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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Please see our information on medical insurance overseas.

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

Jamaica

******
Healthy Travelling In Jamaica
*******
General Information;
Jamaica is the 3rd largest of the Caribbean islands and is situated about 600 miles south of Miami, Florida. The climate in Jamaica remains fairly steady throughout the
year with temperatures averaging 27 - 35 C during the summer months (May to September) and 21 - 27 C during their winter! The ambient temperature and rainfall are both affected markedly by the changes in elevation and geography throughout the island. Rainfall varies from an annual average of 25" in the capital, Kingston, to an average of 250" at Blue Mountain Peak. Most of the rain tends to fall between April/May or October/November. The relative humidity in Kingston ranges from an average low of 63% in February to 86% in October.
Health Care Facilities;
The US Department of State’s consular information sheet states that medical care may be limited. Doctors and hospitals often expect immediate cash payment for health services. A list of some of the IAMAT doctors in Jamaica follows;
- Dr. Luois S. Grant - Kingston - tel 927 1106
- Dr. B.A. Morgan - May Pen - tel 986 2370
- Dr. Noel Black - Ochos Rios - tel 972 2296
Sun Exposure;
Frequently travellers from Ireland to Jamaica will want to soak up the sunshine before returning to our rather less exposed shores. Some will tan easily but even they need to take care with the extent of their sun exposure. Many fair skinned Irish travellers will burn easily and so remember to limit your exposure especially during the first week. Use high sun blocking lotions (15+) while you acliamatise and then only drop down the protective factor (10+) if you are sure you will not burn. Watch out especially for the back of your neck, the front of your ankles and the top of your legs. Many of these areas will be unused to such exposure! Also remember if you are travelling in a car or coach watch out that you cover your exposed elbow which may be cooled by the passing breeze.
Sun Stroke / Dehydration;
In such a warm climate you can become quite significantly dehydrated without realising it. Make sure you drink plenty of fluids and, if you have no blood pressure problems or heart difficulties, then increase the amount of salt you put on your normal meals. This will help to maintain your energy levels.
Mosquito Borne Disease;
Malaria transmission does not normally occur in Jamaica so taking prophylactic tablets is not necessary. Nevertheless mosquitoes abound and so remember to use insect repellants, especially when there are mosquitoes about, day or night.
Animals;
Unfortunately Jamaica is not free of rabies and transmission is reported in some areas. The main animal appears to be the mongoose but obviously try and make sure that you have no exposure to any warm blooded animals. If by any chance you are bitten immediatly wash out the wound, apply an antiseptic and seek medical attention.
Asthmatics;
Because of the dense foliage and high pollen levels the climate may adversly affect some asthma sufferers.
Food & Water Borne Disease;
By comparison to many of the hotter areas throughout the world Jamaica has high health standards. Despite this it would be unwise to take risks so follow simple common- sense rules
* Drink only bottled water (and use it for brushing your teeth)
* Don’t use ice cubes in your drinks
* Eat only food served hot and avoid all shell fish
* Only pasturised dairy products should be consumed
* Don’t eat food from street vendors
Blood Borne Disease
Unfortunately, as in most other countries, AIDs does occur and the blood supply may not be adequately screened.
Swimming in Jamaica;
Beautiful beaches make swimming a must for your holiday but be careful of the coral and also jellyfish. The hot sand may burn your feet so always use flip flops when walking on the beach.
Vaccinations;
None are essential for entry/exit purposes but it is wise to at least protect yourself against * Polio
* Typhoid
* Tetanus
* Hepatitis A
Other vaccines may be required for travellers intending to trek through Jamaica or those who will be undertaking extensive adventure sports. Also remember that if you initially visit a Central or South American country before Jamaica then Yellow Fever vaccine may be required.
General Comments;
Some of the items above may seem too serious to consider a holiday in Jamaica. Nevertheless the vast majority of travellers have a marvellous holiday and develop no sickness following their visit. Some simple commonsense is mainly all that is required. For further information please contact the Tropical Medical Bureau - Dublin.

Travel News Headlines WORLD NEWS

21 Feb 2019

https://travelhealthpro.org.uk/news/390/dengue-outbreak-in-the-caribbean
Dengue outbreak in the Caribbean

Dengue outbreak in the Caribbean

Reported via Travel Health Pro:  As of 17 January 2019 and following a recent report of increased cases of dengue in Jamaica in January 2019 [1], the Caribbean Public Health Agency (CARPHA) has advised that there is a possibility of an outbreak of dengue in the Caribbean region [2]. The last major regional outbreak occurred in 2009 [1]. Countries in the region have been advised to increase their disease surveillance measures. Residents and travellers are advised to take measures to reduce mosquito breeding sites and follow mosquito bite prevention advice.

Dengue is a viral infection transmitted through the bite of an infected Aedes mosquito. Although most patients with dengue will recover spontaneously, a small number will develop more severe life-threatening forms of the disease. Dengue is common in the tropics including the Caribbean, South and Central America, Africa, SE Asia, the Indian sub-continent and the Pacific Islands.

Check our Country Information pages for individual country recommendations.

Date: Mon 14 ay 2918
Source: Loop [edited]

A new species of mosquito has been discovered in Jamaica. It is the Asian tiger mosquito or _Aedes albopictus_, which is similar to the _A. aegypti_ mosquito, which is endemic to Jamaica and which transmits the dengue, chikungunya, Zika, and other viruses.

Acting Chief Public Health Inspector for St Catherine, Grayston Hutchinson told last Thursday's [10 May 2018] monthly meeting of the St Catherine Municipal Corporation that the Asia tiger mosquito was discovered following surveillance throughout the island.

He was responding to questions from councillors attending the monthly meeting.

The tiger mosquito is so named because of its striped appearance, which resembles that of the tiger.

Similar to the _Aedes aegypti_ mosquito, the female is the carrier of several viruses, including yellow fever, dengue, chikungunya, and Zika.
===================
[_Aedes albopictus_ has been expanding throughout the world including in North, Central America, and Caribbean: Barbados (not established), Belize, Cayman Islands, Costa Rica, Cuba, Dominican Republic, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Trinidad (not established), and USA (<https://ecdc.europa.eu/en/disease-vectors/facts/mosquito-factsheets/aedes-albopictus>). It is not surprising that it has been found in Jamaica. It was found last year (2017) in several locations in southern California and is distributed across the southern USA and more recently in the northern states.

Reference
---------
Bonizzoni M, Gasperi G, Chen X, James AA. The invasive mosquito species _Aedes albopictus_: current knowledge and future perspectives. Trends Parasitol. 2013; 29(9): 460-8. doi: 10.1016/j.pt.2013.07.003; <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777778/> - ProMED Mod.TY]

[HealthMap/ProMED-mail map
Date: Fri 23 Oct 2015
Source: Jamaica Observer [edited]

Consultant congenital cardiologist Dr Sandra Williams-Phillips says she has treated at least 12 cases of the feared mosquito-borne Zika virus (ZIK-V) [infection] and that she has written to Health Minister Dr Fenton Ferguson on the matter.

Speaking on a daytime radio programme yesterday [22 Oct 2015], Dr Williams-Phillips said she had received no response to her e-mail to Dr Ferguson, although she could not confirm that the minister had received her correspondence.

The medical doctor of 34 years said she was among the 1st local doctors to identify the presence of the chikungunya virus, which wreaked havoc on the country last year [2014], but that her diagnoses had not been taken seriously.

Dr Williams-Phillips, who treats paediatric as well as adult cases of congenital heart disease, said some of her patients who presented symptoms of the Zika virus [infection] were children. She argued strongly that the symptoms she had seen were convincing enough to diagnose the virus even in the absence of lab tests.

Late yesterday afternoon [22 Oct 2015], on another radio programme, chief medical officer (CMO) in the health ministry, Dr Marion Bullock Ducasse, said the ministry would be launching an investigation into the matter. She said that, even if the patients had recovered, tests could still prove whether they had in fact been infected with the virus.

The CMO said she could not speak on whether Dr Ferguson was in receipt of a report about the cases, but that no official report had come to the ministry from St Catherine [parish], where Dr Williams-Phillips said she treated patients, via the standard reporting system for these types of events.

The CMO has maintained over the past several months, that there are no confirmed cases of the Zika virus in Jamaica. Earlier this month [October 2015], the ministry said a sample which it had sent to the Caribbean Public Health Agency (CARPHA) in September [2015] tested negative for chikungunya, dengue and Zika viruses. "Outside of Brazil [and more recently, Colombia], there have been no cases confirmed in any country in the Latin American and Caribbean region, including Jamaica," Dr Ferguson said at a hand, foot and mouth disease press conference on 2 Oct [2015].

The ministry has also refuted claims by Opposition spokesperson on health, Senator Marlene Malahoo-Forte, that she had been reliably informed about 3 confirmed cases of Zika virus. "I have heard that there are confirmed cases of the Zika virus here.... I got a call from someone whose employee was tested, and I'm reliably advised that it is a confirmed case," Malahoo-Forte stated at a press conference a few weeks ago.

The Pan American Health Organisation (PAHO) in May [2015] issued a warning about an outbreak of Zika in Brazil and said there was potential for it to spread to other countries.

The virus causes symptoms which are similar to CHIKV [chikungunya virus] and is transmitted by the same vector -- the _Aedes aegypti_ mosquito.

Communities have been plagued by mosquitoes over the past few weeks, with residents in Portmore [Saint Catherine parish] in particular complaining bitterly about the insects, which they say have descended on their homes in droves. The nuisance is also evident in the Corporate Area [Kingston area], and has citizens concerned about whether the country could soon find itself in the throes of yet another mosquito-borne disease.  [Byline: Alphea Saunders]
====================
[The situation in Jamaica is not clear at the moment. Because infections with Zika, dengue and chikungunya viruses are difficult to distinguish from each other clinically, laboratory confirmation is essential. One hopes that laboratory tests will be carried out to confirm or rule out Zika virus infections in these cases. It would be of interest to know where the confirmed cases reported by the Opposition Senator were tested, if they were tested at all. ProMED awaits further news from Jamaica with interest.

A HealthMap/ProMED-mail map of Jamaica can be accessed at
Date: Fri 11 Jan 2013
Source: Jamaica Gleaner [edited]

The health sector is in a frenzy after the revelation that a Jamaican was on the weekend diagnosed with the highly contagious disease malaria after a recent visit to a country on the African continent.

The infected man was hospitalised and isolated in order to be treated for the illness. "He has responded to treatment, and the region has contacted persons with whom he had close contact and advised those persons as well as the medical facilities in the areas (where) those persons are so that they can take the necessary precautions," he said.  [Byline: Nadisha Hunter]
*****************************
Date: 12 Jan 2013
Source: Caribbean 360 [edited]

The Jamaican government on Friday [11 Jan 2013] dismissed media reports that the island is on alert following an outbreak of malaria fever.

Chief Medical Officer Dr. Michael Coombs in a statement said that the island has had no locally transmitted cases of malaria since 2009.

Last year [2012], there were 5 imported cases of malaria and one confirmed case so far this year [2013].

Dr. Coombs said, regarding the media reports of the imported case, that so far this year [2013], the Ministry of Health has been managing the patient according to World Health Organization guidelines.

"Our public health team has visited the community to check persons with whom the patient had contact. The ministry is also continuing its routine surveillance, which will allow us to be in a position to quickly identify and treat persons if the need arises," Dr. Coombs said.

Malaria, caused by the malaria parasite, is spread when the _Anopheles_ mosquito bites an infected person and then bites others. There is no direct person-to-person transmission. Symptoms include fever, chills, headache, muscle aches, and fatigue. Nausea, vomiting, and diarrhoea are also possible.

Health authorities Friday [11 Jan 2013] urged residents to continue efforts to destroy mosquito breeding sites and protect themselves from mosquito bites.

Dr. Coombs is also advising people to check with the Ministry of Health or their Parish Health Department before they travel to ensure that they take the necessary health related precautionary measures.

There are some countries for which persons need certain vaccines or prophylaxis before they travel.

"We are urging persons to check with us if they are not sure about the requirements for a particular country. This is important to prevent illness and the spread of certain diseases among our population," Dr. Coombs said.
=========================
[The last case of autochthonous malaria in Jamaica was reported in ProMED in 2010. The outbreak started in 2006, and the peak was in 2007 (see reports below). Cases imported from highly endemic areas, such as tropical Africa, are recurrent events, and the last reported case from Jamaica was a patient infected in Haiti.

