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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: 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."
22nd July 2017

- National. 7 Jun 2017. 1760 cases with 3 deaths from January-May 2017. Dengue fever cases recorded in the Lao capital city of Vientiane at a higher rate than other provinces in the country.

[Maps of Laos can be seen at
<http://healthmap.org/promed/p/146>. - ProMED Sr.Tech.Ed.MJ]
30th January 2017
A ProMED-mail post
<http://www.promedmail.org>

Laos
- National. 25 Jan 2017. Lao health authorities have admitted that the outbreak of dengue fever is higher this year [2017] compared to the same period in 2016. From [1 to 24 Jan 2017], 70 dengue fever infections have been recorded in Lao capital Vientiane, while in the same period last year [2016] there were no reports of any outbreaks, Head of Epidemiology Division under the Vientiane Health Department Chanthalay Sayavong said on [Wed 25 Jan 2017]. The news comes with 12 out of 18 provinces in the country reporting dengue fever at alarming epidemic levels though no deaths have been recorded from a total of 235 reported cases following a nationwide outbreak this year [2017], according to Lao state-run Vientiane Times.  <http://news.xinhuanet.com/english/2017-01/25/c_136012675.htm>

[Maps of Laos can be seen at
<http://healthmap.org/promed/p/146>. - ProMED Sr.Tech.Ed.MJ]
More ...

Central African Republic

Central African Republic US Consular Information Sheet
April 01, 2008
COUNTRY DESCRIPTION:
The Central African Republic is one of the world’s least developed nations and has experienced several periods of political instability since inde
endence from France in 1960.
Despite an on-going peace process and the presence of a democratically-elected government in the capital, Bangui, rebels still control large portions of the northern provinces in the country, and highway bandits prey on civilians and travelers in much of western CAR. In the country’s Dzanga-Sangha National Park in the southwest, facilities for tourists are being developed but remain limited. Read the Department of State Background Notes on the CAR at http://www.state.gov/r/pa/ei/bgn/4007.htm for additional information.
ENTRY/EXIT REQUIREMENTS:
A valid passport, visa, and evidence of yellow fever vaccination are required for entry. Travelers should obtain the latest information and details from the Embassy of the Central African Republic, 1618 22nd Street NW, Washington, DC 20008, telephone: (202) 483 – 7800/7801, fax: (202) 332 – 9893. Overseas, inquiries should be made to the nearest Central African Republic Embassy or Consulate. NOTE: In any country where there is no Central African Republic diplomatic mission, the French Embassy has authorization to issue a visa for entry into the Central African Republic.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
See the Department of State’s Travel Warning for the CAR.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Crime remains a significant problem in the capital, Bangui, though it has decreased notably in recent years. Americans should exercise caution while traveling around the city and immediate environs. Petty theft remains a problem in large market areas, particularly in the crowded markets near KM 5 on the outskirts of the city. Armed gangs may operate in outlying residential areas. During previous periods of civil unrest and civil conflict, including most recently in 2002 and 2003, foreign mercenaries and citizens engaged in widespread looting and damaged much of the city’s infrastructure. In the northern and western parts of the country, there are consistent reports of armed robbery and kidnapping by highway bandits (called “coupeurs de routes” or “zaraguinas”), especially during the December to May dry season. When a crime does occur in Bangui, the victim may have to pay to send a vehicle to pick up police officers due to the shortage of police vehicles and fuel.

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 are extremely limited in the CAR, and the quality of acute care is unreliable. Sanitation levels are low. Many medicines are not available; travelers should carry properly labeled prescription drugs and other medications with them.
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 CAR is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
In Bangui, road conditions vary, and many roads have large holes and degraded points that prevent the normal flow of traffic. Only a small portion of the roads in the country, including in the capital, are paved, and many of the compacted dirt roads have been degraded. Drivers tend to prefer to drive on the smoothest portion of the road and ignore basic traffic laws, thus slowing the flow of traffic and increasing the risk of collision. The city of Bangui does have a public transportation system consisting of green buses and yellow taxis, though these vehicles are often dangerously overcrowded and very badly maintained.
Due to the risk of armed attacks on motorists in the northern and western regions of the country, overland travel in these areas should be avoided.
Any driving outside the capital should be only during daylight hours.
Most remote areas in the CAR that are frequented by tourists are accessible only by four-wheel drive vehicles, although some roads are not passable at all during the rainy season, from May to October.
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 the Central African Republic, the U.S. Federal Aviation Administration (FAA) has not assessed the CAR’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Taking photographs of police or military installations, or any other government buildings, is prohibited. Unauthorized photography may result in the seizure of photographic equipment by CAR authorities. Police or other government authorities can provide information and grant permission for photographing a particular subject or location.
Corruption remains a serious problem among CAR security forces, some members of which have harassed travelers for bribes and small amounts of money. At night, the roads in the capital are often manned with impromptu checkpoints, at which police or other military members ask motorists and travelers for money.
Banking infrastructure remains limited in the CAR, and facilities for monetary exchange exist only in the capital. There are no ATMs in the CAR, and exchange bureaus normally accept dollars and euros but not West African Francs (CFA).

