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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: 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:
Date: Thu, 19 Oct 2017 16:37:27 +0200
By Ricardo ARDUENGO, con Nelson DEL CASTILLO en San Juan y Leila MACOR en Miami

Utuado, Puerto Rico, Oct 19, 2017 (AFP) - It's been a month since Hurricane Maria ripped through Puerto Rico and Samuel de Jesus still can't drive out of his isolated, blacked-out town.   In fact, much of the US territory in the Caribbean is still a crippled mess four weeks after that fierce Category Four storm.

The bridge connecting Rio Abajo to the rest of the island was swept away when Maria slammed the island on September 20. For two weeks Rio Abajo, located in a mountainous region in central-western Puerto Rico, was cut off and forgotten, without power or phone service.   "We didn't know what to do. We were literally going crazy," said de Jesus, 35.   "Those were difficult, desperate days. We could not find a way out, and the hurricane caused extensive damage," he told AFP.

During the two long weeks following Maria, the 27 families living in Rio Abajo saw their supplies quickly deplete.   De Jesus, who has diabetes, needed to keep his insulin refrigerated. The storm blew away the island's already decrepit power grid, so people resorted to emergency generators.   "But I was running out of gasoline to run the generator," he said.   A helicopter now makes regular deliveries of food, water and medicine because with the bridge washed out, there is no other way in or out of town.

People can't wade across the river because it is contaminated with human waste after a pipe broke when the bridge went.   Some brave souls use a precarious ladder rigged to get across the water, but for most people it is too dangerous.   We need a bridge "to take out our vehicles and leave in case of emergency, or if there is a landslide," he said.   Where the bridge once stood, residents set up a system of ropes, pulleys and buckets to move supplies over the river, which has been contaminated with sewer water since the hurricane.   Over the remains of the bridge locals hung the single-star, red, white and blue flag of Puerto Rico and a sign that reads "the campsite of the forgotten."

- Desperate need for electricity -
Puerto Rico Governor Ricardo Rossello visited the surrounding municipality of Utuado on Wednesday to deliver supplies, but he did not stop in Rio Abajo.   "Utuado is certainly one of the most severely affected municipalities in all of Puerto Rico," Rossello said.   "Our commitment is to give it support and aid during the whole road to recovery."   Eighty-one percent of Puerto Rico remains blacked out one month after Maria struck. Clean water for drinking, cooking and bathing is scarce, too.

Puerto Ricans' main obstacle to getting back to some semblance of normality is the slowness of the Puerto Rico Electric Power Authority in getting the power grid back up and running.   The lack of power has paralyzed a key industry -- pharmaceutical production -- and most businesses including restaurants are closed or operating at great cost through the use of diesel powered generators.

This nightmare comes about a year after the US government established an external fiscal control board for the island after it declared bankruptcy because of 73 billion dollars in debt.   Economist Joaquin Villamil told AFP that damage from Hurricane Maria is estimated at 20 billion dollars -- four times that of Hurricane Georges in 1998, when measured in 2016 dollars.

Villamil said reconstruction money provided by the Federal Emergency Management Agency and from insurance companies will have a positive impact on the island's economy in the second half of fiscal 2018 and in fiscal 2019, but this boost will just be temporary.   "From an economic point of view there is not much net gain," said Villamil, who works for a consulting firm called Estudios Tecnicos.   He said the economy has been shrinking since 2006 and Maria will delay any prospect of recovery.   It will take at least until 2026 to get back to the GDP level of 2006, he added.

Making things worse, people are leaving the island for the mainland US. Forecasts are that the population now at 3.4 million will go down to 3.1 million or even less by 2026, said Villamil.   The government of Florida estimates that since October 3 -- the day a state of emergency to deal with an influx of Puerto Ricans was declared -- more than 36,000 people from the island have poured in.
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Gibraltar

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

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

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

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

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

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

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

Please see our information on medical insurance overseas.

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

St. Kitts and Nevis - US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
St. Kitts and Nevis is a developing Caribbean nation consisting of two islands.
Tourist facilities are widely available.
Read the Department
f State Background Notes on St. Kitts and Nevis for additional information.

ENTRY/EXIT REQUIREMENTS:
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.

We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Visitors may be asked to present an onward/return ticket and proof of sufficient funds to cover the cost of their visit.
Stays of up to three months are granted at immigration.
Anyone requiring an extension must apply to the Ministry of National Security.
There is an airport departure tax and environmental levy charged when leaving the country.

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

SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings, and Travel Alerts 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:
Petty street crime occurs in St. Kitts and Nevis, as well as the occasional burglary; visitors and residents should take common-sense precautions.
Avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents.
Do not leave valuables unattended on the beach or in cars.
Exercise caution when walking alone at night.

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 care is limited.
The main hospitals are Joseph N. France General Hospital (telephone (869) 465-2551) on St. Kitts and Alexandria Hospital (telephone (869) 469-5473) on Nevis.
St. Kitts has two additional hospitals and both islands have several health clinics.
Neither island has a hyperbaric chamber.
Divers suffering from decompression illness are transported to the island of Saba, in the Netherlands Antilles.
Serious medical problems requiring hospitalization and/or medical evacuation to the U.S. can cost thousands of dollars.
Doctors and hospitals expect immediate cash payment for health services.

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

Traffic in St. Kitts and Nevis moves on the left-hand side of the road.
Roads are reasonably well paved but narrow and sometimes poorly marked.
Drivers often stop on the side of or in the middle of the road to visit with other drivers, blocking one lane of traffic.
Honking one's horn is a common form of greeting, not a warning.
Travelers are required to obtain a visitor's drivers license, which may be obtained from the Traffic Department or the Fire Station for a small fee on presentation of a valid home or international license.
Public Transportation consists of mini-buses and taxis.
Established fares are available from airport dispatchers and local hotels.
Complaints regarding taxi or minibus services may be lodged with The Department of Tourism or with your hotel.

More detailed information on roads and traffic safety can be obtained from the Ministry of Tourism, Culture and the Environment, Bay Road, Pelican Mall, P.O. Box 132, Basseterre, St. Kitts, telephone (869) 465-4040.
For specific information concerning St. Kitts and Nevis driving permits, vehicle inspection, road tax and mandatory insurance, contact the St. Kitts and Nevis national tourist organization via the Internet at http://www.stkitts-tourism.com/index.asp.
Please refer to our Road Safety page for more information

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

SPECIAL CIRCUMSTANCES:
There is no U.S. Embassy or Consulate in St. Kitts and Nevis.
The U.S. Embassy in Bridgetown, Barbados, is responsible for American citizen services in these islands.
U.S. citizens are encouraged to carry a copy of their U.S. passports or other proof of citizenship with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship are readily available.

All Caribbean countries can be affected by hurricanes.
The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

Please see 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 St. Kitts and Nevis laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in St. Kitts and Nevis 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 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 St. Kitts and Nevis 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 St. Kitts and Nevis.
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 in Barbados in the Wildey Business Park, Wildey, St. Michael, telephone 1-246-436-4950, web site http://barbados.usembassy.gov/.
The Consular Section telephone number is 1-246-431-0225. The Consular Section fax number is 1-246-431-0179. Hours of operation are 8:30 a.m. to 4:00 p.m. Monday-Friday, except Barbados and U.S. holidays.
In certain circumstances, the U.S. Consular Agency in Antigua can be of assistance.
Persons seeking assistance should call the Consular Agent, Rebecca Simon, at 1-268-463-6531 to schedule an appointment.
*

*

*
This replaces the Country Specific Information for St. Kitts and Nevis dated June 6, 2006, to update sections on Entry/Exit Requirements, Safety and Security, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed 21 May 2014
Source: West Indies News Network (WINN) FM [edited]

There are now 20 confirmed cases of chikungunya disease in St Kitts, according to Acting Chief Environmental health Officer Alexander Riley. Mr Riley made this confirmation Tuesday [20 May 2014] during an edition of WINN FM's Talking Trash programme.

Chikungunya is a mosquito-borne disease that causes fever and joint pain in humans. Other symptoms of the disease include rash, muscle pain, and fatigue.