The outbreaks from 2006-2010 illustrate that transmission potential exists in Jamaica for the reintroduction of autochthonous malaria. Jamaica was declared malaria free in 1972. - ProMed Mod.EP]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/r/1_g4>.]
Sunday 17th June 2012
A ProMED-mail post
<http://www.promedmail.org>

- Jamaica. 13 Jun 2012. Jamaican health officials have warned that there has been a spike in dengue fever cases, but says it is not at the level of an outbreak. Director of Emergency Services in the Ministry of Health, Dr. Marion Bullock-Duccase, said several cases have been reported in Kingston and St. Andrew and 2 other parishes, but adds this is not unusual at this time of the year.
===================
[A HealthMap/ProMED-mail interactive map showing the location of Jamaica can be accessed at <http://healthmap.org/r/00Vh>. - ProMed Mod.TY]
More ...

Laos

Laos - US Consular Information Sheet
March 27, 2008
COUNTRY DESCRIPTION: The Lao People's Democratic Republic (Laos) is a poor, developing country ruled by an authoritarian, Communist, one-party government. Political power is centralized in the
Lao People's Revolutionary Party. Services and facilities for tourists are adequate in the capital, Vientiane, and the UNESCO World Heritage town of Luang Prabang, but are extremely limited in other parts of the country. Read the Department of State Background Notes on Laos for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and visa are required. The Lao Ministry of Foreign Affairs states that visas can be issued upon arrival in Laos to U.S. citizen tourists with two passport-size photographs and $35 at the following ports of entry: Wattay Airport, Vientiane; Friendship Bridge, Vientiane, Pakse and Luang Prabang Airports; Boten-Bohan and Vangtao-Chong Mek. Persons who obtain entry visas prior to their arrival in Laos may also enter at the following international entry points: Huaixay, Khammouane-Nakhonphanom, Savannakhet-Mukdahan, Daensayanh-Laobao, Namphao-Kaopae, and Namkan. Foreign tourists are generally admitted to Laos for 30 days. The Department of Immigration in Vientiane will extend 30-day tourist visas up to an additional 60 days for a fee of $2 per day. Foreigners who overstay their visas in Laos risk arrest and upon departure will be fined $10 for each day of overstay.
The Lao government requires payment of visa fees and fines in U.S. dollars. Thai baht and Lao kip may sometimes be accepted for the fees, but at unfavorable exchange rates.

Foreign tourists who wish to obtain a visa in advance may contact a Lao embassy or consulate. In the United States, visas and further information about Lao entry requirements can be obtained directly from the Embassy of the Lao People's Democratic Republic, 2222 S St. NW, Washington DC 20008, tel: 202-332-6416, fax: 202-332-4923.

Business visas can only be arranged in advance; a company or individual “sponsor” must contact the Lao Ministry of Foreign Affairs (MFA) in Vientiane and request a visa for the traveler by offering a “guarantee.” Once this request is approved by the MFA, the approval will be communicated to the Lao Embassy in Washington, DC and the U.S. traveler may then apply for the business visa. This process normally takes 1-3 months. After the traveler’s arrival, these visas can usually be extended for one month.

U.S. citizens should not attempt to enter Laos without valid travel documents or outside of official ports of entry. Travelers should not cross the border between Laos and Thailand along the Mekong River except at official immigration check crossings. Unscrupulous travel agents have sold U.S.-citizen travelers false Lao visas, which have resulted in those travelers being denied entry into Laos. Persons attempting to enter Laos outside of official ports of entry risk arrest or other serious consequences.
Immigration offices at some of the less-used land border crossing points are not well marked. Travelers should make sure that they complete immigration and customs formalities when they enter Laos. Travelers who enter Laos without completing these formalities may be subject to fine, detention, imprisonment, and/or deportation.

In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points. These often include requiring documentary evidence of relationship, such as the child’s birth certificate, and permission for the child's travel from the parent(s) or legal guardian not present. Having such documentation on hand, even if not required, may facilitate entry/departure.

At Wattay Airport (Vientiane), Pakse Airport and the Luang Prabang Airport, there is an international airport departure tax of US$10. This tax may be included in the price of the airline ticket, depending on the carrier.
At the Friendship Bridge (Vientiane, Laos - Nong Khai, Thailand border crossing) there is an overtime fee after 4:00 pm weekdays and during weekends. Visit the web site of the Embassy of Laos in the Untied States at: http://www.laoembassy.com for the more visa information.

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

SAFETY AND SECURITY:
In recent years (2003-2005), there were periodic incidents of attacks on buses and other vehicles that killed 22 people; small bombings in public places; and other incidents of violence by anti-government forces. In 2007, the Embassy received reports from multiple sources of sporadic fighting between Lao Government forces and unidentified opponents in the area of Vang Vieng in northern Vientiane Province and in Bokeo Province. The Department of State recommends that U.S. citizens traveling or residing in Laos exercise caution in public places and be alert to their surroundings, since the locations of future violent incidents are unpredictable.
Travelers are advised to be cautious when traveling the roads of Laos and to check with local authorities, transport companies, other travelers, and/or the Embassy regarding any recent developments prior to travel. Road obstacles such as changes in surface conditions due to the weather occur frequently.

The Lao Government security forces often stop and check all transport on main roads. Travelers should comply with requests to stop at checkpoints and roadblocks.
U.S. citizens, especially those considering travel outside urban centers, are advised to contact relevant Lao government offices, such as Lao Immigration Police Headquarters in Vientiane, the Lao Tourist Police, local police and customs offices, or contact the U.S. Embassy for the most current security information. To avoid trouble with the authorities, U.S. citizens traveling outside of normal tourist areas or contemplating any unusual activity (including, but not limited to, engaging in business, extensive photography, or scientific research of any kind) should consider seeking advance permission from the Village Chief, District Head, Provincial Governor, or National Tourism Authority, as appropriate.

More than 100 casualties per year are caused by the large amount of unexploded ordnance (UXO) in Laos left over from the Indochina War. Savannakhet, Xieng Khouang, Saravane, Khammouane, Sekong, Champassak, Houaphan, Attapeu, and Luang Prabang Provinces and parts of Vientiane Province are severely contaminated by UXO. In addition, numerous mine fields are left over from the war, including mine fields along Route 7 (from Route 13 to the Vietnam border), Route 9 (Savannakhet to the Vietnam border), and Route 20 (Pakse to Saravane). While traveling in Laos, U.S. citizens should never pick up unknown metal objects and should avoid traveling off of well-used roads, tracks and paths.

U.S. citizens considering travel by air, road or river within Laos are advised to carefully evaluate the relative risks of the three modes of transport (see sections on Aviation Safety Oversight, Traffic Safety, and River Travel below). Travelers should also exercise caution if contemplating swimming in rivers in Laos. Currents can be deceptive and strong.

The whereabouts of three Hmong-American men who went missing in August 2007 after reportedly going on a business trip to Xieng Khouang Province remains unknown. The Government of Laos stated that the three departed Laos, but none of the three has contacted family members in the U.S. since they were last seen in 2007.

U.S. citizens are also advised to exercise caution in remote areas along the Lao border with Burma. Bandits, drug traffickers, and other people pursuing illegal activities operate in these border areas, as do armed insurgent groups opposed to the government of Burma.
Travelers should be aware that from 2004 to 2006, seven Lao- and Hmong-American citizens have been murdered in northern and northeastern Thailand near the border with Laos.
During the same period, a number of non-Americans with ties to Laos have also been murdered in this region of Thailand. In addition, in March 2006 a Hmong-American disappeared from his residence in Chiang Mai along with seven other individuals. In most of these cases, no arrests have been made.
If U.S. citizens, particularly Lao-Americans or Hmong-Americans, must travel to these areas, they should exercise caution and remain vigilant with regard to their personal security. It is also recommended that persons wishing to travel to border areas check first with the Thai Police and the U.S. Consulate General in Chiang Mai or the U.S. Embassy in Bangkok or the U.S. Embassy in Vientiane.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
While Laos generally has a low rate of violent crime, it is not immune from crime. While in Laos, Americans should remain aware of their surroundings and exercise appropriate security precautions. With the introduction of methamphetamines and other illicit drugs, thefts and assaults in Vientiane have increased and some have turned violent.
Bag-snatching is increasingly frequent and sexual assaults have also occurred. Residential burglary is commonplace. Expatriates attempting to report burglaries in progress to the police often find that police telephones are not answered or they are informed that the police are not authorized to respond to criminal activity at night or that they have no transportation. U.S. citizens who move to Vientiane are encouraged to contact the U.S. Embassy for security advice.

Travelers in Vientiane should exercise caution, particularly after dark, at roadside restaurants and stalls near the banks of the Mekong River. Foreigners are often the victims of purse snatchings while sitting down to eat or while riding bicycles or motorcycles in this area. To help ensure the security of valuables and documents carried on their person, travelers may wish to carry them in bags that cannot be easily stolen. U.S. citizens traveling to Vang Vieng should be aware that some tourists have been robbed and assaulted while walking alone to the caves on the far side of the Nam Song River.
Camping at night anywhere except in authorized campgrounds in national parks is dangerous.
Many restaurants in popular tourist locations in the Vang Vieng area offer menu items, particularly “pizzas,” “shakes” or “teas” which may contain unknown substances or opiates. These products are often advertised as “happy” or “special” items. These unknown foods and drinks can be dangerous, causing illness and death.

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:
Medical facilities and services in Laos are limited and do not meet Western standards. In Vientiane, U.S. citizens may wish to contact the Primary Care Center also known as the Centre medical de L’Ambassade de France (CMAF), which is supported by the French Embassy.
The CMAF is located on Khou Vieng Road across the street from the Green Park Hotel, Tel. +856-21-214-150, or +856-20-558-4617, email: cmafloa@gmail.com.
U.S. citizens in Laos often seek medical care in Thailand. The Friendship Bridge linking Vientiane, Laos, to Nong Khai, Thailand, is open daily 6:00 a.m. to 10:00 p.m. Officials generally will allow travelers to cross after hours in cases of medical emergency. AEK International Hospital (tel: 66-42-342-555) and North Eastern Wattana General Hospital, both in Udorn, Thailand (tel: 66-1-833-4262) have English-speaking staff accustomed to dealing with foreign patients. Nong Khai Wattana Hospital in Nong Khai, Thailand (tel: 66-1-833-4262) can handle most simple medical procedures. Ambulances for both AEK International Hospital and Nong Khai Wattana Hospital have permission to cross the Friendship Bridge to collect patients from Vientiane. In Vientiane, the Setthatirat Hospital ambulance (tel: 021-413-720) can take patients to Thailand. The Department of State assumes no responsibility for the professional ability or reputation of these hospitals.

Avian Influenza:
The Centers for Disease Control (CDC), the World Health Organization (WHO), and Lao authorities have confirmed the presence in Laos of the H5N1 strain of avian influenza, commonly known as “bird flu.” In 2007, two Lao nationals died after contracting the H4N1 virus. Travelers to Laos and other countries affected by the virus are cautioned to avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals. In addition, the CDC and WHO recommend eating only fully cooked poultry and eggs. The Lao government’s avian influenza hotline may be reached by calling 166 from anywhere in Laos.
This hotline may be used to report suspected cases of avian influenza in animals or humans, or to obtain information on areas in Laos where avian influenza may have been recently detected.
Operators speak Lao and English.
For the most current information and links on avian influenza in Laos, see the State Department’s Avian Influenza Fact Sheet or visit the website of the U.S. Embassy in Laos.

There is a problem with counterfeit pharmaceuticals throughout Southeast Asia. American citizens should be aware of this problem and purchase pharmaceuticals only through the most reputable pharmacies with a physician’s prescription.

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

The number of road accidents and fatalities in Laos has risen sharply in the last decade as the number of motor vehicles has increased. U.S. citizens involved in traffic accidents have been barred from leaving Laos before paying compensation for property damage or injuries, regardless of who was at fault.
A driver involved in a traffic accident should remain at the scene and attempt to contact the police or wait for them to arrive to prepare an accident report.
If renting a car or motorcycle, contact the rental company and its insurance agent.
If there is major damage, injury or death, contact the Consular Section or Embassy Duty Officer.

Traffic in Laos is chaotic and road conditions are very rough. Few roads have lane markings. Where lane markings, road signs, and stoplights do exist, they are widely ignored. Many drivers are unlicensed, inexperienced and uninsured. Driving under the influence of alcohol or illegal drugs is not uncommon, and penalties for such offenses may not be enforced. Theoretically, traffic moves on the right, but vehicles use all parts of the road. Motorcyclists pay little or no heed to cars. Motorcycles carry as many as five people, greatly impeding the drivers' ability to react to traffic. The evening hours are particularly dangerous. Road construction sites are poorly marked, appear with no advance warning, and can be difficult to see at night. Roads are poorly lit, many vehicles have no operating lights, few bicycles have reflectors, and trucks without reflectors commonly park on unlit roads.

