada or 1-202-501-4444 from overseas. The duty officer at the U.S. Embassy Bridgetown, Barbados, can be reached at 246-823-2675.
5 February 2003 The vast majority of visits to Montserrat are trouble free. However, because of ongoing volcanic activity, entry into the southern part of the island and the southern coastal waters is prohibited. Life and commercial activity, including tourism continue as normal in the central and northern regions. There is no history of terrorism in the territory. Though the crime rate is very low you should take sensible precautions against petty crime, including tourism continue as normal in the central and northern regions. To view the article in full, visit the page below: http://www.fco.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&c=Page&cid=1007029390590&a=KCountryAdvice&aid=1013618386244
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World Travel News Headlines

31st May 2019

A volcano on the Indonesian island of Bali erupted Friday, spewing a plume of ash and smoke more than 2,000 metres (6,500 feet) into the sky. Mount Agung, about 70 kilometres from the tourist hub of Kuta, has been erupting periodically since it rumbled back to life in 2017, sometimes grounding flights and forcing residents to flee their homes.
Mount Agung is about 70 kilometres from the tourist hub of Kuta

The latest shortly before noon on Friday shot a cloud of volcanic ash high into the sky, but caused no disruption to flights, Indonesia's geological agency said.  Agung remained at the second highest danger warning level, and there is a four-kilometre no-go zone around the crater.

Last summer, dozens of flights were cancelled after Agung erupted, while tens of thousands of locals fled to evacuation centres after an eruption in 2017.

The last major eruption of Agung in 1963 killed around 1,600 people.

Indonesia is situated on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.

31st May 2019

Heatwaves across India have exacted heavy casualties this year, including dozens of deaths by sunstroke and other heat-related causes. The deaths have been mainly reported from states like Maharashtra (particularly Vidarbha), Andhra Pradesh (mainly Rayalseema) and Telangana, due to the temperature extremes in these regions. What's worrying is, a study suggests that the heatwave conditions are likely to increase from next year and continue till 2064 because of El Niño Modoki and depletion in soil moisture. Here's how the heatwave is taking a toll in the above states.

Maharashtra

Parts of Maharashtra have been reeling under high temperatures accompanied by severe heatwave condition during this summer. According to a report in The Times Of India, a 50-year old man in Beed succumbed to death because of heatstroke recently, taking the overall number to 8. Reports show a total of 456 cases of heat-related illnesses in Maharashtra this summer. Last year, the number of cases reported was 568. However, the death toll this year is more than last year's figure of 2 victims.

Regions like Nagpur and Akola show the most number of deaths and illnesses in the Vidarbha region. About 163 cases of heat-related illness were reported in Nagpur and 76 ailments were reported in Latur region. Recently, Chandrapur in Maharashtra (which lies 150km south of Nagpur) registered a day temperature of 48°C, the highest recorded in India this summer.

Andhra Pradesh

Parts of Andhra Pradesh have been experiencing temperatures of 45°C and more since the last few days. These conditions have persisted in the state after the heavy rains caused by Cyclone Fani.

Two women going on a two-wheeler and covered themselves with scarfs to protect themselves from the heat wave, in Vijayawada
(Mahesh G, TOI, BCCL, Vijayawada.)

Three people have died in Andhra Pradesh due to heat-related causes this year. Also, 433 people have been diagnosed with heatstroke. Earlier this month, electrical transformers had blown up in many parts of Krishna and Guntur districts, disrupting power supply for more than five hours and intensifying the effects of heatwave conditions and the severe temperatures.

In 2015, Andhra Pradesh experienced the most number of heat deaths in the country: 1,369 people died that year from heat-related illnesses.

Telangana

Seventeen people have succumbed in Telangana over the last 22 days. However, the number of unconfirmed deaths is expected to be higher. The region saw 541 heat-related deaths in 2015, and 27 in 2018. The farmers and those who work in the sun are usually the ones to be affected the most by high temperatures and heatwave conditions.