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Central African laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the CAR 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:
The U.S. Embassy in Bangui resumed operations in January 2005, following the evacuation of all American staff in 2002 during the civil conflict and looting in Bangui in 2002. The Embassy’s American presence increased in 2006, and a new American Ambassador to the CAR presented his credentials to President Bozize in 2007. Nonetheless, the Embassy continues to operate with limited staffing, and can only provide basic services to American citizens in the CAR.

Americans living or traveling in the CAR are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site so that they can obtain updated information on travel and security within the CAR. 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 Avenue David Dacko, B.P. 924, Bangui, tel: 2161-0200; fax: 2161-4494.
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This replaces the Country Specific Information for Cameroon dated December 21, 2007, to update sections on Traffic Safety and Road Conditions, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Sun 1 Sep 2019
Source: WHO Weekly Bulletin on Outbreaks and Other Emergencies, Week 35 [edited]

On 19 Aug 2019, the Institut Pasteur of Bangui (IPB), Central Africa Republic, reported a confirmed case of Rift Valley fever (RVF) in Bossembele health district, Boali sub-prefecture. The case-patient is a 45-year-old male farmer from Bogoin village who initially fell ill on 5 Aug 2019 and presented, on 8 Aug 2019, to the local health facility with fever, chills, headache, nausea, asthenia, myalgia, arthralgia and retro-ocular pain. As part of influenza surveillance, a blood specimen was collected on 9 Aug 2019 and transported to the IPB. Test results released on 19 Aug 2019 confirmed RVF infection by reverse transcriptase-polymerase chain reaction. As of 24 Aug 2019, the case-patient remained in admission in good clinical condition.

Outbreak investigations carried out by the rapid response team identified 7 additional suspected RVF cases from the same health district, 5 through records review in the local health facility and 2 by active case search in the affected community. A total of 12 blood specimens (5 from suspected cases and 7 from healthy control cases) were collected and are being analysed at the IPB; the test results are pending. The suspected cases, with ages ranging from 5 to 45 years, are being followed as outpatients.

Additionally, animal health investigations carried out in the affected community reportedly identified sick domestic animals (mainly cows and sheep), manifesting symptoms such as runny nose, cough and diarrhoea. A total of 21 blood specimens were collected from the sick animals (cows and small ruminants) and taken for laboratory analysis and the test results are pending.

Further epidemiological and entomological investigations are ongoing, and updates will be provided as new information becomes available.

Public health actions
The Ministry of Health is coordinating the response to the RVF outbreak through the emergency operations centre, with support from the health partners.

A multisectoral national rapid response team, comprising of both public and animal health specialists, and entomologists was deployed from 21-24 Aug 2019 to conduct in-depth outbreak investigation.

The epidemiological and laboratory surveillance have been enhanced, and healthcare workers have been oriented on the standard case definition for RVF to facilitate early case detection. Data collection and reporting tools have been distributed to the health facilities.

Case management is ongoing in the affected health district, with some suspected cases being managed as outpatients.

Risk communication activities using various channels are ongoing in the affected communities, however this needs to be enhanced.

Situation interpretation
Health authorities in Central African Republic have reported a new outbreak of RVF, the 1st time such an event has been formally reported in the country. Information on the circulation of RVF virus (RVFV) in Central African Republic is limited, partly due to gaps in the surveillance system, and specifically due to limited surveillance for RVF disease. Literature indicates that RVFV was 1st isolated in Central African Republic in 1969 from a pool of _Mansonia africana_ mosquitoes. However, a recent study in Central African Republic detected RVFV-specific antibodies in humans, and 15 strains [isolates] of RVFV were isolated from humans and sylvatic mosquitoes.

The current confirmation of RVF in the country should alert health authorities to strengthen surveillance for the disease and other zoonoses. Additionally, in-depth epidemiological and entomological investigations should be undertaken to properly understand the epidemiology of the disease and identify all potential vectors species in the country. The ongoing rainy season, running from May to October 2019, may result in increased [mosquito] vector density, constituting another risk factor for escalation of RVF.
======================
[It is interesting that this year (2019) it was a human case that signaled the presence of Rift Valley fever virus RVFV) in the country. The results of the subsequent field studies by the multidisciplinary rapid response team found additional human cases and evidence that the virus is being transmitted to livestock.

Finding evidence of RVF virus in the Central African Republic (CAR) is not surprising. Last year (2018), human and animal cases occurred in neighboring South Sudan (see Valley fever - South Sudan (09): (EL) human, animal, WHO http://promedmail.org/post/20180410.5735975). If focal geographic areas of transmission are identified in this CAR situation, increased surveillance of people and livestock should be initiated and livestock vaccination considered. RVF-infected livestock can pose a significant risk to humans in contact with them, often livestock owners and veterinarians. Abortions in livestock with a loss in productivity present an economic problem for many ethnic groups that depend on them for livelihoods. Apparently, this RVF outbreak did not result in an abortion storm that could have had serious economic, social and public health consequences. It is likely that RVF virus will persist in this area in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods of time and hatch when flooded during future rain events, with subsequent emergence of infected females ready to transmit the virus. This risk provides justification for maintaining livestock of the area well vaccinated into the future. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Central African Republic: <http://healthmap.org/promed/p/66>]
Date: Fri 1 Feb 2019
Source WHO Weekly Bulletin on Outbreaks and Other Emergencies [edited]

During the period 2 Mar 2018 - 27 Jan 2019, 34 cases of monkeypox, of which 25 are confirmed, have been reported to the WHO. There have been 2 deaths.

Since 2 Oct 2018, clusters of cases have been identified across 3 health districts, namely; Mbai-ki district with 9 cases including 8 confirmed, Bangassou district with 5 cases including 3 confirmed, and Bossembele district with 4 cases including 3 confirmed. One death was reported in Bossem-bele. Previous clusters have occurred in 3 districts: Bangassou (weeks 9-11, 9 cases including 6 confirmed), Bambari (weeks 13-16, 15 cases including 3 confirmed) and Mbaiki (weeks 26-27, 5 cases including 2 confirmed).
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[ProMED-mail has been reporting sporadic cases of monkeypox (MPX), which are not new to the Central African Republic (CAR). Since 2013, CAR has been experiencing at least one MPX outbreak every year, especially in its eastern region. The case fatality rate continues to be very low.

Prevention of MPX virus infections will not be possible without knowing the source of infection. The question remains about the source of these recent infections within Nigeria, Cameroon, Liberia, and more recently in CAR. Monkeys are not the reservoirs of the virus, despite the name that the virus has received.

One wonders whether there is an MPX virus epizootic going on in rodent hosts across a relatively wide geographic area in CAR and the other affected countries. Studies of prevalence of MPX virus in populations of rodent hosts are not mentioned in this or in previous reports. The main reservoirs of MPX virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp., an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_. Halting the bushmeat trade and consumption of wild animals to halt MPX virus exposure will be culturally and economically difficult, so continued occurrence of cases can be expected.

The MPX virus clade involved in this outbreak and previous ones is not mentioned. As noted in previous ProMED-mail posts, the monkeypox virus clade in the Congo Basin causes more severe disease in humans -- with a case fatality rate of 11-17 percent -- than the clade in Ghana, which causes few fatalities. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Central African Republic: <http://healthmap.org/promed/p/66>]
Date: Mon 3 Dec 2018
Source: Outbreak News Today [edited]

In a follow-up to the hepatitis E outbreak in Bocaranga-Koui Health District, Central African Republic, since late October 2018, 67 new cases of acute jaundice syndrome were reported, of which 51 were confirmed with hepatitis E virus infection. As of 23 Nov 2018, a total of 119 cases of acute jaundice syndrome were recorded, including 2 deaths (case fatality ratio, 1.7%). Of the 119 cases, 80 (67%) have been confirmed positive for hepatitis E virus infection by the Institut Pasteur Bangui. The outbreak has largely been localized to Bocaranga City.

The outbreak of hepatitis E was declared by the Minister of Health on 2 Oct 2018. Epidemiological investigation revealed that the 1st suspected cases emerged in July 2018. Health officials report an increasing trend being observed lately.

Hepatitis E infection is found worldwide. The virus is shed in the stools of infected persons and enters the human body through the intestine. It is transmitted mainly through contaminated drinking water. Usually the infection is self-limiting and resolves within 2 to 6 weeks. Occasionally a serious disease, known as fulminant hepatitis (acute liver failure) develops, and a proportion of people with this disease can die [especially pregnant women - ProMED Mod.LL].

According to WHO, every year, there are an estimated 20 million hepatitis E infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E, and 56 600 hepatitis E-related deaths.
======================
[Hepatitis E is found worldwide, and different genotypes of the hepatitis E virus determine differences in epidemiology. For example, genotype 1 is usually seen in developing countries and causes community-level outbreaks, whereas genotype 3 is usually seen in developed countries and does not cause outbreaks. Acute epidemic hepatitis E is attributable to infection with hepatitis E virus genotypes 1 and 2. Many of the deaths are in pregnant women, characteristic of genotype 1.

The highest seroprevalence rates (number of persons in a population who test positive for the disease) are observed in regions where low standards of sanitation increase the risk for transmission of the virus.

Ouham-Pende is one of the 16 prefectures of the Central African Republic (<https://en.wikipedia.org/wiki/Ouham-Pend%C3%A9>). Located in the west of the country, its capital is Bozoum. In the north it has a border with Cameroun and Chad. In the south is the prefecture Ombella-Mpoko; in the southwest, the prefecture Nana-Mambere; and in the east, the prefecture Ouham. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Central African Republic: <http://healthmap.org/promed/p/66>]
Date: Thu, 6 Dec 2018 06:36:12 +0100
By Charles BOUESSEL

Bangui, Central African Republic, Dec 6, 2018 (AFP) - The line of parents waiting to see doctors stretches back outside the hospital into the dusty courtyard. Mums and dads carrying weak, starving children. Many hanging limply in their arms like half empty sacks of rice.  The scene at the paediatric complex in Bangui, capital of Central African Republic, is not dissimilar to a war zone.