Public transportation is unreliable and is limited after sunset. The most common form of public transport is three-wheeled, open-sided taxis called "tuk-tuks.” Automobile taxis or cars for hire are available at the airport, the Friendship Bridge, and most major hotels, and near the Morning Market in Vientiane. Tuk-tuks and taxis are frequently in poor repair, and drivers generally speak little or no English. Inter-city transport is provided by buses, pickups, and trucks, which are also often in poor repair.

Emergency services in Laos are either unreliable or non-existent. Lao road traffic regulations require any driver coming upon a road accident to assist in transporting injured persons to a hospital. Emergency telephone numbers in Vientiane are Fire: 190, Ambulance: 195 or 021-413-720, Traffic Police: 191, Tourist Police: 021-251-128 (only for incidents involving tourists). Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Laos, the U.S. Federal Aviation Administration (FAA) has not assessed the Lao 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:
TRAVEL OF FOREIGNERS WITHIN LAOS:
The Lao tourist police have informed foreign tourists that a licensed Lao tour guide must accompany any group of more than 5 foreign tourists; however, this regulation does not appear to be strictly enforced.
The authorities may restrict travel in rural areas outside of popular tourist destinations. Restricted areas may not be marked or even widely known by local citizens. If traveling without a reputable tour guide who is aware of local conditions, travelers should consult with local authorities before entering remote areas away from obvious tourist destinations.
Lao citizens who wish to have a foreign citizen -- including a family member -- stay in their home must obtain prior approval from the village chief. The foreigner may be held responsible if the Lao host has not secured prior permission for the visit. American citizens are strongly advised to ensure that such permission has been sought and granted before accepting offers to stay in Lao homes.
Security personnel may at times place foreign visitors under surveillance. Hotel rooms, telephones and fax machines may be monitored, and personal possessions in hotel rooms may be searched. Taking photographs of anything that could be perceived as being of military or security interest may result in problems with the local authorities. See Section below on Photography and Other Restrictions.

RELATIONSHIPS WITH LAO CITIZENS:
Lao law prohibits sexual contact between foreign citizens and Lao nationals except when the two parties have been married in accordance with Lao Family Law. Any foreigner who enters into a sexual relationship with a Lao national risks being interrogated, detained, arrested, or fined. Lao police have confiscated passports and imposed fines of up to $5000 on foreigners who enter into disapproved sexual relationships. The Lao party to the relationship may also be jailed without trial. Foreigners are not permitted to invite Lao nationals of the opposite sex to their hotel rooms; police may raid hotel rooms without notice or consent.

Foreign citizens intending to marry Lao nationals are required by Lao law to obtain prior permission from the Lao Government. The formal application process can take as long as a year. American citizens may obtain information about these requirements from the U.S. Embassy in Vientiane. The Lao Government will not issue a marriage certificate unless the correct procedures are followed. Any attempt to circumvent Lao regulations may result in arrest, imprisonment, a fine of $500-$5000, and deportation. A foreigner who cohabits with or enters into a close relationship with a Lao national may be accused by Lao authorities of entering into an illegal marriage and be subject to these same penalties.
A foreign citizen who wishes to become engaged to a Lao national is required to obtain prior permission from the chief of the village where the Lao national resides. Failure to obtain prior permission can result in a fine of $500-$5000. Lao police may impose a large fine on a foreign citizen a few days after he or she holds an engagement ceremony with a Lao citizen based on the suspicion that the couple subsequently had sexual relations out of wedlock.

MARRIAGE:
A Lao Prime Ministerial decree requires that marriages of Lao citizens abroad be registered with Lao embassies in order to be legal in Laos. If an American citizen marries a Lao citizen in the U.S. and then the couple comes to Laos, the American could be subject to penalties under the Lao law governing sexual relationships (above) if the marriage has not been registered beforehand with a Lao Embassy.

RELIGIOUS WORKERS:
Religious proselytizing or distributing religious material is strictly prohibited. Foreigners caught distributing religious material may be arrested or deported. The Government of Laos restricts the importation of religious texts and artifacts. While Lao law allows freedom of religion, the Government registers and controls all associations, including religious groups. Meetings, even in private homes, must be registered and those held outside of established locations may be broken up and the participants arrested.

RIVER TRAVEL:
River travel is common in Laos, but safety conditions do not conform to U.S. standards. In particular, travel by speedboat (local term “fast boat”) is dangerous and should be avoided, particularly during the dry season, which generally occurs from December through April. Travel on or across the Mekong River along the Thai border should be avoided at night. Lao militia forces have shot at boats on the Mekong after dark. Several people have drowned during the rainy season while inner-tubing or swimming in the Nam Song River near Vang Vieng.

PHOTOGRAPHY AND OTHER RESTRICTIONS:
Taking photographs of anything that could be perceived as being of military or security interest — including bridges, airfields, military installations, government buildings, or government vehicles — may result in problems with authorities, including detention or arrest and confiscation of the camera. Tourists should be cautious when traveling near military bases and strictly observe signs delineating the military base areas. Military personnel have detained and questioned foreigners who have unknowingly passed by unmarked military facilities.
Because of the prohibition on religious proselytizing, travelers should use caution when taking photographs or videotaping non-Buddhist religious services. If attending public services or religious gatherings, foreigners should ask permission from the local police and civil authorities to photograph or videotape. See section above on Religious Workers. Local police may suspect persons using any kind of very sophisticated still or video camera equipment of being professional photographers or possibly photojournalists which may lead to questioning, detention, arrest or deportation by the police.

FINANCIAL TRANSACTIONS:
There are network-connected ATMs in Vientiane, including those operated by the Foreign Commercial Bank of Laos, also know as the Banque Pour le Commerce Exterieur de Laos (BCEL). BCEL also has network-connected ATMS in Vang Vieng, and the Provincial capital cities, or “Muang”, of Luangnamtha, Oudomxay, Luangprabang, Khammouan, Savannakhet, and Champasak Provinces.
These machines are generally limited to withdrawals of the equivalent of about $100.00 in Lao kip only. Credit cards are accepted at major hotels and tourist-oriented businesses. Credit card cash advances and/or Western Union money transfers are available at banks in most provincial capitals and other tourist centers. While the government requires that prices be quoted in Lao kip, prices are often given in U.S. dollars or Thai baht, especially in tourist areas or at markets. The Lao Government requires payment in U.S. dollars for some taxes and fees, including visa fees and the airport departure tax.

CUSTOMS/CURRENCY REGULATIONS:
Lao customs authorities may enforce strict regulations concerning temporary importation into or export from Laos of items such as firearms, religious materials, antiquities, foreign currency, cameras and other items. It is advisable to contact the Embassy of the Lao People's Democratic Republic in Washington for specific information regarding customs requirements. (Please also see section on “Religious Workers” above). There are prohibitions against importing or exporting more than $2500 (U.S. dollar equivalent) of currency without authorization. Contact the Lao Embassy or Lao customs authorities for more details. 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.

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 Lao laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Laos 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 Laos 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 Laos. 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 Bartholonie (near Tat Dam), in Vientiane; from the U.S., mail may be addressed to U.S. Embassy Vientiane, Unit 8165, Box V, APO AP 96546; Telephone (856-21) 267-000, recorded emergency information for American citizens (856-21) 267-111; duty officer emergency cellular telephone (856-20) 550-2016; Embassy-wide fax number (856-21) 267-190; Consular Section e-mail: CONSLAO@state.gov, Embassy web site: http://laos.usembassy.gov/.
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This replaces the Country Specific Information for Laos dated September 5, 2007, to update sections on Entry/Exit Requirements, Safety and Security, Traffic Safety and Road Conditions, and Financial Transactions.

Travel News Headlines WORLD NEWS

Date: Thu, 21 Nov 2019 01:34:32 +0100 (MET)

Bangkok, Nov 21, 2019 (AFP) - A 6.1-magnitude earthquake hit north-western Laos near the Thai border early Thursday, the United States Geological Survey reported.    The shallow quake hit at 6:50 am local time (2350 Wednesday GMT), USGS said. 
Date: Thu, 31 Oct 2019 09:40:50 +0100 (MET)

Loei, Thailand, Oct 31, 2019 (AFP) - The once-mighty Mekong river has been reduced to a thin, grubby neck of water in stretches of northern Thailand -- record lows blamed on drought and a recently completed dam far upstream.   The $4.47 billion Thai-owned Xayaburi hydro-electric power plant went into operation this week in Laos after years of warnings over the potential impact on fish flow, sediment and water levels on a river which feeds tens of millions.

Along parts of Thailand's northeastern border at Loei, the kilometre-wide (3,300-foot) river has shrivelled to a few dozen metres, with boulders and bedrock encasing muddy pools of water.   From above, the encroaching banks of Laos and Thailand are now a thread of water apart, restricting fishing grounds to a slim channel.   Fishermen blame a combination of this year's weak monsoon and the Xayaburi dam, around 300 kilometres (185 miles) to the north.   "I don't want any more dam construction," said fisherman Sup Aunkaew, who tossed a meagre catch into his boat, adding that the fish spawning habits have been "confused" by the unseasonally low water levels.   "But we can't really oppose their plans if they want to do it."

Landlocked and impoverished Laos has set its sights on becoming "the battery of Asia", with 44 operating hydro plants and 46 more under construction many on key tributaries of the Mekong, according to monitor International Rivers.  The Mekong River Commission (MRC), a body governing regional water diplomacy, said the water levels from June to October are the lowest in nearly 30 years.   In Nong Khai, which faces the Laos' capital Vientiane, the water dropped to around one metre (3.2 feet) on Tuesday, several times shallower than average, the MCR said.   Measurements across the river "are significantly below the minimum levels for this time of year and are expected to decreases further", it said in a statement to AFP.   "The concern is for the upcoming dry season."

- 'Death of a thousand cuts' -
Experts say the dam-building frenzy in China and Laos has compounded the drought.   "These are causing the Mekong to die a death of a thousand cuts," said Brian Eyler, author of "The Last Days of the Mighty Mekong".   He said the lower part of the river is at a "crisis point" until rains come again next year.   The Mekong, which rises on the Tibetan plateau and courses through China, Myanmar, Laos, Thailand, Cambodia and Vietnam -- sustains tens of millions of people along its banks through fishing and agriculture. 

The 1,285-megawatt Xayaburi dam was built by CKPower -- a subsidiary of the Thai builder and majority shareholder CH Karnchang -- which went ahead with construction despite protests in Thailand, which is buying most of the electricity.   As it began operations the company plastered Thai newspapers with advertising this week referring to the "greatness of the Mekong" and calling the dam "fish riendly".   It did not respond to several requests for comment but the company has trumpeted its commitment to clean, sustainable energy.   In July the dam operator denied tests on the mega-structure were responsible for the river drying up downstream in northeastern Thailand.
Date: Tue, 20 Aug 2019 05:21:07 +0200 (METDST)

Bangkok, Aug 20, 2019 (AFP) - At least 13 Chinese tourists were killed and dozens injured when their bus skidded off the road and plunged 30 metres into a ravine in Laos, a police officer said Tuesday.   The bus was carrying more than 40 Chinese nationals heading towards the tourist town of Luang Prabang when the accident occurred late on Monday.   "At this moment, 13 bodies have been recovered... while two are still missing," police officer Xaiyaphon Chitavong told AFP, blaming brake failure for the accident.   He added that 31 people were receiving medical treatment.    Chinese state media showed photos of rescuers wading through ankle-deep floodwaters.

Traffic accidents in Laos, Thailand, Cambodia and Myanmar are common, with safety regulations often flouted and law enforcement low.    The monsoon season from June to October also drenches rural roads with heavy rains creating slippery conditions.   Tourism to communist-run Laos has grown in recent years, and visitors from China increased by 13 percent in the first half of 2019 compared to the year before, according to the state-backed Vientiane Times.
Date: Sat, 28 Jul 2018 13:48:53 +0200

Attapeu , Laos, July 28, 2018 (AFP) - Rescuers battled thick mud and flood waters across a swathe of remote southern Laos to find survivors of a deadly dam burst that submerged entire villages, as an official suggested faulty construction may have led to the disaster.   The exact number of dead and missing from Monday's dam collapse remains a mystery because of the complexity of the rescue operation in an inaccessible area and the secretive reflexes of Laos's Communist authorities in the face of an unprecedented crisis.

