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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The phone number for police/fire/ambulance emergency services - the equivalent of "911" in the U.S. - is “999” in the United Kingdom and “112” in Gibraltar.
This number should also be used for warnings about possible bombs or other immediate threats.
The UK Anti-Terrorist Hotline, at 0800 789 321, is for tip-offs and confidential information about possible terrorist activity.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings, Travel Alerts, as well as the Worldwide Caution can be found.
Recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the U.S. Embassy's American Citizens' Services web site at http://london.usembassy.gov/cons_new/acs/index.html.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet, A Safe Trip Abroad.
CRIME:
The United Kingdom and Gibraltar benefit from generally low crime rates and rates decreased slightly in 2007 in significant categories, including violent crime.
The crime situation in the UK is similar to the United States, with typical incidents including pick-pocketing; mugging; “snatch and grab” thefts of mobile phones, watches and jewelry; and theft of unattended bags, especially at airports and from cars parked at restaurants, hotels and resorts.
Pickpockets target tourists, especially at historic sites, restaurants, on buses, trains and the London Underground (the “Tube,” or subway).
Thieves often target unattended cars parked at tourist sites and roadside restaurants, looking for laptop computers and hand-held electronic equipment, especially global positioning satellite equipment.
Walking in isolated areas, including public parks, especially after dark, should also be avoided, as these provide advantageous venues for muggers and thieves.
At night or when there is little foot traffic, travelers should be especially careful using the underground pedestrian tunnels.
As a general rule, either walk the extra distance to use a surface crossing or wait until there are other adult pedestrians entering the tunnel.

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

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate at the opening of the next business day.
The U.S. Embassy or Consulate only issues replacement passports during regular business hours.
If you are the victim of a crime while overseas, report it to local police.
The nearest U.S. Embassy or Consulate will also be able to assist by helping you to find appropriate medical care, contacting family members or friends, and explaining how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

Visit the “Victim Support” web site, maintained by an independent UK charity to helps people cope with the effects of crime: http://www.victimsupport.org.uk/
See our information for Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
While medical services are widely available, free care under the National Health System is allowed only to UK residents and certain EU nationals.
Tourists and short-term visitors will be charged for medical treatment in the UK.
Charges may be significantly higher than those assessed in the United States.
Hiking in higher elevations can be treacherous.
Several people die each year while hiking, particularly in Scotland, often due to sudden changes in weather.
Visitors, including experienced hikers, are encouraged to discuss intended routes with local residents familiar with the area, and to adhere closely to recommendations.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
If your medical insurance policy does not provide overseas coverage, you may want to purchase a short-term policy for your trip.
The Department of State provides a list of travel insurance companies that can provide the additional insurance needed for the duration of one’s trip abroad in its online at medical insurance overseas.
Remember also that most medical care facilities and medical care providers in the UK do not accept insurance subscription as a primary source of payment.
Rather, the beneficiary is expected to pay for the service and then seek reimbursement from the insurance company.
This may require an upfront payment in the $10,000 to $20,000 range

Please see our information on medical insurance overseas.

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

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

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

SPECIAL CIRCUMSTANCES:
The legal drinking age in the UK is generally lower than in the U.S. and social drinking in pubs is often seen as a routine aspect of life in Britain. Parents, organizers of school trips, and young travelers should be aware of the impact that this environment may have when combined with the sense of adventure that comes with being abroad.
Please see our Students Abroad web site as well Studying Abroad to help students plan a safe and enjoyable adventure.
The UK has strict gun-control laws, and importing firearms is extremely complicated. Travelers should consider leaving all firearms in the United States.
Restrictions exist on the type and number of weapons that may be possessed by an individual.
All handguns, i.e. pistols and revolvers, are prohibited with very few exceptions.
Licensing of firearms in the UK is controlled by the Police.
Applicants for a license must be prepared to show 'good reason' why they require each weapon.
Applicants must also provide a copy of their U.S. gun license, a letter of good conduct from their local U.S. police station and a letter detailing any previous training, hunting or shooting experience. Background checks will also be carried out.
Additional information on applying for a firearm certificate and/or shotgun certificate can be found on the Metropolitan Police Firearms Enquiry Teams web site at http://www.met.police.uk/firearms-enquiries/index.htm.
A number of Americans are lured to the UK each year in the belief that they have won a lottery or have inherited from the estate from a long-lost relative.
Americans may also be contacted by persons they have “met” over the Internet who now need funds urgently to pay for hospital treatment, hotel bills, taxes or airline security fees.
Invariably, the person contacted is the victim of fraud.
Any unsolicited invitations to travel to the UK to collect winnings or an inheritance should be viewed with skepticism.
Also, there are no licenses or fees required when transiting a UK airport, nor is emergency medical treatment withheld pending payment of fees.
Please see our information on International Financial Scams. Please read our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating British law, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the UK are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
Many pocketknives and other blades, and mace or pepper spray canisters, although legal in the U.S., are illegal in the UK and will result in arrest and confiscation if detected.
A UK Metropolitan Police guide to items that are prohibited as offensive weapons is available at http://www.met.police.uk/youngpeople/guns.htm.
A UK Customs Guide, detailing what items visitors are prohibited from bringing into the UK, is available at http://customs.hmrc.gov.uk/channelsPortalWebApp/downloadFile?contentID=HMCE_CL_001734.
Air travelers to and from the United Kingdom should be aware that penalties against alcohol-related and other in-flight crimes (“air rage”) are stiff and are being enforced with prison sentences.
Please also see our information on customs regulations that pertain when returning to the US.

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

Gabon

Gabon - US Consular Information Sheet
August 15, 2008
COUNTRY DESCRIPTION:
Gabon is a developing nation on the western coast of central Africa.
French is the official language; few Gabonese speak English.
Facilities for tourism o
tside the capital city, Libreville, are available, but they are often limited and can be expensive.
Read the Department of State Background Notes on Gabon for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
Proof of yellow fever vaccination is required for entry.
Visas must be obtained in advance, as airport visas are no longer available.
Travelers should obtain the latest information and details from the Embassy of Gabon, 2034 20th Street NW, Washington, DC
20009, telephone: (202) 797-1000, fax: (202) 332-0668.
Travelers may also contact the Gabonese Consulate at 18 East 41st St., Ninth Floor, New York, NY 10017, telephone (212) 683-7371.
Overseas, inquiries should be made to the nearest Gabonese embassy or consulate.
All non-Gabonese citizens, with the exception of those bearing diplomatic or official passports, are required to obtain exit visas from the Direction Générale à la Documentation et l’Immigration (DGDI, formerly known as CEDOC) before departing Gabon.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
Americans should maintain security awareness at all times.
There have been isolated incidents of civil unrest within the past year, both in the capital city and in the interior.
Large gatherings such as sporting events or any other event where crowds have congregated to demonstrate or protest should be avoided.

Americans may contact the U.S. Embassy in Gabon for the most up-to-date information on safety and security.
The Embassy informs the registered resident American community of security matters through a warden system (please see the Registration/Embassy Location section below for more information).

In the event of a fire, dial 18.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website 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:
In Gabon, petty thievery is common.
Violent crime is more common in urban areas, and there have been cases of armed robberies in homes and in restaurants frequented by foreigners.
Occasionally Americans or Europeans have been victims of crime.