As heat blankets the country, make sure you stay protected. Follow official guidelines and do not step out in the Sun, especially in the afternoon hours, unless absolutely necessary.

(With inputs from The Times Of India.)

11th June 2019
https://afro.who.int/news/confirmation-case-ebola-virus-disease-uganda

Kampala, 11 June 2019 - The Ministry of Health and the World Health Organization (WHO) have confirmed a case of Ebola Virus Disease in Uganda. Although there have been numerous previous alerts, this is the first confirmed case in Uganda during the Ebola outbreak on-going in neighbouring Democratic Republic of the Congo.

The confirmed case is a 5-year-old child from the Democratic Republic of the Congo who travelled with his family on 9th June 2019. The child and his family entered the country through Bwera Border post and sought medical care at Kagando hospital where health workers identified Ebola as a possible cause of illness. The child was transferred to Bwera Ebola Treatment Unit for management. The confirmation was made today by the Uganda Virus Institute (UVRI). The child is under care and receiving supportive treatment at Bwera ETU, and contacts are being monitored.

The Ministry of Health and WHO have dispatched a Rapid Response Team to Kasese to identify other people who may be at risk, and ensure they are monitored and provided with care if they also become ill. Uganda has previous experience managing Ebola outbreaks. In preparation for a possible imported case during the current outbreak in DRC, Uganda has vaccinated nearly 4700 health workers in 165 health facilities (including in the facility where the child is being cared for); disease monitoring has been intensified; and health workers trained on recognizing symptoms of the disease. Ebola Treatment Units are in place.

In response to this case, the Ministry is intensifying community education, psychosocial support and will undertake vaccination for those who have come into contact with the patient and at-risk health workers who were not previously vaccinated.  

Ebola virus disease is a severe illness that is spread through contact with the body fluids of a person sick with the disease (fluids such as vomit, faeces or blood). First symptoms are similar to other diseases and thus require vigilant health and community workers, especially in areas where there is Ebola transmission, to help make diagnosis. Symptoms can be sudden and include:
  • Fever
  • Fatigue
  • Muscle pain
  • Headache
  • Sore throat
People who have been in contact with someone with the disease are offered vaccine and asked to monitor their health for 21 days to ensure they do not become ill as well.

The investigational vaccine being used in DRC and by health and frontline workers in Uganda has so far been effective in protecting people from developing the disease, and has helped those who do develop the disease to have a better chance of survival. The Ministry strongly urges those who are identified as contacts to take this protective measure.

Investigational therapeutics and advanced supportive care, along with patients seeking care early once they have symptoms, increase chances of survival.

The Ministry of Health has taken the following actions to contain spread of the disease in the country:
  • The District administration and local councils in the affected area have been directed to ensure that any person with Ebola signs and symptoms in the community is reported to the health workers immediately and provided with advice and testing.
  • The Ministry of Health is setting up units in the affected district and at referral hospitals to handle cases if they occur.
  • •Social mobilization activities are being intensified and education materials are being disseminated.

There are no confirmed cases in any other parts of the country.

The Ministry is working with international partners coordinated by the World Health Organization.

The Ministry of Health appeals to the general public and health workers to work together closely, to be vigilant and support each other in helping anyone with symptoms to receive care quickly. The Ministry will continue to update the general public on progress and new developments.
Date: Mon, 10 Jun 2019 14:24:43 +0200

Lima, June 10, 2019 (AFP) - Peru has declared a health emergency in five regions, including Lima, after the deaths of at least four people linked to Guillain-Barre syndrome, an autoimmune disorder that attacks the nervous system.   Health Minister Zulema Tomas said Sunday that in addition to the deaths there were currently 206 cases of the disease.   "We have an outbreak, there has been a brusque increase" since June 5, Tomas said on state-run TV Peru, adding that health authorities were taking steps to control and contain the disease.

While the syndrome is not contagious, a 90-day health emergency was declared because the current cases "have unusual and atypical characteristics that require rapid or immediate initial treatment," Peru's Institute of Neurological Sciences said.   The precise cause of the disorder is unknown, but most cases develop after a person has been sick with diarrhoea or a respiratory infection.