"The search is very complicated, many areas cannot be accessed by cars or boats. Also we have limited modern equipment to bring to the field," deputy secretary of Attapeu province committee Meenaporn Chaichompoo told reporters Friday.   The head of the rescue mission Kumriang Authakaison said Saturday that eight people are confirmed dead, down from 27 reported by officials earlier this week. He added that 123 were confirmed missing.    But conflicting information swirled about how many remain unaccounted for after Chaichompoo said Friday "we can't find 1,126 people", without elaborating. 

Makeshift shelters are packed with thousands of people who fled their homes in panic with just a few hours' notice of the impending disaster, now spending their days on plastic mats waiting for news of missing neighbours.    All karaoke bars and entertainment venues were ordered tone down loud music and celebrations in the province as the nation mourned the calamity, the most devastating to hit Laos's contentious hydropower sector.

A stretch of land dozens of kilometres long and wide was submerged when the Xe-Namnoy dam collapsed after heavy rains.    Slowly retreating floodwaters have cut off access to villages and covered much of the area with thick, sticky mud.      "This is one of the worst (disasters) I've ever seen. Especially because we're not a very strong country in terms of rescue operations," a volunteer rescue worker told AFP, requesting anonymity as he was not authorised to speak to media.

- Poor construction? -
Days into the treacherous search for survivors, questions are being raised about the quality of the construction of the $1.2 billion dam, a joint venture between South Korean, Laotian and Thai firms.    Operators said it burst after heavy rains in a country regularly battered by monsoons.

But Laos Minister of Energy and Mines Khammany Inthirath said poor design may have contributed to the accident, according to state media and Radio Free Asia.   "It might be construction technique that led to the collapse after it was affected by the rain," he told RFA in an interview broadcast Friday.    One of the Korean firms involved in the project, SK Engineering & Construction, said it was investigating the cause of the dam break and would donate $10 million in relief aid.   The accident has kicked up criticism of Laos' ambitious dam-building scheme as it bids to become a major power exporter, billing itself the "battery of Asia" with more than 50 projects set to o online by 2020.     The majority of energy generated in the tiny, landlocked country is sold to its neighbours, mostly to Thailand where much of it is sucked up in the sweaty, energy-hungry capital Bangkok.

Villagers have complained of being relocated -- sometimes repeatedly -- while river waters crucial for fishing and farming have been diverted, destroying livelihoods in one of Asia's poorest countries.    Downstream countries like Cambodia and Vietnam also fret that their waterways and fishing stocks could be damaged by the hydopower boom in Laos.    The accident has prompted fears over the safety of other dams in the country.   "Most of the dams are built by foreign companies and Laos authorities don't have expert knowledge and management to check for weaknesses or problems, that's our worry," villager Si Wonghajak told AFP.
Date: Thu, 26 Jul 2018 13:09:09 +0200

Attapeu , Laos, July 26, 2018 (AFP) - The torrent of water unleashed in a deadly Laos dam collapse has drained into Cambodia, forcing thousands to evacuate, as rescuers on Thursday battled monsoon rains to find scores of Laotians still missing after entire villages were washed away.   Twenty-seven people have been confirmed dead, with 131 still missing, after the Xe-Namnoy dam collapsed on Monday in a remote southern corner of Laos, leaving villagers with little time to escape.   It is an unprecedented accident to strike the hydropower industry in Laos, where the Communist government has dammed large sections of its myriad waterways to generate electricity that is mostly sold to its neighbours.

The search and rescue effort entered a third day Thursday, with China, Vietnam and Thailand sending in specialists, while villagers picked through their wrecked, mud-caked homes for possessions as the flood waters receded.   Carcasses of livestock floated in the knee-deep waters in a devastated village visited by AFP, as heavy rain pounded the area.   Thousands of villagers downstream in Cambodia have also been forced to flee as the water once held back by the dam flowed south.   "Water is still rising, so more people will be evacuated," Men Kong, a government spokesman in Cambodia's Stung Streng province, told AFP.   Cambodian soldiers ferried villagers and motorbikes from flooded zones on wooden boats, while supplies were handed out to some who found refuge on dry land.

In Laos, Chinese rescuers in life jackets and helmets joined local soldiers searching for the missing Thursday, according to an AFP reporter at the scene, while community volunteers pitched in with private boats to return to villages still submerged.   Residents recalled their terror as water rushed through their homes.   Tran Van Bien, 47, from Ban Mai village close to the ruined dam said he was told to evacuate just two hours before the dam burst on Monday evening, running to a neighbour's house with his family as his home quickly filled with water.   "We were on the roof of that house the whole night, cold and scared. At 4:00 am a wooden boat passed and we decided to send my wife and my kid out," he told AFP from a nearby town where he eventually found dry land.   "My wife tied our child to her body, saying if they died, they would die together rather than being alone."

- 'Insufficient warning' -
The $1.2 billion Xe-Namnoy dam, a joint venture between Laos, Thai and Korean companies, was still under construction in southern Attapeu province when it collapsed after heavy rains pounded the area earlier this week.   Two South Korean companies involved in the project's construction and operation said damage was reported a day before the auxiliary "Saddle D" dam collapsed.   However a timeline from operator Korea Western Power Co. obtained by AFP said 11 centimetres (four inches) of subsidence was spotted at the dam's centre as early as Friday.   The company told AFP it could not yet determine the cause of the collapse.   "It is too early to define whether it was a natural disaster or a manmade disaster," a spokesman told AFP Thursday.

Thailand issued new regulations for its hydro plant operators in Laos this week, ordering companies to report on dam conditions every week and communicate closely with residents.    "If a dam plans to release water they must coordinate with local officials to warn people and to prevent people from panic at least seven days (in advance)," Thailand's Energy and Mining Minister Khammany Inthirath announced Wednesday.   Southeastern Laos is frequently lashed by monsoon rains, and dam operators regularly release water from reservoirs in order to avoid overflow -- or collapse.   The 410 MW Xe-Namnoy project is one of more than 50 hydropower plans underway in Laos, which has billed itself as the "battery of Asia" in its ambitious bid to become a major power exporter in the region.

Laos has said it wants to double its power generation capacity to 28,000 MW by 2020 and has opened its doors to foreign investors -- mainly from China, Thailand and Vietnam -- to build dams across the country.   But the projects have come under fire from rights groups who say local communities are forcibly moved and lose key access to river waters for farming and fishing.   "This tragedy has compounded their suffering," International Rivers said in a statement Thursday.   "Communities were not given sufficient advanced warning to ensure their safety and that of their families. This event raises major questions about dam standards and dam safety in Laos."
More ...

Bhutan

Bhutan - US Consular Information Sheet
February 23, 2009
COUNTRY DESCRIPTION:
Bhutan is a small, land-locked Himalayan country that completed its transition from an absolute monarchy to a constitutional monarchy in June 2008.
Bhutan i
one of the world’s smallest and least developed economies.
The United States does not have full diplomatic relations with Bhutan and there is no U.S. diplomatic presence there.
Consular issues relating to Bhutan, including assistance to U.S. citizens, are handled by the U.S. Embassy in New Delhi.
Read the Department of State Background Notes on Bhutan for additional information.
ENTRY/EXIT REQUIREMENTS:
Independent travel is not permitted in Bhutan. Visitors are required to book travel through a registered tour operator in Bhutan. This may be done directly or through a travel agent abroad.
Further information, including a list of authorized tour operators in Bhutan, may be obtained from the Tourism Council of Bhutan, PO Box 126, Thimphu, Bhutan, telephone +975-2-323251, 2-323252, fax +975-2-323695.
Entry by air is available only via India, Bangladesh, Nepal, and Thailand. The border with China is closed. The minimum daily tariff is set by the Bhutanese Department of Tourism and cannot be negotiated. The rate includes all accommodations, all meals, transportation, services of licensed guides and porters, and cultural programs where and when available. The rate is the same for both cultural tours and treks. Travelers should contact the Tourism Council for the latest daily tariff.
At this time, the only carrier servicing Bhutan is Drukair, the Bhutanese government airline. Drukair will board only travelers with visa clearance from the Tourism Authority of Bhutan.

A passport and visa are required for entry into and exit from Bhutan.
Visa applications are available from selected travel agencies.
Travel agencies will usually arrange for a traveler’s entry visa and clearance.
Visitors, including those on official U.S. government business, should obtain visas prior to entering the country.
For additional entry/exit information, please contact the Bhutan Mission to the United Nations (Consul General), 763 First Avenue, New York, NY
10017, telephone (212) 682-2268, fax (212) 661-0551.

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:
Recent efforts to resettle many of the approximately 100,000 Bhutanese refugees of Nepali ethnic origin currently living in Nepalese refugee camps, coupled with the transition to democracy, have given rise to some civil unrest in usually peaceful Bhutan.
Bhutanese Maoists and Communist groups (including the Bhutan Communist Party and the Bhutan Tiger Force operating from the camps in Nepal), who denounce the monarchy and demand that the refugees be repatriated to Bhutan, have been linked to violence in the country.
A series of small bombs were set off between October 2006 and December 2008; most took place in small cities and towns on the southwestern border, near India, except for one in the capital, Thimphu.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME:
There is relatively little crime in Bhutan. Petty crime, such as pick-pocketing and purse snatching, is occasionally reported.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Embassy in New Delhi.
If you are the victim of a crime while in Bhutan, in addition to reporting to local police, please contact the U.S. Embassy in New Delhi for assistance.
(See the contact information below.)
The Embassy’s consular 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 crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line for Bhutan police in Bhutan is 113.
The emergency number for ambulance service is 112.

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

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Bhutanese laws, even unknowingly, may be expelled, arrested or imprisoned.
Bhutan recently implemented extremely strict restrictions on the sale or use of cigarettes and other tobacco products.
A traveler caught selling tobacco products could be charged with illegal smuggling and fined or imprisoned.
Smoking is prohibited in public places.
Penalties for possession, use, or trafficking in illegal drugs in Bhutan are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime prosecutable in the United States.
Please see our information on Criminal Penalties.
SPECIAL CIRCUMSTANCES:
Visitors are advised to carry cash or travelers checks, since credit cards are not widely accepted in Bhutan.
When credit cards are accepted, usually during bank hours, an extra service fee, usually a percentage of the overall purchase, is often charged.

Druk Air, the only carrier servicing Bhutan, has rigid restrictions on the amount and size of luggage passengers may carry into the country. Passengers are advised to book bulky items ahead as unaccompanied baggage, since the aircraft servicing Bhutan have limited space available for large bags, and airline employees may not load large pieces of luggage. Flights into and out of Paro Airport are restricted to daylight hours and are dependent on suitable weather conditions. Flights are sometimes delayed or cancelled, particularly during the monsoon season between June and August. Passengers are advised to allow at least 24 hours' transit time for connecting flights from Paro Airport and to travel on non-restricted air tickets so that they can be rebooked on the first available air carrier if a connecting flight is missed.

Bhutanese customs authorities enforce strict regulations concerning temporary importation into or export from Bhutan of items such as firearms, ammunition, explosives and military stores; narcotics and drugs (except medically prescribed drugs); tobacco products; wildlife products, especially those of endangered species; and antiques. It is advisable to contact the Bhutan Mission to the United Nations (Consulate General), 763 First Avenue, New York, NY
10017, telephone (212) 682-2268, fax (212) 661-0551, for specific information regarding customs requirements.
Please see our Customs Information.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in the populated areas in Bhutan such as Thimphu and Paro are available but may be limited or unavailable in rural areas.
If Americans need urgent medical care, they should try to get to the General Hospital in the capital city, Thimphu.
Medical services may not meet Western standards, and some medicines are in short supply.
Certain emergency medical services are provided free of charge to all tourists.
Visitors planning to trek in Bhutan should pay special attention to the risk of altitude illness.
Treks in Bhutan can take visitors days or weeks away from the nearest medical facility.
Helicopter evacuation from remote areas is available in Bhutan through the registered tour operators, or by contacting the U.S. Embassy in New Delhi.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Bhutan.
There are no disclosure regulations or restrictions for HIV/AIDS patients who enter Bhutan on a tourist visas for a maximum two week visit.
For longer stays applicants must present the results of an HIV/AIDS test completed within the six months prior to their visit.
The test can also be administered by Bhutanese officials upon arrival. Travelers should verify this information with the Bhutan Mission to the United Nations at (212) 682-2268.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
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 Bhutan is provided for general reference only and may not be totally accurate in a particular location or circumstance.
General road conditions outside of urban areas are poor, and emergency services generally are not available.
Because of the mountainous terrain, roads tend to have steep drop-offs and blind curves.
However, because tourists to Bhutan are required to arrange their trips through registered tour operators, tourists do not drive themselves, but travel in groups with experienced drivers.
Please refer to our Road Safety page and Bhutan’s Ministry of Economic Affairs for more information.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bhutan, the U.S. Federal Aviation Administration (FAA) has not assessed Bhutan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA web site.
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:
There is no U.S. Embassy or Consulate in Bhutan. Although no formal diplomatic relations exist between the United States and Bhutan, informal contact is maintained through the U.S. Embassy in New Delhi, India. Updated information on travel and security in Bhutan may be obtained at the U.S. Embassy in New Delhi, at any other U.S. Consulate in India, or at the U.S. Embassy in Kathmandu, Nepal, as well as at the U.S. Embassy in Bangkok, Thailand.
Americans living or traveling in Bhutan are encouraged to register through the State Department’s travel registration web site or with the U.S. Embassy in New Delhi to obtain updated information on travel and security within Bhutan.
Americans without Internet access may register directly with the U.S. Embassy in New Delhi in person or via mail.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy in New Delhi is located on Shanti Path, Chanakya Puri, New Delhi 110 021, India, telephone +91-11-2419-8000, fax +91-11-2419-8407.

The following U.S. missions are included as they are Drukair destinations:
The U.S. Consulate in Kolkata is located at 5/1 Ho Chi Minh Sarani, Kolkata 700 071, India, telephone +91-33-3984-2400, fax +91-33-2282-2335.
The U.S. Embassy in Kathmandu is located at Maharajgunj in Kathmandu, Nepal.
The Consular Section can be reached through the Embassy switchboard at (977) (1) 400-7200 or directly by fax at (977) (1) 400-7281 or contacted by email.
The U.S. Embassy in Bangkok is located at 120/22 Wireless Road, Bangkok, Thailand, telephone +66-2-205-4000, fax +66-2-205-4103.
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This replaces the Country Specific Information dated April 25, 2008, to update the sections on Country Description, Safety and Security, Traffic Safety and Road Conditions, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

National. 7 Sep 2019

Dengue fever cases in Phuentsholing are on the rise 2 months after the outbreak was 1st reported. Public awareness and campaigns have been of little help. Phuentsholing hospital saw a total of 2121 dengue-positive cases as of yesterday [6 Sep 2019], 313 more than the [1 Sep 2019] record. With 894 dengue-positive cases reported from private diagnostic centres in the town, Phuentsholing saw 3015 positive cases as of yesterday [6 Sep 2019].

Figures from the diagnostic centres, however, include both Bhutanese and people from across the border. The chief programme officer with Department of Public Health (DoPH), Ministry of Health, Rixin Jamtsho, said that 77% of the total cases in the country were reported from Phuentsholing hospital." The cases were reported from 19 dzongkhags [administrative district] till yesterday [6 Sep 2019]," Rixin Jamtsho said. "[The] majority of the cases reported from other districts had travelled to Phuentsholing prior to their illness."

[HealthMap/ProMED-mail map of Bhutan:

1 Aug 2019. A total of 138 acute undifferentiated fever or dengue fever cases were reported in Doksum in Trashiyangtse as of yesterday [31 Jul 2019]. Health officials in Doksum tested 64 samples using dengue rapid test kit. Two tested positive for dengue NS1, 4 for dengue IgM, and 21 for 8 dengue IgG antibody.

[Dengue IgG antibody test is not confirmatory of acute infection unless serial serum samples have been tested. - ProMED Mod.UBA]

- National. 9 Aug 2019. The number of people affected by the dengue outbreak in Doksum in Trashiyangtse has increased 4-fold since the outbreak was reported on 26 Jul [2019] with 76 cases. A total of 314 cases were reported from Doksum as of yesterday evening [8 Aug 2019]. Most cases presented fever, joint pain, headache, and generalised body pain as symptoms.

HealthMap/ProMED-mail map of Bhutan:
26th June 2019
http://www.xinhuanet.com/english/2019-06/26/c_138176103.htm

THIMPHU, June 26 (Xinhua) -- Heavy rainfall in Bhutan has killed at least two people, triggered flash floods, landslides and road blocks, and damaged homes, streets and vehicles. The two were buried alive after the landslide washed away their home in southern district of Samtse on Tuesday due to massive landslide that was triggered by heavy rains. The continuous rainfall and flash floods have blocked more than four national highways, damaged bridges and affected many commuters and office goers.

According to the National Center for Hydrology and Meteorology, the southern belt of Bhutan has recorded heavy rainfall on Tuesday. The downpour continued on Wednesday, further affecting the lives of people living in southern part of the country.  People residing in Phuentsholing said that they had to evacuate at early as 3 a.m. due to swollen rivers. The engineering workshops were overflown and drains were invisible due to landslides and flash floods. Falling of boulders and landslides damaged many vehicles, with some being submerged in mud. The schools in Phuentsholing town had to postpone their exams due to the damages caused by the heavy rainfall.

In Gelephu district a highway bridge was damaged. National highways between four districts were blocked. Many public buses and commuters were cancelled due to swollen rivers.  In 2017 a monsoon rainfall washed away an entire town in southern district of Sarpang.

Date: Sat 20 Apr 2019
Source: Kuensel [edited]

The recent [influenza A(H1N1)] outbreak in Bumthang is under control with the number of infected people visiting hospital declining from 30 to 35 a day to about a dozen these days.

Since the 1st case was reported on [8 Apr 2019] about 227 people were reported to have been infected by influenza A(H1N1)pdm09 causing seasonal flu.

Of the total infected, around 90 percent were students of Wangdicholing lower secondary school (WLSS), Bumthang. The 1st incident was reported on [8 Apr 2019] when 45 students did not come to school. Some were sent home and some referred to hospital.

Medical Officer of Wangdicholing hospital Dr Pema Wangchuk said the samples from the infected were sent to the Royal Center for Disease Control for investigation, which confirmed the disease as influenza A(H1N1). However, the doctor said it is a normal seasonal flu that occurs every year, especially during early spring and winter.

Signs and symptoms of influenza are fever, cough, headache, muscle and joint pains, sore throat and runny nose, sometimes with vomiting and diarrhoea.

Students are infected easily mainly because of congestion, lack of hand hygiene practice, and not having preventive measures for cough, according to health officials. The hospital organised advocacy and preventive measures to avoid further spreading of the disease.

As per the report from WLSS, about 64 infected students could not attend regular classes until [15 Apr 2019]. Although the number decreased, there are students not being able to attend classes while some teachers were also infected.

This is the 2nd consecutive outbreak. Last winter more than 350 people were infected by the same virus.

The current outbreak falls under the moderate category, where preventive measure and sensitization programme and treatment could work.  [Byline: Nim Dorji]
==================
[HealthMap/ProMED-mail map of Bumthang, Bhutan:
Date: Sat 13 Apr 2019
Source: Kuensel Online [edited]

A bird flu (H5N1) outbreak has affected 13 poultry farms and one turkey farm at Dhamdara in Phuentsholing. The outbreak was confirmed on 8 Apr 2019 through laboratory testing from the National Centre for Animal Health (NCAH), Serbithang, Thimphu.  No human contact was reported.

In response, a total of 1130 poultry birds in the affected areas were culled, about 4002 eggs disposed, 613 kg (1351 lb) of feed disposed, and 12 chicken coops destroyed.

The National Incident Command Committee (NICC) has activated the Incident Operation Centre (IOC) at Thromde Veterinary Hospital in Phuentsholing with the Rapid Response Team (RRT) from different ministries and agencies for immediate containment and response to the outbreak.

A press release from the ministry states, "As the disease is brought under control at the source of outbreak the public should not panic. The public is also advised to take precautions like washing of hands after handling poultry, chicken and eggs with soap and water."

Program director of NCAH, Dr. RB Gurung, the focal person of bird flu, said the outbreak was reported in the field on 6 Apr 2019. He said the outbreak is under control by about 80% yesterday [Fri 12 Apr 2019]. As the outbreak location was at the outskirt of town, there were not many vehicles on the road, which made it easier, he added.

The response team also created awareness in the community. Vehicles traveling out of the demarcated infected and restricted zones are also disinfected.

Dr. RB Gurung said poultry farmers are cautioned to comply with farm biosecurity measures and not allow visitors into the farms without proper safety measures. "We need to observe the outbreak area for one month," Dr. RB Gurung said.

The Department of Livestock, Chhukha Dzongkhag Livestock Sector, Department of Public Health, Royal Bhutan Police, Bhutan Agriculture and Food Regulatory Authority and the Regional Livestock Development Centre Tsimasham and local authorities in Phuentsholing have initiated the response to the H5NI outbreak jointly. [Byline: Rajesh Rai]
=========================
[Phuntsholing, also spelled as Phuentsholing, is a border town in southeastern Bhutan and is the administrative seat of Chhukha District. The town occupies parts of both Phuentsholing Gewog and Sampheling Gewog; map at <http://tinyurl.com/y672je4t>.

It may be assumed that the event in Bhutan is related to wild bird migration; 2 of the 3 earlier outbreaks notified by Bhutan to the OIE took place in a similar season, namely, March (2018) and April (2015). Bhutan has already reported the event to the OIE; see http://promedmail.org/post/20190413.6418964. - ProMED Mod.AS]

[HealthMap/ProMED-mail maps:
Chhukha District, Bhutan: <http://healthmap.org/promed/p/12668>]
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Turks and Caicos Islands

Turks & Caicos US Consular Information Sheet
November 17, 2008
COUNTRY DESCRIPTION:
The Turks and Caicos Islands are a British Overseas Territory comprising a small archipelago of eight major islands and numerous uninhabited keys, 500 mile
southeast of Miami.
Most tourist facilities are located on Providenciales ("Provo") Island.
The U.S. dollar is the unit of currency and the larger hotels and shops accept credit cards.
The U.S. Embassy in Nassau, Bahamas, has jurisdiction for consular matters in the Turks and Caicos.
ENTRY/EXIT REQUIREMENTS:
U.S. citizens do not need to obtain visas to visit the Turks and Caicos Islands.
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed-loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have either a WHTI-compliant document (such as a valid U.S. passport or passport card) or both a government-issued photo identification and a document showing their U.S. citizenship (for example, a certified U.S. birth certificate or certificate of nationalization).
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.
Applications for the new U.S. Passport Card are now being accepted.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the passport card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Visit the British Embassy web site at http://ukinusa.fco.gov.uk/en for the most current entry information, including any visa requirements.
Information about dual nationality or the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the United States and Canada, or for callers outside the United States 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:
Petty street crime does occur.
Visitors should not leave valuables unattended in their hotel rooms or on the beach.
Visitors should make sure that their hotel room doors are securely locked at all times.
In the Turks and Caicos, carrying illegal/undeclared firearms or ammunition is a very serious crime, as is possession of illegal narcotics.

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 are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in the Turks and Caicos Islands is 999 or 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are available but limited in the Turks and Caicos Islands.
There is a small public hospital on Grand Turk and a private clinic on Provo, which has a hyperbaric chamber.
Most serious medical problems require medical evacuation by air from the Turks and Caicos to the United States.

The Turks and Caicos Islands do not have a pathologist to perform services in cases of death.
Medical examiners from neighboring countries visit the island regularly to provide this service.
It can take up to two weeks for the Government of the Turks and Caicos Islands to release the remains of the deceased under normal circumstances, and severe weather during the hurricane season could delay the process even more.The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the Turks and Caicos Islands.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) 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 the Turks and Caicos Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Driving in the Turks and Caicos Islands is on the left.
Traffic tends to be light, and the terrain is flat.
When entering roundabouts and other intersections without signs or traffic signals, drivers are required to give way to those on their immediate right.
Driving under the influence of alcohol is illegal, and drivers convicted of the offense may face fines, detention, or both.
Wild donkeys are a common sight and often walk on the roads, presenting a hazard to drivers, especially at night.
Road signs are not prevalent, but as there are few roads on the island, finding one's way with a tourist map is generally not a problem.
Drivers should be alert for unmarked hazards such as blind intersections or changes in road conditions.
Primary roads are generally drivable in both urban and rural areas.
Secondary roads are often unpaved, and have ruts and potholes.
Be aware that, in the event of a breakdown, roadside assistance is generally not available.
For emergencies, drivers may call 999 or 911 for police, fire, or medical assistance.
Visitors require a valid driver's license from their country of residence.
Safety of public transportation in the Turks and Caicos is generally good.
Most car and motor scooter rental agencies will not rent to anyone under the age of 21.
A government tax is levied on all car and motor scooter rentals (insurance is extra).Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office at http://www.turksandcaicostourism.com.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the Turks and Caicos Islands fall under the jurisdiction of British authorities.
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 more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
The importation of firearms to the Turks and Caicos is strictly forbidden without prior approval in writing from the Commissioner of Police.
U.S. citizens may contact the Turks and Caicos Customs Department at (649) 946-2867 for specific information regarding customs requirements. Please see our Customs Information.