The U.S. Embassy encourages Americans to take extra precautions when traveling in Libreville.
To prevent carjacking, citizens are encouraged to travel with their automobile windows up and doors locked.
Marginal neighborhoods, poorly lit streets, and unfamiliar areas of the city should be avoided, especially at night.
Walking or running on the beach alone at night should be avoided.
When dining in restaurants or visiting markets, it is recommended that one carry only minimal amounts of cash and avoid wearing excessive amounts of jewelry.
If involved in an attempted robbery or carjacking, Americans are encouraged to comply with the attacker to avoid injury and to report all incidents to the police and the U.S. Embassy.
Police response time to reports of crime can be slow.

Scams or confidence schemes do occur in Gabon.
For general information on scams, see our Financial Scams webpage.
Credit cards are not widely accepted except at hotels, and because of the high rates of credit card fraud, their use outside major chain hotels is not recommended.

There have been incidents of sexual assault against foreigners.

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

The local equivalent to the “911” emergency line in Gabon to reach the police is 177.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Gabon's major cities are limited, but they are generally adequate for routine or basic needs.
Medical services in rural areas are generally unavailable.
Additionally, some medicines are not available; travelers should carry necessary, properly labeled medications with them.

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

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 website at http://wwwn.cdc.gov/travel/default.aspx.
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/en.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Gabon is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Travel by road in Gabon can be hazardous.
It is recommended that you drive with your car windows up and the doors locked.
Travelers are routinely stopped at police checkpoints within cities and on roads to the interior.
Americans should comply politely if stopped, but avoid encouraging bribery if possible.
Travelers should use extreme caution when driving after dark.
Two-lane roads are the norm throughout Gabon.
Roads to outlying cities have visible and hidden dangers that are profuse, including large potholes, absence of road signs, poor to non-existent streetlights, and the presence of pedestrians and animals.
Construction work is often poorly indicated.
Four-wheel drive vehicles are recommended for travel beyond the paved road to Lambarene, especially during the rainy season.

Roadside assistance and emergency medical services are available in Libreville, but they may not be dependable.
Such services are nonexistent outside of the city.
Service stations are available along main roads, but vehicle repair facilities are not always available.
Drivers must have a valid international driver's license (available from AAA and the American Automobile Routing Alliance) when driving in Gabon.

Use of taxis is generally safe but does pose added risks.
It is recommended that one use a hotel taxi when possible.
Before riding in a taxi, check that the taxi has seatbelts and agree on a fare.
Riding in a taxi alone or during late hours of the evening is not recommended and creates additional risk of becoming a victim of crime.
Rail services are available, but infrequent, and travelers should be prepared for delays.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
Gabon is a francophone country; travelers who do not speak French will face difficulties associated with the language barrier.

Americans should always carry identification with them in the event they are stopped at a police checkpoint.

Taking photographs of the Presidential Palace, military or other government buildings is strictly forbidden.
Official corruption is common, but offering bribes is not recommended.
Gabon is largely a cash economy.
Credit cards are accepted at only a few major hotels.
Travelers’ checks can be cashed or dollars exchanged for Central African Francs (CFA) at hotels and banks.
ATMs are available in major urban centers, and dispense CFA.

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 Gabonese laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Gabon are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Gabon are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Gabon.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, Americans make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is located downtown on the Boulevard du Bord de Mer.
The mailing address is Centre Ville, B.P. 4000, Libreville, Gabon.
The telephone numbers are (241) 76-20-03 or (241) 76-20-04.
The fax numbers are (241) 74-55-07 or (241) 76-88-49 and the web site is http://libreville.usembassy.gov/.
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*
This replaces the Country Specific Information dated November 5, 2007 to update sections on Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Sat 16 Dec 2017 16:00 SAST
Source: News 24, Agence France-Presse (AFP) report [edited]

The World Health Organisation has declared Gabon a "polio-free country", given the lack of new reported or suspected cases in the central African country.

According to a WHO statement obtained by AFP on [Sat 16 Dec 2017], the UN health agency nonetheless recommended taking the necessary steps to continue monitoring for possible signs of the disease.

Gabon's Health Minister Denise Mekam'ne Edzidzie also urged families on [Sat 15 Dec 2017] to "continue to immunise children and prevent a resurgence of this disease."

Polio is a highly-infectious viral disease which mainly affects young children and can result in permanent paralysis. There is no cure and it can only be prevented through immunisation.

Cases of polio have decreased by 99 percent since 1988, when polio was endemic in 125 countries and 350 000 cases were recorded worldwide.
==================
[Positive news as another country in Africa is declared polio-free. The most recent confirmed case of WPV associated disease in Gabon was reported in 2011 (<https://extranet.who.int/polis/public/CaseCount.aspx>) when there was an outbreak associated with an importation from Angola (see ProMED post Poliomyelitis - worldwide (07): update http://promedmail.org/post/20110512.1462). Of note, reviewing the surveillance data available, since 2000, there has only been one confirmed WPV associated case in Gabon (in 2011), with "compatible" cases reported in 2000 (3 cases), 2001 (3 cases), and 2015 (3 cases).

Maps of Gabon:
Date: Sat, 16 Dec 2017 12:24:21 +0100

Libreville, Dec 16, 2017 (AFP) - The World Health Organization has declared Gabon a "polio-free country", given the lack of new reported or suspected cases in the central African country.   According to a WHO statement obtained by AFP on Saturday, the UN health agency nonetheless recommended taking the necessary steps to continue monitoring for possible signs of the disease.   Gabon's Health Minister Denise Mekam'ne Edzidzie also urged families on Saturday to "continue to immunise children and prevent a resurgence of this disease".

Polio is a highly-infectious viral disease which mainly affects young children and can result in permanent paralysis. There is no cure and it can only be prevented through immunisation.   Cases of polio have decreased by 99 percent since 1988, when polio was endemic in 125 countries and 350,000 cases were recorded worldwide.   Now the disease is endemic only in Afghanistan and Pakistan, where the WHO recorded four cases this year -- two in each country. Last year, there were 37 cases globally.
Date: Thu, 1 Sep 2016 14:38:10 +0200

Miami, Sept 1, 2016 (AFP) - Tropical Storm Hermine picked up speed Thursday as it barrelled down on the US state of Florida, where it was expected to make landfall as a hurricane, forecasters said.   A hurricane warning was in effect for northern Florida, the Miami-based National Hurricane Center said, warning of potential strong winds and storm surges that could cause flooding.   "Hurricane conditions are expected to reach the coast within the warning area beginning tonight," the National Hurricane Center said.

"Preparations to protect life and property should be rushed to completion."   With the tropical storm approaching, intensifying winds threaten to make outside preparations "difficult or dangerous," it added.   Governor Rick Scott declared Wednesday a state of emergency in 51 counties to free up resources to brace for the storm.   The center of Hermine is expected to be near the Florida coast in the warning area by late Thursday night or early Friday, forecasters said.   They warned of potentially "life-threatening inundation" along Florida's western coast on the Gulf of Mexico.

Tropical Storm Hermine picked up speed as expected and was moving north-northeast near 12 miles (19 kilometres) per hour, according to the NHC report.   Its maximum sustained winds strengthened to 65 miles per hour, nearing the minimum 74 miles per hour of a category one hurricane.   The Atlantic hurricane season runs June 1 to November 30, but this year's first hurricane, Alex, formed in January in an unusual weather event.

Earlier this month, the season's second hurricane, Earl, left more than 45 people dead in Mexico.   The 2015 season was less active than average, with 11 tropical storms in the Atlantic, of which four became hurricanes and two major hurricanes.
Date: Wed, 31 Aug 2016 21:14:06 +0200

Libreville, Aug 31, 2016 (AFP) - Angry protesters set fire to Gabon's national assembly on Wednesday as thousands of people took the streets after an announcement that President Ali Bongo had been re-elected, witnesses said.   "The whole building is catching fire," said a man at the scene called Yannick.   AFP journalists further away saw a plume of fire and smoke rising into the air above the building.    "They got in and burned it," Yannick told AFP, saying the security forces had pulled back from the area. They had been deployed there since Tuesday afternoon, when the results were initially due to be published.