As the hurricane season approaches Mr Riley lists measures that the environmental health department will be taking to prevent the spread of chikungunya [virus] include fogging beginning this Wednesday [20 May 2014].

Meanwhile, Mr Riley sought to allay fears and concerns about the health and environmental health department risks of fogging, noting that the chemicals used are environmentally friendly.  [Byline: Andre Huie]
===================
[Fogging will provide only temporary vector mosquito control. Elimination or treatment of breeding sites is necessary for significant vector mosquito population reduction. This same report was also sent in by Roland Hubner.

Maps of St Kitts and Nevis can be accessed at
and <http://healthmap.org/promed/p/31>. - ProMed Mod.TY]
Date: Thu 20 Feb 2014
Source: Winn FM [edited]

The Federation [St. Kitts and Nevis] has recorded its 1st confirmed case of the chikungunya virus [infection]. A statement from the Ministry of Health Thursday morning [20 Feb 2014] indicated that the 30-year-old male resident of St. Kitts was hospitalized and discharged without complications 2 weeks ago. Confirmation testing was done by the Trinidad-based Caribbean Public Health Agency (CARPHA).

Speaking to WINN FM Thursday morning, Chief Medical Officer Dr. Patrick Martin assured that there was no need to panic. "There is no need for travel or trade restrictions, no need for alarm, no need to panic. If you have the fever and pain, Paracetamol, lots of fluids... don't tire out yourself," Dr. Martin said Thursday.

Like dengue, chikungunya is characterized by fever and pain which appear up 3-7 days after being bitten by an infected mosquito. Other symptoms include headache, nausea, vomiting, fatigue and rash.

Acute chikungunya fever typically lasts a few days to a few weeks, but as with dengue, some patients have prolonged fatigue lasting several weeks. There is no risk of bleeding complications with chikungunya which distinguishes it from dengue.

Dr. Martin advised that persons exhibiting symptoms can be treated at, and use over the counter medications except for aspirin and ibuprofen.

Dr. Martin said Thursday [20 Feb 2014] that in all likelihood the virus has been in the Federation [St. Kitts and Nevis] for several weeks and that there have been other cases.   [Byline: Toni Frederick]
-----------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===================
[This report does not indicate whether the chikungunya virus infection was acquired locally on St. Kitts or in another locality where transmission is going on. No mention was made of the individual's travel history off of St. Kitts island, and the Chief Medical Officer mentioned that it is likely that the virus has been present in the Federation for several weeks with occurrence of other cases; these factors suggest that the infection was, in fact, acquired locally.

A HealthMap/ProMED-mail map showing the location of St. Kitts can be accessed at
<http://healthmap.org/r/1E3K>. - ProMed Mod.TY]
Wednesday 15th February 2012

WASHINGTON, Feb 14, 2012 (AFP) - US Supreme Court Justice Stephen Breyer was robbed at his Caribbean island vacation home last week by a masked, machete-wielding bandit, a court spokeswoman said Tuesday.  The incident took place February 9 at the justice's home in Nevis, with about $1,000 cash taken, the spokeswoman said.  "No one was hurt," said the official, noting that the 73-year-old Breyer was "robbed by an armed intruder" and that "the individual was armed with a machete."  Breyer was on vacation during a break from the schedule of the top US court, which resumes hearings Friday.

St Kitts and Nevis

Flag of St Kitts and Nevis
Still current at: 30 November 2011
Updated: 29 November 2011

This advice has been reviewed and reissued, with an amendment to the Entry Requirements - Passport Validity section (updated). The overall level of the advice has not changed; there are no travel restrictions in place in this travel advice for St Kitts and Nevis.

(see travel advice legal disclaimer)


  • There is no British High Commission in St Kitts and Nevis. British nationals requiring emergency consular assistance may contact the British Honorary Consul, Sarah Percival, on +1 (869) 764 4677 begin_of_the_skype_highlighting +1 (869) 764 4677 end_of_the_skype_highlighting. If the Honorary Consul is not available and for all other non-consular related matters please contact the British HighCommission in Bridgetown, Barbados.
  • Around 4,700 British nationals visited St Kitts and Nevis in 2008 (Source: Ministry of Tourism). Most visits to St Kitts and Nevis are trouble-free. The main type of incidents for which British nationals required consular assistance in St Kitts and Nevis in 2008 were replacing lost and stolen passports and dealing with hospitalisations. Over the past year, there has been an overall increase in crime in St Kitts, including gun crimes although these tend to occur within the local community.
  • There is a low threat from terrorism. But you should be aware of the global risk of indiscriminate terrorist attacks which could be in public areas, including those frequented by expatriates and foreign travellers.
  • The hurricane season in St Kitts and Nevis normally runs from June to November. See the Natural Disasters section of this Travel Advice.
  • You should take out comprehensive travel and medical insurance before travelling. See General - Insurance.

Safety and Security - Terrorism
There is a low threat from terrorism. But you should be aware of the global risk of indiscriminate terrorist attacks which could be in public areas, including those frequented by expatriates and foreign travellers. For more general information see our Terrorism Abroad page.

Safety and Security - Crime
Around 5,000 British nationals visit St Kitts and Nevis each year (Source: Ministry of Tourism) and the vast majority of visits are trouble-free. St Kitts and Nevis is a friendly and welcoming country but incidents of violent crime including murder do occur. Gun crime is increasingly problematic; there have been more than 25 murders in 2011, the majority as a result of shootings. Although these tend to occur within the local community, there have been a number of recent incidents involving British nationals in the Half Moon Court area, including a double murder and violent attack.

You should maintain vigilance at all times even when staying with family or friends. Avoid walking alone in isolated areas, including beaches, after dark. Do not carry large amounts of cash or jewellery. Valuables and travel documents should be left, where possible, in safety deposit boxes and hotel safes.

For more general information see our Victims of Crime Abroad page.

Safety and Security - Local Travel

Safety and Security - Local Travel - Road Travel
In order to be able to drive a car in St Kitts and Nevis you must purchase a local driving licence, usually from the car hire company, at a cost of EC$ 100. You must show your current driving licence to obtain this. Motorists drive on the left in St Kitts and Nevis. Main roads are generally well maintained but many follow winding routes so careful driving is necessary. Roads are not well lit at night. You must be alert for stray livestock and speed bumps in some areas that are not well marked. Hiring of scooters is popular amongst visitors but safety equipment is not included in the hire price; despite the additional cost this is highly recommended for your own protection. You should be cautious when driving a scooter, as other road users do not always give them due consideration.

For more general information see our Driving Abroad page.

Safety and Security - Local Travel - Air Travel
You will have to pay a departure tax when leaving St Kitts and Nevis. Departure tax is EC$58 (per adult) and EC$25 (child under 12).

Safety and Security - Political Situation
St Kitts and Nevis Country Profile

You should note that there are severe penalties for all drug offences. Pack all luggage yourself and do not carry anything through customs for anyone else. You should be aware that it is an offence for anyone, including children, to dress in camouflage clothing. Certain homosexual acts are illegal under the laws of St Kitts and Nevis. For more general information for different types of travellers see our Your Trip page.

Entry requirements - Visas
British Passport holders do not require visas to visit St Kitts and Nevis. On entry you are granted a one month stay. If you wish to stay longer you must apply and pay for an extension of stay through the St Kitts and Nevis Immigration Department. It is an offence to overstay the entry period granted or to work without a work permit.

Entry requirements may change from time to time and should be checked with the High Commission of St Kitts and Nevis in London.

Entry requirements - Passport validity
You must hold a valid passport to enter St Kitts & Nevis. Your passport must be valid for a minimum period of six months from the date of entry into St Kitts & Nevis.

The medical facilities on the islands are limited to one hospital, which can deal only with routine medical cases. More serious cases will need to be dealt with in Puerto Rico, USA once the patient is in a stable condition.

Dengue fever is common across the Caribbean and can occur throughout the year. Dengue is a mosquito-borne infection that can cause a feverish illness associated with headache, muscle aches and pains, and rash. Some cases of dengue are severe. Dengue can be prevented by avoiding being bitten by the disease-carrying mosquitoes that feed predominately during daylight hours. For more information on prevention, see the National Travel Health Network and Centre website.