The Turks and Caicos Islands, like all countries in the Caribbean basin, are vulnerable to hurricanes.
Hurricane season officially runs from June 1 to November 30, although hurricanes have been known to occur outside that time period.
Visitors to the Turks and Caicos Islands during hurricane season are advised to monitor weather reports in order to be prepared for any potential threats.
General information about 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 offenses.
Persons violating Turks and Caicos laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the Turks and Caicos 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 residing or traveling in the Turks and Caicos Islands 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 the Turks and Caicos Islands.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at 42 Queen Street, Nassau, The Bahamas.
It is next to the McDonald’s Restaurant on Queen Street and may be reached Monday-Friday at telephone (242) 322-1181 x4406; after-hours (242) 328-2206; fax (242) 356-7174.
The U.S. Embassy web site is http://nassau.usembassy.gov.
Office hours are from 9:00 a.m. to 11:00 a.m. and 1:00 p.m. to 3:00 p.m. Monday-Thursday; 9:00 a.m. to 11:00 a.m. Friday (except for U.S. and Bahamian holidays).
* * *
This replaces the Country Specific Information for the Turks and Caicos Islands dated March 14, 2008, without substantive changes.

Travel News Headlines WORLD NEWS

Date: Wed, 4 Sep 2019 23:41:56 +0200 (METDST)

St. John's, Antigua and Barbuda, Sept 4, 2019 (AFP) - Masked gunman have shot dead a 71-year-old British holidaymaker in a robbery on the tourist paradise of Turks and Caicos, police said Wednesday.

The victim had been visiting a friend in the British territory, around 150 miles (200 kilometres) north of Haiti, when two assailants burst into the home shortly after 11:00 pm Tuesday (0300 GMT Wednesday).   They demanded money, but it was not immediately clear how the situation escalated before the gunmen made off with an undisclosed amount of cash, a ring and a watch, said police spokeswoman Takara Bain.   The friend was treated for non-life threatening injuries at a private residence in Cooper Jack on the tiny island's south coast.

It is the second murder in three days in the archipelago, home to just 35,000 people, taking the 2019 homicide toll to 10, Police Commissioner Trevor Botting said in a statement.   A shooting at a nightclub in Providenciales on Saturday night left one man dead and a second wounded.   "This spike in gun crime simply has to change," Botting said. "No one should be happy with how gun crimes are increasing in the Turks and Caicos Islands."   Earlier this year, the US State Department warned travellers to "exercise increased caution" when visiting the archipelago 600 miles (970 kilometres) southeast of Miami.
Date: Tue, 6 Aug 2019 20:04:36 +0200 (METDST)

St. John's, Antigua and Barbuda, Aug 6, 2019 (AFP) - Three American tourists have drowned in the Turks and Caicos Islands after apparently getting caught in a fast-moving tide fueled by high winds, authorities and local residents said Tuesday.   The victims -- two men and a woman -- were from two families from Texas who were spending the holidays together, along with their two girls, police said.

They had been exploring scenic Bambarra Beach on the sparsely populated island of Middle Caicos when disaster struck on Monday, police and local residents said.   The children were plucked from the ocean by rescuers and were being cared for by local social welfare services.   The body of a 34-year-old woman washed ashore shortly after the incident. Searchers scouring the beaches recovered the second body a few hours later. The third was discovered early this morning with assistance from the US Coast Guard.   Residents said the families may have been attempting to cross the half-mile distance through shallow water from Bambarra Beach to nearby Pelican Cay.

Police Commissioner Trevor Botting described the incident as a "terrible tragedy."   "Five tourists from two families got into difficulties in the waters off Middle Caicos. Whilst two children were thankfully recovered alive from the water, two adults related to one of the girls were recovered but sadly they had died. One other man, related to the other child, was found early today and has also died," he said.   The tragedy has triggered calls locally for increased warning signs on the islands' often deserted beaches.   The Turks and Caicos Islands is British overseas territory that consists of two island chains southeast of the Bahamas.
Date: 12 Jun 2017
Source: TC weekly News [edited]

The Ministry of Health is advising the public of an increase in the number of cases of conjunctivitis in the Turks & Caicos Islands [TCI].

Conjunctivitis, also called "pink eye," is defined as an inflammation of the conjunctiva and can be caused by viruses, bacteria, or an allergy. It can affect children and adults.

Viral conjunctivitis is typically caused by a virus that can also cause the common cold. A person may have symptoms of conjunctivitis alone or as part of a general cold syndrome like fever, a sore throat and runny nose.

Viral conjunctivitis is highly contagious; usually people catch it from touching something that has been in contact with an infected person's eye (e.g. door handle, towel or pillow case), and then that person touches his or her eyes.

Some of the most common symptoms of conjunctivitis are pink or red eyes; the eyes might secrete a gooey liquid or become itchy or burn, get stuck shut, especially when you 1st wake up. These symptoms tend to last for several days.

The ministry stated in a press release: "The treatment depends on the cause. When pink eye is caused by a virus, antibiotics will not help. You can use warm or cool compresses to relieve the pain and irritation in the eyes.

"Most cases of pink eye go away on their own without treatment, but it is best to see your primary care physician if you are experiencing these symptoms so that you can be treated properly.

"Simple hygiene measures can help minimise transmission to others. Adults or children with bacterial or viral conjunctivitis should not share handkerchiefs, tissues, towels, cosmetics, or bed sheets/pillows with uninfected family or friends. Hand washing is an essential and highly effective way to prevent the spread of infection. Hands should be wet with water and plain soap, and rubbed together for 15 to 30 seconds.

"Teach children to wash their hands before and after eating and after touching the eyes, coughing or sneezing. Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available."

Anyone with viral conjunctivitis should remain home from school and work to avoid spreading the virus to others.
================
[The report above does not specify any laboratory confirmation of the conjunctivitis cases.

Conjunctivitis can result from many causes, including viruses, bacteria, allergens, contact lens use (especially the extended-wear type), chemicals, fungi, and certain diseases. Viral conjunctivitis can be caused by the following viruses, with adenoviruses being the most common cause: adenoviruses, picornaviruses (particularly enterovirus 70 and coxsackievirus A24), measles virus, and several herpes viruses.

Viral conjunctivitis is highly contagious. Most viruses that cause conjunctivitis are spread through hand-to-eye contact by hands or objects that are contaminated with the infectious virus. Hands can become contaminated by coming into contact with infectious tears, eye discharge, faecal matter, or respiratory discharges.

Many of the viruses that cause conjunctivitis may be associated with an upper respiratory tract infection, cold, or sore throat. - ProMED Mod.UBA]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Mon 9 May 2016
Source: Outbreak News Today [edited]

Health officials on the Caribbean island group, Turks and Caicos (TCI), are reporting a significant increase in chickenpox [varicella] cases during the 1st 4 months of 2016.

As of the end of the week of 23 Apr 2016, a total of 327 cases have been reported for the year. Of these, 41 (13 percent) were reported by persons younger than 5 years old and 296 (87 percent) were reported by persons older 5 years old.

These cases were reported by TCI Hospital on Providenciales 234 (72 percent) and Grand Turk 5 (1 percent); with 28 cases in North Caicos and 60 (18 percent) cases in clinics in Providenciales. In summary, the majority cases are being reported from Providenciales (90 percent).

By comparison, in all of 2015, a total of 98 cases of chickenpox were reported by TCI Hospital in Providenciales.

Chickenpox is a common, usually benign childhood disease caused by the varicella-zoster virus (VZV), a member of the herpes family. This virus causes 2 distinct diseases; varicella (chickenpox) is the primary infection, and later when VZV reactivates, herpes zoster (shingles).

Chickenpox is highly contagious and is spread by coughing and sneezing, by direct contact, and by aerosolization of the virus from skin lesions. You can also get it by contact with the vesicle secretions from shingles.

The disease is characterized by fever and a red, itchy skin rash of that usually starts on the abdomen, back, or face and then spreads to nearly all parts of the body. The rash begins as small red bumps that appear as pimples or insect bites. They then develop into thin-walled blisters that are filled with clear fluid which collapse on puncture. The blisters then breaks, crusts over, and leaves dry brown scabs.

The chickenpox lesions may be present in several stages of maturity and are more abundant on covered skin rather than exposed. Lesions may also be found in the mouth, upper respiratory tract, and genitals.

Chickenpox is contagious from 1-2 days before the rash forms and continues until all the lesions are crusted over (usually about 5 days).

This disease is more serious in adults than in children. Complications of chickenpox are rare, but include pneumonia, encephalitis, and secondary bacterial infections.

Infection with this virus usually gives lifelong immunity, although 2nd attacks have been documented in immunocompromised people. The viral infection remains latent, and disease may recur years later as shingles.

The TCI Ministry of Health strongly advises persons affected with chickenpox to remain at home during their sick leave period to prevent further spread of this illness within the community and schools.  [Byline: Robert Herriman]
=====================
[Varicella-zoster virus, a member of the herpesvirus family is the causative agent for chickenpox. Humans are the only reservoir of the virus, and disease occurs only in humans. After primary infection as varicella (chickenpox), the virus remains dormant in the sensory-nerve ganglia and can reactivate at a later time, causing herpes zoster (shingles).

Varicella occurs worldwide. In temperate climates, varicella tends to be a childhood disease, with peak incidence among preschool and school-aged children during late winter and early spring. In these countries, less than 5 percent of adults are susceptible to varicella. In tropical climates, the highest incidence was described in the driest, coolest months; overall, infection tends to be acquired later in childhood, resulting in higher susceptibility among adults than in temperate climates, especially in less densely populated areas.

All people, including those traveling or living abroad, should be assessed for varicella immunity, and those who do not have evidence of immunity or contraindications to vaccination should receive age-appropriate vaccination. Vaccination against varicella is not a requirement for entry into any country (including the United States), but people who do not have evidence of immunity should be considered at risk for varicella during international travel.

Varicella vaccine contains live, attenuated varicella-zoster virus. Single-antigen varicella vaccine is licensed for people aged 12 months and older, and the combination measles-mumps-rubella-varicella (MMRV) vaccine is licensed only for children 1-12 years. CDC recommends varicella vaccination for all people aged 12 months and older without evidence of immunity to varicella who do not have contraindications to the vaccine: 1 dose for children aged 1-4 years and 2 doses for people aged 4 years and older. The minimum interval between doses is 3 months for children aged less than 13 years and 4 weeks for people aged 13 years and older. Contraindications for vaccination include allergy to vaccine components, immune-compromising conditions or treatments, and pregnancy. When evidence of immunity is uncertain, a possible history of varicella is not a contraindication to varicella vaccination. Vaccine effectiveness is approximately 80 percent after 1 dose and 95 percent after 2 doses.

(Excerpted and edited from

Maps of the Turks and Caicos Islands may be accessed at
and <http://healthmap.org/promed/p/48358>. - ProMED Mod.LK]
Date: 7 Jul 2014
Source: TC Weekly News [edited]

Pet owners are being cautioned about a tick disease which is becoming a problem in dogs in the Turks and Caicos Islands. Licensed veterinarian Mark Woodring said that the disease, babesiosis, can be transmitted by bites from ticks.

Infected dogs show a number of signs, including decreased appetite, weight loss, fever, an enlarged abdomen, and dark orange or yellow skin and urine. The disease causes the dog's red blood cells to be destroyed, leading to pale gums and fatigue due to anemia. All dogs, including potcakes, (the local indigenous dog of the islands) can be infected. Some breeds are more susceptible to infection, especially greyhounds and all pitbull breeds, both purebred and mixed.

Woodring said that this disease can develop in a dog without ticks after an infected dog bites him or her, even playfully. He said that an infected female will pass along the disease to her puppies before birth.

"Accurate testing for babesiosis can be done with blood sent to the US for DNA studies, but most cases in the TCI are diagnosed by experienced veterinarians based on signs and physical exam. Although the disease is treatable with antibiotics, not every dog responds."