The national assembly lies on the same road as several important institutions, among them the senate, the oil ministry, several embassies and the headquarters of state television.    The clashes erupted as soon as Bongo was declared the winner of Saturday's presidential poll, with opposition supporters chanting "Ali must go!"   As chaos erupted on the streets outside, Bongo hailed the outcome of the election, which he declared had been "peaceful and transparent" despite the opposition crying foul.   "I want to reiterate our primary victory: this election was exemplary," he said in his first remarks since the result was announced.
Date: Tue, 17 Mar 2015 03:53:44 +0100 (MET)
By Celia LEBUR

Libreville, March 17, 2015 (AFP) - Strikes in schools, hospitals and in private business, along with a drop in vital oil revenues, have brought turbulent times for Gabon's President Ali Bongo Ondimba.   Rallied by a score of trade unions in the public sector, teachers and health workers have stayed off work since the beginning of February to press home their wage claims, prompting the administration to dock pay.

In weeks of rowdy negotiations, the strikers' representatives have made no concessions to the government of the densely forested equatorial African country, which benefits from plentiful oil reserves as well as tropical hardwood.   Teachers' unions have threatened to write off the current academic year for students if the government refuses to meet their demands for a substantial rise in the minimum monthly salary from 80,000 CFA francs (122 euros, $129 dollars) to 300,000 CFA francs.    "The government shot itself in the foot by deciding to cut the wages of striking staff," said a leader of the movement, Marcel Libama.    "This pointless tactic won't affect our determination to pursue the struggle for our country. Classrooms have remained shut," he added.   "This (school) year can no longer be salvaged."

In rejecting the teachers' claims, the government argued that to comply would mean a spending hike "from 680 billion CFA francs (one billion euros, $1.1 billion) to 2,500 billion CFA francs per year ... which is insupportable for the smooth running of the state."   But as so often in Gabon, the last word lies with the president, whose role it is to mediate during such clashes, though critics hold him primarily responsible for social discontent.   Ali Bongo has ruled since a disputed presidential election in August 2009. The poll was held within three months after his father Omar Bongo died in office after leading the country for no fewer than 41 years.

- 'We want something concrete' -
March 10, Bongo called for classes to resume, asserting that he had met the main demands of the strikers. According to his spokesman Alain-Claude Bilie By Nze, the president agreed to performance bonuses and the introduction of a "new pay scale".     "We want something concrete!" countered an unimpressed maths teacher, asking not to be named. "What does it mean, 'to revise the pay system'? Are they going to raise our basic salary, yes or no?"   Lambert, a high school teacher in the capital Libreville, earns a gross monthly income of 450,000 CFA francs (680 euros), on top of which he is paid a further 200,000 CFA francs in allowances for housing, transport and the like.   "Some teachers with the same promotions, the same seniority as me obtain bonuses that can total twice as much," he complained. "It's all so crooked that no one understand it."   "All civil servants are affected, not just we teachers," Lambert added.

Recent strikes have also paralysed firms in the private sector. Gabon was nearly cut off from the rest of the world late in February and then early in March when workers at the main Internet provider Gabon Telecom walked off the job, demanding higher wages.   During the first two weeks of December, oil workers also downed tools, heavily disrupting production and sparking major energy shortages in Libreville. Since oil accounts for 60 percent of state revenue, the tension undermined Bongo's regime.   At the same time, many major infrastructure projects have ground to a standstill for lack of funds. Despite oil and mineral wealth, about a third of the population of some 1.6 million still lives in deep poverty.

Less than two years ahead of the next presidential poll, the opposition is taking advantage of the groundswell of discontent to call on Bongo to step down.   An opposition rally turned bloody in Libreville on December 22, with different sources reporting between one and three fatal casualties.   The outcome of the last presidential poll in 2009 led to violence and looting in Port Gentil, the country's second city on the Atlantic and a hub of the oil and timber trades.   "It's now more than 50 years that we've put up with the same family in power and nothing has changed for we 'makaya' (street people). We want change," young, unemployed Prospere told AFP.
More ...

Congo, Democratic Republic

Democratic Republic of the Congo US Consular Information Sheet
23rd September 2008
COUNTRY DESCRIPTION: The Democratic Republic of the Congo (Congo-Kinshasa) located in central Africa, is the third largest country on the continent. The capital
s Kinshasa. French is the official language. Years of civil war and corruption have badly damaged the country's infrastructure. Read the Department of State Background Notes on the Democratic Republic of the Congo (DRC) for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport, visa and evidence of yellow fever vaccination are required for entry. Some travelers arriving in the DRC without proper proof of yellow fever vaccination have been temporarily detained, had their passports confiscated, or been required to pay a fine. Information about yellow fever vaccination clinics in the U.S. may be found at http://www2.ncid.cdc.gov/travel/yellowfever/.
Visas must be obtained from an embassy of the DRC prior to arrival.
Travelers to the DRC frequently experience difficulties at the airport and other ports of entry, such as temporary detention, passport confiscation and demands by immigration and security personnel for unofficial “special fees.”
All resident foreigners, including Americans, are required to register at the office of the Direction General de Migration (DGM) in the commune of their place of residence.
Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.
Dual nationals arriving in the DRC should carefully consider which passport they use to enter the DRC. For departure from the DRC, airlines will require a valid visa for all destination countries before they will issue a ticket or allow a passenger to board. Airlines also require that the passenger have the correct entry stamp in the passport they wish to use to exit the country. Passengers who are unable to leave the country on the passport they used to enter the DRC may not be able to continue on their travel itinerary.
Additional information about visas may be obtained from the Embassy of the Democratic Republic of the Congo, 1726 M Street NW, Washington, DC 20036, tel. (202) 234-7690, or the DRC's Permanent Mission to the UN, 866 United Nations Plaza, Room 511, New York, NY 10017, tel. 212-319-8061, fax: 212-319-8232, web site http://www.un.int/drcongo. Overseas, inquiries should be made at the nearest Congolese embassy or consulate. 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:
See the Department of State’s Travel Warning for the Democratic Republic of the Congo.

Though the DRC is now significantly more stable than it has been over the past decade, security remains problematic. The first democratic elections in more than forty years were held in 2006, and a new government is now in place. Post-election disturbances occurred as recently as March 2007 in Kinshasa, resulting in deaths of civilians and military personnel. During civil disturbances in 2007 there were incidents of hostility towards U.S. citizens and other expatriates.

Both inside and outside Kinshasa, there can be roadblocks, especially after dark. Vehicles are often searched for weapons and valuables, and travelers are checked for identity papers. Security forces regularly seek bribes. If confronted with such a situation, it is suggested that U.S. citizens remain courteous and calm. If detained, report the incident to the U.S. Embassy in Kinshasa as soon as possible.

The United Nations has its largest peacekeeping operation in the world in the DRC. Known by its French acronym of MONUC, it has close to 17,000 peacekeepers deployed in the country – primarily in the east. Violence nevertheless persists in the eastern DRC due to the presence of several militias and foreign armed groups, with sporadic outbreaks occurring in North Kivu, South Kivu, and northern Katanga provinces, as well as in the Ituri District of Orientale province. Members of the Lord’s Resistance Army entered into northeastern DRC from Sudan in 2005, and have camps in an isolated region of the DRC, Garamba National Park, where they killed eight MONUC peacekeepers in January 2006.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
In the DRC, poor economic conditions continue to foster crime, especially in urban areas. Travel in many sections of Kinshasa, Kisangani, Lubumbashi and most other major cities, is generally safe during daylight hours, but travelers are urged to be vigilant against criminal activity which targets non-Congolese, particularly in highly congested traffic and areas surrounding hotels and stores. Outlying, remote areas are less secure due to high levels of criminal activity and the lack of adequate training, supervision, and salary payments to the security forces present.

Vehicle thefts, burglaries, and armed robbery occur throughout the country; there have been recent reports of after-dark carjackings, resulting in deaths in the North Kivu area. It is recommended to drive with doors locked and windows closed at all times. If confronted by members of the military or security forces, visitors should not permit soldiers or police officers to enter their vehicles nor get into the vehicle of anyone purporting to be a security official. It is recommended that in such instances U.S. citizens remain courteous and calm and, if threatened, not resist. All incidents should be reported to the U.S. Embassy in Kinshasa.

Consistency in administering laws and regulations is notably absent. Travelers should note that in cases of theft and robbery, legal recourse is limited. Therefore, valuable items may be safer if kept at home or another secure location.

Security officials and/or individuals purporting to be security officials have detained and later robbed American citizens and other foreigners in the city of Kinshasa. This type of crime has increased in recent months, but generally occurs more frequently during the Christmas and New Year's holidays.

Travelers using public transportation or visiting high pedestrian traffic areas of any type are advised to be vigilant against robbery and pick-pocketing which is a persistent problem in all major cities in the DRC. The presence of “street children”, who can be persistent and sometimes aggressive, remains a problem particularly in Kinshasa.
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:
In the DRC, medical facilities are severely limited, and medical materials are in short supply. Travelers should carry properly labeled prescription drugs and other medications with them and should not expect to find an adequate supply of prescription or over-the-counter drugs in local stores or pharmacies. Payment for any medical services required is expected in cash, in advance of treatment.

Malaria is common throughout the DRC and outbreaks of cholera, typhoid, yellow fever, the Ebola virus, and hemorrhagic fever occur.
Travelers should take appropriate precautions to prevent the spread of HIV/AIDS.
Tuberculosis is an increasingly serious health concern in the DRC.
For further information, please consult the CDC's Travel Notice on TB at: http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the DRC.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
For planning purposes, the minimum estimated cost of medical air evacuation to the nearest suitable health care facility (in South Africa) is $35,000.

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 the DRC is provided for general reference only, and may vary according to location or circumstance.

Inter-city roads are scarce, and throughout the DRC roads are generally in poor condition, and often impassable in the rainy season. When driving in cities, keep windows up and doors locked. At roadblocks or checkpoints, documents should be shown through closed windows. In the event of a traffic incident involving bodily injury to a third party or pedestrian, do not stop to offer assistance under any circumstances. Proceed directly to the nearest police station or gendarmerie to report the incident and request official government intervention. Attempting to provide assistance may further aggravate the incident, resulting in a hostile mob reaction such as stoning or beating.

Presidential and other official motorcades pose serious risks to drivers and pedestrians in Kinshasa. When hearing sirens or seeing security forces announcing the motorcade's approach, drivers should pull off the road as far as possible, stop their vehicles, and extinguish headlights. Vehicles should not attempt to move until the entire motorcade has passed by; the security forces will physically indicate when this has occurred. Failure to comply may result in arrest, and/or vehicle damage with possible personal injury.

Public transportation of all forms is unregulated and is generally unsafe and unreliable. Taxis, mini-buses, and trains are in poor mechanical condition and are invariably filled beyond capacity.

Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.

Drivers should stop their cars and pedestrians should stand still when passing a government installation during the raising and lowering of the Congolese flag. This ceremony occurs at roughly 7:30 a.m. and 6:00 p.m.
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 the DRC’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of the DRC’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.
Civil aviation in the DRC continues to experience air incidents and accidents; more than a dozen crashes and in-flight accidents resulted in more than 300 fatalities between 2000 and August 2008. Incidents included hard landings, engine failures, collapsed landing gear, and planes veering off the runway.
In-country air travel schedules are unreliable and planes are frequently overloaded with passengers and/or cargo.
The U.S. Embassy in the DRC has prohibited official travel by U.S. government employees and contractors on all DRC-owned and -operated commercial air transportation services due to concerns regarding safety and maintenance.
International flights on foreign-owned and -operated carriers are not affected by this notice.
SPECIAL CIRCUMSTANCES:
Photography: Travelers should note that photography in public places in Kinshasa and around any public or government building or monument in the DRC is strictly forbidden. Persons caught photographing such sites will likely have their photographic equipment confiscated and risk detention and possible arrest.

Travel to and from Congo-Brazzaville (Republic of Congo): Ferry service to and from Kinshasa and Brazzaville stops running in the late afternoon, does not operate on Sundays, and may close completely with minimal notice. If ferry service is functioning, a special exit permit from the DRC's Immigration Service and a visa from the Republic of the Congo (Congo-Brazzaville) are required for U.S. citizens to cross the Congo River from Kinshasa to Brazzaville.

Ferry and riverboat service to the Central African Republic is suspended due to rebel control of the Ubangui River.
Phone Service: In the DRC, cellular phones are the norm, as other telephone service is unreliable. Depending on the type of phone, it may be possible to locally purchase a SIM card to use an American-compatible cell phone in the DRC.

Currency: U.S. currency is widely accepted in the urban areas, but most vendors and banking institutions will accept only Series 1996 bills or newer, with the large, off-center portraits, that provide stronger protection against counterfeiting. In addition, bills must be in near perfect condition; even those with minor stains or small tears will be rejected. One dollar bills are rarely accepted, even if in mint condition. U.S. bills should be examined before they are accepted to ensure that they are legitimate, as counterfeit currency is widely circulated. It is recommended that currency exchange be conducted at reputable banks and not on the street where several schemes exist to either short-change the unwitting customer or to pass counterfeit bills.

CRIMINAL PENALTIES:
While in any 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. 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.

Penalties for breaking the law can be more severe in the DRC than in the United States for similar offenses.
Persons violating Congolese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the DRC are severe, and convicted offenders can expect long jail sentences and heavy fines. Accusations of engaging in crimes against the security of the State, which are loosely defined, often result in detention for prolonged periods without being formally arrested. The DRC’s justice system remains plagued by corruption and uneven application of the law. Attorney fees can be expensive and are expected to be paid in advance of services rendered.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the DRC are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, so that they can obtain updated information on travel and security within the Congo. Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 310 Avenue des Aviateurs; tel. 243-081-225-5872 (do not dial the zero when calling from abroad). Entrance to the Consular Section of the Embassy is on Avenue Dumi, opposite the Ste. Anne residence. The Consular Section of the Embassy may be reached at tel. 243-081-884-6859 or 243-081-884-4609; fax 243-081-301-0560 (do not dial the first zero when calling from abroad).
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This replaces the Country Specific Information for the Democratic Republic of the Congo, dated April 29, 2008, to update sections on Entry/Exit Requirements and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."
Date: Wed, 9 Oct 2019 22:01:17 +0200 (METDST)

Kinshasa, Oct 9, 2019 (AFP) - Six people were killed in the Democratic Republic of Congo after torrential rains hit the capital Kinshasa, flooding several neighbourhoods. a local official said.    The bodies were found between Tuesday night and Wednesday morning.    Five people were killed in the capital's Selembao municipality where around 30 houses collapsed, local mayor Augustin Mankesi told Top Congo radio station.   One woman died in the Pelende district after she was electrocuted, he added.    "Our community is stricken," Mankesi added, calling on the Congolese authorities for help.   Fatal floods and rains are frequent in Kinshasa. In January last year 48 people were killed in landslides, floods and after houses collapsed, according to authorities.    Residents told AFP the road from the sea port district of Matadi to the Kinshasa turnoff has been closed due to erosion caused by the rain.    The passage is Kinshasa's main supply route for imported goods and also serves as an exit point for exports.
Date: Wed 9 Oct 2019
Source: Provinces 26 RDC [in French, trans. Google, abridged, edited]

Measles killed 246 children in one month in the Basankusu health zone. The epidemic is currently raging in 12 health zones in [Equateur]. Civil society organizations are launching an SOS in the face of the scale of this epidemic.

