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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: Thu, 16 Jan 2020 02:45:27 +0100 (MET)
By Ivelisse RIVERA, con Leila MACOR en Miami

Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid.   Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.

In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA.  "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning.    "We are living in constant fear of another powerful tremor," he said.

He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said.   Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake.    The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.

Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old.  "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later.   "It's different to a hurricane. What is happening now is much nastier," he said.

As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted.   The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant.    The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.

- Seeking disaster designation -
Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more.   The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said.   On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.

In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster.   It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests.   The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Date: Sat, 11 Jan 2020 15:43:12 +0100 (MET)

Washington, Jan 11, 2020 (AFP) - A 5.9 magnitude earthquake rocked Puerto Rico Saturday, the latest in a series of powerful tremors that have shaken the US territory in recent days, the US Geological Survey reported.

The latest quake occurred at 8:54 am local time (1254 GMT) around 13 kilometres (eight miles) southeast of Guanica, a town on the island's southern Caribbean coastline that was hard hit by earlier quakes.   The USGS revised its initial report of a 6.0 magnitude quake to 5.9.   It follows a 6.4 magnitude quake Tuesday that killed one person, knocked
out electric power and caused widespread damage.

Puerto Rico Governor Wanda Vazquez declared a state of emergency after Tuesday's quake, which forced an automatic shutdown of the power grid.    Puerto Rico's electric power authority reported outages in the towns of Ponce, Lares, Adjuntas and San German after the latest quake.   The Pacific Tsunami Information Center in Hawaii issued a statement saying there was "no significant tsunami threat" but a small possibility of tsunami waves along coasts nearest the epicentre.

The island is still recovering from Hurricane Maria, which came ashore more than two years ago as a devastating Category 4 storm.   Starting December 28, a wave of tremors have swept the island, putting residents on edge.   The 6.4 quake on January 7 came a day after a 5.8 magnitude quake; it was followed by major aftershocks.   Saturday's quakes were also preceded by a string of smaller tremors.
Date: Tue, 7 Jan 2020 23:44:45 +0100 (MET)
By Ricardo Arduengo

Guayanilla, Puerto Rico, Jan 7, 2020 (AFP) - Puerto Rico's governor declared a state of emergency on Tuesday after a powerful 6.4 magnitude earthquake killed at least one person in the south of the island and caused widespread damage.   Governor Wanda Vazquez said the declaration would allow for the activation of National Guard troops in the US territory still recovering from a devastating 2017 hurricane.   The US Geological Survey said the quake struck at 4:24 am (0824 GMT) with the epicenter off the coast of the southern city of Ponce, and was followed by more than a dozen aftershocks.

Tuesday's quake was the most powerful in a series of tremors that have shaken the island since December 28.   Scientists initially sent out an alert about a potential tsunami but it was later canceled.   The island's electricity authority said the quake had forced an automatic shutdown of the power grid, already severely damaged by Hurricane Maria more than two years ago.   The worst damage appeared to be in towns on the southwest coast, including Ponce, Guayanilla and Guanica.   El Nuevo Dia newspaper said a 73-year-old man died after a wall fell in his home in Ponce. Eight others there were reported injured.

Two power plants in Guayanilla sustained major damage, the Puerto Rico Electric Power Authority said. The city could be without power for two weeks, its mayor Nelson Torres Yordan said.   Celebrity chef Jose Andres announced that a charity he runs, World Central Kitchen, had started serving meals and distributing solar-powered lamps in quake-hit areas.   Vazquez announced that $130 million in emergency aid funding will be disbursed.   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep."   "Everybody is awake & scared all over," she posted.   In Guayanilla, the Inmaculada Concepcion church, built in 1841, was heavily damaged.   Volunteers salvaged statues and other valuable items from the ruins as a priest consoled distraught parishioners.

- 'Be safe' -
A 5.8 magnitude quake on Monday toppled some structures, caused power outages and small landslides, but did not result in any casualties.   It also destroyed a popular tourist landmark, Punta Ventana, a natural stone arch that crumbled on the island's southern coast.   Vazquez, the governor, said government employees were being given the day off on Tuesday to take care of their families.   "We want everyone to be safe," she said.   She said ports were undamaged and there are several weeks' supply of gasoline, diesel and natural gas stored so people need not worry about shortages.

The White House said President Donald Trump had been briefed and Pete Gaynor, head of the Federal Emergency Management Agency (FEMA), had been in touch with the governor.   Trump's administration came under severe criticism for its response to Hurricane Maria.   The Category 4 storm destroyed the island's already shaky power grid, overwhelmed public services, left many residents homeless and claimed several thousand lives, according to government estimates.
Date: Tue, 7 Jan 2020 12:52:34 +0100 (MET)

Washington, Jan 7, 2020 (AFP) - A strong earthquake struck south of Puerto Rico early Tuesday, the US Geological Survey said, the latest in a series of tremors that have shaken the island since December 28.   The shallow 6.5 magnitude quake struck 13.6 kilometres (8.5 miles) south of the city of Ponce, the USGS said, revising down its initial reading of 6.6.   The quake struck just off the US territory's southern Caribbean coastline at 4:24 am local time (0824 GMT).   "The whole island is without power," the director of Puerto Rico Electric Power Authority, Jose Ortiz, told local media.

Puerto Rico's governor Wanda Vazquez Garced posted on Twitter that the government's security protocols had been activated.   She said government employees were not expected at work, adding: "We want everyone to be safe."   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep", adding "Everybody is awake & scared all over."

Dramatic images also shared on social media appeared to show widespread damage in the town of Guayanilla, home to around 20,000 people, as well as nearby Guanica.   The mayor of Guayanilla told local news channel NotiUno that the town's church had collapsed in the incident.

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled.   Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake.   That earthquake toppled houses and caused power outages, but there were no reports of casualties.
Date: Mon, 6 Jan 2020 18:04:21 +0100 (MET)

Miami, Jan 6, 2020 (AFP) - A 5.8-magnitude earthquake shook Puerto Rico Monday, toppling houses and causing power outages and small landslides but there were no reports of casualties, the US Geological Survey said.   The quake, just off the US territory's southern Caribbean coastline, was felt throughout much of the island, including the capital San Juan.

Some 250,000 customers were hit by electric power outages after the quake, which struck at 6:32 am local time (1032GMT).   Images posted on social media showed houses tumbled from their supporting pillars, cracks in walls, cars crushed under collapsed houses and small scale landslides.   The quake was the strongest of a series that have rippled through the island since December 28, and it was followed by at least eight aftershocks, officials said.   No tsunami alerts were issued.
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Gibraltar

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

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

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

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

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

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

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

Please see our information on medical insurance overseas.

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

Guatemala - US Consular Information Sheet
October 13, 2006
COUNTRY DESCRIPTION:
Guatemala has a developing economy, characterized by wide income disparities.
Hotels and other tourist facilities in the principal tourist sites most freq
ented by visitors from the United States are generally good to excellent.
A peace accord, signed in 1996, ended a 36-year armed conflict.
Violent crime, however, is a serious concern due to endemic poverty, an abundance of weapons, a legacy of societal violence, and dysfunctional law enforcement and judicial systems.
Read the Department of State Background Notes on Guatemala for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid U.S. passport is required for all U.S. citizens, regardless of age, to enter Guatemala and to depart Guatemala for return to the U.S.
Even if dual nationals are permitted to enter Guatemala on a second nationality passport, U.S. citizens returning to the United States from Guatemala are not allowed to board their flights without a valid U.S. passport.
Guatemalan authorities do not accept Certificates of Naturalization, birth certificates, driver's licenses, and photocopies as alternative travel documents.
While in Guatemala, U.S. citizens should carry their passports, or a photocopy of their passports, with them at all times.

An exit tax must be paid when departing Guatemala by air.
The exit tax (currently $30) is generally included in an airline ticket price, but may be charged separately.
There is an additional airport security fee (20 Quetzales, approximately $2.50) that all travelers must pay at the airport.

Minors under 18 traveling with a valid U.S. passport need no special permission from their parents to enter or leave Guatemala.
U.S. citizens do not need a visa for a stay of 90 days or less (that period can be extended for an additional 180 days upon application to Guatemalan immigration).

A U.S. citizen whose passport is lost or stolen in Guatemala must obtain a new passport at the U.S. Embassy as soon as possible and present it, together with a police report of the loss or theft, to the Dirección de Migración (Guatemalan immigration agency), Sub-director de Control Migratorio (Sub-director for Migratory Control), to obtain permission to depart Guatemala.
The agency is located in Guatemala City at 6 Avenida 3-11, Zone 4, Guatemala City.
Office hours are weekdays from 8:00 a.m. to 4:00 p.m.; telephone 2411-2411.
No fee is charged by Guatemalan immigration for this service.

In June 2006, Guatemala entered a "Central America-4 (CA-4) Border Control Agreement" with El Salvador, Honduras, and Nicaragua.
Under the terms of the agreement, citizens of the four countries may travel freely across land borders from one of the countries to any of the others without completing entry and exit formalities at Immigration checkpoints.
U.S. citizens and other eligible foreign nationals, who legally enter any of the four countries, may similarly travel among the four without obtaining additional visas or tourist entry permits for the other three countries.
Immigration officials at the first port of entry determine the length of stay, up to a maximum period of 90 days.
Foreign tourists who wish to remain in the four country region beyond the period initially granted for their visit are required to request a one-time extension of stay from local Immigration authorities in the country where the traveler is physically present, or travel outside the CA-4 countries and reapply for admission to the region.
Foreigners "expelled" from any of the four countries are excluded from the entire "CA-4" region.
In isolated cases, the lack of clarity in the implementing details of the CA-4 Border Control Agreement has caused temporary inconvenience to some travelers and has resulted in others being fined more than one hundred dollars or detained in custody for 72 hours or longer.

See our Foreign Entry Requirements brochure for more information on Guatemala and other countries.

For further information regarding entry, exit and customs requirements, travelers should contact the Guatemalan Embassy at 2220 R Street, NW, Washington, DC 20008; telephone (202) 745-4952, extension 102; fax (202) 745-1908; e-mail at info@guatemala-embassy.org; Internet web site - http://www.guatemala-embassy.org or contact the nearest Guatemalan consulate (Chicago, Denver, Houston, Los Angeles, Miami, New York, or San Francisco).

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

SAFETY AND SECURITY:
Violent criminal activity has been a problem in all parts of Guatemala for years, including murder, rape, and armed assaults against foreigners.
The police force is inexperienced and under-funded, and the judicial system is weak, overworked, and inefficient.
Well-armed criminals know that there is little chance they will be caught and punished.
Traditionally, Guatemala experiences increases in crime before and during the Christmas and Easter holiday seasons.
Large demonstrations occur throughout Guatemala, often with little or no notice, and they can cause serious traffic disruptions.
Although most demonstrations are peaceful, they can turn violent, and travelers should avoid areas where demonstrations are taking place.
The use of roadblocks and/or blocking of public facilities, including the international airport, has increased and demonstrators may prevent tourists caught behind the blockades from leaving.

Due to uncontrolled drug and alien smuggling, the Guatemalan border with Mexico is a relatively high-risk area, in particular in the northern most Peten Department.
The most dangerous area in that region is on the northwestern border of the Peten, in the area including the Sierra de Lacandon and Laguna del Tigre National Parks.
Extra precautions are required when travel by U.S. Government personnel to the region is required.

In October 2005 Hurricane Stan caused widespread flooding and landslides on Guatemala's Pacific coast and in many parts of the Highlands, affecting a number of tourist destinations frequented by foreign travelers.
All major highways and tourist destinations reopened by the end of the month, and most secondary routes are also fully open.
Temporary repairs are still in place; some have already been washed out and others will likely fail during the current rainy season (May through October).
The following recommendations will help residents and visitors alike to increase their safety:

Avoid gatherings of agitated people.
Guatemalan citizen frustration with crime and a lack of appropriate judicial remedies has led to violent incidents of vigilantism, including lynching, especially in more isolated, rural areas.
Attempting to intervene may put you at risk of attacks from mobs.

Avoid close contact with children, including taking photographs, especially in rural areas.
Such contact can be viewed with deep alarm and may provoke panic and violence.
Rumors of foreigners stealing children surface periodically and can provoke a violent response towards strangers.
Foreign tourists have been attacked by mobs and some years ago one was killed while photographing children.

Keep informed of possible demonstrations by following the local news and consulting hotel personnel and tour guides.
Avoid areas where demonstrations are occurring.

Strong currents, riptides, and undertow along Guatemala's Pacific Coast beaches pose a serious threat to even the strongest swimmers.
Signs warning of treacherous surf are rare and confined mostly to private beaches owned by hotels.
Lifeguards are rarely present on beaches.

Tourists planning to climb Pacaya and Agua volcanoes during Guatemala's rainy season (May through October) should plan their climb for the morning hours, when it is less likely that thunderstorms will occur.
Climbers should monitor the weather situation and return to the base of the volcano as quickly as safely possible if thunderstorms gather.
In 2003, a Canadian tourist was killed by lightning while climbing Pacaya.
INGUAT, the Guatemalan Tourist Institute, has organized an active community-based tourism program in San Vicente Pacaya to minimize the risk of armed robbery on Pacaya.
Climbing in groups is still highly advisable for any volcano climb to reduce the risk of assault.

Security escorts for tourist groups and security information are available from the Tourist Assistance Office of INGUAT (the Guatemalan Tourist Institute) at 7a Avenida 1-17, Zona 4 Centro Cívico, Ciudad de Guatemala.
INGUAT's 24 hour/seven days per week direct telephone numbers for tourist assistance and emergencies are (502) 2421-2810 and (502) 5578-9836 and the fax is (502) 2421-2891.
INGUAT may be reached by its toll free number within the United States at 1-888- 464-8281.
You may also simply dial 1500 in Guatemala to reach INGUAT Tourist Assistance.
The e-mail address is asistur@inguat.gob.gt.
Travelers may also wish to visit INGUAT's website, http://visitguatemala.com.
Tourist groups are advised to request security escorts from INGUAT, Attention: Coordinator of the National Tourist Assistance Program.
There have been no incidents of armed robbery of groups escorted through the Tourist Protection Program.
The request should be submitted by mail, fax or e-mail and should arrive at INGUAT at least three business days in advance of the proposed travel, giving the itinerary, names of travelers, and model and color of vehicle in which they will be traveling.
Travelers should be aware that INGUAT might not be able to accommodate all requests.

For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site at http://travel.state.gov where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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 number of violent crimes reported by U.S. citizens and other foreigners has remained high in recent years.
Incidents include, but are not limited to, assault, theft, armed robbery, carjacking, rape, kidnapping, and murder.
Criminals often operate in groups of four or more and are confrontational and violent.
Gangs are a growing concern in Guatemala City and rural Guatemala.
Gang members are often well armed with sophisticated weaponry and they sometimes use massive amounts of force.
Emboldened armed robbers have attacked vehicles on main roads in broad daylight.
Travel on rural roads always increases the risk of a criminal roadblock or ambush.
Widespread narcotics and alien smuggling activities can make remote areas especially dangerous.
Though there is no evidence that Americans are particularly targeted, criminals look for every opportunity to attack, so all travelers should remain constantly vigilant.

Most tourists and visitors travel throughout Guatemala without mishap.
However, violent criminal activity on the highways continues, and tourists, among others, have been targeted.
Many of the robbery attempts have occurred in daylight hours on main highways.
Carjacking incidents and highway robberies are often violent.
Four Americans were killed in highway robbery attempts in 2002 and three killed and one wounded in 2003.
In 2004 one American tourist was murdered, and women and children were raped in highway assaults.
Several highway assaults of American citizens also took place in 2005, but without serious injury to the victims.
In some cases, assailants have been wearing full or partial police uniforms and have used vehicles that resemble police vehicles, indicating that some elements of the police might be involved.
Armed robberies have occurred within minutes of the tourist's vehicle being stopped by the police.
U.S. Embassy personnel continue to observe heightened security precautions in Guatemala City and on the roads outside the capital city.
U.S. tourists are urged to be especially aware of safety and security concerns when traveling on the roads in Guatemala.
Rather than traveling alone, use a reputable tour organization.
Stay in groups; travel in a caravan consisting of two or more vehicles; and, stay on the main roads.
Ensure that someone not traveling with you is aware of your itinerary.
Resist the temptation to stay in hotels that do not have adequate security.
Travel after dark anywhere in Guatemala is extremely dangerous.
It is preferable to stay in the main tourist destinations.
Do not explore back roads or isolated paths near tourist sites.
Pay close attention to your surroundings, especially when walking or when driving in Guatemala City.
Refrain from displaying expensive-looking jewelry, large amounts of money, or other valuable items.
Finally, if confronted by criminals, be aware that resistance may provoke a more violent response.

Additional information:
In recent months there has been an increasing number of carjacking incidents and armed robberies near the airport, most frequently between 6:00 and 10:00 am (see list of Recent Crime Incidents Involving Foreigners on the Embassy website for more specifics).
In the most common scenario tourists or business travelers who land at the airport around 7:00 am are held up by armed men as their vehicle departs the airport.
Private vehicles, taxis and shuttle buses have been attacked.
Typically, the assailants steal money, passports, and luggage, and in some but not all cases, the assailants steal the vehicle as well.
Victims who did not resist the attackers were not physically injured.
The Embassy advises its own employees to seek alternative routes for exiting the airport.

Pickpockets and purse-snatchers are active in all major cities and tourist sites, especially the central market and other parts of Zone 1 in Guatemala City and the city of Antigua.
In a common scenario, an accomplice distracts the victim, while an assailant slashes or simply steals a bag or backpack while the victim's attention is diverted.

As in other countries, criminals also use a number of scams to steal money and possessions from tourists in Guatemala.
In one popular scam, robbers place a nail in a parked vehicle's tire.
The vehicle is then followed by the robbers who pose as "good Samaritans" when the tire becomes flat and the victims pull to the side of the road.
While "help" is being rendered, the contents of the car are stolen, often without the knowledge of the victims.
However, in some cases, the robbers have threatened the tourists with weapons.
Parking areas in and around the Guatemala City International Airport are particularly prone to this crime.
In another scam, victims are approached in a hotel, restaurant or other public place by an individual claiming there is some sort of problem with his or the would-be victim's automobile in the parking lot.
On the way to investigate the "problem," usually in a remote or concealed area near the parking lot, the robber pulls a gun on the victim demanding cash, credit cards and other valuables.
A third popular scam involves various attempts to acquire a victim's ATM card and PIN number.
Some sophisticated criminals have even placed boxes outside ATM kiosks that record PIN numbers when unsuspecting victims believe they must enter their PIN number to gain entry to the ATM foyer.
After recording PIN numbers, robbers then steal the owner's ATM card to complete their crime.
There are dozens of techniques scammers can use to rob victims of money and possessions.
While most people mean no harm, always be cautious when strangers approach you for any reason or make unusual requests.

Parents adopting children in Guatemala have also been victimized in public places and at their hotels by police (or individuals dressed as police) who have threatened to arrest foster mothers and turn adoptive children over to orphanages, but released them in exchange for significant payments, often approaching $1000.
Such threats have no basis in Guatemalan law, and should be immediately reported to the Embassy.

For security reasons, the Embassy does not allow U.S. government employees to stay in hotels in Zone 1 in Guatemala City and urges private travelers to avoid staying in this area.

Avoid low-priced intra- and inter-city buses (recycled U.S. school buses); they are often attacked by armed robbers and are poorly maintained and dangerously driven.
The use of modern inter-city buses somewhat improves security and safety.
There have been, however, several attacks on travelers on first-class buses on highway CA-2 near the border areas with both Mexico and El Salvador and on highways CA-1 and CA-9 near the El Salvador border and in the highlands between Quetzaltenango and Solola.
Be cautious with personal items such as backpacks and fanny packs while riding buses, because tourists' possessions are a favorite target of thieves.

Do not hail taxis on the street in Guatemala City.
Use radio-dispatched taxis or taxis from major hotels instead.
The main road to Lake Atitlan via the Inter-American Highway (CA-1) and Solola is safer than the alternatives, though attacks in recent years have made traveling in a caravan highly recommended, even on the Inter-American Highway.
Robbery and assault have been frequently reported on secondary roads near the lake with the highest number of incidents occurring on the RN-11 (Las Trampas road) parallel to the east side of the lake.
Robbers have used mountain roads advantageously to stop buses, vans and cars in a variety of ways.

Armed attacks have occurred on roads from Guatemala City to the Peten.
Visitors to the Mayan ruins at Tikal are urged to fly to nearby Flores and then travel by bus or tour van to the site.

Violent attacks have occurred in the Mayan ruins in the Peten, including in the Cerro Cahui Conservation Park, Yaxha, the road to and inside Tikal Park, and in the Tikal ruins.
Tourist police (POLITUR) patrols inside the park have significantly reduced the violent crime incidents inside the park, but travelers should nevertheless remain in groups and on the principal trails leading to the Central Plaza and the Temple IV complex, and avoid remote areas of the park.

POLITUR (a joint police/Guatemalan Tourism Institute initiative) is present in all major tourist destinations.
They should be contacted in case of any criminal incident in such areas, even if minor.

Foreign residents of Guatemala have special concerns.
Twenty American citizen residents and five American citizen tourists have been murdered since December 1999, and suspects have been convicted in only two cases.
There have been "express" kidnappings in recent years, primarily in Guatemala City, in which a relatively small ransom that can be quickly gathered is demanded.
U.S. citizens have been kidnapped in recent years.
At least one incident of a random kidnapping, in which the victim was grabbed off the street in an affluent neighborhood of the city, occurred in December 2003 and resulted in a physical and sexual assault.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: A full range of medical care is available in Guatemala City, but medical care outside the city is limited.
Guatemala's public hospitals frequently experience serious shortages of basic medicines and equipment.
Care in private hospitals is generally adequate for most common illnesses and injuries, and many of the medical specialists working in them are U.S. trained and certified.

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

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

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

Driving in Guatemala requires one's full attention, and safe drivers must take extraordinary efforts to drive defensively to avoid dangerous situations.

Traffic rules are only casually observed.
Many drivers do not use their turn signals to alert other drivers.
Instead, a common custom is for a driver or passenger to stick a hand out the window and wave it to indicate that they will be taking an unspecified action.
Speed limits, lane markings and stop signs are frequently ignored.
Passing blindly on winding and/or steep mountain roads, poorly designed surfaces, and unmarked hazards, including frequent landslides and precarious temporary highway repairs, present additional risks to motorists.

Common public transportation is by local recycled school busses, which serve every town in the country.
Criminal activity and frequent fatal accidents, however, make the low-priced inter-city buses particularly dangerous.
Modern inter-city buses offer some security from highway violence, but armed attacks are increasing, showing that all buses are vulnerable.
(See additional information in the CRIME section.)

Although city streets are lit, secondary and rural roads have little to no illumination.
Driving outside of urban areas at night is dangerous and not recommended.
The Inter-American Highway (CA-1) and the road from Guatemala City to the Caribbean coast (CA-9) are especially dangerous due to heavy traffic, including large trucks and trailers.
There are no roadside assistance clubs, however a roadside assistance force (PROVIAL) patrols most of the major highways in the country.
PROVIAL can be contacted by calling 2422-7878.
Their vehicles are equipped with basic tools and first aid supplies, and their services are free.
Police patrol the major roadways and may assist travelers, but the patrols are sporadic and may be suspended due to budget restraints.
For roadside assistance, travelers may call the police by dialing 120 or the fire department by dialing 122 or 123.
Cellular telephone service covers most areas frequented by tourists.

Valid U.S. driver's licenses are accepted for the first 30 days of a visit, and international driving permits are accepted in Guatemala for extended stays.
Guatemala's road safety authorities are the Department of Transit and the Joint Operations Center of the National Police.
Drivers use the right-hand side of the road in Guatemala, and speed limits are posted (in kilometers) depending on the condition of the road.
Speed limits are different in rural and urban areas, but are rarely enforced.
Drivers often drive at the absolute maximum speed possible for the particular vehicle at the time.
These drivers share the road with slow vehicles, some barely able to manage 20 miles per hour, creating a hazardous mix of velocities.
Turning right on red is not permitted unless otherwise posted, and drivers must yield when entering a traffic circle.
Seat belts must be worn in Guatemala, but there are no laws regarding the use of child safety seats.
It is against the law for drivers to operate cellular phones while driving.

People found driving under the influence of alcohol or other drugs are arrested and may serve jail time.
In an accident resulting in injury or death, every driver involved is taken into custody and the vehicle(s) impounded until a judge determines responsibility in a re-enactment of the accident.

Please refer to our Road Safety page for more information.
Visit the website of Guatemala's national tourist office and national authority responsible for road safety at http://www.inguat.gob.gt or via e-mail at asistur@inguat.gob.gt or info@inguat.gob.gt.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Guatemala's Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Guatemala's air carrier operations.
For more information, travelers may visit the FAA's Internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
A major renovation of the international terminal at La Aurora International Airport in Guatemala City is currently under way.
Until completion in late 2006 or early 2007, there is a temporary reconfiguration of arrival and departure vehicle traffic and major construction works inside the terminal.

Guatemalan customs authorities may enforce strict regulations concerning temporary importation into or export from Guatemala of items such as antiquities and other cultural property.
It is advisable to contact the Embassy of Guatemala in Washington or one of Guatemala's consulates in the United States for specific information regarding customs requirements.
In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines.

Please see our Customs Information.

Non-Guatemalan citizens who wish to marry in Guatemala are required to provide proof of identity and civil status (indicating whether they are single or divorced).
Prior notice of the marriage must be given in the Diario de Centro America (Guatemala's Official Record) and any large circulation daily newspaper for fifteen days.
The marriage must take place within six months of the publication of the notice.

DISASTER PREPAREDNESS:
Guatemala is a geologically active country.
Visitors should be aware of the possibility of earthquakes at any time and the need for contingency plans.
There are also four active volcanoes.
Volcanic activity, such as that of Fuego Volcano near Antigua in January 2003, and again in January 2006, has on occasion forced evacuations of nearby villages; the January-February 2000 activity of Pacaya Volcano near Guatemala City also briefly closed Guatemala City's international airport.
Both the Caribbean and Pacific coasts of Guatemala are also vulnerable to hurricanes and tropical storms from June through November.
Mudslides and flooding during the May to November rainy season often kill dozens of people and close roads.
In October 2005 Hurricane Stan caused widespread flooding and landslides on Guatemala's Pacific coast and in many parts of the Highlands.
Over 1000 Guatemalans died, and many highways across the affected regions were closed for days.
All highways have now reopened.
Temporary repairs are still in place; some have already been washed out and others will likely fail during the current rainy season.
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/.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Guatemala are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website and to obtain updated information on travel and security within Guatemala.
Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The latest security information is available from the Embassy, including its website, http://guatemala.usembassy.gov
The Consular Section is open for citizen services, including registration, from 7:30 a.m. to 12:00 noon and 1:00 p.m. to 3:30 p.m. Monday through Thursdays and 7:30 a.m. to 11:30 a.m. Fridays, excluding U.S. and Guatemalan holidays.
The second and last Friday of each month are reserved for administrative matters; therefore, routine citizen services are not provided.
Emergency services are available at all times.
The U.S. Embassy is located in Guatemala City at Avenida La Reforma 7-01, Zone 10; telephone (502) 2-326-4000 during Embassy business hours (8:00 a.m. to 5:00 p.m.), or (502) 2-331-2354 for emergencies during non-business hours; fax (502) 2-332-4353; Internet web site - http://guatemala.usembassy.gov.
* * *
This replaces the Consular Information Sheet dated June 13, 2006 to update the Entry and Exit requirements section.

Travel News Headlines WORLD NEWS

Date: Sat, 9 Mar 2019 23:07:09 +0100

Guatemala City, March 9, 2019 (AFP) - The parents of a British tourist who has been missing in Guatemala for the past five days launched an emotional appeal for her return Saturday as authorities continued their investigation.   Catherine Shaw, 23, was last seen Monday at a hotel in San Juan La Laguna near the country's fabled Lake Atitlan, about 75 kilometres (45 miles) west of the capital Guatemala City.   The area is famous for its lakes beneath towering volcanoes. Lake Atitlan is one of Guatemala's main tourist attractions.

Her parents put up a video appeal on the Twitter account of the Lucie Blackman Trust, a British charity that provides support to the families who have relatives missing, murdered or in a crisis abroad.   "Hello Catherine, we've been out of touch for five days and we, your family and your friends, need to know you're happy and that you're well. So please get in touch, get in touch with us, and we really you home," said her mother, who did not provide her name on the video.   "We need you, please come home, sweetheart," added her father.

Shaw was described as being five feet seven inches tall (170 centimetres) and of slim build, with blonde hair, blue eyes and piercings in her nose, lip and ears.   She had been traveling in Guatemala for two weeks having previously been in Mexico and California, leaving home in England in September 2018, according to the charity.   Eduardo Smith, the British embassy spokesman, told Prensa Libre that embassy staff were working with Guatemalan police on the case.
Date: Tue, 20 Nov 2018 02:54:29 +0100

Guatemala City, Nov 20, 2018 (AFP) - Guatemalan authorities declared a red alert and evacuated around 4,000 people Monday after the Fuego volcano erupted for the fifth time this year, sending bursts of ash and lava down the mountain before its activity decreased and then stopped.   Memories are still painfully fresh of the volcano's eruption in June, which swept away villages and left nearly 200 people dead and 235 missing.   The Institute of Volcanology's director Pablo Oliva said the volcano's activity level had dropped significantly by late Monday.

A spokesman for Guatemala's disaster management agency CONRED had earlier said it decided to evacuate the municipality of Escuintla and two other districts. Some 4,000 people were taken to temporary shelters as a precaution.   The spokesman, David de Leon, said the eruption became increasingly violent after it began Sunday morning, leading to fears for the safety of the thousands of people who live on the slopes of the 3,763 meter-high (12,246 feet) mountain.

A column of ash rose about 1,000 meters above the crater and areas west of the volcano -- 35 kilometers (22 miles) from Guatemala City -- were under a barrage of gas ash and fiery rocks, CONRED said.   As the volcano's activity fell back to normal parameters, evacuees were asked for the sake of cautiousness to return home on Tuesday by bus.

A previous eruption on October 12-13 was characterized by increasingly loud booms and lava flow. On that occasion, 62 people were evacuated from their homes as a precaution and a highway around the mountain was closed.   Many of those evacuated on Monday said they had feared a repeat of the deadly June eruption.   "We were scared and that's why we evacuated," said Miriam Garcia, from the village of El Rodeo which was largely spared the deadly eruption.

Oscar Juarez from El Rodeo said: "You have to get out as soon as possible because when that (volcanic material) comes close, you no longer have time to leave, even if you run, because it comes very fast."   Activity inside Guatemala's two other volcanoes, Pacaya and Santiaguito, has increased in recent months but they have not entered the eruptive phase.
Date: Mon, 19 Nov 2018 11:28:44 +0100

Guatemala City, Nov 19, 2018 (AFP) - Guatemalan authorities on Monday declared a red alert after the Fuego volcano erupted again, forcing about 200 residents to flee.   A fiery glow rose from the crater of Fuego which is erupting for the fifth time this year, one month after the last one and following a June 3 rain of rocks, ash and toxic gases that left almost 200 people dead and 235 missing.   A spokesman for Guatemala's disaster management agency CONRED, David de Leon, said 214 residents who live on the slopes of Fuego, mostly in the southern municipality of Escuintla, were moved to safe zones and more will follow.

He said about 2,000 people in total have been asked to leave the area of the 3,763-meter (12,246-foot) volcano, 35 kilometres (22 miles) from Guatemala City.   Since the eruption began Sunday morning, lava rises 500 meters above Fuego's crater, while the ash column exceeds one kilometre above the volcanic cone and is causing a rain of particles, the Institute of Volcanology said.   The previous eruption lasted from October 12-13 with loud booms and lava flow. It caused the evacuation of 62 people and closed a highway.
Date: Fri, 12 Oct 2018 18:54:16 +0200

Guatemala City, Oct 12, 2018 (AFP) - Guatemala's deadly Fuego volcano erupted anew early Friday, unleashing a 600-meter flow of lava and sending clouds of ash spiralling into the sky.   Increased volcanic activity over the last 24 hours could release tons of fiery volcanic material and force evacuations of mountain villages, warned Guatemala's disaster management agency CONRED.

A powerful June 3 eruption of the Fuego volcano -- located 35 kilometres (22 miles) southwest of the capital -- rained rocks, ash and toxic gases on several villages and left 190 people dead and 235 missing.   CONRED had yet to issue evacuation orders for mountain communities early Friday, but spokesman David de Leon said: "Considering how the volcano is behaving some communities could make decisions to evacuate to safe areas."

Authorities shut down a nearby highway as a precaution and vulcanologists warned the civil aviation agency of an ash cloud to the west and southwest of the volcano.   Scientists monitoring the 3,763-meter (12,346-foot) volcano reported increased activity from late Thursday. However, activity intensified on Friday with loud booms and lava flows, the Institute of Vulcanology said.   Some 2,900 displaced victims of the earlier disaster remain in temporary shelters as government promises to build a 1,000 permanent homes on a state farm have been held up by irregularities.
Date: Tue 6 Feb 2018
Source: Cooperativa.cl [in Spanish, machine trans., edited]

The Ministry of Public Health and Social Welfare of Guatemala reported [Tue 6 Feb 2018], that the number of people intoxicated by an outbreak of salmonellosis detected in a bakery in the country's capital has risen to 115. A source from the portfolio confirmed that, although initially reported of 54 affected, the number has risen to 115 and added that no further details of this case can be given as it is under investigation.

Health Minister Carlos Soto had previously indicated that the 1st 54 people infected after eating at this establishment, located in zone one of the capital, had already received medical discharge. In addition to _Salmonella_, the authorities detected in the establishment the bacterium _E. coli_ and during the investigations they verified that the workers did not have sanitary cards.

The bakery had until last [Fri 2 Feb 2018], to present the proof of release in this case, but asked for an extension at which time theHealth portfolio will make the decision to close or sanction the establishment.
====================
[The source of the salmonellosis outbreak linked to the bakery is not clear.

A map of (Guatemala): <http://healthmap.org/promed/p/13>. - ProMED Mod.LL]
More ...

Niger

Niger US Consular Information Sheet
March 03, 2008
COUNTRY DESCRIPTION: Niger is a developing, landlocked African nation whose northern area includes the Sahara Desert. Tourism facilities are minimal, particularly outside the capital city, Niam
y, and the ancient caravan city of Agadez. Ecotourism and adventure tourism opportunities are plentiful. Read the Department of State Background Notes on Niger for additional information.
ENTRY/EXIT REQUIREMENTS: A passport, visa, and proof of yellow fever inoculation are required. Travelers from countries without a Nigerien Embassy may be able to obtain a visa at the airport. Travelers from the United States should obtain a visa before arriving in Niger. Failure to do so could result in being denied entry to Niger. Travelers should obtain the latest information on entry/exit requirements from the Embassy of the Republic of Niger, 2204 R Street NW, Washington DC 20008; telephone: (202) 483-4224.
Visit the Embassy of Niger web site at http://www.nigerembassyusa.org/ the most current visa information. Outside the U.S., inquiries should be made at the nearest Nigerien embassy or consulate.
See our information about dual nationality and the prevention of international child abduction. Please refer to our Customs Information to learn more about customs regulations.
SAFETY AND SECURITY:
U.S. citizens are advised to avoid street demonstrations and maintain security awareness at all times.
Large and small street demonstrations occur regularly in Niger. These demonstrations tend to take place near government buildings, university campuses, or other gathering places such as public parks. Although demonstrations can occur spontaneously, large student demonstrations typically begin in January and February and continue through May. American citizens are, therefore, urged to be particularly vigilant at these times. During previous student demonstrations, NGO and diplomatic vehicles bearing "IT"or "CD" plates have been targeted by rock throwing demonstrators. Many past demonstrations have featured rock throwing and tire burning, especially at key intersections in the city of Niamey.

Due to the abrupt nature of street demonstrations, it is not possible for the U.S. Embassy to notify American citizens each time a demonstration occurs. Consequently, Americans are reminded to maintain security awareness at all times and to avoid large public gatherings and street demonstrations. Americans are reminded that even demonstrations intended to be peaceful can turn confrontational without much advanced warning. While the U.S. Embassy will endeavor to inform citizens of ongoing demonstrations through the warden system when possible, local radio and television stations are good sources for information about local events.

As of May 17, 2007, the U.S. Embassy in Niamey prohibits official personnel from traveling into areas of Niger to the north of Abalak.
All American citizens are strongly urged to follow the same guidelines due to the escalation of violence by the local rebel group, Movement for Justice in Niger (MNJ). Northern Niger, particularly in and around the cities of Iferouane, Arlit, and Agadez, is affected by MNJ activities. In July 2007, MNJ ambushed a convoy in the Agadez region, kidnapping a Chinese citizen and holding him for ten days. Futhermore, landmines have been placed in the region and several have exploded killing military and civilian personnel.
There were several landmine incidents in the south of Niger with the most recent on January 9, 2008 in Niamey.
They are disturbing because they were the first to occur outside the northern region where MNJ has operated. MNJ did not take responsibility for these landmines.
Most recently, MNJ attacked the town of Tanout, killing several troops and capturing arms and several people, including the prefet.
Several international organizations, including private and nongovernmental groups, have temporarily relocated personnel from these areas. On August 27, 2007, the President of Niger declared a State of Alert for the region of Agadez, to include the cities of Agadez, Arlit, and Iferouane. This State of Alert means that all travelers in and around these cities are liable to be stopped and held for questioning.
Moreover, the Nigerien military now has the authority to hold individuals for questioning, without cause, for more than the standard 48-hours.
Foreigners who elect to travel in northern Niger despite the current security situation must submit an approved travel plan through the office of the Governor of Agadez. Travelers should first contact the Syndicat de Tourisme in Agadez (telephone: 96 98 78 81) to enlist the services of a registered tour operator, who will formally coordinate with Nigerien government and security officials on tourist safety and security in the North and who can facilitate the submission of the required itinerary and intended route.
For travel in any remote area of the country, the Department of State urges U.S. citizens to use registered guides, to travel with a minimum of two vehicles equipped with global positioning systems (GPS) and satellite phones. Travelers are advised to avoid restricted military areas and to consult local police authorities regarding their itinerary and security arrangements.

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 Public Announcements, including the Worldwide Caution , can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
NOTE TO NON GOVERNMENTAL ORGANIZATION (NGO) WORKERS: Following the murder of a French tourist in the region of Agadez in December 2005, the Government of Niger (GON) began requiring that NGOs not only be registered and officially recognized but that they inform the GON of each mission they plan to undertake in Niger. To avoid detainment and/or expulsion by Nigerien authorities, Embassy Niamey strongly recommends that NGO workers:
* Make sure that their NGO has registered and received official recognition from the Government of Niger. For details on how to do this please visit the Managing Office of Decentralised Cooperation and Non Governmental Organizations (Direction De La Cooperation Decentralisee Et Des Organisations Non Gouvernementales) in the Ministry of Foreign Affairs (Ministre des Affaires Etrangères).
* Carry with them a copy of the official recognition (Arrêté) of the right of their NGO to operate in Niger.
* If their international NGO sponsor is without a permanent presence in Niger, American citizens should verify that their NGO group has informed the Ministry of Foreign Affairs at least two weeks prior to the start of a mission in Niger. This notice should be in written form and should include the purpose of the mission, names of the individuals who will be working for the NGO on the mission, the dates of the mission, where the mission will take place and the types & license plate numbers of the vehicles involved in the mission. The Ministry of the Interior should be copied on this notice of mission.
* If their NGO is a national NGO, i.e., has a headquarters operation in Niger, the American citizens should verify that their group has informed the Ministry of Territorial and Community Development (Minstre de l’Aménagement du Territoire et du Développement Communautaire) at least two weeks prior to the start of a mission in Niger. This notice should be in written form and should include the purpose of the mission, the names of the individuals who will be working for the NGO on the mission, the dates of the mission, where the mission will take place and the types & license plate numbers of the vehicles involved in the mission. The Ministry of the Interior should be copied on this notice of mission.
* NGOs should ask for receipt of their notification provided to the Ministry of Foreign Affairs, Ministry of the Interior and Ministry of Territorial and Community Development.
Embassy Niamey strongly recommends that in addition to the above, NGO workers present themselves at the Regional Governor’s office prior to beginning their mission in a particular portion of Niger. Again, NGO workers should ask for receipt of their presentation to the Regional Governor. It would also be wise to provide the Regional Governor with the same written notification that was provided to the Ministries listed above.
CRIME: Crime is at a critical level due primarily to thefts, robberies, and residential break-ins. Foreigners are vulnerable to attempts of bribery and extortion by law enforcement authorities. Thefts and petty crimes are common day or night. However, armed attacks are normally committed at night by groups of two to four persons, with one assailant confronting the victim with a knife while the others provide surveillance or a show of force. Tourists should not walk alone around the Gaweye Hotel, National Museum, and on or near the Kennedy Bridge at any time, or the Petit Marche after dark. These areas are especially prone to muggings and should be avoided. Walking at night is not recommended as streetlights are scarce and criminals have the protection of darkness to commit their crimes. Recent criminal incidents in Niger have included carjackings, sexual assaults, home invasions, and muggings. In December 2000, an American was killed in a carjacking incident in Niamey, and another American was gravely wounded in a carjacking incident outside of Niamey in 2004. In 2007, two American citizens were raped and two others attacked with a machete. Travelers should always keep their doors locked and windows rolled up when stopped at stoplights.
In August 2004, an attack against 2 buses on the Agadez-Arlit road left 3 dead and numerous persons wounded. A French tourist was murdered by bandits in the Agadez region in December 2005 during a robbery attempt. In August 2006, several Italian tourists were abducted near the Niger-Chad border. They were robbed of some of their possessions and later released. Due to continued sporadic incidents of violence and banditry and other security concerns, the Department of State urges U.S. citizens visiting or residing in Niger to exercise caution when traveling within the northern and eastern parts of the country, especially along the borders of Mali, Libya, Algeria and Chad. Given the insecurity along these border regions, the Department of State recommends that American citizens in Niger avoid traveling overland to Algeria and Libya.
In previous attacks, groups of foreign travelers, including Americans, have been robbed of vehicles, cash and belongings. The government of Niger is taking steps to address crime/banditry but operates under severe resource constraints.
Use caution and common sense at all times to avoid thieves and pickpockets. An information sheet on safety and security practices is available from the Consular Section of the U.S. Embassy in Niamey.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and provide an attorney list if needed.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Health facilities are extremely limited in Niamey and urban centers, and completely inadequate outside the capital. Although physicians are generally well trained, even the best hospitals in Niamey suffer from inadequate facilities, antiquated equipment and shortages of supplies (particularly medicine). Emergency assistance is limited. Travelers must carry their own properly labeled supply of prescription drugs and preventative medicines.
Malaria is prevalent in Niger. Plasmodium falciparum malaria, the serious and sometimes fatal strain in Niger, is resistant to the anti-malarial drug chloroquine. Because travelers to Niger are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). The CDC has determined that a traveler who is on an appropriate antimalarial drug has a greatly reduced chance of contracting the disease. Other personal protective measures, such as the use of insect repellents, also help to reduce malaria risk. 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 antimalarials they have been taking. For additional information on malaria, protection from insect bites, and antimalarial drugs, please visit the CDC travelers’ health web site at http://wwwn.cdc.gov/travel/contentDiseases.aspx#malaria.
Tap water is unsafe to drink throughout Niger and should be avoided. Bottled water and beverages are safe, although visitors should be aware that many restaurants and hotels serve tap water. Ice made from tap water is also unsafe to consume.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Niger is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road safety throughout Niger is a concern, and visitors are strongly urged to avoid driving at night outside of major cities. The public transportation system, urban and rural road conditions, and the availability of roadside assistance are all poor. U.S. travelers should exercise caution on Niger's roads, as traffic accidents are frequent. The main causes of accidents are driver carelessness, excessive speed, poorly maintained vehicles, and poor to non-existent road surfaces. Other factors include the hazardous mix of bicycles, mopeds, unwary pedestrians, donkey carts, farm animals, and buses on roads that are generally unpaved and poorly lighted. Overloaded tractor-trailers, "bush taxis," and disabled vehicles are additional dangers on rural roads, where speeds are generally higher. Travel outside Niamey and other cities often requires four-wheel-drive vehicles, which creates an additional security risk since these vehicles -- especially Toyota Land Cruisers — are high-theft items. Driving at night is always hazardous and should be avoided. Banditry is a continuing problem in northern and eastern Niger. There have been occasional carjackings and highway robberies throughout the country.
While taxis are available at a fixed fare in Niamey, most are in poor condition, and do not meet basic U.S. road safety standards. Inter-city "bush-taxis" are available at negotiable fares, but these vehicles (minibuses, station wagons, and sedans) are generally older, unsafe models that are overloaded, poorly maintained, and driven by reckless operators seeking to save time and money. A national bus company (SNTV) operates coaches on inter-city routes and, since being reorganized in 2001, has provided reliable service and experienced no major accidents. Air Transport, Rimbo and Garba Messagé are private bus companies operating in Niger. There is some concern regarding the youth of drivers and the speed with which the private bus companies travel the Nigerien roads.
Please refer to our Road Safety page for more information. Visit the National Tourism Office on Rue de Grand Hotel in Niamey.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Niger, the U.S. Federal Aviation Administration (FAA) has not assessed Niger’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: Dress Restrictions - Local culture and Islamic tradition encourage conservative dress for both men and women. There have been incidents of groups of men assaulting women who are, or appear to be, African and who are wearing other than traditional garments.
Photography Restrictions - Tourists are free to take pictures anywhere in Niger, except near military installations, radio and television stations, the Presidency Building, airport, or the Kennedy Bridge. Tourists should not photograph political and student demonstrations.
Currency Regulations - The West African Franc (FCFA) is the currency Niger shares with several other West African francophone countries, and is fully convertible into Euros. Foreign currency exchange over 1 million CFA (about $2,000 at 500 CFA/$1) requires authorization from the Ministry of Finance (available from all major banks).
Telephone Service - Due to poor line quality, callers often experience delays in getting a telephone line, and faxes are often garbled. Cellular phone service is available in Niamey and in many major cities.
Please see our Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Nigerien laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Niger are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Niger are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Niger.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located on Rue des Ambassades, Niamey, Niger.
The U.S. Embassy mailing address is B.P. 11201, Niamey, Niger.
Telephone numbers are: (227) 20-72-26-61 through 64 and fax numbers (227) 20-73-31-67 or 20-72-31-46. The Embassy’s after hours emergency number is (227) 20-72-31-41. Embassy’s Internet address is http://niamey.usembassy.gov.
* * *
This replaces the Country Specific Information dated September 6, 2007 to update the section on ”Safety and Security.

Travel News Headlines WORLD NEWS

Date: Sun, 20 Oct 2019 06:45:19 +0200 (METDST)

Niamey, Oct 20, 2019 (AFP) - Floods in southeast Niger have forced 23,000 people to flee their homes since early October, officials said Saturday, threatening a new humanitarian crisis in a region already wracked by Boko Haram Islamist violence.   Heavy rains have caused the Komadougou Yobe river that flows through the semi-desert Diffa region into Lake Chad to burst its banks, inundating villages, flooding fields and damaging crops.   Two villages near the city of Diffa were "completely submerged" and 2,500 households have been forced to move, according to national radio the Voice of the Sahel.

Some 400 families were sheltering in a gym in the city, it added.   "We have been fighting for days to stop the water rising, but it's not working," Amadou Issa, a rice farmer, told AFP. "The sandbags we've been using to keep the water out are completely under water."   Extreme weather events are common in Niger, one of the world's poorest countries.   Between June and September 57 people were killed and more than 130,000 affected by flooding according to government figures.

The capital Niamey was hit badly in September, with the waters of the Niger river -- the third biggest in Africa -- rising to a level not seen in more than 50 years and swamping parts of the city.   Last year, drought and flooding led to food shortages in a crisis which, exacerbated by jihadist violence, left more than 10 percent of the population needing humanitarian aid.   Niger, along with neighbouring Burkina Faso, Chad, Mali and Mauritania is also struggling against escalating attacks by armed Islamists.   According to the UN's human rights agency UNHCR, the Diffa region is home to almost 120,000 refugees and 109,000 internally displaced people.
Date: Mon, 16 Sep 2019 16:24:55 +0200 (METDST)
By Boureima HAMA

Niamey, Sept 16, 2019 (AFP) - "At last, we're here!" Amina and Halima, who live in Niger's capital Niamey, exulted after reaching high ground following the worst floods to hit the city in 50 years.   Two weeks ago, authorities in Niamey declared a red alert when the waters of the Niger river -- the third biggest in Africa -- rose to a level "not seen in more than 50 years".

The floods have affected more than 6,300 people in the traditionally dusty city.   Nearly 60 have been killed and 130,000 displaced across the nation this rainy season, officials say.    Amina and Halima are among those who have been evacuated to tent shelters at Saguia in the highlands overlooking Niamey.   The women travelled in a van, but officials have been chartering all kinds of transport to move people in trouble, while others hire taxis, ride motorbikes and even walk.

Saguia is a patch of land owned by the army and usually off limits to the public.    In 2012, it was used to house about 400 soldiers from neighbouring Mali who had fled an offensive by Tuareg rebels.   For access to the site, people need "tickets" that are distributed in schools serving as transit centres for flood victims, according to the armed paramilitary police checking new arrivals.   The heights give a panoramic view of the homes and rice paddies largely submerged by the water.

- 'Surprised in our sleep' -
Inside the camp, the fire brigade and municipal employees have put up dozens of white tents supplied by the Red Cross and the United Nations.   "When people arrive here, they are installed in tents (...) and we have enough food for them all," Niamey governor Issaka Assane Karanta told AFP.   A generator and a fresh-water well have both been repaired, lamp posts will soon be installed and a medical centre is open "for the treatment of emergency cases", the governor said.

Some 122 households, comprising 854 people, have been allocated tents and the site can take in a total of 1,200 flood victims, he added.   "They gave us rice, millet, mosquito nets, blankets and drinking water," said Aissa Salifou, putting on makeup in her tent, her head and shoulders covered in a broad veil.   "The water surprised us in our sleep," added the woman from one of Niamey's hardest-hit districts, Kirkissoye. "We had to demolish the walls in neighbouring houses to scramble out."   "We live on the low ground where we were trapped by the water, but this place is spacious, well-aired and above all safe," said Fatouma Boubacar, another Kirkissoye resident, watching her cooking pot on the fire.

- 'I was lucky' -
Though Boubacar arrived only two days earlier, she has resumed her customary job, selling vegetables.   "I was lucky," said Ramatou Abdou, reclining in an armchair with a toothpick stuck between her teeth.   "I barely got out of the house before the roof fell in. I'm expecting my first baby in a month and I shall call it Saguia."    In the shade of a huge tree, a dozen new arrivals awaited the completion of their shelters before moving in.    Barefoot children meanwhile made up football teams and chased a rag ball on a makeshift pitch in the baking heat.

On the far side of the camp, a policeman with a gun slung over his shoulder watched over a bunch of children carrying plates and queuing for a hot meal provided by an NGO.   "We're trying to live here and waiting to see what Allah has in store for us," Boubacar said.    The level of the Niger has fallen slightly after bursting its banks, but governor Karanta is urging people from affected areas to be watchful and "to keep well away from the bed of the river".   Upstream in Mali, technicians have opened floodgates on a major dam and the extra water is "slowly but surely" flowing down to Niger, Karanta said.
Date: Fri, 13 Sep 2019 16:44:33 +0200 (METDST)

Niamey, Sept 13, 2019 (AFP) - Niger launched a campaign on Friday to vaccinate more than four million children against measles, one of the biggest causes of child mortality in the country, the health ministry said.

The one-week nationwide vaccination programme aims to "eliminate measles by the end of 2020", Health Minister Illiassou Mainassara said, adding, it "will reach 4.254 million children" aged from 9 months up to the age of five.   "Despite all the efforts made in the fight against communicable diseases, we still note the persistence of localised measles epidemics (in Niger)," Mainassara said on his way to the capital Niamey to launch the campaign.    But some experts say the vaccination programme should have kicked in sooner    "The delay of this campaign which should have happened in 2018 has resulted in ...the emergence of epidemics in several health districts," said Niger's UNICEF representative, Felicite Tchibindat.

Since January this year, 9,741 suspected cases have been documented in Niger resulting in 53 deaths, she said.   "Measles is a serious and extremely contagious viral disease and remains one of the leading causes of early childhood death, while it can be prevented by vaccination," TchibiNdat said.    She believes the children of migrants, refugees and displaced people will especially benefit from the campaign.    Niger's vaccination programme is supported by the World Health Organization (WHO), UNICEF (United Nations Children's Fund) and the Gavi vaccine Alliance.
Date: Wed, 4 Sep 2019 21:12:00 +0200 (METDST)
By Boureima HAMA

Niamey, Sept 4, 2019 (AFP) - "That's it, time to go!" As a rising swell of muddy water creeps towards his house in Niger's capital Niamey, Mamoudou Barkire is finally leaving.   Deadly floods have swamped several parts of the city and the rest of the country, forcing thousands to flee as it demolished homes and turned streets into rivers.   And the 63-year-old retiree, propped on crutches, is joining them.   But leaving was not an easy choice. Barkire, whose neighbours left weeks ago, spent the past two days piling sandbags onto a clay wall he built in a futile bid to keep the water away.   "I barely have enough to feed my family on this measly pension, and now I risk losing my home".

Extreme weather is an all-too-common phenomenon in Niger. Last year, drought and flooding led to food shortages in a crisis which, exacerbated by jihadist violence, left over 10 percent of the population needing humanitarian aid.   But the World Health Organisation (WHO) has warned that the current floods -- sparked by exceptionally high water levels in the river Niger -- could lead to a cholera epidemic.   The waterborne disease killed dozens last year in the southern Maradi region, currently the worst-hit by floods.

- Red alert -
The disaster has already claimed 42 lives. Only 25,000 of the 70,000 people affected by the crisis have received aid, said Lawan Magadji, Niger's minister for humanitarian affairs.   Niger, one of the world's poorest countries, is in the midst of its annual rainy season, which lasts three to four months over summer.   At the start of the week, water rose to 6.38 metres (21 feet) in Niamey, levels "not seen in more than 50 years", the city's governor Assane Issaka Karanta said.

It prompted authorities to trigger a "red alert", which they renewed on Wednesday.   Even the arid Agadez region -- home to a UNESCO-protected historic centre -- has been hit.   In Niamey inhabitants have clubbed together in the struggle to save their neighbourhoods.   Children drag carts piled with dam-building materials through the streets, while women try their best to clean up courtyards brimming with water.    With more heavy rain predicted in coming weeks, authorities have asked humanitarian agencies for help.   The vast majority of the city's inhabitants live on the banks of the river Niger, and some even built their homes on the river bed.   But "the worst has been avoided" for now, as dams surrounding the city "are holding up", Niamey's Mayor Mouctar Mamoudou said.

- Sleepless nights -
Watching over the city, a "brigade" of locals are tasked with keeping an eye on the river banks at night.   "We haven't been sleeping. If the water levels rise again, we'll let people know," says Ali, who hasn't slept for two nights.   And in the capital's Kirkissoye district -- one of the worst affected -- firefighters patrol the streets, assessing damage and registering victims on a list.   Saouda Abdoulaye is one of those who decided to stay, despite authorities warning residents to pack their bags and ration food and water.    Abdoulaye says she had underestimated the damage the flooding would cause.   "Kirkissoye has suddenly turned into a swamp. At night, it's a ghost town," she says.
Date: Sun 31 Mar 2019
Source: BrandSpur Ng [edited]

The National Agency for Food and Drug Administration and Control (NAFDAC) [Nigeria] alerts the public, especially the health care providers, on the circulation of fake MencevaxTM ACWY and MencevaxTM ACW vaccines circulating in the Niger Republic. The Health Authorities of the Republic of Niger issued an alert on the fake vaccines discovered during routine inspections of the pharmacies in Niamey, the Niger Republic on [14 Mar 2019].

The lot number of the fake MencevaxTM ACW vaccine is AMEN A020 AA while the Lot number of the fake MencevaxTM ACWY is AMEH A020 AA. The fake MencevaxTM ACWY vaccine has a manufacturing date of December 2016 and an expiring date of November 2021.

Genuine MencevaxTM ACW and MencevaxTM ACWY vaccines are used to control the outbreak of meningococcal infection. The genuine vaccines were registered by NAFDAC [Nigeria] in favour of Glaxo SmithKline Beecham (GSK). Pfizer acquired the vaccines from GSK in 2015.

Pfizer Specialties Limited, 7th Floor, Heritage Place, 21 Lugard Avenue, Ikoyi Lagos discontinued commercialization of Mencevax Vaccines in Nigeria in June 2018. As a result of the discontinuation of commercialization of the vaccines, Pfizer Specialities Limited no longer import the vaccines into Nigeria.

NAFDAC implores all importers, wholesalers, and retailers not to illegally import, distribute and sell the fake Mencevax vaccines. Surveillance has been strengthened by NAFDAC at all ports of entry to prevent importation of the fake vaccines from the Niger Republic. The agency has also heightened surveillance to prevent distribution and sales of the fake vaccines.

Health care providers and other members of the public are advised to be vigilant and contact the nearest NAFDAC office with any information on the fake vaccines. Anybody in possession of the fake vaccines should submit it to the nearest NAFDAC office.

Consumers are advised to report adverse events related to the use of vaccines to the nearest NAFDAC office, NAFDAC PRASCOR (20543 TOLL-FREE for all Network) or via pharmacovigilance@nafdac.gov.ng.  [Byline: Bolaji Samuel]
===========================
[The genuine meningococcal vaccine manufactured by GlaxoSmithKline, Mencevax ACWY, is a lyophilized preparation of purified polysaccharides from _Neisseria meningitidis_ (meningococcus) of serogroups A, C, W and Y, that must be reconstituted with the sterile diluent that is supplied in another glass vial or pre-filled syringe for subcutaneous injection  (<http://www.gsk.com.au/resources.ashx/vaccineproductschilddataproinfo/114/FileName/0D20DC52BDDA8B361FA1AA0D654B93C5/PI_Mencevax.pdf>).

The previous ProMED-mail post said that a fake meningococcal vaccine, Mencevax ACWY, marked as having been manufactured in December 2016, with an end-date for use by November 2021, was being distributed in Niger (See Meningitis, meningococcal - Niger: counterfeit vaccine http://promedmail.org/post/20190317.6372003.) The news report above adds that the fake meningococcal meningitis vaccines include both the quadrivalent Mencevax ACWY (lot number AMEH A020 AA) and a trivalent Mencevax ACW (lot number also AMEN A020 AA). However, we are not told how these fake vaccines differ from the genuine meningococcal vaccine products in Niger.

WHO issued a report in May 2015 for Niger of falsified Mencevax ACWY, 50 doses per vial, with false batch number (AMEHA020AA), manufacturing date (December 2013) and expiry date (November 2016); falsified Mencevax ACW, 50 doses per vial, with a genuine batch number (AMENA020AA), but with false manufacturing date (December 2014) and expiry date (November 2017) - the genuine version of this batch expired in 2011; and falsified diluent, 50 doses, with false batch number (A003B128AA), manufacturing date (February 2013) and expiry date (January 2019)  (<https://www.who.int/medicines/publications/drugalerts/AlertWHO2.2015MENCEVAX_EN.pdf>).

Use of fake vaccines will leave a substantial portion of the population susceptible to meningococcal disease and engender further loss of confidence in the utility of vaccines. It will also undermine public confidence in the ability of government to safeguard the public. - ProMED Mod.ML]

[HealthMap/ProMED map available at:
More ...

Jordan

General Information:
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The Middle East is a favourite destination for many Irish holiday makers. The combination of a beautiful climate linked with such historical richness is hard to beat. Unfortunately the
security situation throughout the region has led to some significant concerns over the years. Nevertheless, in the vast majority of cases those visiting the region will not encounter any particular concerns in this regard. It is a wise precaution to ensure that your passport is valid for at least a further six months beyond the time of your holiday as otherwise you may be refused entry.
Security Situation:
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Security throughout the Middle East is generally tight. Carry some means of identification at all times in case you are requested to produce it by police or army personnel. In Jerusalem the city has been divided and it is sensible to remember which quarter you are in at all times.
Health Facilities:
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Generally the health facilities throughout the region are excellent. However, when visiting certain rural regions you may find it difficult to obtain hospital care similar to that at home. In Israel, travellers can find information in English about emergency medical facilities and after-hours pharmacies in the "Jerusalem Post" and English language "Ha'aretz" newspapers.
Food & Water Facilities:
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Again, this depends on your location and the facilities which are there at the time of the year you visit. Bottled water is easily available and food hygiene is usually excellent throughout all the main tourist destinations. However, it is generally wiser not to drink hotel tap water and only to use it for brushing your teeth if there is a clear smell of chlorine. When on organised trips tourists are sometimes offered local tea or other drinks. Generally this will be safe as the water is boiled but take care that the cup hygiene is acceptable.
Sun Exposure:
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The climatic conditions in the Middle East vary considerably throughout the year. Many tourists visit in late autumn or early spring. At these times the climate is much cooler and the evenings can be distinctly chilly. However, during the main tourist season (May to September) the temperatures rise high into the 80’s or 90’s and dehydration can easily occur. Increasing fluid and salt intake is important under these circumstances. It is essential that travellers are aware of the climatic conditions which should be present for their trip and that sensible clothing is used at all times.
Rabies:
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Tourists should avoid all animals as this viral disease is transmitted through the bite, lick or scratch of any infected warm blooded animal. In Israel the most common animals involved are foxes and jackals and in Jordan, dogs tend to be the main culprits.
Exploring the Region:
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Leaving the main tourist routes is unwise. There are a number of security risks which have to be considered and there are also significant health concerns which may be encountered. In July 2000 an 18 year old American tourist died of sunstroke when she became separated from her group in the Dead Sea region of Israel. Those exploring caves and parts of the desert areas also run the risk of diseases like Borreliosis and Rabies.
Walking & Trekking:
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For many going to these countries their trip will involve visiting some of the major ruins and archeological sites. This will involve a good deal of walking and trekking. Good supporting foot wear is essential and it would be wise to carry a crepe bandage in case of a sprained ankle. Having a suitable painkiller or anti-inflammatory medication would also be advantageous. Check your health will be up to the journey.
Swimming:
***************************************
Pools are usually very well maintained and the risk of disease is small. Those swimming in the sea should remember that the Mediterranean is home to many jelly fish. Swim with others and never alone and especially after alcohol or a heavy meal.
Anthrax:
***************************************
This bacterial disease is rare in the Middle east though travellers should be aware that it can be transmitted through unprepared leather goods usually bought in the local market places. Typically the disease may then present with a black ulcerated skin lesion.

Malaria:
***************************************
Fortunately this disease does not occur in Israel or Jordan. However other mosquito and sandfly diseases do occur and so protection against their bites should be used when necessary.
Hepatitis:
***************************************
There are many forms of this disease but the most common is Hepatitis A, often known as Infectious Jaundice. This disease can keep an infected individual off work for many weeks and it is wise to consider vaccination cover before exposure. In Israel approx 65% of the population will have been infected before 18 years of age.
Vaccinations:
***************************************
There are no essential vaccines for entry/exit however most Irish tourists are recommended to receive cover against; Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Those living in these countries or planning an extended trip should also consider cover against Hepatitis B and Rabies.
Summary:
***************************************
Due to the unrest within Israel there are concerns regarding the safety of tourists at this time. If you are travelling to this region it is wise to ensure that your insurance policy is sufficient if your circumstances or travel plans change.

Travel News Headlines WORLD NEWS

Date: Wed, 6 Nov 2019 15:31:58 +0100 (MET)

Amman, Nov 6, 2019 (AFP) - Eight people, including four tourists, were wounded in a knife attack on Wednesday at the famed archeological site of Jerash in northern Jordan, a security spokesman told AFP.   Four tourists -- three Mexicans and a Swiss woman -- were wounded, along with a Jordanian tour guide and a security officer who tried to stop the assailant, public security directorate spokesman Amer Sartawi said.   The attack took place around noon (1000 GMT) at the Roman ruins of Jerash, a popular attraction 50 kilometres (30 miles) from the capital Amman.   The health ministry confirmed that eight people had been wounded, with Sartawi saying earlier that they had "been transported to hospital for treatment".    He said the assailant had been arrested but did not specify his nationality, noting that the motive was as yet unknown.

Jordanian tour guide Zouheir Zreiqat was at the scene and told AFP that the attack happened "just before midday when around 100 foreign tourists" were at the site.    "A bearded man in his twenties wearing black and brandishing a knife started to stab tourists," according to Zreiqat.   He said others started to shout for help and he, along with three other tour guides and three tourists managed to stop the assailant.   "We chased him until we could grab him and get him on the ground," Zreiqat said.    "We took the knife from him. He stayed silent, without saying a word until the police arrived and arrested him."

- Violent attacks -
It was not the first time tourist sites have been targeted by attacks in Jordan.    In December 2016, in Karak, home to one of the region's biggest Crusader castles, 10 people were killed in an attack that also left 30 wounded.    Seven police officers, two Jordanian civilians and a Canadian tourist were killed in the attack.

The attack was claimed by the Islamic State group (IS) and sparked concern over its impact on tourism, a mainstay of the Jordanian economy.    Ten people were convicted of carrying out the attack, with two sentenced to death.   Several violent incidents struck the country the same year, including a suicide attack in June claimed by IS that killed seven Jordanian border guards near the frontier with Syria.    Amman has played a significant role in the United States-led coalition fight against IS in Syria and Iraq, both neighbouring Jordan.

- Economic troubles -
Lacking in natural resources, the country of nearly 10 million depends on tourism and the kingdom has been working to pull the key sector out of a crisis caused by regional unrest in recent years.   Jordan's economy as a whole was hit hard by the combined impact of the international financial crisis, the Arab Spring uprisings that convulsed the Middle East in 2011 and the conflict in Syria.

Tourism accounts for 10 to 12 percent of gross domestic product and the government aims to double this by 2022, former tourism minister Lina Annab told AFP in an interview last year.  The country boasts 21,000 archaeological and historical sites that span millennia, according to the tourism board.   They include the Roman ruins of Jerash, the ancient city of Petra, the Dead Sea and Wadi al-Kharrar, or Bethany Beyond the Jordan, where some believe Jesus was baptised.   Jordan welcomed seven million tourists in 2010, but arrivals plunged to around three million in each of the following two years, tourism board head Abed Al Razzaq Arabiyat said in April.    Numbers have rebounded as spillover from the war in neighbouring Syria has abated, officials have said, with the government working to bring annual tourist arrivals back up to 7 million by 2020.
Date: Mon 26 Apr 2019, 3:51 PM
Source: Roya News [edited]

The initial results of the laboratory specimens of the food poisoning cases in Raymon town, west of Jarash revealed that _E. coli_ bacteria was the cause of the poisoning. The reports indicated that the bacterium was found in samples taken from water tanks in a bakery and restaurant during inspections conducted by teams of the Ministry of Health, the Ministry of Environment and the Jordan Food and Drug Administration (JFDA).

The report said that 5 people were referred to hospital on [Sat 24 Aug 2019], where it was suspected that they have food poisoning. The Ministry of Health had then sent an investigation committee to take water samples, after it was thought that the poisoning was caused by water that people used from 2 water stations.

Water samples were also taken from houses of people who suffered poisoning, 2 restaurants and a bakery. However, the bacteria were found in one of the restaurants and the bakery.

So far, 49 cases were referred to the Comprehensive Health Center, while 22 were referred to Jarash Government Hospital, where 7 of which left the hospital.

Preliminary results of the water samples taken from the 2 stations showed that water is clear of any kind of bacteria. The restaurant and bakery were closed down.
=======================
[_E. coli_ contamination does not necessarily mean that the organism was the cause of the illnesses as the observation can just reflect human faecal contamination and other pathogens including viruses, parasites and other bacteria may be involved. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Sat, 10 Nov 2018 16:22:28 +0100

Amman, Nov 10, 2018 (AFP) - Flash floods killed 12 people in Jordan and forced nearly 4,000 tourists to flee the famed ancient desert city of Petra, emergency services said on Saturday.   Search teams were scouring valleys near the historic hill town of Madaba for a young girl who was still missing after Friday's floods, civil defence spokesman Iyad Amru told state television.

Among those confirmed dead after torrential rains swept the south of the kingdom were six people found in the Madaba area southwest of the capital Amman.   To the east, three people were killed near Dabaa on the Desert Highway, one of Jordan's three main north-south arteries, while one was killed near Maan in the south.    It was not immediately clear where the other two died.   Amru said two girls had gone missing in the Madaba region, later announcing that one of their bodies had been found.

Government spokeswoman Jumana Ghneimat said authorities had found alive four Israeli tourists who had gone missing in the Wadi Rum desert in southern Jordan but were looking for two more.   "Our embassy in Tel Aviv contacted the Israeli foreign ministry for information on the identities of the missing Israelis," Ghneimat said in statements carried by the state news agency Petra.   Israel initially confirmed the report but in a later update a spokesman for the foreign ministry said that "all the Israelis in Jordan have contacted us. All of them were found".

- Tourists evacuated -
The Jordanian army deployed helicopters and all-terrain vehicles to help with search and rescue operations after floodwaters cut off the Desert Highway in both directions.   A rescuer was also among the dead, the civil defence spokesman said.   State television said the waters had reached as high as four metres (13 feet) in parts of the red-rock ravine city of Petra and the adjacent Wadi Musa desert.

It broadcast footage of tourists sheltering on high ground on both sides of the access road to Jordan's biggest attraction.   The government spokeswoman said 3,762 tourists were evacuated.   Designated a UNESCO World Heritage site in 1985, Petra draws hundreds of thousands of tourists a year to its rock-hewn treasury, temples and mausoleums.   Its buildings have been used as sets for several Hollywood blockbusters including "Indiana Jones and the Last Crusade".   Wadi Rum, also a UNESCO World Heritage site, has attracted generations of tourists with its spectacular sandstone and granite rock formations.   Its landscapes served as a backdrop in the filming of the Hollywood classic "Lawrence of Arabia".

The latest deaths come after October 25 flash floods in the Dead Sea region of the kingdom killed 21 people, most of them children on a school trip.   Jordan's education and tourism ministers both resigned last week over failings in the government's response to those floods.   The education ministry ordered schools closed nationwide on Saturday amid warnings of more heavy rains.   Jordan's minister of water and irrigation, Raed Abu al-Saoud, said on Saturday that the country's 14 main dams had filled up by some 26 percent of full capacity in the past 48 hours because of the torrential rains.   Jordan is a water-poor country that is 90 percent desert.
Date: Fri, 26 Oct 2018 11:36:00 +0200

Amman, Oct 26, 2018 (AFP) - At least 20 people, most of them school pupils, have been killed in flash floods in Jordan, the emergency services said Friday in an updated toll.   A further 35 people were injured following heavy rains on Thursday, including members of the security forces involved in rescue operations, said an official from the civil defence -- Jordan's fire service -- who asked not to be named.   He said rescuers were still searching for people missing in the area, a popular tourist attraction around 50 kilometres (30 miles) west of Amman.   "Most of the dead were schoolchildren aged 11 to 14 who were taking part in a school trip to the Dead Sea region" when their bus was swept away by floodwaters.   Also among the dead were passers-by who had been picnicking in the area, he said, adding that a nearby bridge had collapsed.   "Security force personnel who were taking part in the rescue operations were among the injured," he added.

The Dead Sea, the lowest point on earth, is surrounded by steep valleys and gullies that frequently see flash floods and landslides.   Education Minister Azmi Mahafzah promised a "full inquiry" into the schoolchildren's deaths.   He said the bus took a route not agreed upon by the ministry and the organiser of the trip bore full responsibility.   Roads leading to the area were closed on Friday morning "to allow the continuation of search and rescue operations", the Directorate of General Security said.   The Israeli military said on Thursday it was helping with the operation, sending helicopters and forces specialised in search and rescue.   Jordanian television reported that King Abdullah II had cancelled a planned visit to Bahrain to monitor developments.
Date: Tue 26 Sep 2017
Source: Jordan Times [edited]

Following a rise in hepatitis A cases among school students in Mafraq's Akeider area, the president of the Lower House's Health Committee, Ibrahim Bani Hani, has called for more governmental attention to the area, which "has suffered negligence for so long".

The Ministry of Health has recorded 32 cases of Hepatitis A in students from the Akeider area, in Mafraq Governorate, since [22 Aug 2017]. Hepatitis A is a liver disease caused by a virus transmitted through contaminated food or water, inadequate sanitation and poor personal hygiene, the Health Ministry's spokesperson, Hatem Azrui, told The Jordan Times.

Bani Hani visited Akeider 2 months ago, along with other officials and the Lower House's Environmental Committee, to examine the impacts of the landfill in Akeider on the environment and the health of its citizens. "There is no doubt that hepatitis A has spread in the area due to a lack of hygiene in health and public facilities," he stated.

Mafraq health director at the Ministry of Health, Hani Oleimat, said that the disease is not epidemic and that the rate of [past] infection in adults amounts to over 90 percent.

Azrui said that the ministry has conducted experiments on the water sources at schools and homes and noted that no signs of the virus were found. He said that the disease is spread through sharing personal items like towels at public health facilities.

For his part, Bani Hani stressed that the area is lacking a health centre, which the ministry had promised to build, but noted that "no real measures were taken". He also said that the area suffers from other issues such as the emission of phenol gas from Akeider landfill and the increased number of stray dogs, a potential source of rabies.

Oleimat noted that since the discovery of the cases, no schools have stopped working in the area and noted that the ministry urged the school staff to direct any suspected case to the health directorate, in order to provide the infected students with a 7- to 10-day sick leave. The sickness needs no medication other than rest, Oleimat highlighted, noting that the body of the infected person naturally generates immunity  against the virus.  [Byline: Sawsan Tabazah]
==================
[This is a completely preventable disease using the inactivated hepatitis A vaccine. In the developing world, it is seen primarily in children and by adulthood, almost all individuals are immune. Most infections in children are asymptomatic so a cluster of 32 cases, so far here, implies a great deal more total infections. - ProMED Mod.LL]

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

World Travel News Headlines

Date: Thu, 13 Feb 2020 13:58:41 +0100 (MET)
By Suy SE

Sihanoukville, Cambodia, Feb 13, 2020 (AFP) - A US cruise ship blocked from several Asian ports over concerns that a passenger could have been infected with the new coronavirus docked at a Cambodian pier Thursday, as frustrated holidaymakers expressed hope their ordeal may soon be over.   The Westerdam was supposed to be taking its 1,455 passengers on a dream 14-day cruise around east Asia, beginning in Hong Kong on February 1 and disembarking on Saturday in Yokohama, Japan.   But the ship was turned away from Japan, Guam, the Philippines, Taiwan and Thailand over fears of the novel coronavirus epidemic that has killed more than 1,300 people in China.

Cruise operator Holland America has insisted there are no cases of the SARS-like virus on board and Cambodia announced Wednesday that the boat would be able to dock in Sihanoukville, on its southern coast.   By evening, the ship moved into the beach town's port, moving past the small fishing vessels that usually ply the waters.   As it slowly approached the pier, people onshore snapped selfies of themselves with the massive vessel.   The mood was equally buoyant on the boat.   "Thank you Cambodia! You believed in us when no one would!" tweeted passenger Lydia Miller around 7 pm (1200 GMT). "We promise to spend lots of money in your country."

Fellow cruiser Christina Kerby -- who has been posting light-hearted updates from the Westerdam -- tweeted she was "feeling rebellious tonight so I'm wearing sneakers in the dining room".   But all passengers would have to remain onboard until flights have been arranged, said provincial governor Kuoch Chamroeun.    "The arrangement of the planes to take them from (Sihanoukville) airport to Phnom Penh airport is underway," he said, explaining that three flights were scheduled Friday morning.    Buses were lined up by the pier ready to transfer passengers to Sihanoukville's airport. Holland America has said they would foot the bill to return all guests.

- 'Disease of fear' -
Before the ship docked, doctors conducted health checks for the passengers.    The samples of 20 on board who were sick were sent to the Pasteur Institute in Phnom Penh to test for the virus, said transport minister Sun Chanthol.    Cambodian premier Hun Sen is a staunch Chinese ally and has been vocal in his support of Beijing's handling of the epidemic, even going so far as to visit China last week in a show of solidarity.   "The permission to dock is to stop the disease of fear that is happenin
around the world," he told state-affiliated media website Fresh News on Wednesday.    "We must help them when they asked us for help," he added.   Neighbouring Thailand, which blocked the Westerdam from docking in its eastern seaboard port, on Thursday received two cruise liners in holiday resort town Phuket. 

Both Seabourne Ovation and Quantum of the Seas were allowed to dock, and passengers to alight for roughly 10 hours as part of the scheduled stop.    "They were all checked by their doctors on the ship, and we also examined them when they disembarked," Phuket governor Pakapong Tawipat told AFP.    He added that the passengers and the crew members "were not Chinese", and that Phuket was part of their regular routes, unlike the Westerdam.    Japan's premier Shinzo Abe expressed worries last week over a possible infection on the Westerdam, and said measures will be taken to "reject entries" for foreigners into the country.    Cambodia, which has one confirmed case of the virus, is the recipient of billions of dollars in soft loans, infrastructure, and investment from China.
Date: Thu, 13 Feb 2020 11:14:36 +0100 (MET)

Jakarta, Feb 13, 2020 (AFP) - Indonesia's Mount Merapi, one of the world's most active volcanoes, erupted Thursday as fiery red molten lava streamed down from the crater and it belched clouds of grey ash 2,000 metres (6,500 feet) into the sky.   Authorities did not raise the rumbling volcano's alert status after the early-morning eruption, but they advised commercial planes to take caution in the area.   But any activity at Merapi raises concern and local residents were ordered to stay outside a three-kilometre no-go zone around the rumbling crater near Indonesia's cultural capital Yogyakarta.    Volcanic ash rained down on a 10-square kilometre area, according to the Volcanology and Geological Hazard Mitigation Centre.

Mount Merapi's last major eruption in 2010 killed more than 300 people and forced the evacuation of some 280,000 residents.   It was Merapi's most powerful eruption since 1930, which killed around 1,300 people, while another explosion in 1994 took about 60 lives.   The Southeast Asian archipelago has more than 17,000 islands and islets -- and nearly 130 active volcanoes.   It sits on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.
Date: Thu, 13 Feb 2020 08:13:16 +0100 (MET)

Sydney, Feb 13, 2020 (AFP) - Australia on Thursday announced a ban on travellers from China would extend for at least a week beyond Saturday's planned deadline, as the death toll from the coronavirus soared.    Prime Minister Scott Morrison said the government would maintain "entry restriction on foreign nationals who have recently been in mainland China" for further week "to protect Australians from the risk of coronavirus".   A decision to extend the ban further will be taken week-to-week, he said.   The decision is a blow to Australian tourism operators who have seen business from Chinese visitors dry up, as well as for tens of thousands of Chinese students hoping to return to Australia for the new academic year.

China's official death toll and infection numbers from a new coronavirus spiked dramatically on Thursday after authorities changed their counting methods, fuelling concern the epidemic is far worse than being reported.   The virus has now officially killed more than 1,350 people in China and the World Health Organisation has warned the disease has not yet peaked.   "I just want to assure all Australians, that we are doing everything we can to keep Australians safe at this time, and to ensure that we are mitigating everything that is possible to address any of the threats," Morrison said.
Date: Thu, 13 Feb 2020 06:46:12 +0100 (MET)

Sydney, Feb 13, 2020 (AFP) - Dams near Sydney overflowed Thursday after days of torrential rain, as Australia braced for more storms expected to bring dangerous flash flooding to the country's east.   Recent downpours have brought relief to areas ravaged by bushfires and drought -- as well as chaos and destruction to towns and cities along the eastern seaboard.   On Thursday, Nepean Dam south of Sydney was at full capacity and spilling over, with video footage showing excess water cascading over the dam wall and downstream.   Two other dams in New South Wales, Tallowa and Brogo, were also overflowing and more dams could reach capacity in the coming days, a WaterNSW spokesman told AFP.

Sydney's dams have seen water levels spike dramatically -- the Nepean was just a third full less than a week ago -- though many inland areas are facing severe water shortages missed out on the flows.   A devastating months-long bushfire crisis that killed 33 people has effectively been ended by the downpours, with just one blaze yet to be brought under control in New South Wales.   Hundreds of people have been rescued from floodwaters in recent days.   Police said a man's body was discovered in a flooded river on Queensland's Sunshine Coast on Thursday, though the cause of his death was not immediately clear.

Wild weather is set to ramp up again from Friday, with the Bureau of Meteorology forecasting ex-Tropical Cyclone Uesi would bring "damaging to destructive winds" and heavy rainfall to remote tourist destination Lord Howe Island.   Senior meteorologist Grace Legge said storms were also expected for Queensland and New South Wales -- with areas still recovering from bushfires likely to be hit again.   "Any showers and thunderstorms that do develop are falling on already saturated catchments, so there is a risk with severe thunderstorms of flash flooding," she said.   Emergency services have warned residents in affected areas to be cautious in the dangerous conditions.
Date: Thu, 13 Feb 2020 06:24:23 +0100 (MET)

Vinh Phuc, Vietnam, Feb 13, 2020 (AFP) - Vietnam announced Thursday that a commune of 10,000 people will be placed under quarantine due to fears over the spread of the new coronavirus.    "As of February 13, 2020, we will urgently implement the task of isolation and quarantine of the epidemic area in Son Loi commune," said a health ministry statement.    "The timeline... is for 20 days".    There are 15 confirmed cases of the COVID-19 virus in Vietnam, five of them in Son Loi commune.
Date: Wed, 12 Feb 2020 21:09:17 +0100 (MET)

Geneva, Feb 12, 2020 (AFP) - The UN health agency on Wednesday said it was extending its global emergency designation for the Ebola outbreak in the Democratic Republic of Congo but said the sharp decline in cases was "extremely positive".   The recent outbreak was first identified in August 2018 and has since killed more than 2,300 people in eastern DR Congo -- an area where several militia groups are operating.   "As long as there is a single case of Ebola in an area as insecure and unstable as eastern DRC, the potential remains for a much larger epidemic," WHO chief Tedros Adhanom Ghebreyesus told reporters in Geneva.

The WHO, however, said it was downgrading the national and regional risk of the disease from very high to high, while it kept the global risk at low.    Tedros also voiced hope that the emergency could be lifted within the next three months on the advice of the WHO's Emergency Committee of international experts.   The World Health Organization last July declared it a "public health emergency of international concern" -- a designation that gives the WHO greater powers to restrict travel and boost funding.   Tedros, who will be travelling to DRC on Thursday to meet President Felix Tshisekedi, on Tuesday said only three cases had been reported in the past week.

But for the epidemic to be declared over, there have to be no new cases reported for 42 days -- double the incubation period.   The health emergency designation last year came a few days after a patient was diagnosed with the virus in the provincial capital Goma -- the first case in a major urban hub.   More than a month before that, the WHO reported that the virus had spread to Uganda for the first time.   The Ebola virus is passed on by contact with the blood, body fluids, secretions or organs of an infected or recently deceased person.   The death rate is typically high, ranging up to 90 percent in some outbreaks, according to the WHO.

This is the second worst outbreak of the disease since 2014 when it killed about 11,000 people -- mostly in Guinea, Liberia and Sierra Leone.   Efforts to contain the current outbreak have been hindered by attacks on health workers and conflicts in the east.   The WHO said in November it had moved 49 staff out of the Beni region in eastern DRC because of the insecurity.   The Beni region, straddling the North Kivu and Ituri provinces, has been repeatedly attacked by the Allied Democratic Forces (ADF) rebel group, which activists say has massacred more than 300 people since October.
Date: Wed, 12 Feb 2020 11:48:53 +0100 (MET)

Tomohon, Indonesia, Feb 12, 2020 (AFP) - Bats, rats and snakes are still being sold at an Indonesian market known for its wildlife offerings, despite a government request to take them off the menu over fears of a link to the deadly coronavirus.   Vendors at the Tomohon Extreme Meat market on Sulawesi island say business is booming and curious tourists keep arriving to check out exotic fare that enrages animal rights activists.   But scientists are debating how the new virus, which has killed more than 1,100 people in China and spread to dozens of countries around the world, was transmitted to humans.

A wildlife market in Wuhan, the epicentre of the virus, is thought to be ground zero and there is suspicion it could have originated in bats.    The possible link wasn't on many radar screens at the Indonesian market, however.   Its grubby stalls feature a dizzying array of animals including giant snakes, rats impaled on sticks and charred dogs with their hair seared off by blowtorches -- a gory scene described by some critics as "like walking through hell".

Bat seller Stenly Timbuleng says he's still moving his fare for as much as 60,000 rupiah ($4.40) a kilogram to buyers in the area, where bats are a speciality in local cuisine.   "I'm selling between 40 and 60 kilograms every day," the 45-year-old told AFP.   "The virus hasn't affected sales. My customers still keep coming."   Restaurateur Lince Rengkuan -- who serves bats including their heads and wings stewed in coconut milk and spices -- says the secret is preparation.   "If you don't cook the bat well then of course it can be dangerous," she said.   "We cook it thoroughly and so far the number of customers hasn't gone down at all."

This despite a request from the local government and the health agency to take bats and other wildlife out of circulation -- a call that has been all but ignored.   "We're also urging people not to consume meat from animals suspected to be carriers of a fatal disease," said Ruddy Lengkong, head of the area's government trade and industry agency.   Indonesia has not yet reported a confirmed case of the virus.   In the capital Jakarta, vendors selling skinned snakes and cobra blood on a recent Saturday night didn't have any trouble finding takers.   "It's good for you, sir," said one vendor of his slithering fare.   "Cures and prevents all diseases."
Date: Mon, 10 Feb 2020 17:59:57 +0100 (MET)

Malé, Maldives, Feb 10, 2020 (AFP) - The Maldives' speaker of parliament on Monday apologised to a British tourist after footage of her arrest by several policemen triggered a social media storm.   Tourism is a major earner for the Maldives, a tropical island paradise in the Indian Ocean popular with honeymooners and celebrities.   Police said the bikini-clad woman, who was walking on a main road, was "inappropriately" dressed and allegedly unruly and drunk when she was detained after refusing to comply with requests to cover up on Thursday.   The Maldives previously confined tourists to resort islets separate from the local Muslim population, but in recent years has allowed foreigners to stay on inhabited islands.

Tourists can wear swimwear such as bikinis in the resorts but are subject to local dress codes elsewhere.   Videos shared on social media showed three men trying to detain the traveller, while a fourth person tried to cover her with a towel.   The woman was heard shouting "you're sexually assaulting me" during the incident.   The speaker, Mohamed Nasheed, told parliament he was extending an apology to the woman over the incident, which saw her detained by police for two hours before they released her.

The tourist has since left the nation of 340,000 Sunni Muslims, but Nasheed said he hoped tourism authorities would invite her to return to the luxury vacation spot.   Maldives Police Service Commissioner Mohamed Hameed said on Twitter after the footage was shared online that the incident "seems to be badly handled".   "I apologise to the tourist & the public for this. The challenge I have taken up is to professionalise the police service & we are working on that. This matter is being investigated."   A police statement on Friday called on tourists to respect "cultural sensitivities and local regulations".

The video of the incident also sparked anger among Maldivians. Some took to social media to criticise the tourist's behaviour after other videos showed her grabbing the sunglasses of a police officer.   Former foreign minister Dunya Maumoon criticised both the tourist and the police.   "She should have respected the religious and cultural norms of the country in terms of modest attire in a residential area," Maumoon said on Twitter.   "Condemn the man-handling by the Maldivian police. It could have been handled better and more professionally."
Date: Fri 7 Feb 2020
Source: Food Safety News [edited]

Almost 250 new infections have been recorded in a multi-country outbreak of salmonellosis linked to eggs from Poland. The European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) reported that as of January 2020, 18 countries have reported 656 confirmed and 202 probable cases since February 2017. There are 385 historically confirmed and 413 historical probable cases going as far back as 2012, making it the largest European _Salmonella_ Enteritidis outbreak ever recorded. However, ECDC officials said the true extent of the outbreak was likely underestimated. Since the last update in November 2018, 248 new cases have been reported, of which 124 were confirmed, 36 probable, 42 historical-confirmed and 46 historical-probable infections.

Belgium, Croatia, Czech Republic, Denmark, Finland, France, Greece, Hungary, Ireland, Italy, Luxembourg, Netherlands, Norway, Poland, Romania, Slovenia, Sweden and the UK have recorded 1656 infections since 2012. The UK has the most with 688 confirmed and probable cases, Netherlands has 280, Belgium has 202 and Czech Republic has 111. Information on hospitalization is available for 427 patients in 12 countries, and 136 needed hospital treatment among the confirmed and historical-confirmed cases. Two historical-confirmed deaths, a child and an elderly patient, were also reported.

In each year from 2016 to 2018, outbreak cases peaked in September, with large waves reported between late spring and early autumn. Such a large seasonal increase was not seen in 2019. Epidemiological, microbiological and food tracing investigations have linked cases before 2018 to eggs from laying hen farms of a Polish consortium. Despite control measures in 2016 and 2017, farms of the Polish consortium were positive in 2018 and 2019 with outbreak strains, suggesting persistent contamination, according to officials. Investigations on the laying hen production and feed supply chains did not find the possible origin of contamination.

One of the outbreak strains was found from 2017 to 2019 in primary production in Germany. This outbreak strain represents two-thirds of confirmed cases.

In September 2018, a cluster of 9 confirmed cases was associated with the consumption of an RTE raw liquid egg-white drink distributed by Dr. Zak's. _Salmonella_-positive samples of RTE liquid egg whites from 2 batches matched those from this outbreak cluster. Both batches were produced by a French company. One was produced with raw materials such as pasteurized white egg from a Spanish company. The other used raw materials from 13 German laying hen farms and 11 Dutch laying hen farms. An investigation of this outbreak showed positive batches were produced with eggs from Spain, the Netherlands and Germany, who all supplied _Salmonella_-free eggs to the French company.

On the same day as production of one of the contaminated batches, a different batch of liquid eggs was produced at the French company with eggs supplied by a Polish packing center from a Polish laying farm belonging to the Polish consortium. However, the possibility of cross-contamination was ruled out due to the different production line used with different equipment (tanks, filling machine) and because of heat treatment on packaged products.

Investigations in the UK identified 14 cases potentially part of the outbreak travelling to Cyprus and staying in the same place between end of May and end of June 2018. This site received eggs from a Polish laying farm through the Polish packing center and a Dutch wholesaler.

Measures taken in 2016 and 2017, including depopulation of positive flocks, were not enough to eliminate contamination in the Polish consortium. So, the laying hen farms of this group were still positive for outbreak strains in 2018 and 2019. Between August 2018 and December 2019, 7 of 13 sampled Polish laying hen farms belonging to the Polish consortium tested positive for _Salmonella_ Enteritidis. >From November 2019 to January 2020, all flocks belonging to the Polish group were tested in accordance with Regulation 2160/2003, but _Salmonella_ was not detected.

Polish authorities reported that all _Salmonella_ Enteritidis positive flocks belonging to the Polish consortium were depopulated, including flocks found positive in May 2019. From 2015 to 2019, 16 laying hen farms, 13 of which belonged to the Polish consortium, were positive for at least one of the 4 SNP addresses causing human infections. Four rearing farms belonging to the Polish company were positive for _Salmonella_ Enteritidis between January 2017 and July 2019.

ECDC officials said the outbreak was still ongoing, and more infections were expected. "Since no evidence has been provided that the source of contamination has been eliminated, it is expected that further infections will occur and that new cases will be reported in the coming months. Additional investigations are necessary to identify the source of contamination."  [Byline: Joe Whitworth]
==================
[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with fecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation and thus were contaminated with the bacteria before the egg shell was formed. To avoid this, uncooked eggs should be used only as an ingredient, if pasteurized.

The continuing outbreak was summarized in this 2019 report: Pijnacker R, Dallman TJ, Tijsma ASL, et al. An international outbreak of _Salmonella enterica_ serotype Enteritidis linked to eggs from Poland: a microbiological and epidemiological study. Lancet Infect Dis. 2019;19(7):778-786.

Abstract
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Background: _Salmonella_ spp. are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak of _Salmonella enterica_ serotype Enteritidis in the EU and European Economic Area (EEA).

Methods: A confirmed case was defined as a laboratory-confirmed infection with the outbreak strains of _S._ Enteritidis based on whole-genome sequencing (WGS), occurring between 1 May 2015 and 31 Oct 2018. A probable case was defined as laboratory-confirmed infection with _S._ Enteritidis with the multiple-locus variable-number tandem repeat analysis outbreak profile. Multi-country epidemiological, trace-back, trace-forward, and environmental investigations were done. We did a case-control study including confirmed and probable cases and controls randomly sampled from the population registry (frequency matched by age, sex, and postal code). Odds ratios (ORs) for exposure rates between cases and controls were calculated with unmatched univariable and multivariable logistic regression.

Findings: A total of 18 EU and EEA countries reported 838 confirmed and 371 probable cases; 509 (42%) cases were reported in 2016, after which the number of cases steadily increased. The case-control study results showed that cases more often ate in food establishments than did controls (OR, 3.4 [95% CI, 1.6-7.3]), but no specific food item was identified. Recipe-based food trace-back investigations among cases who ate in food establishments identified eggs from Poland as the vehicle of infection in October 2016. Phylogenetic analysis identified 2 strains of _S._ Enteritidis in human cases that were subsequently identified in _Salmonella_-positive eggs and primary production premises in Poland, confirming the source of the outbreak. After control measures were implemented, the number of cases decreased but increased again in March 2017, and the increase continued into 2018.

Interpretation: This outbreak highlights the public health value of multi-country sharing of epidemiological, trace-back, and microbiological data. The re-emergence of cases suggests that outbreak strains have continued to enter the food chain, although changes in strain population dynamics and fewer cases indicate that control measures had some effect. Routine use of WGS in _Salmonella_ surveillance and outbreak response promises to identify and stop outbreaks in the future. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Sun 9 Feb 2020
Source: San Francisco (CA) Chronicle [subscription required, edited]

Several cases of hepatitis A were confirmed in customers who ate in the same California restaurant, health officials said. The Long Beach Department of Health and Human Services announced [Fri 31 Jan 2020], that the patients ate at 555 East American Steakhouse on or around [24 Dec 2019], KABC-TV reports.

The department did not disclose how many cases were diagnosed. The source of the illness is still under investigation, officials said.

Hepatitis A can be transmitted through consumption of contaminated food or water. Symptoms can include fatigue, low appetite, stomach pain, dark urine, nausea, and jaundice. Most patients eventually recover completely, but some may require hospitalization or develop severe illness, health officials said.

The restaurant's management and staff are cooperating with health officials and there is no continuing risk to the public, officials said.

"We are notifying the public of the exposure so that people can immediately seek medical care if they begin to develop symptoms," Long Beach health officer Dr. Anissa Davis said in a statement. "Individuals who have been vaccinated for hepatitis A or have had the disease are protected," Davis said. "Those who are not immune to hepatitis A should consult their medical provider if they develop symptoms, and let their provider know they may have been exposed to hepatitis A."
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[This cluster (the number of cases is not stated) may be related to an HAV-contaminated food (such as shellfish) or an infected food service worker. If the former were the case, one might expect to see cases related to other restaurants. It would be interesting to know if the HAV strain is that from the still on-going multistate outbreak. This outbreak has been controlled in California and involved primarily homeless and substance abusing individuals and is related to poor sanitation rather than food/water vehicles. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
California, United States: <http://healthmap.org/promed/p/204>]