Early treatment is best, but even then, the disease can be fatal. The veterinarian said that another problem is that since 2012, the antibiotics most commonly used to treat tick-borne diseases have tripled in cost.

"Some antibiotics are in very short supply worldwide, to the point of restricting veterinarians from even ordering the medication. Preventing babesiosis means treating dogs and their environments to limit tick exposure."

He said that many prescription and non-prescription flea and tick prevention medications as well as yard treatments like Diatomaceous Earth and chemical preparations are available.

"This can be a difficult, expensive and frustrating task, as ticks eventually can become resistant to most products. To stop the spread of babesiosis, infected dogs should be treated with a full course of antibiotics."

Even after a dog recovers, he or she may still carry the disease. Females who have had the disease, even healthy-appearing ones, should not be bred. Adopting puppies from previously infected dogs or dogs with an unknown infection history is risky. Puppies are more likely to die from it than adult dogs.

Woodring said that the good news is that dogs cannot transmit this to humans.
===============
[Canine babesiosis is a disease caused by the intra-erythrocytic protozoan parasites _Babesia canis_ and _Babesia gibsoni_. Babesiosis is transmitted by ticks to susceptible canine hosts. _Rhipicephalu ssanguineus_ is the most common tick vector in the United States. Splenectomized dogs, immunocompromised dogs and young dogs between the ages of 2 and 8 months are most susceptible to infection. Canine babesiosis occurs worldwide. Within the United States, it is most common in the southeast. Although canine babesiosis is considered uncommon in the U.S., it is of clinical significance due to its morbidity and mortality. It is an important differential when history and clinical signs are consistent with infection and other more common diseases have been ruled out.

Hemolytic anemia and hypotensive shock are typical clinical syndromes of infection. Hemolytic anemia results from direct erythrocyte damage by the parasite, and both intravascular and extravascular immune-mediated destruction of red blood cells. Infection can produce thrombocytopenia, the mechanism of which consists of immune-mediated destruction and sequestration in the spleen. Physical examination reveals splenomegaly, lymphadenomegaly, fever and, less frequently, lethargy, vomiting, hematuria, and icterus. Hypotensive shock results from the release and production of vasoactive amines and cytokines which produce vasodilation. It most often occurs in puppies with the peracute form of the disease. Death may occur and is seen most often in _B. gibsoni_ infections and in puppies affected with _B. canis_ and _B.gibsoni_. Chronic infections, subclinical carrier states and atypical canine babesiosis may also occur.

Infection with _B. canis_ or _B. gibsoni_ is definitively diagnosed by demonstration of the parasites on red cells. Blood smears may be stained with Diff-Quik or preferably Wright's or Giemsa stain.

The most effective drugs used in the treatment of canine babesiosis include diminazene aceturate, phenamidine isethionate, and imidocarb dipropionate, which are not available or approved for use in the United States. Treatment of canine babesiosis in the U.S. is, therefore, mostly aimed at treating signs. The majority of babesia cases diagnosed in dogs in the U.S. are caused by the less virulent strains of _B. canis_, and dogs frequently recover from these infections naturally with supportive therapy. Clindamycin has been successfully used to treat canine babesiosis and may be considered in refractory or more severe and virulent infections.

Prevention of canine babesiosis is mostly aimed at controlling the vector. It is an important aspect since treatment is not always successful. The environment should be treated to decrease tick numbers, dogs should be treated to control tick infestations, and ticks should be removed from parasitized animals as quickly as detected.

Recently, a vaccine which minimizes the severity of infection was developed. The vaccine is reported to be 70 to 100 percent effective in diminishing the pathologic effects which typically ensue upon infection. The vaccine is currently available in Europe where canine babesiosis is a more common life-threatening disease.

Blood transfusion poses a significant risk to recipient animals; therefore, it is recommended that donor animals be tested for infection with babesia organisms. Splenectomy prior to testing significantly improves the likelihood of finding organisms in a blood sample from an infected donor.

Portions of this comment were extracted from:

Turks and Caicos Islands, a British Overseas Territory, may be located on the interactive HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/6007>. - ProMed Mod.TG]
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World Travel News Headlines

Date: Fri, 13 Dec 2019 16:41:23 +0100 (MET)
By Mariëtte Le Roux and Joseph Schmid

Paris, Dec 13, 2019 (AFP) - French commuters gritted their teeth for a ninth day of public transport strikes Friday, with unions vowing to keep up their protest against a pension overhaul through the holidays unless the government backs down.   Officials have said they are ready to negotiate, with Education Minister Jean-Michel Blanquer meeting teachers' representatives on Friday to try and stave off another day of class shutdowns.   "It was an intense and frank meeting... but we still need details, and maintain our call to strike on Tuesday," Stephane Crochet of the SE-Unsa union said.

Unions are hoping for a repeat of 1995, when they forced a rightwing government to back down on pension reforms after three weeks of metro and rail strikes just before Christmas.   The prospect of a protracted standoff has businesses fearing big losses during the crucial year-end festivities, and travellers worried that their Christmas plans may be compromised.   "Right now it's a catastrophe here, but we're hoping there will be a solution before Christmas," Frederic Masse, a foie gras producer at the huge Rungis wholesale food market south of Paris, told AFP on Friday.

The capital city was again choked by huge traffic jams as most metro lines remained shut, only a handful of buses and trams were running, and one in four TGV trains were cancelled.   "I'm sick of this, and I won't be able to keep working if it goes on," Zigo Makango, a 57-year-old security agent, told AFP onboard a bus in the Bobigny suburb northeast of Paris.   To get home at night Makango said he has to use taxis, but "my boss doesn't reimburse me for that".

- 'Historic reform' -
President Emmanuel Macron on Friday expressed his "solidarity" with people impacted by the strike, "but I want the government to continue its work" in forging a single pension system, a key campaign promise.   "It's a historic reform for the country," he told journalists at an EU summit in Brussels. 

The overhaul unveiled by Prime Minister Edouard Philippe would do away with 42 separate regimes, some of which offer early retirement and other benefits to public-sector employees such as train drivers, dockers and even Paris Opera employees.   But Philippe angered unions further by proposing a reduced payout for people who retire at the legal age of 62 instead of a new, so-called "pivot age" of 64.

They have called for new mass demonstrations for next Tuesday, the third since the action started on December 5 in the biggest show of strength in years by France's notoriously militant unions.   Philippe insisted on Twitter that "My door is open and my hand outstretched".   But Laurent Brun of the hard-line CGT union, the largest among public-sector workers including those at rail operator SNCF, has already warned "There won't be any Christmas truce" unless the government drops the plan entirely.

- France divided -
A poll released Thursday by the Elabe institute found France evenly divided on Philippe's plan, with 50 percent for and 49 percent against.  But 54 percent rejected the mooted 64-year cutoff for a full pension, and 54 percent supported the protest.

Staff at four of France's eight oil refineries were on strike Friday, affecting output and raising fears of shortages down the line.   And both Paris operas, the Garnier and the Bastille, again cancelled Friday performances and others through the weekend.   Macron's government insists the changes will make for a fairer system and help erase pension system deficits forecast to reach as much as 17 billion euros ($19 billion) by 2025.   The average French person retires at just over 60, years earlier than most in Europe or other rich OECD countries.
Date: Fri, 13 Dec 2019 14:05:22 +0100 (MET)

Milan, Dec 13, 2019 (AFP) - More than 300 flights were cancelled Friday in Italy due to a planned one-day strike by workers from Alitalia and Air Italy.   Alitalia said in a statement that 315 flights were cancelled on Friday, with another 40 cancelled Thursday night and Saturday morning. It was not immediately clear how many flights were cancelled at Air Italy.   The 24-hours strike, which involves pilots, flight attendants and ground personnel, was called by three unions to draw attention to what they called "the ongoing crisis at Alitalia and Air Italy."

The strike was felt most in Sardinia, with about 30 flights cancelled.    Money-losing Alitalia has been under special administration since 2017 when employees rejected a restructuring plan that would have laid off 1,700 workers out of an approximately 11,000.   The government has so far looked for buyers without success.    Unions plan to meet on Tuesday with Economy Minister Stefano Patuanelli.    A potential consortium of buyers for the ailing carrier fell apart last month after Atlantia, which operates Rome's airports, pulled out.
Date: Fri, 13 Dec 2019 05:24:44 +0100 (MET)
By Neil SANDS

Wellington, Dec 13, 2019 (AFP) - Adventure tourism is a key part of New Zealand's international appeal but the White Island volcano eruption is a tragic reminder that such activities carry genuine risk that must be better explained to travellers, experts say.   The South Pacific nation offers a wealth of adrenaline-fuelled pursuits, from heli-skiiing on snow-capped mountains to ballooning and blackwater rafting through caves.

Some, such as bungee-jumping, jet-boating and zorbing -- where you hurl yourself down a hill inside an inflatable ball -- were invented or popularised in a country that prides itself on catering to intrepid visitors.   The tourism industry as a whole is among New Zealand's biggest earners, generating about NZ$16.2 billion ($10.7 billion) and attracting 3.8 million international visitors annually.     "Adventure tourism is a massive sector in New Zealand. We are promoting ourselves as the adventure capital of the world," professor Michael Lueck, a tourism expert at Auckland University of Technology, told AFP.

New Zealand is also renowned for its rugged landscapes, which feature prominently films such as Kiwi director Peter Jackson's "Lord of the Rings".   Day-trips to White Island combined both, taking tourists including cruise ship passengers to a desolately beautiful island off the North Island coast where they could experience the thrill of standing on an active volcano.   Instead, at least 16 people are believed to have died and dozens suffered horrific burns when 47 tourists and guides were caught on the island during Monday's eruption.

The disaster has raised questions about why tourists were allowed on a volcano where experts had recently raised threat levels, as well as broader issues about the regulation of risky activities in the tourism sector.   "There will be bigger questions in relation to this event," Prime Minister Jacinda Ardern told parliament after the eruption.   "These questions must be asked, and they must be answered."

- 'Slapdash' or world's best? -
The disaster on White Island -- also known as Whakaari -- is not the first mass-fatality accident to affect tourists in New Zealand.   In 2015, seven people were killed when a scenic helicopter flight crashed into Fox Glacier. Two years earlier, a hot-air balloon claimed 11 lives and in 2010 nine died when a plane carrying skydivers plunged into a paddock.

Briton Chris Coker's son Brad, 24, died in the skydive plane crash and since then he has campaigned from afar for tighter regulations in New Zealand's adventure tourism sector.   "In my opinion, the New Zealand authorities... are still slapdash about tourist safety," Coker told news website stuff.co.nz after the White Island eruption.   "To run tourists there is insane. I know they signed a waiver and so on, but it's not really taking care of people."

Trade body Tourism Industry Aotearoa disputes such assessments, saying operators are "working within a world's best regulatory framework", but could not eliminate risk completely.   "Operators put safety first, but adventure activity inherently carries some risk and it's critical that 'adventure' remains in adventure tourism," TIA chief executive Chris Roberts told AFP.   "Operators take all practical actions to minimise the risks and the safety culture of individual operators remains the key factor in preventing accidents."

Roberts said the issue was not tourism operators, but the alert system they relied on at volcanic destinations such as White Island, which attracts about 17,000 visitors a year.   The GeoNet monitoring agency raised White Island's threat level in the week before the eruption but also advised current activity "does not pose a direct hazard to visitors".   "The reviews need to look at the science and specifically the guidance provided about volcanic activity, and whether the operating practices followed for the past 30 years need to change," Roberts said.

- 'Understand the risks' -
Travel companies such as White Island Tours brief customers before setting off and require them to sign a waiver declaring they understand the risk, as well as supplying equipment such as hard-hats and gas masks.   However, some relatives of those affected by the eruption have expressed scepticism that their loved ones truly appreciated the potential danger they faced.   Options for legal redress are limited under New Zealand's Accident Compensation Commission scheme, which covers victims' medical bills and provides modest compensation but does not allow civil suits for damages.

Neither Roberts nor Lueck expected the White Island eruption to hit international arrivals in New Zealand, which have continued to climb despite major earthquakes in 2011 and 2016.   The nature of any review arising from White Island remains uncertain, but Lueck said at the very least tourists needed to be better informed about any risks.   "Operators and tourism boards should have tourists understand what these risks are, and not brush over quickly signing a waiver," he said.   "Only then can tourists make an informed decision and decide whether or not they want to take that particular risk."
Date: Thu, 12 Dec 2019 21:25:36 +0100 (MET)

Kinshasa, Dec 12, 2019 (AFP) - Twenty-three cases of Ebola have been recorded in four days in eastern Democratic Republic of Congo, where deadly violence is hampering efforts to end the 16-month-old epidemic, authorities said on Thursday.   Ten cases were recorded on Tuesday alone in Mabalako in North Kivu province, after six on Monday, according to the Multisectoral Committee for Epidemic Response (CMRE).   Three out of the six were practitioners of traditional medicine, it said.

On Wednesday, three cases were recorded in North Kivu, including one in the Biena neighbourhood -- which has had no new Ebola cases for the last 85 days.   More than 2,200 people have died since the epidemic was declared on August 1, 2018.   As of November 22, the rate of new cases had fallen to 10 per week.   CMRE said "security reasons" -- attacks on Ebola health workers and sites by armed groups and angry youths -- had "paralysed" work in the key zones of Beni, Biakato and Mangina.   The attacks led to a pullout of locally-employed Ebola workers in Biakato by the UN's World Health Organization (WHO) and Doctors Without Borders (MSF).
Date: Thu, 12 Dec 2019 15:59:23 +0100 (MET)

Juba, Dec 12, 2019 (AFP) - Devastating flooding in South Sudan following a fierce drought could tip parts of the country into famine in the next few months, the World Food Programme (WFP) warned on Thursday.   According to the UN refugee agency nearly one million people were affected by floodwaters that submerged entire towns, compounding an already dire humanitarian situation after six years of war.

The WFP said that 5.5 million people are expected to be going hungry in early 2020 -- the time at which the population is generally benefiting from their harvest in October and November of the previous year.   An earlier harvest failed due to drought. This time crops have been washed away.    "The number of people in need is likely to increase because of the catastrophic level of destruction caused by floods since October following a drought that hammered parts of the country earlier in the year," the agency said in a statement.

The floods wiped out 73,000 metric tons of potential harvests as well as tens of thousands of cattle and goats, said the WFP.   "We know the problems that we've been having in South Sudan, but the rains and the floods have led to a national disaster and are much worse than anyone could have anticipated," said WFP Executive Director David Beasley.    "In fact, if we don't get funding in the next few weeks and months, we are literally talking about famine. We need support, we need help and we need it now."   The agency estimated its needs at $270 million (242 million euros) for the first half of 2020.   South Sudan declared a "man-made" famine affecting around 100,000 people in 2017. 

The term "famine" is used according to a scientific system agreed upon by global agencies, when at least 20 percent of the population in a specific area has extremely limited access to basic food; acute malnutrition exceeds 30 percent; and the death rate exceeds two per 10,000 people per day for the entire population.   "Famine in South Sudan was defeated after four months in 2017 by a concerted large-scale humanitarian response," said the WFP.   "Experts now say the country's food security outlook has never been so dire."   Political instability is also high as President Salva Kiir and his rival Riek Machar have again delayed their formation of a power-sharing government, this time by 100 days until February 2020.
Date: Wed, 11 Dec 2019 09:33:13 +0100 (MET)
By Holly ROBERTSON

Sydney, Dec 11, 2019 (AFP) - Up to 20,000 protesters rallied in Sydney on Wednesday demanding urgent climate action from Australia's government, as bushfire smoke choking the city caused health problems to spike.   Sydney has endured weeks bathed in toxic smoke as hundreds of blazes have raged across the countryside, with hospitals recording a 25 percent increase in the number of people visiting emergency departments last week.   On Tuesday smoke alarms rang out across Australia's biggest city, with thick haze triggering smoke alarms and forcing buildings to be evacuated, school children to be kept indoors, and ferries to be cancelled.   The devastating fires have focused attention on climate change, with scientists saying the blazes have come earlier and with more intensity than usual due to global warming and a prolonged drought.   Police estimated the crowd size at 15,000, organisers put the figure at 20,000.

Many of the protestors voiced anger at the government's silence in the face of the crisis.   "The country is on fire" said 26-year-old Samuel Wilkie attending his first climate protest. He described politicians' response as "pathetic".    "Our government is not doing anything about it," said 29-year-old landscape gardener Zara Zoe. "No one is listening, no one is doing anything."   Prime Minister Scott Morrison -- a staunch backer of Australia's vast coal industry -- has said little about the smoke since the crisis began, preferring to focus on fire-hit rural communities.   Organiser Chloe Rafferty said that had created anger at the conservative government's inaction.   "I think the wider public can see that we are not expecting the climate crisis in the future but we are facing the climate crisis now," she told AFP.   "People are experiencing it in their day-to-day lives."   As well as a rise in people visiting hospitals with smoke-related health symptoms, the number of emergency calls for ambulances spiked 30 percent last week.    "For most people, smoke causes mild symptoms like sore eyes, nose and throat," top health department official Richard Broome said.   "However, people with conditions like asthma, emphysema and angina are at greater risk because the smoke can trigger their symptoms."

Smoke from bushfires is one of the biggest contributors to air pollution in Australia, releasing fine particles that can lodge deep within people's lungs and cause "severe" health impacts over time, according to scientist Mick Meyer from government-funded scientific research agency CSIRO.   "The impact of smoke on people remote from the fires may, on occasion, substantially exceed the direct injury to people within the fire zone," he wrote in The Conversation.   "But we currently lack the operational tools to understand the extent of these impacts or to manage them."   Six people have been killed and more than 700 houses destroyed in bushfires this fire season.   Though the human toll has been far lower than the deadliest fire season in 2009 -- when almost 200 people died -- the scale of this year's devastation has been widely described as unprecedented.   Three million hectares (7.4 million acres) of land has been burnt -- the size of some small countries -- and vast swathes of koala habitat scorched.   Official data shows 2019 is on track to be one of the hottest and driest years on record in Australia.
Date: Tue 3 Dec 2019
Source: Trinidad Express [abridged, edited]

The number of local deaths from the influenza virus has risen to 24. At the Health Ministry's update last week, 16 fatalities were reported from the flu, with Health Minister Terrence Deyalsingh appealing to citizens -- especially those considered at-risk -- to get vaccinated.
Date: Sat 30 Nov 2019
Source: The New Indian Express, Express News Service [edited]

According to official data, 14 swine flu [influenza A/H1N1] deaths across the state were recorded this year [2019] till [17 Nov 2019]. The figure is slightly less than the previous year's [2018] toll of 17. The total number of H1N1 swine flu-positive cases [has] also come down this year [2019] compared with 2018 from 402 to 325. Health officials are setting up isolation wards in hospitals as a preventive measure.

As the winter season has set in and the minimum temperatures are coming down, health officials are instructing the public to take precautions in order to stay away from being infected by swine flu. The health department has initiated steps to set up district-[wide] swine flu testing facilities and isolation wards in every district hospital, area hospital, and community health centre.

As per the requirement of treatment procedure, the government has to set up special isolation wards in all government hospitals and provide protection kits to the healthcare staff, especially to those who will attend to the patients suffering from the flu. Across the state, Visakhapatnam registered the highest number of positive swine flu cases and deaths. Out of 325 positive cases, 180 alone were reported from Visakhapatnam, of which 8 died. West Godavari district registered 3 deaths, and Anantapur, East Godavari, and Srikakulam registered one death case each.

All the district health officials have been instructed to intensify awareness camps and screening centres. As part of the action plan, isolation wards with 5-10 beds are to be set up in every teaching, district, and area hospital. A sufficient stock of drugs, masks, and PPE [personal protective equipment] kits are to be made available. Currently, there are 18 labs eligible for conducting confirmation test in the state. "We are creating awareness by distributing pamphlets and putting up screening centres at bus stops and railway stations," DMHO [district medical and health officer] Dr. TSR Murthy said.

Symptoms of swine flu are generally similar to that of seasonal flu. These include cough, fever, sore throat, stuffiness, runny nose, body aches, headache, chills, fatigue, diarrhoea, and vomiting. Later on, breathlessness, chest pain, drowsiness, low blood pressure, sputum mixed with blood, and bluish discoloration of nails also develops.
Date: Thu 28 Nov 2019
Source: GDN Online [edited]

Two expatriates living in Oman died after contracting the seasonal influenza (H1N1) or swine flu in the governorate of Dhofar -- the 1st in July and the 2nd in August [2019]. They were among 78 confirmed cases of swine flu registered at the Sultan Qaboos Hospital over the first 9 months of 2019 in the governorate.

The hospital authorities reported a total of 599 registered suspected cases of H1N1 between January and last September [2019]. Doctors working at Sultan Qaboos Hospital dealt overall with 1779 cases of respiratory infections during the same period.

Patients most vulnerable to the respiratory viruses are those over 18 years, particularly pregnant women; those suffering from chronic illnesses, kidney and heart diseases, liver problems, diabetes, asthma, blood disorders, and HIV/AIDS; and even health workers, according to Muscat Daily.
Date: Wed 11 Dec 2019
Source: UNICEF/WHO Situation report 11 Dec 2019 [edited]

Highlights
- 5 new human cases reported in the past week
- In response to 1st human vaccine-derived poliovirus type 1 (VDPV1) case from the island province of Basilan, in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), outbreak immunization was conducted
in Maluso, Basilan, with bivalent oral polio vaccine (bOPV) against polio type 1, vaccinating 13 547 children under 10 years old (102% of the target).
- Currently 9 human cases confirmed with circulating VDPV type 2 (cVDPV2), 1 case with VDPV1, 1 case with cVDPV1, and 1 case with immunodeficiency-related VDPV type 2 (iVDPV2).
- A case with VDPV1 from Sultan Kudarat is pending genetic analysis; 1 case of cVDPV1 from Malaysia was confirmed as genetically linked to the Basilan case.
- Synchronized polio vaccination campaign conducted on [25 Nov 2019 - 10 Dec 2019] (including 2 days of extension) vaccinated 4 309 566 children under 5, which is 98% of the target total of 4.4 million children under 5. A total of 1 395 365 children under 5 were vaccinated in National Capital Region (NCR), which is 109% of the target, and 2 914 201 (94%) in Mindanao.
- DOH planning to conduct outbreak immunization with bOPV targeting 710,296 children under 10 in the Sulu Archipelago, Zamboanga City, and Lambayong, Sultan Kudarat, on [6-12 Jan 2020].
- Current polio outbreak resulting from persistently low routine immunization coverage, and poor sanitation and hygiene.
- Philippines is affected by both cVDPV1 and cVDPV2. cVDPV is considered a public health emergency of international concern (PHEIC).

cVDPV1
---------
- In response to the 1st human case confirmed with VDPV1 from Maluso, Basilan (BARMM), outbreak immunization was conducted in the area with bOPV for children under 10 years old, vaccinating 13,547 children under 10 years of age (102% of the target).
- A cVDPV1 case in Sabah state, Malaysia, was confirmed to be genetically linked to the Basilan case by the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Australia. Since the 2 viruses are genetically linked, they are both classified as circulating.
- A new VDPV1 case from Sultan Kudarat (Region XII) was confirmed on [6 Dec 2019] and is pending further genetic analysis.
- All 13 cVDPV1 environmental samples found in Manila are genetically linked.

cVDPV2
---------
- All 9 human cases and 17 environmental samples confirmed with cVDPV2 are genetically linked. All human cases were reported from Mindanao (BARMM and Region XII), whereas environmental samples were found in NCR and Davao.
- All samples were tested by the National Polio Laboratory at the Research Institute for Tropical Medicine (RITM), whereas sequencing and genetic analysis is done at the NIID in Japan, and additional genetic characterization is provided by the United States Centers for Disease Control and Prevention (CDC).
=======================
[Given the identification of the cVDPV1 case in Malaysia that is genetically related to the VDPV1 case in Basilan, it is now clear there are at least 2 separate cVDPV outbreaks in the Mindinao region of the Philippines: one of the outbreaks is associated with cVDPV2, and the other with cVDPV1 and one outbreak of cVDPV1 in the Manila Metropolitan area (although only environmental samples have been positive without AFP (acute flaccid paralysis) cases as yet.) What all these areas have in common is pockets of populations with suboptimal vaccination coverages. Clearly, we await further information on the genetic profiling of the newly identified VDPV1 case in Sultan Kudarat, also located in southern Philippines. Note that Basilan Island, Sultan Kudarat, and Sabah state in Malaysia, while all in the same general area, are not contiguous, each being on a different island. In. total, there are 11 cases of AFP in the Philippines that are attributable to infection with a VDPV.

A map showing the provinces in the Philippines can be found at

HealthMap/ProMED-mail map of the Philippines: