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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 ...

Equatorial Guinea

Equatorial Guinea US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Equatorial Guinea is an oil-rich, developing country on the western coast of central Africa.
Its capital and main port, Malabo, is located on the isla
d of Bioko, off the coast of Cameroon.
A secondary port, Luba, is also on Bioko.
The mainland territory of Equatorial Guinea is bordered by Cameroon and Gabon.
The principal city on the mainland is Bata.
Facilities for tourism are limited but growing.
Official languages are Spanish, which is widely spoken, and French, which is not widely understood, but sometimes used in business dealings.
Read the Department of State Background Notes on Equatorial Guinea for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and evidence of a yellow fever vaccination are required to enter Equatorial Guinea.
Visas are not required for U.S. citizens unless the traveler will be there for an extended stay or is intending to work there.
U.S. citizens entering without a visa but staying longer than 90 days should register with the local police station.

Private vessels landing in an Equato-Guinean port must get clearance prior to approaching the shore.
Travelers should obtain the latest information and details from the Embassy of the Republic of Equatorial Guinea, 2020 16th Street NW, Washington, DC
20009, telephone (202) 518-5700, fax (202) 518-5252.

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

SAFETY AND SECURITY:
Although large public demonstrations are uncommon, U.S. citizens should avoid large crowds, political rallies, and street demonstrations.

In February 2009, approximately 50 gunmen arriving by speedboats attacked government buildings in Malabo but were repelled by Equato Guinean military and police.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME:
Violent crime is rare and the overall level of criminal activity is low in comparison to other countries in the region.
However, there has been a rise in non-violent street crime and residential burglaries.
Travelers should exercise prudence and normal caution, including avoiding dark alleys, remote locations, and traveling alone.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the U.S. Embassy in Malabo at (240) 098895; Embassy personnel will assist in contacting the local police.
If you are the victim of a crime while in Equatorial Guinea, please remember to report the incident to local police, and contact the U.S. Embassy in Malabo for assistance.
The Embassy staff can, for example, assist you in finding 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, the consular officer can help you understand the local criminal justice process and to find an attorney if needed.

Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

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

SPECIAL CIRCUMSTANCES:
It is not uncommon for a uniformed member of the security forces to stop motorists on the pretext of minor or nonexistent violations of the local motor vehicle regulations in order to extort small bribes.
Visitors are advised not to pay bribes, and to request that the officer provide a citation to be paid at the local court.
If visitors encounter any of these problems they should contact the Embassy Consular Officer at 516008 and inform him/her of the situation.

Equatorial Guinea has a strictly cash economy.
Credit cards and checks are not accepted; credit card cash advances are not available and there are no ATMs.
In addition, most local businesses do not accept travelers' checks, dollars or euros.
However, dollars can be changed at local banks for CFA.
Cash in CFA is usually the only form of payment accepted throughout the country.

Special permits from the Ministry of Information and Tourism (or from the local delegation if outside Malabo) are required for virtually all types of photography.
Police or security officials may charge a fine, attempt to take a violator into custody, or seize the camera and film of persons photographing the Presidential Palace and its environs, military installations, airports, harbors, government buildings, and other areas.

Travelers are advised that the possession of camouflage-patterned clothing, large knives, binoculars, firearms, or a variety of other items may be deemed suspicious by the security forces and grounds for confiscation of the item and detention of the carrier.
Please see our Customs Information sheet.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are extremely limited. Pharmacies in Malabo and Bata stock basic medicines including antibiotics, but cannot be counted on to supply advanced medications. Outside of these cities, many medicines are unavailable. Travelers are advised to carry any special medication that they require. The sanitation levels in even the best hospitals are very low though the new Israeli-built and staffed La Paz Hospital in Bata approaches European standards of sanitation and is reported by Red Cross officials to be the best in the region. Doctors and hospitals often require immediate payment for health services, and patients are often expected to supply their own bandages, linen and toiletries.
The Malabo hospital is likewise undergoing a complete update, with expected completion in late 2009.

Malaria is a serious and sometimes fatal disease. The national government, along with U.S. oil companies in the country, has taken aggressive steps to control the mosquito population and limit the impact of malaria on the population centers in Malabo and Bata.
Plasmodium falciparum malaria, the type that predominates in Equatorial Guinea, is resistant to the anti-malarial drug chloroquine. Because travelers to the country are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following anti-malarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarials they have been taking.
Visit the CDC travelers’ health page for additional information on malaria, including protective measures.

There are periodic outbreaks of cholera in Equatorial Guinea. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease.

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

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

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Hospitals, clinics, and other businesses and hotels do not accept credit cards.
If there are any concerns that travelers may need medical care or assistance while in Equatorial Guinea, they should make arrangements to have access to enough cash to cover possible expenses.
There are companies such as Western Union where international money orders can be arranged and cash obtained.
There are no ATM machines in the country (See SPECIAL CIRCUMSTANCES Section above).
You can see more 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 Equatorial Guinea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Generally, Equatorial Guinea's road networks are underdeveloped.
There are few road and traffic signs, though more signs are becoming evident.
Livestock and pedestrians create constant road hazards.
During the rainy season, many roads are passable only with four-wheel-drive vehicles.
However, new road construction and repair is taking place all over the country and road conditions have improved markedly over the course of the past year.
If you plan on staying and driving around the country for any length of time you should attempt to purchase a cell phone for assistance in case of an emergency.

Travelers outside the limits of Malabo and Bata may expect to encounter occasional military roadblocks.
Travelers should be prepared to show proper identification (for example, a U.S. passport) and to explain their reason for being at that particular location.
The personnel staffing these checkpoints normally do not speak or understand English or French; travelers who do not speak Spanish would do well to have their reason for being in the country and their itinerary written down in Spanish before venturing into the countryside.

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 Equatorial Guinea, the U.S. Federal Aviation Administration (FAA) has not assessed Equatorial Guinea’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA web site.

Commercial air travel to and from Equatorial Guinea can be difficult.
Malabo is served by European airlines a few times per week.
The island of Bioko and the African mainland are connected by several small local airlines offering daily service.
Schedules are subject to change or cancellation without notice; flights are often overbooked and reservations may not guarantee seats.

Malabo Airport has navigational aids and can accommodate night landings.
There are no navigational aids at Bata Airport.
Special clearances are required to land in or overfly Equatorial Guinea territory.

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

The United States reopened its Embassy in Malabo in October 2003.
However, due to reduced staffing, it can offer only limited services to U.S. citizens in distress.
The U.S. Embassy in Malabo can be contacted at (240) 098-895.
Additional services are provided through the U.S. Embassy in Yaoundé, Cameroon, located on Avenue Rosa Parks in the Mbankolo Quartier, adjacent to the Mount Febe Golf Club; mailing address P.O. Box 817; embassy tel. (237) 2220-1500, fax: (237) 2220-1572.
The Embassy Branch Office in Douala, Cameroon, is located on Rue Flatters, in the Citibank Building, tel.: (237) 3342-53-31, fax: (237) 3342-77-90.
* * *
This replaces the Country Specific Information for Equatorial Guinea, dated November 15, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Special Circumstances, Medical Facilities and Health Information, Medical Insurance, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Sun, 26 May 2019 06:31:33 +0200
By Camille MALPLAT

Sipopo, Equatorial Guinea, May 26, 2019 (AFP) - Gleaming but eerily empty, the luxurious Sipopo resort with its five-star hotel and exclusive facilities rises from a tropical beach, symbolising the dilemma of Equatorial Guinea -- a notoriously closed country that has turned to tourism to help fill its coffers.  The purpose-built town was carved out of an ancient forest in 2011 at a cost of 600 million euros ($670 million), initially to host a week-long African Union summit and showcase the rise of the tiny oil-rich state.   A 16-kilometre (10-mile) drive from Equatorial Guinea's capital Malabo, the resort boasts a vast conference centre, the Sofitel Malabo Sipopo Le Golf hotel, as well as 52 luxury villas -- one for every head of state to attend the summit -- each with its own swimming pool.    There is also an 18-hole golf course, several restaurants and exclusive beaches guarded by police.

For almost a decade, Sipopo has been the crown jewel in a strategy to lure high-end visitors to Equatorial Guinea to diversify an economy badly hit by a slump in oil revenue.   But the town, visited by an AFP reporter two months ago, seemed quite empty -- an impression strengthened by conversations with people who live or who work there.   "It's depressing, there's no-one," said a visiting Gabonese consultant.   A worker, who asked not to be named, said the complex was quiet year-round: "You can hear the sound of your own footsteps."   The occasional visitors tend to be well connected, rich and in search of privacy, the sources said.    Many are guests of a government described by Human Rights Watch as corrupt and repressive.    One of the villas, according to the sources, was occupied by former Gambian dictator Yahya Jammeh after he fled his country in 2017.

- Empty lobby -
At Easter, the 200-room hotel's guests included a Spanish couple on honeymoon, a few families and some businessmen, who were all foreigners.   In the echoing lobby, a huge black and white portrait of the country's 76-year-old authoritarian president, Teodoro Obiang Nguema -- Africa's longest-serving ruler -- hung on the wall, watching over the vacant reception area.   A 1.5-kilometre (nearly mile-long) beach -- an artificial shore secluded from curious eyes -- was virtually deserted, in contrast to a public beach near the capital. The three-lane highway leading from Malabo to Sipopo was mostly empty of traffic.   A hospital was added after the villas were built, but is unused, the sources said.   In 2014, a mall was built at the resort to house 50 shops, a bowling alley, two cinemas and a children's play area.   But a hotel receptionist said the complex was not open yet, adding: "If you want to buy a souvenir, you will have to go to Malabo." At night-time, shiny limousines arrived at a luxury restaurant to drop off diners.