And as conflict tears through the country, people here are desperately fighting another deadly foe: hunger.   In a doorway, a young girl stands with the round shape of her belly protruding out above her skinny legs.   A few metres away another malnourished girl sits barefoot, joints protruding, with shoulder blades poking out of her skin like blades, a baggy top the only clothing to cling to her perished frame.   "Central African Republic is one of the most difficult countries to be a child," Donaig Le Dru, UNICEF spokesperson in CAR, told AFP.

The statistics underline the horrors that stalk childhood in the country.   Infant mortality in CAR is the highest in the world, according to the UN.    One in 24 children die in the first 28 days of life.   The number of children with severe or acute malnutrition rose from around 32,000 to 43,000 between 2014 and the end of 2018.   And two out of three children -- 1.5 million youngsters in total -- are in need of humanitarian assistance, according to UNICEF.   The UN's World Food Programme warned last month that CAR was facing the worst situation of food insecurity in four years, with nearly two million people in urgent need of food aid.


- 'More dangerous for children' -
Civil unrest has lacerated this impoverished but mineral-rich country for years, leaving the economy in tatters and causing misery for those caught in the violence.    In a report released last month, the UN expressed alarm over a "sharp increase in fighting" and said "life may be even harder and more dangerous for children" than it was at the height of the last outbreak of civil war five years ago.    One of the world's poorest countries, the CAR spiralled into bloodshed after longtime leader Francois Bozize was overthrown in 2013 by a predominantly Muslim rebel alliance called the Seleka.

Nominally Christian militias called the anti-Balaka emerged in response, accelerating a cycle of sectarian violence.   France intervened militarily from 2013 to 2016 to push out the Seleka, winding down the operation after Faustin-Archange Touadera was elected president.   Touadera governs today with the support of a large UN peacekeeping operation. But most of the country is controlled by ex-rebels and militias, many of them claiming to act as guardians for the Muslim or Christian communities.

- Severe malnutrition -
The Bangui hospital is just a few kilometres from the mainly Muslim PK5 district -- an area that has become a flashpoint in the troubled country.   But just five paediatricians work here, struggling with limited equipment or support eked out of the creaking healthcare system.   Inside the hospital, a group of parents and children stare at a malnourished girl crying during what has become a daily routine -- being weighed on scales in a large blue bucket.   One by one, the children are lifted onto the scales as other emaciated infants and parents look on, waiting their turn.

In the overcrowded hospital grounds, a father called Theodore hugs his young daughter who is suffering from malnutrition.   His wife is in hospital after having a nervous breakdown, he says, after the couple's first child died. He struggles to earn enough money to buy food.   In general, children are hospitalised for a little over a week until their weight recovers.   But not all survive, with some losing the fight against severe malnutrition or disease -- the lasting consequences of violence and poverty in a nation wracked by conflict.
Date: Wed 24 Oct. 2018
Source: Xinhua News Agency [in French trans. Corr.SB, edited]

On [Tue 23 Oct 2018], the Central African Minister of Health and Population, Pierre Some, formally recognized the existence in the Central African Republic city of Bocaranga ([Ouham-Pende prefecture] in the extreme north west) of a case of yellow fever, whose signs were discovered in a woman aged 80 and confirmed by the Pasteur Institute of Bangui.

As a result, Mr Somse announced the strengthening of epidemiological surveillance in the locality and response measures that have benefited from the support of the World Health Organization (WHO), the Pasteur Institute of Bangui, and the NGO CORDAID [Catholic Organization for Relief and Development Aid].

These measures, he added, include immunization, patient care, and community outreach to improve hygiene and sanitation.

Mr Somse urged residents of so-called risk areas or forest areas to sleep under impregnated mosquito nets. He also advised people in these areas to immediately refer all people with yellow fever indications to health centres.

He described yellow fever as responsible for a mortality rate of between 25 and 50 percent of proven cases, manifested by jaundice caused by a virus. The disease, which is transmitted to humans through mosquitoes, he added, has a reservoir in primates, like monkeys.  [Byline: Gao Ke, Yishuang Liu]
======================
[The situation of yellow fever (YF) remains worrying in Africa, particularly in Central Africa. Yet, there is an effective vaccine, available, and well tolerated; a single dose of the vaccine protects against the disease for life.

Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The term "yellow" refers to jaundice presented by some patients.

A big epidemic of YF had broken out in the DRC in June 2016. This epidemic was the subject of much ink: it was declared over in February 2017, after more than 6 months without new cases; it occurred following cases of YF in Angola; there was a shortage of vaccines; the usual dose had been divided to cover needs.

In the face of this epidemic in CAR, an epidemiological survey must be carried out, an anti-vector control must be undertaken, as well as a response vaccination. - ProMED Mod.BM]

[It would be of interest to know which mosquito vector species were involved in YF virus transmission in this small outbreak. If mosquito species that transmit YF virus in urban/suburban settings are present there is a risk of ongoing transmission and a significant outbreak. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Central African Republic:
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World Travel News Headlines

Fri 11/10/2019 14:43
WorldHealthOrganizationNews@who.int

Attributable to the Federal Ministry of Health in Sudan, WHO and UNICEF

KHARTOUM, 11 October 2019 -  "Sudan has launched an oral cholera vaccination campaign in response to the ongoing outbreak of cholera. More than 1.6 million people aged one year and above in the Blue Nile and Sinnar states will be vaccinated over the coming five days.  “The announcement of the Federal Ministry of Health in Sudan on the cholera outbreak last month allowed national and state authorities, and health partners, to act quickly and respond to the outbreak.

“Since the announcement on 8 September, 262 cases of suspected cholera and eight related deaths have been reported as of 9 October in the Blue Nile and Sinnar states. No cholera-related deaths have been reported since mid-September. “The vaccines were procured and successfully shipped using funding from Gavi, the Vaccine Alliance. In addition, Gavi is providing nearly US$ 2 million to cover operational costs for the campaign.

“We joined efforts to respond as quickly as possible to contain the current outbreak of cholera and prevent it from spreading further in Sudan. The vaccination campaign kicking off today in combination with other measures including scaling up water, sanitation and hygiene activities, enhancing surveillance, prepositioning supplies and case management, will help protect people who are at highest risk.

“The first round of the campaign will conclude on 16 October and will be followed by a second round in four to six weeks to provide an additional dose to ensure people are protected for at least the next three years.  “As part of the campaign, over 3,560 vaccinators, more than 2,240 social mobilizers, and almost 70 independent monitors have been trained and deployed to the two affected states.”
Date: Sun, 20 Oct 2019 21:29:49 +0200 (METDST)

Paris, Oct 20, 2019 (AFP) - French rail services ground to a halt in parts of the country Sunday as workers walked off the job for a third day in a dispute over train staffing levels, stranding holiday travellers.   Services in the Paris suburbs, the northeastern Champagne-Ardenne region and the southern Occitanie region, which includes Toulouse and Montpellier, were particularly affected.   The state railway company SNCF said most services would return to normal on Monday.

The industrial action began on Friday after a train in north-eastern France slammed into a truck at a level crossing, injuring 11 people.  The train driver was himself among those hurt but being the sole employee of state railway company SNCF on board had to help take care of passengers.   Unions said the incident highlighted understaffing on trains, notably the absence of ticket inspectors on some lines.

Since Friday, staff have been exercising their "right to withdraw" their labour -- a clause that allows workers to walk off the job in case of "clear and present danger to their life or health".   SNCF's management has accused the workers of abusing that right on a busy weekend for train travel, at the start of the mid-autumn school holidays.   It argues that some train lines have not had ticket inspectors for decades.
Date: Sun, 20 Oct 2019 17:53:19 +0200 (METDST)

Frankfurt am Main, Oct 20, 2019 (AFP) - Cabin crew at four Lufthansa subsidiary airlines staged a day-long strike Sunday, causing dozens of cancellations at German airports in a battle for better pay and conditions.   The walkout, called by the UFO cabin crew union, was initially set to last from 5:00 am until 11:00 am (0300-0900 GMT) but a worsening spat with Lufthansa bosses prompted the union to extend the strike until midnight.

The industrial action at Eurowings, Germanwings, SunExpress and Lufthansa CityLine led to over 100 flight cancellations, mainly hitting short-haul journeys at Hamburg airport, Munich, Berlin-Tegel, Cologne and Stuttgart, according to DPA news agency.   Frankfurt airport, the country's busiest, reported "only a few" cancellations, affecting CityLine flights.

In a statement, UFO said it had ramped up the strike after the Lufthansa group told employees the walkouts were "illegal" and "endanger your jobs".   "This is not only wrong, it also signals the next level in the threats against cabin crew colleagues," UFO said. "This behaviour must be stopped."   But the Lufthansa group downplayed the impact of the strike, with a spokesman telling DPA that "more than 90 percent of the crew members showed up on time for their shift".

The union had previously called off plans for Lufthansa workers to join Sunday's warning strike after the company offered a surprise two-percent pay hike to flight attendants at the flagship airline.   But other demands for better conditions have yet to be met and UFO has not ruled out further action, with fresh talks at all five airlines scheduled for Monday.   Bosses at the Lufthansa group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.
Date: Sun, 20 Oct 2019 06:45:19 +0200 (METDST)

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

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

The capital Niamey was hit badly in September, with the waters of the Niger river -- the third biggest in Africa -- rising to a level not seen in more than 50 years and swamping parts of the city.   Last year, drought and flooding led to food shortages in a crisis which, exacerbated by jihadist violence, left more than 10 percent of the population needing humanitarian aid.   Niger, along with neighbouring Burkina Faso, Chad, Mali and Mauritania is also struggling against escalating attacks by armed Islamists.   According to the UN's human rights agency UNHCR, the Diffa region is home to almost 120,000 refugees and 109,000 internally displaced people.
Date: Fri, 18 Oct 2019 22:45:46 +0200 (METDST)

Washington, Oct 18, 2019 (AFP) - The US moved to further hurt Cuba's vital tourism industry by tightening the ability of the country's airlines to lease aircraft.   The US Department of Commerce said it was revoking existing licenses for US companies leasing aircraft to Cuban carriers, and will deny future applications for aircraft leases.   The move could make it harder for Cuba to service its rapidly growing tourism sector, a key source of foreign revenue for the poor country.