The Centers for Disease Control and Prevention in the US says its research suggests that the syndrome is "strongly associated" with the Zika virus, a mosquito-borne illness.   The regions affected by GBS include three on the country's northern coast -- Piura, Lambayeque, La Libertad -- tourist destinations known for their archaeological sites and beaches.   Also included was the central region of Junin and Lima, which has nine million inhabitants.   Two deaths were reported in Piura, one in La Libertad and another in Junin.
Date: Mon, 10 Jun 2019 16:39:03 +0200

Madrid, June 10, 2019 (AFP) - Three tourists have fallen from their hotel balconies in Spain's Balearic Islands in recent days, one of them dying on impact, police said Monday as the summer season in the party archipelago begins.   The incidents came as Britain's foreign office warned holidaymakers heading to Spain against "balcony falls" and asked them not to "take unnecessary risks... particularly if you're under the influence of drink or drugs."   On Friday in Magaluf, a party resort notorious for its booze-fuelled tourism, a 19-year-old British man fell to his death from the second floor of his hotel, Spain's Civil Guard police force said.

A spokesman said police were looking at two theories -- either "he threw himself off voluntarily, or he fell by accident."   He did not know whether the victim had consumed drugs or alcohol.   On Thursday, a 35-year-old German man fell from the second floor of his hotel too, this time in Palma de Majorca, and was seriously injured, police said.   A source close to the probe, who declined to be named, said the man had drunk, dozed off, woken up and subsequently fallen from the balcony, possibly disorientated.   And on Monday, an Australian man in his early thirties fell from the second floor of his hotel in Ibiza and was seriously hurt, police said, without giving further details.

Balcony falls happen every year in the Balearic Islands and other party resorts in Spain, most of them due to excessive drinking or drug-taking/   Some are accidental slips, while others happen when tourists miss while trying to jump into pools or onto another balcony -- a practice known as "balconing."   The British foreign office's online travel advice for Spain has an entire section warning against "balcony falls".   "There have been a number of very serious accidents (some fatal) as a result of falls from balconies," says the website.    "Many of these incidents have involved British nationals and have had a devastating impact on those involved and their loved ones."
Date: Mon, 10 Jun 2019 06:44:54 +0200

Sydney, June 10, 2019 (AFP) - Australian police said Monday they were scouring bushland for a Belgian teenage tourist missing in a popular surf town for more than a week.   Theo Hayez, an 18-year-old backpacker, was last seen on May 31 at a hotel in the coastal tourist town of Byron Bay -- some 750 kilometres (470 miles) north of Sydney -- New South Wales state police said.   "We have a large amount of resources searching... in bushland that is towards the east and northeast of the town," police Chief Inspector Matthew Kehoe said in a statement.   "We are advised that this disappearance is completely out of character for him."   Police said they were alerted to his disappearance on Thursday after he failed to return to a hostel he was staying in.   Hayez's passport and personal belongings were all left at the hostel, and police believe he had not made any financial transactions since his disappearance or used his mobile phone.
Date: Sat 8 Jun 2019
Source: New Jersey 101.5 [edited]

The potentially deadly Powassan tick-borne virus has been confirmed in 2 Sussex county residents, one of whom died last month [May 2019], state health officials confirmed [Sat 8 Jun 2019].

The Powassan virus is spread by the deer tick [_Ixodes scapularis_]. The illness is rarer than Lyme disease, which is also spread by the tick, but 10% of people who contract the [Powassan virus] illness die from it.

A Department of Health official on [Sat 8 Jun 2019] said that the department had not determined the cause of death for the patient who died last month [May 2019] but said that lab results this week [week of 3 Jun 2019] confirmed that he had the virus.

A 2nd victim continues to recover at home.

Symptoms of the virus include brain swelling, meningitis, fever, headache, vomiting, weakness, confusion, loss of coordination, trouble speaking, and memory loss. Symptoms can appear a week to a month after a tick bite, although some people show no symptoms and do not require treatment.