The coordinator of the citizen movement ECCHA / Basankusu, Christian Boketsu, says that after his visit Mon 7 Oct 2019 through hospitals and health institutions, he noted "a total of 246 deaths in this territory. Patients are abandoned because of lack of medication."

Provincial health minister / Equateur, Bruno Efoloko, confirms that this measles outbreak has been reported since the 36th week in 12 health zones in the province. He said that as far as Basankusu was concerned, "WHO is planning to go down there soon in its 2nd phase of intervention." This includes the "free measles care, but also the strengthening of routine vaccination with a double dose of vaccine."

Dr. Bruno Efoloko lamented the fact that "many parents were hiding their children, saying that measles cannot be cured in the hospital. This caused this high mortality."
=======================
[Also see <https://www.apnews.com/f45e17d506f842f3ad10f3080d57ed48>. More than 4000 people have died in Congo this year [2019] in the world's largest measles outbreak, the UN's children's agency said Wednesday [9 Oct 2019]. Since January [2019], more than 200,000 cases of measles have been reported across Congo, UNICEF said. More than 140,000 involve children under 5, who also make up nearly 90% of deaths. UNICEF said health workers were rushing additional medical kits to help care for more than 110 000 people infected with the measles, a highly contagious and potentially deadly virus. More than 1.4 million children have been vaccinated this year [2019]. - ProMED Mod.LK]
Date: Thu 19 Sep 2019
Source: Wellcome Trust Sanger Institute [edited]

The 1st extensively drug-resistant (XDR) strains of _Salmonella_ Typhimurium, a pathogen which is responsible for millions of bloodstream infections per year in sub-Saharan Africa, have been identified in the Democratic Republic of Congo (DRC). Drug-resistance has increased in successive groups of _S._ Typhimurium over time. These new strains are resistant to all but one of the commonly available drugs in the DRC, with one sample showing reduced susceptibility to this final antimicrobial.

The study, published today (19 Sep 2019) in Nature Communications, was conducted by researchers from the Institute of Tropical Medicine (ITM) in Antwerp, the Institut National de Recherche Biomedicale (INRB) in the DRC, the Wellcome Sanger Institute, the University of Cambridge and their collaborators. The findings suggest that _S._ Typhimurium has evolved in sub-Saharan Africa in the past decades and continues to do so. A multifaceted approach will be needed to track and control the spread of XDR _Salmonella_, including further microbiological and genomic surveillance.

Most _Salmonella_ infections result in symptoms associated with food poisoning. While unpleasant, symptoms are not life-threatening in the vast majority of cases. But in sub-Saharan Africa, _Salmonella_ such as _S._ Typhimurium can cause infections of the blood, known as invasive non-typhoidal _Salmonella_ (iNTS) infections. Every year, iNTS infections are estimated to affect 3.4 million people and result in 681 316 deaths globally*, of which the majority are caused by _S._ Typhimurium. The containment and treatment of iNTS infections in places like the DRC is complicated by limited access to healthcare, infrastructure challenges and weakened immunity, with children under 5 years of age particularly at risk.

It is known that iNTS infections in sub-Saharan Africa are dominated by a type of _S._ Typhimurium known as ST313, which is associated with antimicrobial resistance. Two groups of ST313 (named lineage I and II) split off independently and subsequently spread over the African continent. Antimicrobial resistance has been growing over time, with lineage II now the primary cause of iNTS infections.

Now a global research partnership is working to understand how _Salmonella_ ST313 continues to evolve and develop drug resistance. Working on blood samples collected in DRC hospitals from people with suspected bloodstream infections, researchers from the INRB and ITM observed antimicrobial resistance levels never seen before in _S._ Typhimurium causing bloodstream infections, including resistance to the antimicrobial azithromycin, a drug normally held in reserve in case others prove ineffective**.

To better understand these findings, these strains were genome sequenced and analyzed, including bioinformatics analyses and laboratory experiments at ITM and the Wellcome Sanger Institute, and machine learning analyzes at the Centre for Genomic Pathogen Surveillance (CGPS). Analysis of these _S._ Typhimurium genomes identified a new sub-group that is branching off from ST313, named lineage II.1. Estimated to have emerged in 2004, this new group exhibits extensive drug resistance (XDR).

Dr Sandra Van Puyvelde, 1st author of the study from the Institute of Tropical Medicine and Visiting Scientist at the Wellcome Sanger Institute, said: "All antibiotic resistance genes contributing to XDR are present on the same plasmid. This is worrying because a plasmid is a mobile genetic element that could be transferred to other bacteria. While accumulating more antibiotic resistance, we discovered that the novel _Salmonella _ Typhimurium line is also showing further genetic and behavioral changes, which suggest ongoing evolution of the bacteria towards bloodstream infections."

The researchers also studied the way _S._ Typhimurium is adapting to an invasive lifestyle, moving away from the forms of _Salmonella_ that cause gastrointestinal illness towards the types that cause dangerous invasive bloodstream infections in sub-Saharan Africa. In addition to lab experiments, the samples were tested with a machine learning algorithm designed to look for characteristic patterns in the DNA of _Salmonella_ that indicate the potential to cause dangerous invasive infections.

Dr Nicole Wheeler, a bioinformatician at the Centre for Genomic Pathogen Surveillance, based at the Wellcome Sanger Institute, said: "In the lab, we've observed changes in this new group of _Salmonella_ Typhimurium_ that we've seen in other invasive salmonella. What's interesting as a bioinformatician is that we've been able to pick up these changes using machine learning. The hope is that in the near future, we'll be able to deploy machine learning in a more predictive role to help control the emergence and spread of drug-resistant strains of bacteria such as _S._ Typhimurium."

INRB and ITM have established bloodstream infection surveillance in the past 10 years which has been pivotal in the early detection of the XDR _S._ Typhimurium. Professor Octavie Lunguya of INRB in the DRC, said: "We isolated the organism from patients in hospitals across the Democratic Republic of Congo during our bloodstream infection surveillance activities. It is now crucial that we closely monitor the bacteria and their progression."

Professor Gordon Dougan, from the University of Cambridge, said: "Studies like this are unique, as we are making the bridge between the most important health issues observed in hospitals across the world with in-depth biological research for which we apply cutting edge technologies. Collaborations like this are key and will be important in the future to gain further insights on emerging diseases."
=====================
[The publication discussed is:
Van Puyvelde S, Pickard D, Vandelannoote K, Et al: An African Salmonella Typhimurium ST313 sublineage with extensive drug-resistance and signatures of host adaptation. Nat Commun. 2019 Sep 19;10(1):4280. doi: 10.1038/s41467-019-11844-z.

Abstract:
Bloodstream infections by Salmonella enterica serovar Typhimurium constitute a major health burden in sub-Saharan Africa (SSA). These invasive non-typhoidal (iNTS) infections are dominated by isolates of the antibiotic resistance-associated sequence type (ST) 313. Here, we report emergence of ST313 sublineage II.1 in the Democratic Republic of the Congo. Sublineage II.1 exhibits extensive drug resistance, involving a combination of multidrug resistance, extended spectrum B-lactamase production and azithromycin resistance. ST313 lineage II.1 isolates harbour an IncHI2 plasmid we name pSTm-ST313-II.1, with one isolate also exhibiting decreased ciprofloxacin susceptibility. Whole genome sequencing reveals that ST313 II.1 isolates have accumulated genetic signatures potentially associated with altered pathogenicity and host adaptation, related to changes observed in biofilm formation and metabolic capacity. Sublineage II.1 emerged at the beginning of the 21st century and is involved in on-going outbreaks. Our data provide evidence of further evolution within the ST313 clade associated with iNTS in SSA.

The combination of an extensively drug resistance phenotype with increased invasiveness is a very problematic combination. - ProMed Mod.LL]

[HealthMap/ProMED map available at:
Date: Fri 4 Oct 2019
From: Dr. Pascal Adroba, Dr. Anne Laudisoit, and Dr. William Karesh [edited]

On 25 Sep 2019, a rodent and guinea pig die-off was reported to the health authorities of the Aru Health Zone, Ituri Province, DRC, in the village of Omeyi in the Ongoyi health area. Subsequently a family cluster of 4 cases with the clinical symptoms consistent with the definition of bubonic plague was reported. Symptoms were high fever in 3 patients and high fever with a painful inguinal swollen lymph node in the 15-year-old patient. This family was admitted at the health center of Ekanga on 25 Sep 2019; unfortunately, the 15-year-old boy died on 26 Sep 2019. The other 3 patients were treated with doxycycline (200 mg/day for 5 days).

The DRC health zone team arrived on 27 Sep 2019 to spray the houses with deltamethrin, take human and wildlife samples, and raise community awareness of the measures to be taken. In response to this situation, the head of the Health Center of Ekanga alerted the Central Office of the health zone, and 225 villagers were given doxycycline preventively (single 200-mg dose for adults and children ). A plague rapid diagnostic test (RDT) was performed on the 3 other patients but only one was weakly positive, possibly due to antibiotic treatment. Two samples taken on the dying guinea pigs (lymph node aspirate) were strongly positive with the same RDT.

In total, 12 suspected plague cases (4 male, 8 female) and 3 deaths have been reported since 27 Sep 2019: 7 cases and 3 deaths from Omeyi, 3 cases from Ongoyi, 1 case from Doro and 1 case from Alembele village.

The provincial division of health is closely monitoring the situation and should send a team to the outbreak site on 7 Oct 2019. Rodent samples have been stored in ethanol for PCR diagnostic confirmation of bubonic plague.

The location of the village in proximity with the Ugandan border (20 km [12.4 mi] maximum) and with people seeking treatment in Uganda presents an additional risk of transborder outbreak as earlier this year [2019]. In March 2019, a 35-year-old woman died of pneumonic plague in Uganda after spending time in Atungulei village in DRC's Ituri province, and where her 4-year-old child had died days before. Further investigation revealed that finding her sick at her child's burial, her relatives took her to Uganda for treatment.
------------------------------------------
Dr. Pascal Adroba
Caritas, Bunia, Ituri Province, DRC
with additional details from
Dr. Anne Laudisoit
EcoHealth Alliance
<laudisoit@ecohealthalliance.org>
William B. Karesh, DVM
Executive Vice President for Health and Policy
EcoHealth Alliance
=======================
[ProMED is grateful to Drs. Adroba, Laudisoit, and Karesh for reporting this cluster of rodent and human plague occurring in Ituri, DRC. Although rodents and their fleas are the source of human plague, we don't often identify ill and dying animals in proximity and in advance of human cases.

From ProMED Mod.LL: "Most cases are due to bubonic plague following the bite of an infected rodent flea causing a swollen and very tender lymph gland. The swollen gland is called a 'bubo'. Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas. A person usually becomes ill with bubonic plague 2 to 6 days after being bitten.

"When bubonic plague is left untreated, plague bacteria invade the bloodstream. As the plague bacteria multiply in the bloodstream, they spread rapidly throughout the body and cause a severe and often fatal condition. Infection of the lungs with the plague bacterium causes the pneumonic form of plague, a severe respiratory illness. The infected person may experience high fever, chills, cough, and breathing difficulty and may expel bloody sputum. If plague patients are not given specific antibiotic therapy, the disease can progress rapidly to death."

Plague is endemic in this region of DRC, and this outbreak adds to the woes of a region where Ebola virus disease and measles have been occurring. Moreover, symptoms and signs of plague may overlap with those of Ebola and complicate diagnosis and provision of appropriate medical care. ProMED reported plague in an adjacent region of Uganda in March 2019 (Archive number http://promedmail.org/post/20190312.6363171). - ProMED Mod.LM]

[HealthMap/ProMED-mail map:

HealthMap/ProMED map available at:
Ituri, Democratic Republic of the Congo:
More ...

Vietnam

General:
************************************
Viet Nam is becoming a more popular tourist destination with Irish travellers each year. In many cases these will be those who have no defined itinerary and so their travel plans may change at short
otice. Facilities for tourists vary greatly throughout the country and this needs to be borne in mind when considering some of the serious health issues which can occur throughout the country. The climate is cooler in the north and more tropical further south. There is a monsoon season from May to November each year and the Mekong Delta is prone to significant flooding. Transport during this time can be very difficult and there will be a higher incidence of various diseases during and soon after times of flooding.
Further local information on health issues in Viet Nam is available at http://www.doctorkot.com/index.htm
Safety & Security:
************************************
The majority of those visiting Viet Nam will have no particular difficulty though street crime can be a problem in the main cities of Hanoi and Ho Chi Ming. Generally this is in the form of pick-pocketing, or snatch and grab incidents. Take care of your personal belongings at all times and tourists should not flaunt their relative wealth. Be careful while walking along the footpaths as occasionally a motorcyclist may grab at your bag or camera. Use the hotel safe to store belongings. Attacks against ships in the South China Sea are reported and it is sensible to be vigilant at all times.
Local Laws & Customs:
************************************
Drug smuggling offences carry the death penalty. Don’t take photographs of any military or police installation and avoid any large gathering as the mood can suddenly change. Travel to some of the border areas of the country can be very restricted and so should be avoided. Religious freedom in Viet Nam is quite restricted and those attending gatherings may be detained and fined. Police may occasionally raid hotel rooms without notice. Seizure of documents, pornographic material, compact disks and other goods have lead to high fines and detention.
Road Transport:
************************************
Traffic accidents are becoming more common throughout the country and tourists are occasionally involved with serious consequences. Hiring your own means of transport (car, motorbike etc) is generally unwise. International driving licences are not valid and those wishing to drive will need to obtain a Vietnamese licence. The streets are crowded and many road users will stop suddenly to make purchases from roadside vendors. Traffic laws are often unobserved and horns and gesticulations are used to indicate right of way! Outside the cities, buses and trucks often travel at high speed and accidents are a regular occurrence.
Food & Water:
************************************
The level of food and water hygiene varies greatly throughout the country. Many tourists become ill following consumption of food from both street vendors and also from good quality hotels. Care should be taken at all times. Undercooked or reheated food should be avoided and tap water must be checked for the smell of chlorine. Make sure that a sealed bottle of water is brought to your table during meals. Carbonated water is safer. Bivalve shellfish meals are high risk and previously peeled fruit should not be eaten. Typhoid is reported as a particular problem in the Mekong Delta.
Malaria Risks:
************************************
Viet Nam is endemic for malaria and the risk of transmission occurs in many regions of the country. However, the risk is highest during the monsoon season (May to November) and in the southernmost provinces of Ca Mau and Bac Lieu. The urban areas of Hanoi, Ho Chi Minh City, the Red River Delta and the coastal plain north of Nha Trang are regarded as low risk regions throughout the year.
Mosquito Borne Diseases:
************************************
The other two main mosquito borne diseases are Dengue Fever and Japanese B Encephalitis. Both of these viral conditions can cause serious disease and it is essential that all travellers continually take special care to avoid mosquitoes. The mosquitoes which transmit Dengue tend to bite in the main urban areas while the ones that transmit Japanese B (and malaria) are more common out of the large cities.
Sun Exposure:
************************************
The direct sunlight in Viet Nam can be very intense and both burn and dehydration can easily occur. After a long-haul flight this is a particular concern as many travellers will sleep beside the hotel pool to recover from their journey. After just a short while they may have become significantly burnt. Those trekking should increase their fluids and also take more salt in their diet if possible.
Entertainment Problems:
************************************
Viet Nam has a reputation of a location where it is too easy to obtain sexual exposure for those unaware of the risks. This is particularly true following the consumption of alcohol. The risk of AIDS and other serious STD’s is very high and so contact should be avoided at all costs. A number of otherwise healthy male travellers have suddenly died during the past few years following what is thought to have been laced alcoholic drinks.
Rabies Risk:
************************************
Rabies occurs throughout Viet Nam and any contact with warm-blooded animals should be avoided at all times. Dogs, Cats and Monkeys are most commonly involved in transmitting the disease to humans. Treat any exposure very seriously and wash out the wound, apply an antiseptic and seek urgent medical attention immediately.
Vaccinations for Viet Nam:
************************************
There are no essential vaccines for entry to Viet Nam from Western Europe. However, for personal health, it is advised that all travellers consider cover against;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water borne disease)
*
Hepatitis A (food & water borne disease)
For those trekking within the country there are a number of other vaccines which should be considered including Hepatitis B, Rabies, Japanese B and Meningitis.
Summary:
************************************
The biggest risks within Viet Nam tend to be associated with food and water borne diseases, mosquito bites and the traffic. Commonsense and care is needed at all times to ensure a good safe holiday.

Travel News Headlines WORLD NEWS

Date: Thu, 10 Oct 2019 13:13:57 +0200 (METDST)

Hanoi, Oct 10, 2019 (AFP) - Selfie-snapping tourists railed against the closure of Hanoi's 'train street' on Thursday after police blocked off the Instragram-famous tracks for safety reasons.   The narrow railway corridor in central Hanoi has become a hotspot among visitors seeking the perfect holiday snap on the tracks -- often dodging trains that rumble through daily.    But Hanoi authorities said this week they would block people from the tracks to avoid accidents, and police on Thursday erected barricades to keep out disappointed visitors.    "I'm very frustrated because today I can't go in and take a picture," Malaysian tourist Mustaza bin Mustapha told AFP, vowing to come back later.

Dozens of other tourists were turned away, though some managed to get onto still-open sections of the railway, moving out of the way as an afternoon train chugged past.    Built by former colonial rulers, the railway once shipped goods and people across France's former Indochina colony and remains in use today by communist Vietnam's state-run railway company.    The stretch of the tracks was once known as a rough part of town, occupied by drug users and squatters until their recent discovery by camera-wielding holidaymakers who have splashed images of the area across social media.

Cafe owners complained that business would be hurt thanks to the new regulations, and that tourists always moved out of the way for oncoming trains.   "There has never been any regretful accidents here," said Le Tuan Anh, who runs a cafe from his home along the tracks.   "Compared to traffic density elsewhere in the city, this is much safer," he said, referring to Hanoi's chaotic, motorbike-clogged streets.   New signs were installed in the area Thursday, warning passersby not to take photos or videos in the "dangerous area", much to the chagrin of British tourist Harriet Hayes.   "People come from all over the world to Hanoi just to see the train go past," she told AFP.   "It's such a shame that we come and have been told that we have to leave."
Date: Wed 11 Sep 2019
Source: Saigon Giai Phong [edited]

The Hanoi-based Bach Mai Hospital yesterday [Tue 10 Sep 2019] warned of a high possibility of death from rare Whitmore's disease [melioidosis], as the disease re-occurred and killed 4 people in August [2019].

Moreover, the fatal disease infected 12 patients including a woman suffering from a severe abscess on her nose. The case was very rare, and the hospital treated such cases for the 1st time, said Director of the hospitals' Tropical Disease Center Dr. Do Duy Cuong. The patient was misdiagnosed as having sepsis caused by a staphylococcal infection at a local hospital. However, tests from her wound carried out at the center were positive for the Whitmore bacterium, _Burkholderia pseudomallei_.

The doctors had to change the treatment regimen; otherwise the patient could have died, as Dr. Cuong said. After 2 weeks of treatment, her wound had improved. However, she will still be undergoing treatment for at least 3 months under the close watch of doctors to avoid disease recurrence.

Dr. Cuong added that there have been around 20 cases of melioidosis in the past 5 to 10 years, but since the beginning of the year [2019], the center has admitted 20 cases, mostly from the northern and central provinces.

Melioidosis is an infectious disease caused by the bacterium _Burkholderia pseudomallei_. that can affect humans or animals. It is predominately a disease of tropical climates, especially in Southeast Asia and northern Australia where it is widespread.

The bacteria causing melioidosis are found in contaminated water and soil. It is spread to humans and animals through direct contact with the contaminated source. Patients developing the disease may die without proper treatment.  [Byline: Minh Khang - Translated by Uyen Phuong]
=======================
[Melioidosis is a disease of the rainy season in its endemic areas. It mainly affects people who have direct contact with soil and water. Many have an underlying predisposing condition such as diabetes (most common risk factor), renal disease, cirrhosis, thalassemia, alcohol dependence, immunosuppressive therapy, chronic obstructive lung disease, cystic fibrosis, and excess kava consumption (kava is an herbal member of the pepper family that can be associated with chronic liver disease).

Melioidosis may present at any age but peaks in the 4th and 5th decades of life, affecting men more than women. In addition, although severe fulminating infection can and does occur in healthy individuals, severe disease and fatalities are much less common in those without risk factors.

The most commonly recognized presentation of melioidosis is pneumonia, associated with high fever, significant muscle aches, and chest pain, and -- although the cough can be nonproductive -- respiratory secretions can be purulent, significant in quantity, and associated with on-and-off bright red blood. The lung infection can be rapidly fatal -- with bacteremia and shock -- or somewhat more indolent.

Acute melioidosis septicemia is the most severe complication of the infection. It presents as a typical sepsis syndrome with hypotension, high cardiac output, and low systemic vascular resistance. In many cases, a primary focus in the soft tissues or lung can be found. The syndrome, usually in patients with risk factor comorbidities, is characteristically associated with multiple abscesses involving the cutaneous tissues, lung, liver, and spleen, and a very high mortality rate of 80-95%. With prompt optimal therapy, the case fatality rate can be decreased to 40-50%.

The melioidosis bacillus is intrinsically insensitive to many antimicrobials, and in fact bioterrorism strains may be engineered to be even more resistant. _Burkholderia pseudomallei_ is usually inhibited by tetracyclines, chloramphenicol, trimethoprim-sulfamethoxazole (SXT), antipseudomonal penicillins, carbapenems, ceftazidime, and amoxicillin/clavulanate or ampicillin/sulbactam. Ceftriaxone and cefotaxime have good in vitro activity but poor efficacy; and cefepime did not appear, as well, to be equivalent to ceftazidime in a mouse model. The unusual antimicrobial profile of resistance to colistin and polymyxin B and the aminoglycosides but sensitivity to amoxicillin/clavulanate is a useful tool to consider in treatment of infection with the organism.

The randomized and quasi-randomized trials comparing melioidosis treatment have been reviewed, and it was found that the formerly standard therapy of chloramphenicol, doxycycline, and SXT combination had a higher mortality rate than therapy with ceftazidime, imipenem/cilastatin, or amoxicillin/clavulanate (or ampicillin/sulbactam). The betalactam-betalactamase inhibitor therapy, however, seemed to have a higher failure rate.

Source: Tolaney P, Lutwick LI: Melioidosis. In: Lutwick LI, Lutwick SM (eds). Bioterror: the Weaponization of Infectious Diseases. Totowa NJ: Humana Press, 2008 pp 145-58. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Fri, 10 May 2019 11:12:19 +0200

Ha Long Bay, Vietnam, May 10, 2019 (AFP) - Most visitors to Vietnam's famed Ha Long Bay opt for cruise views of the UNESCO heritage site but from Friday tourists can hop on a helicopter to see the area's famous karst rock formations from the skies.    Nervous flyers beware.   A pair of five-seater helicopters soared up to 300 metres (1,000 feet) to offer passengers aerial views of the limestone towers, cruise ships and the odd houseboat dotting Ha Long's green waters for the maiden flights on Friday.

Helicopter manufacturer Bell said the trips, which start at $125 for 12 minutes, were aimed at tapping into a growing number of tourists to Vietnam -- many from the world's second biggest economy.    "With the Chinese economy growing, you're seeing more tourists come here," said David Sale, Bell's managing director for Asia-Pacific.

The number of visitors to Vietnam grew nearly 20 percent last year, with one-third of the total coming from its powerful communist neighbour to the north.    Domestic tourism is also booming among Vietnam's fast-growing middle class with expanding appetites -- and budgets -- for travel.   Ha Long Bay is one of the country's top draws, with as many as 500 cruise ships in the bay every day and a newly-opened airport helping to funnel visitors into the area.

But the tourist boom has also prompted environmental concerns in the once-pristine bay in Quang Ninh province, also home to home to rapid industrialisation.    "We're under pressure from the coal industry, the urbanisation process, the arrival of more tourists and the population increase," said Le Minh Tan, deputy director of Quang Ninh's tourism department.    He added that a waste-water management system is set to be rolled out soon to deal with sewage spewed out by cruise ships daily.   "We're launching many programs in the area to ensure the environment of Ha Long is green and clean."
Date: Tue, 9 Apr 2019 13:43:38 +0200

Hanoi, April 9, 2019 (AFP) - Three divers who helped rescue a Thai football team last year have made a fresh discovery in Vietnam where they explored a tunnel that could expand the footprint of the world's largest cave.   The team was invited to descend into a waterlogged pit in the Son Doong cave in central Vietnam that has never been explored and is believed to connect to nearby chambers.    They were forced back at 77 meters (252 feet) because they did not have enough oxygen to push further, but they think the tunnels could be 120 meters deep.   If the tunnel connects to another cave, it would make Son Doong "easily the largest cave in the world and it would never be overtaken," British cave expert Howard Limbert, who helped organise the dive, said Tuesday at a press conference announcing the find.

The three divers -- Rick Stanton, Jason Mallinson and Chris Jewell -- were part of the daring rescue to save 12 Thai footballers and their coach who were trapped in a cave for eighteen days last year.    Stanton -- who found the boys on a ledge -- said the painstaking task of safely leading the group out of the tunnel alive helped to prepare for the mission in Vietnam.    "Our planning and preparation is without parallel," he said.   The team plans to return to Vietnam next year to try to link the tunnel to another cave near Son Doong, which is so big that it has its own ecosystem and weather patterns.

The cave in central Quang Binh province was first found by a local forager in 1991, but was not re-discovered for another 19 years because its entrance was hidden by thick surrounding jungle.   Only 30 percent of Vietnam's Phong Nha national park -- where Son Doong and a network of adjacent caves are located -- has so far been explored.     Son Doong is the world's largest cave by volume, big enough to house a New York city block -- including 40-storey skyscrapers -- according to Oxalis, which runs tours into the caves. 

Proposed plans to build a cable car in the area have sparked anger among the Vietnamese public who fear it will harm the area's wildlife and pristine views.      An official said Tuesday there were no plans to move ahead with the project despite offers from several companies.   "That is only in theory, in truth, to build a cable car there is no such project yet," the vice chairman of Quang Binh province Tran Thien Dung said Tuesday.       Vietnam's tourism industry is booming among domestic and foreign travellers alike, but the communist country has come under fire for failing to preserve landscapes as it rapidly expands the sector.
Date: Fri, 25 Jan 2019 12:21:09 +0100
By Jenny VAUGHAN

Vu Thu, Vietnam, Jan 25, 2019 (AFP) - Tran Huu Hoa was scared, desperate and on the verge of suicide after his leprosy diagnosis in 1958, fearing he'd never work or marry in an age when lepers were completely shunned from Vietnamese society.   He could not imagine he would find new life at the leprosy hospice where he has been living for 61 years, a walled off compound in northern Thai Binh province where he met his wife, worked as a union boss and took in needy children.    "There were about 2,000 people here then, mostly young people. It was fun because we started a teen union," the 80-year-old told AFP, sitting on his bed with his wife Teo of 54 years. 

Today there are only 190 patients at the hospital, all cured but living with disabilities caused by leprosy.    Many walk with prosthetic legs. Others like Hoa have lost fingers. Some are so severely disabled they spend the day bent over in bed, covered with thick blankets to keep the cold at bay.    Founded in 1900, Van Mon is the oldest leprosy hospital in northern Vietnam.    At its peak it treated 4,000 patients a year -- a number that has dwindled as leprosy cases have dropped across Vietnam thanks to improved healthcare, hygiene and greater awareness of the disease.   World Leprosy Day is January 27.

There were 248 people being treated for leprosy in 2017 in Vietnam, down by more than half from a decade earlier, according to data from the World Health Organization.    But as numbers have decreased so have the live-in patients at the Van Mon centre.   Meandering days are punctuated with a morning and midday meal. Some pass the time worshipping at the on-site chapel or pagoda, while most watch TV or listen to the radio during the day when they are not sleeping.    "I have no one to count on, I'm so lonely, so I just follow God. When I die I will follow God then too," said Pham Van Bac, 83, who has been at the centre since 1960. 

His daughter no longer visits and his grandchildren come only once a year, so he has little to look forward to most days, he says.    But many like Bac chose to stay, fearing they will be a burden on their families, or lose the care and small stipend provided at the government-run hospital.   Some, like Hoa, have found companions in the centre.   "It's a source of encouragement and motivation and they can have a happier and better life," said Nguyen Thi Thai, deputy director of the hospital where both her parents were once treated for leprosy.    And even though stigma against leprosy sufferers has largely faded outside the walls of the hospice, many prefer to remain at Van Mon.    Hoa said: "This is my second home, I will live here until my death."
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World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."