Washington has stepped up pressure on Havana due to its support for the embattled regime of Venezuelan President Nicolas Maduro.   "This action by the Commerce Department sends another clear message to the Cuban regime -- that they must immediately cease their destructive behaviour at home and abroad," Secretary of Commerce Wilbur Ross said in a statement.

It was not immediately clear how many aircraft the move would impact.   Cuba's cash-poor carriers depend on aircraft rented from leasing companies or other airlines, which are often very old.   In May 2018, 112 people died in the crash of a 39-year-old Boeing 737 leased by national carrier Cubana de Aviacion from a small Mexican firm, Global Air.

In June of this year, US President Donald Trump announced a US ban on cruise ship stopovers by Americans on the island, forcing Havana to cut its 2019 tourism target by 15 percent to 4.3 million visitors.   Nearly 900,000 tourists visited the island on cruise ships last year, and almost 40 percent were American, according to official figures.   The announcement Friday also expanded restrictions on imports from Cuba and on products with US content that can be sold to the country.
Date: Fri, 18 Oct 2019 15:43:29 +0200 (METDST)

Accra, Oct 18, 2019 (AFP) - Floods caused by eight days of torrential downpours in north-eastern Ghana have left 28 people dead and displaced hundreds, officials said Friday.     "At the moment the death toll is 28. About 640 people in some six communities have been displaced and we are providing shelters for them," George Ayisi, spokesman for the National Disaster Management Organisation, told AFP.    "We've counted about 286 collapsed houses during this disaster and that is making life difficult for the people."

Relief items were being transported 800 kilometres (500 miles) by road from the capital Accra to the affected region on the border with Burkina Faso as meteorologists warned the rains could last into November.    "We have to just prepare for anything," Ayisi said.   So far this year 46 people have been killed in floods in the West African nation, the disaster relief agency said.   Flooding in northern and other parts of Ghana happens each year during the rainy season.    Last year, 34 people died in northern Ghana during flooding caused by heavy rains and waters spilling from a dam in Burkina Faso.
Date: Fri, 18 Oct 2019 04:33:10 +0200 (METDST)
By Patrick FORT

Bobo-Dioulasso, Burkina Faso, Oct 18, 2019 (AFP) - "They've placed us in the red zone, which means the tourists aren't coming like before. Even the aid workers don't come," said Antoine Atiou, governor of Burkina Faso's Hauts-Bassins region.   The "red zone" refers to the risk of jihadist attacks -- a top-end warning by Western embassies to travellers wanting to visit southwest Burkina and the economic capital, Bobo-Dioulasso, once a popular tourist destination.   The impact has been brutal for local businesses. The city's hotels have emptied, its heritage sites are quiet and the souvenir shops shuttered.    "It's hard, hard, hard!... We haven't seen a tourist for a fortnight," said Sanou Moumouni, a guide at the city's mosque and in the historic Kibidwe district for 22 years.   In the past he could sometimes earn 100,000 CFA francs ($167, 150 euros) in two days, he said, but he has not made 5,000 francs in the last three months.    "I'm living on loans," he said. "We no longer have work because of the murderers. We're sick of it."    The north and the east of the landlocked country in West Africa endure frequent Islamist attacks, which have claimed some 600 lives in the past four years. There have also been some raids in the west.

In December 2018, an Italian man and his Canadian companion were kidnapped on the road from Bobo to the capital Ouagadougou. Last April, the Burkinabe government said it had information that the couple was still alive, but might have been taken to another country.   Bobo-Dioulassou itself has been relatively spared as the jihadist threat expands across poor nations of Africa's Sahel region.   Ministry of tourism statistics from 2017 show that of about half a million annual visitors to Burkina Faso, fewer than 150,000 came from abroad -- down 5.6 percent from 2015.   The number of nights stayed in the country by Westerners fell from 30,000 in 2012 to fewer than 15,000 in 2017. "This trend has probably sped up in 2018 and 2019," a local tour operator said.

- Crafts and wonders -
Renowned for its traditional masks, its batik print textiles and the balafon -- a West African instrument like a xylophone -- Bobo attracted thousands of Western tourists.   The Lonely Planet guide, which notes the security situation currently prohibits travel, says the city's "tree-lined streets exude a languid, semitropical atmosphere that makes it a favourite rest stop for travellers", adding that highlights include a "thriving live-music scene and excellent restaurants". 

The city itself has an array of charms, with its grand railway station, bustling market and striking Great Mosque -- an undulating white-plastered mud structure studded with wooden poles that dominates the historic centre.   Bobo-Dioulasso is a jumping-off point to visit regional highlights like the ruined fortress of Loropeni, a UNESCO World Heritage Site. It was also a base for exploring the Dogon country in Mali, Ivory Coast and Ghana.   "Everyone came through Bobo. We really were a tourist region. Now it's over," said Benjamin Ouedraogo, owner of the Watinoma hotel and president of the professional association of hotel and restaurant owners in High Basins.   He said hotels in the region only do a third of the business they did before the attacks   To avoid closing his hotel, Ouedraogo took on a second job in the building trade. "We asked for help, but state aid is a disaster," he said, explaining that the authorities rejected applications for tax rebates and preferential tariffs on water and electricity.

- 'We subsist' -
In Kibidwe, an old neighbourhood of the city near the mosque, children play in alleys and women wash clothes in the open air, but most of the shops that catered for tourists are now shut.   Sanon Bissiri, an artist, was quick to bring out his batik prints on spotting Western journalists.    "I don't hang them every day any more, that's pointless. Since July, I haven't even sold two. All this because of those jihadists. Now I have to do masonry whenever I'm wanted."   Bissiri used to sell his textiles to an Italian association that made regular visits.   "That's over. We just get by. It's my wife who meets our needs," he said. "I come in to work each day on foot, six kilometres (nearly four miles). I can't afford medicine for my son with his cough."   Bobo's nightlife is not what it was, though the locally-brewed beer is the same.    "There's still a little activity with Burkinabe visitors," said musician Gaoussou Ben Sanou. But "there's less money, fewer dates, fewer gigs. We can't sell records".   Governor Atiou said people were reluctant to go out.   "All that weighs on economic activity. Unfortunately, this is the aim of the terrorists."
Date: Thu, 17 Oct 2019 12:37:14 +0200 (METDST)

Manila, Oct 17, 2019 (AFP) - Five people were killed and dozens were injured after a powerful earthquake hit the southern Philippines, authorities said Thursday.   The 6.4-magnitude quake struck the Mindanao region on Wednesday night, reducing dozens of houses to rubble on the southern third of the Philippines.   On Thursday afternoon, authorities said five people were killed and 53 injured, mainly in a cluster of small farming towns.   Three people were killed in landslides while another was crushed by the collapsed wall of a house. The fifth suffered a fatal heart attack, the National Disaster Risk Reduction and Management Council said.   No fatalities were reported in Mindanao's major cities. Local authorities had earlier told AFP three children were among the dead.   The Philippine seismology office has recorded more than 300 weaker aftershocks in the area since the big quake, but authorities said they do not expect the toll to rise significantly.

The disaster council's spokesman Mark Timbal told local television it had not received any reports of missing people from any of the quake-hit areas.   "People have returned home... They are OK now, unlike last night when they were terrified and slept on roads beside their homes," Zaldy Ortiz, civil defence officer of Magsaysay town, told AFP.   Local school and government holidays were announced in Magsaysay, where the landslides struck, to allow building inspectors to check structures for damage, Ortiz added.   Power was being restored in the bigger cities, but there was substantial damage to some hospitals, government buildings, schools, churches and houses in the small towns, the council said in a report.   In General Santos City, firefighters on Thursday finally put out a blaze that started at a shopping mall shortly after the quake.   The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.
Date: Thu, 17 Oct 2019 05:32:08 +0200 (METDST)
By Tom LITTLE

Kulusuk, Denmark, Oct 17, 2019 (AFP) - Kayaking past blue-white icebergs drifting along near a pristine harbour, wandering around colourful houses or trekking in the snow-capped wilderness: July and August are high season for tourists in eastern Greenland.   Many of the 85,000 tourists who visit each year head to the west coast, but eastern Greenland, with its glaciers, wilderness and wildlife starring whales and polar bears, is also drawing visitors.

Sarah Bovet, a 29-year-old Swiss artist, said it's hard to know what to expect.   "Thinking you're going to be surprised, you are even more so in reality," she said standing outside a hostel in the tiny village of Kulusuk.   Bovet was on an artistic residency in Greenland when she visited Kulusuk and its 250 souls.   Although she had imagined a small village before arriving, its stunning views and bright colours still came as a surprise.   With just one supermarket, an airport built in the 1950s by the US military to serve a Cold War radar base, and a harbour surrounded by brightly painted wooden houses, most of the villagers appreciate the extra revenue from tourism.

Justus Atuaq, a young hunter in Kulusuk, takes tourists out on sled tours in March and April -- the spring high season -- earning money that helps him feed and care for the dogs he uses for racing and hunting.   "Now I can take dogsleds for hunting, and sometimes tourists coming from other countries also want to dogsled," he said outside his wooden house.   Tourists also take boat trips during the summer high season from July to August.   Arrivals to the island grew 10 percent year-on-year from 2014 to 2017, and three percent in 2018, according to the tourist board, Visit Greenland.   Many adventure seekers and nature lovers arrive by plane, but cruise ships also bring admirers, hugging the picture perfect coastline.

- Growing strategic importance -
But they are not alone in taking an interest in the world's largest island.   The Danish territory's rich natural resources and growing strategic importance as the Arctic ice sheet melts have attracted the attention of US President Donald Trump.   The Arctic region has untapped reserves of oil, gas and minerals, as well as abundant stocks of fish and shrimp.   In August, Trump offered to buy Greenland, then called off a visit to Copenhagen over its refusal to sell.

Denmark colonised Greenland in the 1700s, granting it autonomy in 1979.    Today, many Greenlandic political parties advocate full independence.   The territory still receives an annual subsidy from Copenhagen, which was 4.3 billion Danish kroner (576 million euros) in 2017, and tourism could help it to become economically self-reliant.   Like many parts of Greenland, Kulusuk has no tarmac roads and visitors must travel by plane or boat.   The growth in tourism could put a strain on the village's infrastructure, and the sector faces unique challenges given Greenland's location, weather and the cost of travelling there.

Day tours of Kulusuk with flights from the Icelandic capital Reykjavik are 97,000 Icelandic kronur ($780, 700 euros).   Jakob Ipsen, a 48-year-old who grew up between Denmark and Greenland's west coast, runs Kulusuk's sole hotel.   The 32-room hotel stands beside a fjord, and from its dining room, guests can watch icebergs drift by during the summer.    But the region's isolation can be problematic, Ipsen admits.    "We have to get all our supplies in with the first ship for the whole summer season, and for the winter season when everything is frozen over, we have to get all our supplies in with the last ship for the whole winter," he said.

- 'They go back as different people' -
Greenland must tackle its infrastructure challenges if it wants to develop tourism, Visit Greenland says.   Government-funded work is under way to extend runways at the capital Nuuk and Ilulissat, both on the west coast, and a new airport is planned in the south.   The tourist body said it would weigh the environmental impact of boosting infrastructure, both on the environment and on local communities.    Ipsen worries about the effects of uncontrolled tourism to the region.   "We want to try to maintain it as it is, so it's not exploding," he said.

Already, said Johanna Bjork Sveinbjornsdottir, who runs tours in Kulusuk for an Iceland-based company, the rise in visitor numbers is making itself felt.   "In the campsites here out in nature where you used to be alone, there's two, three groups at a time," she said.   Like Ipsen, she is also concerned about the effect that rising visitor numbers could have on the wilderness around the village.    "If you want nature to survive that, you have to build up the infrastructure," she said, pointing to the lack of officially designated campsites around Kulusuk, with no rubbish bins or toilets for travellers outdoors and no one supervising the sites.   Despite the concerns, Sveinbjornsdottir hopes visitors will keep coming.   "They go back as different people," she said. "Everything is beyond what you ever imagined."
Date: Tue, 15 Oct 2019 19:33:58 +0200 (METDST)

Beirut, Oct 15, 2019 (AFP) - Lebanon has turned to its neighbours for help battling forest fires that have ravaged homes and killed a volunteer firefighter in the Mediterranean country, its premier said on Tuesday.   Heavy rain fell on parts of the country including Beirut in the evening, after Cyprus dispatched help and as Greece and Jordan vowed to follow suit.   "We have contacted the Europeans who will send means of help," Prime Minister Saad Hariri said earlier in comments carried by national news agency NNA.

Dozens of blazes have hit Lebanon in recent days, fire chief Raymond Khattar told NNA, amid unusually high temperatures and strong winds.   Thick smoke had been seen drifting over the outskirts of Beirut, the mountainous Chouf region to its southeast, and the southern city of Saida.   In the Chouf, an area famed for its forests, a volunteer firefighter lost his life trying to put out the flames, his family said.   In an area south of Beirut, firefighters have for two days been unable to stop the blaze, which has burnt four homes to the ground and caused dozens to suffer breathing difficulties, NNA said.

Interior Minister Raya El-Hassan said nearby Cyprus and Greece had responded to Lebanon's call for help.   "Two Cypriot planes have been working to put out the fires since yesterday," she said on Twitter.   "Greece has responded to our request and will send two planes to help us," she added.   Jordan's army said the king had ordered two firefighting planes to be dispatched.   NNA said the army was working together with helicopters and the Cypriot planes to fight the blaze, with access sometimes impeded by thick smoke and high-voltage power lines.   Personnel from UN peacekeeping force UNIFIL, who usually patrol the country's southern border with Israel, have also joined in the efforts, the agency said.   Lebanese on social media criticised the government's apparent inability to respond fast enough on its own.

In neighbouring war-torn Syria, fires also killed two people, Syrian state media said.   Flames have ripped through parts of the coastal provinces of Latakia and Tartus, as well as the central province of Homs but most have been brought under control, state news agency SANA said.   Two members of the Latakia forestry department were killed while fighting the blaze, it added.   In Tartus, the fires -- mostly stamped out -- coincided with the olive harvest, the governor told SANA.   In Homs, trees were burnt and electricity networks disrupted in mountainous areas, the agency reported.