There is no vaccine or cure for the disease. Treatment includes hospitalization, support for breathing, and intravenous fluids.

Prevention involves the same precautions that should be taken to avoid Lyme disease: avoid wooded areas with tall grasses, use insect repellent while outdoors, and check for ticks after being outdoors.

Powassan [virus] -- first discovered in Powassan, Ontario, in 1958 -- has been confirmed in recent years in New Jersey, with one case each in 2013, 2014, and 2015, and 4 cases in 2017, the most recent year for which data is available. The cases were reported in Sussex, Warren, Morris, and Essex counties.

Between 2008 and 2017, there were 125 confirmed cases in the entire country and 9 deaths.

A person who said they were close to the man who died last month [May 2019] posted on Facebook that the man was bitten in the arm by a tick while gardening and fell ill about 2 weeks later. The Facebook post said that there was no bull's-eye mark around the bite -- a known tell-tale sign for Lyme infection. About a day before he was hospitalized, the man reported feeling like he was coming down with a cold and had a high fever.

State health department's tip sheet for preventing Powassan [virus infection]:
- avoid contact with ticks by avoiding wooded areas with high grass;
- when hiking, stay on the center of the trail;
- picnic in areas away from wooded and bushy areas;
- keep children on playground equipment and away from tall grass and shrubs;
- when outdoors, apply insect repellents;
- wear light-colored clothes so it is easy to see and remove ticks;
- wear long-sleeve shirts and pants;
- tuck long pants into socks so ticks cannot crawl under pants;
- do tick checks every couple hours while outdoors and before coming indoors;
- if you see a tick during tick checks, remove it right away;
- keep grass mowed short;
- keep children's toys, playground equipment, pools, and lawn furniture at least 15 feet [4.6 m] from wooded areas;
- create a woodchip or mulch border between your yard and wooded areas;
- keep areas under bird feeders and pet dishes clean, so they do not attract animals that may carry ticks;
- keep trash in closed containers or areas so it does not attract animals that may carry ticks.  [Byline: Sergio Bichao]
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[Powassan virus is endemic in New Jersey, and cases occur there sporadically. The tick vector is the deer tick, _Ixodes scapularis_. Humans become infected with POWV during spillover transmission from the natural transmission cycles. In humans, POWV can be a causative agent of a severe neuroinvasive illness, with 50% of survivors displaying long-term neurological sequelae. Individuals living or visiting areas where the deer tick occurs, should follow the above recommendations to avoid tick bites. If a tick is found feeding, it should be removed with forceps or tweezers grasping the tick at skin level and then gentle, constant force applied. The tick should never be removed by grasping it with thumb and forefinger, as squeezing the tick may cause inoculation of contents containing the pathogenic agent into the feeding site.

POWV was recognized as a human pathogen in 1958, when a young boy died of severe encephalitis in Powassan, Ontario, Canada. In that case, POWV was isolated from the brain autopsy. There are 2 distinct genetic lineages now recognized: POWV (lineage I) and deer tick virus (lineage II). Since the index case in 1958, over 100 human cases of POWV have been reported, with an apparent rise in disease incidence in the past 16 years. This recent increase in cases may represent a true emergence of POWV in regions where the tick vector species are prevalent, or it could represent an increase in POWV surveillance and diagnosis. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of New Jersey, United States:
New Jersey county map:
Date: 6 Jun 2019
Source: Washington Post [edited]

Dominican government officials released more-detailed autopsy results on Thursday [6 Jun 2019] for 3 American tourists who died at adjacent beach resorts owned by the same hotel company during the last week of May 2019.

All 3 victims experienced eerily similar symptoms and internal trauma before their deaths, according to a news release from Dominican authorities. Pathologists said autopsies showed the 3 had internal haemorrhaging, pulmonary oedema, and enlarged hearts.

Toxicology reports are pending [These are likely to be the most interesting. - ProMED Mod.TG].