You should exercise normal precautions to avoid exposure to HIV/AIDS. For more general information on how to do this see our HIV and AIDS page.

You should seek medical advice before travelling to St Kitts & Nevis and ensure that all appropriate vaccinations are up-to-date. For further information on vaccination requirements, health outbreaks and general disease protection and prevention you should visit the websites of the National Travel Heath Network and Centre (NaTHNaC) and NHS Scotland's Fit For Travel or call NHS Direct on 0845 46 47.

For more general health information see our Travel Health and Swine Flu page.


The hurricane season in St Kitts and Nevis normally runs from June to November. You can also access the World Meteorological Organisation for updates and the US National Hurricane Centre. For more general information see our Tropical cyclones page.

General - Insurance

You should take out comprehensive travel and medical insurance, which includes medical evacuation, before travelling. Check for any exclusions and that your policy covers you for all the activities you want to undertake. Be especially careful about cover for recurring illnesses as they may not be include in all insurance policies. For more general information see our Travel Insurance page.

If things do go wrong when you are oversees see our When Things Go Wrong page.

General - Registration

Register with our LOCATE service to tell us when and where you are travelling abroad or where you live abroad so our consular and crisis staff can provide better assistance to you in an emergency. More information about registering with LOCATE can be found here.

General - Package Holidays

If you are on a package holiday, you must travel on the specified return date. If you fail to do so it is likely that you will have to pay for a return ticket yourself.

General - Passports


Keep a copy of the photo page of your passport and relevant entry stamp in case your documents are stolen.

The passport service for British nationals in St Kitts and Nevis has now moved from Barbados to the UK Passport Service Centre for the Americas and Caribbean in Washington D.C. (http://ukinusa.fco.gov.uk/passports).

If you are applying for a renewal of your UK passport and you are in St Kitts and Nevis your application, with the appropriate passport fee plus a return courier fee of US $21, should be sent direct to:

The UK Passport Service for the Americas and Caribbean
British Embassy
19 Observatory Circle, NW
Washington, DC 20008

The British High Commission in Bridgetown will continue to issue Emergency Passports for people who have lost their passports and who have an urgent need to travel to the UK.

Date: Fri 15 Jan 2010
Source: Institut de Veille Sanitaire: Le point epidemiologique - N2 [in French, trans. & summ. ProMed Mod.TY, edited]
<http://www.invs.sante.fr/surveillance/dengue/points_sbsm/2009/pe_sb_2009_14_dengue.pdf>

Surveillance of cases clinically suggestive of dengue
-----------------------------------------------------
After reaching very high values between mid-Nov and mid-Dec [2009], the number of cases clinically suggestive of dengue fever has abruptly decreased in week 2009-52 without, however, running below the epidemic threshold. Since then, there has been a gradual increase in new cases, with an estimated 40 cases in the 1st week of Jan [2010]. The number of suggestive [dengue] cases has been well above the epidemic threshold for the past 2 months. It is estimated that during this period, 340 cases suggestive of dengue were seen by general practitioners on the island, averaging over 40 per week. The number of cases clinically suggestive of dengue fever is an estimate for the entire population of the island, based on the number of people who consulted a general practitioner for a clinical syndrome suggestive of dengue. This estimation is performed using data collected from the network of sentinel physicians.

Monitoring of laboratory confirmed cases
----------------------------------------
The number of laboratory confirmed cases of dengue fever follows a dynamic similar to that of suggestive cases. After a sharp decline in week 2009-52, there was a further increase in the number of confirmed cases during the last week of Dec (2009-53), then an equally high number of laboratory confirmations during the past week (2010-01). Since the 3rd week of Nov (2009-47), 239 laboratory confirmed cases were recorded, and the number of weekly cases has far exceeded the epidemic threshold.

Positivity rate of requests for laboratory confirmation and circulating [dengue virus, DENV] serotypes
-------------------------------------------------------
As in the previous week, the positivity rate has been very high in the week 2010-01, since 26 of the 41 samples analyzed have been positive (66 per cent). This is the 2nd consecutive week for this rate, so it is increasing during the upswing of the epidemic. Since mid-Nov 2009 (week 2009-47), DENV-1 has constituted the vast majority [of isolates], accounting for 95 per cent of viruses isolated (73 of 77 samples analyzed). DENV-2 has also been identified but only 4 times.

Hospitalized cases
------------------
Since early Dec [2009], no new confirmed cases of dengue have been hospitalized for more than 24 hours. The number of laboratory confirmed hospitalized cases has been constant since October 2009, with 2 hospitalizations occurring each month.

Spatial distribution
--------------------
The geographical distribution of laboratory confirmed cases indicates their presence on all sectors of the island, indicating that there still is widespread circulation of the virus.

Situation analysis
------------------
At Saint Barthelemy, the epidemic continues. Virus circulation is still important and widespread on the island. The number of hospitalized cases remains very low. The epidemiological situation is still in Phase 3 of PSAG of the Northern Islands as an epidemic phase.
======================
[A map of Saint Barthelemy (St. Barts) in the Caribbean can be accessed at
<http://www.worldatlas.com/webimage/countrys/namerica/caribb/stbarts.htm>. - ProMed Mod.TY]
More ...

Bangladesh

Bangladesh - US Consular Information Sheet
June 17, 2008

COUNTRY DESCRIPTION:
Bangladesh is a democratic republic with a parliamentary form of government.
On January 11, 2007, President Iajuddin Ahmed declared a state of emergenc
.
On May 12, 2008, the Chief Adviser announced that national parliamentary elections would be held in the third week of December, 2008.
Bangladesh remains a developing country with poor infrastructure.
Tourist facilities outside major cities and tourist areas are minimal.
Read the Department of State Background Notes on Bangladesh for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, visa and onward/return ticket are required.
All travelers to Bangladesh, including American citizens, must have a valid visa in their valid passport prior to arrival.
Although airport visas (landing permits) are available upon arrival by air, the U.S. Embassy in Dhaka does not recommend this option for most categories of travelers as working hours may not coincide with flight arrival times and precise formalities can vary.
Additionally, if issued, landing permit validity is usually limited to a maximum of fifteen days.
A valid visa in an expired or cancelled U.S. passport is not acceptable to the Bangladeshi authorities; if you are issued a new U.S. passport, you will need a new visa.

If you intend to use Dhaka as a hub from which to visit other countries in the region, ensure that you obtain a multiple-entry visa before arrival.
If you intend to work for a non-governmental organization (NGO) in Bangladesh, you should ensure that your sponsor has provided you with up-to-date advice on the kind of visa you must obtain before arrival.
It is difficult and time-consuming to change your immigration status once you have arrived in Bangladesh.

Visas to Bangladesh which are expiring may be extended at the Directorate of Immigration and Passport, located at Sher-e-Bangla Nagar, Agargaon, Dhaka.
The phone numbers are (880-2) 913-1891 and 913-4011.

New visa rules, introduced in October 2006, require foreign nationals who come to Bangladesh to work or for long-term visits to have the appropriate work permits and clearances on arrival.
There are increased financial penalties for overstaying visas.
Additionally, those who overstay for more than 90 days face the possibility of being charged with violating the Foreigners Act of 1946.
For further information on these rules, please check with the nearest Bangladeshi Embassy or Consulate (U.S. addresses listed below) before traveling, or visit the Bangadeshi Immigration Police web site at www.immi.gov.bd, which provides further details on rules relating to foreigner registrations.

There are two exit requirements:
A.
When traveling by air, there is a departure tax on all foreigners except children under the age of two.
This tax is often included when air tickets are purchased.
Otherwise, it is collected at the airport at the time of departure.
The amount of the departure tax varies, depending on the destination (e.g., the departure tax for the U.S. is the most expensive, at USD $43).
There is no travel tax for transit passengers transiting Bangladesh without a visa and in country for 72 hours or fewer.
These requirements may be subject to change, and travelers are advised to check with the Embassy of Bangladesh before traveling.

B.
Departing foreign nationals are also required to comply with the income tax ordinance of 1984 and submit an income tax clearance certificate/income tax exemption certificate to local airline offices upon departure from Bangladesh.
More information can be obtained from the Bangladesh Board of Revenue web site at http://www.nbr-bd.org/.

For further information on entry requirements and possible exceptions to the exit requirements, please contact the Embassy of the People's Republic of Bangladesh, 3510 International Drive NW, Washington, DC
20008, telephone 202-244-0183, fax 202-244-5366, web site http://www.bangladoot.org, or the Bangladeshi Consulates in New York at 211 E. 43rd Street, Suite 502, New York, NY 10017, telephone 212-599-6767 or Los Angeles at 10850 Wilshire Boulevard, Suite 1250, Los Angeles, CA 90024, telephone 310-441-9399. Visit the Embassy of Bangladesh web site at http://www.bangladoot.org for the most current 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:
Bangladesh is currently under a state of emergency.
As of May, 2008, national parliamentary elections have been scheduled for the third week of December, 2008.
The security situation in Bangladesh is fluid, and Americans are urged to check with the U.S. Embassy for the latest information.
Spontaneous demonstrations take place in Bangladesh from time to time.
American citizens are reminded that even demonstrations intended to be peaceful can turn confrontational and escalate into violence quickly and unexpectedly.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
American citizens should stay up-to-date with media coverage of local events and be aware of their surroundings at all times.
Information regarding demonstrations in Bangladesh can be found on the U.S. Embassy Dhaka’s web site at http://dhaka.usembassy.gov/.

A terrorist bombing campaign in the second half of 2005, political violence throughout the country at the end of 2006, and threats to U.S. and Western interests led to increased security around U.S. Government facilities.
On August 17, 2005, a banned Islamist terrorist group, Jamaatul Mujahideen Bangladesh (JMB), claimed responsibility for nearly 500 coordinated small bomb blasts in virtually every part of Bangladesh that killed two persons and injured several dozen.
The most recent JMB bombing occurred on December 8, 2005, and the Bangladeshi government subsequently apprehended the known senior leadership of JMB.
Six JMB leaders convicted of complicity in JMB attacks were executed on March 29, 2007.
JMB and other extremist groups are small in number but remain active and may resume violent activities.

Demonstrations, political activity, and hartals (nationwide strikes) were initially banned during the state of emergency, but the rules restricting political activity have been slightly relaxed as part of the process leading up to the planned elections in the third week of December 2008.
Prior to the state of emergency, rallies, marches, demonstrations and hartals took place frequently.
In August 2007, violent protests involving thousands of demonstrators occurred in several cities in Bangladesh, including Dhaka.
Authorities imposed a curfew to restore calm.
Protests involving workers from the large garment-manufacturing industry are not uncommon.
Visitors to Bangladesh should check with the Consular Section of the U.S. Embassy in Dhaka for updated information on the current political situation.

U.S. citizens are advised against traveling to the Khagrachari, Rangamati and Bandarban Hill Tracts districts (collectively known as the Chittagong Hill Tracts) due to kidnappings and other security incidents, including those involving foreign nationals.
Foreigners traveling in the Chittagong Hill Tracts are required to register with local authorities.
Additionally, the U.S. Embassy has in the past received reports of incidents of kidnapping, arms and narcotics smuggling and clashes between local Bangladeshis and Rohingyan refugees in areas near Rohingyan refugee camps in the Teknaf, Kutupalong, Ukhia, and Ramu areas of the Cox’s Bazar district.
The U.S. Embassy also recommends against travel to these areas.
Individuals who choose to visit these districts are urged to exercise extreme caution.

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, including the Worldwide Caution, can be found.
Americans traveling to or living in Bangladesh who are registered at the U.S. Embassy will receive updated security information about Bangladesh via e-mail.
All Demonstration Notices and Warden Messages are posted on the Embassy’s web site at http://dhaka.usembassy.gov/.
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:
Urban crime can be organized or opportunistic, conducted by individuals or groups, and commonly encompasses fraud, theft (larceny, pick-pocketing, snatch-and-grab), robbery (armed and unarmed), carjacking, rape, assault, and burglary (home and auto).
Incidents of crime and levels of violence are higher in low-income residential and congested commercial areas, but are on the rise in wealthier areas as well.
Visitors should avoid walking alone after dark, carrying large sums of money, or wearing expensive jewelry.
Valuables should be stored in hotel safety deposit boxes and should not be left unattended in hotel rooms.
Police are generally responsive to reports of crimes against Americans.
Crimes, however, often go unsolved.

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

The local equivalent to the “911” emergency line in Bangladesh is 999.
This connects you to the Dhaka Metro Police Exchange.
There is no guarantee that English will be spoken or understood at the Dhaka Metro Police Exchange.
The Police Exchange can only transfer calls to the appropriate police station within the Dhaka metropolitan area, and then the caller will have to speak with that police station in order to actually have any police services performed.
There is similarly no guarantee that English will be spoken or understood at the local police station.

Outside of Dhaka, the caller will need to add the city code for Dhaka, so dial 02-999.
The caller will again be connected to the Dhaka Metro Police Exchange, which should be able to provide the number of the appropriate police station within Bangladesh, but the Dhaka Metro Police Exchange is unlikely to be able to transfer the call to a police station outside Dhaka.
The caller would have to hang up and dial the number provided by the Dhaka Metro Police Exchange.
The ability to speak and/or understand English is even more unlikely at local police stations outside of Dhaka.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Bangladesh do not approach U.S. standards, even in tourist areas.
There is limited ambulance service in Bangladesh.
Several hospitals in Dhaka (e.g., Apollo Hospital and Square Hospital) have emergency rooms that are equipped at the level of a community hospital.
Hospitals in the provinces are less well equipped and supplied.
There have been reports of counterfeit medications within the country, but medication from major pharmacies and hospitals is generally reliable.
Medical evacuations to Bangkok or Singapore are often necessary for serious conditions or invasive procedures.

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 Bangladesh is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Conditions differ around the country.

The Bangladeshi road network is in poor condition and poorly maintained.
The streets of Dhaka are extremely congested; bicycle rickshaws compete with three-wheeled mini-taxis (CNGs), cars, overloaded buses, and trucks on limited road space.
Also, driving on the left-hand side of the road may be confusing to American visitors.
Inter-city roads are narrow.
Driving at night is especially dangerous.
Streetlights are rare even in cities.
Road accidents are common in Bangladesh.
Fatal head-on collisions on inter-city roads are common.
When vehicle accidents occur, a crowd quickly gathers and violence can occur when the crowd becomes unruly.
Travelers are strongly urged not to use public transportation, including buses, rickshaws, and three-wheeled baby taxis due to their high accident rate and crime issues.
An alternative to consider is a rental car and driver.

Please refer to our Road Safety page for more information.
Visit the website of Bangladesh’s National Tourism Organization at http://www.parjatan.org, e-mail bpcho@bangla.net.

SPECIAL CIRCUMSTANCES:
Bangladesh is a country crisscrossed with rivers, and thus uses a wide network of water-based public transportation.
Ferries and other boats compete with the railroads as a major means of public transport.
Typically overloaded and top-heavy, ferries do capsize, particularly during the monsoon season from May to October or during unexpected thunderstorms or windstorms.
Every year there are dozens of fatalities resulting from ferry accidents.

Bangladeshi customs authorities may enforce strict regulations concerning temporary importation into or export from Bangladesh of items such as currency, household appliances, alcohol, cigarettes and weapons.
There is no restriction as to the amount of U.S. currency visitors may bring into Bangladesh; however, they must declare to customs authorities if they are carrying more than USD $5,000 at the time of arrival.
It is advisable to contact the Bangladeshi Embassy or Consulates for specific information regarding customs requirements.

Please see our Customs Information.

Land disputes are extremely common in Bangladesh and are extremely difficult to resolve through legal channels.
Court cases can last for months, and sometimes years, without there ever being a final and accurate determination of which party has legitimate claim to the title.

The U.S. Embassy currently has on file nearly twenty cases of American citizens who claim to be victimized in land-grabbing disputes.
Rarely are these simple cases of a legitimate property owner and an opportunistic land-grabber.
More often, it is a case of disagreement between an owner who believes he has historical ownership of the property and a new owner who has just purchased the same property.
One of them has been swindled, both of them have deeds, and it is next to impossible to determine whose deed is valid.

The dangers in becoming involved in a property dispute range from being threatened by bullies to being involved in a lengthy court dispute.
Those involved in a court dispute run the risk of having cases filed against them, and may be arrested and jailed, sometimes for months.

American Citizens wishing to purchase property in Bangladesh should be thoroughly aware of the risks they take and should only purchase property from a seller whose ownership is beyond doubt.
Additionally, they should recognize the risks associated if they are not physically present to oversee their property.
American Citizens should bear in mind that the U.S. Embassy cannot protect personal property in the absence of owners and cannot take sides in a legal dispute.

A marriage must be entered into with the full and free consent of both individuals.
The parties involved should feel that they have a choice.
If an American citizen is being forced into a marriage against his/her will, help and advice are available.
For more information, please and the U.S. Embassy in Dhaka information on forced marriage at http://dhaka.usembassy.gov/forced_marriage_home.html, or contact the American Citizens Services unit directly at DhakaACS@state.gov, or 011-88-02-885-5500 from the United States, 02-885-5500 from inside Bangladesh, or 885-5500 from anywhere in the city of Dhaka.
All travelers to Bangladesh should retain their passports and their return plane tickets to ensure independence to travel.

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

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 Bangladeshi laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Bangladesh 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, international parental child abduction and the U.S. Embassy in Dhaka information on forced marriage at http://dhaka.usembassy.gov/forced_marriage_home.html.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Bangladesh 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 Bangladesh.
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 approximately four miles south of Zia International Airport, and five miles north of downtown in the Diplomatic Enclave, Madani Avenue, Baridhara, Dhaka, telephone (88-02) 885-5500, fax number (88-02) 882-3744.
The workweek is Sunday through Thursday.
The Consular Section is open for American Citizens Services Sunday through Thursday from 1:00 p.m. to 4:00 p.m.
For emergency services and general information during business hours, please call (88-02) 882-3805.
For emergency services after hours, please call (88-02) 885-5500 and ask for the duty officer.
The Embassy's Internet home page is http://dhaka.usembassy.gov/
* * *
This replaces the Country Specific Information for Bangladesh dated November 23, 2007 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Traffic Safety and Road Conditions, Special Circumstances, and Children’s Issues.

Travel News Headlines WORLD NEWS

1st April 2019
https://www.aa.com.tr/en/asia-pacific/rainstorm-lightning-kill-10-kill-in-bangladesh/1439210

Rainstorm, lightning kill 10 kill in Bangladesh

DHAKA, Bangladesh 

At least 10 people were killed and dozens other injured as a tropical storm lashed different parts of Bangladesh, including capital Dhaka, on Sunday evening, local media reports said. The storm, coupled with gusty winds and lightning uprooted trees, sunk a boat, blew away bricks from buildings and collapsed a wall, reports said citing police and Met Office as sources. Of the deceased, six were killed in Dhaka, including a woman and her five-year-old son who drowned when a boat capsized in River Buriganga during the storm. Two people were killed as bricks from under construction buildings fell on them. A 45-year-old woman was killed after a tree fell on her and a rickshaw puller died as a wall collapsed on him.

Authorities had to close down river routes and operations of flights at Dhaka’s international airport for about two hours, the New Age newspaper reported.  Also, four people including two teenage sisters were struck dead by lightning on Sunday, the report added.  According to Dhaka Medical College and Hospital sources, at least 18 people came to the hospital with minor injuries after the storm. Both April and May are very prone to seasonal storms in the South Asian country with hundreds of rivers.

Date: Fri 15 Mar 2019
Source: Prothom Alo [edited]

The 3 members of a family from Baliadangi upazila's [2nd-lowest tier of regional administration] Ujarmoni village in Thakurgaon [district] are suspected to have been infected with the deadly Nipah virus, reports United News of Bangladesh [apparently later confirmed as Nipah virus; see below. - ProMED Mod.TY].

The victims include a 28 year old mother; her son, aged 8; and her daughter, aged 4. They were taken to Rangpur Medical College Hospital on Thursday [14 Mar 2019], said ABM Maniruzzaman, the resident medical officer of Baliadangi Upazila Health Complex. He said the victims had been suffering from fever for the last 3 days. They also reported headache and vomiting. The trio was 1st taken to Thakurgaon Modern Sadar Hospital and later shifted to RMCH.

Nipah virus is transmitted from animals to humans and can also be transmitted through contaminated food or directly between people, according to the World Health Organisation. There is no vaccine for the virus, which is spread through body fluids and can cause inflammation of the brain.

The mother's husband said his wife and children fell sick after eating jujube [fruit of the _Ziziphus jujuba_ bush] on Wednesday night [13 Mar 2019].

Thakurgaon civil surgeon Abu Mohammad Khairul Kabir said their blood samples had been collected for testing. A medical team from the Institute of Epidemiology, Disease Control and Research is scheduled to visit RMCH.

In February [2019], 5 members of a family died mysteriously in Baliadanga upazila. It is unclear what caused their deaths [Nipah virus is suspected]. In 2001, Nipah virus was identified as the causative agent in an outbreak of human disease occurring in Bangladesh. Genetic sequencing confirmed this virus as Nipah virus, according to the Centre for Disease Control and Prevention.
======================
[This is the 2nd family in Bangladesh to have been infected by Nipah virus this year [2019]. Nipah virus infections occur sporadically in Bangladesh. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), "Giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and . . . they contaminate date palm sap or the fruit. [The above report suggests that the family may have eaten contaminated jujube fruit]. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April."

"It is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur."

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED-mail maps:
Rangpur Division, Bangladesh: <http://healthmap.org/promed/p/16030>]
Date: Mon 4 Mar 2019
Source: The Daily Star [edited]

The Institute of Epidemiology, Disease Control and Research (IEDCR) has found the presence of Nipah virus in one of the 5 family members who died in Baliadangi upazila of Thakurgaon early in February [2019; upazilas are the 2nd lowest tier of regional administration in Bangladesh].  "Samples of one of the deceased were collected, and investigators detected presence of Nipah virus there," said IEDCR Director Meerjady Sabrina Flora in a statement yesterday [3 Mar 2019].

IEDCR formed 2 committees, which conducted investigations at Baliadangi Upazila Health Complex, Thakurgaon Sadar Hospital, Rangpur Medical College Hospital and various places of Baliadangi upazila between 25 Feb-1 Mar [2019].

During the time, investigators also collected samples of hospital doctors, nurses, health workers and family members of the victims, neighbours, and villagers. The investigation found that those who died had fever, headache, vomiting, and infection. Nipah virus was not found in samples of living persons of the family.  "In the investigation, it was not known if the deceased had a history of drinking raw date palm sap (a popular drink), but the investigators think 4 of the victims were infected by Nipah virus from the other," said the IEDCR statement.

Nipah virus generally transmits through drinking date palm sap infected by bats carrying the virus. Meerjady has advised all not to drink raw date sap.  If anyone is infected by Nipah virus, health personnel and family members should use masks and gloves when they take care of the patients, and wash hands with soap afterwards. The patients should be kept in isolated environment, she said.
====================
[Nipah virus infections occur sporadically in Bangladesh. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251) "Giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and, as the above report indicates, they contaminate date palm sap or the fruit. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April.

As mentioned in comments in a previous post (ProMED-mail archive no. http://promedmail.org/post/20140113.2168940), local residents scarify the upper areas of palm trees to collect sap in large jars. The bats come to drink the sap and defecate and urinate in the sap. If the bats are shedding Nipah virus, it contaminates the sap. If the sap is consumed uncooked, humans that drink it can become infected. Local people say that cooking the sap adversely alters the flavour. However, skirts made of local bamboo can serve as a barrier preventing bats' access to the sap collecting sites. Person to person transmission can occur as well.

It is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered, there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection is implemented, sporadic cases will continue to occur.

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED map available at:
Date: Thu, 21 Feb 2019 07:20:54 +0100
By Shafiqul ALAM

Dhaka, Feb 21, 2019 (AFP) - At least 70 people were killed when fire tore through crumbling apartment blocks in a historic part of Dhaka, setting off a chain of explosions and a wall of flames down nearby streets, officials said Thursday.    It started in one building where chemicals for deodorants and other household uses were illegally stored and spread at lightning speed to four nearby buildings, the fire service said.    People became trapped by the flames at a nearby bridal party and a restaurant. TV images showed the gates to one building were chained up so residents were unable to escape.

Traffic jams in the clogged narrow streets held up the rescue operation.   Bangladesh fire chief Ali Ahmed said at least 70 people were killed but that the toll would likely rise.    "The number of bodies may increase. The search is still going on," he told AFP.   Doctors said at least 10 of the scores of injured were in critical condition.   Firefighters who took almost 12 hours to bring the fire under control, went through the blackened floors of the building, littered with spray cans, looking for bodies.

The fire started at about 10.40pm (1640 GMT) on Wednesday at Chawkbazar in the old Mughal part of the capital.   Ahmed said it may have been started by a gas cylinder and quickly spread through the building where chemicals were stored in rooms alongside the apartments.   Chemicals used for household products were also stored in the nearby buildings. They exploded as the fire spread, witnesses said.     "There was a traffic jam when the fire broke out. It spread so quickly that people could not escape," the fire chief said.   Another fire official told reporters the blaze was under control but was not extinguished despite the efforts of more than 200 firefighters.   "It will take time. This is not like any other fire," he said, adding that the inferno had been made more devastating by the "highly combustible" chemicals.   Fire trucks had struggled in the narrow streets to reach the scene and there was also a lack of water for the battle, officials said.   The main gate of one five storey building was chained up, trapping residents inside, according to images shown on Bangladesh television.

- 'Flames were everywhere' -
Members of a bridal party in a nearby community centre were also caught in the fire and many were injured. Others were caught in small restaurants.   Dhaka deputy police commissioner Ibrahim Khan said at least two cars and 10 cycle rickshaws were burned in the fire.   "The victims included passersby, some people who were eating food at a restaurants and some members of the bridal party," he told AFP.   "I saw the charred body of a woman who was holding her daughter in her lap as their rickshaw was caught in the fire," said one witness.

Haji Abdul Kader, whose shop was destroyed, said he only survived the blaze as as he had left to go to a pharmacy.   "When I was at the pharmacy, I heard a big bang. I turned back and saw the whole street, which was jam packed with cars and rickshaws, in flames. Flames were everywhere," he told AFP.   "I got burned and rushed to hospital," he said.

Doctors at Dhaka Medical College Hospital said at least 55 people were injured, including 10 in a critical condition.   Hundreds of people rushed to the hospital looking for missing relatives.  However, most of the bodies of the dead were charred beyond recognition.    Sohag Hossain, one of the injured, told the Daily Star that he and two friends were working at a plastic factory in one of the buildings at the time of the fire.    They heard an explosion and could not escape the flames.

A similar blaze in 2010 in an old Dhaka building, which was also used as a chemical warehouse, killed more than 120 people in one of the worst fire disasters in the city of 20 million people.      Dhaka authorities launched a crackdown on chemical warehouses in residential areas following the blaze, but efforts to rein in the practice have waned.   Many buildings in Bangladesh lack adequate fire safety measures and the enforcement of fire regulations in factories and apartment buildings is lax.  
Date: Tue, 8 Jan 2019 09:55:22 +0100

Dhaka, Jan 8, 2019 (AFP) - Bangladeshi police Tuesday fired rubber bullets and tear gas as thousands of striking workers in the South Asian country's huge garment industry staged protests for a third day demanding wage hikes.   Bangladesh's 4,500 textile and clothing factories exported more than $30 billion worth of apparel last year, making clothing for retailers such as H&M, Walmart, Tesco, Carrefour and Aldi.

Police said more than 5,000 workers blocked a national highway at Hemayetpur outside the capital Dhaka and clashed with them for hours after they walked out of their factories.   "At least 12 policemen were injured after they threw rocks at our officers. We fired tear gas and rubber bullets to disperse the protesters. Twelve factories were shut down," police official Sana Shaminur Rahman told AFP.

The online edition of the Manabjamin newspaper said at least 50 protesters were injured in waves of clashes, which also spread to garment factory hubs in Dhaka, Ashulia and Uttara involving thousands more workers.   The protests are the first major test for Prime Minister Sheikh Hasina since winning a fourth term in December 30 elections marred by violence, thousands of arrests and allegations of vote rigging and intimidation.   Bangladesh raised the minimum monthly wage for the garment sector's four million workers by 51 percent to 8,000 taka ($95) from December.

But senior workers say their raise was less than this and unions, which warn the strikes may spread, say the hike fails to compensate for price rises in recent years.   "The wages were hiked after five years. But in the five years the cost of living has increased more than the wage hike," Babul Akhter, head of the Bangladesh Garment and Industrial Workers Federation, told AFP.

Bangladesh is the world's second-largest garment maker after China.  But despite the industry's role in transforming the impoverished nation into a major manufacturing hub, garment workers are some of the lowest paid in the world.   The industry also has a poor workplace safety record with the collapse of a Rana Plaza garment factory complex killing more than 1,130 people in 2013 in one of the world's worst industrial disasters.    Following the disaster, major retailers formed two safety groups to push through crucial reforms in the factories, prompting manufacturers to plough in more than a billion dollars in safety upgrades.
More ...

World Travel News Headlines

31st May 2019

A volcano on the Indonesian island of Bali erupted Friday, spewing a plume of ash and smoke more than 2,000 metres (6,500 feet) into the sky. Mount Agung, about 70 kilometres from the tourist hub of Kuta, has been erupting periodically since it rumbled back to life in 2017, sometimes grounding flights and forcing residents to flee their homes.
Mount Agung is about 70 kilometres from the tourist hub of Kuta

The latest shortly before noon on Friday shot a cloud of volcanic ash high into the sky, but caused no disruption to flights, Indonesia's geological agency said.  Agung remained at the second highest danger warning level, and there is a four-kilometre no-go zone around the crater.

Last summer, dozens of flights were cancelled after Agung erupted, while tens of thousands of locals fled to evacuation centres after an eruption in 2017.

The last major eruption of Agung in 1963 killed around 1,600 people.

Indonesia is situated on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.

31st May 2019

Heatwaves across India have exacted heavy casualties this year, including dozens of deaths by sunstroke and other heat-related causes. The deaths have been mainly reported from states like Maharashtra (particularly Vidarbha), Andhra Pradesh (mainly Rayalseema) and Telangana, due to the temperature extremes in these regions. What's worrying is, a study suggests that the heatwave conditions are likely to increase from next year and continue till 2064 because of El Niño Modoki and depletion in soil moisture. Here's how the heatwave is taking a toll in the above states.

Maharashtra

Parts of Maharashtra have been reeling under high temperatures accompanied by severe heatwave condition during this summer. According to a report in The Times Of India, a 50-year old man in Beed succumbed to death because of heatstroke recently, taking the overall number to 8. Reports show a total of 456 cases of heat-related illnesses in Maharashtra this summer. Last year, the number of cases reported was 568. However, the death toll this year is more than last year's figure of 2 victims.

Regions like Nagpur and Akola show the most number of deaths and illnesses in the Vidarbha region. About 163 cases of heat-related illness were reported in Nagpur and 76 ailments were reported in Latur region. Recently, Chandrapur in Maharashtra (which lies 150km south of Nagpur) registered a day temperature of 48°C, the highest recorded in India this summer.

Andhra Pradesh

Parts of Andhra Pradesh have been experiencing temperatures of 45°C and more since the last few days. These conditions have persisted in the state after the heavy rains caused by Cyclone Fani.

Two women going on a two-wheeler and covered themselves with scarfs to protect themselves from the heat wave, in Vijayawada
(Mahesh G, TOI, BCCL, Vijayawada.)

Three people have died in Andhra Pradesh due to heat-related causes this year. Also, 433 people have been diagnosed with heatstroke. Earlier this month, electrical transformers had blown up in many parts of Krishna and Guntur districts, disrupting power supply for more than five hours and intensifying the effects of heatwave conditions and the severe temperatures.

In 2015, Andhra Pradesh experienced the most number of heat deaths in the country: 1,369 people died that year from heat-related illnesses.

Telangana

Seventeen people have succumbed in Telangana over the last 22 days. However, the number of unconfirmed deaths is expected to be higher. The region saw 541 heat-related deaths in 2015, and 27 in 2018. The farmers and those who work in the sun are usually the ones to be affected the most by high temperatures and heatwave conditions.

As heat blankets the country, make sure you stay protected. Follow official guidelines and do not step out in the Sun, especially in the afternoon hours, unless absolutely necessary.

(With inputs from The Times Of India.)

11th June 2019
https://afro.who.int/news/confirmation-case-ebola-virus-disease-uganda

Kampala, 11 June 2019 - The Ministry of Health and the World Health Organization (WHO) have confirmed a case of Ebola Virus Disease in Uganda. Although there have been numerous previous alerts, this is the first confirmed case in Uganda during the Ebola outbreak on-going in neighbouring Democratic Republic of the Congo.

The confirmed case is a 5-year-old child from the Democratic Republic of the Congo who travelled with his family on 9th June 2019. The child and his family entered the country through Bwera Border post and sought medical care at Kagando hospital where health workers identified Ebola as a possible cause of illness. The child was transferred to Bwera Ebola Treatment Unit for management. The confirmation was made today by the Uganda Virus Institute (UVRI). The child is under care and receiving supportive treatment at Bwera ETU, and contacts are being monitored.

The Ministry of Health and WHO have dispatched a Rapid Response Team to Kasese to identify other people who may be at risk, and ensure they are monitored and provided with care if they also become ill. Uganda has previous experience managing Ebola outbreaks. In preparation for a possible imported case during the current outbreak in DRC, Uganda has vaccinated nearly 4700 health workers in 165 health facilities (including in the facility where the child is being cared for); disease monitoring has been intensified; and health workers trained on recognizing symptoms of the disease. Ebola Treatment Units are in place.

In response to this case, the Ministry is intensifying community education, psychosocial support and will undertake vaccination for those who have come into contact with the patient and at-risk health workers who were not previously vaccinated.  

Ebola virus disease is a severe illness that is spread through contact with the body fluids of a person sick with the disease (fluids such as vomit, faeces or blood). First symptoms are similar to other diseases and thus require vigilant health and community workers, especially in areas where there is Ebola transmission, to help make diagnosis. Symptoms can be sudden and include:
  • Fever
  • Fatigue
  • Muscle pain
  • Headache
  • Sore throat
People who have been in contact with someone with the disease are offered vaccine and asked to monitor their health for 21 days to ensure they do not become ill as well.

The investigational vaccine being used in DRC and by health and frontline workers in Uganda has so far been effective in protecting people from developing the disease, and has helped those who do develop the disease to have a better chance of survival. The Ministry strongly urges those who are identified as contacts to take this protective measure.

Investigational therapeutics and advanced supportive care, along with patients seeking care early once they have symptoms, increase chances of survival.

The Ministry of Health has taken the following actions to contain spread of the disease in the country:
  • The District administration and local councils in the affected area have been directed to ensure that any person with Ebola signs and symptoms in the community is reported to the health workers immediately and provided with advice and testing.
  • The Ministry of Health is setting up units in the affected district and at referral hospitals to handle cases if they occur.
  • •Social mobilization activities are being intensified and education materials are being disseminated.

There are no confirmed cases in any other parts of the country.

The Ministry is working with international partners coordinated by the World Health Organization.

The Ministry of Health appeals to the general public and health workers to work together closely, to be vigilant and support each other in helping anyone with symptoms to receive care quickly. The Ministry will continue to update the general public on progress and new developments.
Date: Mon, 10 Jun 2019 14:24:43 +0200

Lima, June 10, 2019 (AFP) - Peru has declared a health emergency in five regions, including Lima, after the deaths of at least four people linked to Guillain-Barre syndrome, an autoimmune disorder that attacks the nervous system.   Health Minister Zulema Tomas said Sunday that in addition to the deaths there were currently 206 cases of the disease.   "We have an outbreak, there has been a brusque increase" since June 5, Tomas said on state-run TV Peru, adding that health authorities were taking steps to control and contain the disease.

While the syndrome is not contagious, a 90-day health emergency was declared because the current cases "have unusual and atypical characteristics that require rapid or immediate initial treatment," Peru's Institute of Neurological Sciences said.   The precise cause of the disorder is unknown, but most cases develop after a person has been sick with diarrhoea or a respiratory infection.

The Centers for Disease Control and Prevention in the US says its research suggests that the syndrome is "strongly associated" with the Zika virus, a mosquito-borne illness.   The regions affected by GBS include three on the country's northern coast -- Piura, Lambayeque, La Libertad -- tourist destinations known for their archaeological sites and beaches.   Also included was the central region of Junin and Lima, which has nine million inhabitants.   Two deaths were reported in Piura, one in La Libertad and another in Junin.
Date: Mon, 10 Jun 2019 16:39:03 +0200

Madrid, June 10, 2019 (AFP) - Three tourists have fallen from their hotel balconies in Spain's Balearic Islands in recent days, one of them dying on impact, police said Monday as the summer season in the party archipelago begins.   The incidents came as Britain's foreign office warned holidaymakers heading to Spain against "balcony falls" and asked them not to "take unnecessary risks... particularly if you're under the influence of drink or drugs."   On Friday in Magaluf, a party resort notorious for its booze-fuelled tourism, a 19-year-old British man fell to his death from the second floor of his hotel, Spain's Civil Guard police force said.

A spokesman said police were looking at two theories -- either "he threw himself off voluntarily, or he fell by accident."   He did not know whether the victim had consumed drugs or alcohol.   On Thursday, a 35-year-old German man fell from the second floor of his hotel too, this time in Palma de Majorca, and was seriously injured, police said.   A source close to the probe, who declined to be named, said the man had drunk, dozed off, woken up and subsequently fallen from the balcony, possibly disorientated.   And on Monday, an Australian man in his early thirties fell from the second floor of his hotel in Ibiza and was seriously hurt, police said, without giving further details.

Balcony falls happen every year in the Balearic Islands and other party resorts in Spain, most of them due to excessive drinking or drug-taking/   Some are accidental slips, while others happen when tourists miss while trying to jump into pools or onto another balcony -- a practice known as "balconing."   The British foreign office's online travel advice for Spain has an entire section warning against "balcony falls".   "There have been a number of very serious accidents (some fatal) as a result of falls from balconies," says the website.    "Many of these incidents have involved British nationals and have had a devastating impact on those involved and their loved ones."
Date: Mon, 10 Jun 2019 06:44:54 +0200

Sydney, June 10, 2019 (AFP) - Australian police said Monday they were scouring bushland for a Belgian teenage tourist missing in a popular surf town for more than a week.   Theo Hayez, an 18-year-old backpacker, was last seen on May 31 at a hotel in the coastal tourist town of Byron Bay -- some 750 kilometres (470 miles) north of Sydney -- New South Wales state police said.   "We have a large amount of resources searching... in bushland that is towards the east and northeast of the town," police Chief Inspector Matthew Kehoe said in a statement.   "We are advised that this disappearance is completely out of character for him."   Police said they were alerted to his disappearance on Thursday after he failed to return to a hostel he was staying in.   Hayez's passport and personal belongings were all left at the hostel, and police believe he had not made any financial transactions since his disappearance or used his mobile phone.
Date: Sat 8 Jun 2019
Source: New Jersey 101.5 [edited]

The potentially deadly Powassan tick-borne virus has been confirmed in 2 Sussex county residents, one of whom died last month [May 2019], state health officials confirmed [Sat 8 Jun 2019].

The Powassan virus is spread by the deer tick [_Ixodes scapularis_]. The illness is rarer than Lyme disease, which is also spread by the tick, but 10% of people who contract the [Powassan virus] illness die from it.

A Department of Health official on [Sat 8 Jun 2019] said that the department had not determined the cause of death for the patient who died last month [May 2019] but said that lab results this week [week of 3 Jun 2019] confirmed that he had the virus.

A 2nd victim continues to recover at home.

Symptoms of the virus include brain swelling, meningitis, fever, headache, vomiting, weakness, confusion, loss of coordination, trouble speaking, and memory loss. Symptoms can appear a week to a month after a tick bite, although some people show no symptoms and do not require treatment.

There is no vaccine or cure for the disease. Treatment includes hospitalization, support for breathing, and intravenous fluids.

Prevention involves the same precautions that should be taken to avoid Lyme disease: avoid wooded areas with tall grasses, use insect repellent while outdoors, and check for ticks after being outdoors.

Powassan [virus] -- first discovered in Powassan, Ontario, in 1958 -- has been confirmed in recent years in New Jersey, with one case each in 2013, 2014, and 2015, and 4 cases in 2017, the most recent year for which data is available. The cases were reported in Sussex, Warren, Morris, and Essex counties.

Between 2008 and 2017, there were 125 confirmed cases in the entire country and 9 deaths.

A person who said they were close to the man who died last month [May 2019] posted on Facebook that the man was bitten in the arm by a tick while gardening and fell ill about 2 weeks later. The Facebook post said that there was no bull's-eye mark around the bite -- a known tell-tale sign for Lyme infection. About a day before he was hospitalized, the man reported feeling like he was coming down with a cold and had a high fever.

State health department's tip sheet for preventing Powassan [virus infection]:
- avoid contact with ticks by avoiding wooded areas with high grass;
- when hiking, stay on the center of the trail;
- picnic in areas away from wooded and bushy areas;
- keep children on playground equipment and away from tall grass and shrubs;
- when outdoors, apply insect repellents;
- wear light-colored clothes so it is easy to see and remove ticks;
- wear long-sleeve shirts and pants;
- tuck long pants into socks so ticks cannot crawl under pants;
- do tick checks every couple hours while outdoors and before coming indoors;
- if you see a tick during tick checks, remove it right away;
- keep grass mowed short;
- keep children's toys, playground equipment, pools, and lawn furniture at least 15 feet [4.6 m] from wooded areas;
- create a woodchip or mulch border between your yard and wooded areas;
- keep areas under bird feeders and pet dishes clean, so they do not attract animals that may carry ticks;
- keep trash in closed containers or areas so it does not attract animals that may carry ticks.  [Byline: Sergio Bichao]
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[Powassan virus is endemic in New Jersey, and cases occur there sporadically. The tick vector is the deer tick, _Ixodes scapularis_. Humans become infected with POWV during spillover transmission from the natural transmission cycles. In humans, POWV can be a causative agent of a severe neuroinvasive illness, with 50% of survivors displaying long-term neurological sequelae. Individuals living or visiting areas where the deer tick occurs, should follow the above recommendations to avoid tick bites. If a tick is found feeding, it should be removed with forceps or tweezers grasping the tick at skin level and then gentle, constant force applied. The tick should never be removed by grasping it with thumb and forefinger, as squeezing the tick may cause inoculation of contents containing the pathogenic agent into the feeding site.

POWV was recognized as a human pathogen in 1958, when a young boy died of severe encephalitis in Powassan, Ontario, Canada. In that case, POWV was isolated from the brain autopsy. There are 2 distinct genetic lineages now recognized: POWV (lineage I) and deer tick virus (lineage II). Since the index case in 1958, over 100 human cases of POWV have been reported, with an apparent rise in disease incidence in the past 16 years. This recent increase in cases may represent a true emergence of POWV in regions where the tick vector species are prevalent, or it could represent an increase in POWV surveillance and diagnosis. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of New Jersey, United States:
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Date: 6 Jun 2019
Source: Washington Post [edited]

Dominican government officials released more-detailed autopsy results on Thursday [6 Jun 2019] for 3 American tourists who died at adjacent beach resorts owned by the same hotel company during the last week of May 2019.

All 3 victims experienced eerily similar symptoms and internal trauma before their deaths, according to a news release from Dominican authorities. Pathologists said autopsies showed the 3 had internal haemorrhaging, pulmonary oedema, and enlarged hearts.

Toxicology reports are pending [These are likely to be the most interesting. - ProMED Mod.TG].

A U.S. State Department official said authorities have not yet established a connection between the 30 May 2019 deaths of 49-year-old CAD, and 63-year-old NEH, both of Prince George's County, MD, and the death on 25 May 2019 of 41-year-old MSW of Pennsylvania.

The FBI is providing Dominican law enforcement with "technical assistance with the toxicology reports," the State Department official said.

MSW had just checked into the Luxury Bahia Principe Bouganville, in the town of San Pedro de Macoris, and was taking pictures from her room balcony when she started to feel ill.

Less than 2 hours later, she was dead, local authorities said.

The bodies of CAD and HEH were found inside their room at the Grand Bahia Principe La Romana after relatives grew concerned because they had not checked out of the resort.

The hotels are located next to each other on the island's southern coast, about 60 miles from the tourist-heavy Punta Cana area.

Dominican authorities initially did not run toxicology tests for MSW because there were no signs of violence, said Ramon Brito, a spokesman for the National Police's special tourism unit. After the Maryland couple was found, investigators ordered a set of tests to determine whether anything the 3 Americans consumed may have led to their deaths, Brito said.  [Byline: Arelis R. Hernandez]
Date: 31 May 2019
Source: 4 News [edited]

The Alachua County Health Department is warning residents that there are 12 confirmed cases of mumps, primarily from college students at the University of Florida.  "This is a little more than usual," says Steve Orlando, University of Florida spokesman.

Alachua County normally receives around 2 reported cases a year, and UF believes more students could be infected.  "So, it's curious because these are individuals who are vaccinated, and that's what we are seeing nationwide," says Paul Myers, Alachua County Health Department administrator.

Officials say it is still unclear why there has been an uptick with the virus. So far, the CDC shows 736 people have contracted mumps nationwide in 2019.

"The sharing of the utensils, sharing of the cups, sharing of the water bottles, you know it is a very common thing for students to share those things, and that's exactly the kind of thing that could lead to transmission," says Orlando.
Date: Sat 8 Jun 2019
Source: Business Standard [edited]

As many as 14 children have died due to acute encephalitis syndrome (AES) in the district, while over a dozen are admitted in hospitals with high fever and other symptoms of the infection.

Sunil Shahi, Superintendent of Shri Krishna Medical College and Hospital (SKMCH), told ANI, "We have received 38 patients so far; most of them have a deficiency of glucose in their blood. Of these, 2 have also tested JE [Japanese encephalitis] positive; the overall casualty till now is 14."

Dr Gopal Sahni, head of Critical Care Unit, said, "When heat and humidity rise, the body's sweat cannot evaporate. The humidity level is over 50 per cent in the last few days. We have about 15 such children admitted in the hospital currently, and 89 such cases come regularly."

Encephalitis is a viral infection, which causes mild flu-like symptoms such as a fever or a headache.
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[Again, this year (2019), cases of AES and JE are appearing in north-western India. Of the 14 AES cases, 2 tested positive for JE. The aetiology of the remaining cases is not stated, but the majority are reported as hypoglycaemic. As noted previously, frequently, in reports of JE cases in India, acute encephalitis syndrome (AES) of undefined aetiology is often mentioned with JE cases that are a minority of those hospitalized.

The determination of the aetiology or aetiologies of AES has been confusing and elusive. Various etiological agents have been proposed in recent years as responsible for AES cases. AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). Recently, scrub typhus has been implicated in many AES cases. A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in acute encephalitis syndrome (AES). Unfortunately, existing surveillance for AES does not include routine testing for dengue. Dengue accounts for 5% of AES cases in India, especially in the absence of laboratory evidence for other pathogens tested. Dengue should be added to the list of possible AES etiological agents.

Reference:
Vasanthapuram Ravi, Shafeeq Keeran Shahul Hameed, Anita Desai, Reeta Subramaniam Mani, Vijayalakshmi Reddy, et al.: Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): Results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. International Journal of Infectious Diseases. 2019. doi: <https://doi.org/10.1016/j.ijid.2019.01.008>.

Maps of India:

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