- Tourism hopes -
Located on the mid-Atlantic coast of central Africa, Equatorial Guinea has flooded social media with messages of its allure as a holiday destination.   Plans to build a new passenger terminal at the airport in Bata city have also just received a 120-million-euro ($133-million) injection from the Development Bank of Central African States.   Figures for visitors are unavailable, and the tourism ministry in Malabo did not respond to AFP's requests for information. In the latest global compilation of figures posted by the World Bank, the number of tourists for Equatorial Guinea has been left blank.   But much of the tourism in evidence are business people, such as oil company workers, relaxing for a few days, or attending energy or economic conferences. 

A few travel firms offer trips tailor-made for both luxury and adventure, but they also allude to the difficulties, notably of being allowed to enter the country.   "The country has been a mystery to outsiders, who were discouraged from entering by a difficult visa process and a lack of tourism infrastructure," says the website of British tour operator Undiscovered Destinations.   The firm claimed, however, that "things are changing fast... with an excellent road network and numerous hotels springing up seemingly overnight."   Few Equatoguineans have the chance of staying in such places. At Sipopo's hotel, a basic room costs the equivalent of more than 200 euros ($224) a night, while exclusive accommodation tops 850 euros.   The discovery of vast oil reserves off the coast in the mid-1990s has boosted the country's gross national income to a theoretical annual $19,500 per person per year, according to the UN Development Programme.   But that wealth benefits a small elite among the country's 1.2 million inhabitants. More than two-thirds of Equatoguineans live below the poverty line, and 55 percent of the population aged over 15 are unemployed.
Date: Wed 14 Jan 2015
Source: Eye Witness News [edited]

The Africa Cup of Nations (Afcon) finally gets underway on Sat [17 Jan 2015] after a controversial build-up to the 30th edition, which included a hasty late switch of hosts to Equatorial Guinea in the wake of concerns over the Ebola virus.

16 nations again line up for the biennial continental championship, seeking Africa's top sporting prize at the tournament, which starts on Sat [17 Jan 2015] and finishes on 8 Feb [2015].

Few previous editions have had such a dramatic backdrop, with the hosting of the 2015 finals being switched 2 months ago after Morocco asked for a postponement in the wake of the spread of the Ebola virus in West Africa. That request precipitated a crisis that left the tournament having to be organised almost from scratch in a few weeks.

Fears that travelling fans could spread Ebola and damage Morocco's tourist industry were seen as alarmist by the Confederation of African Football (CAF), who rejected the request and then stripped Morocco of their hosting rights.

>From a country with plentiful resources, who have previously bid to host the World Cup, Afcon is now being played in one of Africa's smallest and most enigmatic countries.

Equatorial Guinea is a family-ruled former Spanish colony which has newfound oil wealth and is reveling in rescuing the continent's most eagerly anticipated sporting event. ... - more
Date: Thu 17 Apr 2014
Source: WHO Global Alert and Response [edited]

Update on polio in central Africa -- polio confirmed in Equatorial Guinea, linked to outbreak in Cameroon
--------------------------------------------------------------------------------
In Equatorial Guinea, 3 new wild poliovirus type 1 (WPV1) cases have been reported, the 1st polio in the country since 1999. Genetic sequencing indicates these cases are linked to an on-going WPV1 outbreak in Cameroon which has subsequently been detected in Equatorial Guinea. The cases had onset of paralysis on [28 Jan 2014], [19 Jan 2014] and [24 Mar 2014], from Centro Sur, Bioko Norte and Litoral. Outbreak response in Equatorial Guinea is currently being planned, including National Immunization Days (NIDs) with bivalent oral polio vaccine (OPV) on [21-24 Apr 2014]. An estimated 40 percent of children are fully immunized against polio in the country.

On [17 Mar 2014], the World Health Organization (WHO) had elevated the risk assessment of international spread of polio from Cameroon to 'very high' (http://www.who.int/csr/don/2014_03_17_polio/en/). The risk assessment was elevated due to: confirmation of 3 additional WPV1 cases (with onset of paralysis on [6, 25 and 31 Jan 2014]) from 3 new regions of Cameroon, confirming continued WPV transmission and geographic expansion of infected areas following detection of 4 cases in October 2013; gaps in surveillance; and, influx of vulnerable refugee populations from Central African Republic. The confirmation of new cases in Cameroon resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity on [11-13 Apr 2014], and implementing nationwide campaigns in May and June 2014. Critical to success will be to ensure substantial improvement in the quality of immunization campaigns that reach all children multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.

Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo. In Gabon, a nationwide immunization campaign is planned for [22-26 Apr 2014] (targeting all children aged less than 15 years), and in the Republic of Congo, a nationwide activity will be conducted on 1 May 2014.

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for acute flaccid paralysis (AFP) cases in order to rapidly detect any new virus importations and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.

WHO's International Travel and Health (http://www.who.int/ith/chapters/en/) recommends that all travellers to and from polio-affected areas be fully vaccinated against polio.
Date: Sat 23 June 2012
Source: Guinea Equatorial [in Spanish, trans. ProMed Mod.JG, edited]

After the last measles vaccination campaign that took place last April 2012, a new outbreak of the disease has been reported in some communities in Malabo district, and for this reason, the Ministry of Health initiated a new vaccination campaign [Malabo is the capital of Equatorial Guinea, located on the northern coast of Bioko Island. - ProMed Mod.CP].

Activities started last Thursday, with the cooperation of the National Vaccination Programme (PAV, according to its Spanish initials). The campaign will concentrate its activities in the most severely affected communities, such as Santa Maria III, Lampert and Sunco.

Some medical officers gathered in Madre Bisila Health Centre in order to organise local vaccination units and to deal with mothers who brought their children to the Health Centre in order to have them vaccinated. Vaccine will be dispensed throughout the next 10 days, and subsequently, the vaccination campaign will continue in the Continental region of Equatorial Guinea.

Local officials from the Ministry of Health are inviting the population, particularly mothers, to bring their children to local health centres or to bring their children to mobile vaccination units when these teams arrive to their communities.
=====================
[According to La Voz de Rusia (<http://spanish.ruvr.ru/2012_06_22/Guinea-epidemia-sarampion/>), the last major measles epidemic in the country occurred in November 2008, when more than a dozen children died in various hospitals in Equatorial Guinea. No fatalities have been reported in the current outbreak so far.

Equatorial Guinea, officially the Republic of Equatorial Guinea, is a country located in central Africa. It has 2 parts: a Continental Region (Rio Muni), including several small offshore islands including Corisco, Elobey Grande and Elobey Chico; and an insular region containing Annobon island and Bioko island (formerly Fernando Po), where the capital Malabo is situated. A map of Equatorial Guinea can be accessed at: <http://www.africa.upenn.edu/CIA_Maps/Equatorial_Guinea_19871.gif>. - ProMed Mod.CP]

[The ProMED HealthMap for Equatorial Guinea can be found at
<http://healthmap.org/r/1KlO>.]
Date: Wed 30 Dec 2009
From: Patricio Leite (translated and edited)

Three people are sick with malaria in the Madeira archipelago of Portugal. One is in intensive care for complications of the disease in the Central Hospital of Funchal; the other 2 remain hospitalized but stabilized.

These people from Madeira were working in Equatorial Guinea and returned for the Christmas holidays. There is a 4th, a Brazilian national who also may be infected and is undergoing diagnostic tests.

Although they are cases of imported malaria, it is noteworthy that the archipelago of Madeira has a sub-tropical humid climate, conducive to the development of emerging diseases which are usually more prevalent in the tropics.

For example, for about the last 3 years the presence of the vector _Aedes aegypti_ has been documented, and it is now endemic in Madeira, posing the threat of dengue in the short term. In the archipelago, including the island of Porto Santo, weather conditions have allowed the survival of _Anopheles_.

Studies indicate that the next 30 years will see the emergence of diseases in Madeira, such as dengue, yellow fever, and malaria.
-------------------------------------------
Patricio Leite, MD
Specialist in General & Family Medicine
Regional Health Administrator for Lisbon & the Tejo Valley, Ministry
of Health, Portugal
Ex-collaborator of Travel Medicine Consultation, Institute of Hygiene
& Tropical Medicine,
New University of Lisbon
Portugal
========================
[Portugal reported 41 imported malaria cases in 2008 (Source: <http://data.euro.who.int/cisid/>). The climate of Madeira in December with temperatures below 20 C do not support local transmission of _Plasmodium falciparum_. Malaria is endemic in Equatorial Guinea, and the risk of infection is high without proper prophylaxis.

The introduction of dengue fever is a possibility, as in most of southern Europe. The introduction of yellow fever is a risk because the vector is present; however, yellow fever is limited to tropical areas, and Madeira probably does not, at present, have a climate which supports sustained transmission of yellow fever. - ProMed Mod.EP]
More ...

Papua New Guinea

Papua New Guinea - US Consular Information sheet
October 17, 2008
COUNTRY DESCRIPTION:
Papua New Guinea is a developing country in the Southwest Pacific. The capital is Port Moresby. Tourist facilities outside major towns are limited. Crim
is a serious concern throughout Papua New Guinea (please see the section on crime below). Read the Department of State Background Notes on Papua New Guinea for additional information.
ENTRY/EXIT REQUIREMENTS: Travelers must possess a valid passport, onward/return airline ticket, and proof of sufficient funds for the intended visit. Travelers may obtain business or tourist visas (valid for stays of up to 60 days, with extensions available for an additional 30 days) upon arrival at Jacksons International Airport in Port Moresby. All persons boarding international flights originating from Papua New Guinea pay a departure fee, which should be included in airline fares. Travelers may obtain more information on entry and exit requirements from the Embassy of Papua New Guinea, 1615 New Hampshire Avenue NW, Suite 300, Washington, DC 20009, tel. 202-745-3680, fax 202-745-3679, e-mail kunduwash@aol.com, or via the Papua New Guinea Embassy web site at http://www.pngembassy.org/
Travelers who plan to transit or visit Australia must enter with an Australian visa or, if eligible, an Electronic Travel Authority (ETA). The ETA replaces a visa and allows a stay of up to three months. It may be obtained for a small service fee at http://www.eta.immi.gov.au/. Airlines and many travel agents in the United States are also able to issue ETA’s. Travelers may obtain more information about Australian entry requirements from the Australian Embassy at 1601 Massachusetts Avenue NW, Washington, DC 20036, tel. 202-797-3000, or via the Australian Embassy's web site at http://www.austemb.org/.

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

SAFETY AND SECURITY:
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.
Civil Unrest/Political Tension: Tension between communal or clan groups, particularly in the Highlands region, occasionally leads to outbreaks of tribal fighting, often involving the use of firearms. Travelers should consult with their tour operator, the U.S. Embassy in Port Moresby, or with Papua New Guinean authorities before visiting the region.

Visitors intending to travel to the autonomous region of Bougainville Island should contact the U.S. Embassy in Port Moresby for updated security information. Bougainville Island is not peaceful, law enforcement is weak, and tourist and transportation facilities are limited. We advise travelers to Bougainville, as in other parts of Papua New Guinea, to exercise a high degree of caution. Areas near the Panguna mine, located on the southern part of the Island of Bougainville, have been officially designated “no go zones” by the Autonomous Government of Bougainville; Americans should avoid those areas.
Up-to-date information on 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 that travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad.
CRIME: Papua New Guinea has a high crime rate. Numerous U.S. citizen residents and visitors have been victims of violent crime in recent years, and they have sometimes suffered severe injuries. Carjackings, armed robberies, and stoning of vehicles are problems in and around major cities such as Port Moresby, Lae, Mount Hagen, and Goroka, but can happen anywhere. Pickpockets and bag-snatchers frequent crowded public areas. Hiking or other travel in rural areas and visiting isolated public sites such as parks, golf courses, beaches, or cemeteries can be dangerous. Individuals traveling alone are at greater risk for robbery or gang rape than are those who are part of an organized tour or under escort. Visitors to Papua New Guinea should avoid using taxis or buses, known as Public Motor Vehicles (PMV's), and should instead rely on their sponsor or hotel to arrange for taxi service or a rental car.
Road travel outside of major towns can be hazardous because criminals set up roadblocks near bridges, curves in the road, or other features that restrict vehicle speed and mobility. Visitors should consult with the U.S. Embassy or with local law enforcement officials concerning security conditions before driving between towns. (See also Traffic Safety and Road Conditions below). Travel to isolated places in Papua New Guinea is possible primarily by small passenger aircraft; there are many small airstrips throughout the country. Security measures at these airports are rare. Organized tours booked through travel agencies remain the safest means to visit attractions in Papua New Guinea. The Embassy recommends that prospective visitors consult a Primer on Personal Security for Visitors to Papua New Guinea at http://travel.state.gov/travel/cis_pa_tw/cis/cis_1757.html
Kokoda Track: Americans should exercise a high degree of caution when walking the Kokoda Track and traveling through the areas adjacent to each end of the track. Travelers should travel with guides from a reputable tour company. This is particularly important given occasional threats by villagers to close parts of the track because of local land and compensation disputes. Trekkers should ensure that their tour company provides a permit in return for fees paid for this purpose. The Kokoda Track Authority (KTA) has stationed rangers along the track and at airports to collect fees from trekkers who have not obtained a valid trekking permit. The KTA can be contacted on telephone (675) 325 6165 regarding payment of the applicable fee.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance. The embassy/consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds may be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you understand the local criminal justice process and to find an attorney, if needed.
The local equivalent to the “911” emergency line in Papua New Guinea is: 000
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Papua New Guinea vary from hospitals in Port Moresby and the larger towns to aid posts (including some missionary stations) in remote areas. Medical facilities vary in quality, but those in the larger towns are usually adequate for routine problems and some emergencies. However, equipment failures and sudden shortages of common medications can mean that even routine treatments and procedures (such as X-rays) may become unavailable. A hyperbaric recompression chamber for diving emergencies is available in Port Moresby. Pharmacies in Papua New Guinea are found only in urban centers and at missionary clinics. They are small and may be inadequately stocked. Doctors and hospitals often expect immediate cash payment for medical services.
Medical conditions arising as a result of diving accidents will almost always require medical evacuation to Australia, where more sophisticated facilities are available. Medical evacuation companies could charge thousands of dollars to transport a victim to Australia or the U.S. A last-minute, one-way commercial ticket from Port Moresby to Brisbane or Cairns costs upwards of US$250 for economy class and upwards of US$550 for business class. The most commonly used facilities are in Brisbane and Cairns, both in the Australian State of Queensland. Travelers who anticipate the possible need for medical treatment in Australia should obtain entry permission for Australia in advance. Entry permission for Australia can be granted by the Australian Embassy in Port Moresby, but it is easier to obtain it prior to leaving the United States (see section above on Entry/Exit Requirements).
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Papua New Guinea. The Government of Papua New Guinea does not currently have any policy guidelines that prevent entry into the country by short- and long-term travelers and/or residents.

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 (CDC) and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and if 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 Papua New Guinea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic in Papua New Guinea moves on the left. Travel on highways outside of major towns can be hazardous. Motor vehicle accidents are a common cause of serious injury in Papua New Guinea, especially when passengers are sitting in the open bed of a pickup truck. Drivers and passengers are advised to wear seatbelts. There is no countrywide road network. Roads are generally in poor repair, and flat tires occur routinely as a result of potholes and debris on the roadways. During the rainy season landslides can be a problem on some stretches of the Highlands Highway between Lae and Mount Hagen. Criminal roadblocks have occurred during the day and more widely after dark on the Highlands Highway. Visitors should consult with local authorities or the U.S. Embassy before traveling on the Highlands Highway.
Crowds can react emotionally and violently after road accidents. Crowds form quickly after an accident and may attack those whom they hold responsible, stoning and/or burning their vehicles. Friends and relatives of an injured party may demand immediate compensation from the party they hold responsible for injuries, regardless of legal responsibility. Persons involved in accidents usually should proceed directly to the nearest police station rather than stop at the scene of the accident.
Please refer to our Road Safety page for more information. Visit the website of Papua New Guinea’s national tourism office and national authority responsible for road safety. For specific information concerning Papua New Guinea driving permits, vehicle inspection, road tax and mandatory insurance, please contact Papua New Guinea’s Tourist Promotion Authority via the Internet at http://www.pngtourism.org.pg/.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Papua New Guinea, the U.S. Federal Aviation Administration (FAA) has not assessed Papua New Guinea’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Customs: Papua New Guinean and Australian customs authorities enforce strict regulations concerning temporary importation into or export from Papua New Guinea and Australia of items such as firearms, certain prescription drugs, wooden artifacts, exotic animals, food, and sexually explicit material. Other products may be subject to quarantine. It is advisable to contact the Embassies of Papua New Guinea and Australia in Washington, D.C. for specific information regarding each country’s customs requirements. (See the contact information in the section on Entry/Exit Requirements above.)
Natural Disasters: Papua New Guinea is prone to earthquakes, volcanic eruptions, and sudden tidal movements. There are numerous active volcanoes throughout Papua New Guinea. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
Documentation: U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that if questioned by local officials, proof of identity and U.S. citizenship is readily available.

Please see our Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offences. Persons violating Papua New Guinea‘s laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession or use of, or trafficking in illegal drugs in Papua New Guinea 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. Homosexual activity is illegal in Papua New Guinea. 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 AND CONSULATE LOCATIONS: Americans living or traveling in Papua New Guinea 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 Papua New Guinea. The U.S. Embassy website is http://portmoresby.usembassy.gov. Americans without Internet access may register directly at the Consular Section of the U.S. Embassy in Port Moresby and obtain updated information on travel and security within Papua New Guinea. The U.S. Embassy is located on Douglas Street, adjacent to the Bank of Papua New Guinea, in Port Moresby, Papua New Guinea. That address should be used for courier deliveries. The mailing address is P.O. Box 1492, Port Moresby, NCD 121, Papua New Guinea. The Embassy's telephone number is (675) 321-1455; after hour’s duty officer telephone number is (675-601-9689); fax (675) 321-1593. Americans may submit consular inquiries by e-mail to ConsularPortMoresby@state.gov
****
This replaces the Country Specific Information for Papua New Guinea dated July 18, 2008 to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Tue, 1 Oct 2019 06:39:06 +0200 (METDST)

Kokopo, Papua New Guinea, Oct 1, 2019 (AFP) - Papua New Guinea's volatile Ulawun volcano erupted early Tuesday, sending a column of red lava shooting up into the sky and forcing the evacuation of recently returned residents.   Mount Ulawun, situated on the remote Bismarck Archipelago chain, displaced between 7,000 and 13,000 people from their homes when it last erupted in June.   Seismic activity started at midday on Monday before the volcano erupted at about 4:30am Tuesday, according to Rabaul Volcano Observatory assistant director Ima Itikarai.   "It was noiseless and in the dark just before dawn; the eruption was visible (with) a distinct shard (of) red incandescent glow shooting up less than 100 metres from the base," he told AFP.

As light dawned, billowing clouds of grey ash could be seen rising several hundred metres into the sky, he said, while local Chris Lagisa said residents could hear the noise of gushing gas and flowing lava.   Ulamona Volcano Observatory staffer Herman Volele said ash falls could affect Kimbe, the nearby capital of West New Britain province, while regular earthquakes were also occurring in the vicinity of the volcano.   While most people affected by the previous eruption had remained at evacuation centres, an official with the West New Britain Disaster Office said a number who had returned to tend to their homes and gardens at the base of the volcano had to be evacuated again.   The volcano is one of the world's most hazardous, featuring on a list of 16 "Decade Volcanoes" targeted for research because they pose a significant risk of large, violent eruptions.
Date: Thu 1 Aug 2019 12:55 PM NZST
Source: Radio New Zealand (RNZ) [edited]

Papua New Guinea health officials have been dispatched to the Eastern Highlands after dozens of people reportedly died in a disease outbreak. The provincial governor, Peter Numu, told local media 35 people at the local hospital died from curable diseases. He said 11 died over the weekend [27-28 Jul 2019], although he didn't specify when the others died.

PNG's Health Minister, Elias Kapavore, said health department officials alongside the World Health Organisation will arrive in Goroka town today [1 Aug 2019].  "I think it is to do with the lack of infection control monitoring and prevention in the hospital that has led to this particular unfortunate scenario that has affected the lives of many of our people there." Mr Kapavore, who said he would fly to Goroka to look at the situation, noted that media reports linked the deaths to _Klebsiella_, a rare disease often caused by poor infection control.

But according to him, the National Emergency Operations Centre hadn't received a formal report by the hospital or Provincial Health Authority regarding a disease outbreak. However the minister said the situation warranted investigation.
======================
[_Klebsiella pneumoniae_ is an enteric Gram-negative bacillus that has been known to cause hospital-acquired infections and infections in debilitated or immunocompromised patients. However, a distinctive syndrome caused by _K. pneumoniae_ was first seen in Taiwanese patients in the 1980's (<https://www.ncbi.nlm.nih.gov/pubmed/7613255>). Cases have since been reported worldwide.

The syndrome is characterized by life-threatening community-acquired _K. pneumoniae_ infection in relatively healthy hosts that includes liver abscess and bacteremia complicated by the ability of the responsible _K. pneumoniae_ to spread hematogenously to the lungs, brain, meninges, eyes, prostate, bones, joints, and psoas (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732457/>).

Approximately half of the reported patients had diabetes mellitus, with the remainder displaying no apparent underlying diseases. The _K. pneumoniae_ strains were susceptible to many antibiotics, but mortality rates were as high as 10% for liver abscess and 30-40% for those with metastatic meningitis.

Colonies of the strains causing this illness were noted to be unusually mucoviscous with a positive "string test," defined as the formation of a mucoviscous string of over 5 mm in length when using a bacteriology inoculation loop to touch and stretch a colony grown overnight on an blood agar plate at 35 C [95 F] (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685062/>). The strains were called hypervirulent _K. pneumoniae_ or hvKP, and their capsular polysaccharide serotypes were found to be either K1 or K2. Whole genome sequencing indicated that the hypervirulent K1 isolates belonged to clonal complex 23 (CC23) that grouped into a distinct monophyletic clade, with global spread by multiple international transmissions (<https://www.ncbi.nlm.nih.gov/pubmed/26199326>). The hvKP carried siderophores, which confer the ability to more efficiently acquire iron in iron poor environments. A large virulence plasmid, which encodes the siderophores and a regulator of the mucoid phenotype, was detected in all hvKP clonal lineages (<https://www.ncbi.nlm.nih.gov/pubmed/26199326>). The latest development was the acquisition of the virulence plasmid by multidrug resistant hospital-associated ST11 _K. pneumoniae_.

_Klebsiella_ have been known to develop multiple antimicrobial drug resistance, commonly due to production of beta-lactamases that destroy the class of beta-lactam antibiotics known as carbapenems, as well as all other beta-lactam antibiotics. These carbapenemases are referred to as KPCs, that is, _K. pneumoniae_ carbapenemases. Some multidrug resistant strains have also been found to produce extended-spectrum beta-lactamases (ESBLs). The genes that encode KPCs and ESBLs are plasmid-mediated, which readily facilitates horizontal gene transfer between bacteria. The genes that encode these beta-lactamases are often linked to genes that encode resistance to multiple other classes of antibiotics. The principal reservoir for these organisms is the gastrointestinal tract, and spread occurs from there on the contaminated hands of healthcare workers and environment.

More information on this fatal outbreak would be appreciated from knowledgeable sources.

The eastern part of the island of New Guinea forms the mainland of Papua New Guinea, which has been an independent country since 1975. The outbreak is said to be occurring in the Eastern Highlands. Goroka, with a population of about 19 000 residents, is the capital of the Eastern Highlands Province (<https://en.wikipedia.org/wiki/Goroka>). A map showing the location of Goroka can be found at <https://goo.gl/maps/f1PxnS7c9vCogDtw8>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Papua New Guinea:
Date: Thu, 27 Jun 2019 07:13:48 +0200

Kokopo, Papua New Guinea, June 27, 2019 (AFP) - An erupting volcano in Papua New Guinea that has blanketed a town in ash has forced around 5,000 people from their homes, officials said Thursday.   Mount Ulawun -- one of the world's most hazardous volcanoes -- began spewing lava and smoke high into the air on Wednesday.   Chris Lagisa, a community elder, said people had gathered at a church hall to flee on lorries, trucks and 4x4s, clutching sacks filled with belongings.   In the nearby provincial capital of Kimbe, grey ash that had been shot more than 13 kilometres (8 miles) into the air, turning day to night, began to fall on cars and homes.   People downwind from the volcano were advised to take precautions to avoid the ashfall, which can cause respiratory ailments, eye irritation and skin problems.   Images of the volcano early Thursday appeared to show the ash flow easing.   "Parts of (the) erupting column collapsed, sending block and ash flows down the flanks," said Rabaul Volcano Observatory chief geodetic surveyor Steve Saunders.   Initial reports from the provincial disaster committee indicate lava flows had cut through the main coastal road.

Ulawun, on the remote Bismarck Archipelago chain, is listed as one of 16 "Decade Volcanoes" targeted for research because they pose a significant risk of large, violent eruptions.   Saunders said they will be deploying staff today to Ulamona to assess the situation as the eruption continues.   "We are monitoring instrumentally from Rabaul Volcano Observatory and have access to satellite data," he said.   "However due to the continuing eruption (and) the potential for unexpected resurgence, it is recommended that the alert be raised to Stage 2," Saunders said.   National airline Air Niugini cancelled all flights into Hoskins Airport in Kimbe for an indefinite period, and the Darwin Volcanic Ash Advisory Centre issued a "red" warning to international airlines.   Thousands of people live in the shadow of Ulawun, despite its being one of the most active volcanoes in the country.
Date: Wed, 26 Jun 2019 10:37:11 +0200
By Elizabeth Vuvu

Kokopo, Papua New Guinea, June 26, 2019 (AFP) - Papua New Guinea's volatile Ulawun volcano -- designated one of the world's most hazardous -- erupted Wednesday, spewing lava high in the air and sending residents fleeing.   A pilot for Niugini Helicopters flying near the crater witnessed a column of lava spurting vertically into the equatorial sky, along with ash that has been belching since early morning.   Ulawun, on the remote Bismarck Archipelago chain, is listed as one of 16 "Decade Volcanoes" targeted for research because they pose a significant risk of large, violent eruptions.   Witnesses said lava had cut off the main highway in north of the island.   "The volcanic activity at Mt Ulawun began at 7:00 am this morning after slight rumbling and light emission," Leo Porikura, an official with the West New Britain Disaster Office, told AFP earlier.   "The Rabaul Volcano Observatory has declared a stage one alert warning of a possible eruption."

Witnesses had reported ash spewing out of the 2,334 metre (7,657 foot) summit, sending trails spanning high overhead.    "The sky has turned black," said Kingsly Quou, manager of the nearby Mavo Estates palm plantation.   Quou said that villagers living at the base of the volcano had already been evacuated and he and his colleagues were gathering their belongings.   Japanese satellite imagery and sources on the ground had shown sulphur dioxide and now volcanic ash drifting from the crater.   Australia's Bureau of Meteorology said the ash reached more than 13 kilometres (44,000 feet) into the air.   The bureau's Darwin Volcanic Ash Advisory Centre issued a "red" warning to airlines, indicating the eruption was imminent, although there is not believed to be an immediate threat for flight routes.   Thousands of people live in the shadow of Ulawun, despite it being one of the most active volcanoes in the country.

Porikura said people living in the vicinity of the volcano had been instructed to move away to safer areas and a disaster team had been dispatched.   "The disaster team will liaise with the local community, local businesses and local level government authorities to prepare for a possible eruption," he said.   "Three crucial priority areas being addressed include transport plan, care centre preparations and getting the communities in the high-risk areas to prepare for an evacuation," Porikura said.   The nearby Rabaul Volcano Observatory said emissions from the volcano were getting darker, indicating a higher ash content -- which can cause breathing problems, eye irritation and skin irritation because of the high acid content.   A team of experts had visited earlier this month and reported the volcano was "quiet" adding "there is no indication of any change in its state of unrest."   The ash emissions had been proceeded by an increase in seismic activity, Porikura said.
Date: Tue, 7 May 2019 01:11:25 +0200

Port Moresby, May 6, 2019 (AFP) - A powerful but deep 7.2-magnitude earthquake rocked Papua New Guinea on Tuesday, officials said, cutting power and knocking items off shelves though there were no immediate reports of serious damage.

The quake struck at a depth of 127 kilometres (80 miles) about 30 kilometres (20 miles) from the town of Bulolo at 2119 GMT Monday according to the US Geological Survey, and was felt in the capital Port Moresby about 250 kilometres away.   Officials said there were no immediate reports of major damage and the depth of the tremor meant there was no tsunami threat.   "We have no reports as yet" of serious damage, Inspector Leo Kaikas, Bulolo police station commander, told AFP. "We are still assessing the situation," he said.

Staff at Bulolo's Pine Lodge hotel said there was very minor damage from objects falling off tables, but nothing more serious.   Residents in Lae, more than 100 kilometres away, said the quake knocked things off shelves and worktops and cut electricity in some areas.   "I had just woken up," Christopher Lam, a designer who lives in the city, told AFP. "It lasted a little more than 30 seconds. We had household items knocked off their shelves and the power got cut.   "Things seem to have returned to normal. No structural damage here, though I'm not sure about other buildings in the city."   There are estimated to be around 110,000 people living within 50 kilometres of the epicentre, according to UN data.

The Moresby-based National Disaster Management office said while there were no early reports of damage, but news from the quake zone could take time to trickle in.  "We are awaiting assessments," a spokesman told AFP.   The country's rugged highlands region was hit by a 7.5-magnitude quake in February last year that buried homes and triggered landslides, killing at least 125 people.

The scale of that disaster did not become apparent for days due to PNG's poor communications and infrastructure.   There are regular earthquakes in Papua New Guinea, which sits on the so-called Pacific Ring of Fire -- a hotspot for seismic activity due to friction between tectonic plates.   Along the South Solomon trench, an area of the Pacific that includes PNG, there have been 13 quakes of magnitude 7.5 or more recorded since 1900, according to USGS data.
More ...

Germany

Germany US Consular Information Sheet
December 08, 2008
COUNTRY DESCRIPTION:
Germany is a modern and stable democracy. Tourist facilities are highly developed. In larger towns, many people can communicate in English.
Read the Departme
t of State Background Notes on Germany for additional information.

ENTRY/EXIT REQUIREMENTS: Germany is a party to the Schengen Agreement. As such, U.S. citizens may enter Germany for up to 90 days for tourist or business purposes without a visa. The passport should be valid for at least three months beyond the period of stay. For further details about travel into and within Schengen countries, please see our fact sheet. Further information on entry, visa and passport requirements may be obtained from the German Embassy at 4645 Reservoir Road N.W., Washington, D.C. 20007, telephone (202) 298-4000, web site: http://www.germany.info/Vertretung/usa/en/Startseite.html, or the German Consulates in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, or San Francisco. Passengers transiting Germany en route to other countries should ensure that they are aware of and in compliance with the entry requirements for their final destinations as individuals not presenting appropriate documentation for their destination may be denied boarding on connecting flights.

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

SAFETY AND SECURITY:
German authorities remain vigilant in combating the threat posed by foreign and resident extremists. Specific threats have been uncovered and persecutions undertaken, though Germany itself has been largely free of terror incidents. However, like other countries in the Schengen area, Germany’s open borders with its European neighbors allow the possibility of dangerous individuals entering/exiting the country with anonymity. Germany regularly experiences demonstrations on a variety of political and economic themes. Prior police approval is required for public demonstrations, and police oversight is routinely provided for participants and passersby. Nonetheless, these demonstrations can attract counter-demonstrators and have the potential to turn violent. In addition, hooligans, most often young intoxicated “skinheads” have been known to harass or even attack people whom they believe to be foreigners or members of rival groups. On occasion, American have reported that they were assaulted for racial reasons or because they appeared “foreign.” All Americans are cautioned to avoid the area around protests and demonstrations and to check local media for updates on the situation.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site at http://travel.state.gov, where the current Travel Alerts, including the Worldwide Caution, can be found.

Up-to-date information on 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 A Safe Trip Abroad.

CRIME:
Violent crime is rare in Germany- but can occur, especially in larger cities or high-risk areas such as train stations. Most incidents of street crime consist of theft of unattended items and pick-pocketing. There have been a few reports of aggravated assault against U.S. citizens in higher-risk urban areas. American travelers are advised to take the same precautions against becoming crime victims as they would in any American city.

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 or Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. For more information on possible U.S. sources of assistance, see our information on Victims of Crime.

The local equivalent to the 911 emergency line in Germany is 112.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Good medical care is widely available. Doctors and hospitals may expect immediate payment in cash for health services from tourists and persons with no permanent address in Germany. Most doctors, hospitals and pharmacies do not accept credit .

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. U.S. military facilities in Germany will not provide treatment to private American citizens who are not affiliated with the Department of Defense.

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 Germany is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Individuals holding U.S. driver’s licenses may drive in Germany for up to six months without acquiring a German driver’s license.

Road conditions in general are excellent, although caution should be exercised while traveling on older roads in eastern Germany. The high speed permitted on the German autobahn, weather, and unfamiliar road markings can pose significant hazards, and driver error is a leading cause of accidents involving American motorists in Germany. Rules on right-of-way differ significantly from the U.S.
Notice should be taken that it is generally illegal in Germany to pass vehicles from the right and that the threshold for determining whether a person has been driving under the influence of alcohol is lower than in some U.S. states.

Many German streets and sidewalks have dedicated bike lanes for use by bicyclists. Pedestrians should be aware that bicycles have priority use of these lanes and should be careful to observe whether any bicyclist is approaching before crossing or stepping into the bike lane. Bicyclists also have priority over cars turning onto side streets, and motorists should always confirm whether a bicyclist is approaching from either direction before attempting to enter side streets, even when the light is in their favor. Motorists turning into a side street who hit a bicyclist who is using a marked bike lane will be held responsible for any injury or damage caused.
The use of cell phones while driving is prohibited in Germany. For specific information on travel within Germany contact the German National Tourist Board Office in New York at (212) 661-7200, fax (212) 661-7174 or via the Internet at http://www.germany-tourism.de/
Travelers should also note that railroad crossings are marked differently in Germany than in the U.S. There have been several accidents involving Americans in recent years at railroad crossings. In addition to the standard crossbuck (X-shaped) sign, railroad crossings are often marked by signal lights. Signal lights at a railroad crossing means that a train is approaching and that all vehicles should stop.

Please refer to our Road Safety page for information. Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.germany-tourism.de/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Germany’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Germany’s air carrier operations. For more information, travelers may visit the FAA’s web site at www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Germany’s customs authorities may enforce strict regulations concerning temporary importation into or export from Germany of certain items such as firearms, military artifacts (particularly those pertaining to the Second World War), antiques, medications/pharmaceuticals and business equipment. Under German law it is also illegal to bring into or take out of Germany literature, music CDs, or other paraphernalia that glorifies fascism, the Nazi past of the former “Third Reich.” It is advisable to contact the German Embassy in Washington or one of the German consulates in the United States for specific information regarding customs requirements.

Automatic Teller Machines (ATMs) are widely available throughout Germany. They utilize many of the same account networks that are found in the U.S., so it is possible in most cases to get euros directly from your U.S. bank while you are in Germany without paying any inordinate fees for currency exchange. Credit cards are not accepted as widely as in the United States. Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating German laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Germany are strict and convicted offenders can expect 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:
American citizen parents have at times encountered difficulties having visitation orders enforced in Germany. For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION/EMBASSY AND CONSULATE LOCATIONS:
Americans living or traveling in Germany are encouraged to register with the nearest U.S. Embassy of Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov/, and to obtain updated information on travel and security within Germany.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

U.S. Consular Sections are located at:
Berlin: Clayallee 170;
Tel: (49) (30)832-9233; Fax: (49) (30) 8305-1215
American Citizen Services Email: ACSBerlin@state.gov
Frankfurt: Giessner Str. 30,
Tel. (49) (69) 75350; Fax: (49) (69) 7535-2304.
American Citizen Services Email:GermanyACS@state.gov
Passport Inquiries Email: FrankfurtPassports@state.gov
Leipzig: Wilhelm-Seyfferth-Strasse 4,
Tel. (49) (341) 213-8418; Fax: (49) (341) 2138417 (emergency service only).

Munich: Koenigstrasse 5,
Tel. (49) (89) 2888-0; Fax: (49) (89) 280-9998.
American Citizen Services Email: ConsMunich@state.gov
There is also a U.S. consular agency in Bremen at Bremen World Trade Center,
Birkenstrasse 15,
Tel: (49) (421) 301-5860; Fax: (49) (421) 301-5861.

When calling another city from within Germany, dial a zero before the city code (for example, when calling Berlin from Munich, the city code for Berlin is 030).
*
*
*
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This replaces the Consular Information Sheet dated April 23, 2008 to update information on Entry Requirements, Safety and Security and Medical Insurance.

Travel News Headlines WORLD NEWS

Date: Mon 2 Sep 2019
Source: Onetz [in German, trans. Sabine Zentis, edited]

The 1st recorded death from [a] hantavirus [infection] may have occurred in Bavaria. The suspected case has not yet been confirmed.

The bank vole is the main carrier of [Puumala] hantavirus.

The deceased man had been infected with the virus. Whether the hantavirus was the cause of death is still to be clarified, according to the reports of the Bayerischer Rundfunk, the State Office of Health and Food Safety.

In Bavaria in 2019, 224 cases of hantavirus infection have so far been reported, 107 of which were in Lower Bavaria. Last year [2018], there were 31 cases in Bavaria.

The bank vole is the main carrier of the virus. Its spread in 2019 is due to a particularly large food supply. Virus transmission to humans occurs through inhalation or through contact of injured skin with virus-contaminated dust, and through bites.

According information from the State Office of Health and Food Safety (LGL), special caution is recommended for activities in sheds, cellars, attics, and garden sheds, where mice live. In case of visible mouse infestation, gloves and masks should be worn.

Information is available from the State Office for Health and Food Securities Unit (LGL) for Hantaviruses.
======================
[This has been an active year (2019) for hantavirus transmission and, in the recent past, in other parts of Germany as well. This year (2019), there were more than 200 registered cases in Baden-Wurttemberg (see ProMED-mail Hantavirus - Europe: Germany http://promedmail.org/post/20190523.6482626).

Although not stated in the report above, the hantavirus most likely involved in these cases is Puumala virus [PUUV], with the bank vole (_Myodes glareolus_) as the rodent reservoir host. Puumala virus is endemic to southwestern and western Germany and causes haemorrhagic fever with renal syndrome (HFRS).

The above report and the earlier one comment on the abundant food supplies (beech tree mast and acorns) as contributory to abundant bank voles. In a recent comment on the Baden-Wurttemberg cases, Dr. Jan Clement comments that the illness caused by PUUV is the so-called haemorrhagic fever with renal syndrome (HFRS), with extremely variable fatality rates, depending not only on the infecting hantavirus species, but also largely on the immune response itself of the infected patient. He further commented that more PUUV-infected voles equals more human PUUV infections. PUUV prevalence in bank vole populations depends on several changing factors, resulting sometimes in denser vole populations, but with lower PUUV prevalence, hence the recent Belgian study cited below, titled: "Why hantavirus prevalence does not always increase with host density: modelling the role of host spatial behaviour and maternal antibodies."

Reference:
Leirs H, et al; abstract no. 152 at the XI Int. Conf. on Hantaviruses, September 1-4, 2019, Leuven, Belgium.

An image of _Myodes glareolus_, the Puumala virus host, can be accessed at

Map of Germany: <http://tinyurl.com/ycbyuk5g>. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Wed 14 Aug 2019
Source: Universitat Hohenheim [in German, trans. Britta Lassmann, edited]

The University of Hohenheim and the Bundeswehr Institute of Microbiology [IMB] have detected spotted fever in a hyalomma tick, the 1st time such a tick is suspected to have caused disease in a human in Germany.

This tick feeds on humans and can transmit a form of spotted fever in Germany. What were still unanswered questions about the tropical giant tick hyalomma is now certainty. At the beginning of August [2019], it was suspected that for the 1st time, a human in Germany had contracted a disease with the typical symptoms of rickettsiosis from the bite of a hyalomma tick. Experts from the University of Hohenheim in Stuttgart and the IMB in Munich were able to detect the pathogen _Rickettsia aeschlimannii_ in the tick. The number of hyalomma ticks in Germany increased significantly in 2019 compared to the previous year [2018]. In nearly half of the hyalomma ticks, _R. aeschlimannii_ can be detected. The tick researchers continue to ask the population to send them suspicious ticks.

It was probably no coincidence that this 1st case was in a horse owner. Tropical ticks of the genus _Hyalomma_ feed on large mammals. For several years, these ticks have been on the rise in Germany. Now tick researchers report the 1st suspected case of spotted fever transmitted in Germany. "Not only do we now know for sure that the hyalomma tick is also targeting humans," says Prof Dr Med Ute Mackenstedt, a parasitologist at the University of Hohenheim, "but also that there is the urgent suspicion that the transmission of spotted fever by these ticks is actually possible here in Germany."

The case: At the end of July [2019], the horse owner from near Siegen was bitten by a hyalomma tick. He sent the tick to the tick researcher in Hohenheim. He then presented to the hospital only a few days later with severe symptoms. Spotted fever caused by the bacterium _R. aeschlimannii_ was suspected. The tick was sent by courier service to the IMB in Munich, where the pathogen was detected in the tick. Thereafter, the patient received targeted antibiotic therapy, and his symptoms rapidly improved.

"We are talking about a suspected case, because direct detection of the pathogen from the patient was not possible," explains PD Dr Med Gerhard Dobler, medical doctor at the IMB. "The treatment of the patient came 1st. But the preceding tick bite, the typical symptoms
and, above all, the proof of the pathogen in the tick suggest that the case was spotted fever. The fact that the patient responded to targeted antibiotic therapy further supports this."

_R. aeschlimannii_ causes a feverish infection with headache and muscle pain, extreme joint pain, and a burning sensation. Typical for the disease, however, is the rash that gave the disease its name. This classic sign shows mainly on the extremities. The incubation period is about one week.

"If spotted fever is suspected after a hyalomma bite, a swab should be taken from the bite site and sent for examination," advises PD Dobler. "If there are questions, you are welcome to contact us. Ideally, we would also like to examine the tick."

About half of the hyalomma ticks, the researchers say, are infected with rickettsia. Transmission takes place exclusively via tick bite. "The number of hyalomma ticks in Germany is significantly higher this year [2019] than in the previous year [2018]," reports Prof Dr Med Mackenstedt, referencing the publication in which the situation was presented in 2018. The Hohenheim parasitologist not only cooperates closely with the IMB in Munich, but also with the working group of Prof Dr Med Christina Strube at the Veterinary University (TiHo) Hannover. "Together they already have found 50 such ticks in Germany in 2019. Last year [2018] there were a total of 35." Last year, these ticks had survived the winter in Germany for the 1st time.

"Rickettsia are the only pathogens that we have been able to detect so far," explains PD Dr. Dobler. "We have not found the virus that causes the dangerous Crimean Congo hemorrhagic fever, nor the pathogens _Theileria equi_ and _Babesia caballi_, both of which can be transmitted from ticks to horses."

The research team continues to ask the population for support to further explore the spread and potential dangers. In case of a tick bite, it's best to remove the tick with a tick remover, TickCard, or tweezers. Then send the animal in a small, tightly closed container to:
University of Hohenheim
Prof. Dr. Ute Mackenstedt
Department of Parasitology
Emil-Wolff-Strasse 34
70599 Stuttgart

Background: Tick genus _Hyalomma_
_Hyalomma marginatum_ and _Hyalomma rufipes_ are native to the dry and semi-arid areas of Africa, Asia, and southern Europe. Until recently, they did not occur in central and northern Europe. Their striped legs are striking, and they are much larger than the native ixodes ticks.

The adult ticks feed on large animals. They are active hunters and move quickly towards their host. They cover a distance of up to 100 m [328 ft]. Humans can serve as hosts. In contrast, tick larvae and nymphs mainly infest birds and small mammals and can stay up to 28 days with their hosts. Migratory birds can introduce larvae and nymphs to Germany.

In Eurasia, both _Hyalomma_ species are considered transmitters of the Crimean Congo hemorrhagic fever virus and the Arabic hemorrhagic fever virus (Alkhumra virus). They also transmit the bacterium _Rickettsia aeschlimannii_, which causes a form of spotted fever.

Reference:
Chitimia-Dobler L, et al. Imported _Hyalomma_ ticks in Germany in 2018. Parasites & Vectors. 2019; 12 (134).

More information:
Picture and video material [in German]
Press release: Tropical ticks in Germany: University of Hohenheim asks to send conspicuous tick finds [in German]
Press release: Tropical ticks: New immigrant species winters in Germany for the 1st time [in German]
-----------------------------------
communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
====================
[Given that the ticks were found last year (2018) and that they overwintered and were found again this year (2019), it is likely that this genus of tick is becoming established in Germany. Although the species of _Hyalomma_ that infected the man with _Rickettsia aeschlimannii_ was not determined, there is a clear association of this rickettsia with the 2 species of _Hyalomma_ that were tested. The published report cited above states, "35 ticks with an unusual appearance or behaviour were reported to us during summer-autumn 2018. For 17 of them, the description or photos implied that they belong to the hard tick genus _Hyalomma_. The remaining 18 ticks were sent to us and were identified as adult _Hyalomma marginatum_ (10 specimens) or adult _Hyalomma rufipes_ (8 specimens). All ticks tested negative for CCHF virus, _Coxiella burnetii_, _Coxiella_-like organisms, _Babesia_ spp. and _Theileria_ spp. The screening for rickettsiae gave positive results in 9 specimens. The _Rickettsia_ species in all cases was identified as _R. aeschlimannii_." Given that these ticks can be transported by birds migrating from Africa, continued surveillance in Germany for the rickettsia and the other pathogens that were not found currently is prudent. - ProMED Mod.TY]

The first human case of _R. aeschlimannii_ infection was identified in a patient who had fever, rash, and an eschar similar to _R. conori_ infection (Mediaterrian spotted fever) after travel in Morocco (1). _R. aeschlimannii_ infections in humans have been previously confirmed in South Africa, in Algeria, and in Tunisia (2). To our knowledge, the first human case of _R. aeschlimannii_ infection reported in Europe occurred in Greece and was reported in 2013 (3).

1. Raoult D, Fournier PE, Abboud P, Caron F. First documented human Rickettsia aeschlimannii infection. Emerg Infect Dis. 2002; 8: 748-9. doi: 10.3201/eid0807.010480
2. Demoncheaux JP, Socolovschi C, Davoust B, Haddad S, Raoult D, Parola P. First detection of _Rickettsia aeschlimanii_ in _Hyalomma dromedarii_ ticks in Tunisia. Ticks Tick Borne Dis. 2012; 3: 398-402.
3. Germanakis A, Chochlakis D, Angelakis E, Tselentis Y, Psaroulaki A. _Rickettsia aeschlimannii_ infection in a man, Greece. Emerg Infect Dis. 2013; 19: 1176-7.  - ProMED Mod. LL]

[HealthMap/ProMED-mail map of Germany:
Date: Thu 1 Aug 2019
Source: Deutsche Welle [edited]

An unusually high number of students and teachers at a school in southwestern Germany have been infected with tuberculosis. Health officials are scouring the school for clues about why the disease spread.

Health officials on Thursday [1 Aug 2019] examined a school in the southwestern German town of Bad Schonborn where a tuberculosis outbreak has infected dozens of children and adults.

A total of 109 students, teachers and other school employees have been infected, the district administration of Karlsruhe said. Four people, including at least 2 students, have active cases of tuberculosis. That means they are presenting symptoms and could be contagious. The actively sick students have been removed from the school and are receiving medical treatment, the district administration said.

"We cannot rule out the possibility that there will be new cases of active illness," Ulrich Wagner from the Karlsruhe health department told the Badische Neueste Nachrichten newspaper.

At the beginning of July [2019], 2 children at 2 different schools in Bad Schonborn were found to have active tuberculosis. Since then, the number of infected people has continued to rise, particularly at the Michael Ende Gemeinschaftsschule, where a student in the 8th grade was initially infected. Officials said that some 56 students in the 8th grade -- 88% of the entire class -- are currently infected.

The case is concerning because several children from different grades as well as teachers who would not have been greatly exposed to the 8th grade students have also tested positive for the infection.

Health officials are now examining the school's classrooms to determine how the bacteria were able to spread to so many people, local public broadcaster SWR reported.

Local officials emphasized that tuberculosis is a treatable and curable illness, adding that not everyone who is infected with the disease will become sick.

Tuberculosis is caused by bacteria that spread from person to person through tiny droplets released into the air by coughing and sneezing. When active, tuberculosis most often affects the lungs -- resulting in chest pain, fever, weight loss, and coughing that lasts for weeks. Sometimes blood is coughed up. The World Health Organization (WHO) estimates that around a quarter of the world's population is infected with latent tuberculosis -- meaning they are not actively ill and cannot transmit the disease.

The WHO says that those who are infected with tuberculosis bacteria have a 5% to 15% chance of becoming sick.
=====================
[The news report above says that a total of 109 students, teachers and other school employees at possibly 2 schools in Bad Schonborn have been infected, but only 4 of the 109 people, including at least 2 students, have active cases of tuberculosis (TB), the others presumably having latent tuberculous infection (LTBI). LTBI is a non-contagious form of TB and is detected by tuberculin skin testing or interferon-gamma release assays.

We are told that the 2 students with active TB are at 2 different schools in Bad Schonborn, but we are not told anything about the 2 adults with active TB; adults are usually thought to be better disseminators of TB than young children. A total of 56 of the students in the 8th grade -- 88% of the entire class at one of the schools -- are infected, but the source for this outbreak has not as yet been identified.

Although transmission of tuberculosis is thought to usually require close, repeated or prolonged contact with a contagious individual in a poorly ventilated environment, such as households, homeless shelters or schools, outbreaks of cases with TB due to genetically linked TB strains who do not have anything in common other than living in the same neighborhood or using the same public facilities such as food markets or cybercafes at a shopping mall have been described. See ProMED-mail posts Tuberculosis, MDR - Singapore (03): (AMK) linked to 2012 cybercafe outbreak http://promedmail.org/post/20160622.4302632 and Tuberculosis - China: (SH) neighborhood transmission, residents, migrants http://promedmail.org/post/20180428.5771588.

Bad Schonborn, with a population of 13 028 residents, is a town in northern Karlsruhe district in Baden-Wurttemberg, a state in southwest Germany
(<https://en.wikipedia.org/wiki/Bad_Schonborn>).

A map showing the location of Bad Schonborn can be found at

More information on this outbreak would be appreciated from knowledgeable sources. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Baden-Wurttemberg, Germany: <http://healthmap.org/promed/p/61075>]
Date: Wed, 17 Jul 2019 12:56:26 +0200

Berlin, July 17, 2019 (AFP) - Germany will make childhood measles vaccinations mandatory from March 2020, aiming to wipe out the resurgent and potentially deadly disease, Chancellor Angela Merkel's cabinet decided Wednesday.   Children will only be admitted to kindergarten or school if they have had the jabs, and vaccinations will also be compulsory for staff in day-care centres, educational institutions, medical facilities and refugee shelters.   "We want to protect as many children as possible from a measles infection," said Health Minister Jens Spahn, who is aiming for at least 95 percent coverage.

Violations will lead to fines of up to 2,500 euros ($2,800) under the bill that is expected to pass easily through the Bundestag lower house of parliament.   Germany's paediatricians' association has long demanded mandatory childhood vaccinations against measles and a range of other diseases.   The UN World Health Organization (WHO) has warned that global efforts to increase immunisation coverage against deadly diseases are stagnating.

Last year, 350,000 cases of measles were reported worldwide, more than double the number for 2017.   And they increased fourfold globally in the first quarter of 2019 compared to the same period last year, according to WHO.   Germany recorded 543 cases last year, and hundreds so far this year.   The resurgence of the disease in some countries has been blamed on the so-called "anti-vax" movement, which is largely based on a 1998 publication linking the measles vaccine and autism that has since been debunked.
Date: Tue, 2 Jul 2019 13:38:57 +0200

Schwerin, Germany, July 2, 2019 (AFP) - German fire-fighters were Tuesday battling a huge forest blaze ripping through a former military training area littered with unexploded munitions dating back to the Nazi era.   Hundreds of emergency personnel -- backed by helicopters, army vehicles and police water canon -- have been fighting the flames and evacuated four nearby villages with a total of over 1,000 residents in Mecklenburg-Western Pomerania state.   The acrid smell from the blaze, the largest recorded in the ex-communist northeastern state, has drifted as far as Berlin, 200 kilometres (125 miles) away, as much of Europe swelters in blistering summer temperatures.

The German army on Tuesday sent in armoured vehicles to clear pathways of dangerous unexploded ordnance (UXO) so that fire engines can enter the burning region that measured some 600 hectares (1,400 acres).   The former military training ground near the town of Luebtheen is littered with bombs, grenades and bullets from the Nazi era's Wehrmacht, the former Soviet army, and from reunited Germany's Bundeswehr.   Tests in the past had unearthed more than 45 tonnes of UXO per hectare, state environment minister Till Backhaus told local newspaper the Ostsee Zeitung, adding: "I pray to God that he sends us rain, as quickly as possible."
More ...

World Travel News Headlines

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."
Date: Thu, 10 Oct 2019 20:02:59 +0200 (METDST)
By Robbie COREY-BOULET

Addis Ababa, Oct 10, 2019 (AFP) - A palace that once housed Ethiopia's emperors and also served as a torture site under the communist Derg regime is to open to the public in a controversial government tourism project.    The palace compound in Addis Ababa, which Prime Minister Abiy Ahmed's government has rebranded "Unity Park", was formally launched Thursday and will be open from Friday.    Abiy's office said on Twitter Thursday that the project "symbolises our ability to come together".

But critics have dismissed it as vanity project for Abiy that could prove divisive.   Backed by the United Arab Emirates, the project cost more than $160 million (145 million euros), Ethiopian officials told reporters at a briefing earlier this week.    Built in the late 1800s by Emperor Menelik II, who founded Addis Ababa, the palace was the residence of Ethiopia's rulers for more than a century.   Abiy himself does not live there, and it has seen little activity in recent years.    Abiy's advisers say he has taken a keen interest in transforming the palace into a tourist attraction since coming to power in April 2018 -- visiting the site every day in recent weeks to monitor progress.

The government's "Home-Grown Economic Reform" agenda, unveiled last month, describes tourism as a primary engine of potential job creation.    On Thursday, government officials and the diplomatic corps toured the expansive site before attending a banquet that was expected to draw five regional heads of state and other dignitaries.    The restored rooms feature items like Menelik's sword and a life-size wax replica of former Emperor Haile Selassie, who lived at the palace and was then etained there after the Derg overthrew him in 1974.

The site also includes a sculpture garden with installations representing Ethiopia's nine regions, and a zoo is expected to open by the end of the year.    Aklilu Fikresilassie, an Ethiopian employee of the United Nations who attended the launch Thursday, said he was "really fascinated" to set foot inside a place that had been closed to the public his entire life.    "For us it's like a government house, so now when you enter that palace it tells you that we are getting somehow closer to our leaders," he said.

But not everyone is convinced the palace will succeed in bringing Ethiopians together.   In a country grappling with ethnic divisions, some worry that the palace could alienate ethnic Oromos who contend that their ancestors were forced off their land when Addis Ababa was built.    Journalist and former political prisoner Eskinder Nega said the renovations were undertaken "without consultation from the public", which he called "a huge mistake."    "This is all about heritage, about preserving heritage. The people should have had a say in it," he said.    "Like everything else this was decided from the top and implemented only by the decision of the prime minister."
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: Thu, 10 Oct 2019 06:51:42 +0200 (METDST)
By Holly ROBERTSON

Sydney, Oct 10, 2019 (AFP) - Large numbers of tourists are rushing to scale Uluru -- also known as Ayers Rock -- ahead of a looming ban on climbing a site sacred to indigenous Australians.   Photographs of hundreds of people clambering up the giant red monolith have provoked a social media backlash, with critics lashing as "ignorant" those going against the wishes of the traditional Aboriginal owners of the land, the Anangu.   "A mass of morally and ethically bankrupt people," indigenous woman Laura McBride tweeted alongside an image showing a queue of people snaking up the side of Uluru.    "One even hiking a toddler up, teaching the next generation how to be ignorant."   "Imagine rushing to climb Uluru before it closes just so you could brag about disrespecting the oldest living culture in the world," tweeted National Indigenous Television journalist Madeline Hayman-Reber, who called the scenes "embarrassing".

Officials say the ban, which comes into effect on October 26, is intended to show respect for cultural practices, protect the site from further environmental damage and to ensure visitors' safety.    More than 395,000 people visited the Uluru-Kata National Park in the 12 months to June 2019, according to Parks Australia, about 20 percent more than the previous year. Around 13 percent of those who visited during that period made the climb, park authorities said.    More recent figures are not available but Tourism Central Australia CEO Stephen Schwer said there had been a "significant jump" in the number of people visiting in recent weeks, with the period leading up to the ban coinciding in part with school holidays.   "Its been very busy, particularly down in the national park precinct itself," he told AFP.   "We've had quite an issue with accommodation availability, because there's a lot of people want to climb Uluru before it closes. It's been a busier than normal holiday period."   Japanese visitors and Australians on driving holidays were most likely to want to scale Uluru, Schwer said, though he urged them not to do so.

Australian tourist Belinda Moore, 33, drove to Uluru from her home in central Queensland state to ascend the rock, an experience she said she "absolutely loved".   "It's always been something to tick off the bucket list and when we heard it was closing, we knew it was now or never," she told AFP.   Moore said she did not think her climb was disrespectful to traditional owners as she was not Aboriginal.    "It may be for their own people, because it's their sacred site," she said.   "I'm pretty sad that they're closing it, but it's still amazing just to see it. I would still recommend it."   The climb will be permanently closed as of October 26, the anniversary of ownership being handed back to the Anangu people.

Uluru has great spiritual and cultural significance to indigenous Australians, with their connection to the site dating back tens of thousands of years.   Though visitor numbers were expected to decline once the ban was in place, Schwer said local tourism operators were "not particularly concerned" as it would return the area to normality.   "People need to remember that in central Australia we're a very interconnected community," he said. "The people who are requesting the climb closure are our friends and colleagues.   "We're just looking forward to being able to have the climb consigned to the annals of history."
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: Tue, 8 Oct 2019 04:13:25 +0200 (METDST)
By Margioni BERMÚDEZ

Caracas, Oct 8, 2019 (AFP) - The small waiting room at the home of self-styled healer "Brother Guayanes" in Caracas' rundown Petare district fills up quickly with patients -- business has never been better.   With Venezuela's chronic medicine shortages and hyperinflation, more and more people are turning to alternative medicine to treat common ailments in the crisis-wracked South American country.   "We go to the hospital and there's nothing there. They don't have medicines, or they're too expensive, what are we to do?" said Rosa Saez, 77, who has come to get treatment for a painful arm.   Carlos Rosales -- he uses the more ceremonious "Brother Guayanes" for his business -- is finishing up a "spiritual intervention" on a patient in what passes for his surgery.   The patient lies, eyes closed, on a cot as, in a series of swishes and clicks, the healer waves five pairs of scissors one after another over his prone body.    The healer says he performs 200 such interventions a week in a dim, candle-lit room that features two camp beds and an array of plaster statues that Rosales says represent "spiritual entities".   A regular visitor to the spiritual center, Saez says she has faith in Rosales' methods: "He healed my kidneys."

- Natural healing -
All across Venezuela, but particularly in poor areas like Petare, patients cannot hope to afford the price of medicines that due to the economic crisis, have become exceedingly rare.  Venezuela's pharmacists' federation say pharmacies and hospitals have on average only about 20 percent of the medicine stock needed.   Rosales' clinic is muggy with the smell of tobacco. A crucifix suspended from a chain around his neck, he practices a seeming mixture of smoke-blowing shamanism, plant-based medicine and mainstream religion.    Posters hung near the entrance remind clients to arrive with a candle and tobacco and "Don't forget that payment is in cash".   Much like a general practitioner, Rosales spends time consulting with his patients, examining them with a stethoscope, before offering a diagnosis. Often he prescribes potions based on plants and fruit, such as pineapple and a type of local squash known as chayote.   "We know medicines are necessary," he says. "I'm not against medicine, but my medicine is botany."

- Plants replace drugs -
At her stall in a downtown Caracas market, 72-year-old Lilia Reyes says she has seen her trade in medicinal plants flourish.   "I can't keep up with the demand," she said at her stall, bathed in the aroma of camomile, one of the 150 plants she sells.   Careless consumption of some herbs can be deadly, warns Grismery Morillo. A doctor at a Caracas public hospital, she says she has seen many cases of acute liver failure in people who have eaten certain roots.   According to Venezuela's opposition parties, some 300,000 chronically ill people are in danger of dying from the shortages of medicines.

But despite the risks, people like Carmen Teresa say they have no alternative.    In the kitchen of her restaurant which closed down three years ago as the economic crisis took hold, the 58-year-old Colombian prepares an infusion of fig leaves to treat "diabetic neuropathy".   The painkillers needed for the condition are "too expensive" and prices are going up due to hyperinflation, so she is cutting back on the pills and supplementing her treatment with herbal infusions.   She needs at least four tablets a day to keep her diabetes at bay. Her mother, bedridden since breaking a leg a year ago, suffers from Alzheimer's disease and needs five pills a day for hypertension.   "I'm still taking my pills, but I reduced the dose," says Teresa, who is also replacing cholesterol pills with lemon juice.
Date: Sun, 6 Oct 2019 12:04:37 +0200 (METDST)

Riyadh, Oct 6, 2019 (AFP) - Saudi Arabia announced Sunday it would allow unmarried foreign couples to rent hotel rooms together as the ultraconservative kingdom begins offering up tourist visas for the first time.   The tourism authority said in a statement published on Twitter that Saudi women travelling alone would also be able to check into a hotel by presenting valid ID.

In the past, couples wanting to stay in a hotel had to prove they were married.    "This is no longer required for tourists," the statement said.   Saudi Arabia announced on September 27 it was opening its doors to holidaymakers with the goal of diversifying its oil-dependent economy.   The kingdom had previously only issued visas to Muslim pilgrims, foreign workers, and recently to spectators at sporting or cultural events.

Kickstarting tourism is one of the centrepieces of Crown Prince Mohammed bin Salman's Vision 2030 reform programme to prepare the biggest Arab economy for a post-oil era.   Citizens from 49 countries are now eligible for online e-visas or visas on arrival, including the United States, Australia and several European nations.   On September 28, Saudi authorities warned that tourists who violated "public decency", including with immodest clothing and public displays of affection, would be subject to fines.
Date: Sat, 5 Oct 2019 03:30:17 +0200 (METDST)
By Giovanna FLEITAS

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

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

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

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

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

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