A U.S. State Department official said authorities have not yet established a connection between the 30 May 2019 deaths of 49-year-old CAD, and 63-year-old NEH, both of Prince George's County, MD, and the death on 25 May 2019 of 41-year-old MSW of Pennsylvania.

The FBI is providing Dominican law enforcement with "technical assistance with the toxicology reports," the State Department official said.

MSW had just checked into the Luxury Bahia Principe Bouganville, in the town of San Pedro de Macoris, and was taking pictures from her room balcony when she started to feel ill.

Less than 2 hours later, she was dead, local authorities said.

The bodies of CAD and HEH were found inside their room at the Grand Bahia Principe La Romana after relatives grew concerned because they had not checked out of the resort.

The hotels are located next to each other on the island's southern coast, about 60 miles from the tourist-heavy Punta Cana area.

Dominican authorities initially did not run toxicology tests for MSW because there were no signs of violence, said Ramon Brito, a spokesman for the National Police's special tourism unit. After the Maryland couple was found, investigators ordered a set of tests to determine whether anything the 3 Americans consumed may have led to their deaths, Brito said.  [Byline: Arelis R. Hernandez]
Date: 31 May 2019
Source: 4 News [edited]

The Alachua County Health Department is warning residents that there are 12 confirmed cases of mumps, primarily from college students at the University of Florida.  "This is a little more than usual," says Steve Orlando, University of Florida spokesman.

Alachua County normally receives around 2 reported cases a year, and UF believes more students could be infected.  "So, it's curious because these are individuals who are vaccinated, and that's what we are seeing nationwide," says Paul Myers, Alachua County Health Department administrator.

Officials say it is still unclear why there has been an uptick with the virus. So far, the CDC shows 736 people have contracted mumps nationwide in 2019.

"The sharing of the utensils, sharing of the cups, sharing of the water bottles, you know it is a very common thing for students to share those things, and that's exactly the kind of thing that could lead to transmission," says Orlando.
Date: Sat 8 Jun 2019
Source: Business Standard [edited]

As many as 14 children have died due to acute encephalitis syndrome (AES) in the district, while over a dozen are admitted in hospitals with high fever and other symptoms of the infection.

Sunil Shahi, Superintendent of Shri Krishna Medical College and Hospital (SKMCH), told ANI, "We have received 38 patients so far; most of them have a deficiency of glucose in their blood. Of these, 2 have also tested JE [Japanese encephalitis] positive; the overall casualty till now is 14."

Dr Gopal Sahni, head of Critical Care Unit, said, "When heat and humidity rise, the body's sweat cannot evaporate. The humidity level is over 50 per cent in the last few days. We have about 15 such children admitted in the hospital currently, and 89 such cases come regularly."

Encephalitis is a viral infection, which causes mild flu-like symptoms such as a fever or a headache.
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[Again, this year (2019), cases of AES and JE are appearing in north-western India. Of the 14 AES cases, 2 tested positive for JE. The aetiology of the remaining cases is not stated, but the majority are reported as hypoglycaemic. As noted previously, frequently, in reports of JE cases in India, acute encephalitis syndrome (AES) of undefined aetiology is often mentioned with JE cases that are a minority of those hospitalized.

The determination of the aetiology or aetiologies of AES has been confusing and elusive. Various etiological agents have been proposed in recent years as responsible for AES cases. AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). Recently, scrub typhus has been implicated in many AES cases. A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in acute encephalitis syndrome (AES). Unfortunately, existing surveillance for AES does not include routine testing for dengue. Dengue accounts for 5% of AES cases in India, especially in the absence of laboratory evidence for other pathogens tested. Dengue should be added to the list of possible AES etiological agents.

Reference:
Vasanthapuram Ravi, Shafeeq Keeran Shahul Hameed, Anita Desai, Reeta Subramaniam Mani, Vijayalakshmi Reddy, et al.: Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): Results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. International Journal of Infectious Diseases. 2019. doi: <https://doi.org/10.1016/j.ijid.2019.01.008>.

Maps of India:

[HealthMap/ProMED map available at: